This paper describes the advantages and disadvantages of radiofrequency ablation from the current situation of hepatocellular carcinoma treatment, radiofrequency ablation treatment, the efficacy of radiofrequency ablation in hepatocellular carcinoma, the shortcomings of radiofrequency ablation treatment, and the experience of the author’s treatment team. For the treatment of liver cancer, we should not blindly pursue minimally invasive and ignore the principle of radical resection, nor blindly pursue radical resection and ignore the risk of surgery. We should choose reasonable treatment methods, let the patient get the best treatment.
Objective To explore favorable factors of reducing incidence of postoperative liver failure after radical resection of Bismuth-Corlette type Ⅳ hilar cholangiocarcinoma in condition of hyperbilirubinemia. Methods All the clinical data of one patient with Bismuth-Corlette type Ⅳ hilar cholangiocarcinoma underwent radical resection in June 2017 in the West China Hospital of Sichuan University were collected. The preoperative total bilirubin level of this patient was 470.3 μmol/L, the patient didn’t receive preoperative biliary drainage. The preoperative jaundice time and cholangitis were calculated accurately. A 3D imaging system for quantitative evaluation of the liver was used to reconstruct the images with contrast-enhanced CT images of this patient. And the total liver volume and the future liver remnant volume (FLRV) were calculated. Finally, 6 months of follow-up were conducted after surgery. Results The exact jaundice time was 20 d and there was no preoperative cholangitis. The postoperative FLRV accounted for about 70%. No postoperative liver failure occurred. No recurrence of tumor and death of patient occurred after 6 months of follow-up. Conclusions Radical resection of hilar cholangiocarcinoma in condition of hyperbilirubinemia is not an absolute contraindication for surgery, but indications should be strictly controlled. For special patient whose jaundice with short duration, no preoperative cholangitis and a high FLRV may be treated with directly radical surgery to prevent for losting the best time of surgery.
Objective To summarize the diagnosis and treatment for primary hepatic neuroendocrine carcinoma. Methods The clinicopathologic data of three patients with primary hepatic neuroendocrine carcinoma from June 2010 to June 2011 in this hospital were analyzed retrospectively. Results Three cases were difficult to diagnose primary hepatic neuroendocrine carcinoma before operation. All the treatments were resection. Three patients were diagnosed as neuroendocrine carcinoma by pathology and immunohistochemistry after operation. All of them were treated by octreo-tide after operation and discharged from hospital successfully. There was no relapse one year later. At present， 3 patients were still continue to follow-up. Conclusions The diagnosis of primary hepatic neuroendocrine carcinoma is very difficult before operation， the assessment of treatment and curative effect is exploring.
ObjectiveTo summarize the experiences of precise liver resection for giant complex hepatic neoplasm. MethodsFifty-two cases of giant complex hepatic neoplasms were resected using precise liver resection techniques from April 2008 to August 2009. Hepatic functional reserve and liver imaging were evaluated before operation. Appropriate surgical approach, halfhepatic blood flow occlusion, new technique of liver resection, and intraoperative ultrasonography were applied during operation. ResultsThe mean operative time, halfhepatic blood occlusion time, blood loss, recovery of alanine aminotransferase, and total bilirubin were 350 min (210－440 min), 43 min (8－57 min), 370 ml (250－1 150 ml), 10 d (7－14 d), and 4.5 d (3－10 d), respectively. Only 6 patients had mild bile leakage. No liver failure and other major complications emerged, and no death happened. ConclusionPrecise liver resection is a safe and effective approach for giant complex hepatic neoplasm.