Abstract:Objective To define the factors that influence the safety of hepatectomy for hepatocellular carcinoma(HCC) associated with cirrhosis. Methods Based on the patients treated before and after February 1997,229 cases of HCC associated with cirrhosis were divided into two groups, Group A and Group B,respectively. The patients′ general condition, operative procedure, morbidity and mortality rates were compared between the two groups. The factors that influenced surgical morbidity were analysed.
Results In group B, patients′ average age was higher (P<0.05). Blood loss, blood transfusion requirement during the operation, morbidity and mortality rates were significantly reduced in group B(P<0.05). Operation time and blood transfusion were independent factors that influenced postoperative morbidity and mortality.
Conclusions Before operation, the scope of the operation is decided by a correct assessment of the function of the liver and the size of the postoperative liver remnant. During the operation,technical improvement can shorten the time of operation, reduce blood loss and prevent bile leakage. After operation, isovolumic fluid infusion is given, along with nutritional support and early intestinal nutrition. In this way,the safety of hepatectomy for HCC associated with cirrhosis can be greatly enhanced.