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Liver| Volume 169, ISSUE 6, P1424-1426, June 2021

Surgical resection for hepatocellular carcinoma with bile duct tumor thrombus

  • Jia-Yi Wu
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
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  • Ju-Xian Sun
    Affiliations
    Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
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  • Wan Yee Lau
    Affiliations
    Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China

    Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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  • Shu-Qun Cheng
    Affiliations
    Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
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  • Mao-Lin Yan
    Correspondence
    Reprint requests: Mao-Lin Yan, MD, PhD, The Shengli Clinical Medical College of Fujian Medical University, Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Dongjie Road 134, Fuzhou 350001, China.
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
    Search for articles by this author
Published:February 12, 2021DOI:https://doi.org/10.1016/j.surg.2020.12.045
Surgical resection for hepatocellular carcinoma with bile duct tumor thrombus
Previous ArticleDoes surgery provide a survival advantage in non-disseminated poorly differentiated gastroenteropancreatic neuroendocrine neoplasms?
Next ArticleOutcomes of laparoscopic versus open pancreatoduodenectomy: A nationwide retrospective cohort study
      Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is relatively rare, with an incidence of about 1.2% to 12.9%.
      • Zeng H.
      • Xu L.B.
      • Wen J.M.
      • et al.
      Hepatocellular carcinoma with bile duct tumor thrombus: a clinicopathological analysis of factors predictive of recurrence and outcome after surgery.
      Medicine (Baltimore). 2015; 94: e364
      Surgical resection is the preferred treatment for HCC with BDTT; however, whether the extrahepatic bile duct should be preserved or resected remains controversial.
      • Shiomi M.
      • Kamiya J.
      • Nagino M.
      • et al.
      Hepatocellular carcinoma with biliary tumor thrombi: aggressive operative approach after appropriate preoperative management.
      Surgery. 2001; 129: 692-698
      , 
      • Kim D.S.
      • Kim B.W.
      • Hatano E.
      • et al.
      Surgical outcomes of hepatocellular carcinoma with bile duct tumor thrombus: a Korea-Japan multicenter study.
      Ann Surg. 2020; 271: 913-921
      , 
      • Yamamoto S.
      • Hasegawa K.
      • Inoue Y.
      • et al.
      Bile duct preserving surgery for hepatocellular carcinoma with bile duct tumor thrombus.
      Ann Surg. 2015; 261: e123-e125
      BDTT rarely invades the walls of the extrahepatic bile duct due to its expansive growth characteristics. Thus, most BDTT can be treated with tumor thrombectomy, avoiding resection of the extrahepatic bile duct.
      • Yamamoto S.
      • Hasegawa K.
      • Inoue Y.
      • et al.
      Bile duct preserving surgery for hepatocellular carcinoma with bile duct tumor thrombus.
      Ann Surg. 2015; 261: e123-e125
      The reported techniques include choledochotomic thrombectomy, endoscopic thrombectomy, and peeling-off thrombectomy.
      • Yamamoto S.
      • Hasegawa K.
      • Inoue Y.
      • et al.
      Bile duct preserving surgery for hepatocellular carcinoma with bile duct tumor thrombus.
      Ann Surg. 2015; 261: e123-e125
      ,
      • Inoue T.
      • Ohashi T.
      • Nakade Y.
      • et al.
      Diagnostic utility of digital cholangioscopy for dislodged bile duct tumor thrombus of hepatocellular carcinoma.
      Endoscopy. 2017; 49: E33-E34
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      References

        • Zeng H.
        • Xu L.B.
        • Wen J.M.
        • et al.
        Hepatocellular carcinoma with bile duct tumor thrombus: a clinicopathological analysis of factors predictive of recurrence and outcome after surgery.
        Medicine (Baltimore). 2015; 94: e364
        View in Article
        • Shiomi M.
        • Kamiya J.
        • Nagino M.
        • et al.
        Hepatocellular carcinoma with biliary tumor thrombi: aggressive operative approach after appropriate preoperative management.
        Surgery. 2001; 129: 692-698
        View in Article
        • Kim D.S.
        • Kim B.W.
        • Hatano E.
        • et al.
        Surgical outcomes of hepatocellular carcinoma with bile duct tumor thrombus: a Korea-Japan multicenter study.
        Ann Surg. 2020; 271: 913-921
        View in Article
        • Yamamoto S.
        • Hasegawa K.
        • Inoue Y.
        • et al.
        Bile duct preserving surgery for hepatocellular carcinoma with bile duct tumor thrombus.
        Ann Surg. 2015; 261: e123-e125
        View in Article
        • Inoue T.
        • Ohashi T.
        • Nakade Y.
        • et al.
        Diagnostic utility of digital cholangioscopy for dislodged bile duct tumor thrombus of hepatocellular carcinoma.
        Endoscopy. 2017; 49: E33-E34
        View in Article

      Article info

      Publication history

      Published online: February 12, 2021
      Accepted: December 28, 2020

      Footnotes

      Jia-Yi Wu and Ju-Xian Sun are first coauthors.

      Identification

      DOI: https://doi.org/10.1016/j.surg.2020.12.045

      Copyright

      © 2021 Elsevier Inc. All rights reserved.

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