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Fung et al. Hepatoma Res 2017;3:196-204 Hepatoma Research
DOI: 10.20517/2394-5079.2017.23
www.hrjournal.net
Topic: Management of Huge and Advanced Hepatocellular Carcinoma Open Access

Outcomes of emergency and interval

hepatectomy for ruptured resectable

hepatocellular carcinoma: a single tertiary

referral centre experience

Andrew Kai Yip Fung, Charing Ching Ning Chong, Kit Fai Lee, John Wong, Yue Sun Cheung, Anthony Kwong Wai
Fong, Paul Bo San Lai

Department of Surgery, the Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong 999077, Hong Kong, China.
Correspondence to: Dr. Andrew Kai Yip Fung, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong
Kong 999077, Hong Kong, China. E-mail: andrewfung@surgery.cuhk.edu.hk

How to cite this article: Fung AKY, Chong CCN, Lee KF, Wong J, Cheung YS, Fong AKW, Lai PBS. Outcomes of emergency and interval
hepatectomy for ruptured resectable hepatocellular carcinoma: a single tertiary referral centre experience. Hepatoma Res 2017;3:196-204.
ABSTRACT

Article history: Aim: The short and long term outcomes of patients who underwent emergency and interval
Received: 24-05-2017 hepatectomy for ruptured and resectable hepatocellular carcinoma (HCC) were analysed.
Accepted: 29-08-2017 Methods: The data of patients with ruptured HCC presenting between April 2004 and
Published: 08-09-2017 October 2015 were analysed. Emergency hepatectomy was defined as hepatectomy within 48 h
of the clinico-radiological diagnosis of HCC rupture. Results: Thirty patients underwent
Key words: hepatectomy for ruptured HCC. Nine (30%) patients underwent emergency hepatectomy.
Hepatocellular carcinoma, The median age was 56 and 54 years (P = 0.13) with a similar gender distribution. The mean
rupture, HCC size (10.5 vs. 8.3 cm, P = 0.17), total blood loss (3,000 vs. 850 mL, P = 0.002) and total
hepatectomy units of red blood cell transfusion (1.9 vs. 0.5 units, P = 0.27) were greater in the emergency
hepatectomy group. The complication rate was 44% and 38% (P = 0.53), with median length
of hospital stay of 10 and 12 days (P = 0.07) in the emergency and interval hepatectomy
groups, respectively, and no 30-day mortality in both groups. The median overall survival
was 29 and 15.7 months (P = 0.25), with survival rates of 78%, 45%, 0% and 85%, 43%
and 5% at 1, 3 and 5 years in the emergency and interval hepatectomy groups, respectively.
Conclusion: Hepatectomy should be considered for ruptured HCC provided the patient could
tolerate curative resection.

INTRODUCTION rupture includes increased pressure within the tumour,
rapid tumour growth or necrosis. This situation might
Hepatocellular carcinoma (HCC) is the fifth commonest be exacerbated by the presence of liver cirrhosis with
malignancy globally. Rupture of HCC is the third concurrent thrombocytopenia and coagulopathy. [5]
[1]
commonest presentation of this condition, with an
incidence of 3-15% and an associated in-hospital The treatment for ruptured HCC is determined by
mortality of up to 75%. [2-4] The pathogenesis of HCC the haemodynamic stability of the patient. In the
[6]
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