Retrospective Study
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World J Gastroenterol. Oct 28, 2014; 20(40): 14921-14926
Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14921
Risk factor analysis of perioperative mortality after ruptured bleeding in hepatocellular carcinoma
Hao-Ming Lin, Li-Ming Lei, Jie Zhu, Guo-Lin Li, Jun Min
Hao-Ming Lin, Guo-Lin Li, Jun Min, Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
Li-Ming Lei, ICU of Cardiac Surgery, Guangdong General Hospital, Guangzhou 510030, Guangdong Province, China
Jie Zhu, Department of Emergency Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
Author contributions: Lin HM and Lei LM performed the majority of data collection and analysis, these two authors contributed equally to this work and should be considered co-first authors; Zhu J provided vital analytical tools and was also involved in editing the manuscript; Li GL co-ordinated and provided the collection of some data; Min J designed the study and also provided financial support for this work.
Correspondence to: Jun Min, Professor, Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, No.107 Yanjiang West Road, Guangzhou 510120, Guangdong Province, China. surgeon0001@163.com
Telephone: +86-20-34071165 Fax: +86-20-34071163
Received: March 8, 2014
Revised: August 16, 2014
Accepted: September 18, 2014
Published online: October 28, 2014
Processing time: 235 Days and 9.5 Hours
Abstract

AIM: To discuss strategies and prognosis for the emergency treatment of ruptured bleeding in primary hepatocellular carcinoma.

METHODS: The retrospective analysis was performed by examining the emergency treatment experiences of 60 cases of ruptured bleeding in primary hepatocellular carcinoma. The treatment methods included surgical tumour resection, transcatheter arterial embolization (TAE) and non-surgical treatment. Univariate and multivariate analyses were performed to identify the risk factors that impacted 30-d mortality in the research groups.

RESULTS: The 30-d mortality of all patients was 28.3% (n = 17). The univariate analysis showed that Child-Pugh C level liver function, shock, massive blood transfusion and large tumour volume were risk factors that influenced 30-d mortality. The multivariate analysis showed that shock and massive blood transfusion were independent risk factors that impacted the 30-d mortality of surgical resection. As for the TAE patients, larger tumour volume was a risk factor towards prognosis.

CONCLUSION: Radical resection and TAE therapy would achieve better results in carefully selected ruptured hepatocellular tumours.

Keywords: Hepatocellular carcinoma; Spontaneous rupture; Liver resection

Core tip: The univariate analysis of 60 cases of ruptured bleeding in primary hepatocellular carcinoma revealed that Child-Pugh C level liver function, shock, massive blood transfusion and large tumour volume were risk factors that influenced 30-d mortality. Multivariate analysis showed that shock and massive blood transfusion were independent risk factors that impacted the 30-d mortality of surgical resection. As for the transcatheter arterial embolization (TAE) patients, larger tumour volume was a risk factor towards prognosis. Radical resection and TAE therapy would achieve better results than non-surgical treatment in carefully selected cases of ruptured hepatocellular tumour.