Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Sep 18, 2015; 7(20): 2292-2302
Published online Sep 18, 2015. doi: 10.4254/wjh.v7.i20.2292
Management before hepatectomy for hepatocellular carcinoma with cirrhosis
Hisashi Nakayama, Tadatoshi Takayama
Hisashi Nakayama, Tadatoshi Takayama, Department of Digestive Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan
Author contributions: Both authors contributed to this work.
Supported by A Grant-in-Aid for Scientific Research (C) 25350856 from the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hisashi Nakayama, MD, PhD, Department of Digestive Surgery, Nihon University School of Medicine, 30-1, Oyaguchikami-machi, Itabashi-ku, Tokyo 173-8610, Japan. nakayama.hisashi@nihon-u.ac.jp
Telephone: +81-3-35542345 Fax: +81-3-39578299
Received: May 18, 2015
Peer-review started: May 19, 2015
First decision: July 6, 2015
Revised: August 4, 2015
Accepted: August 30, 2015
Article in press: August 31, 2015
Published online: September 18, 2015
Processing time: 120 Days and 13.1 Hours
Abstract

The global distribution of hepatocellular carcinoma (HCC) varies markedly among regions, and patients in East Asia and Central Africa account for about 80% of all cases. The risk factors are hepatitis B, hepatitis C, alcohol, and etc. The risk of carcinogenesis further increases with progression to hepatic cirrhosis in all liver disorders. Radical treatment of HCC by liver resection without causing liver failure has been established as a safe approach through selection of an appropriate range of resection of the damaged liver. This background indicates that both evaluation of hepatic functional reserve and measures against concomitant diseases such as thrombocytopenia accompanying portal hypertension, prevention of rupture of esophageal varices, reliable control of ascites, and improvement of hypoalbuminemia are important issues in liver resection in patients with hepatic cirrhosis. We review the latest information on perioperative management of liver resection in HCC patients with hepatic cirrhosis.

Keywords: Hepatocellular carcinoma; Liver resection; Liver cirrhosis; Portal hypertension

Core tip: Radical treatment of hepatocellular carcinoma (HCC) by liver resection without causing liver failure has been established as a safe approach through selection of an appropriate range of resection of the damaged liver. This background indicates that both evaluation of hepatic functional reserve and measures against concomitant diseases such as thrombocytopenia accompanying portal hypertension, prevention of rupture of esophageal varices, reliable control of ascites, and improvement of hypoalbuminemia are important issues in liver resection in patients with hepatic cirrhosis. The latest information on perioperative management of liver resection in HCC patients with hepatic cirrhosis was reviewed.