J.Jpn. Surg. Soc.. 79(8): 648-653, 1978

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Report on the annual meeting

THE SURGICAL TREATMENT FOR HEPATOMA WITH HEPATIC CIRRHOSIS
－THE OPERATIVE RESULTS OF HEPATECTOMY－

Of 33 patients with hepatoma associated with hepatic cirrhosis, 17 were subjected to hepatectomy. The present paper reports the results of hepatectomy in these 17 patients, with special reference to the pathophysiological findings at the time of postoperative course and to the study of experimental animals. There were 9 patients with partial hepatectomy, 2 patients with left lateral segmentectomy, and 6 patients with right lobectomy. There were three deaths within one month after right lobectomy, and the causes of death were acute hepatic failure. Of 14 patients who survived more than one month after operation, three died of recurrent cancer, three died of hepatic failure and three others died of rupture of the esophageal varices, while the remaining five patients were still alive without any sign of cancer recurrence. The longest survival period was four years and four months.
Regeneration and metabolic changes of the liver following hepatectomy of normal liver and cirrhotic liver were studied biochemically on the patients and experimental animals. As the results, cirrhotic liver showed poor regeneration, and delayed amelioration of metabolic disturbance after hepatectomy. It was demonstrated that increase of the hepatic blood flow by adding hepatic periarterial neurectomy at the time of hepatectomy may bring an advantageous influence on the promotion of hepatic regeneration and the amelioration of metabolic disturbance.

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