Repeated postoperative adjuvant TACE after curative hepatectomy improves outcomes of patients with HCC.

BACKGROUND AND AIMS: To gain a clear picture of the influence of postoperative adjuvant transcatheter arterial chemoembolization (TACE) on recurrence after curative resection for HCC. MATERIAL AND METHODS: According to the inclusion criteria and the exclusion criteria, the clinical data of 118 patients with HCC at Qilu Hospital, Shan Dong University between January 2011 and August 2013, who were treated by curative hepatectomy and postoperative TACE (two groups of patients received TACE once or twice, respectively) or by curative hepatectomy alone were retrospectively studied. RESULTS: The three-year survival (RFS) rate was 51.7% for the whole study population. The three-year relapse-free RFS rates were 73.0% and 55.0% for the patients who received two and one postoperative adjuvant TACE treatments, groups respectively, and 29.3% for the hepatectomy alone group. The three-year RFS of the patients who received postoperative adjuvant TACE once was significantly higher than that of the patients who received hepatectomy alone (p = .024). And the outcome of patients with two adjuvant TACE treatments was better than that of patients who received one treatment (p = .033). CONCLUSIONS: Repeated postoperative adjuvant TACE seems to be a promising treatment for HCC that might delay tumor recurrence and improve the RFS rates of patients after curative hepatectomy.

Application of pancreaticojejunostomy with one-layer suture in pancreaticoduodenectomy: A retrospective cohort study.

BACKGROUND: Postoperative pancreatic fistula (POPF) is the most common critical complication after pancreaticoduodenectomy (PD) and a primary reason for increased mortality and morbidity after PD. To perform a safe pancreaticojejunostomy (PJ), a fast and simple technique of duct-to-mucosa PJ with one-layer suture was devised at our institution. MATERIALS AND METHODS: We conducted a retrospective analysis of 81 successive cases of PD performed at our hospital from March 2012 to August 2016. Data of perioperative parameters were collected for all PD cases. RESULTS: A total of 17 (21.0%) cases of morbidity occurred after PD, including 5 (6.1%) cases of POPF (grade A), 8 (9.8%) cases of delayed gastric emptying, 1 (1.2%) case of abdominal infection, and 3 (3.7%) cases of incision infection. The median operative time for the PJ was 7 min. No mortality or relaparotomy was observed. CONCLUSION: Our technique could significantly reduce the incidence of POPF and other complications after PD and may be a promising technique for pancreaticoenteric anastomosis.