Additional Hassab's operation for esophagogastric varices in cirrhotic patients with resectable hepatocellular carcinoma.

ABSTRACT

BACKGROUND/AIMS: The aim of this study was to clarify the role of the additional Hassab's operation to hepatectomy in cirrhotic patients with resectable hepatocellular carcinomas and esophagogastric varices. METHODOLOGY: Subjects were 36 cirrhotic patients with hepatocellular carcinomas and concomitant esophagogastric varices 20 underwent hepatectomy alone (non-Hassab group) and 16 underwent hepatectomy with Hassab's operation (Hassab group). RESULTS: Patients in the Hassab group had more advanced esophageal varices and the accompanied gastric varices, preoperatively (p<0.01). Both preoperative platelet counts (p<0.01) and prothrombin time (p<0.05) were significantly lower in the Hassab group, and serum albumin level also tended to be worse than those in the non-Hassab group. Portal pressure was significantly higher in the Hassab group (p<0.01). Despite these disadvantages, no significant differences were found in operative mortality, postoperative courses and long-term prognosis between the two groups. Comparing the cause of death, the incidence of the fatal variceal hemorrhage was significantly lower (0%) in the Hassab group than that (25%) in the non-Hassab group (p<0.05). CONCLUSIONS: This study suggested that additional Hassab's operation to hepatectomy might have reduced the risk of variceal hemorrhage after hepatectomy.