การผ่าตัดรักษามะเร็งปฐมภูมิของตับในโรงพยาบาลราชบุรี

บทคัดย่อ

          Forty-two patients with hepatocellular carcinoma (HCC) were admitted to Ratchaburi Hospital for surgical treatment from September 1988 to December 1994. Most of the tumors were in late stages (III - IV). Formal lobectomy, partial hepatectomy and hepatic artery ligation (HAL) were performed on 10, 3, and 29 patients respectively. HBsAg, alfafeto-protein (AFP) level, and associated cirrhosis were the significant parameters in diagnosis and prognosis. Operative mortality was higher (40%) in patients with major resection, compared to 10% in HAL group. Postoperative complications in these patients were more serious, but survival period was nearly equal to HAL group. The poor results can be attributed to late stage lesions and associated cirrhosis. New modalities such as transcatheter intraarterial oil-chemoemboIization (TOCE), and ultrasound or microwave resector may improve the results of surgical treatment in such cases.