Experience with major hepatic resections for hepatocellular carcinoma.

Nine major hepatic resections for hepatocellular carcinoma were performed during a period of 2 years and 4 months. HBsAg was positive in six patients, preoperative serum alpha-fetoprotein was more than 20 ng/ml in 5 patients, and liver cirrhosis was present in four patients. Two patients presented with spontaneous rupture of hepatocellular carcinoma. The great value of ultrasonography is stressed as an emergency diagnostic tool in any patient with an acute abdomen without obvious cause. There was no operative mortality or morbidity among this series of patients. All but one patient with a ruptured hepatoma are alive without evidence of disease 3-31 months after liver resection. These encouraging operative results made the authors willing to adopt an aggressive policy toward the surgical treatment of hepatocellular carcinoma.