Abstract:
Objective
To assess the application of model for end-stage liver disease (MELD)to estimate the hepatic functional reserve in patients with spontaneous rupture of primary hepatocellular carcinoma in order to indicate for emergency surgery.
Methods
From January 2002 to april 2005,eighteen cases with spontaneous rupture of primary hepatocellular carcinoma, who underwent curative emergency hepatectomy were retrospectively analyzed. Preoperative assessment of hepatic reserve function was carried out by MELD, and other criteria for conventional hepatic resection were all confirmed.
Results
Of all the cases, the score of MELD was lower than 18(mean=13.3±4.2).No operation death occurred in all of 18 cases,of which 15 cases were followed up.The survival time was 4-51 months,and the overall 1-year and 3-year survival rates were 66.7%(10/15)and 33.3%(5/15) respectively.
Conclusions
Emergency hepatectomy is a safe and feasible approach for selecting optimal treatment in patients with spontaneous rupture of primary hepatocellular carcinoma.MELD may be useful for determining the hepatic reserve function with its simple, rapid and sensitive characters, playing an important role in identifying therapeutic procedure for spontaneous rupture of primary hepatocellular carcinoma.
Key words:
Liverneoplasms,
Modelforend-stageliverdisease,
Hepatectomy,
Hepaticfunctionalreserve
Bo XU, Jin-tang XIA, Wen-Song CAI, Guang-Hui ZHU, Yong HONG, Jie-feng WENG. Clinical value of MELD in emergency preoperation of spontaneous rupture of primary hepatocellular carcinoma[J]. Chinese Archives of General Surgery(Electronic Edition), 2009, 03(02): 27-29.