[Surgical treatment of hepatocellular carcinoma in cirrhosis. Value of peroperative ultrasonography].

During the past three and half years, 19 patients with hepatocellular carcinoma associated with cirrhosis were operated on. Pain was present in seven patients while 12 were asymptomatic. Alpha foeto-protein was negative in 7 patients. Intraoperative ultrasonography was performed in the last 15 patients. Three right hepatic resections, 5 left hepatic lobectomies and 11 segmentectomies or subsegmentectomies were performed. The operative mortality was 5 p. 100 (one patient). The long term survival in the 3 patients who underwent palliative resection was 6 months. Among the 15 other patients, four died from causes unrelated to their tumor; three patients with tumors larger than 8 cm died from recurrence 12 to 26 months after surgery; and the remaining 7 are still alive without evidence of recurrence 3 to 18 months after surgery. We concluded that in patients with cirrhosis, resection of limited hepatocellular carcinoma is possible, using intraoperative sonography, with low operative mortality. Early detection by repeated ultrasonic examination of the liver in patients with cirrhosis could be the best way to improve the surgical treatment of hepatocellular carcinoma.