Introduction/Objective: Hepatocellular carcinoma presenting with obstructive jaundice due to bile duct tumor thrombi is a rare entity, with a reported incidence worldwide of about 1 to 12 %. The objective of this study is to analyse the clinicopathological and post-surgical outcomes in patients who had hepatocellular carcinoma with bile duct tumor thrombi.

Materials and Methods: 42 cases of pathologically proven Hepatocellular carcinoma with bile duct tumor thrombi in non-cirrhotic liver, who underwent hepatectomies at Institute of Surgical Gastroenterology and Liver Transplant, Government Stanley Medical College and hospital, between January 1997 and September 2016 were analysed retrospectively. Clinicopathological, biochemical, radiological, operative variables and post-operative morbidity and mortality were analysed.

Results: Pre-operative AFP were elevated in 28 patients (> 400 ng/ml). Right hepatectomy with thrombectomy and T tube drainage, extended right hepatectomy with bile duct excision, left hepatectomy, extended left hepatectomy with bile duct excision, left lateral segmentectomy were done in 17,11,10,2 and 2 patients respectively. 14 patients had significant post-operative morbidity while mortality was seen in three patients. Median survival was about 27.2 months. Tumor recurrence was observed in 28 of 42 cases (66.67%) with a median time to recurrence of about 10.3 months.

Conclusion: Bile duct tumor thrombi does not preclude hepatic resection and these patients who are otherwise fit to undergo hepatectomy are offered surgery as the first line treatment.

Keywords – hepato cellular carcinoma, obstructive jaundice, bile duct tumor thrombi.

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Dr K. Sathish Kumar

Resident, Institute of Surgical Gastroenterology and Liver Transplant,

Government Stanley Medical College and Hospital, Chennai