Abstract: Objective To investigate clinical feature and the effect of surgical treatment on primary hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDT).MethodsThe clinical feature and effect of surgical treatment on 50 cases of HCC with BDT were analyzed retrospectively.All the patients were treated in our hospital between 1998 and 2006,and were diagnosed through B ultrasound,CT,MRCP,AFP and exploratory celiotomy.Treatments included resection of HCC with BDT,cholangiotomy with BDT resection,and biliary tract prosthesis drainage.Results46 patients received radical operation,which including 26 cases treated by resection of HCC with BDT and 20 cases treated by hepatectomy with BDT clearance.4 cases were treated by biliary tract prosthesis drainage.For all of the patients,the postoperative complications ratio was 26.0% (13/50),and the perioperative death ratio was 12.0% (6/50).The 1-,2-and 3-year actuarial survival were 59.1% (26/44),29.5% (13/44) and 20.5% (9/44) respectively.The average survival time was 19.6 months,with the longest as 121 months.The univariate analysis showed that the factors such as AFP level,tumor size,operation mode and thrombi site could affect survival time significantly.The multivariate analysis showed that the independent predictor for survival time was surgical operation mode.ConclusionsSurgical operation mode is the most important prognostic factor for HCC patient with BDT.Surgical removal of primary tumor and BDT is crucial for prolong patient’s survival time.

Key words: Hepatocellular carcinoma, Bile duct tumor thrombus, Diagnostic and Treatment, Prognosis