Abstract

Although invasion of portal veins and hepatic veins is common in hepatocellular carcinoma (HCC), macroscopic bile duct invasion is rare. Bile duct thrombi have been identified in 0.5% to 9% of HCC patients. In general, these patients have a worse clinical course and shorter survival than patients without bile duct thrombi, probably attributable to the low resectability rate secondary to poor functional reserve caused by obstructive jaundice and cholangitis, and combined major vascular invasion. However, a few data demonstrated that an aggressive operative approach after appropriate preoperative management offered a better chance of long-term survival in some patients with HCC with bile duct thrombi. Herein, we describe some cases of HCC with bile duct thrombi and summarize clinical features and treatment outcomes on the basis of the literatures published to date.

• Keywords: Hepatocellular carcinoma;Bile duct thrombi