Table of Contents
HPB Surgery
Volume 5, Issue 2, Pages 87-94
http://dx.doi.org/10.1155/1992/47601

Arterioportal Fistulas (APF) in Liver Tumors: Prognosis in Relation to Treatment

Central Research Institute of Roentgenology and Radiology, ul. Leningradskaja 70/4, Pesochny-2, Leningrad 189646, Russia

Received 3 April 1991; Accepted 3 April 1991

Copyright © 1992 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Prognosis of 16 patients with hepatic tumors and angiographically proven arterioportal fistulas was analysed in relation to treatment. Six patients received only conservative therapy; they all died of variceal bleeding in the course of two months after angiography. Hepatic resection was performed in four patients; three of them are still alive 13–52 months later including two free of both the tumor and portal hypertension. Hepatic artery embolization was carried out in six patients. All of them died in 2–36 months after the procedure, but only two from gastroesophageal hemorrhage. It is concluded that prognosis of arterioportal fistulae in liver neoplasms is poor due to hyperkinetic portal hypertension and following variceal bleeding. Hepatic resection of both the tumor and the fistula is the treatment of choice. In unresectable cases hepatic artery embolization will decrease the risk of variceal hemorrhage.