الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 109 |  |  |
| | | from | 109 | | |
Abstract
Hepatocellular carcinoma is ranked as the fifth leading cause of cancer and
the third leading cause of cancer death throughout the world. (Yu et al., 2000),
(Parkin et al., 2005) and (Bosch et al., 2005) HCC accounts for approximately 85%
to 90% of all primary liver cancers with a median survival of less than one year,
out of which 80% of HCC cases occur in either sub- Saharan Africa or in
eastern Asia. (El-Serag and Rudolph, 2007)
HCC is the fifth most common cancer among men worldwide, but is the
eighth in women. (Parkin et al., 2005) and (Parkin, 2006) Geographical variations in
HCC incidence and mortality can be ascribed to different levels of exposure to
HCC risk factors where chronic infections with hepatitis B virus, hepatitis C
virus and aflatoxin exposure in developing countries, and smoking and alcohol
abuse in developed countries. (Okuda, 1997)
Hepatocarcinogenesis is a multi-factor, multi-step and complex process. (Yu
and Keeffe 2003) Obviously, four major (more than 80% of HCC occurs in
hepatitis virus related cirrhosis and chronic viral hepatitis (Bosch, 1997) and
several minor causal associations of HCC have been identified. (Kew, 1981)
Diagnostic confirmation and assessment of HCC extent are crucial for
proper clinical management which is based on imaging characteristics
in combination with clinical and laboratory findings, a biopsy is not required
pre-surgery, but is required before the start of systemic therapy. (Lencioni et al.,
2005) and (Asmis et al., 2010)
There are multiple applications of Intraoperative ultrasonography including:
1. Re-evaluation of the tumor and detection of new Tumor lesions.
2. Evaluation of intrahepatic vasculature.
3. Guidance for Hepatic Resection.
4. Guidance of intraoperative radiofrequency ablation and other ablative
techniques.
5. Laparoscopic techniques. (Arita et al., 2009)
82
Summary & Conclusions
We concluded:
Hepatocellular carcinoma was more common in male than women
approximately 3:1 and all of the studied patients were cirrhotic due to HCV
infection except two patients are cryptogenic in origin.
There was no positive family history illustrating no hereditary factors is
related to etiology of HCC.
Using of AFP and abdominal ultrasound and triphasic CT are not enough for
diagnosis of HCC. We need adding another modality for better detection of
HCC such as Multidetector CT, Magnetic Resonance Imaging (MRI) or
contrasted enhanced ultrasonography (CEUS).
Using of intraoperative ultrasonography was cornerstone modality for any
hepatic surgery because its accuracy in detecting lesions especially on inferior
and diaphragmatic surfaces and detection of new malignant lesions here, we had
to take a core biopsy especially for doubtful lesions less than 2cm in diameter,