| Hepatocellular carcinoma (HCC) threatens our life severely. Our country is the high invasion area of HCC. More than one hundred thousand patients died of HCC and relevant complications every year. Surgical resection of the tumors is considered the only potentially curative therapy, and it is regarded as the first choice for the treatment of HCC. The majority of HCC patients are in their medium and late stage when they were diagnosed. Besides 80%of them are combined with cirrhosis in our country. So the extension of the hepatectomy of HCC is greatly limited. Hepatectomy with less hepatic volume may be helpful to the safety of the operation, but this may be not radical cure, and even tumor residual. Hepatectomy with more hepatic volume will lead to postoperative hepatic function failure, infection, hemorrhage and even death. So the eradication rate of HCC is not high for a long time. It was about 15% to 30%. Researchers have proposed the concept of "two-step hepatectomy", and tried with the method of transcatheter artery embolization (TAB) and so on. Some progresses had been made in two-step hepatectomy after thrinking of the HCC.In 1986, Kinoshita et al reported the experience of two-step hepatectomy after selective portal vein embolization (SPVE). This a totally new method. The purpose of preoperative SPVE is to induce atrophy of the embolized (tumor) lobe and compensate hypertrophy of the remnant lobe. Thus lead to an increase of the remnant liver volume and a decreased ratio of resected volume to total liver volume. In recent years, reports of two-step hepatectomy after SPVE gradually increased in the foreign countries. It is believed that SPVE before hepatectomy can extend the indication of operation of HCC, increase the safety of the hepatectomy, and improve thelong-term survival rate after the hepatectomy. But there has been no such clinical report in our country.Besides, there are many factors that can affect hepatectomy, such as tumor size, location, multifocality and patients' statue, hepatic function. For those who undergo hepatectomy, there is considerable postoperative complications and mortality. And the HCC recurrent rate after hepatectomy is still high. About 40% to 60% HCC patients will recurrent after hepatectomy. So, in recent decades, local treatment of HCC has been greatly progressed, especially for radiofrequency ablation (RFA).RFA was widely adopted in the treatment of HCC, and fairly good effects had been made in small HCC. The prominent advantage of RFA is it's minimal invasive, safe, effective, repeatable and milder impact on human functions. The disadvantage of RFA is that it's single effective destroy extent is too limited, and usually can not totally cover the tumor extent. This may lead to tumor residual and recurrence after RFA. So the indication and effect of RFA on HCC are greatly affected. How to improve the effect of RFA on HCC become the "bottle neck" of the further development of RFA technique. The primary researches in foreign countries indicated that large amount of heat was taken away by the rich blood supply of the liver during RFA. This may greatly affect the effect of RFA on HCC. So Occlusion of the blood supply to the liver may improve the effect of RFA. But there are still many problems to be solved. For example, the method to occlude the blood supply, comparison of the effect of occlusion of different blood supply. There has been no such report as combining RFA with occlusion of portal vein blood supply to the liver by interventional method in the treatment of HCC.In this study, based on the analysis of the feasibility and safety of ultrosound-guilded percuteaneous transhepatic selective portal vein embolization with fine needle, We discussed the effect of preoperative SPVE in the two-stage hepatotectomy of medium and late stage HCC, and the effectof SPVE in improving the effect of RFA in the treatment of hepatic VX2 tumor in rabbits and large HCC in human.Main methods1. Research of the feasibility and safety of ultrosound-guided percut...
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