DOI: 10.36347/sjmcr.2023.v11i04.060

Pages: 654-664

Purpose: Review the efficiency of chemoembolization and discuss the place of this technique in the strategy of management of hepatocellular carcinoma. Materials and Methods: This is a retrospective and prospective study including 25 patients who received 40 sessions of lipiodolated chemoembolization for hepatocellular carcinoma between 13/07/2018 and 26/11/2021, performed at the Radiology Department of Mohamed VI Hospital in Marrakech in collaboration with our expert Pr El Hajjam from Ambroise-Paré Hospital in Paris. Results: The average age of the patients was 61 years, with a sex ratio of 1.4. Among the 22 patients, 21 were cirrhotic. The etiologies of cirrhosis were dominated by HVC in 10 patients (50%), followed by HVB in 7 patients (35%). The circumstances of discovery of hepatocellular carcinoma were dominated by right hypochondrial pain in 12 patients (48%). Biologically, 14 patients (56%) had secreting hepatocellular carcinoma with high AFP level. In the radiological assessment, nodules were located in the right lobe only in 15 patients (68,2%), in both right and left lobe in 5 patients (22,8%), in left lobe only in one patient (4,5%) and in the caudate lobe in one patient (4,5%). Arterial mapping on abdominal CT angiography was modal in 13 patients (59 %), whereas anatomical variations were observed in 9 patients (41%). Patients were classified according to the Barcelona clinic liver cancer classification as follows: 9 patients (41%) were classified as BCLC B, 10 patients (45,5%) were classified as BCLC C, and 3 patients (13,5%) as BCLC A. During the chemoembolization sessions, several types of catheters were used in all our patients for selective catheterization of the celiac trunk and common hepatic artery, whereas a 2.7F microcatheter was used in 14 sessions (35%) for more selective catheterization of segmental hepatic arterial branches. Embolization agents were administered to patients in 32 sessions, resorbable (gelatin) was used in 8 sessions (25%) ..