G. Mentha et al., OPERATIVE RISK OF MAJOR HEPATECTOMY - A S ERIES OF 113 CONSECUTIVE EXTENSIVE HEPATECTOMIES, Schweizerische medizinische Wochenschrift, 125(39), 1995, pp. 1820-1824
Up to now, liver resections have been the initial treatment of almost
all cancers and benign tumors limited to a liver lobe. This retrospect
ive review assesses the results of a consecutive series of 113 major e
lective hepatic resections during a ten-year period. Major hepatectomy
was defined by the resection of at least 3 Couinaud segments. Mean ag
e was 52 years (20 to 79 years). There were 62 women and 51 men. 35 re
sections were performed for colorectal metastases, 22 for a benign tum
or, 20 for non-colorectal metastases, 11 for hydatid disease, 10 for h
epatocarcinoma, 7 for cholangiocarcinoma and 8 for other indications.
The resections performed were 86 right hepatectomies with 18 extended
right hepatectomies, 24 left hepatectomies with 4 extended left hepate
ctomies and 3 trisegmentectomies. Total vascular exclusion was used in
22 patients (19%). Mortality rare was zero. Significant morbidity was
encountered in 24 patients (21%). These results suggest that the mort
ality rate may be independent of the extent of liver resection, provid
ed that hepatic function is normal and preoperative selection adequate
. With improving surgical management and techniques, and the use of in
tra-operative sonography, extensive liver surgery can now be performed
with a very low mortality rate.