STANDARDIZED APPROACHES TO HEPATECTOMY - REPORT ON 18 CASES AT A GENERAL-HOSPITAL

Hepatectomy has long been a formidable surgical procedure becauSe the risk of hemorrhage it can involve. With a better understanding of hepa tic anatomy, left hepatectomy, right hepatectomy and segmental hepatic resections have been standardized. Between January 1989 and December 1991. 18 hepatectomies were performed on 16 patients in the Department of Surgery, General Hospital, La Chaux-de-Fonds, Switzerland. The mea n age of the patients was 65. The surgical indications were: hepatic m etastases 11 (61%): gallblader or biliary duct neoplasm 4 (22%); hydat ic cyst 3 (17%). 11 segmental resection, 3 left hepatectomies, 2 right hepatectomies, 2 pericystectomies were performed. Blood loss during t hese operations averaged 2800 ml. Surgical complications appeared in 6 cases (hemorrhage 1, postoperative effusion 4, sepsis 1). One patient died within 30 days (mortality 5%). Hepatectomy is nowadays a safe pr ocedure. It can be performed in a general hospital with a trained surg ical team and an efficient intensive care unit.