Hepatectomy experience in Baghdad teaching hospital

ABSTRACT

Hepatectomy is usually performed because it is the most effective way of removing liver tumour [s]. Cryosurgery, Radiofrequency, Laser, Microwave and Chemo-therapies are less effective alternatives. To review the experience of hepatectomy in Baghdad Teaching Hospital - Medical city Iraq with a review of the obstacles and needs for promotion and development. During the period from March 1999 to September 2005, Out of 27 patients admitted to the second surgical unit in Baghdad Teaching Hospital - Medical City with liver tumours, 15 had hepatectomy done by the same surgical team. The remaining 12 cases were beyond resection. The age of patients ranged from 2 to 65 years old with mean age of 34.4 years. Only one [6.7%] patient underwent left lobectomy, 2 [13.3%] left segmentectomy, while the rest 12 patients [80%] underwent right partial or total lobectomy, divided equally between anatomical and non-anatomical resection. Two main techniques were used in transection of liver parenchyma CUSA Dissector which is used in 9 patients [60%] and clamp-crushing or finger fracture technique was used in the remainder. In addition to CUSA knife, argon beam was used in 5 cases [33.3%]. Postoperative mortality rate was 26.7% [4patients]. The histopathological examination of resected segments of the liver revealed 11 [73.3%] cases of hepatocellular carcinoma, 2 [13.3%] of hepatoblastoma, 1 [6.7%] case metastatic colorectal carcinoma, and 1 [6.7%] case of benign cells [haemangioma]. Hepatectomy for liver tumours can be performed with acceptable safety and efficacy in a suitably staffed and equipped center. The outcome will improve with time and experience