Major liver resection for giant hepatic tumors in adults and children

ABSTRACT

With the evolution in surgical technique, anaesthetic care and postoperative management, major hepatic resections for giant liver tumors are now considered reasonably safe procedures with a low surgical death rate. The aim of this study is to evaluate the results of major hepatic resection for giant hepatic tumors in the National Liver Institute during the period between September 1991 and September 2001 and to compare these results with reports from other centers. From September 1991 to September 2001 twenty-six giant liver tumors undenvent major hepatic resection out of a total number of one hundred and thirty seven liver tumors that were resected in the National Liver Institute. The tumor diameter was ranging from 8 cm to 27 cm. There were 6 children their ages ranged from 8 months to 13 years. Four of them had hepatoblastoma, one malignant mesenchymoma [undifferentiated embryonal sarcoma] and one case of liver cell adenoma. The adult group included 20 cases with a mean age of 52.5 years [range 26-65 years]. There were six cases of hepatocellular carcinoma [HCC]; two of them were done as an emergency due to bleeding after tumor rupture. The remaining 14 cases were 2 cases of HCC fibrolammellar type, one gallbladder carcinoma, 2 cases of colorectal liver metastasis, 5 cases of haemangioma, one case of haemangioendothelioma, one case of secondary leomyosarcoma from the stomach, one case of cholngiocarcinoma and one case adenocarcinoma. Right or extended right hepatectomy was done in 14 patients and left or extended left hepatectomy was done in 12 cases. Ultrasonic dissector and bipolar coagulation was used in 21 cases. Hospital mortality was three cases; two of them were emergency cases on top of chronic liver disease. Postoperative complications included temporary ascites, chest infection, minor biliary leak and wound infection. major liver resection is a reasonably safe procedure especially, when performed on normal liver under elective conditions