Inevitable Anterior Approach for a Massive Hepatoma with Diaphragmatic Invasion
Korean Journal of Hepato-Biliary-Pancreatic Surgery
; : 134-139, 2005.
Article
in Korean
| WPRIM (Western Pacific)
| ID: wpr-75918
Responsible library:
WPRO
ABSTRACT
PURPOSE:
Most liver surgeons perform a right hepatic resection for a hepatocellular carcinoma (HCC) for the complete mobilization of the right lobe of liver, via the conventional approach, prior to a parenchymal transection. However, in selected patients, with a massive hepatoma that has invaded to the diaphragm, the conventional mobilization of the liver prior to a parenchymal transection may be very difficult and result in excessive bleeding. The feasibility of an 'anterior approach' was evaluated by analyzing of the clinical result of the surgical treatment for a massive hepatoma with diaphragmatic invasion.METHODS:
Between November, 2001 and November, 2002, six patients underwent a major right hepatic resection, using an anterior approach, for a HCC that had invaded or was adhered to the diaphragm, preventing the easy mobilization of the right lobe of the liver.RESULTS:
There was no hospital mortality among six patients. A massive transfusion, followed by massive bleeding, was performed in four patients, but no post-operative liver failure occurred.CONCLUSION:
These cases, performed via an anterior approach, had massive bleeding, but no hospital mortality or post- operative liver failure was observed. If the patients had undergone the procedure via the conventional approach, much more bleeding would have been expected. An 'anterior approach' is a safe and effective option in selected patients with a massive hepatoma and diaphragmatic invasion.
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Diaphragm
/
Hospital Mortality
/
Liver Failure
/
Carcinoma, Hepatocellular
/
Hemorrhage
/
Liver
Limits:
Humans
Language:
Korean
Journal:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Year:
2005
Document type:
Article