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Abstract
Background. An aggressive approach to liver resection for neoplasms was adopted during a 5-year
period. The results were evaluated by comparing the outcome between extended and nonextended
liver resections.
Methods. Among 73 consecutive patients undergoing liver resections for neoplasm or suspicion
of neoplasm, 33 underwent extended liver resections (26 extended right lobectomies
and 7 extended left lobectomies) and 40 underwent resections of lesser extent. Mortality,
morbidity, and survival between the two groups were compared.
Results. Overall morbidity was 21% and perioperative mortality was 5.4%. Morbidity and mortality
were not significantly different between extended and nonextended liver resections
(24% vs 18% and 6.1% vs 5.0%, respectively). Liver resections for extrahepatic cholangiocarcinomas
were found to be associated with a higher morbidity (6 of 10) and mortality (2 of
10) when compared with liver resections for noncholangiocarcinomas. Bile leaks occurred
mainly in patients with cholangiocarcinomas (4 of 6) and contributed to an increased
overall morbidity in this series. After a median follow-up of 31 months, there was
no difference in survival between extended and nonextended liver resections.
Conclusions. Extensive liver resections for neoplasms can be carried out without significant increase
in the operative risk. Short-term survival is comparable between patients undergoing
extended and nonextended liver resections.
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References
- On a new arrangement of the right and left lobes of the liver.J Anat Physiol. 1897; 32: iv, ix
- Morbidity and mortality of hepatic resection for metastatic colorectal carcinoma.Dis Colon Rectum. 1990; 33: 408-413
- Poor prognoses following left hepatic trisegmentectomies for cancer.Jpn J Clin Oncol. 1989; 19: 271-275
- Hepatic resection for colorectal liver metastases.Ann Surg. 1987; 205: 256-263
- Focal liver lesions: a plan for management.Br Med J. 1985; 290: 1643-1644
- Liver resection—liver and biliary tumours.in: Surgery of the liver and biliary tract. vol 2. Churchill Livingstone, Edinburgh1988: 1251-1280
- Schéma général de la distribution intrahépatique.in: Couinaud C Le Foie: études anatomiques et chirurgicales. Masson & Cie, Paris1957: 9-12
- The surgical anatomy pertaining to liver resection.Surg Gynecol Obstet. 1957; 105: 310-318
- Left hepatic trisegmentectomy.Surg Gynecol Obstet. 1982; 155: 21-27
- New water-jet dissector: initial experience in hepatic surgery.Br J Surg. 1991; 78: 502-503
- Primary hepatic malignancy: surgical management and determinants of survival.Surgery. 1989; 106: 740-749
- Hepatic resection for primary and metastatic tumors.Am J Surg. 1988; 156: 368-372
- Vascular occlusions for liver resections.Ann Surg. 1989; 209: 211-218
- Hepatic resection for primary and secondary neoplasms of the liver.Am J Surg. 1987; 153: 428-433
- The changing face of hepatic resection.Curr Probl Surg. 1989; 26: 281-379
- Factors affecting the morbidity of elective liver resection.Am J Surg. 1987; 153: 189-196
- The influence of intraoperative hypotension and perioperative blood transfusion on disease-free survival in patients with complete resection of colorectal liver metastases.Ann Surg. 1991; 214: 107-113
- Perioperative blood transfusions are associated with decreased time to recurrence and decreased survival after resection of colorectal liver metastases.Ann Surg. 1988; 208: 679-687
- Intra-abdominal sepsis after hepatic resection.Ann Surg. 1989; 209: 302-306
- Surgically-induced acute hepatic failure in the rat.Eur Surg Res. 1982; 14: 185-191
- Extended hepatectomy for hepatocellular carcinoma.Br J Surg. 1990; 77: 1247-1250
- Improvements in survival by aggressive resection of hilar cholangiocarcinoma.Ann Surg. 1993; 217: 20-27
- Hepatectomy for large hepatocellular carcinoma: the optimal resection margin.World J Surg. 1991; 15: 141-145
- Resection of the liver for colorectal carcinoma metastases: a multiinstitutional study of indications for resection.Surgery. 1988; 103: 278-288
- Resection of the liver for colorectal carcinoma metastases a multiinstitutional study of patterns of recurrence.Surgery. 1986; 100: 278-284
- Clinical management of recurrent hepatoceltular carcinoma after primary resection.Br J Surg. 1988; 75: 203-206
Article info
Publication history
Accepted:
September 18,
1992
Identification
Copyright
© 1993 Published by Elsevier Inc.
