Objective To report the authors’ own experience and results of recent studies of anatomical liver resection for patients with hepatocellular carcinoma (HCC).
Methods From January 2004 to June 2005, anatomical liver resection procedure were completed in 93 patients with HCC. Surgical techniques were designed to reduce intraoperative blood loss, blood transfusion and postoperative complications by parenchymal crushing with kelly forceps, inflow and outflow selective clamping. In 13 patients with large liver tumors, liver hanging maneuver performed in the course of hemihepatectomy. Liver transection with intermittent closure of the blood influx to the liver, using a Pringle manoeuvre.
Results Of 93 patients undergoing hepatectomy for HCC, underlying cirrhosis was present in 82 (88%) patients. The median blood loss was 300 ml (100-6 000 ml) and 71%(66/93) of the patients did not require blood transfusion.The postoperative complication rate was 34%(32/93), complications were primarily subphrenic collection (8 cases). Within 30 postoperative days, no death was recorded.
Conclusion The anatomical liver resection of HCC may be improve the surgical outcome.
Citation:
WANG Lu,SUN Huichuan,QIN Lunxiu,YE Qinghai,REN Ning,MA Zengchen,WU Zhiquan,FAN Jia,TANG Zhaoyou. Primary Experience of The Anatomical Liver Resection Procedure for Hepatocellular Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(1): 39-41. doi:
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- 1. Healey JE Jr, Schroy PC. Anatomy of the biliary ducts within the human liver; analysis of the prevailing pattern of branchings and the major variations of the biliary ducts [J]. AMA Arch Surg, 1953; 66(5)∶599.
- 2. Takasaki K. Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation [J]. J Hepatobiliary Pancreat Surg, 1998; 5(3)∶286.
- 3. Makuuchi M, Hasegawa H, Yamazaki S. Ultrasonically guided subsegmentectomy [J]. Surg Gynecol Obstet, 1985; 161(4)∶346.
- 4. Belghiti J. Systematic hepatectomy for liver cancer [J]. J Hepatobiliary Pancreat Surg, 2005; 12(5)∶362.
- 5. Matsushima T, Kanematsu T, Takenaka K, et al. Pattern of intrahepatic recurrence after curative resection of hepatocellular carcinoma [J]. Hepatology, 1989; 9(2)∶457.
- 6. Kosuge T, Makuuchi M, Takayama T, et al. Longterm results after resection of hepatocellular carcinoma: experience of 480 cases [J]. Hepatogastroenterology, 1993; 40(4)∶328.
- 7. Fan ST, Lai EC, Lo CM, et al. Hospital mortality of major hepatectomy for hepatocellular carcinoma associated with cirrhosis [J]. Arch Surg, 1995; 130(2)∶198.