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Extended left hepatectomy (left hepatic trisegmentectomy) in childhood.

R D Glick1, E P Nadler, L H Blumgart

  • 1Department of Surgery (Pediatric and Hepatobiliary Surgery), Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

Journal of Pediatric Surgery
|February 29, 2000
PubMed
Summary

Extended left hepatectomy in children is a rare but feasible procedure. This study shows it can achieve curative results with low morbidity for various liver conditions.

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Area of Science:

  • Pediatric Surgery
  • Hepatobiliary Surgery
  • Surgical Oncology

Background:

  • Extended left hepatectomy (left hepatic trisegmentectomy) involves excising segments II, III, IV, V, and VIII.
  • This complex procedure is rarely performed in pediatric patients.

Purpose of the Study:

  • To describe the anatomy, technique, indications, and outcomes of extended left hepatectomy in children.
  • To evaluate the feasibility and safety of this extensive liver resection in a pediatric population.

Main Methods:

  • Retrospective review of medical records for pediatric patients who underwent extended left hepatectomy over 15 years.
  • Analysis of demographic, operative, pathological, and follow-up data.

Main Results:

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  • Seven pediatric patients (median age 3.1 years) underwent the procedure for diagnoses including hepatoblastoma, focal nodular hyperplasia, leiomyosarcoma, hepatocellular carcinoma, and metastatic neuroblastoma.
  • All surgical margins were negative, with low median blood loss (13 mL/kg) and short hospital stays (median 9 days).
  • No major complications or perioperative mortality occurred; 6 of 7 patients had normal liver function post-surgery.

    • Conclusions:

    • Extended left hepatectomy is technically challenging but achievable in children.
    • The procedure can lead to curative outcomes with minimal morbidity for selected pediatric liver conditions.