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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
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.
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:
- 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.