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Mesohepatectomy.

C H Scudamore1, A K Buczkowski, H Shayan

  • 1Department of Surgery, Vancouver Hospital and Health Sciences Center, University of British Columbia, Vancouver, British Columbia, Canada.

American Journal of Surgery
|August 10, 2000
PubMed
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Mesohepatectomy offers a viable alternative to extended hepatectomy for central liver tumors, demonstrating reduced blood loss and shorter hospital stays. This complex procedure preserves more liver tissue, leading to favorable outcomes for selected patients.

Area of Science:

  • Hepatobiliary surgery
  • Surgical oncology
  • Gastroenterology

Background:

  • Formal anatomic or extended hepatectomies are standard for central liver malignancies.
  • Mesohepatectomy resects central segments, preserving more liver tissue.
  • Mesohepatectomy is technically demanding and its application is not well-defined.

Purpose of the Study:

  • To evaluate the safety and efficacy of mesohepatectomy.
  • To compare mesohepatectomy outcomes with lobar and extended hepatectomies.
  • To define the application of mesohepatectomy for central liver tumors.

Main Methods:

  • Retrospective review of 244 liver resection patient charts.
  • Analysis of 18 patients treated with mesohepatectomy (metastatic liver tumor, hepatocellular carcinoma, gallbladder adenocarcinoma).

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  • Comparison with lobar hepatectomy (n=71) and extended hepatectomy (n=43) groups.

    • Main Results:

    • Mesohepatectomy had significantly lower estimated blood loss (914 cc vs. 1628 cc) and resected liver volume (560 cc vs. 1500 cc) compared to extended hepatectomy.
    • Postoperative hospital stay was comparable (9 vs. 16 days, P=0.054).
    • Late complication rate was lower than extended hepatectomy and comparable to lobar hepatectomy.

    Conclusions:

    • Mesohepatectomy is a technically demanding but favorable alternative to extended hepatectomy for selected central liver tumors.
    • It offers comparable complication rates to lobar resections with better preservation of liver tissue.
    • Favorable postoperative recovery and reduced complications support considering mesohepatectomy.