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Major hepatic resection: an update.

W H Edwards1, J L Sawyers, R B Adkins

  • 1Department of Surgery, Metropolitan Nashville General Hospital, Tenn.

Southern Medical Journal
|January 1, 1990
PubMed
Summary
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Major hepatic resections for liver tumors have seen improved outcomes. This study shows decreased operative mortality and increased aggressive approaches for malignant primary and metastatic liver tumors, leading to better patient survival rates.

Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Major hepatic resections were previously reported in 1981 with specific indications for trauma, benign, and malignant diseases.
  • Indications for major hepatic resection have evolved, with a shift towards conservative management of hepatic trauma and more aggressive treatment of hepatic tumors.

Purpose of the Study:

  • To update the outcomes of major hepatic resections performed at Vanderbilt University Hospital and Metropolitan Nashville General Hospital.
  • To evaluate the changing trends and outcomes in the surgical management of primary and metastatic liver tumors.

Main Methods:

  • Retrospective review of 88 major hepatic resections performed since 1977.
  • Analysis of patient demographics, primary diagnoses (trauma, benign, malignant), tumor types, and survival data.

Related Experiment Videos

  • Comparison of operative mortality rates between the current series and a previous report.

    • Main Results:

    • In the current series, 32 resections were for trauma, 25 for benign disorders, and 31 for malignant disease.
    • For primary malignant tumors, children showed excellent survival (mean 5.7 years), while adult survival averaged 1.7 years.
    • For metastatic lesions, survival averaged two years with two long-term survivors (9 years); operative mortality for elective resection decreased from 12% to 3%.

    Conclusions:

    • The decreased operative mortality for elective hepatic resections supports a more aggressive surgical approach for malignant primary and metastatic liver tumors.
    • Improved survival rates, particularly in pediatric cases, highlight the efficacy of hepatic resection for liver malignancies.
    • The study underscores the evolving role and improved outcomes of major hepatic resection in managing complex liver conditions.