Long-term results after in-situ split (ISS) liver resection

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Liver Regeneration

Background:

• In-situ split (ISS) liver resection is a novel technique to promote contralateral liver lobe hypertrophy.
• This method is crucial for patients at risk of postoperative liver failure due to insufficient liver remnant.
• Limited data exists on the long-term oncological survival following ISS liver resection.

Purpose of the Study:

• To evaluate the oncological long-term survival outcomes in patients who underwent in-situ split (ISS) liver resection.
• To assess the efficacy of ISS liver resection in selected patients with advanced liver malignancies and insufficient liver remnant.

Main Methods:

• Retrospective analysis of patients treated with ISS liver resection at the University of Regensburg.
• Inclusion of 13 patients with follow-up exceeding 3 months for oncological analysis.
• Assessment of liver lobe hypertrophy, disease-free survival (DFS), and overall survival (OS).

Main Results:

• The ISS procedure resulted in a median 86.3% increase in the left lateral liver lobe within 9 days.
• Median follow-up was 26.4 months.
• Median DFS was 14.6 months, and median OS was 41.7 months (26.4 months including 90-day mortality). Three-year survival was 56.4% (48.9% including perioperative mortality).

Conclusions:

• In-situ split (ISS) liver resection is a viable option for selected patients with advanced liver malignancies.
• This technique can provide long-term survival for patients otherwise ineligible for resection due to insufficient liver remnant.
• ISS liver resection facilitates significant liver regeneration, improving outcomes in complex cases.