Hepatic resection in cirrhotic patients

Cirrhotic patients are at increased risk for the development of hepatocellular carcinoma, and surgical resection of the involved liver represents the only effective mode of therapy. The presence of cirrhosis significantly complicates hepatic resection. We describe the clinical course of a patient with ruptured hepatoma localized to the lateral segment of the left lobe. This case illustrates many of the problems encountered during hepatic resections in cirrhotic patients, which should be limited to segmental or subsegmental resections. Preoperative attention to bleeding and nutrition, meticulous intraoperative hemostasis, and postoperative management of any pulmonary complications, ascites, and renal or hepatic failure are mandatory for successful management.