Partial hepatectomy on cirrhotic liver with a right lateral tumor

A total of 24 patients with cirrhotic liver and solitary, small hepatocellular carcinoma (HCC) located at the lateral part of the right lobe underwent surgery with our technique of hepatic clamping and finger dissection. There were no operative mortality or acute or chronic hepatic failure. Total operating time was 129 +/- 20 minutes; actual resection time was only 22.7 +/- 4.9 minutes. The average amount of blood transfused during this procedure was 1552 +/- 909 ml. The preoperative serum bromsulphalein retention rate proportionately reflected the postoperative peak serum conjugated bilirubin concentration if the weight of the resected specimen was less than 310 gm (p less than 0.001). An evaluation of the enzymes (SGOT, SGPT, and lactate dehydrogenase) released from liver cells on the first postoperative day found that more prominent elevation was observed in the group of patients with hypotension than in those without hypotension (all p less than 0.001). Although all enzyme levels returned to the preoperative level on the fourteenth postoperative day, the excretory capacity of liver cells as measured by serum bromsulphalein retention rate on day 14 time was still abnormally high (p less than 0.001) and took 2 to 3 months to decline to a level that still exceeded preoperative levels (p less than 0.05). In conclusion, partial hepatectomy on cirrhotic liver by hepatic clamping and finger dissection was a simple, rapid technique without any serious side effects.