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Personal experience with 411 hepatic resections.

S Iwatsuki1, T E Starzl

  • 1Department of Surgery, University Health Center of Pittsburgh, University of Pittsburgh, Pennsylvania.

Annals of Surgery
|October 1, 1988
PubMed
Summary
This summary is machine-generated.

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Partial hepatectomy is a valuable treatment for liver disease, offering low mortality for benign conditions. However, cancer recurrence remains a concern for malignant liver tumors.

Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Partial hepatectomy is a complex surgical procedure for various liver conditions.
  • Understanding the outcomes and risks associated with different types of partial hepatectomy is crucial.

Purpose of the Study:

  • To evaluate the outcomes of 411 partial hepatic resections over 24 years.
  • To analyze mortality rates and recurrence patterns based on lesion type and extent of resection.

Main Methods:

  • Retrospective analysis of 411 partial hepatic resections including trisegmentectomies, lobectomies, segmentectomies, and local excisions.
  • Categorization of resections by indication: benign lesions, primary hepatic malignancies, and hepatic metastases.
  • Assessment of 30-day operative mortality, late mortality, and long-term survival rates.

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Main Results:

  • Overall 30-day operative mortality was 3.2%, with higher rates for trisegmentectomies (6.3%) and primary malignancy (8.5%) often linked to disease extent and cirrhosis.
  • No mortality was observed in patients with metastatic disease or specific benign conditions like hemangioma and adenoma.
  • Cancer recurrence significantly impacted survival for primary malignancy (5-year survival 31.9%) and metastases (5-year survival 29.5%).

Conclusions:

  • Partial hepatectomy is effective for benign liver diseases with minimal recurrence risk.
  • While mortality is low for benign conditions, careful consideration of disease extent and patient factors is needed for malignant tumors.
  • The study highlights the expanding role of partial hepatectomy and suggests considering total hepatectomy and liver replacement in select cases.