[Liver resection from the viewpoint of the internist]

Resection of the liver as the most suitable mode of treatment of hepatocellular carcinoma is successful, if the principles of secondary prevention are enforced when following up known cirrhotic patients, and the hepatoma is detected in the initial stage with a defined focus of 2-4 cm in diameter. Alternative treatment can be direct under ultrasonographic control and administration of 96% alcohol, or a combination of the two procedures or the use of cytostatics. In benign focal hepatic processes such as hepatocellular adenoma, haemangioma, focal nodular hyperplasia, nowadays resection is usually not used if the benign character of the tumour is beyond doubt. An exception is hepatocellular adenoma, where the risk of haemorrhage is enhanced. Special attention should be paid to surgery of a single or few metastases in the liver found during surgery of colorectal carcinoma or during the follow-up of operated patients. Sometimes thus the quality of their lives is improved and prolonged.