World Journal of Surgery

, Volume 36, Issue 7, pp 1657–1665 | Cite as

Is There any Benefit from Expanding the Criteria for the Resection of Hepatocellular Carcinoma in Cirrhotic Liver? Experience from a Developing Country

  • Danijel A. Galun
  • Predrag Bulajic
  • Marinko Zuvela
  • Dragan Basaric
  • Tatjana Ille
  • Miroslav N. Milicevic



Patients with large-size (>10 cm) hepatocellular carcinoma (HCC) in Child B cirrhosis are usually excluded from curative treatment, i.e., hepatic resection, because of marginal liver function and poor outcome. This study was designed to evaluate the feasibility of the radiofrequency (RF)-assisted sequential “coagulate-cut liver resection technique” in expanding the criteria for resection of large HCC in cirrhotic livers with impaired liver function.


Forty patients with Child-Pugh A or B cirrhosis underwent liver resection from December 1, 2001 to December 31, 2008. Of these, 20 patients (13 Child-Pugh A and 7 Child-Pugh B) with advanced stage HCC (stage B and C according to Barcelona-Clinic Liver Cancer Group) underwent major liver resection. The two groups were comparable in terms of patient age, liver cirrhosis etiology, tumor number, and size.


All resections were performed without the Pringle maneuver. There was no significant difference found between the two groups regarding resection time, perioperative transfusion, postoperative complications, hospital stay, and day 7 values of hemoglobin and liver enzymes. Likewise, there was no significant difference found in the overall survival between Child A and Child B patients who underwent major liver resection


RF-assisted sequentional “coagulate-cut liver resection technique“ may be a viable alternative for management of patients with advanced HCC in cirrhotic liver with impaired function.


Liver Resection Tace Cirrhotic Liver Milan Criterion Impaired Liver Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Danijel A. Galun
    • 1
  • Predrag Bulajic
    • 1
  • Marinko Zuvela
    • 1
  • Dragan Basaric
    • 1
  • Tatjana Ille
    • 3
  • Miroslav N. Milicevic
    • 1
    • 2
  1. 1.First Surgical ClinicClinical Center of SerbiaBelgradeSerbia
  2. 2.Faculty of MedicineUniversity of BelgradeBelgradeSerbia
  3. 3.Faculty of Medicine, Department for Biostatistics, Medical informatics, and Researches in MedicineUniversity of BelgradeBelgradeSerbia

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