Abstract
Background
Surgical management of giant liver tumors involving the hepatic hilum tends to be very difficult. The present study assessed the feasibility and safety of resection of such liver tumors.
Methods
We evaluated 27 patients with liver tumors involving the hepatic hilum. The patients ranged in age from 3 months to 14 years (mean, 4.2 years). Of the 27 cases, 23 were resected completely during the past 10 years. The other four cases did not undergo operation because of their parents’ decisions to discontinue treatment; these cases had multiple space-occupying lesions in addition to tumors involving the hepatic hilum. Before resection, the tumor was fully exposed and an occluding tape was placed around the vena cava when necessary.
Results
The hepatectomies were performed under intermittent portal triad clamping; 23 cases were successfully resected without postoperative mortality or morbidity. The mean operation duration was 205 min and mean blood loss was 120 ml. Pathological diagnoses included hepatoblastoma (n = 9), endotheliosarcoma (n = 1), mesenchymal hamartoma (n = 4), teratoma (n = 1), adenoma (n = 3), and hepatocellular carcinoma (n = 4). The nine cases with benign liver tumors were healthy at follow-up at 11 months to 9 years after operation. Of the 14 cases with malignant tumors, six died from recurrence, metastasis, or other complications. The other eight cases were still alive without clinical tumors.
Conclusions
Resecting giant liver tumors involving the main hepatic veins and/or the retrohepatic vena cava, although challenging, is feasible and safe.
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References
Dong Q, Xu W, Jiang B, Lu Y, Hao X, Zhang H et al (2007) Clinical applications of computerized tomography 3-D reconstruction imaging for diagnosis and surgery in children with large liver tumors or tumors at the hepatic hilum. Pediatr Surg Int 23:1045–1050
Dong Q (2005) Pediatric hepatic tumor. Pediatric hepatobiliary surgery, 1st edn. People’s Medical Publishing House, Beijing, pp 225–274
Moore SW, Davidson A, Hadley GP, Kruger M, Poole J, Stones D, Wainwright L, Wessels G (2008) Malignant liver tumors in South African children: a national audit. World J Surg 32:1389–1395
Meyers RL, Katzenstein HM, Krailo M, McGahren ED 3rd, Malogolowkin MH (2007) Surgical resection of pulmonary metastatic lesions in children with hepatoblastoma. J Pediatr Surg 42:2050–2056
Andres AM, Hernandez F, Lopez-Santamaría M, Gámez M, Murcia J, Leal N et al (2007) Surgery of liver tumors in children in the last 15 years. Eur J Pediatr Surg 17:387–392
Tsuchida Y, Hashimoto H, Iwanaka T, Honna T (1989) Left hepatic trisegmentectomy for interlobar hepatoblastoma located close to the hepatic hilum. J Pediatr Surg 24:1167–1168
Faraj W, Dar F, Marangoni G, Bartlett A, Melendez HV, Hadzic D et al (2008) Liver transplantation for hepatoblastoma. Liver Transpl 14:1614–1619
Finegold MJ, Egler RA, Goss JA, Guillerman RP, Karpen SJ, Krishnamurthy R et al (2008) Liver tumors: pediatric population. Liver Transpl 14:1545–1556
Sorge I, Bierbach U, Finke R, Hirsch W (2008) Multiple malignant and benign lesions in the liver in a child with adrenocortical carcinoma. Pediatr Radiol 38:588–592
Meyers RL (2007) Tumors of the liver in children. Surg Oncol 16:195–203
Dong Q, Jiang B, Zhang H, Lu Y, Hao X, Zhang H et al (2005) Clinical application of the three-dimensional reconstruction with spiral CT in giant liver tumor. Chinese J Pediatr Surg 27:6
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Dong, Q., Jiang, B., Lu, Y. et al. Surgical Management of Giant Liver Tumor Involving the Hepatic Hilum of Children. World J Surg 33, 1520–1525 (2009). https://doi.org/10.1007/s00268-009-0060-0
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DOI: https://doi.org/10.1007/s00268-009-0060-0