Abstract
One hundred eight patients have undergone major hepatic resection by the senior author during the eight year period April 1970 to April 1978. Primary liver cancer was present in 36; metastatic colorectal cancer in 25, miscellaneous metastatic cancers in 15, hepatoblastoma in 5, gallbladder cancer in 4, and bile duct cancer in 3. Benign tumors, principally giant hemangioma, were resected in 20 additional patients. The 30 day operative mortality rate was 9% overall. Prior to 1975, 41 of the resections were done using the vascular isolation perfusion technique. The operative mortality rate of 17% for this technique is a reflection of early experience and the advanced stage of disease of many patients. The operative mortality for the standard resection has been only 4%. Subphrenic abscess has developed in only 13% of patients during the past three years. Postoperative hospitalization has been shortened, being a median of 13 days. The resectability rate for malignant disease was 33%. Forty-six percent of the resections were performed with curative intent. Fifty-four per cent were palliative, performed in individuals with regional spread or distant metastasis. After curative surgery, three year survival was 88% for individuals with primary liver cancer and 72% with metastatic colorectal cancer. After palliative resection, the rates were 31 and 0%, respectively. The three year survival rate is 46% overall, being 81% for the curative resection group and 18% for the palliative group. Tumor markers proved useful in monitoring patients after hepatic resection.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brasfield R. D., Bowden L., McPeak C. J. Major hepatic resection for malignant neoplasms of the liver. Ann Surg. 1972 Aug;176(2):171–177. doi: 10.1097/00000658-197208000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Calne R. Y., Williams R. Orthotopic liver transplantation: the first 60 patients. Br Med J. 1977 Feb 19;1(6059):471–476. doi: 10.1136/bmj.1.6059.471. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fortner J. G., Beattie E. J., Jr, Shiu M. H., Kawano N., Howland W. S. Orthotopic and heterotopic liver homografts in man. Ann Surg. 1970 Jul;172(1):23–32. [PMC free article] [PubMed] [Google Scholar]
- Fortner J. G., Shiu M. H., Kinne D. W., Kim D. K., Castro E. B., Watson R. C., Howland W. S., Beattie E. J., Jr Major hepatic resection using vascular isolation and hypothermic perfusion. Ann Surg. 1974 Oct;180(4):644–652. doi: 10.1097/00000658-197410000-00030. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kim D. K., Watson R. C., Pahnke L. D., Fortner J. G. Tumor vascularity as a prognostic factor for hepatic tumors. Ann Surg. 1977 Jan;185(1):31–34. doi: 10.1097/00000658-197701000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lin T. Y. Results in 107 hepatic lobectomies with a preliminary report on the use of a clamp to reduce blood loss. Ann Surg. 1973 Apr;177(4):413–421. doi: 10.1097/00000658-197304000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PACK G. T., BAKER H. W. Total right hepatic lobectomy; report of a case. Ann Surg. 1953 Aug;138(2):253–258. doi: 10.1097/00000658-195308000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stanek R., Bock G. R., Goran M. L., Saunders J. C. Age dependent susceptibility to auditory trauma in the hamster: behavioral and electrophysiologic consequences. Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol. 1977 Mar-Apr;84(2):465–472. [PubMed] [Google Scholar]
- Starzl T. E., Bell R. H., Beart R. W., Putnam C. W. Hepatic trisegmentectomy and other liver resections. Surg Gynecol Obstet. 1975 Sep;141(3):429–437. [PMC free article] [PubMed] [Google Scholar]
- Starzl T. E., Porter K. A., Putnam C. W., Schroter G. P., Halgrimson C. G., Weil R., 3rd, Hoelscher M., Reid H. A. Orthotopic liver transplantation in ninety-three patients. Surg Gynecol Obstet. 1976 Apr;142(4):487–505. [PMC free article] [PubMed] [Google Scholar]