Resection of hilar liver cancer close to major vessels

Abstract

To study the surgical experience with resection of a hilar liver cancer close to major vessels and how to improve the therapeutic result. From January 1990 to June 1997, 58 hilar liver tumors (segment I, IV, V, VIII) were resected. The tumors in these 58 patients were within a distance of 1 cm to major hepatic vessels (retrothepatic inferior vena cava, root of hepatic veins, and left or right trunk of portal vein). The diameter of the tumors was > 5 cm in 42 cases and < 5 cm in 16 cases, respectively. The size of the largest tumor was 20 cm × 18 cm × 18 cm. The surgical techniques are summarized, and the prevention and treatment of postoperative complications are discussed. All operations have been carried out successfully and had a regular follow-up until now with 1−, 3− and 5− year survival rate of 71%, 38% and 25%, respectively. While hilar liver surgery is quite difficult and risky, the safety and therapeutic of surgery could be improved by observing a meticulous surgical technique, and by preventing and treating postoperative complications by multimodal measures.