Abstract
Ab
Highlights
A significant increase in child–Turcotte–Pugh score (CTP) A and CTP B cirrhotic patients complicated by portal hypertension who requiring surgical resection was observed
Tumor size precisely may not indicate safe hepatectomy and some authors reported that tumors above ten centimeters had more than 45% five years survival [79]
Hepatocellular carcinoma (HCC) invasion of a biliary tree or main vessels might be a contraindication for resection, except portal vein involvement or hepatic segmental thrombosis [80]
Summary
A significant increase in CTP A and CTP B cirrhotic patients complicated by portal hypertension who requiring surgical resection was observed. There were substantial improvements in the HCC resection techniques that has resulted in the reduction of operative mortality This allowed doing major hepatectomy in cirrhotic patients who are suitable for liver transplantation but lacking availability of cadaveric or living donors. If multifocal HCC underlying hepatic cirrhosis was unsuitable for liver transplantation, hepatectomy can be carried out to increase the tumor cure chances, prevent it’s recurrences, and lead to significant survival rate improvement. The interdisciplinary assessment of liver function by surgeons, hepatologists, anesthesiologists, and specialists of critical care are essential for maximum critical stabilization of the patients
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