[41 hepatic resections]. / Consideratii asupra unui numar de 41 de rezectii hepatice

ABSTRACT

Clinical and therapeutical aspects are discussed with reference to 41 cases of malignant and benign tumours of the liver for which various types of hepatic resections were performed. The high mortality rate (22%) and short postoperative survival (less than a year) in malignant tumours of the liver plead for limited hepatic exeresis in cancer. Hepatic exeresis in benign tumoural pathology gave better, but nevertheless restricted, immediate and late results. Hepatic scintigraphy with colloidal 198Au and 131I rose bengal proved to be useful both preoperatively for determining the quality and quantity of the intact hepatic parenchyma and for late, postoperative follow up of the hepatic regeneration process. Moderate intraoperative hypothermia was used as an adjuvant method, allowing for the approach of broader hepatic exeresis by scissural access and longer clamping of the hepatic pedicles and inferior vena cava.