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Ruminations of an Ordinary Hepatic Surgeon: A Journey Through the Pitfalls of Major Liver Resections by Thomas S Helling is a Medicine article available to read on EtoBox.

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Historically, major hepatic resections have been fraught with voluminous blood losses and, at times, high mortality rates. Improvements in patient selection and operative technique over the past 20 years have resulted in marked reduction in death and complications and have given the impression that liver surgery can be relatively effortless. Contrary to this belief, the present review illustrates some of the pitfalls and dangers of major hepatectomy and may serve to alert ordinary surgeons to approach this operation with a degree of trepidation and careful planning. Over a 22-year period, 147 liver resections were performed by one surgeon for solid liver tumors (range 0 to 21/yr). Of these, 101 were major hepatectomies comprising at least three anatomic segments (63 right, 24 left, 11 extended right, and 3 extended left) and form the basis for this report. The major resections were performed for benign disease in 16 patients and malignant tumors in 85 (24 primary and 61 metastatic lesions). All but one patient were noncirrhotic. Seventeen patients were more than 70 years and 84 were less than 70 years of age. There were five postoperative deaths among these 101 patients: two intrao

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Author

Thomas S Helling

Publisher

Springer-Verlag; Springer Verlag; Elsevier BV; Springer Science and Business Media LLC; Society for Mining, Metallurgy and Exploration Inc.; Springer Nature (ISSN 1091-255X)

Published

2002

Language

EN

Field

Medicine (Health Sciences)