Epatocarcinoma su cirrosi. Le resezioni epatiche segmentarie.

Translated title of the contribution: Hepatic carcinoma in cirrhosis. Segmental liver resections

E. Forni, F. Meriggi

Research output: Contribution to journalArticle

Abstract

Liver cirrhosis is frequently complicated by the onset of an hepatocellular carcinoma. An accurate monitoring of the cirrhotic patient often assures an early diagnosis, so that an hepatic resection is still possible. Hepatectomy has been accepted as the only chance of cure, but selection of the appropriate extent of surgery has to be made taking into account both the risk of postoperative hepatic failure and oncologic needs. Intraoperative sonography and intermittent hepatic vascular clamping lead to a safer liver resection, while the postoperative course is improved by monitoring the hepatic function and preventing sepsis. In the period November 1973-March 1991, 34 hepatic segmentectomies (unisegmentectomy 47%, bisegmentectomy 38.3%) were performed in our Service in cirrhotic patients with hepatocellular carcinoma. The clinical stage was defined using a modified Child-Bismuth's grading (A 67.6%, B 32.4%). In the majority of cases (53%), tumors were less than 5 cm in diameter. Perioperative blood loss was less than 1,500 ml and fresh frozen plasma was preferred for volume substitution. The operative (one month) mortality rate was 20.5%. Postoperative complications occurred in 45% of cases. The mean survival rate was 14 months. The above results suggest early detection and curative resection as the best way to improve long term prognosis. Segmentectomy achieves a good balance between liver function preservation and radical exeresis. Postoperative intensive care is needed to prevent complications which might lead to hepatic failure.

Original languageItalian
Pages (from-to)99-104
Number of pages6
JournalGiornale di Chirurgia
Volume14
Issue number2
Publication statusPublished - Feb 1993

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Fibrosis
Carcinoma
Liver
Segmental Mastectomy
Liver Failure
Hepatocellular Carcinoma
Bismuth
Postoperative Care
Physiologic Monitoring
Hepatectomy
Critical Care
Constriction
Liver Cirrhosis
Blood Vessels
Early Diagnosis
Ultrasonography
Sepsis
Survival Rate
Mortality
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Epatocarcinoma su cirrosi. Le resezioni epatiche segmentarie. / Forni, E.; Meriggi, F.

In: Giornale di Chirurgia, Vol. 14, No. 2, 02.1993, p. 99-104.

Research output: Contribution to journalArticle

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