Surgical excision of giant primary carcinoma in the medial liver lobe

<正> OBJECTIVE: To assess the techniques for surgical excision of giant primary carcinoma in the medialliver lobe.METHODS: Operative managements, complications and their causes during and after resection of giantcarcinoma in the medial liver lobe were analyzed retrospectively in 166 cases treated from October 1996through December 2001.RESULTS: Of the 166 patients, 123 (74.1%) underwent tumor resection and 43 (25.9%) regularlobectomy, including left trilobectomy (8,4.8%), medial lobectomy (21,12.7%), right anteriorlobectomy (11, 6.6%), and hemihepatectomy (3,1.8%). All patients were subjected to surgery withintermittent interruption of the first porta hepatis under normothermia. The total interruption time was 7-68 minutes and average time was 24.5 minutes. The maximum single interruption time was 41 minutes.Intraoperative blood loss was 50-4000 ml, averaging 726 ml. The maximum blood transfusion was 5200ml, averaging was 811 ml, and transfusion was not needed in 54 patients. Postoperative complicationsoccurred in 9 patients (5.4%), of whom, 2 (1.2%) died of liver failure and acute respiratory distresssyndrome respectively.CONCLUSIONS: An adequate reserve of liver function is a prerequisite for a smooth recovery afteroperation. Careful intraoperative management is crucial to decrease postoperative complications.