Mesohepatectomy without hilar dissection in the treatment of malignant focal liver diseases.

Background/aims: Mesohepatectomy is a method of surgical treatments for the centrally-located liver diseases. These operations were performed without hilar dissection by our modification and the results were evaluated.

Methodology: Between 2000 and 2002 we performed eight modified mesohepatectomy in cases of central malignant tumors of the liver. Preoperative examinations were done by strict protocol. We performed the operation with CUSA US scalpel. On postoperative days 1, 3, 5 and 7, we monitored the patients' liver enzymes, bilirubin level and hemostasis factors. After recovering the patients received chemotherapy. Follow-up was done 3 and 6 months later.

Results: The time of operation and the blood consumption were significantly less with this modified technique comparing data found in the literature. The average tumor-free interval is 6.5 months, in five patients.

Conclusions: On reflection of these data, we consider mesohepatectomy performed without hilar dissection to be a suitable method for the treatment of centrally-located tumors. Postoperative morbidity rate is of a similar degree to that of operations using prior dissection, and the advantageous effects of parenchyma sparing mesohepatectomy are retained.