Major hepatic resections: analysis of 51 cases.

The experience with 51 patients who underwent major hepatic resections is analyzed. The operations performed were right lobectomy (in 13 patients); partial right lobectomy (in six patients); lateral left segmentectomy (in 15 patients); and medial left segmentectomy (in one patient). Traumatic injuries determined the need for resection in 31 patients; there were nine (29%) operative deaths. The remaining 22 patients left the hospital and returned to active life. Other indications for hepatic resection were: hepatic abscess (in four patients); primary hepatic tumors (in 11 patients - seven benign, 4 hepatomas); and metastatic tumors (in five patients). Three patients (15%) died in the hospital. All patients who underwent operations for hepatic abscess and benign tumors survived and remained well. Two patients with hepatomas died after operation; the other two patients survived a few months. One patient who underwent operation for a metastatic tumor died after operation; four patients survived 16-36 months. These observations suggest that major hepatic resections benefit patients with severe hepatic injuries that devitalize large segments of hepatic parenchyma, some selected patients with multiple recurrent hepatic abscesses, patients with benign hepatic tumors that are an impending threat to their survival, and perhaps to patients with localized metastatic hepatic tumors. Hepatectomy was of limited benefit to patients with hepatomas.