Central hepatic resection for pediatric tumors

Abstract

Background/purpose: Resection of hepatic malignancies in childhood has been facilitated greatly by an understanding of hepatic segmental anatomy. This report documents the indications and technique of central hepatic resection (mesohepatectomy) in children with hepatic malignancies.

Methods: This is a retrospective study, and data are obtained from patient charts and operative reports. Three patients underwent central hepatic resection on or between June 27, 1997 and October 1, 1999.

Results: All patients were boys, and their ages at diagnosis were 0.3, 0.8, and 3.8 years. Two had hepatoblastoma and one central hepatic metastases from a poorly defined epithelial malignancy. All 3 received neoadjuvant chemotherapy before hepatic resection. Segments IV, V, and VIII were removed in 2, and IV and V in the third. All patients survived, and histopathologic margins were clear in each. One patient had a postoperative bile collection treated with percutaneous catheter drainage. At follow-up, all patients remain alive without evidence of disease, and all have normal hepatic function.

Conclusion: Central hepatic resection of malignant tumors involving segments IV, V, and VIII is feasible and effective in childhood.