Surgery for liver and biliary leasions at our department between 2005 and 2008

Introduction: Authors evaluate the experiences gained with liver and biliary tract surgery between June 2005 and December 2008.

Patients: During this period 38 patients were operated for liver or biliary tract lesion at our departments. 6 of these were benign whereas 32 were malignant. Amongst the malignant cases there were 8 gall bladder, 7 Klatskin, 4 primer hepatocellular carcinoma and 13 metastatic liver (colorectal, pulmonal, gynaecological) tumours. The benign cases were 1 echinococcal cyst, 1 liver adenoma and 4 haemangiomas.

Discussion: We performed 10 major anatomical resections: 6 right and 4 left hepatolobectomies of which 6 due to metastatic tumours and 4 due to primer HCC. Five patients had metastasectomies, 1 had trisegmentectomy. We performed 4 nonanatomical resections for haemangiomas and 1 pericystectomy for echinococcal cyst. 4 patients with Klatskin tumour had resection of the tumorous bile duct with hepato-jejunostomy. A 6cm in diameter liver adenoma was accidentally recognised and laparoscopicaly resected during laparoscopic cholecystectomy. We treated 8 gall bladder tumours. 5 of those were T1 tumours accidentally diagnosed during the routine histological examination of laparoscopic cholecystectomy specimens. We did segmental liver resection for 2 other gall bladder tumours. We had 5 patients (1 gall bladder, 3 Klatskin and 1 metastatic tumor) where the disease was technically and/or oncologicaly inoperable. We experienced one major complication which required reoperation, and we lost one patient due to cardiac and hepatic insufficiency.

Conclusion: Liver and biliary tract surgery seems to be feasible and safe at our department.