Surgical resection for benign and malignant liver disease.

The indications for major hepatic resections in 32 patients and the results are presented. Twelve right lobectomies, eight partial left lobectomies, five left lobectomies, four extended right lobectomies and three partial right lobectomies were performed with a 46% complication rate and an operative mortality rate of 12.5%. Ten primary liver cancers, 12 metastatic lesions, four hemangiomas and six "benign" lesions were removed. Of seven patients with hepatomas, four are alive at an average of 24 months postresection and three have no evidence of recurrence. Of 11 adult patients with metastatic lesions, six are alive at an average of 27 months postresection and three patients have no evidence of recurrence. All four patients with hemangioma are alive at an average of seven years. As in other series, our experience has increased with seven resections prior to 1970 and 25 since. Operative mortality has decreased in that period of time (42% to 4%); however, our complication rate in survivors has remained elevated (25% to 50%). Our experience agrees with others that cautious selection of patients for resection of malignant tumors of the liver can extend survival.