Abstract

ABSTRACT: BACKGROUND: Hepatectomy is usually performed because it is the most effective way of removing liver tumour(s). Cryosurgery, Radiofrequency, Laser, Microwave and Chemo-therapies are less effective alternatives. OBJECTIVE: To review the experience of hepatectomy in Baghdad Teaching Hospital – Medical city,Iraq with a review of the obstacles and needs for promotion and development. PATIENTS AND METHODS: During the period from March 1999 to September 2005, Out of 27 patients admitted to the second surgical unit in Baghdad Teaching Hospital – Medical City with liver tumours, 15 had hepatectomy done by the same surgical team. The remaining 12 cases were beyond resection. RESULTS: The age of patients ranged from 2 to 65 years old with mean age of 34.4 years. Only one (6.7%) patient underwent left lobectomy, 2 (13.3%) left segmentectomy, while the rest 12 patients (80%) underwent right partial or total lobectomy, divided equally between anatomical & non-anatomical resection. Two main techniques were used in transection of liver parenchyma: CUSA Dissector which is used in 9 patients (60%) and clamp-crushing or finger fracture technique was used in the remainder. In addition to CUSA knife, argon beam was used in 5 cases (33.3%). Postoperative mortality rate was 26.7% (4patients). The histopathological examination of resected segments of the liver revealed 11 (73.3%) cases of hepatocellular carcinoma, 2 (13.3%) of hepatoblastoma, 1 (6.7%) case metastatic colorectal carcinoma, and 1 (6.7%) case of benign cells (haemangioma). CONCLUSION: Hepatectomy for liver tumours can be performed with acceptable safety and efficacy in a suitably staffed and equipped center. The outcome will improve with time and experience