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Revista do Colégio Brasileiro de Cirurgiões

Print version ISSN 0100-6991On-line version ISSN 1809-4546


SANTOS, Roberto Oliveira Cardoso dos et al. Partial hepatectomy in pediatric surgery. Rev. Col. Bras. Cir. [online]. 2003, vol.30, n.1, pp.51-58. ISSN 1809-4546.

BACKGROUND: Although less frequent in childhood nowadays, hepatectomies may still be the best choice in some cases. Our objective is to describe a 10-year experience with large hepatic resections in pediatric patients. METHODS: A retrospective review of clinical and surgical data of 12 patients submitted to hepatic lobectomy, at Pediatric Surgery Service of Hospital das Clinicas da Faculdade de São Paulo and Hospital Santa Lydia, Ribeirão Preto (Brazil), between 1985 and 1995. RESULTS: There were eight left lobectomies and four right lobectomies. The indication of surgery were neoplastic diseases in 10 children, and complicated hepatic trauma in two. The age range was six days to 16 months in children with hepatic tumors, and the mean age was 3,8 months. Histopathological diagnosis were hemangioendothelioma in five (50%), hepatic adenoma in two (20%), hepatoblastoma in two (20%), and hepatic carcinoma in one (10%). Mean tumor weight was 7,1 % of body weight. Mean surgical time was 2h 58m. Postoperative follow-up was up to 141 months, and mean follow-up was 76,5 months. Seven patients received intraoperative blood transfusion, corresponding to 23,3 % of volemy. Only one patient had a late reoperation for resection of a new tumor. There were no postoperative complications. CONCLUSION: Although hepatic lobectomy is a major surgery, and undoubtedly technically difficult, it can be safely performed without expensive devices and sophisticated methods (some of them not always available in common hospitals) if the surgeon is skilled and well prepared for such a procedure.

Keywords : Hepatectomy; Hepatic Tumors; Child; Infant.

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