[A safe, extended right-side hemihepatectomy using anatomic preparation, controlled hypotension and compression of the hepatoduodenal ligament. Technic, early and late results].

From 1.4. 1977 to 1.4. 1983, extended right hepatectomies were performed in 18 patients. It succeeded in 16 cases with malignant lesions and in 2 cases with benign lesions. As a new method, controlled hypotension with maintained compression of hepatoduodenal ligament for 30 minutes was carried out and the preparation succeeded through the anatomical way. This procedure allowed safe resection of very big liver tumours (including metastasis) with low blood loss. Hospital mortality was 5.5%. Only in one case there was unclarified liver insufficiency which led to death and the cause could not be discovered due to refusal of postmortem dissection. At 1.4. 1983, 14 patients were still living which represent 5 years survival of more than 50%. The prognosis after extended right hepatectomy due to big hepatocellular carcinoma is therefore not unfavourable, and sure better than that (prognosis) after liver transplantation performed for this indication. It can possibly be improved by adjuvant chemotherapy.