PRELIMINARY-RESULTS WITH EXSITU SURGERY FOR HEPATIC-TUMORS - AN ALTERNATIVE BETWEEN LIVER-TRANSPLANTATION AND PALLIATIVE TREATMENT

We report 3 cases of liver tumors which were unsuitable for conventional resection and which were removed using a technique combining hypothermic portal perfusion with an anhepatic period of more than 2 hours. The liver was mobilized after section of the infra- and supra-hepatic inferior vena cava in 2 cases. The tumor was a cholangiocarcinoma in 2 cases and colonic metastasis in 1 case. Nontumoral liver parenchyma was normal in all cases. The inferior vena cava was involved by the tumor in 2 cases. Complete tumor resection was achieved in all cases, but required reconstruction ot the hepatic veins in 1 case. Two patients in whom portal venous bypass was not used developed hemodynamic failure after liver revascularization. One of them died. In patients without underlying chronic liver disease and with unresectable tumor by conventional technique, << ex situ >> resection can be a worthwhile therapeutic alternative.