Postoperative biochemical liver function after major hepatic resection in children

Outcome of central hepatectomy for hepatoblastomas

“…If the 0.3 BCV transfused reported in our series of CH was comparable to the 0.28 of our LT for HBL, most of the transplanted patients underwent additional blood transfusion during their stay in the intensive care unit. In our study, comparing 24.5 mL/kg blood transfusion in the CH group to the 10 and 41 mL/kg in the ERH group is not relevant owing to the small amount of patient with ERH but the amount of blood transfused in CH seems comparable to the 18 mL/kg to the 30 mL/kg reported for other conventional hepatectomies (including ERH) in children [10,11]. Moreover, because our experience with this procedure increased, we were able to decrease blood loss (Table 3).…”

“…In our study, the rate of biliary leakage for CH was less than for ERH, but this result could have been hampered by the small number of patients in the ERH group. In the literature, the rate of biliary complication reported after conventional hepatectomies (including ERH) for HBL in children is 12.5% to 17% [10,11]. Nevertheless, we believe that biliary leakages in CH are related to the proximity of the resection planes with the bile ducts.…”

“…Even if this situation is rare, it could encourage liver surgeons not to sacrifice healthy liver sections in children who underwent or will undergo high-risk chemotherapy as most of the patients in our series. This argument is reinforced by a recent study showing that liver biochemical tests after conventional resections are affected by prior chemotherapy [11]. Moreover, liver failures were reported after ERH for HBL [15] or conventional liver surgery in the SIOPEL protocol [16].…”

Biliary Rhabdomyosarcoma in Pediatric Patients: A Systematic Review and Meta-Analysis of Individual Patient Data

“…Moreover, liver resections in children who have received or are scheduled for chemotherapy are regarded as problematic by some authors, since toxicity of chemotherapeutic agents such as dactinomycin, ifosfamide, etoposide, or cyclophosphamide largely depends on liver metabolism (33). However, is has been clearly shown that this argument can be abandoned, since major hepatectomy is well-tolerated by children even after NAC and liver function recuperates sooner than in adults (34,35). Additionally, the surgical techniques and the perioperative management of children has markedly improved over recent years (36,37), enabling pediatric surgeons to perform extended procedures with higher patient safety (32).…”

The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma

“…Needham et al studied changes of postoperative biochemical liver function after major hepatic resection and established normal profiles of standard biochemical liver function tests after major liver resection in noncirrhotic patients. 11 Kuroda et al investigated the changes in liver function parameters after percutaneous RFA and drew a conclusion that a ChildePugh score of nine or more represented a major risk factor for the aggravation of liver function after RFA therapy. 12 Kawaoka et al studied the changes of liver function in patients after TACE.…”