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Long-term results after in-situ split (ISS) liver resection

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Abstract

Purpose

In-situ split (ISS) liver resection is a novel method to induce rapid hypertrophy of the contralateral liver lobe in patients at risk for postoperative liver failure due to insufficient liver remnant. So far, no data about oncological long-term survival after ISS liver resection is available.

Methods

We retrospectively analyzed our patients treated with ISS liver resection at the Department of Surgery of the University of Regensburg, the first center worldwide to perform ISS.

Results

Between 2007 and 2014, ISS liver resection was performed in 16 patients. Two patients (12.5 %) were lost in early postoperative phase (90 days) and one was lost to follow-up. Thirteen patients with a follow-up period of more than 3 months were included into oncologically focused analyses. Median follow-up was 26.4 months (range 3.2–54.6). Seven patients had suffered from colorectal liver metastases (CRLM) and six from various other liver malignancies (non-CRLM). The ISS procedure had led to a median increase of 86.3 % of the left lateral liver lobe after a median of 9 days (range 4–28 days). Median disease-free survival (DFS) was 14.6 months and median overall survival (OS) was 41.7 months (26.4 months when including 90-days mortality). Three-year survival was calculated with 56.4 and 48.9 % when including perioperative mortality, respectively (CRLM 64.3 % vs. non-CRLM 50 %).

Conclusion

ISS liver resection can provide long-term survival of selected patients with advanced liver malignancies that otherwise are not eligible for liver resection due to insufficient liver remnant.

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Authors’ contributions

Lang, Loss, and Schlitt were incharged for the study conception and design; Lang and Benseler for the acquisition of data; Lang, Glockzin, and Schlitt for the analysis and interpretation of data; Lang for drafting of the manuscript; and Lang, Loss, and Schlitt for the critical revision of manuscript.

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Correspondence to Sven A. Lang.

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Lang, S.A., Loss, M., Benseler, V. et al. Long-term results after in-situ split (ISS) liver resection. Langenbecks Arch Surg 400, 361–369 (2015). https://doi.org/10.1007/s00423-015-1285-z

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  • DOI: https://doi.org/10.1007/s00423-015-1285-z

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