[Anterior approach for liver resection in the cases of the treatment of large liver tumors].

The authors compare the results of the patients who underwent right hemihepatectomy through anterior approach with those by conventional hemihepatectomy. In 119 patients hemihepatectomy was done, 52 of them were anterior approaches. We used this technique when the tumor was large, or it seemed to be fragile and its mobilisation could be dangerous or infiltrated the diaphragm or the the hepatic vein's preparation was difficult or impossible. We started the operation with dissecting parenchyma from the anterior surface toward hilus without preparation and ligation of the affected vessels and bile duct. No patient died following anterior technique. Death and reoperation occurred in two cases following conventional hemihepatectomy. The operation time and the average nursing days was not significantly different. The blood transfusion was significantly less during anterior approach. However, between the two groups, in those cases when the operations were performed because of liver malignancies, there were no differences regarding to survival rate after 62 months follow up in contrast with the literature. The anterior technique used and modified by authors can be performed safely. The blood consumption is significantly less in the cases of anterior technique. There was no significant difference between the groups regarding to the operation-time and the average nursing days. The median survival rate was similar in both groups. Our team suggest this method of the anterior approach for liver resection in the above mentioned cases.