Liver tumors in children

Abstract

Improvements in the outcome of pediatric liver tumors over the past four decades have come from advances in chemotherapy radiographic imaging, surgical technique, and perioperative management. Increasingly sophisticated surgical techniques have been based on a more accurate understanding of the segmental anatomy of the liver and an increasing breadth of experience in complex liver resection. Meticulous review of contrast enhanced CT/MR imaging facilitates PRETEXT and POST-TEXT grouping to determine optimal timing and desired extent of liver resection. Excellent knowledge of liver anatomy is essential and the dissection must ensure protection of the vascular inflow and outflow to the remaining liver at all times. Referral to a liver specialty center in advanced cases may facilitate resectability and timely transplantation when necessary. Potential surgical complications include bleeding, vascular injury, cardiac arrest, liver failure, and bile leak. The risk of complications can be minimized with preoperative planning, appropriate referral, and precise surgical technique.