Paediatric Hepatobiliary

Liver tumours in children: Current surgical management and role of Transplantation

Alastair J W Millar

Abstract


This article reviews the current surgical management of liver tumours in children in the light of improved chemotherapy, surgical techniques and outcomes from transplantation. It is a principle of management that complete removal of a tumour must be achieved for cure. Neoadjuvant chemotherapy may downstage advanced local disease to enable safe curative tumour resection. When this is not achievable, transplant is indicated. Conventional indications for transplant are unresectable stages 3 and 4 tumours confined to the liver. With the realisation that lifelong immunosuppressive therapy has considerable adverse consequences, there has been a recent trend towards extreme and ‘acrobatic’ liver resection to avoid transplantation, but still obtain a cure. The current literature is reviewed in the light of these trends and our own experience.  


Author's affiliations

Alastair J W Millar, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa

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Keywords

Liver tumours; Children

Cite this article

South African Medical Journal 2014;104(11):813-815. DOI:10.7196/SAMJ.8919

Article History

Date submitted: 2014-09-15
Date published: 2014-10-24

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