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Major liver resection in pregnancy: three cases with different etiologies and review of the literature
Authors:Niv Pencovich  Muhammad Younis  Yonatan Lessing  Lilach Zac  Joseph B. Lessing  Yariv Yogev   Michael J. Kupferminc
Affiliation:1. Department of Surgery, The Nikolas &2. Elizabeth Shlezak Fund for Experimental Surgery, Tel Aviv, Israel;3. Division of Anesthesiology, Pain, and Intensive Care, Tel Aviv, Israel;4. Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Abstract:Background: Major liver resection during pregnancy is extremely rare. When required, the associated physiologic and anatomic changes pose specific challenges and greater risk for both mother and fetus

Materials and methods: Three cases of major liver resection during pregnancy due to different etiologies are presented. The relevant literature is reviewed and discussed.

Results: We present three cases of major liver resection due to giant liver hemangioma with Kasabach–Merrit syndrome, giant hydatid cyst, and intrahepatic cholangiocarcinoma, at gestational week (GW) 17, 19, and 30, respectively. All patients had an uneventful postoperative course, continued the pregnancy and gave birth at GW 38.

Conclusion: Major liver resection can be performed safely during pregnancy. A multidisciplinary team of surgeons, anesthesiologists and gynecologists, in a highly experienced tertiary hepatobiliary center, should be involved.

Keywords:Liver hemangioma  hepatectomy  coagulopathy  pregnancy  Echinococcus  cholangiocarcinoma
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