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The role of liver resection (LR) in patients with non-tumoral hepatic disease (NTHD) remains controversial.To analyze the indications and outcomes of liver resections in patients with NTHD.A retrospective analysis in a multicentric data base was performed. Outcome measures were incidence of postoperative cholangitis, infectious and non-infectious complications, hospital stay and overall mortality.One hundred and fourteen patients underwent LR due to NTHD from January 2001 to November 2011. Fourteen patients presented complex bile duct injuries (CBDI), 18 intra-hepatic lithiasis (IL), 32 liver hydatid cysts (LHC), 10 polycystic liver disease (PLD), 19 Caroli's disease (CD) and 21 other NTHD. Forty seven patients underwent a major hepatectomy and 67 a liver segmentectomy or an atypical liver resection. Thirty four patients (29%) presented surgical related complications. There was not intra or post-operative mortality. In long term outcomes, 98 patients (85%) were asymptomatic, 10 presented episodes of intermittent cholangitis that were treated with antibiotics, and 7 underwent another surgical procedure.LR is a radical and effective procedure to treat benign NTHD instead of other surgical or percutaneous procedures, avoiding multiple sessions of treatment and high post procedure complications rates.

Surgery is the treatment of choice for hilar cholangiocarcinoma (HCC). Obtaining tumor-free margins (RO resection) has been reported as the only prognostic factor associated with increased survival. The aim of this study was to analyze a consecutive series of patients operated with curative intent over a 14-year period.This is a retrospective study of patients operated with curative intent between 1994 and 2008. Hepatic resection was associated with resection of segment 1, extrahepatic bile duct and lymph node dissection in all cases.40 patients, 62% male with a mean age of 58.2 years. Jaundice was the most common presenting symptom (70%). Biliary confluence was compromised in 62% oftumors. Thirty-nine patients underwent major hepatectomy with 95% RO resections and 6 associated vascular resections. Postoperative morbidity was 37.5% and mortality 10%. Overall survival and disease-free survival at 1, 3 and 5 years was 88% and 63%, 55% and 34%, and 43% and 24%, respectively.The association of major hepatectomy with caudate lobe resection and vascular resection when needed, was associated with 95% tumor-free margin and morbidity and mortality rate according to the standards of the international literature. While it is necessary a greater number of cases, associated vascular resection seems to be a feasible and safe option in the treatment of locally advanced HCC.

Hepatic involvement by tuberculosis is a rare type of manifestation of the disease. There are several forms of clinical presentations. One of them is the hepatic tuberculoma in which we base our presentation. Given that hepatic tuberculoma is a rare entity and generally shows inespecific symptoms, it is rarely suspected by the clinical picture. The diagnosis of hepatic tuberculosis is generally done in the intraoperative or postoperative period by analyzing a specimen taken by laparoscopy or laparotomy during the study of a hepatic mass. Laboratory tests or image studies do not give pathognomonic information to conform the diagnosis. The cornerstone in the treatment of this pathology is the antituberculous therapy. Surgical or endoscopic interventions are occasionally required. The role of surgery in the treatment of this pathology is reserved for a few solitary lesions. Once the correct treatment is performed the outcome is favorable. We present 4 cases of hepatic tuberculoma with different imaging and clinical presentations.