Anesthetic management in hepatectomy of a cirrhotic patient with hepatocellular carcinoma: a case report

Fernandez-Delgado D.M.; Montesinos S.Y.; Estela-Fernandez C.A.; Aguilar-Marín I.C. · Revista Mexicana de Anestesiologia (2026) · DOI: 10.35366/123598

Resumen

Introduction: surgical resection in hepatocellular carcinoma (HCC) remains one of the most effective curative methods; however, the complexity of perioperative management is controversial in relation to current guidelines. Objective: to describe the anesthetic and perioperative approaches used in a patient with cirrhosis undergoing radical hepatectomy for HCC, emphasizing the relevant determinants of surgical outcomes. Case presentation: an 82-year-old man diagnosed with hepatocellular carcinoma in the right lobe due to alcoholic cirrhosis (Child-Pugh A). He underwent radical right hepatectomy after preoperative portal embolization. Total intravenous anesthesia with controlled infusion was used. Continuous central venous pressure control was maintained by fluid restriction combined with vasopressor infusion. Postoperative care included liver protection measures and complication management. The patient was subsequently discharged with outpatient follow-up. Conclusion: the surgical risks in this case were considerable, but the outcome was positive thanks to adequate preoperative and perioperative management. Further research is needed to investigate how these factors influence the surgical outcome of certain difficult-to-manage pathologies.

Instituciones: Universidad Científica del Sur