• Surgical management strategy for liver tumors in children
en To content Full text of article

Surgical management strategy for liver tumors in children

Paediatric Surgery (Ukraine). 2025. 4(89): 59-64. doi: 10.15574/PS.2025.4(89).5964
Кalinchuk О. О.¹, Kulyk О. М.², Shevchuk D. V.¹,3, Dvorakevych А. О.¹, Miskiv I. P.1
¹CC «First Lviv Territorial Medical Union» Subdivision «St. Nicholas Hospital», Ukraine
²SNPE «Danylo Halytsky Lviv National Medical University», Ukraine
3Ivan Franko Zhytomyr State University, Ukraine

For citation: Кalinchuk ОО, Kulyk ОМ, Shevchuk DV, Dvorakevych АО, Miskiv IP. (2025). Surgical management strategy for liver tumors in children. Paediatric Surgery (Ukraine). 4(89): 59-64. doi: 10.15574/PS.2025.4(89).5964.
Article received: Aug 19, 2025. Accepted for publication: Dec 12, 2025.

In childhood, liver tumors are quite rare. Liver tumors account for slightly more than 1% of all malignant neoplasms in children. They account for about 5-6% of abdominal tumors. Among abdominal tumors, liver tumors rank third in frequency after neuroblastoma and Wilms' tumor. A third of liver tumors are benign tumors, the other two thirds are malignant.
Aim – to analyze the surgical tactics used for liver tumors in children.
Materials and methods. A retrospective study of 25 children with liver tumors who were treated in 2023-2025 was conducted. Observation of operated children is carried out in dynamics.
Results. Benign tumors accounted for 84%, malignant – 16%. Surgical interventions were performed in 84% of patients using laparoscopic (56%), open (12%) and robotic (16%) techniques. In 44% of cases, ICG navigation (indocyanine fluorescence, ICG – Indocyanine Green) was used. No relapses were detected, liver function was preserved.
Conclusions. Benign neoplasms prevail in the structure of liver tumors in children. Minimally invasive surgical treatment methods, in particular robotic surgery, demonstrate better perioperative results compared to open interventions in children with liver tumors. The use of ICG navigation increases the accuracy of surgical interventions.
The study was performed in accordance with the principles of the Declaration of Helsinki. Informed consent of the parents was obtained.
The authors declare no conflict of interest.
Keywords: liver tumors, children, surgery, indocyanine green (ICG).

REFERENCES

1. Benzar I, Poluliakh OK. (2014). Assessment of clinical activity and effectiveness of treatment of infantile hemangiomas using ultrasound scanning. Neonatology, Surgery and Perinatal Medicine. 3 (13); IV: 86-91. https://doi.org/10.24061/2413-4260.IV.3.13.2014.14

2. Benzar IM, Zhumick DV. (2019). Hepatic Hemangiomas in Children: Potential Risks and Principles of Treatment. Paediatric Surgery. Ukraine. 1(62): 31-36. https://doi.org/10.15574/PS.2019.62.31

3. Bernts LHP, Echternach SG, Kiewit V, Rosman K, Drent JFH. (2019). Clinical response after laparoscopic fenestration of symptomatic liver cysts: a systematic review and meta-analysis. Surgical Endoscopy. 33(3): 691-704. https://doi.org/10.1007/s00464-018-6490-8; PMid:30334152 PMCid:PMC6394680

4. Frenette C, Mendiratta-Lala M, Saljia R, Wong RJ, Sauer BG, Pillai A. (2024, Jul 1). ACG Clinical Guidelines: Focal Liver Lesions, American Journal of Gastroenterology. 119(7): 1235-1271. Epub 2024 Jan 26. https://doi.org/10.14309/ajg.0000000000002857; PMid:38958301

5. Gnarra M, Behr G, Kitajewski A, Wu JK, Anupindi SA, Shawber CJ et al. (2016). History of the infantile hepatic hemangioma: From imaging to generating a differential diagnosis. World J Clin Pediatr. 8; 5(3): 273-280. https://doi.org/10.5409/wjcp.v5.i3.273; PMid:27610342 PMCid:PMC4978619

6. Harada K, Fujikawa T, Uemoto Y. (2025 Jan-Dec). Usefulness of indocyanine green fluorescence-guided surgery for simultaneous laparoscopic fenestration of liver cysts and cholecystectomy. Asian Journal of Endocrine Surgery. 18(1): e70120. https://doi.org/10.1111/ases.70120; PMid:40635336

7. Iacobas I, Phung TL, Adams DM, Trenor CC 3rd, Blei F, Fishman DS et al. (2018). Guidance Document for Hepatic Hemangioma (Infantile and Congenital) Evaluation and Monitoring. J Pediatr. 203: 294-300. https://doi.org/10.1016/j.jpeds.2018.08.012; PMid:30244993

8. Ian D, Agata D, Williams F, Balistreri D. (2001). Evaluation of Liver Diseases in the Pediatric Patient. Pediatric in Review. 20,(11): 376-389. https://doi.org/10.1542/pir.20.11.376; PMid:10551891

9. Khanna R, Verma SK. (2018). Pediatric hepatocellular carcinoma. World J Gastroenterol. 24: 3980-3999. https://doi.org/10.3748/wjg.v24.i35.3980; PMid:30254403 PMCid:PMC6148423

10. McGlynn KA, Petrick JL, London WT. (2015). Global epidemiology of hepatocellular carcinoma: an emphasis on demographic and regional variability. Clin Liver Dis. 19: 223-238. https://doi.org/10.1016/j.cld.2015.01.001; PMid:25921660 PMCid:PMC4712629

11. Meyers RL. (2017). Tumors of the liver in children. Surg Oncol. 16(3): 195-203. https://doi.org/10.1016/j.suronc.2007.07.002; PMid:17714939

12. Ng K, Mogul DB. (2018). Pediatric Liver Tumors. Clin Liver Dis. 22: 753-772. https://doi.org/10.1016/j.cld.2018.06.008; PMid:30266161

13. Pfeiffenberger J, Mogler C, Gotthardt DN, Schulze-Bergkamen H, Litwin T, Reuner U et al. (2015). Hepatobiliary malignancies in Wilson disease. Liver Int. 35: 1615-1622. https://doi.org/10.1111/liv.12727; PMid:25369181

14. Pohorilyi VV, Kotenko OH, Konoplitskyi VS, Dmytriiev DV, Kalinchuk OO, Konoplitskyi DV. (2015). Personal experience of curation of children with vascular tumors of the liver. Modern Gastroenterology. 1(81): 91-95.

15. Schmid I, von Schweinitz D. (2017). Pediatric hepatocellular carcinoma: challenges and solutions. J Hepatocell Carcinoma. 4: 15-21. https://doi.org/10.2147/JHC.S94008; PMid:28144610 PMCid:PMC5248979

16. Zimmermann A. (2018). Liver Tumors of Childhood. In: Romil Saxena editor. Practical Hepatology Pathology: A Diagnostic Approach. 2nd ed. Philadelphia PE: 555-582. https://doi.org/10.1016/B978-0-323-42873-6.00035-4