Too Big to Fail: Volumetric Analyses and Incidence of Posthepatectomy Liver Failure in 125 Major Hepatectomies in Children

CONCLUSION: This is the largest reported single-center series of pediatric major hepatectomies. PHLF is exceedingly rare in children. The liver volume-to-body weight ratio is higher in children compared to adults, and the FLR is sufficient even in extreme resections with less than 20% of liver remnant. These findings strongly question the use of ALPPS, portal vein embolization, or transplantation based on suspected insufficient liver remnant in …