Recent Advances in Liver Surgery
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Edited By:Renzo DionigiDepartment of Surgical Sciences, Azienda Ospedaliera;Polo Universitario, Via Guicciardini, 21100, Varese, Italy. ISBN: TBA Published: 2008-09-01 |
Chapters available from this book
Transection Techniques in Liver Surgery
Luigi Boni, Gianlorenzo Dionigi, Mario Diurni, and Renzo Dionigi
The main problem which is experienced during liver resection still remains the bleeding control in course of parenchymal division. Over the past decades several techniques such as crush‑clamp, ultrasonic dissection, radiofrequency or stapler assisted liver dissection have been proposed in orde...
Staging Algorithms for Patients with HCC and Prognostic Indicators
Christos S. Georgiades
Assigning a specific prediction of survival to any patient with HCC is difficult under the best of circumstances. The nature of the disease, the underlying liver function, the performance status of the patients as well as the misleading conclusions with which the relevant literature is replete, all ...
Loco-regional Ablative Therapies for Colorectal Metastases
Ricardo Lencioni, Laura Crocetti and Dania Cioni
During the past decade, several methods for local ablation of hepatic colorectal metastases have been developed and clinically tested. Among these methods, radiofrequency (RF) ablation is currently established as the primary ablative modality at most institutions. Despite several cohort studies have...
Liver Surgery: A Historical Account
Renzo Dionigi, Giulio Carcano, Gianlorenzo Dionigi and Francesca Rovera
This introductory article, which includes a list of references for the interested reader, reviews the accomplishments of the past, on which twenty‑first‑century surgery of the liver depends on. The first relevant descriptions of the anatomy of the liver appeared with the renditions of He...
Resection of Noncolorectal Cancer Liver Metastases
Cristina R. Ferrone and Kenneth K. Tanabe
The liver remains second only to the regional lymph nodes as the most common site of metastases from gastrointestinal tract malignancies. Other primary tumors outside of the gastrointestinal tract also metastasize to the liver, but with a lower frequency. The safety of hepatic resection has improved...
Liver Surgery: A Historical Account
Renzo Dionigi
This introductory article, which includes a list of references for the interested reader, reviews the accomplishments of the past, on which twenty‑first‑century surgery of the liver depends on. The first relevant descriptions of the anatomy of the liver appeared with the renditions of He...
Resection of Noncolorectal Cancer Liver Metastases
Cristina R. Ferrone and Kenneth K. Tanabe
The liver remains second only to the regional lymph nodes as the most common site of metastases from gastrointestinal tract malignancies. Other primary tumors outside of the gastrointestinal tract also metastasize to the liver, but with a lower frequency. The safety of hepatic resection has improved...
Sepsis after Liver Resection: Predisposition, Clinical Relevance and Synergism with Liver Dysfunction
Gennaro Nuzzo, Ivo Giovannini, Felice Giuliante, Francesco Ardito and Carlo Chiarla
Liver resection, compared with other abdominal operations, is characterized by greater predisposition to septic complications. This may be explained by several factors, including the major role of the liver in immune defence, anatomical features such as the close relationship of the hepato‑bil...
Preoperative Portal Vein Embolization for Hepatocellular Carcinoma
Taku Aoki, Hiroshi Imamura, Takuya Hashimoto, Norihiro Kokudo and Masatoshi Makuuchi
Preoperative portal vein embolization (PVE) has been introduced to increase the safety of major hepatic resection for hepatocellular carcinoma (HCC). PVE induces atrophy of the embolized portion of the liver to be resected with compensatory hypertrophy of the preserved liver remnant, even in chronic...
Intraoperative Ultrasonic Examination in Liver Surgery
Junichi Arita, Norihiro Kokudo, Keiji Sano and Masatoshi Makuuchi
The safety of liver surgery has improved dramatically over the course of a few decades through the development of intraoperative ultrasonography, an imaging modality that is currently indispensable for hepatic resection. Although intraoperative ultrasonography is necessary at all stages and for a va...
Genetics of Hepatocellular Carcinoma
Andreas Teufel
Hepatocellular carcinoma (HCC) is among the most common malignancies worldwide. At present, approximately 550 000 new patients are diagnosed with HCC each year worldwide. However, regional differences in the incidence of HCC are significant. The highest prevalence is found in Southeast Asia an...
Hepatocyte Transplantation: A New Approach to Treat Liver Disorders
Javed Akhter, Loreena A Johnson and David L Morris
As demand for liver transplantation increases, hepatocyte transplantation will play an increasingly important role in the clinic. Clinically, hepatocyte transplantation has already shown its potential as a bridging adjunct to the standard clinical practice of Orthotopic Liver Transplantation (OLT). ...
Vascular Embolotherapy in Hepatocellular Carcinoma
Saad M. Ibrahim, Gianpaolo Carrafiello, Robert J. Lewandowski, Robert K. Ryu, Kent T. Sato , Reed A. Omary and Riad Salem
Treatment options for hepatocellular carcinoma, that cannot be resected or ablated, are based on trans‑arterial techniques. These include drug delivery in the form of traditional chemoembolization, bland embolization, radioembolization and drug‑eluting beads. These technologies are rapid...
Staging Systems to Predict Survival in Hepatocellular Carcinoma
Sonia Pascual and Miguel Pérez-Mateo
There has been a considerable controversy regarding which is the best prognostic staging system to predict survival in patients with cirrhosis and hepatocellular carcinoma (HCC). Several prognostic models have been developed in the recent years but none has been widely accepted. The staging systems ...
One Liver for Two: Split and Living Donor Liver Transplantation for Adult and Pediatric Patients
B. Gridelli, S. Gruttadauria, A. Luca, M. Spada, R. Volpes, W. Marsh and A. Marcos
The dramatic gap between need and availability of grafts for patients on liver transplantation waiting lists has prompted some of the most advanced technical evolutions in transplantation surgery. The knowledge derived from liver surgical anatomy, which has been first applied to liver resection for ...
Response Evaluation Criteria in Hepatocellular Carcinoma (Moving beyond the Recist)
Carlo Fugazzola, Gianpaolo Carrafiello, Chiara Recaldini, Elena Bertolotti, Tamara Cafaro, Maria Gloria Angeretti, Paolo Nicotera and Domenico Lumia
To assess the clinical success of percutaneous minimally invasive therapies for HCC, conventional anatomical imaging based upon size criteria alone (WHO and RECIST) is not sufficient; therefore, additional criteria provided by new imaging techniques, concerning neoangiogenesis and tumor metabolism, ...
Perioperative Blood Transfusion in Hepatocellular Carcinomas
Gianlorenzo Dionigi, Salvatore Cuffari, Giovanni Cantone, Alessandro Bacuzzi and Renzo Dionigi
Allogeneic blood transfusion during liver resection for malignancies has been associated with an increase incidence of different types of complications: infectious complications, tumor recurrence, decreased survival. Even if there is clear evidence of transfusion‑induced immunosuppression, it ...
Inferior Vena Cava Resection for Infiltrating Hepatic Malignancy
Gabriele Piffaretti, Gianlorenzo Dionigi, Matteo Tozzi, Patrizio Castelli and Renzo Dionigi
Liver tumors with involvement of the inferior vena cava (IVC) may demand the combined resection of the liver and IVC. This approach, even if it has become common for hepatic malignancies involving the IVC, still represents a high risk surgical procedure with a poor long‑term prognosis. The obj...
Liver Transplantation in HIV‑Infected Individuals
Paolo Antonio Grossi
Several recent reports have shown that end‑stage liver disease is the leading cause of death among HIV‑infected persons in the highly active antiretroviral therapy (HAART) era. Until a few years ago, HIV infection was an exclusion criteria for organ transplantation. One major concern was...
Second Messenger Systems in Planaria
Scott M. Rawls
Second messengers are the cellular currency of information transfer. These signaling molecules, along with their related pathways, mediate the acute effects of drugs and the changes in neural plasticity caused by long‑term drug exposure. Three of the best characterized second messengers are cy...
Percutaneous Treatment of Surgical Bile Duct Injury
Gianpaolo Carrafiello , Domenico Laganà, Monica Mangini, Federico Fontana, Massimiliano Dizonno, Andrea Ianniello, Elisa Cotta, Riad Salem and Carlo Fugazzola
Surgical bile duct injury (SBDI) is one of the most serious complications of hepato‑biliary surgery and liver transplantation. Regardless of the improvements in surgical techniques in recent years, SBDI remains a critical problem and a major cause of morbidity. Proper diagnosis and treatment o...
Aggressive Surgery for Hepatocellular Carcinoma with Vascular and/or Biliary Involvement
Tsuyoshi Sano and Yuji Nimura
In patients with advanced hepatocellular carcinoma (HCC) presenting with vascular and/or biliary invasion, major hepatectomy is often indicated for curative resection. In HCC patients with portal vein tumor thrombus, limited anatomical resection such as sectionectomy is a possible alternative for a ...
Sequential Arterial and Portal Vein Embolization before Right Hepatectomy in Patients with Cirrhosis and Hepatocellular Carcinoma
Jacques Belghiti, Béatrice Aussilhou and Valérie Vilgrain
Major hepatectomy for large HCC in patients remains a crucial procedure due to the possibility of a low regeneration of the future liver remnant (FLR). It has been demonstrated that preoperative portal vein embolization (PVE) increase the tolerance of right hepatectomy. Selective transcatheter arter...
Vascular Isolation Techniques in Liver Resection
Jacques Belghiti, Safi Dokmak and Catherine Paugam-Burtz
During liver resection, various techniques of hepatic vascular control have been proposed to minimize the intraoperative blood losses. They include the isolated occlusion of the hepatic inflow (pedicular clamping) or the combination of occlusion of the hepatic inflow and outflow (total vascular excl...
Surgical Strategies and Technique for Hilar Cholangiocarcinoma
Tsuyoshi Sano and Yuji Nimura
Hepatobiliary resection for hilar cholangiocarcinoma (HC) remains a technically demanding procedure, calling for a high level of expertise in biliary and hepatic surgery. Treatment strategy for HC includes preoperative staging, perioperative managements and radical surgery. Multidetector row compute...
Radiological Intervention for Treatment of Complications after Liver Transplantation
Giovanni Gandini, Maria Carla Cassinis, Dorico Righi, Andrea Doriguzzi-Breatta, Maria Cristina Martina and Maria Antonella Ruffino
Orthotopic liver transplantation (OLT) is a widely accepted treatment for end‑stage chronic liver disease and severe liver failure. Despite improvement in survival due to advances in surgical technique, organ preservation technology and immunosuppressive strategies, there are significant compl...
Virtual Liver Surgery: Computer-assisted operation planning in 3D liver model
Hauke Lang, Milo Hindennach, Arnold Radtke and Heinz Otto Peitgen
Ongoing development in CT imaging-based computer assistance has enabled an optimal visualization of the intrahepatic vascular branching in a virtual 3D liver model providing an individual territorial liver mapping as well as volume calculation of the corresponding vascular territories. Thus, liver r...
Current Role of Laprascopic Surgery for Liver Malignancies
Andrew A. Gumbs and Brice Gayet
Since the first report of a laparoscopic liver resection, laparoscopic hepatic resection has become increasingly more common in the surgical treatment of both benign and malignant tumors. The minimally invasive approach to resections of the entire liver including the posterior and deep segments, how...
