scholarly journals Video-assisted transthoracic liver resection in patients with marginal liver function: a retrospective cohort study

2021 ◽  
Vol 17 (2) ◽  
pp. 122-125
Author(s):  
Ryong Ho Jung ◽  
Hyug Won Kim ◽  
Sam-Youl Yoon
Keyword(s):  
Liver Resection ◽  
Liver Function ◽  
Liver Tumors ◽  
Wedge Resection ◽  
Laparoscopic Hepatectomy ◽  
Surgical Techniques ◽  
Normal Diet ◽  
Liver Malignancy ◽  
Video Assisted ◽  
Abdominal Approach

Purpose: Laparoscopic hepatectomy has been widely performed by hepatobiliary surgeons for malignancy of liver and gained wide acceptance for various liver tumors, thanks to advances in surgical techniques and devices. But, there are some challenges for right side tumor in patients of cirrhotic liver. Especially, tumor located in right upper area is difficult for wedge resection in patients with marginal liver function, because trans-abdominal approach requires normal parenchymal dissection. Radiofrequency wave ablation is also difficult for such a lesion. So, we demonstrate unique technique of video-assisted transthoracic liver resection (VTLR) for overcome right upper side tumor abutting diaphragm.Methods: Four patients underwent VTLR. Four ports in right chest wall were created by a chest surgeon and diaphragm was open. Then traction of the diaphragm was done by suture. After exposure of liver surface, tumor localization was done by ultrasound. The mass excision was done by ultrasonic shear.Results: Four patients were discharged without complications within 11.3 days (range, 6–15 days). On average, patients started to consume a normal diet on an average of 2.4 days (range, 1–4 days).Conclusion: VTLR is could be performed by an experienced surgeon and chest surgeon for right upper liver malignancy abutting diaphragm in patient of marginal liver function.

scholarly journals A safe and simple procedure for laparoscopic hepatectomy with combined diaphragmatic resection

2021 ◽  
Author(s):  
Keisuke Oyama ◽  
Shin Nakahira ◽  
Sakae Maeda ◽  
Akihiro Kitagawa ◽  
Yuki Ushimaru ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Liver Resection ◽  
Liver Metastasis ◽  
Laparoscopic Liver Resection ◽  
Liver Tumors ◽  
Simple Procedure ◽  
Laparoscopic Hepatectomy ◽  
Pleural Space ◽  
Absorbable Suture ◽  
Surgical Field

AbstractDiaphragmatic resection may be required beneath the diaphragm in some patients with liver tumors. Laparoscopic diaphragmatic resection is technically difficult to secure in the surgical field and in suturing. We report a case of successful laparoscopic hepatectomy with diaphragmatic resection. A 48-year-old man who underwent laparoscopic partial hepatectomy for liver metastasis of rectal cancer 20 months ago underwent surgery because of a new hepatic lesion that invaded the diaphragm. The patient was placed in the left hemilateral decubitus position. The liver and diaphragm attachment areas were encircled using hanging tape. Liver resection preceded diaphragmatic resection with the hanging tape in place. Two snake retractors were used to secure the surgical field for the inflow of CO2 into the pleural space after diaphragmatic resection. The defective part of the diaphragm was repaired using continuous or interrupted sutures. Both ends of the suture were tied with an absorbable suture clip without ligation. In laparoscopic liver resection with diaphragmatic resection, the range of diaphragmatic resection can be minimized by performing liver resection using the hanging method before diaphragmatic resection. The surgical field can be secured using snake retractors. Suturing with an absorbable suture clip is conveniently feasible.

Innovative Surgical Approaches for Locally Advanced Hepatic Malignancy

2020 ◽  
Vol 04 (01) ◽  
pp. 046-052
Author(s):  
Young-Dong Yu ◽  
Dong-Sik Kim
Keyword(s):  
Liver Resection ◽  
Liver Surgery ◽  
Liver Tumors ◽  
Locally Advanced ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Portal Vein Ligation ◽  
Hepatic Malignancy ◽  
Term Survival ◽  
Advanced Malignancy

AbstractPrimary and secondary liver tumors are among the most common tumors in humans. Liver resection and liver transplantation are used to treat these malignancies. However, in many patients with locally advanced malignancy, it is not possible to resect these tumors using conventional techniques due to their enormous size or complex location. Refinements of surgical techniques have led to great improvements in terms of postoperative outcome and long-term survival in the past decades. This review explores innovative technologies in liver surgery, including both resection and transplantation, and their potential role in treating locally advanced hepatic malignancy. A number of innovative surgical techniques such as associating liver partition and portal vein ligation for liver surgery (ALPPS), ex vivo resection, ante situm liver resection, liver resection using extracorporeal hepatic venous bypass, and resection and partial liver segment 2/3 transplantation with delayed total hepatectomy (RAPID) have been developed to overcome the barriers of conventional liver resection and may offer acceptable outcomes for well-selected patients with locally invasive tumors that are otherwise inoperable by conventional techniques.

scholarly journals Hepatobiliary scintigraphy in the preoperative assessment of the future remnant liver function (literature review and own examples)

2020 ◽  
Vol 7 (1) ◽  
pp. 62-69
Author(s):  
Yu. N. Likar ◽  
D. G. Akhaladze ◽  
A. G. Rumyantsev
Keyword(s):  
Liver Resection ◽  
Liver Function ◽  
Liver Tumors ◽  
Combined Treatment ◽  
Preoperative Assessment ◽  
Hepatobiliary Scintigraphy ◽  
Remnant Liver ◽  
Future Remnant Liver ◽  
The Future ◽  
Remnant Liver Function

Liver resection remains one of the most important option in combined treatment for liver tumors; however, it harbors the risk of developing posthepatectomy liver failure. The principal risk is associated with the quality and quantity of the future remnant liver. Therefore, preoperative assessment of the future remnant liver is essential in patients scheduled for major hepatectomy. Technetium-99m-mebrofenin hepatobiliary scintigraphy is increasingly applied for the quantitative assessment of liver function before major liver resection.

scholarly journals OPEN, LAPAROSCOPIC, AND ROBOTIC-ASSISTED HEPATECTOMY IN RESECTION OF LIVER TUMORS: A NON-SYSTEMATIC REVIEW

2017 ◽  
Vol 30 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Túlio Felício da Cunha RODRIGUES ◽  
Bianca SILVEIRA ◽  
Flávia Pádua TAVARES ◽  
Gustavo Moreira MADEIRA ◽  
Iara Proença XAVIER ◽  
...  
Keyword(s):  
Open Surgery ◽  
Metabolic Response ◽  
Liver Tumors ◽  
Laparoscopic Hepatectomy ◽  
Surgical Techniques ◽  
New Drugs ◽  
Limiting Factors ◽  
Laparoscopic Technique ◽  
Robotic Assisted ◽  
Scientific Papers

ABSTRACT Introduction: Several factors have made hepatectomy an increasingly safe surgery and new drugs allowed surgical treatment for patients who initially were not candidates for resection. Lesions often require resection, which can be performed by open, laparoscopic, or robotic assisted hepatectomy. Aim: Compare the surgical techniques in open, laparoscopic, and robotic assisted hepatectomy for resection of liver tumors. Methods: Literature review based on scientific papers published on Lilacs/Pubmed/Scielo in the last 17 years regarding the indications of these techniques for liver tumor resections and on papers comparing such techniques. Results: The comparative study shows the benefits of laparoscopic surgery over open surgery, such as smaller incisions, less postoperative pain, shorter recovery time, smaller immune and metabolic response, and quicker restoration of oral ingestion as well as lower morbidity rates. However, the need for a specialized surgical team and the reduction in handling area still remain as disadvantages in the laparoscopic technique. It is yet not clear whether robotic assistance presents considerable benefits over the laparoscopic technique considering that high acquisition and maintenance costs are limiting factors. Conclusion: Despite all challenges, laparoscopic hepatectomy presents many benefits over open surgery. The robotic assisted technique is still in evolution as many centers in the world perform hepatic resections with the platforms but only after a thorough patient selection. Thus, laparoscopy stands as the best option, unless there is some contraindication to the procedure.

scholarly journals Single-Incision Laparoscopic Liver Resection for Colorectal Metastasis through Stoma Site at Time of Reversal of Diversion Ileostomy: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Bård I. Røsok ◽  
Bjørn Edwin
Keyword(s):  
Liver Resection ◽  
Laparoscopic Liver Resection ◽  
Single Incision ◽  
Liver Tumors ◽  
Single Port ◽  
Surgical Techniques ◽  
Metastatic Lesion ◽  
Minimally Invasive Surgical ◽  
Malignant Liver Tumors ◽  
Malignant Liver

Minimally invasive surgical techniques for liver tumors are gaining increased acceptance as an alternative to traditional resections by laparotomy. In this article we describe a laparoscopic liver resection of a metastatic lesion in a patient primarily operated for colorectal cancer. The resection was conducted as a single port procedure through the stoma aperture at time of reversal of the diversion ileostomy. Sigle incision liver resections may be less traumatic than conventional laparoscopy and could be applied in selected patients with both benign and malignant liver tumors.

scholarly journals Hemoperitoneum After Spontaneous Rupture of Liver Tumor: Results of Surgical Treatment

HPB Surgery ◽  
1988 ◽  
Vol 1 (1) ◽  
pp. 81-83 ◽  
Author(s):  
Roland Andersson ◽  
Karl-Göran Tranberg ◽  
Stig Bengmark
Keyword(s):  
Surgical Treatment ◽  
Liver Resection ◽  
Spontaneous Rupture ◽  
Liver Tumors ◽  
Primary Liver Cancer ◽  
Liver Cyst ◽  
Liver Malignancy ◽  
Suture Ligation ◽  
Initial Symptoms ◽  
Operative Delay

Five cases of massive hemoperitoneum caused by spontaneous rupture of liver tumors, collected during a 27-year period, are reported. Four patients had a primary liver malignancy and one patient a liver cyst with hemangioma. Initial symptoms were obscure and hemoperitoneum was suspected pre-operatively in only one patient. At operation, a mean of 3100 ml of blood was found in the abdomen. Hemostatis was achieved by liver resection in four patients and by suture ligation in one. Two patients died during or shortly after operation. The three patients surviving the operation had primary liver cancer and lived for 6 months to 6.5 years. It is concluded that liver resection, whenever possible, is the treatment of choice and that pre-operative delay and mortality may be diminished by increased awareness of this condition.

Eight years after introducing liver resection at the Oncology Institute of Vojvodina

2013 ◽  
Vol 21 (3-4) ◽  
pp. 101-104
Author(s):  
Ivan Majdevac ◽  
Nikola Budisin ◽  
Milan Ranisavljevic ◽  
Dejan Lukic ◽  
Imre Lovas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Liver Tumors ◽  
Liver Parenchyma ◽  
Malignant Neoplasms ◽  
Chemotherapy Treatment ◽  
Primary Liver Tumors ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases ◽  
Medical Histories

Background: Hepatectomies are mostly performed for the treatment of hepatic benign or malignant neoplasms, intrahepatic gallstones, or parasitic cysts of the liver. The most common malignant neoplasms of the liver are metastases from colorectal cancer. Anatomic liver resection involves two or more hepatic segments, while non-anatomic liver resection involves resection of the metastases with a margin of uninvolved tissue. The aim of this manuscript was to show results of hepatectomies performed at the Oncology Institute of Vojvodina. Methods: We performed 133 liver resections from January 1997 to December 2013. Clinical and histopathological data were obtained from operative protocols, histopathological reports, and patients? medical histories. Results: We did 80 metastasectomies, 51 segmentectomies, and 18 radiofrequent ablations (RFA). Average number of colorectal cancer metastases was 1.67 per patient. We also made 10 left hepatectomies. In all cases, we made non-anatomic resections. Conclusion: Decision about anatomic versus non-anatomic resections for colorectal metastasis and primary liver tumors should be made before surgical exploration. Preservation of liver parenchyma is important with respect to liver failure and postoperative chemotherapy treatment.

scholarly journals Assessment of preoperative liver function in patients undergoing liver resection – The ALICE grade

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S204
Author(s):  
T. Kokudo ◽  
C. Shirata ◽  
T. Toda ◽  
Y. Nishioka ◽  
T. Yamaguchi ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Function ◽  
Preoperative Liver Function

scholarly journals Laparoscopic versus Open Liver Resection: Differences in Intraoperative and Early Postoperative Outcome among Cirrhotic Patients with Hepatocellular Carcinoma—A Retrospective Observational Study

HPB Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Antonio Siniscalchi ◽  
Giorgio Ercolani ◽  
Giulia Tarozzi ◽  
Lorenzo Gamberini ◽  
Lucia Cipolat ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Liver Function ◽  
Hospital Stay ◽  
Perioperative Complications ◽  
Laparoscopic Approach ◽  
Postoperative Outcome ◽  
Laparoscopic Technique ◽  
Surgical Trauma ◽  
Cirrhotic Patients

Introduction. Laparoscopic liver resection is considered risky in cirrhotic patients, even if minor surgical trauma of laparoscopy could be useful to prevent deterioration of a compromised liver function. This study aimed to identify the differences in terms of perioperative complications and early outcome in cirrhotic patients undergoing minor hepatic resection for hepatocellular carcinoma with open or laparoscopic technique. Methods. In this retrospective study, 156 cirrhotic patients undergoing liver resection for hepatocellular carcinoma were divided into two groups according to type of surgical approach: laparoscopy (LS group: 23 patients) or laparotomy (LT group: 133 patients). Perioperative data, mortality, and length of hospital stay were recorded. Results. Groups were matched for type of resection, median number of nodules, and median diameter of largest lesions. Groups were also homogeneous for preoperative liver and renal function tests. Intraoperative haemoglobin decrease and transfusions of red blood cells and fresh frozen plasma were significantly lower in LS group. MELD score lasted stable after laparoscopic resection, while it increased in laparotomic group. Postoperative liver and renal failure and mortality were all lower in LS group. Conclusions. Lower morbidity and mortality, maintenance of liver function, and shorter hospital stay suggest the safety and benefit of laparoscopic approach.

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