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Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 12, Issue 6, pp 498–501 | Cite as

Improvement of surgical margin with a coupled saline-radio-frequency device for multiple colorectal liver metastases

  • Satoshi Ogata
  • Reza Kianmanesh
  • Deepak Varma
  • Jacques Belghiti
Article

Abstract

Complete resection of colorectal liver metastases (LM) has been the only curative treatment. However, when LM are multiple and bilobar, only a few patients are candidates for curative surgery. We report on a 53-year-old woman with synchronous multiple and bilobar LM from sigmoidal cancer who became resectable after a multimodal strategy including preoperative systemic chemotherapy and two-step surgery. The spectacular decrease in tumor size after systemic chemotherapy led us to perform two-step surgery, including right portal-vein ligation and left liver metastasectomies, with a coupled saline-radiofrequency device, in order to improve the surgical margin. An extended right hepatectomy was performed later to remove the remaining right liver lesions. The patient was discharged after 28 days without major complication and was recurrence-free 14 months later. We conclude that improving the surgical margin with a coupled saline-radiofrequency device is feasible and effective, avoiding small remnant liver even after multiple tumorectomies. The multimodal strategy, including preoperative chemotherapy, two-step surgery, and tumorectomies, using a coupled saline-radiofrequency device, could increase the number of patients with diffuse bilobar liver metastases who can benefit from liver resection.

Key words

Diffuse bilobar liver metastases Systemic chemotherapy Portal vein ligation Coupled saline-radiofrequency device Two-step surgery 

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Copyright information

© Springer-Verlag Tokyo 2005

Authors and Affiliations

  • Satoshi Ogata
    • 1
  • Reza Kianmanesh
    • 1
  • Deepak Varma
    • 1
  • Jacques Belghiti
    • 1
  1. 1.Department of Hepato-Pancreato-Biliary Surgery and TransplantationHospital Beaujon — University Paris VIIClichyFrance

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