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Imaging-Based Preoperative Planning

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Extreme Hepatic Surgery and Other Strategies

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Abstract

Liver resection in the treatment of colorectal liver metastases, as for any other primary or secondary liver tumor, needs to be oncologically effective and surgically safe. Both goals need equal consideration, and imaging-based preoperative planning is paramount for achieving each of them. Preoperative imaging should ideally identify all metastatic lesions in the liver, as well as extrahepatic disease. Furthermore, it should provide an anatomical roadmap with the exact localization of each lesion within the segmental hepatic anatomy, and its proximity to adjacent vasculo-biliary structures, to allow for proper resection leaving the patient with a sufficiently functioning liver remnant. This chapter approaches the imaging-based assessment of oncological resectability taking into account a multimodal treatment setting (i.e., impact of chemotherapy), describes the volumetric assessment of the liver, the different imaging-based liver function tests, and computer-assisted virtual resection planning in 3D liver models.

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Authors and Affiliations

  1. Department of General, Visceral, and Transplant Surgery, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany

    Jens Mittler MD & Hauke Lang MD, PhD, MA

  2. Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany

    Roman Klöckner MD

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  1. Jens Mittler MD
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  2. Roman Klöckner MD
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  3. Hauke Lang MD, PhD, MA
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Correspondence to Hauke Lang MD, PhD, MA .

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Editors and Affiliations

  1. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Eduardo de Santibañes

  2. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Victoria Ardiles

  3. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Fernando A. Alvarez

  4. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Virginia Cano Busnelli

  5. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Martin de Santibañes

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Mittler, J., Klöckner, R., Lang, H. (2017). Imaging-Based Preoperative Planning. In: de Santibañes, E., Ardiles, V., Alvarez, F., Busnelli, V., de Santibañes, M. (eds) Extreme Hepatic Surgery and Other Strategies. Springer, Cham. https://doi.org/10.1007/978-3-319-13896-1_4

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