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Management of Patients with Bilateral Multi-focal Colorectal Liver Metastasis: Two-Stage Approach

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Case-Based Lessons in the Management of Complex Hepato-Pancreato-Biliary Surgery

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Abstract

Two-stage hepatectomy is a safe and standardized technique that offers surgical resection to patients with multiple, bilobar colorectal liver metastases who could not be radically resected while leaving an adequate liver remnant in one operation. Despite the need of two separate surgeries, it provides an optimal oncological selection based on response to chemotherapy and absence of rapid progression between stages, and a safe approach to major hepatectomies due to the use of portal vein occlusion and a precise assessment of the liver regenerative capacity. While alternative strategies have been proposed, the two-stage hepatectomy remains the most diffuse technique adopted in this subset of patients with excellent long-term survival rates.

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Author information

Authors and Affiliations

  1. Division of Hepatobilio-Pancreatic Surgery, European Institute of Oncology, Via Ripamonti 435, Milano, Italy

    Dario Ribero

  2. Division of General and Oncologic Surgery, Mauriziano Hospital “Umberto I”, Largo Turati 62, 10128, Torino, Italy

    Roberto Lo Tesoriere & Alessandro Ferrero

Authors
  1. Dario Ribero
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  2. Roberto Lo Tesoriere
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  3. Alessandro Ferrero
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Corresponding author

Correspondence to Dario Ribero .

Editor information

Editors and Affiliations

  1. The Ohio State Wexner Medical Center , The Ohio State University School of Medicine , Columbus, Ohio, USA

    Timothy M. Pawlik

  2. Division of General Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA

    Sharon Weber

  3. Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    T. Clark Gamblin

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Ribero, D., Tesoriere, R.L., Ferrero, A. (2017). Management of Patients with Bilateral Multi-focal Colorectal Liver Metastasis: Two-Stage Approach. In: Pawlik, T., Weber, S., Gamblin, T. (eds) Case-Based Lessons in the Management of Complex Hepato-Pancreato-Biliary Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-50868-9_4

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  • DOI: https://doi.org/10.1007/978-3-319-50868-9_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-50867-2

  • Online ISBN: 978-3-319-50868-9

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