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Parenchyma-sparing Hepatic Resection for Multiple Metastatic Tumors

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The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases

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Abstract

Liver surgery is actually asked to deal with high tumor burden also in case of colorectal metastases. Harming the most diseased part to hypertrophy the future liver remnant remains the mainstream. However, ultrasound guidance has progressively driven to challenge the tumor-vessel detachment (R1vasc), which has proven to be oncologically suitable in term of local control. This finding has boosted the suitability of parenchyma sparing surgery even when tumor burden is extremely high. A further improvement in this sense has been provided in case of hepatic vein tumoral stricture or occlusion: indeed, in these circumstances natural by-pass develop preserving the outflow. Through ultrasound and vessel guidance, parenchyma sparing surgery has entered the complexity. From there, a different way of large tissue deprivation: the meaningful parenchymal sparing major hepatectomies.

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Author information

Authors and Affiliations

  1. Division of Hepatobiliary and General Surgery, Humanitas Clinical and Research Center IRCCS, Milan, Italy

    Bruno Branciforte, Flavio Milana & Guido Torzilli

  2. Department of Biomedical Sciences, Humanitas University, Milan, Italy

    Guido Torzilli

Authors
  1. Bruno Branciforte
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  2. Flavio Milana
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  3. Guido Torzilli
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Corresponding author

Correspondence to Guido Torzilli .

Editor information

Editors and Affiliations

  1. Emeritus Professor, The University of Tokyo, Tokyo, Japan

    Masatoshi Makuuchi

  2. National Center for Global Health and Medicine, The University of Tokyo, Tokyo, Japan

    Norihiro Kokudo

  3. “Dan Setlacec” Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania

    Irinel Popescu

  4. Emeritus Professor University Paris Cité, Paris, France

    Jacques Belghiti

  5. Department of Surgery, Seoul National University College of Medicine Seoul National University Bundang Hospital, Seoul, Korea (Republic of)

    Ho-Seong Han

  6. Nagahama City Hospital Network, Shiga, Japan

    Kyoichi Takaori

  7. Massachusetts General Hospital, Harvard Medical School, Boston, USA

    Dan G. Duda

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Branciforte, B., Milana, F., Torzilli, G. (2022). Parenchyma-sparing Hepatic Resection for Multiple Metastatic Tumors. In: Makuuchi, M., et al. The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-19-0063-1_31

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  • DOI: https://doi.org/10.1007/978-981-19-0063-1_31

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