Abstract
Liver tumors involving hepatic vein (HV) at caval confluence have been always considered an indication for major hepa- tectomy and/or HV reconstruction. However, careful study by means of intraoperative ultrasonography (IOUS) of tumor- vein relations and HV anatomy searching for accessory veins, together with color-Doppler IOUS analysis of portal flow, allows more conservative approaches also in these patients. Indeed, in our experience, only 12% of patients, who were operated because of liver tumors in contact or in close adjacency with one or more HVs, underwent removal of at least 3 segments: none of them required HV reconstruction, and no Hospital mortality was seen. Therefore, IOUS allows sparing liver parenchyma without tumor recurrence in most patients with tumors involving HV at their caval confluence, avoiding more extended hepatectomies or HV reconstructions. This approach to complex presentations of liver tumors by the use of IOUS-guidance is a further confirmation of the importance of this tool for accomplishing a safe and effective surgical treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 323-328 |
| Number of pages | 6 |
| Journal | Annali Italiani di Chirurgia |
| Volume | 77 |
| Issue number | 4 |
| Publication status | Published - Jul 2006 |
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Keywords
- Contrast-enhanced intraoperative ultrasonography
- Hepatocellular carcinoma
- Intraoperative ultrasonography
- Liver cirrhosis
- Liver metastases
- Liver surgery
- Liver tumors
ASJC Scopus subject areas
- Surgery
Cite this
Surgical strategy for liver tumors located at the hepato-caval confluence. / Torzilli, Guido; Del Fabbro, Daniele; Palmisano, Angela; Donadon, Matteo; Marconi, Matteo; Spinelli, Antonino; Montorsi, Marco.
In: Annali Italiani di Chirurgia, Vol. 77, No. 4, 07.2006, p. 323-328.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surgical strategy for liver tumors located at the hepato-caval confluence
AU - Torzilli, Guido
AU - Del Fabbro, Daniele
AU - Palmisano, Angela
AU - Donadon, Matteo
AU - Marconi, Matteo
AU - Spinelli, Antonino
AU - Montorsi, Marco
PY - 2006/7
Y1 - 2006/7
N2 - Liver tumors involving hepatic vein (HV) at caval confluence have been always considered an indication for major hepa- tectomy and/or HV reconstruction. However, careful study by means of intraoperative ultrasonography (IOUS) of tumor- vein relations and HV anatomy searching for accessory veins, together with color-Doppler IOUS analysis of portal flow, allows more conservative approaches also in these patients. Indeed, in our experience, only 12% of patients, who were operated because of liver tumors in contact or in close adjacency with one or more HVs, underwent removal of at least 3 segments: none of them required HV reconstruction, and no Hospital mortality was seen. Therefore, IOUS allows sparing liver parenchyma without tumor recurrence in most patients with tumors involving HV at their caval confluence, avoiding more extended hepatectomies or HV reconstructions. This approach to complex presentations of liver tumors by the use of IOUS-guidance is a further confirmation of the importance of this tool for accomplishing a safe and effective surgical treatment.
AB - Liver tumors involving hepatic vein (HV) at caval confluence have been always considered an indication for major hepa- tectomy and/or HV reconstruction. However, careful study by means of intraoperative ultrasonography (IOUS) of tumor- vein relations and HV anatomy searching for accessory veins, together with color-Doppler IOUS analysis of portal flow, allows more conservative approaches also in these patients. Indeed, in our experience, only 12% of patients, who were operated because of liver tumors in contact or in close adjacency with one or more HVs, underwent removal of at least 3 segments: none of them required HV reconstruction, and no Hospital mortality was seen. Therefore, IOUS allows sparing liver parenchyma without tumor recurrence in most patients with tumors involving HV at their caval confluence, avoiding more extended hepatectomies or HV reconstructions. This approach to complex presentations of liver tumors by the use of IOUS-guidance is a further confirmation of the importance of this tool for accomplishing a safe and effective surgical treatment.
KW - Contrast-enhanced intraoperative ultrasonography
KW - Hepatocellular carcinoma
KW - Intraoperative ultrasonography
KW - Liver cirrhosis
KW - Liver metastases
KW - Liver surgery
KW - Liver tumors
UR - http://www.scopus.com/inward/record.url?scp=39049196089&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=39049196089&partnerID=8YFLogxK
M3 - Article
C2 - 17139962
AN - SCOPUS:39049196089
VL - 77
SP - 323
EP - 328
JO - Annali Italiani di Chirurgia
JF - Annali Italiani di Chirurgia
SN - 0003-469X
IS - 4
ER -