Ultrasound-guided liver resections for hepatocellular carcinoma

Guido Torzilli, Piera Leoni, Adele Gendarini, Fabrizio Calliada, Natale Olivari, Masatoshi Makuuchi

Research output: Contribution to journalArticle

Abstract

Imaging-guided interventional procedures have modified the approach to hepatocellular carcinoma including the surgical one. In fact, liver resections can be carried out with no mortality even if cirrhosis is associated, combining the needs for oncological radicality and liver parenchyma sparing mainly because of the extensive use of intraoperative ultrasonography either for tumor staging or resection-guidance. The aid of intraoperative ultrasonography is therefore optimizing the balance between the oncological radicality and the sparing of the highest amount of functioning liver parenchyma. Intraoperative ultrasonography allows the accomplishment of anatomical resections otherwise not possible such as the systematic segmentectomy. This is of crucial importance if taking into account that anatomical resections seem able to provide better prognosis than the non-anatomical one. However, if non-anatomical resection is carried out intraoperative ultrasonography guidance allows a better tumor clearance. Precise definition of hepatic vein anatomy and association with color Doppler enables hepatectomies otherwise not possible, expanding the indication at surgical resection. In conclusion, we can affirm that liver resection is an imaging-guided procedure and as every interventional imaging-guided procedure, its features are the highest therapeutic efficacy combined with the minimal invasiveness. Then, with the intraoperative ultrasonography guidance liver resection remains the treatment of choice of hepatocellular carcinoma.

Original languageEnglish
Pages (from-to)21-27
Number of pages7
JournalHepato-Gastroenterology
Volume49
Issue number43
Publication statusPublished - 2002

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Keywords

  • Hepatocellular carcinoma diagnosis
  • Hepatocellular carcinoma therapy
  • Intraoperative ultrasonography
  • Liver cirrhosis
  • Liver resection

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Torzilli, G., Leoni, P., Gendarini, A., Calliada, F., Olivari, N., & Makuuchi, M. (2002). Ultrasound-guided liver resections for hepatocellular carcinoma. Hepato-Gastroenterology, 49(43), 21-27.