Allotransplantation, defined as the transfer of tissues between genetically nonidentical individuals, has evolved into a highly successful therapy for end-stage organ failure in the modern era. However, unless some modification of the recipient immune system is made, transplanted organs are…
Introduction Adequate oncologic margins and enough future liver remnant (FLR) with proper inflow and outflow are the pillars for any successful strategy in liver surgery (see Chapter 101 ). Given that tumor-free margin remains the mainstream of any oncologic surgery,…
The associating liver partition and portal vein (PV) ligation for staged hepatectomy (ALPPS) procedure is a modification of the two-staged liver resection combining two established surgical techniques: right portal vein ligation (PVL) and in situ splitting of the liver (ISS).…
Introduction Portal vein embolization (PVE) is the most common portal flow modulation procedure performed preoperatively to reduce the risk of extensive liver resection in patients with a small anticipated future liver remnant (FLR). PVE redirects portal blood flow to the…
Overview Segment-oriented hepatectomy is defined as the removal of one or more of the eight anatomic segments of the liver. The techniques of segment-oriented anatomic liver resection are based on the pioneering work of Claude Couinaud, who identified intrahepatic anatomy…
Introduction Advances in patient selection, surgical technique, and perioperative management have improved the outcomes of patients undergoing hepatic resection in recent years. As a result, the utilization of liver resection for patients with both benign and malignant disease has increased…
Introduction A wide variety of diseases affect the liver that can potentially be addressed with hepatectomy. They range from benign and asymptomatic, as in the case of simple liver cysts (see Chapter 88 ), to premalignant (biliary cystadenomas) and malignant.…
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Each year, isolated hepatic metastases from a variety of primary malignancies pose a significant clinical dilemma for tens of thousands of patients (see Chapters 90 , 91 , and 92 ). For a small percentage of patients, surgical resection or…
Overview Hepatocellular carcinoma (HCC) represents a challenging malignancy of global importance (see Chapter 89 ). It is the fifth most common solid tumor in terms of incidence and the third leading cause of cancer-related death worldwide. Its incidence mirrors that…