Extreme Hepatic Surgery and Other Strategies

1. Front Matter

   Pages i-xix

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2. Global Patient Evaluation and Oncological Assessment

   1. Front Matter

      Pages 1-1

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   2. Liver Surgical Anatomy

      • Henri Bismuth, Ruben Balzarotti, Pietro Majno

      Pages 3-18

   3. Resectability Assessment with Diagnostic Imaging

      • Anthe Sterkenburg, Jan Müller, Marc-André Weber, Peter Schemmer

      Pages 19-30

   4. Preoperative Evaluation of Liver Function

      • Kasia P. Cieslak, Roelof J. Bennink, Thomas M. van Gulik

      Pages 31-52

   5. Imaging-Based Preoperative Planning

      • Jens Mittler, Roman Klöckner, Hauke Lang

      Pages 53-64

   6. Choosing the Best Strategy

      • Victoria Ardiles, Eduardo de Santibañes

      Pages 65-75

3. Non-operative Multimodal Therapies

   1. Front Matter

      Pages 77-77

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   2. Conversion and Neoadjuvant Therapies

      • Jorge Pablo Grondona

      Pages 79-118

   3. Portal Vein Embolization

      • Kristoffer Watten Brudvik, Jean-Nicolas Vauthey

      Pages 119-130

   4. Intra-Arterial Chemotherapy

      • Rohit Chandwani, Michael I. D’Angelica

      Pages 131-142

   5. Radioembolization

      • Ricardo Garcia-Mónaco

      Pages 143-155

4. Surgical Strategies

   1. Front Matter

      Pages 157-157

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   2. Anesthetic Management

      • Francisco Carlos Bonofiglio

      Pages 159-175

   3. Intraoperative Evaluation of Resectability

      • Guido Torzilli, Guido Costa, Fabio Procopio, Luca Viganó, Matteo Donadon

      Pages 177-193

   4. Vascular Control in Major Hepatic Resections

      • Ulrich Bork, Nuh N. Rahbari, Christoph Reissfelder, Sören Torge Mees, Jürgen Weitz

      Pages 195-202

   5. Two-Stage Liver Surgery

      • Katsunori Imai, René Adam

      Pages 203-215

   6. Two-Stage Liver Surgery with Portal Vein Occlusion

      • Michael Linecker, Henrik Petrowsky, Pierre-Alain Clavien

      Pages 217-230

   7. Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS)

      • Fernando A. Alvarez, Eduardo de Santibañes

      Pages 231-247

   8. Parenchymal-Sparing Liver Resections

      • Alessandro Ferrero, Roberto Lo Tesoriere, Serena Langella, Nadia Russolillo

      Pages 249-264

This book describes the diagnoses; staging and management of patients with colorectal liver metastases initially considered unresectable and portrays the different strategies to increase resectability along with their tactics and tricks. Colorectal carcinoma is the third most commonly diagnosed cancer in the world and according to recent cancer statistics around 1.23 million patients are diagnosed each year. Of these patients, approximately 50% will develop liver metastases during the course of their disease and around 15-25% are found to have stage IV disease at diagnosis. Liver resection has been recognized as the treatment of choice for these patients, offering overall 5-year survival rates of up to 50-60% and the only hope for cure. However, at diagnosis only 10-20% of these patients are possibly amenable to surgical resection with curative intent. The possibility to achieve an R0 resection is many times limited by the amount and quality of the future liver remnant (FLR), being posthepatectomy liver failure (PHLF) the most feared and severe complication after major liver resections. With the years, diverse strategies have been developed with the intention to increase resectability by increasing the future liver remnant and/or reducing tumor size, e.g. ALPPS. Along with these techniques, associated surgeries are developed including multivisceral resections, which broadens even more the resectability for patients.

• ALPPS
• Colorectal liver metastasis
• Ex situ ressection
• Liver oncology
• Liver surgery
• surgical oncology
• abdominal surgery
• hepatology

“This book is devoted to difficult problems in hepatic resection for colorectal metastatic disease. It is an attempt to bring together, in a series of chapters, a lot of information about the current status of liver resection (including transplantation) and apply it to this common problem. … It is most likely to be of use to specialists, who may find in its pages additional information or guidance on specific complex problems and techniques.” (Carol Scott-Conner, Doody's Book Reviews, October, 2017)

• General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

  Eduardo de Santibañes, Victoria Ardiles, Fernando A. Alvarez, Virginia Cano Busnelli, Martin de Santibañes

Eduardo de Santibañes MD, PhD, Full Professor of Surgery at University of Buenos Aires (2005-2013) and Full Professor and Head of the Surgery Department (Hospital Italiano, 2008-2012). Chairman of the General Surgery Service since 2005, one of the most active Surgical services of Latin America, having performed over 7,400 procedures in 2013. Chairman of the Liver Transplant Unit of the Hospital Italiano since 1985. Former Chairman of the World Congress of the Hepato Pancreato Biliary Association; Argentine Academy of Surgery, Argentine Association of Surgery, Argentine Liver Transplant Society and the Argentine Chapter of the International Hepato Pancreato Biliary Association. Honorary Member of the American Surgical Association, German Surgical Society, European Surgical Association, among others. Victoria Ardiles MD, PhD, General Surgeon (University of Buenos Aires), Laparoscopic Surgeon (Argentine Association of Surgery) and HPB surgeon (Hospital Italiano de Buenos Aires). Professor of Surgery at University of Buenos Aires and Associated Professor and Coordinator of the Surgery Department of the University School of Medicine, Hospital Italiano. Associated staff of the General Surgery Service, member of the Liver Transplant Unit and General coordinator of the Department of Surgery, Hospital Italiano de Buenos Aires. Martin de Santibañes Surgeon at Liver Transplantation and HPB Unit, Hospital Italiano de Buenos Aires. Assistant Professor Hospital Italiano de Buenos Aires School of Medicine. General Surgery Residency Co-Director, Hospital Italiano de Buenos Aires. Fernando Alvarez MD. Fellowship of HPB Surgery and Liver Transplant at the Italian Hospital of Buenos Aires (2013-2014). Received the "Eduardo F. Beláustegui Award" from the Argentine Surgical Association (2008) and the “Annual Award" from the Argentine Academy of Surgery (2014). Virginia Cano Busnelli MD with Residency training at Italian Hospital of Buenos Aires.

Policies and ethics