Ultrasonography During Liver Surgery

  • Guido Torzilli
Part of the Methods of Cancer Diagnosis, Therapy and Prognosis book series (HAYAT, volume 5)

Since the late 1980s, it has been evident that hepatic surgery performed using the conventional approach, carries a very high risk for patients' survivals due to the high rate of postoperative liver failure (Lin, 1979). In particular, the coexistence of liver cirrhosis in most cases with hepato-cellular carcinoma (HCC) has a considerable adverse effect on the surgical results with 6% postoperative mortality, which is not negligible (Liu et al., 2004). For this reason and for the broadening of ultrasound-guided percutaneous therapies, the surgical treatment of HCC has loosen its role of first choice treatment. Furthermore, the good results with interstitial therapies in the treatment of HCC has induced the extension of their use also for those patients with colorectal cancer (CRC) liver metas-tases (Solbiati et al., 2001). However, the imaging techniques have been introduced also as aids for surgeons in performing liver resection. In fact, at the end of the 1970s, intraoperative ultrasonography (IOUS) in hepatic surgery in the case of liver cirrhosis started (Makuuchi et al., 1980, 1998). Now, liver resections can be carried out with no mortality even if cirrhosis is associated (Torzilli et al., 1999a), combining the needs for oncological radicality and liver parenchyma sparing, and this goal is mainly achievable because of IOUS (Torzilli et al., 2005a, 2006). Recently, the demonstration of feasibility and efficacy of contrast-enhanced ultrasonography performed intraoperatively (CE-IOUS) has furthermore stressed the relevance of IOUS guidance during liver surgery (Torzilli et al., 2004a, b, 2005b).


Liver Resection Hepatic Vein Liver Surgery Cirrhotic Liver Major Hepatectomy 
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Copyright information

© Springer Science + Business Media B.V. 2009

Authors and Affiliations

  • Guido Torzilli
    • 1
  1. 1.Chief Liver Surgery Unit, Department of General Surgery 3, Instituto Clinico Humanitas IRCCS, Faculty of MedicineUniversity of MilanRozzano-MilanoItaly

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