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Review
. 2016 Nov;6(1):51-58.
doi: 10.1159/000449345. Epub 2016 Nov 29.

Current Technical Issues for Surgery of Primary Liver Cancer

Yoshikuni Kawaguchi  1 , Goro Honda  2 , Itaru Endo  3 , Daniel Cherqui  4 , Norihiro Kokudo  1
Affiliations
Review

Current Technical Issues for Surgery of Primary Liver Cancer

Yoshikuni Kawaguchi et al. Liver Cancer. 2016 Nov.

Abstract

Primary liver cancer is the fifth most common cancer worldwide. Apart from liver transplantation, surgical resection has been accepted as the effective local treatment for hepatocellular carcinoma (HCC), one of the most common primary liver cancers. Recent technological innovations including navigation technology and intraoperative real-time fluorescence guidance have been utilized for liver resections in clinical practice. With respect to liver resection techniques, the laparoscopic approach has been increasingly gaining popularity as one of the minimally-invasive treatments of HCC. These technological innovations and technical advancements are expected to further improve the safety and efficacy of liver resections.

Keywords: Fluorescence imaging technique; Hepatocellular carcinoma; Intrahepatic cholangiocellular carcinoma; Laparoscopic liver resection; Three-dimensional computed tomography.

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Figures

Fig. 1
Fig. 1
Variations of the right hepatic artery (a and b). Drainage area of the MHV is visualized (c). Part of posterior segment is drained to the MHV (d).
Fig. 2
Fig. 2
Fluorescence imaging. a Gross appearance of the liver surface after dye injection (left) and corresponding fluorescence image (right). b Tumor location and planned resection line (white dotted line) were demonstrated on preoperative 3DCT. The remnant liver volume was estimated to be 429 ml, consisting of non-veno-occlusive regions drained by the right hepatic vein (246 ml) and of veno-occlusive regions resulting from the division of the MHV tributaries draining segment 5 (V5) (163 ml) and segment 8 (V8) (30 ml). c Intraoperative gross appearance following extended left hepatectomy with excision and reconstruction of the MHV tributaries. d Fluorescence imaging following intravenous injection of ICG reveals the demarcation between the region drained by the reconstructed vein (arrow) and that with venous occlusion (arrowhead) (From left to right, gross appearance and fluorescence image 240 seconds after the injection).
See this image and copyright information in PMC

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