Transileocolic portal vein embolisation. Embolisation of Right Hepatic Artery Arteriography of Right...

Transileocolic portal vein embolisation

Embolisation of Right Hepatic Artery

Arteriography of Right Hepatic Artery

Spiral embolisation of Right Hepatic Artery

Liver resection Operative approach

Discussion:

Anatomical vs.

Nonanatomical resection

Operative technique – anatomical resection

Liver resection nomenclature based on Couinaud’s classification

Right hepatectomyRight hepatectomy

Anatomical liver resection

Operative technique – anatomical resection

Advantage:Relatively simple operation technique - less bleeding, less postoperative bile leeks; Survival benefit (some studies):

5 years survival 37% vs. 20%;Scheele J., Stangl R. et al; World J Surg, 19:59-71,1995

Possibility to increase margin clearenceSolitary lesion > 4 cm had markedly improved outcomes following anatomical resections;Registry of hepatic metastases, Surgery 103:278-288, 1988

Disadvantage:Risk of hepatic failure ( fatty liver, cirrhosis);Not suitable for multiple lesions especially in both lobes