BOOK
Technical Aspects of Oncological Hepatic Surgery, An Issue of Surgical Clinics of North America, E-Book
(2016)
Additional Information
Book Details
Abstract
This issue of Surgical Clinics of North America, guest edited by Dr. Clifford Cho, is devoted to Technical Aspects of Oncological Hepatic Surgery. He has assembled expert authors to review the following topics: Determination of Resectability; Radiographic Characterization of Hepatic Tumors; Chemotherapy-associated Hepatotoxicity; Preoperative Assessment and Optimization of the Future Liver Remnant; Anatomy of Hepatic Resectional Surgery; Resection of Gallbladder Carcinoma; Resection of Hilar Cholangiocarcinoma; Technical Aspects of Orthotopic Liver Transplantation for Hepatocellular Carcinoma; Hemostasis and Hepatic Surgery; Minimally Invasive Hepatic Surgery; Hepatic Tumor Ablation; Hepatic Transarterial Therapies; Hepatic Perfusion Therapy; Hepatic Artery Infusional Chemotherapy; Ex vivo Hepatic Surgery, and more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Technical Aspects of Oncologic Hepatic Surgery | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword\r | vii | ||
| Preface: Oncologic Hepatic Surgery: Appreciating the Landscape\r | vii | ||
| Determination of Resectability\r | vii | ||
| Anatomy of Hepatic Resectional Surgery\r | vii | ||
| Preoperative Assessment and Optimization of the Future Liver Remnant\r | vii | ||
| Chemotherapy-Associated Hepatotoxicities\r | viii | ||
| Hemostasis and Hepatic Surgery\r | viii | ||
| Technical Aspects of Gallbladder Cancer Surgery\r | viii | ||
| Resection of Perihilar Cholangiocarcinoma\r | viii | ||
| Technical Aspects of Orthotopic Liver Transplantation for Hepatocellular Carcinoma\r | viii | ||
| Vascular Reconstruction in Hepatic Malignancy\r | ix | ||
| Minimally Invasive Hepatic Surgery\r | ix | ||
| Hepatic Tumor Ablation\r | ix | ||
| Hepatic Artery Infusional Chemotherapy\r | ix | ||
| Hepatic Perfusion Therapy\r | x | ||
| Transarterial Therapy for Colorectal Liver Metastases\r | x | ||
| SURGICAL CLINICS\rOF NORTH AMERICA\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| June 2016 | xi | ||
| August 2016 | xi | ||
| October 2016 | xi | ||
| RECENT ISSUES | xi | ||
| February 2016 | xi | ||
| December 2015 | xi | ||
| October 2015 | xi | ||
| August 2015 | xi | ||
| Foreword | xiii | ||
| Preface: Oncologic Hepatic Surgery: Appreciating the Landscape\r | xv | ||
| Erratum | xvii | ||
| Determination of Resectability | 163 | ||
| Key points | 163 | ||
| INTRODUCTION | 163 | ||
| ONCOLOGIC APPROPRIATENESS | 164 | ||
| Preoperative Evaluation | 164 | ||
| Tumor-Specific Factors | 164 | ||
| Hepatocellular carcinoma | 164 | ||
| Intrahepatic cholangiocarcinoma | 166 | ||
| Colorectal liver metastases | 167 | ||
| HOST CONDITION | 168 | ||
| TECHNICAL RESECTABILITY | 168 | ||
| Vascular Inflow/Outflow and Biliary Drainage | 168 | ||
| Future Liver Remnant Quantity and Quality | 169 | ||
| Volumetric assessment of the liver | 169 | ||
| Functional assessment of the liver | 170 | ||
| Increasing Technical Resectability | 171 | ||
| Portal vein embolization | 171 | ||
| Two-stage hepatectomy | 172 | ||
| Associating liver partition with portal vein ligation for staged hepatectomy | 172 | ||
| SUMMARY | 172 | ||
| REFERENCES | 172 | ||
| Anatomy of Hepatic Resectional Surgery | 183 | ||
| Key points | 183 | ||
| LIVER ANATOMY | 183 | ||
| Historical Definitions | 183 | ||
| Vascular Anatomy | 184 | ||
| Functional Surgical Anatomy | 185 | ||
| Couinaud segments | 185 | ||
| Brisbane terminology | 187 | ||
| Variations in Anatomy | 187 | ||
| USING ANATOMY TO GUIDE RESECTIONAL SURGERY | 190 | ||
| Minimizing Operative Morbidity | 190 | ||
| Parenchymal preservation without oncologic compromise | 190 | ||
| Minimizing blood loss | 191 | ||
| GENERAL ANATOMIC CONCEPTS AND PITFALLS IN SPECIFIC RESECTIONS | 191 | ||
| Right Hepatectomy | 191 | ||
| Right Posterior Sectorectomy | 192 | ||
| Right Anterior Sectorectomy | 192 | ||
| Central Hepatectomy | 193 | ||
| Left Hepatectomy | 193 | ||
| Left Lateral Sectionectomy | 194 | ||
| Wedge/Atypical/Single Segment Resections | 194 | ||
| REFERENCES | 195 | ||
| Preoperative Assessment and Optimization of the Future Liver Remnant | 197 | ||
| Key points | 197 | ||
| MEASUREMENT OF PREOPERATIVE LIVER VOLUME AND FUNCTION | 197 | ||
| INDICATIONS FOR FUNCTIONAL LIVER REMNANT AUGMENTATION | 198 | ||
| PORTAL VENOUS EMBOLIZATION TECHNIQUES | 200 | ||
| POSTPROCEDURAL COMPLICATIONS | 201 | ||
| ASSESSMENT OF HYPERTROPHY AFTER PORTAL VEIN EMBOLIZATION | 203 | ||
| SUMMARY | 204 | ||
| REFERENCES | 204 | ||
| Chemotherapy-Associated Hepatotoxicities | 207 | ||
| Key points | 207 | ||
| OVERVIEW | 207 | ||
| CATEGORIES OF HEPATOTOXICITY | 208 | ||
| SCOPE OF THE PROBLEM | 208 | ||
| MECHANISMS | 210 | ||
| IDENTIFICATION OF LIVER INJURY | 210 | ||
| IMPACT OF CHEMOTHERAPY-ASSOCIATED HEPATOTOXICITIES | 212 | ||
| MANAGEMENT OF CHEMOTHERAPY-ASSOCIATED HEPATOTOXICITIES | 214 | ||
| SUMMARY | 215 | ||
| REFERENCES | 215 | ||
| Hemostasis and Hepatic Surgery | 219 | ||
| Key points | 219 | ||
| INTRODUCTION | 219 | ||
| ALLOGENEIC RED BLOOD CELL TRANSFUSION IN HEPATIC RESECTION | 220 | ||
| NONOPERATIVE TECHNIQUES TO MINIMIZE BLOOD LOSS DURING HEPATIC RESECTION | 220 | ||
| Low Central Venous Pressure Anesthesia | 220 | ||
| Autotransfusion Strategies | 221 | ||
| Pharmacologic Strategies to Minimize Bleeding | 222 | ||
| OPERATIVE STRATEGIES TO MINIMIZE BLOOD LOSS | 222 | ||
| Vascular Occlusion Techniques | 222 | ||
| Parenchymal Transection | 223 | ||
| Management of the Remnant Surface | 225 | ||
| SUMMARY | 225 | ||
| REFERENCES | 226 | ||
| Technical Aspects of Gallbladder Cancer Surgery | 229 | ||
| Key points | 229 | ||
| INTRODUCTION | 229 | ||
| EPIDEMIOLOGY | 230 | ||
| CAUSE AND PATHOGENESIS | 230 | ||
| TNM STAGING SYSTEM | 231 | ||
| INCIDENTAL GALLBLADDER CARCINOMA | 231 | ||
| Preoperative Work-up | 232 | ||
| Surgical Restaging of Incidental Postcholecystectomy Gallbladder Cancer | 233 | ||
| Timing of Radical Reresection | 233 | ||
| Surgical Treatment of Early (T1 and T2) Incidental Gallbladder Cancer | 233 | ||
| Surgical Treatment of Advanced (T3 and T4) Incidental Gallbladder Cancer | 234 | ||
| Surgical Treatment of the Extrahepatic Bile Duct | 235 | ||
| Surgical Treatment of the Hepatic Margin and Extended Liver Resections | 235 | ||
| Surgical Treatment of Lymph Nodes | 236 | ||
| Surgical Resection of Previous Port Sites | 237 | ||
| Gallbladder Perforation During Cases of Incidental Gallbladder Cancer | 237 | ||
| NONINCIDENTAL GALLBLADDER CARCINOMA | 237 | ||
| Jaundice as a Presenting Sign | 237 | ||
| Preoperative Work-up | 238 | ||
| Preoperative Tissue Diagnosis | 238 | ||
| Extent of Surgical Resection of Nonincidental Gallbladder Cancer | 238 | ||
| MINIMALLY INVASIVE RESECTION OF GALLBLADDER CANCER | 239 | ||
| SYSTEMIC THERAPY | 239 | ||
| LONG-TERM OUTCOMES | 241 | ||
| REFERENCES | 241 | ||
| Resection of Perihilar Cholangiocarcinoma | 247 | ||
| Key points | 247 | ||
| INTRODUCTION | 247 | ||
| PREOPERATIVE STAGING AND MANAGEMENT | 248 | ||
| Classification | 248 | ||
| Preoperative Staging | 248 | ||
| Anatomy | 249 | ||
| Resectability | 249 | ||
| Preoperative Biliary Drainage | 252 | ||
| Portal Vein Embolization | 252 | ||
| EXTENT OF LIVER RESECTION | 253 | ||
| Left or Right Hemihepatectomy | 253 | ||
| Trisectionectomy | 254 | ||
| Caudate Lobectomy | 255 | ||
| Extensive Resections | 256 | ||
| Central Hepatectomy | 257 | ||
| Liver Transplantation | 257 | ||
| INTRAOPERATIVE DECISION MAKING | 258 | ||
| Staging Laparoscopy | 258 | ||
| Frozen Sections | 258 | ||
| Intraoperative Assessment of Resectability | 259 | ||
| Portal Vein Resection and Reconstruction | 259 | ||
| Lymphadenectomy | 259 | ||
| OUTCOMES OF CURATIVE-INTENT RESECTION FOR PERIHILAR CHOLANGIOCARCINOMA | 260 | ||
| SUMMARY | 260 | ||
| ACKNOWLEDGMENTS | 261 | ||
| REFERENCES | 261 | ||
| Appendix 1. APPENDIX 1 METHODS FOR LITERATURE REVIEW SECTIONS | 266 | ||
| Appendix 2. APPENDIX 2 SUPPLEMENTARY FIGURES | 266 | ||
| Technical Aspects of Orthotopic Liver Transplantation for Hepatocellular Carcinoma | 269 | ||
| Key points | 269 | ||
| INTRODUCTION | 270 | ||
| PATIENT SELECTION | 270 | ||
| SURGICAL TECHNIQUE | 271 | ||
| Preoperative Planning | 271 | ||
| SURGICAL APPROACH | 272 | ||
| Recipient Hepatectomy | 272 | ||
| Porta Hepatis Dissection | 273 | ||
| Inferior Vena Cava Dissection | 274 | ||
| IMPLANTATION OF THE DONOR LIVER | 275 | ||
| Inferior Vena Cava Anastomosis | 275 | ||
| Portal Venous Anastomosis | 276 | ||
| Hepatic Arterial Anastomosis | 278 | ||
| Biliary Anastomosis | 279 | ||
| SUMMARY | 280 | ||
| REFERENCES | 280 | ||
| Vascular Reconstruction in Hepatic Malignancy | 283 | ||
| Key points | 283 | ||
| INTRODUCTION | 283 | ||
| PORTAL VEIN RESECTION | 284 | ||
| HEPATIC ARTERY RESECTION | 286 | ||
| HEPATIC VEIN/INFERIOR VENA CAVA RESECTION | 288 | ||
| SUMMARY | 294 | ||
| REFERENCES | 294 | ||
| Minimally Invasive Hepatic Surgery | 299 | ||
| Key points | 299 | ||
| INTRODUCTION | 299 | ||
| PREOPERATIVE PLANNING | 301 | ||
| SURGICAL TECHNIQUE | 301 | ||
| Minimally Invasive Right Hepatic Lobectomy | 302 | ||
| Creation of pneumoperitoneum and port placement | 302 | ||
| Dissection of the ligamentous attachments and mobilization of the right hemiliver | 302 | ||
| Intraoperative ultrasound | 304 | ||
| Dissection of the retrohepatic vena cava and ligation of the short hepatic veins | 304 | ||
| Cholecystectomy and portal dissection | 304 | ||
| Outflow dissection and ligation of the right hepatic vein | 304 | ||
| Parenchymal transection | 305 | ||
| Specimen retrieval and evaluation of the cut surface | 305 | ||
| Minimally Invasive Left Hepatic Lobectomy | 305 | ||
| Creation of pneumoperitoneum and port placement | 305 | ||
| Mobilization of the left hemiliver and intraoperative ultrasound | 305 | ||
| Dissection of the gastrohepatic ligament and portal dissection | 306 | ||
| Outflow dissection | 307 | ||
| Parenchymal transection | 307 | ||
| Inspection of the cut surface and specimen retrieval | 307 | ||
| Minimally Invasive Left Lateral Sectionectomy | 308 | ||
| Establishment of pneumoperitoneum and port placement | 308 | ||
| Mobilization of the left lateral section and intraoperative ultrasound | 308 | ||
| Parenchymal transection | 308 | ||
| Inspection of the cut surface and specimen retrieval | 308 | ||
| POSTOPERATIVE CARE | 309 | ||
| RESULTS | 309 | ||
| SUMMARY | 311 | ||
| REFERENCES | 311 | ||
| Hepatic Tumor Ablation | 315 | ||
| Key points | 315 | ||
| INTRODUCTION | 315 | ||
| PREPROCEDURE PLANNING | 316 | ||
| Patient Selection | 316 | ||
| Hepatocellular carcinoma | 316 | ||
| Metastatic disease | 316 | ||
| Benign disease | 317 | ||
| Ablation Modality Selection | 317 | ||
| Chemical | 317 | ||
| Radiofrequency | 317 | ||
| Microwave | 317 | ||
| Cryoablation | 318 | ||
| Irreversible electroporation | 319 | ||
| Technical Considerations | 319 | ||
| Imaging | 319 | ||
| Anesthesia considerations | 319 | ||
| PREPARATION AND PATIENT POSITIONING | 320 | ||
| PROCEDURAL APPROACH | 320 | ||
| Adjunctive Maneuvers (if Necessary) | 320 | ||
| Combination with intra-arterial therapies | 320 | ||
| Hydrodissection | 320 | ||
| Needle displacement | 322 | ||
| Wedge technique | 322 | ||
| Ablation Procedure | 322 | ||
| IMMEDIATE POSTPROCEDURAL CARE | 326 | ||
| REHABILITATION AND RECOVERY | 326 | ||
| Imaging Follow-up | 326 | ||
| CLINICAL RESULTS IN THE LITERATURE | 328 | ||
| Hepatocellular Carcinoma | 328 | ||
| Metastatic Colorectal Cancer | 329 | ||
| Other Tumors | 329 | ||
| POTENTIAL COMPLICATIONS/MANAGEMENT | 329 | ||
| Hemorrhage | 329 | ||
| Abscess | 329 | ||
| Postablation Syndrome | 329 | ||
| Tumor Seeding | 335 | ||
| Pneumothorax | 335 | ||
| SUMMARY | 336 | ||
| SUPPLEMENTARY DATA | 336 | ||
| REFERENCES | 336 | ||
| Hepatic Artery Infusional Chemotherapy | 341 | ||
| Key points | 341 | ||
| INTRODUCTION | 341 | ||
| TECHNIQUE | 343 | ||
| Preoperative Evaluation | 343 | ||
| Pump Preparation | 343 | ||
| Operative Technique | 344 | ||
| Postoperative Care and Imaging | 347 | ||
| MANAGEMENT OF CHEMOTHERAPY | 347 | ||
| MANAGEMENT OF TECHNICAL COMPLICATIONS | 349 | ||
| Pump Pocket Complications | 349 | ||
| Vascular and Catheter Complications | 350 | ||
| CLINICAL OUTCOMES | 350 | ||
| Adjuvant Hepatic Artery Infusional Therapy for Resectable Colorectal Hepatic Metastases | 350 | ||
| Hepatic Artery Infusional Therapy for Unresectable Colorectal Hepatic Metastases | 351 | ||
| Primary Liver Tumors and Hepatic Artery Infusional Therapy | 352 | ||
| SUMMARY | 352 | ||
| REFERENCES | 352 | ||
| Hepatic Perfusion Therapy | 357 | ||
| Key points | 357 | ||
| INTRODUCTION | 357 | ||
| SURGICAL TECHNIQUE AND SELECTION OF PATIENTS | 357 | ||
| Selection of Patients | 358 | ||
| Technical Details of an Isolated Hepatic Pesrfusion | 359 | ||
| Variants of the Perfusion | 360 | ||
| Percutaneous Hepatic Perfusion (Chemosaturation) | 361 | ||
| LIVER PERFUSIONAL CHEMOTHERAPY | 361 | ||
| OCULAR MELANOMA | 361 | ||
| HEPATOCELLULAR CARCINOMA | 363 | ||
| LIVER METASTASES FROM COLORECTAL CANCER | 363 | ||
| SUMMARY | 366 | ||
| SUPPLEMENTARY DATA | 366 | ||
| REFERENCES | 366 | ||
| Transarterial Therapy for Colorectal Liver Metastases | 369 | ||
| Key points | 369 | ||
| BACKGROUND | 369 | ||
| TRANSARTERIAL HEPATIC THERAPY | 370 | ||
| Rationale | 370 | ||
| Reported Techniques | 371 | ||
| HEPATIC ARTERIAL DRUG-ELUTING BEAD THERAPY | 373 | ||
| Rationale | 373 | ||
| Technique | 373 | ||
| Technical Success, Complications, and Adverse Effects | 378 | ||
| Oncologic Outcomes | 379 | ||
| Hepatic Arterial Therapy in Combination with Systemic Chemotherapy and/or Surgery | 379 | ||
| YTTRIUM-90 RADIOEMBOLIZATION | 381 | ||
| Rationale and Patient Selection | 381 | ||
| Treatment and Toxicity | 383 | ||
| Efficacy and Response Evaluation | 383 | ||
| Concomitant Use with Systemic Chemotherapy, Surgery | 384 | ||
| SUMMARY | 384 | ||
| REFERENCES | 385 | ||
| Index | 393 |