Safe Major Hepatectomy after Preoperative Liver Regeneration

Preopearative PVE, Two-Satage Hepatetomy, ALPPS and Hepatic Vein Deprivation

1st Edition - January 16, 2024
Editors: Yoshihiro Sakamoto, Masatoshi Makuuchi
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 9 9 6 9 8 - 3
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 9 9 6 9 9 - 0

Safe Major Hepatectomy After Preoperative Liver Regeneration: Preoperative PVE, Two-Stage Hepatectomy, ALPPS and Hepatic Vein Deprivation provides both history and recent topics of… Read more

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Safe Major Hepatectomy After Preoperative Liver Regeneration: Preoperative PVE, Two-Stage Hepatectomy, ALPPS and Hepatic Vein Deprivation provides both history and recent topics of major hepatectomy after liver regeneration—as well as the basic background of liver regeneration—allowing liver surgeons, general surgeons, and hepatologists to increase the safety of major hepatectomy in patients suffering from advanced liver disease. This reference provides importance guidance to cutting edge topics, including the molecular mechanism of liver regeneration after preoperative portal vein embolization (PVE), two-stage hepatectomy, associating liver partition and portal vein occlusion for staged hepatectomy (ALPPS) and results of hepatic vein occlusion.

The mortality rate after major hepatectomies is high worldwide and there is a need to establish a strategy for safe major hepatectomies, and hepatectomy after preoperative liver regeneration is a key process to prevent posthepatectomy liver failure (PHLF).

Cover image
Title page
Table of Contents
Copyright
Contributors
Foreword
Preface
Chapter 1. Toward safe major hepatectomy after preoperative liver regeneration
History and development of portal vein embolization
Modifications of portal vein embolization and two-stage hepatectomy
Development of ALPPS
Modifications of ALPPS procedure
Summary
Chapter 2. Hepatic functional deterioration in chronic liver disease
What is the liver function?
Chronic liver disease and liver function impairment
Liver function tests
Integrated systems for the evaluation of liver functional reserve
Summary
Chapter 3. Evaluation of preoperative hepatic functional reserve before major hepatectomy
Introduction
Basic principles in major hepatectomy with a small FLR
Currently used test for evaluating the hepatic functional reserve
Estimation of the hepatic functional reserve considering veno-occlusive areas
Summary
Chapter 4. Major hepatectomy after preoperative liver regeneration—Experience in Tokyo University
Introduction
Indication and techniques
The University of Tokyo experience
Chapter 5. Major hepatectomy after preoperative liver regeneration—Experience in MDACC
Introduction
sFLR versus FLR
Right PVE including segment 4
Liver venous deprivation
Fast-track PVE in two-stage hepatectomy
Chapter 6. Portal venous anatomy and percutaneous preoperative portal vein embolization
Introduction
Portal venous anatomy
Percutaneous preoperative portal vein embolization
Conclusions
Chapter 7. Mechanism of liver segmental hypertrophy after preoperative portal vein embolization and its pathological, volumetric, and functional aspects
Introduction
Mechanisms of liver regeneration following partial hepatectomy and segmental liver hypertrophy after portal vein ligation/embolization
Hemodynamic events that occur immediately after partial hepatectomy and portal vein ligation/embolization
Histological consequences of partial liver resection and portal vein ligation/embolization and the resulting atrophy–hypertrophy complex
Role of the ligated/embolized part of the liver in the atrophy/hypertrophy complex
Degree of hypertrophy of the nonembolized hemiliver after portal vein embolization
Functional aspects of liver regeneration after partial hepatectomy and portal vein ligation/embolization
Several notes on the interpretation of ICG clearance and/or the elimination constant
Chapter 8. Preoperative portal vein embolization and major hepatectomy for perihilar cancer
Introduction
Definition of perihilar cholangiocarcinoma
History of surgical treatment for perihilar cholangiocarcinoma
Portal vein embolization
Nagoya experience
Future plans
Chapter 9. Laparoscopic major hepatectomy after liver regeneration
Introduction
Technique
Conclusion
Chapter 10. ALPPS versus two-stage hepatectomy
Introduction
Classification of staged hepatectomy
ALPPS versus TSH
Paul Brousse experience
Future perspective
Chapter 11. Functional and volumetric regeneration following PVE and ALPPS
Introduction
Liver regeneration after PVE
Liver regeneration after ALPPS
Mechanisms of parenchymal regeneration after PVE or ALPPS
Modalities to assess volumetric and functional liver regeneration
Assessment of liver regeneration after stage-1 in ALPPS
Discussion
Chapter 12. ALPPS for cirrhotic liver
Introduction
Anterior approach versus conventional approach
Complete versus partial split in chronic liver disease
Laparoscopic ALPPS
Oncological outcomes for HCC
Conclusions
Chapter 13. Mini-ALPPS
Introduction
Surgical technique
Discussion
Conclusions
Chapter 14. Modified ALPPS procedures
Introduction
Modified ALPPS to increase the safety and minimize the invasiveness
First stage of partial TIPE ALPPS
Second stage of partial TIPE ALPPS
Summary of initial experience of partial TIPE ALPPS
Modified ALPPS to expand the indication for further fewer FLRV
Rescue ALPPS after failure of PVE
Conclusion
Chapter 15. Major hepatectomy following liver venous deprivation
Introduction
Indication for LVD
Portal vein embolization with hepatic vein embolization
Mechanism of HVE
Technique of HVE
Procedure-related morbidity
Volumetric analysis
Intra- and postoperative outcomes
Conclusion
Index

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