
Safe Major Hepatectomy after Preoperative Liver Regeneration
Preopearative PVE, Two-Satage Hepatetomy, ALPPS and Hepatic Vein Deprivation
- 1st Edition - January 16, 2024
- Imprint: Academic Press
- 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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Request a sales quoteSafe 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).
- Covers various methods of accelerating regeneration of the hemiliver volume, such as portal vein embolization (PVE), two-stage hepatectomy, associating liver partition and portal vein occlusion for staged hepatectomy (ALPPS) and hepatic vein occlusion
- Provides guidance to increase future liver remnant (FLR) volume as the key to avoid posthepatectomy liver failure and succeeding patients’ death after major hepatectomy
- Helps guide the optimal way to program major surgery with decreased risk of liver failure
Liver surgeons, general surgeons, hepatologist, basic researchers in regenerative medicine
- 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
- Edition: 1
- Published: January 16, 2024
- Imprint: Academic Press
- No. of pages: 300
- Language: English
- Paperback ISBN: 9780323996983
- eBook ISBN: 9780323996990
YS
Yoshihiro Sakamoto
Professor Yoshihiro Sakamoto has performed more than 900 hepatectomies and has published more than 300 papers on hepato-biliary-pancreatic surgeries. He is well-versed in liver regeneration and portal vein embolization, contributed on papers on major hepatectomies with portal vein embolization (Ann Surg 2006, Hepato-Gastroenterol 2010, Surgery 2013, Ann Surg Oncol 2017), and also developed modified procedure of ALPPS (Ann Surg 2016 & 2018).
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Masatoshi Makuuchi
Professor Masatoshi Makuuchi has first introduced preoperative portal vein embolization (PVE) for resection of hilar cholangiocarcinoma in 1982. Since then, preoperative PVE has been widely accepted as an ancillary procedure before major hepatectomy, to prevent posthepatectomy liver failure (PHLF). The original paper, “Preoperative PVE to increase the safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report,” published in Surgery 1990, has been cited over 1400 times.