| Theme |
Clinical Gastroenterology -- Past 30 Years and Future Vision |
| Title |
Progress over the Past 30 Years and Foresight Regarding Hepatic Surgery |
| Author |
Suguru Yamashita |
Hepato‒Biliary‒Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo |
| Author |
Kiyoshi Hasegawa |
Hepato‒Biliary‒Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo |
| Author |
Norihiro Kokudo |
Hepato‒Biliary‒Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo |
| [ Summary ] |
New methods introduced during the 1980s including intraoperative ultrasonography, anatomical subsegmentectomy, hepatic vascular occlusion, and portal vein embolization have been safer and even curative in the patients who suffer from hepatocellular carcinoma associated with liver cirrhosis. Thereby, the short‒ and long‒term postsurgical outcomes in these patients have improved markedly. Liver transplantation started in Japan in the 1990s. The unique techniques involved in liver transplantation, such as evaluation of venous congestion area and hepatic venous reconstruction, have accelerated the progress made in hepatic surgery. Laparoscopic hepatic resection has emerged as a minimally invasive surgical technique, and Japanese National Health Insurance coverage for laparoscopic limited resection and left lateral segmentectomy was initiated in April 2010. The future promises safer and more accurate liver resection through the progress of pre‒and intra‒operative navigation techniques and technological developments in the field of liver transplantation. |