| Theme |
The New Guideline for Liver Cancer Treatment |
| Title |
Liver Resection |
| Author |
Shoji Kubo |
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine |
| Author |
Shigekazu Takemura |
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine |
| Author |
Shogo Tanaka |
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine |
| Author |
Hiroji Shinkawa |
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine |
| [ Summary ] |
The indications and the extent of liver resection are determined based on the tumor stage and liver functional reserve. The presence of less than three tumors is a good indication for liver resection. When the liver function is adequate and curative resection is possible, surgery is indicated for tumors with vascular (portal and hepatic veins, and bile duct) invasion. To evaluate the liver function, the indocyanine green retention test is usually performed. Intermittently stopping the inflow to the liver and decreasing the central vein pressure can reduce the degree of bleeding during liver parenchymal dissection. The use of abdominal drainage is not routinely carried out for elective hepatic resection. A partial resection or lateral segmentectomy is indicated for solitary tumors measuring 5 cm or less in diameter, which are located in the antero-inferior area (segment 2-6) of the liver. Sufficient experience in performing laparoscopic procedures and accurate evaluation of the difficulty level associated with laparoscopic liver resection are necessary to perform extended laparoscopic liver resection safely. |