Liver tissue sparing resection using a novel planning tool

Pianka, Frank; Baumhauer, Matthias; Stein, Daniel; Radeleff, Boris; Schmied, Bruno M.; Meinzer, Hans Peter; Müller, Sascha

doi:10.1007/s00423-010-0734-y

Cited by 15 publications

(6 citation statements)

References 37 publications

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“…Several studies have so far demonstrated that a haemorrhage and the need for a transfusion not only adversely affect peri‐operative outcome 2,3 but also the long‐term prognosis of patients undergoing a hepatectomy for primary or secondary malignancies 4–6 . Advances in peri‐operative management, surgical technique and imaging tools have substantially decreased the risk of intra‐operative haemorrhage and the need for a blood transfusion over the past three decades 7–11 . This progress has contributed to the markedly improved outcome of patients undergoing a hepatic resection and high‐volumes centres currently report mortality rates below 5% 2,8,12,13 .…”

Section: Introductionmentioning

confidence: 99%

Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS)

Rahbari

Garden

Padbury³

et al. 2011

HPB

374

226

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Section: Introductionmentioning

confidence: 99%

Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS)

Rahbari

Garden

Padbury³

et al. 2011

HPB

374

226

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“…In this meta-analysis, only nine studies involving 808 patients were included; to date, this possibly represents the best information available to compare 3D versus 2D for LD. According to the NOS used for assessing the quality of the studies, articles included in this meta-analysis were graded with a score of 9 [19,22,25], 8 [21,23,24], or 7 [17,18,20] representing high quality concerning selection of patients, comparability, and exposure measurements. Our analysis reflects the latest surgical results.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the pre-designed strategy, nine retrospective cohort studies (RCSs) [17][18][19][20][21][22][23][24][25] with a total of 808 patients for final analyses were selected ( Figure 1). Table I lists the main data extracted from these studies.…”

Section: Eligible Studies and Quality Assessment And Risk Of Biasmentioning

confidence: 99%

Three-dimensional versus two-dimensional video-assisted hepatectomy for liver disease: a meta-analysis of clinical data.

Zhang¹,

Huang²,

Cai³

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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Introduction: The benefit of three-dimensional (3D) visualization for liver disease is uncertain. Aim: To evaluate the effectiveness and safety of 3D versus two-dimensional (2D) video-assisted hepatectomy for LD. Material and methods: We searched PubMed, Embase, Cochrane Library, Medline, and Web of Science for studies addressing 3D versus 2D for 2D until 30 February 2020. Study-specific effect sizes and their 95% confidence intervals (CIs) were combined to calculate the pooled value using a fixed-effects or random-effects model. Results: Nine studies with 808 patients were included. The 3D group had shorter operative time (mean difference (

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“…It was demonstrated that 80% of deaths caused by PLF occur after resecting more than 50% of the liver volume [4-6], and the PLF incidence increases with the number of resected segments [5]. Therefore, accurate preoperative volumetric calculation of total and partial liver volumes based on preoperative imaging and resection planning is crucial in the assessment of hepatic functional reserve and resectability, especially in cases of major liver resection and patients with underlying parenchymal disease [7]. Liver steatosis and steatohepatitis, for example, are associated with an increased risk of PLF after partial liver resection, especially after neoadjuvant chemotherapy, or in living donor liver transplantation [8].…”

Section: Introductionmentioning

confidence: 99%

A rapid and accurate new bedside test to assess maximal liver function: a case report

et al. 2013

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BackgroundIn liver surgery, appropriate preoperative evaluation and preparation of the patient is of cardinal importance. The up-to-date, preoperative prediction of residual liver function has thus far been limited. As post-hepatectomy liver failure is a major cause of mortality, a new and simple bedside test (LiMAx) has been developed to predict postoperative liver function in conjunction with preoperative volumetric analysis of the liver.Case presentationA 45-year-old patient presented with a cecal carcinoma and a large synchronous liver metastasis for major liver surgery. Liver function was determined by the LiMAx-test for the enzymatic capacity of cytochrome P450 1A2, which is ubiquitously and solely active in the liver. A solution of 2 mg/kg body weight 13C-labeled methacetin was injected as a bolus into an intravenous catheter and, thereafter, was metabolized into acetaminophen and 13CO2 and pulmonarily exhaled. The analysis of the 13CO2/12CO2 ratio was performed using online breath sampling over a period of maximally 60 minutes. Based on this test, a value of more than 315 μg/kg/h represents normal liver function. A laparoscopic right hemihepatectomy was planned during virtual resection with a residual liver volume of 48% and a preoperative anticipated residual LiMAx of 301 μg/kg/h. After successful resection, the initial postoperative LiMAx value was 316 μg/kg/h, indicating good liver function and a correct prediction of the outcome.ConclusionIn the presented patient, residual liver function could be accurately predicted preoperatively using a combination of the new LiMax test with CT-volumetry. This test might significantly improve preoperative evaluation and postoperative outcomes in liver surgery.

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Liver tissue sparing resection using a novel planning tool

Cited by 15 publications

References 37 publications

Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS)

Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS)

Three-dimensional versus two-dimensional video-assisted hepatectomy for liver disease: a meta-analysis of clinical data.

A rapid and accurate new bedside test to assess maximal liver function: a case report

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