Liver resections in cirrhotic patients: A western experience

World Journal of Surgery - Tập 10 - Trang 311-316 - 1986
H. Bismuth1, D. Houssin1, J. Ornowski1, F. Meriggi1
1Unité de Chirurgie Hepatobiliaire, HÔpital Paul Brousse, Villejuif, France

Tóm tắt

Systematic screening for hepatocellular carcinoma (HCC) in cirrhotic patients by alpha-fetoprotein and ultrasound permits the detection of small asymptomatic tumors. Owing to the small tumor size, more liver resections can now be performed than in the past. These resections are performed in a more economical way in terms of loss of functional parenchyma and in a more appropriate manner with regard to carcinology: surgical techniques of liver segmentectomy and use of intraoperative echography are mandatory. Favorable long-term results obtained in Eastern countries by resecting such lesions are encouraging but remain to be confirmed in the Western hemisphere.

Tài liệu tham khảo

Okuda, K., Obata, H., Nakajima, Y., Ohtsuki, T., Okazaki, N., Ohnishi, K.: Prognosis of primary hepatocellular carcinoma. Hepatology 4:3S, 1984 Makuuchi, M., Hasegawa, H., Yamazaki, S.: Intraoperative ultrasonic examination for hepatectomy. Jpn. J. Clin. Oncol.11:367, 1981 Bismuth, H.: Anatomical surgery and surgical anatomy of the liver. World J. Surg.6:3, 1982 Bismuth, H., Houssin, D., Castaing, D.: Major and minor segmentectomies réglées in liver surgery. World J. Surg.6:10, 1982 Bismuth, H., Castaing, D., Houssin, D.: Chirurgie des carcinomes hépatocellulaires: Une nouvelle approche. Chirurgie112:530, 1984 Makuuchi, M.: Interventional ultrasound during liver surgery. In Interventional Real-Time Ultrasound, H. Watanabe and M. Makuuchi, editors. Tokyo, IgakuShoin, 1985, pp. 122–140 Okuda, K., Peters, R.L.: Hepatocellular Carcinoma. New York, John Wiley, 1976, pp. 107–168 Yu, Y., Tang, Z.Y., Zhou, X.: Experience in resection of small hepatocellular carcinoma. Chin. Med. J.93:491, 1980 Bismuth, H., Castaing, D., Houssin, D.: Die Leber-resektion. Indikation und Ergebnisse. Chirurg56:203, 1985 Couinaud, C.: Le Foie. Etudes Anatomiques et Chirurgicales. Paris, Masson Ed., 1957 Kanematsu, T., Takenaka, K., Matsumata, T., Furata, T., Sugimachi, K., Inokuchi, K.: Limited hepatic resection for selected cirrhotic patients with primary liver cancer. Ann. Surg.199:51, 1984 Sheu, J.C., Lee, C.S., Sung, J.L., Chen, D.S., Yang, P.M., Len, T.Y.: Intraoperative hepatic ultrasonography: An indispensable procedure in resection of small hepatocellular carcinoma. Surgery97:97, 1985 Bismuth, H., Houssin, D., Michel, P.: Le risque opératoire des hepatectomies. Chirurgie109:342, 1983 Ozawa, K.: Significance of glucose tolerance as prognostic sign in hepatectomized patients. Am. J. Surg.131:541, 1976 Azano, M., Ozawa, K., Tobe, T.: Postoperative prognosis as related to blood ketone body ratios in hepatectomized patients. Eur. Surg. Res.15:302, 1983 Gill, R.A., Goodman, M.W., Golfus, G.R., Onstad, G.R., Bubrick, M.P.: Aminopyrine breath test predicts surgical risk for patients with liver disease. Ann. Surg.198:701, 1983 Okamoto, E., Kyo, A., Yamonaki, N., Tanaka, N., Kuwata, K.: Prediction of the safe limits of hepatectomy by combined volumetric and functional measurements in patients with impaired hepatic function. Surgery95:586, 1984