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Transileocolic portal vein embolisation
Embolisation of Right Hepatic Artery
Arteriography of Right Hepatic Artery
Spiral embolisation of Right Hepatic Artery
Liver resection Operative approach
Discussion:
Anatomical vs.
Nonanatomical resection
Operative technique – anatomical resection
Liver resection nomenclature based on Couinaud’s classification
Right hepatectomyRight hepatectomy
Anatomical liver resection
Operative technique – anatomical resection
Advantage:Relatively simple operation technique - less bleeding, less postoperative bile leeks; Survival benefit (some studies):
5 years survival 37% vs. 20%;Scheele J., Stangl R. et al; World J Surg, 19:59-71,1995
Possibility to increase margin clearenceSolitary lesion > 4 cm had markedly improved outcomes following anatomical resections;Registry of hepatic metastases, Surgery 103:278-288, 1988
Disadvantage:Risk of hepatic failure ( fatty liver, cirrhosis);Not suitable for multiple lesions especially in both lobes
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