The posterior intrahepatic approach to the left portal pedicle using the ligamentum venosum: anatomical basis.

Purpose: Prevention of blood loss in liver resections is essential for reducing postoperative morbidity. The main method to control bleeding during surgery of the left hemiliver is occlusion of the left portal pedicle. This may be accomplished by hilar, fissural or posterior intrahepatic techniques.

Magnetic resonance-guided focused ultrasound surgery (MRgFUS). Four ablation treatments of a single canine hepatocellular adenoma.

Background: Canine hepatocellular adenomas are benign, well-differentiated, primary hepatic tumors. Surgical resection is technically demanding and is considered a major procedure with relatively high morbidity rates. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) uses focused ultrasonic energy to non-invasively create a heat-coagulated lesion deep within the body.

Magnetic resonance-guided focused ultrasound surgery (MRgFUS): ablation of liver tissue in a porcine model.

Background: Liver surgery is technically demanding and is considered a major procedure with relatively high morbidity rates. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) uses focused ultrasonic energy to create a heat coagulation lesion, which can be achieved in a totally controlled, very accurate manner (<1 mm). The aim of this study was to evaluate the safety and accuracy of non-invasive focal ablation of liver tissue achieved by consecutive MRgFUS sonications.

Use of transportal balloon catheter occlusion of the portal triad in prevention of bleeding during liver resection.

Background: Operative blood loss is among the most important factors determining the prognosis of patients undergoing hepatic resection. The best method for preventing bleeding is preliminary selective vascular occlusion of lobar, sectoral, or segmental portal triads, although not always technically feasible.

Method: Transportal occlusion of the portal triad with a balloon catheter was used in 35 hepatectomies for various tumors.

Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival.

Objective: To evaluate the long-term survival of patients resected for primarily unresectable colorectal liver metastases (CRLM) downstaged by systemic chemotherapy and to use prognostic factors of outcome for a model predictive of survival on a preoperative setting.

Summary Background Data: Surgery of primarily unresectable CRLM after downstaging chemotherapy is still questioned, and prognostic factors of outcome are lacking.

Methods: From a consecutive series of 1439 patients with CRLM managed in a single institution during an 11-year period (1988-1999), 1104 (77%) initially unresectable (NR) patients were treated by chemotherapy and 335 (23%) resectable were treated by primary liver resection.