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Special Issue "Liver Resection: Latest Advances and Prospects"

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Guest Editor

Department of Liver Surgery, Peking Union Medical College Hospital, Beijing, China
Interests: gallbladder cancer; hepatocellular carcinoma; immunotherapy; surgical treatment

Dr. Haifeng Xu

E-Mail Website
Guest Editor

Department of Liver Surgery, Peking Union Medical College Hospital, Beijing, China
Interests: hepatectomy; laparoscopic surgery; surgical resection; liver surgery

Special Issue Information

Dear Colleagues,

Hepatectomy has been applied in the surgical clinic routinely for years to treat benign and malignant liver lesions. It is also seen as a possible curative treatment for liver cancers. With a better understanding of the liver anatomy, improvements in surgical techniques and instruments, and progress in the concept of perioperative care, hepatectomy has become more and more safe and effective for liver cancers. In recent years, great progress has been made in the following fields: liver resection in an anatomically difficult location, minimal invasive surgeries such as laparoscopic and robotic hepatectomy, two-stage hepatectomies such as ALPPS, and fine preoperative evaluation of liver function and risks of surgery. It is time to summarize and comments on the progress of these improvements. We thus tried to organize a Special Issue focusing on the above aspects.

Prof. Dr. Yilei Mao
Dr. Haifeng Xu
Guest Editors

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Keywords

hepatectomy
liver anatomy
liver cancers
hepatocellular carcinoma

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Open AccessEditorial

Minimally Invasive Hepatectomy for Liver Tumors: Where Are We Now?

Kelvin K. C. Ng

J. Clin. Med. 2023, 12(14), 4583; https://doi.org/10.3390/jcm12144583 - 10 Jul 2023

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Abstract

With advancements in minimally invasive (MIS) technology and techniques, MIS hepatectomy has evolved as an effective treatment for both benign and malignant liver tumors [...] Full article

(This article belongs to the Special Issue Liver Resection: Latest Advances and Prospects)

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A Nomogram Based on Preoperative Lab Tests, BMI, ICG-R15, and EHBF for the Prediction of Post-Hepatectomy Liver Failure in Patients with Hepatocellular Carcinoma

and

J. Clin. Med. 2023, 12(1), 324; https://doi.org/10.3390/jcm12010324 - 31 Dec 2022

Cited by 1 | Viewed by 1063

Abstract

Background: Liver cancer is one of the most common malignant tumors, and worldwide, its incidence ranks sixth, and its morality third. Post-hepatectomy liver failure (PHLF) is the leading cause of death in patients who have undergone liver resection. This retrospective study investigated the risk factors for PHLF by predicting and constructing an index to evaluate the risk. This was achieved by combining the lab tests with an indocyanine green (ICG) clearance test. Methods: The study analyzed 1081 hepatocellular carcinoma (HCC) patients who had received liver resection at Sun Yat-sen University Cancer Center between 2005 and 2020. The patients were divided into a PHLF group (n = 113) and a non-PHLF group (n = 968), according to the International Study Group of Liver Surgery (ISGLS) criteria. Receiver operating characteristics (ROC) curves were then used to estimate the optimal cut-off values. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors. Finally, a nomogram was constructed where the calibration plot, the areas under the ROC curve (AUC), and the decision curve analysis (DCA) showed good predictive ability. Results: Correlation analysis revealed that body mass index (BMI) was positively correlated with ICG-R15 and with effective hepatic blood flow (EHBF). Univariate and multivariate logistics regression analysis revealed that BMI, ICG-R15, international normalized ratio (INR), tumor size, hepatic inflow occlusion (HIO) time, and operation method were independent predictive factors for PHLF. When these factors and EHBF were included in the nomogram, the nomogram showed a good predictive value, with a C-index of 0.773 (95% Confidence Interval [CI]: 0.729–0.818). The INR had the largest ROC areas (AUC INR = 0.661). Among the variables, ICG-R15 (AUC ICG-R15 = 0.604) and EHBF (AUC EHBF = 0.609) also showed good predictive power. Conclusions: The risk of PHLF in HCC patients can be precisely predicted by this model prior to the operation. By integrating EHBF into the model, HCC patients at higher risk for PHLF can be identified more effectively. Full article

(This article belongs to the Special Issue Liver Resection: Latest Advances and Prospects)

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Open AccessSystematic Review

Trends in Minimally Invasive Approaches for Liver Resections–A Systematic Review

Florin Graur

Razvan Alexandru Ciocan

and

J. Clin. Med. 2022, 11(22), 6721; https://doi.org/10.3390/jcm11226721 - 14 Nov 2022

Cited by 1 | Viewed by 966

Abstract

Background: SILS (single incision laparoscopic surgery) and NOTES (natural orifice transluminal endoscopic surgery) are considered breakthroughs in minimally invasive surgery, the first consisting in the surgeon working via a single entrance site and the second via a natural orifice (e.g., oral cavity). Methods: Since 2000 until 2022, the original articles published in the online databases were analyzed. Eligible studies included information about the current therapy of patients with liver surgical pathology and how the two new techniques improve the surgical approach. Results: A total of 798 studies were identified. By applying the exclusion criteria, nine studies remained to be included in the review. Two out of nine studies examined the NOTES approach in liver surgery, whereas the other seven focused on the SILS technique. The age of the patients ranged between 24 and 83 years. Liver resections for hepatocellular carcinoma or colorectal metastases were undertaken and biliary or hydatid cysts were removed. The mean procedure time was 95 to 205 min and the average diameter of the lesions was 5 cm. Conclusions: When practiced by multidisciplinary teams, transvaginal liver resection is feasible and safe. The goals of SILS and NOTES are to be less intrusive, more easily tolerated and aesthetic. Full article

(This article belongs to the Special Issue Liver Resection: Latest Advances and Prospects)

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Special Issue "Liver Resection: Latest Advances and Prospects"

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