Lang, S. A. and Loss, M. and Schlitt, H. J. (2014) In-situ Split (ISS) Liver Resection: New Aspects of Technique and Indication. ZENTRALBLATT FUR CHIRURGIE, 139 (2). pp. 212-219. ISSN 0044-409X, 1438-9592
Full text not available from this repository. (Request a copy)Abstract
The combination of right portal vein ligation with complete parenchyma dissection ("in-situ split", ISS) for rapid hypertrophy induction of the left-lateral liver lobe is a novel strategy to convert primarily irresectable liver tumours into a resectable stage. Available data so far show a 60-80% growth induction of the remnant liver within 7(-9) days. Certainly, a novel concept that comprises two operations within a very short time period raises questions. Based on the very few literature reports that have been published so far, as well as our own experience, we here discuss technical issues such as the use of a plastic sheet on the resection margin, the possibility of laparoscopic dissection and the timing of the second operation. Moreover, aspects of the preoperative diagnostic work-up that is necessary are assessed. Finally, open questions, e. g., concerning the influence of preoperative chemotherapy and the use of ISS in patients with cirrhosis are evaluated. In summary, the assessment of chances and risks of this novel concept with regard to indication and technical issues helps to provide the potentially curative option of the "in-situ split" procedure to more patients with marginal or even irresectable liver tumours.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PORTAL-VEIN EMBOLIZATION; LONG-TERM OUTCOMES; HEPATIC RESECTION; HEPATOCELLULAR-CARCINOMA; COLORECTAL METASTASES; PREOPERATIVE CHEMOTHERAPY; 2-STAGE HEPATECTOMY; REMNANT LIVER; ALPPS; REGENERATION; liver resection in two steps; resectability; in-situ splitting; hypertrophy; technique; indication |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 15 Nov 2019 08:33 |
| Last Modified: | 15 Nov 2019 08:33 |
| URI: | https://pred.uni-regensburg.de/id/eprint/10361 |
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