196,272 research outputs found
Ultrasound-guided finger compression in liver subsegmentectomy for hepatocellular carcinoma
No full textSystematic subsegmentectomy is now accepted as the best option for the surgical management of hepatocellular carcinoma in patients with cirrhosis because it optimizes the balance between oncological requirements and the need to spare functioning liver parenchyma. However, this technique can be difficult because it requires a strong background in ultrasound-guided interventional procedures. We describe a new, simplified technique for the anatomical subsegmental hepatic resection of segment 2 or 3. It consists of IOUS-guided blunt portal branch compression to disclose the subsegmental area to be removed. This technique is a further evolution of so-called systematic subsegmentectomy for tumors located in segments 2 and 3. Its main advantages are that it is easy, fast, and reversible. We believe that it has the potential to lead to new opportunities in subsegmental anatomic liver resection
Tricks for ultrasound-guided resection of colorectal liver metastases
No full textNowadays, tumor clearance for colorectal liver metastases can be achieved in most patients undergoing liver resection with survival benefits. Most merits of conservative and radical resections should probably be addressed to the extensive use of intraoperative ultrasound. Mostly for this reason, surgery can be still considered the treatment of choice. For this purpose, intraoperative ultrasound-guidance technique should be a familiar instrument for the hepatic surgeon. The technical tricks needed to perform a real intraoperative ultrasound-guided hepatectomy in the management of liver metastases from colorectal cancer are described
Intraoperative ultrasonography in liver cancer
No full textIOUS has become increasingly important for surgical resection in patients with cirrhosis and healthy liver. IOUS is important in the diagnosis and staging of liver cancer and as an element of the surgical technique, and IOUS can now be considered a fundamental tool for hepatobiliary and other surgical procedures [3]. The American College of Surgeons has recently recognized the need for surgeons to have specific training in ultrasonography. Meanwhile, dedicated monographs on IOUS have been published in the United States, Chile, and Europe [39-42]
Hepatic resection for hepatocellular carcinoma in cirrhosis
No full textHepatocellular carcinoma is one of the most common cancers worldwide. Several treatment modalities have been proposed, but hepatic resection is still considered the first-line therapeutic option for most of the patient carries of HCC. The proper selection of patients candidate to hepatic resection for HCC and the eradication whenever is possible of the intrahepatic metastases are the most crucial steps for improving the surgical outcome in HCC. This article reviews the current state of the art of the surgical treatment of HCC
Differences and similarities in the approach to hepatocellular carcinoma between Eastern and Western institutions
No full textIntraoperative procedures
No full textIn various surgical operations, intraoperative ultrasound (IOUS) has changed the pattern of surgical judgement and management. With a revolution in surgical techniques and US technology, IOUS continue to change. By reviewing the past development and present progress, the future perspective of IOUS in the new millennium is highlighted
History of intraoperative ultrasound
No full textIntraoperative ultrasound (IOUS) using A-mode or non-real-time B-mode imaging started in the 1960s; however, it was not widely accepted mainly because of difficulty in image interpretation. In the late 1970s, IOUS became one of the topics in the surgical communities upon the introduction of high-frequency real-time B-mode ultrasound. Special probes for operative use were developed. In the 1980s, all over the world the use of IOUS spread to a variety of surgical fields, such as hepatobiliary pancreatic surgery, neurosurgery, and cardiovascular surgery. IOUS changed hepatic surgery dramatically because IOUS was the only modality that was capable of delineating and examining the interior of the liver during surgery. After 1990, color Doppler imaging and laparoscopic ultrasound were incorporated into IOUS. Currently, IOUS is considered an indispensable operative procedure for intraoperative decision-making and guidance of surgical procedures. For better surgical practice, education of surgeons in the use of ultrasound is the most important issue
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