• Users Online: 14
  • Print this page
  • Email this page
Year : 2017  |  Volume : 10  |  Issue : 2  |  Page : 83-95

Surgery for primary liver malignancies – innovations and limitations

Department of Abdominal, Vascular and Transplant Surgery, University Hospital Magdeburg, Magdeburg, Germany

Correspondence Address:
Roland S Croner
Department of Abdominal, Vascular and Transplant Surgery, University Hospital Magdeburg, Magdeburg
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.7707/hmj.742

Rights and Permissions

Primary liver malignancies mainly arise from hepatocytes or bile duct cells. They become clinically evident as hepatocellular carcinomas (HCCs) and intrahepatic or hilar cholangiocarcinoma (CC). The treatment of these tumours is based on an interdisciplinary, multimodal approach, in which surgery has a major role. As techniques have improved, more patients can undergo safe operations, including extended resections and vascular reconstructions. In the case of an expected critical liver remnant after surgery, techniques before or during surgery can be used to induce liver hypertrophy, which reduces postoperative liver failure. There is ongoing discussion about whether resection or transplantation in cirrhotic livers is preferred in patients with HCCs. Patients with cholangiocarcinomas should undergo transplantation only within clinical trials. A neoadjuvant treatment protocol (Mayo Clinic protocol) that improves surgical outcome in patients with hilar CCs has been established. Nevertheless, criteria to predict good outcome of liver transplantation in patients HCCs and CCs exist and should be respected. Recent innovations in liver surgery are minimally invasive procedures. The innovative approach of robotic-assisted operations is a technical upgrade to conventional laparoscopy. These methods enable experienced surgeons to perform nearly all types of surgery, including living donor hepatectomy for liver transplantation. The oncological outcomes after minimally invasive liver resection are comparable to those of open procedures. For most patients surgery remains the only chance for complete cure and therefore it is still the most commonly performed procedure for primary liver tumour treatment. New innovative techniques will support the impact of surgery in the future.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded57    
    Comments [Add]    

Recommend this journal