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Tailoring the area of hepatic resection using inflow and outflow modulation

World Journal of Gastroenterology 2013年第7期19卷 1049-1055页

作者： Matteo Donadon fabio procopio Guido Torzilli Liver Surgery Unit Department of General SurgeryUniversity of Milan School of MedicineHumanitas Clinical and Research Center20089 MilanItaly

The performance of hepatic surgery without a parenchyma-sparing strategy carries significant risks for patient survival because of the not negligible occurrence of postoperative liver *** key factor of modern hepatic surgery is the use of the intraoperative ultrasound(IOUS),not only to stage the disease,but more importantly to guide resection with the specific aim to maximize the sparing of the functional *** in patients with hepatocellular carcinoma and underlying liver cirrhosis,or in patients with colorectal liver metastasis,IOUS allows the performance of the so-called "radical but conservative surgery",which is the pivotal factor to offer a chance of cure to an increasing proportion of patients,who until few years ago were considered only for palliative *** some new IOUS-guided surgical maneuvers,which are based on the liver inflow and outflow modulations,more precise anatomically subsegmental-and segmentaloriented resections can be effectively *** present work describes the rationale and the surgical technique for a precise tailoring of the area of hepatic resection using the most recent attainments in *** important technical achievements should be a fundamental part of the surgical armamentarium of the modern liver surgeon.

关键词： Hepatic resection Intraoperative ultrasound Liver inflow Liver outflow Resection guidance

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Surgical treatment of synchronous colorectal liver and lung metastases： the usefulness of thoracophrenolaparotomy for single stage resection

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Hepatobiliary & Pancreatic Diseases International 2016年第2期15卷 216-219页

作者： Daniele Del Fabbro Marco Alloisio fabio procopio Matteo Cimino Matteo Donadon Angela Palmisano Luca Viganò Guido Torzilli Department of Hepatobiliary Surgery Humanitas Research HospitalUniversity of Milan School of MedicineRozzanoMilanItaly Department of Thoracic Surgery Humanitas Research HospitalUniversity of Milan School of MedicineRozzanoMilanItaly

When suitable, surgery still remains the therapeutic option to be preferred for patients carrier of colorectal liver and lung metastases. Since thoracophrenolaparotomy should be helpful during liver resection for some of these patients, simultaneous removal of right lung metastases can be proposed through this approach. Eleven consecutive patients（median age of 53 years） carrier of colorectal liver and lung metastases, underwent single session surgical resection of both liver and right lung lesions by means of J-shaped thoracophrenolaparotomy. The median number of liver metastases removed was 5（range 2-30） and of lung metastases removed was 2（range 1-3）. Lung metastases were located in the upper lobe in 1 patient, in the middle lobe in 2, in the lower lobe in 6, and in the upper and lower lobe in 2. Mortality and major morbidity were nil. Two patients had a minor morbidity： one had wound infection and bile leakage treated conservatively and the other had transient fever. Mean overall survival was 24.4 months. An aggressive surgical approach should be undertaken for colorectal metastases： in case of multifocal liver disease with complex presentations, J-shaped thoracophrenolaparotomy could be considered as safe approach for combined liver and right lung metastasectomies.

关键词： colorectal carcinoma liver metastases lung metastases thoracophrenolaparotomy

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Intraoperative cholangio-ultrasonography(IOCUS)during hepatectomy with resection of the biliary confluence:An effective alternative to intraoperative cholangiography

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 417-420页

作者： Daniele Del Fabbro fabio procopio Jacopo Galvanin Guido Costa Simone Famularo Angela Palmisano Matteo Donadon Guido Torzilli Division of Hepatobiliary Surgery Department of SurgeryIRCCS Humanitas Research HospitalVia A.Manzoni 56Rozzano 20089MilanItaly Department of Biomedical Sciences Humanitas UniversityVia Rita Levi Montalcini 4Pieve Emanuele 20072MilanItaly

Intraoperative ultrasonography(IOUS)in hepatobiliary surgery is well known as an essential tool for radical and safe hepatectomies,allowing to perform parenchymal sparing surgery and,as consequence,to expand the surgical indications for patients otherwise considered ***,since many years,despite its effectiveness in the study of vascular anatomy of the liver,the gold standard for the assessment of biliary anatomy during surgery is intraoperative cholangiography(IOC),which is used for the validation of preoperative imaging as well as for guiding reconstruction in case of bile duct injury or resection.

关键词： anatomy biliary ultrasonography

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Nested stromal-epithelial tumour of the liver:An unusual liver entity

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World Journal of Hepatology 2014年第3期6卷 155-159页

作者： fabio procopio Luca Di Tommaso Silvia Armenia Vittorio Quagliuolo Massimo Roncalli Guido Torzilli Department of Hepatobiliary Surgery University of MilanHumanitas Research Hospital Department of Pathology University of MilanHumanitas Research Hospital Department of Surgical Oncology Humanitas Research Hospital

Nested stromal-epithelial tumours(NSETs)of the liver have been reported to be extremely unusual primary hepatic *** date,few cases have been described in the *** have been defined as non-hepatocytic and non-biliary tumours of the liver consisting of nests of epithelial and spindled cells,myofibroblastic stroma and variable intralesional calcification and ***,we report a case of a young female who underwent liver resection for a large hepatic lesion that proved to be a calcifying NSET on pathological *** about the clinical and histopathological features of the tumour are reported.

关键词： Nested stromal-epithelial tumour Hepatic tumour Liver resection Hepatic mixed tumour Hepatectomy

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