Hepatocellular Carcinoma
Conditions
Keywords
Intraoperative ultrasound, Segmentectomy, HCC
Brief summary
Anatomical resection is the gold standard approach for liver resection in patients with HCC. A new method for that by means of IOUS-guided finger compression has been devised.
Detailed description
We herein describe a novel technique for the demarcation of the resection area by means of IOUS-guided finger compression to systematically accomplish anatomical segmental and subsegmental resections. Using the IOUS, the tumor and the level targeted for compression are identified. Than, under the IOUS guidance, the surgeon compresses bilaterally the liver at the targeted position resulting in the compression of the portal pedicle feeding the tumor previously identified. This maneuver is constantly monitored in real-time just using the same microconvex probe, and it is maintained until the surface of the targeted liver area begins to discolor, at that time the first assistant marks the discolored area with the electrocautery, and the compression is released. Once the area is demarcated, liver dissection is started under intermittent Pringle's maneuver.
Interventions
PROCEDUREIOUS-GUIDED INTRAHEPATIC VESSEL COMPRESSION
Using the IOUS, the tumor and the level targeted for compression are identified. Than, under the IOUS guidance, the surgeon compresses bilaterally the liver at the targeted position resulting in the compression of the portal pedicle feeding the tumor previously identified. This maneuver is constantly monitored in real-time just using the same microconvex probe, and it is maintained until the surface of the targeted liver area begins to discolor, at that time the first assistant marks the discolored area with the electrocautery, and the compression is released. Once the area is demarcated, liver dissection is started under intermittent Pringle's maneuver.
Sponsors
University of Milan
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patients suitable for surgical approach carries of HCC * Serum bilirubin level lower than 1.5 mg/dl
Exclusion criteria
* Presence of ascites * Serum bilirubin level equal or higher than 1.6 mg/dl * Conditions (size, vascular relation, or infiltration) demanding resection larger than a segmental area * Tumor thrombus in portal or hepatic veins
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Technical feasibility | — |
Secondary
| Measure | Time frame |
|---|---|
| Morbidity and mortality | 30 and 90 days |
Countries
Italy
Outcome results
None listed