Hepatectomy under extracorporeal circulation

Heat Shock Preconditioning Ameliorates Liver Injury Following Normothermic Ischemia–Reperfusion in Steatotic Rat Livers

“…Patients with mild to moderate hepatic steatosis are usually asymptomatic [25]. However, during surgical treatment, such as extended liver resection or liver transplantation, even moderate infiltration of fat causes serious complications [7][8][9][10]. The CDD-induced steatotic liver is an established experimental model, in which morphological and functional features are very similar to those of clinical steatotic livers, although the etiology of fatty change differs between the two [15,26].…”

“…Warm ischemia-reperfusion injury sometimes results in impaired liver function. It has been repeatedly documented that steatosis is a serious risk factor for postoperative liver failure after extended liver resection using total vascular exclusion [7] and is also a causative factor of primary graft dysfunction in liver transplantation [8 -10]. Strategies to solve problems associated with ischemia-reperfusion injury in the steatotic liver are necessary, therefore, to increase the potential success of surgery in patients with steatotic liver.…”

Extended right hemihepatectomy with extracorporeal circulation for liver mestastases invading the inferior vena cava and right atrium

“…The limiting factor to surgical resectability depends on the minimum amount of vital remnant liver tissue which is essential for the survival of the patient. Therefore for an optimal organ protection cardiopulmonary bypass with short time profound hypothermic circulatory arrest was utilized [4,5]. Although IVC involvement due to colorectal liver metastases has been described [4,5], however, IVC invasion like presented in our case is very extraordinary.…”

“…Therefore for an optimal organ protection cardiopulmonary bypass with short time profound hypothermic circulatory arrest was utilized [4,5]. Although IVC involvement due to colorectal liver metastases has been described [4,5], however, IVC invasion like presented in our case is very extraordinary. If the circulatory arrest time can be kept as short as possible no severe organ damage particularly to the brain should be expected.…”

Ex situ Resektion und Resektion an der in situ perfundierten Leber – Gibt es noch Indikationen?

“…Die erste ex situ Leberresektion wurde von Rudolf Pichlmayr 1988 durchgeführt und die Technik später von anderen Institutionen übernom-men [33]. In den folgenden Jahren wurden von verschiedenen Arbeitsgruppen nur bei sehr sorgfältig ausgewählten Indikationen extracorporale Leberresektionen durchgeführt, so dass bis heute lediglich kleine Fallzahlen zu den jeweiligen Tumorentitäten verfügbar sind [3, 10,12,18,19,22,24,28,42,44].…”