Surgical Clinics of North America Volume 90, Issue 4 , Pages xvii-xviii, August 2010

In this issue of Surgical Clinics of North America, a spectrum of liver surgery topics is summarized bringing the reader up to date with the era of modern hepatic resection surgery. The basics of liver anatomy and history are reviewed, along with the current molecular mechanisms of liver ischemia/reperfusion injury relevant to liver transplantation, hepatic trauma, and elective hepatic resections. Hepatic imaging techniques of ultrasound, CT, and MRI have improved and greatly facilitate our diagnostic capabilities for benign lesions and malignancies; however, the conundrum of the subcentimeter indeterminate liver lesion remains. The often confusing nomenclature of hepatic resection surgery was standardized at the 2000 Brisbane, Australia, International Heptao-Pancreato-Biliary Association meeting and is now known as the Brisbane 2000 terminology. Advances in the past decade include the development of laparoscopic liver resection techniques, which have been reported in more than 3000 cases worldwide. Further, robotic liver resection surgery has been described but remains in its infancy. Repair of laparoscopic cholecystectomy injury remains an uncommon but important task for the hepatobiliary surgeon, as is the potentially life-saving emergency hepatic resection for traumatic liver injury. Resection of hepatic colorectal cancer metastases has seen a paradigm shift from a prior emphasis on number of lesions to the present-day focus on sufficient liver remnant and invokes strategies of portal vein embolization and two-stage hepatectomies to increase resectability rates. Current approaches to management of hepatocellular carcinoma continue to evolve, including live donor liver transplantation, selective hepatic resection, ablative techniques, regional liver therapies, and newer systemic chemotherapy. Intrahepatic cholangiocarcinoma is on the rise, and major hepatic resections have been advocated for metastatic neuroendocrine cancers. Successful liver surgery requires a fundamental understanding of liver anatomy, disease pathophysiology, and modern hepatic resection techniques. Two questions always need to be addressed when contemplating hepatic resection surgery that requires both technical expertise and judgment: (1) Can the lesion technically be resected and (2) Should the lesion be resected? https://rapidshare.com/files/3965833881/91_5.rar