Adam René, Miller Rafael, Pitombo Marcos, Wicherts Dennis A, de Haas Robbert J, Bitsakou Georgia, Aloia Thomas
AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, 12 Avenue Paul Vaillant Couturier, 94804 Villejuif, France.
Surg Oncol Clin N Am. 2007 Jul;16(3):525-36, viii. doi: 10.1016/j.soc.2007.04.016.
Two-stage hepatectomy has been developed as a surgical strategy for extremely difficult cases of bilobar multinodular metastatic liver disease. This strategy is applied when it is impossible to resect all malignant lesions in a single procedure. The main principle of this approach is sequential resection by a two-staged hepatectomy. Its goal is to achieve a complete metastasectomy in those cases in which a complete resection with a single hepatectomy would have left a remnant postresection liver too small for patient survival. This article describes strategic surgical approaches to multinodular metastatic disease and provides decision guidelines for two-stage hepatectomies.
