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Review Article
Medical Progress
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Volume 356:1545-1559 April 12, 2007 Number 15
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Strategies for Safer Liver Surgery and Partial Liver Transplantation
Pierre-Alain Clavien, M.D., Ph.D., Henrik Petrowsky, M.D., Michelle L. DeOliveira, M.D., and Rolf Graf, Ph.D.

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The liver possesses the unique ability to regenerate within a short period.1,2,3 This feature has led to the development of innovative strategies in liver surgery and transplantation. The anatomy of the liver is paramount in considering advances in hepatic surgery. The liver is divided into eight segments (Figure 1). In healthy adults, the liver weighs about 1.5 kg (3.3 lb).4 The blood supply of the liver is carried through two major vessels, the hepatic artery and the portal vein. The portal vein carries a large volume of venous blood to the liver from the gut, pancreas, and spleen, . . . [Full Text of this Article]

Liver Resection and Liver Transplantation

Liver Regeneration

Response to Major Tissue Loss

Molecular Basis of Liver Regeneration

Liver Volume

Minimal Volume for the Surgically Created Liver Remnant or Allograft

Cirrhosis

Fatty Liver

Liver after Chemotherapy

Remnant Donor Liver and Partial Graft

Preoperative Evaluation

Clinical and Biochemical Tests

Dynamic Liver Tests

Safer Liver Resection and Partial Liver Transplantation

Strategies for Manipulating Liver Volume

Indications for Portal-Vein Occlusion

Portal-Vein Occlusion with Chemotherapy

Portal-Vein Embolization with Chemoembolization

Portal-Vein Embolization with Biliary Drainage

Effect on Tumor Growth

Small Liver Graft

Hepatoprotective Strategies

Pharmacologic Approaches

Surgical Approaches

Conclusions


Source Information

From the Swiss Hepato-Pancreatico-Biliary (HPB) Center, Department of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland.

Address reprint requests to Dr. Clavien at the Department of Visceral and Transplantation Surgery, University Hospital Zurich, Rämistr. 100, CH-8091 Zurich, Switzerland, or at clavien@chir.unizh.ch.


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