Anatomical Segmental and Subsegmental Resection of the Liver for Hepatocellular Carcinoma: a New Approach by Means of Ultrasound-Guided Vessel Compression
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
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.
Observational Model: Cohort, Time Perspective: Prospective
GUIDO TORZILLI, MD, PHD
University of Milan
Italy: Ministry of Health