Main description:

Liver surgery has made extraordinary progress over the past 40 years, evolving from the first, timid partial resections in the 1950s to today's major resections and organ transplants. Examining the rea- sons for this progress, one cannot but be impressed by the substan- tial role that has been played by radiology. Formerly, preoperative planning was based on only nebulous scintigraphic scans. Today, surgeons have at their disposal a wide variety of radiological modalities for diagnosis and topography which are precise enough to exclude most operative surprises. Fur- thermore, the radiologist is becoming increasingly involved in ther- apy: prior to operation for tumor reduction by embolization and after resection for treatment of local complications - which could otherwise necessitate difficult and occasionally dangerous reoper- ations. As the author writes in his preface, it is not really astonishing that a radiologist is publishing a book on this topic, and he must be congratulated for his work-up, which combines important personal experience with a complete analysis of published papers on this topic.

Contents:

1 Anatomy of the Liver.- 1.1 Hepatic Veins.- 1.2 Portal Vein.- 1.3 Hepatic Arteries.- 1.4 Biliary Ducts.- 1.5 Lymphatic Drainage.- 2 Malignant Liver Lesions: Pathology.- 2.1 Hepatocellular Carcinoma.- 2.1.1 Epidemiology.- 2.1.2 Pathology.- 2.2 Hepatoblastoma.- 2.3 Cholangiocarcinoma.- 2.4 Mesenchymal Tumors.- 2.4.1 Angiosarcoma (Hemangioendothelioma).- 2.4.2 Other Mesenchymal Tumors.- 2.5 Metastases.- 3 Diagnosis and Staging of Malignant Liver Disease.- 3.1 Clinical Aspects.- 3.1.1 Hepatocellular Carcinomas.- 3.1.2 Metastases.- 3.2 Biochemical Tests.- 3.3 Techniques in Imaging Malignant Liver Disease.- 3.3.1 Plain Film.- 3.3.2 Ultrasound.- 3.3.3 Computed Tomography.- 3.3.4 Magnetic Resonance.- 3.3.5 Angiography.- 3.3.6 Nuclear Medicine.- 3.4 Imaging Malignant Focal Liver Lesions.- 3.4.1 Hepatocellular Carcinoma.- 3.4.2 Liver Metastases.- 3.4.3 Cholangiocarcinoma.- 3.4.4 Lymphoma.- 3.4.5 Fatty Infiltration.- 3.5 Percutaneous Liver Biopsy.- 3.5.1 Biopsy of Malignant Liver Lesions.- 3.5.2 Biopsy of Liver Hemangiomas.- 3.5.3 Complications of Biopsy.- 3.6 Principles of Staging of Liver Lesions.- 3.7 Which Method to Choose?.- 4 Surgical Treatment of Malignant Liver Lesions.- 4.1 Liver Resection.- 4.1.1 Criteria for Resection.- 4.1.2 Tumorectomy.- 4.1.3 Segmentectomy and Hepatectomy.- 4.1.4 Results and Factors Influencing Survival.- 4.1.5 Complications of Resection Surgery.- 4.2 Arterial Ligature: Dearterialization.- 4.2.1 Techniques.- 4.2.2 Results.- 4.3 Cryosurgery.- 4.4 Transplantation.- 5 Radiotherapy.- 5.1 Tolerance of the Liver to Radiation.- 5.2 External Radiotherapy.- 5.2.1 Irradiation with Curative Intention.- 5.2.2 Irradiation with Palliative Intention.- 5.2.3 Tolerance to Treatment and Complications.- 5.3 Internal Radiotherapy.- 5.3.1 Percutaneous Implantation of Radioactive Seeds.- 5.3.2 Yttrium-90.- 5.3.3 131I-Labeled Lipiodol.- 5.3.4 Radiolabeled Antibodies.- 5.4 Radiotherapy Combined with Chemotherapy.- 6 Ethanol Injection Therapy of Liver Tumors.- 6.1 Patient Selection.- 6.2 Technique.- 6.3 Results.- 7 Systemic Chemotherapy.- 7.1 Tumor Response to Chemotherapy.- 7.2 Hepatocellular Carcinomas.- 7.3 Liver Metastases.- 8 Selective Perfusion of Chemotherapeutic Agents.- 8.1 General Considerations.- 8.1.1 Regional Chemotherapy: High Local Concentration of Drugs.- 8.1.2 Anatomic Considerations: Vascular Remodeling.- 8.1.3 Flow Pattern: Laminar Flow-Turbulent Flow.- 8.1.4 Checking the Homogeneity of Liver Perfusion.- 8.2 Regional Chemotherapy: The "Surgical Way".- 8.2.1 Intraarterial Regional Chemotherapy.- 8.2.2 Portal Versus Intraarterial Chemotherapy.- 8.2.3 Adjuvant Intraportal Chemotherapy for Colorectal Hepatic Metastases.- 8.2.4 Adjuvant Intraperitoneal Chemotherapy for Colorectal Hepatic Metastases.- 8.3 Regional Chemotherapy: the "Radiological" Way.- 8.3.1 Intraarterial Perfusion.- 8.3.2 Chemotherapeutic Drugs and Lipiodol.- 8.3.3 Embolization.- 8.3.4 Chemoembolization.- 8.4 Complications and Side Effects of Regional Chemotherapy.