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This book offers a comprehensive overview on the topic of liver regeneration with the aim of providing a potentially curative surgical treatment for liver tumours. it will be divided into five thematic sessions: from the cellular and haemodynamic mechanisms that act as triggers for the regeneration process, to currently available techniques based on surgical and/or interventional radiology methods, their optimisation and risks, to a discussion of how to use hypertrophy techniques in the context of each specific disease setting and new frontiers. Despite the fact that this is a progressively evolving field, the importance of performing major liver resections in a safe setting - reducing the risk of post-operative liver failure, which is the most serious potentially life-threatening complication in liver surgery - will remain unchanged in the field of cancer surgery. In this scenario, a book providing a systematic discussion of the state of the art and evidence now established in this field is an essential tool for any centre with an active liver surgery programme. The multidisciplinary perspective used to address this topic is a further innovative value of this project, which has the ambition of meeting the need for a lasting cultural background on this subject.
List of contents
Preface.- Foreward.- Mechanisms of liver regeneration.- Microbiota and liver-gut axis in liver regeneration.- Hemodynamic basis of liver regeneration.- Metabolic factors affecting liver regeneration.- Pathogenesis of postoperative liver failure.- Diagnosis and classification of postoperative liver failure.- Volumetric study of the liver and cutoffs for a safe liver surgery.- Functional study of the liver: imaging tests.- Functional study of the liver: non-imaging tests.- Portal vein embolization.- Portal vein ligation.- Two stage hepatectomy.- ALPPS.- Hepatic deprivation.- Radioembolization.- Rationale and techniques for liver hypertrophy in colorectal liver metastases.- Hypertrophy techniques in synchronous colorectal liver metastases.- Hypertrophy techniques in hepatocellular carcinoma.- Hypertrophy techniques in cholangiocarcinoma.- Hypertrophy techniques in transplant setting.- Impact of minimally-invasive approaches.- The issue of drop out.- Management of postoperative liver failure.- future of regenerative hepatology.
About the author
Luca Aldrighetti was the Head of the Hepatobiliary Surgery Division at IRCCS Ospedale San Raffaele and Full Professor at the University Vita-Salute San Raffaele. His research and assistance activities are mainly focused on the diagnosis and treatment of hepatobiliary neoplastic diseases, treatment of portal hypertension and liver failure, and monitoring and treatment of the critical surgical patients, with particular attention to surgery of perihilar cholangiocarcinomas and primary and metastatic liver neoplasms. He was author of 522 scientific publications in the most prestigious national and international journals, with a large number of citations. His H index was 66.
Elio Jovine is Head of the Department of Surgery at Maggiore Hospital in Bologna and Professor of Surgery at Alma-Mater Studiorum, University of Bologna. He has performed, in his career, more than 9,000 major surgical procedures as first operator. Among these cases, he has performed as first operator more than 4,200 cases of HPS Surgery and more than 2,600 colorectal surgery procedures. More than 2,100 cases have been carried out laparoscopically. His research activity focuses on minimally invasive surgery of the liver and ALPPS approach. He is author of 241 scientific publications in the most prestigious national and international journals, with a large number of citations. His H index is 43.
Francesca Ratti is staff surgeon of the Department of Hepatobiliary Surgery of the IRCCS Ospedale San Raffaele and Assistant Professor of Surgery at Vita-Salute San Raffaele University. Her clinical research activities are mainly focused on the diagnosis and treatment of hepatobiliary diseases, minimally invasive liver surgery, protocols for accelerated surgical management, programs for two-stage hepatectomies and liver regeneration. She is author of 251 scientific publications in the most prestigious national and international journals, with a large number of citations. Her H index is 39.
Matteo Serenari is staff surgeon at the Hepatobiliary Surgery and Transplant Unit of Sant’Orsola-Malpighi Hospital and Assistant Professor of Surgery at Alma Mater Studiorum, University of Bologna. His research interests mainly include the study of liver failure. He attended during his medical studies the Chirugische Klinik in Heidelberg (Germany). He also completed a research fellowship at the Hospital Italiano (Buenos Aires, Argentina) on the use of hepatobiliary scintingraphy in ALPPS technique and started a clinical fellowship at the London Health Sciences Centre (Ontario, Canada). He is author of 132 scientific publications in the most prestigious national and international journals, with a large number of citations. His H index is 26.
Summary
This book offers a comprehensive overview on the topic of liver regeneration with the aim of providing a potentially curative surgical treatment for liver tumours. it will be divided into five thematic sessions: from the cellular and haemodynamic mechanisms that act as triggers for the regeneration process, to currently available techniques based on surgical and/or interventional radiology methods, their optimisation and risks, to a discussion of how to use hypertrophy techniques in the context of each specific disease setting and new frontiers. Despite the fact that this is a progressively evolving field, the importance of performing major liver resections in a safe setting - reducing the risk of post-operative liver failure, which is the most serious potentially life-threatening complication in liver surgery - will remain unchanged in the field of cancer surgery. In this scenario, a book providing a systematic discussion of the state of the art and evidence now established in this field is an essential tool for any centre with an active liver surgery programme. The multidisciplinary perspective used to address this topic is a further innovative value of this project, which has the ambition of meeting the need for a lasting cultural background on this subject.
