Introducing Liver Surgery to the MID NORTH COAST NSW. Dr George Petrou FRACS 69Lake Rd, Port Macquarie NSW www.portlapsurgery.com.au Hepatobiliary Surgery, Laparoscopic Surgery, Obesity Surgery, Hernia surgery, Endosurgery. Indications for liver surgery. Colorectal metastases
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Introducing Liver Surgery to the MID NORTH COAST NSW
Dr George Petrou FRACS
69Lake Rd, Port Macquarie NSW
Hepatobiliary Surgery, Laparoscopic Surgery, Obesity Surgery, Hernia surgery, Endosurgery
Preoperative chemotherapy before liver surgery.
Improves survival & increases operability.
After Neoadjuvant chemotherapy this is now operable
A clear margin is necessary to prevent local recurrence in the liver
Rule: excise when minimal
Synchronous Resection with bowel
Rule: safe if minor liver resection is planned (2 or less liver segments to be removed)
Number of lesions
Rule: Doesn’t matter provided a clear margin and adequate remnant liver volume can be achieved.
Portal Vein Embolisation
Increases operability and safety with extended resection.
Inoperable as not enough remnant liver left to make surgery safe
Small L Lateral
Right portal vein is radiologicallyembolised as a day procedure
The remnant liver grows after 4-6 weeks
The tumour is now operable as surgery is now safe
The liver tumour is easily seen at operation with US
George Petrou FRACS
Prometheus stole the secret of fire and gave it to man