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Updated: Aug 25, 2026
Laparoscopic Anatomical Right Hemihepatectomy via the In Situ Anterior Approach
Published on: August 8, 2025
Protection of the liver during hepatic surgery
Pierre-Alain Clavien1, Jean Emond, Jean Nicolas Vauthey
1Department of Visceral and Transplantation Surgery, University Hospital Zurich, 100 Raemistrasse, 8091 Zurich, Switzerland. clavien@chir.unizh.ch
Abstract:
Very few areas in medicine have seen as many controversies as the evaluation and treatment of patients with liver diseases. Many novel therapies, often marketed before conclusive demonstration of their efficacy, have been developed to enable selective destruction of liver tumors to minimize the risk of liver failure associated with major surgery. Whether these techniques are effective and result in lesser complications often remains speculative. Persisting challenges in selecting the optimal therapy are the evaluation of the risk of surgery in patients with normal or diseased liver and the preparation for surgery. A panel of hepato-biliary surgeons experienced in the management of complex cases convened at the annual meeting of the American Hepato-Pancreato-Biliary Association in Boston, MA, to address the rapidly evolving field of protective strategies for hepatic surgery.
Insights
Novel therapies for liver tumors aim to reduce liver failure risk but their efficacy and safety remain debated. Experts convened to discuss protective strategies for hepatic surgery, addressing challenges in patient selection and preparation.
Area of Science:
- Hepatology and Surgical Oncology
Background:
- Controversies surround the evaluation and treatment of liver diseases.
- Novel therapies for liver tumors are emerging, yet their efficacy and safety are often unproven.
- Minimizing liver failure risk during major liver surgery is a critical challenge.
Purpose of the Study:
- To address controversies in liver disease treatment and novel therapies.
- To explore protective strategies for hepatic surgery.
- To improve patient selection and preparation for liver surgery.
Main Methods:
- A panel of experienced hepato-biliary surgeons convened.
- Discussions focused on the management of complex liver cases.
- The panel addressed protective strategies for hepatic surgery.
Main Results:
- Novel therapies' effectiveness and complication rates remain speculative.
- Challenges persist in evaluating surgical risk in patients with normal or diseased livers.
- Optimal patient preparation for hepatic surgery requires further investigation.
Conclusions:
- The field of protective strategies for hepatic surgery is rapidly evolving.
- Further research is needed to conclusively demonstrate the efficacy and safety of novel liver tumor therapies.
- Standardized approaches to risk assessment and patient preparation are crucial for successful hepatic surgery.
