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Updated: Dec 23, 2025

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
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Parenchyma-sparing liver resections.

Guido Torzilli1, Lucas McCormack2, Timothy Pawlik3

  • 1Department of Surgery - Division of Hepatobiliary & General Surgery Humanitas University, Rozzano - Milan, Italy.

International Journal of Surgery (London, England)
|April 27, 2020
PubMed
Summary
This summary is machine-generated.

Parenchyma sparing liver surgery (PSS) is crucial for successful liver resections, prioritizing function preservation. PSS offers benefits over minimal access liver surgery (MALS) for complex cases, enhancing patient outcomes.

Keywords:
CholangiocarcinomaColorectal liver metastasesHepatectomyHepatocellular carcinomaIntraoperative ultrasoundLiver metastasesLiver tumorsLiver tunnelMini-meso-hepatectomyMinimal access liver surgeryMinimal invasive liver surgeryParenchyma sparing surgeryR1 vascularUpper transversal hepatectomy

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Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Liver resection requires advanced surgical skills.
  • Parenchyma sparing liver surgery (PSS) is increasingly important for preserving liver function.
  • PSS aims to minimize the sacrifice of healthy liver tissue during oncological resections.

Purpose of the Study:

  • To evaluate the role and benefits of PSS in liver surgery.
  • To compare PSS with major resections and minimally access liver surgery (MALS).
  • To determine the optimal approach for complex liver resections considering oncological and functional outcomes.

Main Methods:

  • Review of oncological and anatomical insights.
  • Intraoperative ultrasound utilization.
  • Comparison of open PSS and MALS for complex hepatectomies.

Main Results:

  • PSS can be offered even in advanced liver disease, previously considered for major resections.
  • Complex hepatectomies are often performed with open surgery, while MALS is used for major or staged procedures.
  • A potential conflict exists between open PSS and MALS for major hepatectomies.

Conclusions:

  • Prioritizing PSS is recommended due to its advantages in oncological radicality, safety, salvageability, and quality of life.
  • PSS is inherently minimally invasive from a liver-centric perspective.
  • MALS is not always synonymous with minimally invasive liver surgery.