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Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach

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Surgical Considerations for Primary Liver Neoplasms.

Dillon C Cheung¹, Chee-Chee Stucky²

¹Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.

Hematology/Oncology Clinics of North America

|June 17, 2026

Summary

Primary liver cancers like hepatocellular carcinoma and intrahepatic cholangiocarcinoma have poor survival rates. Surgical resection offers the best prognosis, with advanced therapies aiding resectability in select cases.

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Area of Science:

Hepatobiliary surgery
Surgical oncology
Gastroenterology

Background:

Primary liver neoplasms, including hepatocellular carcinoma and intrahepatic cholangiocarcinoma, represent a significant global health challenge.
These cancers are associated with poor survival outcomes and limited effective systemic treatment options.
Accurate preoperative assessment is crucial for determining surgical candidacy.

Purpose of the Study:

To outline the essential components of preoperative assessment for liver neoplasms.
To discuss the role of surgical resection and minimally invasive techniques.
To explore strategies for managing advanced but potentially resectable liver tumors.

Main Methods:

Comprehensive preoperative evaluation including advanced imaging, liver function tests, and future liver remnant (FLR) volumetry.

Keywords:

Future liver remnant Hepatic artery infusion chemotherapy Hepatocellular carcinoma Intrahepatic cholangiocarcinoma Liver resection Minimally invasive surgery Neoadjuvant therapy Portal vein embolization

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Surgical resection aiming for negative margins.

Application of minimally invasive surgical approaches in selected patients.

Neoadjuvant therapies such as chemotherapy, portal vein embolization (PVE), radiation lobectomy, and hepatic artery infusion chemotherapy (HAIC) for downstaging.

Main Results:

Surgical resection with clear margins provides the best opportunity for long-term survival in primary liver neoplasms.
Minimally invasive surgical techniques are increasingly utilized for eligible patients, potentially reducing morbidity.
Neoadjuvant strategies can facilitate tumor downstaging, converting initially unresectable disease into a resectable state.

Conclusions:

Effective management of primary liver neoplasms necessitates a multidisciplinary approach integrating accurate preoperative assessment and tailored treatment strategies.
Surgical resection remains the cornerstone of curative treatment, with advancements in surgical techniques and neoadjuvant therapies expanding resectability.
Further research into systemic therapies and innovative downstaging techniques is warranted to improve outcomes for patients with advanced liver cancer.