title: [The European liver surgery topic--recent developments in liver surgery (in situ protection and ex situ operation)].
abstract: Ex situ operations on the liver, a new surgical approach, and operations on a vascularly isolated and in situ hypothermic-perfused liver were performed in 12 patients. The indications for either approach were limited to patients for whom a conventional approach was impossible or seemed insufficiently radical. In one case a huge symptomatic focal nodular hyperplasia in segment IV became resectable only with the ex situ-technique. Our first experience showed that preoperative cholestasis is a high-risk factor for postoperative hepatic insufficiency; three patients with marked preoperative cholestasis died. In patients with good preoperative liver function these two approaches allow a more radical liver resection and are the only possibility for tumor resection in particular situations.
authors.affiliation: Klinik für Abdominal- und Transplantationschirurgie, Medizinische Hochschule Hannover.
authors.forename: R
authors.initials: R
authors.lastname: Pichlmayr
authors.forename: G
authors.initials: G
authors.lastname: Gubernatis
authors.forename: P
authors.initials: P
authors.lastname: Lamesch
authors.forename: S
authors.initials: S
authors.lastname: Raygrotzki
authors.forename: J
authors.initials: J
authors.lastname: Hauss
mesh_terms: D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion; D011379:Prognosis; D012092:Replantation / Q000379:methods*
vernacular_title: Europäisches Thema Leberchirurgie--Neuentwicklungen in der Leberchirurgie (in situ-Protektion und ex situ-Operation).