Management of tumors of the liver. Combined use of arteriography and venography in the assessment of resectability, especially in hilar tumors.
Twenty-five primary and secondary malignant tumors involving the liver were assessed preoperatively by combined hepatic arteriography and portal venography. The resectability of the lesions as judged by these radiographic techniques was compared with the operative findings. Only 1 of 6 peripheral nonhilar tumors was unresectable, in contrast to 11 of 19 tumors involving the hilus In every case the operative findings confirmed the preoperative radiologic data. Of the patients with hilar lesions, four had isolated unilateral involvement of either the main trunk or a major secondary branch of the lobar artery and vein and were all resectable. None of the 11 hilar lesions with bilateral or stem involvement of the vasculature were resectable. It is suggested that hepatic angiography not only yields information on diagnosis, anatomic abnormalities and concurrent disease, but also is important in assessing tumor resectability. For this purpose, both selective hepatic arteriography and splenic venography are necessary.
D002759:Adenoma, Bile Duct / Q000098:blood supply / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D002277:Carcinoma / Q000000981:diagnostic imaging; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging*; D006801:Humans; D007813:Laparotomy; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010690:Phlebography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging