title: Usefulness of a CT-guided hookwire marking in laparoscopic partial hepatectomy for hepatocellular carcinoma invisible on ultrasonography.
abstract: BACKGROUND
  The intra-operative detection of hepatocellular carcinoma (HCC) by ultrasonography is indispensable for laparoscopic partial hepatectomy. However, it is occasionally difficult to localize an HCC on an ultrasound in chronic liver disease. Two cases of partial hepatectomy using hookwire marking under CT guidance are presented.
  
  
  METHODS
  The location of the HCC was identified by CT scan, and the puncture site was determined. A hookwire system, made of a stainless steel hook, was used to localize the HCC. The hookwire was placed percutaneously close to the HCC, and then the patient was taken to the operating room as soon as possible. After identification of the hookwire marker, the cutting line was determined on the liver surface to ensure a sufficient surgical margin in laparoscopic partial hepatectomy.
  
  
  CONCLUSIONS
  Two cases underwent these procedures with easy intra-operative marking of the resection area. This technique facilitates safe laparoscopic partial hepatectomy for an HCC that is invisible on ultrasound.
authors.affiliation: Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Monden
authors.affiliation: Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sadamori
authors.affiliation: Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Hioki
authors.affiliation: Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Kanyu
authors.initials: K
authors.lastname: Nakano
authors.affiliation: Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Asami
authors.affiliation: Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ohno
authors.affiliation: Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Kyo
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ueki
authors.affiliation: Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yabushita
authors.affiliation: Department of Radiology, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Uka
authors.affiliation: Department of Radiology, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hyodo
authors.affiliation: Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Kousaku
authors.initials: K
authors.lastname: Sakaguchi
authors.affiliation: Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Takakura
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D057918:Fiducial Markers; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
keywords: CT-guided marking; hepatocellular carcinoma; laparoscopic hepatectomy