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ABSTRACT: In this article the radiological work-up before liver surgery is reviewed. Based upon the latest literature the following is recommended: In patients with liver metastases (LM) or hepatocellular carcinoma (HCC), dedicated magnetic resonance imaging with liver-specific contrast or modern multislice computed tomography (MSCT) of the liver should be performed before liver surgery. Positron emission tomography/computed tomography (PET/CT) is the most accurate modality for detection of extra-hepatic tumours in patients with LM from colorectal cancer. When percutaneous radiofrequency ablation is planned, the patient should be evaluated with contrast-enhanced ultrasound. Biopsy should not be performed before liver surgery when typical imaging findings consistent with LM or HCC are present in patients with colorectal cancer or chronic liver disease. Preoperative assessment of resectability of perihilary cholangiocarcinomas is most precisely done with modern MSCT and percutaneous transhepatic cholangiography.
Ugeskrift for laeger 05/2008; 170(16):1330-3.
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ABSTRACT: We describe the first successful down staging with a combination of neoadjuvant intra-arterial chemo-embolisation followed by portal vein embolisation in a Danish patient with hepatocellular carcinoma (HCC). Down staging allowed radical liver resection in the patient who was initially found to be inoperable. Patients with HCC are often irresectable. The only treatment that offers a chance for long term survival is surgery. Liver transplantation is limited by the shortage of donor organs. The combination of chemo-embolisation and portal venous embolisation may increase the number of resectable patients.
Ugeskrift for laeger 02/2008; 170(7):549.
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Peter Nørgaard Larsen
Ugeskrift for laeger 01/2008; 169(51):4469-71.
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ABSTRACT: Sarcoma of the inferior vena cava (IVC) is a rare clinical entity. Surgical treatment of IVC is associated with improved survival. This case report describes a 42-year-old woman with biopsy-proven leiomyosarcoma of the inferior vena cava with intracardial tumour growth. The primary tumour was only 1 x 1 cm in the wall of the vena cava while the intracaval tumour was 12 cm long with a diameter of 5 cm and 1.5 cm in the right atrium. Using venovenous bypass with circulatory support, the tumour was excised in toto and the caval vein closed with a pericardial patch. The patient was discharged in good condition after 19 days.
Ugeskrift for laeger 12/2005; 167(45):4275-6.
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Ugeskrift for laeger 12/2004; 166(46):4161-5.
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ABSTRACT: A 50-year-old Danish man, who neither had wasting disease nor was taking steroid-containing drugs, complained of abdominal distension, due to a markedly enlarged liver. Percutaneous needle biopsies were taken from the liver, and the findings gave suspicion of a neoplastic tumor. Because of reduced liver function and treatment-resistant ascites, he underwent liver transplantation without a definite preoperative diagnosis. The resected liver weighed 2900 g, and almost all of the parenchyma was destroyed and replaced by multicystic blood-filled spaces, diagnosed as extensive peliosis hepatis complicating liver cirrhosis. Extensive peliosis with liver cirrhosis is a rare condition. Only two cases, caused by contraceptives and treated by liver transplantation, are reported in the English-language literature. We could find no cause other than alcohol abuse lasting several years in this patient, and classified the present case as idiopathic extensive peliosis hepatis. Although scarce subjective findings and misleading liver biopsies made an exact diagnosis difficult, an orthotopic liver transplantation was the only treatment for such complicated peliosis hepatis.
Journal of Hepato-Biliary-Pancreatic Surgery 02/2004; 11(5):371-4. · 1.60 Impact Factor
