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A new measure to assess the difficulty of liver resection

Item Type:Article
Title:A new measure to assess the difficulty of liver resection
Creators Name:Beller, S. and Eulenstein, S. and Lange, T. and Niederstrasser, M. and Huenerbein, M. and Schlag, P.M.
Abstract:BACKGROUND: There is no valid measure to assess surgical difficulty and feasibility of a planned liver resection. It is the objective of this study to evaluate a mathematical measure from a 3D graphical analysis. METHODS: Eleven different 3D models of hepatic tumours were evaluated by experts for resectability and analysed with Amira((R)) graphic software taking into consideration the portal and hepatic venous vascular relationships. Virtual resection volumes with increasing resection margins from 1 to 30mm were determined separately for portal veins, hepatic veins, their intersections and volume unions. The integral of the increasing resection volumes was defined as risk coefficient. The risk coefficients from this volumetric analysis were compared with the expert opinion. RESULTS: The risk coefficient based on the integral of portal venous and hepatic venous volume unions reproduced the expert opinion highly significantly (correlation coefficient 0.9, p<0.05) and more accurately than volumetric analysis of the planned resection margin. CONCLUSION: With automated volumetric analysis, anatomically problematic situations in liver surgery can be reproduced and scaled. The risk coefficient obtained is a suitable objective measure for defining risk areas in liver surgery.
Keywords:Liver, Surgery, Risk, 3D, Volumetry
Source:European Journal of Surgical Oncology
Page Range:59-64
Date:January 2009
Official Publication:https://doi.org/10.1016/j.ejso.2008.07.014
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