Challenges and thoughts on precise hepatectomy / 中华消化外科杂志

ABSTRACT

Precise hepatectomy is the application of minimally invasive concept in hepatic surgery. There are big challenges for surgeons to choose the proper approaches to achieve the aim of precise hepatectomy. How to choose therapeutic strategy, chemotherapy, radiotherapy, liver transplantation or radiofrequency ablation? How to choose the operation type, laparoscopic surgery, transabdominal surgery or Da Vinci robot-assisted surgery? How to choose the surgical instruments during hepatectomy? Although answers for these questions are various, the principle is unchangeable, which is providing minimal injury, less blood loss, fast recovery, little expense and good prognosis. The concept of precise hepatectomy includes precise judgment of liver function and careful preparation before operation, and also the elaborate nursing and multi-disciplinary cooperation during operation, as well as the fast track surgery after operation. Precise hepatectomy requires surgeons take the safety and effectiveness of the operations into account, and the conditions of hospitals, the skills and experiences of the surgeons should also be evaluated before operation. Finally, the economic condition of the patients should be considered and proper application of advanced equipments should be emphasized.