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Alternative Surgical Policy for Central Liver Tumors

NCT00600522 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 15

Last updated 2008-01-25

No results posted yet for this study

Summary

Major hepatectomies have not negligible morbidity and mortality. However, when tumors invade middle hepatic vein (MHV) at caval confluence major surgery is usually recommended. Ultrasound-guided hepatectomy might allow conservative approaches. We prospectively check its feasibility in a series of patients carriers of tumors invading the MHV at the caval confluence.

Conditions

Interventions

PROCEDURE

Ultrasound-guided hepatectomy

After laparotomy and staging by intraoperative ultrasound (IOUS), anterior surface of the hepatocaval confluence is exposed. Than, compression by means of the surgeon's finger-tip is applied at the MHV caval confluence verifying at color-Doppler IOUS the disappearance of the blood flow in the MHV or its inversion. Then, MHV clamping itself is carried out, and parenchymal sparing resection would be selected if at least one of these 3 findings is confirmed: 1. Reversal color-Doppler IOUS flow direction in the peripheral portion of the MHV, which suggests the drainage through collateral circulation in the RHV/LHV depending on the side of the MHV branch with reversal flow. 2. Detectable shunting collaterals at color-Doppler IOUS with RHV or LHV. 3. Hepatopetal flow in P5-8 and/or P4inf portal branches. If none of these finding is confirmed and in particular hepatofugal flow direction in the P5-8 and/or P4 inf is detected the hepatectomy has to be extended.

Sponsors & Collaborators

  • University of Milan

    lead OTHER

Principal Investigators

  • Guido Torzilli, MD, PhD · University of Milan, Istituto Clinico Humanitas - IRCCS

Eligibility

Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2004-01-31
Primary Completion
2007-01-31
Completion
2007-05-31

Countries

  • Italy

Study Locations

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Entities

Diseases

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT00600522 on ClinicalTrials.gov