Liver, biliary tree, and gallbladder

Abstract

Surgical resection remains the mainstay therapy for primary cancer of the liver and for most of the metastatic disease affecting this organ. There is a renewed interest in operative approaches to the liver mainly with regard to great developments in staging (imaging technique) and the availability of complex surgical strategies, and predictability of hepatic functional tolerance. At present, the 5-year survival rate following successful resection of metastatic colorectal cancer and hepatocellular carcinoma ranges from 40% to 60%, and the operative mortality after resection is less than 5%. An additional tool aside from resection is the delivery of regional therapy via hepatic artery infusions of chemotherapeutic agents; the latter strategy was at its peak early this decade and was indicated in patients with unresectable metastatic col-orectal cancer to the liver. Presently, the use of this strategy has declined as systemic chemotherapeutic agents have become more effective against this disease. © 2010 Springer-Verlag Berlin Heidelberg.