Parenchyma Sparing Liver Resection [PSLR] as a Viable Option for Multifocal Colorectal Liver Metastases – a Case Report and Review of Literature
Published: 2022-01-31
Page: 54-59
Issue: 2022 - Volume 5 [Issue 1]
M. P. Ashwin Balaji
Liver Transplant & Hepato Pancreato Biliary Surgery, Liver Disease & Transplantation Centre, Kauvery Hospitals, No. 199, Luz Church Road, Mylapore, Chennai, Tamil Nadu, India.
Sugi Subramaniam Raghavan Velayutham *
Liver Transplant & Hepato Pancreato Biliary Surgery, Liver Disease & Transplantation Centre, Kauvery Hospitals, No. 199, Luz Church Road, Mylapore, Chennai, Tamil Nadu, India.
Elankumaran Krishnan
Liver Transplant & Hepato Pancreato Biliary Surgery, Liver Disease & Transplantation Centre, Kauvery Hospitals, No. 199, Luz Church Road, Mylapore, Chennai, Tamil Nadu, India.
Kulaseharan Venugopal Haribabu
Liver Anaesthesia & Intensive Care Unit, Liver Disease & Transplantation Centre, Kauvery Hospitals, No. 199, Luz Church Road, Mylapore, Chennai, Tamil Nadu, India.
B. Hari Balakrishnan
Liver Anaesthesia & Intensive Care Unit, Kauvery Hospitals, No. 199, Luz Church Road, Mylapore, Chennai, Tamil Nadu, India.
Iyyappan Ponnuswamy
Department of Radiodiagnostics, Kauvery Hospitals, No. 199, Luz Church Road, Mylapore, Chennai, Tamil Nadu, India.
*Author to whom correspondence should be addressed.
Abstract
Colorectal liver metastases [CRLM] is the usual natural course of disease in about one third to half of the colorectal cancer patients. The management of CRLM has come across various changes and modifications in the last two decades. Surgical resection has always been the best treatment option providing a good survival benefit. However, this is challenged by the need to preserve adequate liver remnant, preventing post- hepatectomy liver failure, oncological clearance and leaving a good quality remnant to favour post operative liver hypertrophy. Here we present a case of CRLM in a 63-year-old gentleman, that was multifocal involving both the lobes of liver and how parenchyma sparing liver resection using a conglomeration of multiple non-anatomical resections proved to be an effective option under these challenging circumstances.
Keywords: Colorectal liver metastases, post- hepat ectomy liver failure, non-anatomical resections, metastatic lesions