精准肝切除（precise liver resection）.doc

精准肝切除（precise liver resection） Precise hepatectomy -- a new concept of liver surgery in twenty-first Century Department of Hepatobiliary Surgery; PLA General Hospital; Dong Jiahong; Huang Zhiqiang; The historical evolution of hepatectomy Langenbuch, the German surgeon, successfully completed the worlds first elective hepatectomy in 1888, marking the birth of liver surgery. In the early stages of liver surgery, hepatic resection is limited to small wedge resection on the margins of the liver due to lack of anatomical and functional knowledge of the liver. Because of the lack of effective hemostatic measures, the mortality rate of hepatectomy was very high. Until 1908, Pringle created temporary hemostasis of the hepatic pedicle, and a large number of bleeding problems were gradually alleviated during hepatectomy. The middle of the twentieth Century, study on intrahepatic duct casting unveiled the anatomy of the liver, liver surgery, bid farewell to the blind liver resection, liver follow the internal anatomical structure of regular hepatic lobectomy emerged and widely used. However, it is limited by the fact that more than 80% of liver cancer patients have cirrhosis and that there is no reliable method for assessing hepatic reserve function. Since 1960s, irregular liver resection with the goal of preserving more residual liver parenchyma and reducing postoperative liver failure has become a popular surgical procedure for liver resection. In 1980s, liver resection was performed on the surgical stage with the development of liver functional anatomy, liver pathology, and modern anatomical imaging techniques. This method can effectively remove liver lesions and retain more functional liver tissue, and improve the accuracy and validity of liver resection from two aspects of anatomy and pathology [4]. In 1990s, benefiting from the modern medical imaging technology continues to progress, liver function assessment and preoperative liver volume measurement method, the applicat