ABSTRACT
Introduction ............................................................................................................................. 75 Surgery o f H epatobiliary M alignancies ........................................................................... 76 Radiological Imaging M odalities ....................................................................................... 78 Intraoperative Ultrasonography (IO U S)........................................................................... 80 Laparoscopic Ultrasonography (L U S ) ................................................................................81 Therapeutic Laparoscopy (Minimally Invasive Su rgery) ............................................ 99 Conclusions............................................................................................................................ 102
INTRODUCTION
Surgical resection offers the only hope o f cure for patients with hepatobiliary malignancies. Traditionally, potential candidates for resection underwent explor atory laparotomy to determine the exact extent o f their disease. A high percentage o f these patients were found to be incurable due to the unsuspected spread o f tumor beyond the limits of a feasible resection. The salvage rate for patients with hepatobiliary malignancies is low, and this highlights the need for accurate preop erative staging to prevent unnecessary surgical exploration.1 Unlike most gas trointestinal malignancies, liver tumors generally do not require palliative surgi cal procedures. The only therapeutic option available is complete surgical resec tion, although there are increasing reports o f experimental non-resectional thera pies, such as (regional) intra-arterial chemotherapy, immunization schemes and local ablative procedures.