Nowadays surgical resection represents the only therapeutical option that may achieve a radical treat-

Fig. 2a, b. Portal vein embolisation. a Transhepatic portography. b Right portal system after injection of fibrin glue. The drawing shows the balloon catheter used for the injection of fibrin glue

Fig. 3. Left lobe hypertrophy after portal vein embolisation of right portal system. On the right, surgical field after right extended hepatectomy

ment of liver metastases. This procedure allows survival rates that are considerably higher compared with other therapeutical procedures. Surgical resection is effective and effects 5-year survival rates of 26-45% [22], whereas in patients not submitted to surgical resection, 5-year survival is almost zero [48]. Hepatic resection is performed with low morbidity and mortality rates: 0-3% in specialised centres [53].

The most frequent causes of mortality are intra-and post-operative haemorrhage, which occurs in 1-3% of patients. Risk of post-operative hepatic failure is low: 1-5% after major hepatic resections. The more frequently observed surgical complications are: pulmonary in 10-20% of patients, biliary tract lesions in 3-5%, infectious in 2-9% and cardiac complications in 1-5% (Table 6). The mean hospital stay in patients submitted to major hepatic resection usually does not exceed two weeks.

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