Introduction: Selected patients with unresectable colorectal liver metastases (CRLM) may become resectable using a two-step approach with portal vein ligature (PVL). The purpose of this study is the evaluation of the results of the tow-staged liver resection (LR) using PVL for CRLM in our clinic.
Material and methods: During the period 2005-2015 year at the Clinic of hepatobiliary and transplant surgery, MMA-Sofia 290 curative LR for CRL were carried out. In 17 (5.9%) of them is used a two-stage approach with an initial PVL.
Results: The reasons for unresectability were multinodularity of the disease in 70.6%, the size of LM (11.8%), poor location (17.6%). Synchronous LM was at 94% of the cases. Simultaneous resection of the primary tumor at the first operation carried out in 58.8% of the cases. During the second operation, at 94% of patients require a major LR. Patients completed a two-staged approach median survival was 40.43 m., with a found that extended right hemihepatectomy adversely affect survival in patients with two-stage hepatectomy (p=0.023), increasing the risk over 6 times.
Conclusion: The multidisciplinary approach is the most precise form, ensuring proper selection and behavior in patients under consideration for two-stage approach to optimize the therapeutic behavior and clinical outcomes.