Cutting Edge Technique
For liver cancers, surgery is the most effective treatment, and it is therefore essential to conduct proper surgical evaluation as an important part of treatment planning. We have developed the ability to reconstruct a 3D image of the patient’s liver based on preoperative CT scans. With this technique we can pin point precisely the site, size and location of liver tumour, and most importantly, calculate the future remnant liver volume after liver surgery to prevent unnecessary removal of normal liver tissues. We perform over 120 liver operations each year. In the past few years, Professor Nagy Habib has pioneered a surgical technique using a radiofrequency device to reduce intraoperative blood loss and potential postoperative complications (Jiao, LR, Habib NA et al. Hepatogastroenterology 2005; 52: 1685-7). We do not give blood transfusion at all for patients having major liver operations. This allows patients to go home much earlier and without intensive care treatment. The HBP unit has also pioneered laparoscopic methods for both the diagnosis and treatment of hepatobiliary cancers. Using this technique, the team have performed a number of liver resections for liver cancer ((Jiao LR, Habib NA et al. Am J. Surg. 2007;193:143-8). Patients who have undergone a resection with this technique can go home much quicker with minimum trauma and discomfort.
The majority of patients are not suitable for surgical resection and various treatments have been developed for these patients. The Hammersmith Hospital is one of the first two units in the world to use radiofrequency ablation to downstage the tumour to make the tumour resectable, and to treat unresectable liver tumours (Jiao LR, Habib NA et al, Am J Surg 177:303-306 1999).
In the last two years, we have pioneered the use of microspheres (local radiation therapy) for the treatment of unresectable liver cancer which has failed to respond to any conventional chemotherapy. Further information about this treatment can be seen at SIRTEX Spheres.