Abstract
Our policy for treatment of hepatocellular carcinoma is to perform extended resection. When curability can be expected, one segment-additive resection would be ideal. Another purpose of extended resection is to enable effective multimodality therapies by the surgical approach, such as removing a tumor thrombus in the portal vein, NC etc. Extended resection of the liver requires precise judgment of the hepatic functional capacity, and measurement of the blood ketone body ratio is very useful for this. The liver function deteriorates during hepatectomy, as expressed by a prolonged decrease in the blood ketone body ratio. One of the most helpful methods to minimize the extent and duration of the decrease in the intraoperative blood ketone body ratio is to use a Bio-Pump (R) by which portal congestion can be completely avoided.
