Abstract
A precise knowledge of the surgical anatomy of the liver is essential for the performance of safe oncological liver resections. The role of the Couinaud’s segmental anatomy of the liver has changed the surgical management of primary and metastatic liver disease. Advances in liver resection techniques, with improved methods of vascular control and segmental-based surgical resections over the last two decades have reduced operative mortality from 17 to 2–4 % in most large series. Intraoperative ultrasound has improved the surgical oncological outcome by identifying adequacy of resection margins and facilitating parenchymal-sparing resection with less morbidity as well as assisting in identifying the segmental anatomy real time in the resection. Liver surgery has evolved from a dangerous procedure to a safe one and now offers the chance of long-term survival and cure for liver malignancy.
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