Recent Advances in Liver and Pancreatic Surgeries
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Performing hepatectomy is always challenging, especially in patients with underlying liver cirrhosis. Compromised liver function and the presence of portal hypertension can significantly affect patients' postoperative outcomes. Accurate preoperative prediction of liver function, precise calculation of the future liver remnant, and judicious use of a minimally invasive approach could potentially optimize these outcomes.
Apart from preoperative liver function assessment by the ICG retention test, the intraoperative use of ICG can facilitate dissection and identification of the ischemic plane as well.
The use of minimally invasive major hepatectomy was prohibitive in the last decade owing to the fear of massive intraoperative bleeding and distorted anatomy. Nonetheless, studies have shown that this approach may minimize the disturbance of portosystemic collaterals (unlike open surgery, in which abdominal wall varices are disrupted) and decrease blood loss in expert hands, with comparable short- and long-term results.
Conversion therapy, one of the most important breakthroughs in the management of liver cancers in recent years, provides another new hope for the cure of this group of patients. Nonetheless, with input from oncologists, radiologists, hepatologists, and surgeons, the optimal timing for surgical intervention can be determined.
Recently, non-invasive treatment options such as histotripsy have emerged. Early outcomes are promising, and their development across different surgical fields is rapidly advancing.
Clinical Professor (Honorary), Faculty of Medicine, CUHK
Director, Minimally Invasive and Robotic Surgery Centre, Gleneagles Hospital Hong Kong
Professor Chok received his MBBS from the University of Hong Kong (HKU). He joined HKU as Clinical Associate Professor in the Department of Surgery in 2015. He became Deputy Director of Liver Transplant Centre in Queen Mary Hospital and received his Master of Surgery from HKU in the same year. He became a Fellow of the American College of Surgeons (ACS) in 2016 after having received the Carlos Pellegrini Traveling Fellowship award of the ACS. He received his second doctoral degree (Doctor of Medicine) from HKU in 2020. He joined the Chinese University of Hong Kong (CUHK) as a Full Professor in the Department of Surgery in 2024. He is now serving as Clinical Professor (Honorary) in Faculty of Medicine, CUHK, and the Director of the Minimally Invasive and Robotic Surgery Centre in Gleneagles Hospital Hong Kong. He is a Co-PI on various research projects, with a total grant amount of more than HK$100 million. He is a Top 2% scientist in the Stanford/Elsevier database.
Professor Chok has published more than 300 articles in leading peer-reviewed journals on liver surgery and hepatocellular carcinoma, including the Journal of Hepatology, Hepatology, Liver Transplantation, and Annals of Surgery. His H-index was 56 (Google Scholar) with citations of more than 10200. He is actively involved in promoting public health in Hong Kong. He has organized various initiatives, as he is the Vice-Chairman of the Guangdong Society of Hepatology, the President of the Hong Kong Society of HPB Surgery, a council member of the Hong Kong Society of Transplantation, the Hong Kong Liver Foundation, the Hong Kong Society of Gastroenterology and the Hong Kong Society of Minimal Access Surgery.
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