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Korean Journal of Hepato-biliary-pancreatic Surgery

Nam Kyu Choi, Sung-Chul Lim
Lymphoepithelioma-like carcinoma (LELC), an undifferentiated carcinoma with intense lymphoplasmacytic infiltrates, is commonly reported in the nasopharynx and occasionally in other organs. Pure type of LELC has previously been reported in the gallbladder. Mixed type could be reportable in comparison with other organs. Here we present a case of an 83-year-old man with mixed LELC and adenocarcinoma in the gallbladder. To the best of our knowledge, this is the first case of mixed LELC and adenocarcinoma in the gallbladder...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Dimitrios E Giakoustidis, Athanasios A Gargavanis, Evangelia D Katsiki, Nikolaos T Salveridis, Nikolaos A Antoniadis, Vasileios Papanikolaou
Undifferentiated Embryonal Sarcoma of the Liver (UESL) is a tumor highly malignant, of mesenchymal origin. It is a rare finding in adults, though less rare in children. The strategy to be followed and the therapeutic targets to be reached for this tumor, in adult cases, remain ambiguous and controversial. Herein we report the case of a 29 year old female patient with a massive UESL and we describe our therapeutic approach. A 29 year-old female patient was referred to our center with severe intermittent epigastric pain and fever due to a voluminous liver tumor: Needle biopsy was of no specific findings and surgical excision was decided...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Namsrai Baterdene, Shin Hwang, Jong-Wook Lee, Min-Jae Jung, Heeji Shin, Hye Kyoung Seo, Myeong-Hwan Kim, Sung-Koo Lee
Intraductal papillary neoplasms of the bile duct (IPNB) leads to malignant transformation and mucin production. Herein, we presented two cases of mucin-producing IPNB with obstructive jaundice who underwent resection of the intrahepatic lesions and bypass hepaticojejunostomy. The first case was a 69 year-old male patient with 5-year follow up for gallstone disease. Imaging studies showed mucin-secreting IPNB mainly in the hepatic segment III bile duct (B3) and multiple intrahepatic duct stones for which, segment III resection, intrahepatic stone removal, end-to-side choledochojejunostomy and B3 hepaticojejunostomy were conducted...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Batsaikhan Bat-Erdene, Sergelen Orgoi, Erdene Sandag, Ulzii-Orshikh Namkhai, Bat-Ireedui Badarch, Batsaikhan Batsuuri
The sinusoidal obstructive syndrome (SOS) is a complication that usually follows hematopoietic stem cell transplantation. It is also known as veno-occlusive disease, which is a rare complication of living donor liver transplantation (LDLT). Herein, we reported a 34 year-old female patient presenting SOS after LDLT. Its underlying cause was presumed to be associated with liver abscess and subsequent inferior vena cava stenosis. SOS led to graft failure, thus requiring retransplantation with a deceased donor liver graft...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Shin Hwang, Jong-Woo Choi, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung
BACKGROUNDS/AIMS: Open surgery for choledochal cyst has a disadvantage of skin incision scar from operative wound, which can be a definite disadvantage especially in young female patients. This study focused on the cosmetic aspect of skin incision for resection of choledochal cyst in young female patients. METHODS: During a 2-year study period, 11 adult female patients aged less than 40 years underwent primary resection of choledochal cyst by a single surgeon. The cosmetic effect of two types of skin incision was evaluated...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Jong Oh Lee, Dong Won Kim, Mi Ae Jeong, Hee Jong Lee, Kyu Nam Kim, Dongho Choi
BACKGROUNDS/AIMS: Although perioperative therapies have improved greatly, pancreatectomies still often need blood transfusions. However, the morbidity from blood transfusions, the poor prognosis of blood transfused patients, high cost, and decreasing supply of blood products is accelerating transfusion-free (TF) surgery in the patients who have pacreatectomies. The aim of this study was to assess the feasibility of TF pancreatectomies for patients who are Jehovah's Witness. METHODS: We investigated the possibility of TF pancreatectomies for the Jehovah's Witness patients undergoing pancreatectomies between January 2007 and Februay 2014...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Michail Papamichail, Amir Ali, Michail Pizanias, Praveen Peddu, John Karani, Nigel Heaton
BACKGROUNDS/AIMS: Resection or enucleation is currently the treatment of choice for small pancreatic neuroendocrine tumors (NETs). Irreversible electroporation is a novel ablative method that is used for locally advanced pancreatic adenocarcinoma, but little data exists for its use for pancreatic NETs. We report an early experience of IRE for early pancreatic NETs. METHODS: Between April 2014 and March 2015, 3 patients with small (<2 cm) pancreatic NETs were treated with percutaneous IRE...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Sung Hwan Lee, Sung Hyun Kim, Jin Hong Lim, Sung Hoon Kim, Jin Gu Lee, Dae Joon Kim, Gi Hong Choi, Jin Sub Choi, Kyung Sik Kim
BACKGROUNDS/AIMS: Aggressive surgical resection for hepatic metastasis is validated, however, concomitant liver and lung metastasis in colorectal cancer patients is equivocal. METHODS: Clinicopathologic data from January 2008 through December 2012 were retrospectively reviewed in 234 patients with colorectal cancer with concomitant liver and lung metastasis. Clinicopathologic factors and survival data were analyzed. RESULTS: Of the 234 patients, 129 (55...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Sung Hyun Kim, Hye Sung Yoon, Chang Hoon In, Kyung Sik Kim
BACKGROUNDS/AIMS: This study evaluated the hemostatic effects of a novel oxidized regenerated cellulose, SurgiGuard®, during liver surgery, using a reproducible and clinically relevant animal model. METHODS: Fifteen mini-pigs underwent left partial hepatectomy. They were randomized to treatment of the resected surface with SurgiGuard® (Group C [test], n=5), Surgicel® (Group B [reference], n=5), or nothing (Group A [control], n=5). Blood loss was measured 5, 7 and 9 min after resection...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Shin Hwang, Tae-Yong Ha, Chul-Soo Ahn, Deok-Bog Moon, Ki-Hun Kim, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Sung-Gyu Lee
After having experienced more than 2,000 cases of adult living donor liver transplantation (LDLT), we established the concepts of right liver graft standardization. Right liver graft standardization intends to provide hemodynamics-based and regeneration-compliant reconstruction of vascular inflow and outflow. Right liver graft standardization consists of the following components: Right hepatic vein reconstruction includes a combination of caudal-side deep incision and patch venoplasty of the graft right hepatic vein to remove the acute angle between the graft right hepatic vein and the inferior vena cava; middle hepatic vein reconstruction includes interposition of a uniform-shaped conduit with large-sized homologous or prosthetic grafts; if the inferior right hepatic vein is present, its reconstruction includes funneling and unification venoplasty for multiple short hepatic veins; if donor portal vein anomaly is present, its reconstruction includes conjoined unification venoplasty for two or more portal vein orifices...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Sung Hyun Kim, Ji-Ye Kim, Jin Young Choi, Young Deuk Choi, Kyung Sik Kim
Adult pancreatic hemangioma is a rare disease. We presented a case of a woman with pancreatic tail mass mimicking a distant metastasis from the kidney. A 68-year-old woman was found with a left kidney mass on medical checkup. Computed tomography scan showed a 4.3 cm-sized mass in the left kidney, suggesting renal cell carcinoma (RCC), and a strongly enhancing tiny nodule in the pancreatic tail. We could not rule the possibility of RCC metastasis, hence, surgical resection of the pancreatic mass simultaneously with radical nephrectomy for RCC was conducted...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Bulent Kaya, Yetkin Ozcabi, Iksan Tasdelen, Ender Onur, Kemal Memisoglu
Hepaticojejunostomy is an important part of many surgical procedures including pancreaticoduodenectomy. Biliary leakage from hepaticojejunostomy may be associated with intraabdominal abscess formation, biliary peritonitis, and even mortality. A 72-year-old female patient was admitted to our hospital with obstructive jaundice. After initial evaluation, she was diagnosed with distal common bile duct obstruction without accurate diagnosis. Before planned pancreaticoduodenectomy, biliary drainage with a T-tube was performed due to the presence of cholangitis...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Ilseon Hwang, Jihyoung Cho
Ciliated foregut cyst of gallbladder is a very rare benign cystic lesion. A 39-year-old woman was referred to our hospital after abdominal ultrasonography revealed a cystic lesion of gallbladder. On abdominal ultrasonography and computed tomography, a unilocular cystic lesion was found at right upper quadrant with attachment to the gallbladder neck. The gallbladder with cystic lesion was resected through laparoscopic cholecystectomy. The cystic lesion revealed a unilocular cyst with ciliated cuboidal or columnar epithelium and abundant goblet cells...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Sung Hyun Kim, Hae Min Lee, Seung Ho Lee, Jong Yoon Won, Kyung Sik Kim
Portal hypertension can arise from any condition interfering with normal blood flow at any level within the portal system. Herein, we presented two uncommon cases of the portal hypertension and its treatment with brief literature review. A 71-year-old man who underwent right hemihepatectomy revealed a tumor recurrence adjacent to the inferior vena cava (IVC). After radiofrequency ablation (RFA) with lymph node dissection, he was referred for abdominal distension. The abdomen computed tomography scan showed severe ascites with a narrowing middle hepatic vein (MHV) and IVC around the RFA site...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Michail Papamichail, Michail Pizanias, Vincent Yip, Evangellos Prassas, Andreas Prachalias, Alberto Quaglia, Praveen Peddu, Nigel Heaton, Parthi Srinivasan
The incidence of complications after liver resection is closely related to functional future liver remnant (FLR). The standard approach to augment FLR is surgical or radiological occlusion of the artery or portal vein on the tumor side. Associated liver partition and portal vein ligation for staged hepatectomy (ALLPS) has been introduced as an alternative method to augment FLR. It offers rapid and effective hypertrophy for resecting liver metastases. However, data regarding its application in patients with hepatocellular carcinoma (HCC) with a background of chronic liver disease are limited...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Hwan Hyo Lee, Seon Youl Lee
A hepatic lymphangioma is a rare benign neoplasm that is usually associated with systemic lymphangiomatosis. A solitary hepatic lymphangioma is extremely rare. Therefore, we present a rare case of a female patient who underwent right hepatectomy for solitary giant hepatic lymphangioma. A 42-year-old female presented to the emergency department with complaint of severe abdominal pain of the right upper quadrant. Abdominal computed tomography showed an approximately 23×30-cm sized, giant, relatively well-defined, homogenous cystic mass with few septa in the right liver (segments VII and VIII)...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Shin Hwang, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung
Secure reconstruction of multiple hepatic ducts that are severely damaged by tumor invasion or iatrogenic injury is a challenge. Failure of percutaneous or endoscopic biliary stenting requires lifelong placement of one or more percutaneous transhepatic biliary drainage (PTBD) tubes. For such difficult situations, we devised a surgical technique termed cluster hepaticojejunostomy (HJ), which can be coupled with palliative bile duct resection. The cluster HJ technique consisted of applying multiple internal biliary stents and a single wide porto-enterostomy to the surrounding connective tissues...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Jae Hyun Kwon, Shin Hwang, Gi-Won Song, Deok-Bog Moon, Gil-Chun Park, Seok-Hwan Kim, Sung-Gyu Lee
Anomalous portal vein (PV) branching of the donor liver is uncommon and usually makes two, or rarely, more separate PV branches at the right liver graft. Autologous PV Y-graft interposition has long been regarded as the standard procedure, but is currently replaced with the newly developed technique of conjoined unification venoplasty (CUV) due to its superior results. Herein, we presented a case of CUV application to three PV openings of a right liver graft. The recipient was a 32-year-old male patient with hepatitis B virus-associated liver cirrhosis...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Kristaps Atstupens, Haralds Plaudis, Vladimirs Fokins, Maksims Mukans, Guntars Pupelis
BACKGROUNDS/AIMS: Laparoscopic treatment of patients with choledocholithiasis and cholangitis is challenging due to mandatory recovery of the biliary drainage and clearance of the common bile duct (CBD). The aim of our study was to assess postoperative course of cholangitis and biliary sepsis after laparoscopic clearance of the CBD in emergently admitted patients with choledocholithiasis and cholangitis. METHODS: Emergently admitted patients who underwent laparoscopic clearance of the CBD were included prospectively and stratified in 2 groups i...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Hwui-Dong Cho, Shin Hwang, Young-Joo Lee, Kwang-Min Park, Ki-Hun Kim, Jin Cheon Kim, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Sung-Gyu Lee
BACKGROUNDS/AIMS: To understand the changing demands for hepatic resection (HR), we collected data regarding HR performed in a tertiary centre over a period of 10 years. METHODS: We carried out extensive search of institutional databases to identify HR cases performed between January 2005 and December 2014. A study cohort of 9,016 patients were divided into 5 disease categories, namely hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), intrahepatic duct stone disease (IHDS), colorectal cancer liver metastasis (CRLM), and uncommon/rare diseases (URD)...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
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