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Open Hepatectomy

Suk Kyun Hong, Kyung-Suk Suh, Kyung Chul Yoon, Jeong-Moo Lee, Jae-Hyung Cho, Nam-Joon Yi, Kwang-Woong Lee
BACKGROUND: Although the use of pure laparoscopic donor hepatectomy (PLDH) is increasingly common, it remains limited to a few experienced centers and no data on the learning curve are currently available. The aim of this study is to evaluate the learning curve associated with the use of pure laparoscopic donor right hepatectomy (PLDRH). METHODS: Data from donors undergoing PLDRH performed by a single surgeon between November 2015 and October 2017 were retrospectively reviewed...
February 15, 2019: Surgical Endoscopy
Aviad Gravetz, Iswanto Sucandy, Chandler Wilfong, Nirrita Patel, Janelle Spence, Sharona Ross, Alexander Rosemurgy
Robotic liver resection is being introduced with its potential to overcome limitations of conventional laparoscopy. This study was undertaken to document early experience and learning curve of robotic liver resection in our institution. All patients undergoing liver resection between 2013 and 2017 were prospectively followed. Patients were divided into three consecutive tertiles (cohort I-III). Thirty-three patients underwent robotic liver resection within the study period. Twenty-four per cent of patients underwent formal right or left hemihepatectomy, 21 per cent underwent sectionectomy, 6 per cent underwent central hepatectomy, and the remainder underwent nonanatomical liver resection...
January 1, 2019: American Surgeon
Kota Sahara, Anghela Z Paredes, Diamantis I Tsilimigras, J Madison Hyer, Katiuscha Merath, Lu Wu, Rittal Mehta, Eliza W Beal, Susan White, Itaru Endo, Timothy M Pawlik
BACKGROUND: The impact of cirrhosis on perioperative outcomes for elderly patients undergoing hepatectomy remains not well defined. We sought to determine the influence of underlying cirrhosis and minimally invasive surgery (MIS) on postoperative outcomes among elderly patients who underwent a hepatectomy. METHODS: Patients who underwent hepatectomy between 2013 and 2015 were identified using the Center for Medicare Services (CMS) 100% Limited Data Set (LDS) Standard Analytic Files (SAFs)...
February 4, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Federica Cipriani, Francesca Ratti, Arianna Cardella, Marco Catena, Michele Paganelli, Luca Aldrighetti
BACKGROUND: Considering the increasing evidence on the feasibility of laparoscopic major hepatectomies (LMH), their clinical outcomes and associated costs were herein evaluated compared to open (OMH). METHODS: Major contributors of perioperative expenses were considered. With respect to the occurrence of conversion, a primary intention-to-treat analysis including conversions in the LMH group (ITT-A) was performed. An additional per-protocol analysis excluding conversions (PP-A) was undertaken, with calculation of additional costs of conversion analysis...
February 4, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Chao-Ying Wu, Po-Da Chen, Wei-Han Chou, Jin-Tung Liang, Chiun-Sheng Huang, Yao-Ming Wu
BACKGROUND: Robotic hepatectomy has been accepted as an alternative for patients needing surgery. However, few reports addressed the patient-reported outcomes and long-term quality of life (QoL) of patients having undergone robotic liver surgery. METHODS: This study presented the QoL and cost-effectiveness associated with robotic and open hepatectomy by performing a comparative survey using two standardized questionnaires (Short Form-36 and Gastrointestinal Quality of Life Index)...
January 28, 2019: Asian Journal of Surgery
Song Jiang, Zhaoying Wang, Mingrui Ou, Qing Pang, Dongwei Fan, Peiyuan Cui
BACKGROUND: Laparoscopic hepatectomy (LH) has been reported as a safe and efficacious treatment for hepatocellular carcinoma (HCC) patients. However, in cirrhosis patients, LH may be more complex and challenging. So, the short- and long-term outcomes should be well evaluated between LH and open hepatectomy (OH) in HCC patients with cirrhosis. OBJECTIVES: To compare the short- and long-term outcomes of LH with OH in HCC patients with cirrhosis. MATERIALS AND METHODS: The PubMed, EMBASE, and Web of Science were systematically searched to identify the clinical trials published until July 2018 on the comparison of LH and OH in HCC patients with cirrhosis...
January 31, 2019: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Neha Garg, Gaurav Sindwani, Mahesh Kumar Arora, Vinyendra Pamecha
Cocoon abdomen is a rare condition in which abdominal structures are surrounded by thick encapsulating peritoneum resulting in dense adhesions. Liver transplant is a high risk surgery with an already increased risk of massive blood loss due to the pre-existing coagulopathy and portal hypertension. Presence of cocoon abdomen with severe dense adhesions can either lead to difficult hepatectomy with massive intra-operative blood loss or failure to proceed with the surgery. This becomes even more important in live donor liver transplantation where it may not be possible to abandon the surgery once the donor liver resection is started...
January 2019: Saudi Journal of Anaesthesia
Toshikatsu Nitta, Jun Kataoka, Masato Ohta, Yuko Takashima, Kensuke Fujii, Masatsugu Ishii, Yoshihiro Inoue, Atsushi Takeshita, Takashi Ishibashi
Owing to the advantages of a laparoscopic approach, laparoscopic cholecystectomy (LC) is thought to be the treatment of choice in gallbladder disease, even in cases of suspected malignancy. However, it is difficult to differentiate between cholecystitis and gallbladder carcinoma (GBC). We performed radical hepatectomy in patients with pT2 GBC diagnosed by full-thickness frozen biopsy. A 75-year-old Japanese man presented to our hospital with discomfort in the right upper quadrant of the abdomen. This patient was diagnosed with suspected GBC and was scheduled to undergo LC and intraoperative histological examination...
September 2018: Case Reports in Gastroenterology
Choon Hyuck David Kwon, Gyu-Seong Choi, Jae-Won Joh
PURPOSE OF REVIEW: Many institutions have started or are planning to start a purely laparoscopic right hepatectomy (PLRH) for adult living donor recipients but the experience is relatively very limited. The present review will look at the current status of PLRH and go over some of the technical details important for a safe operation. Necessary elements and different strategies to start a safe and reproducible PLRH program will be discussed. RECENT FINDINGS: Several publications with a relatively large number of cases have been published in the last few years...
January 22, 2019: Current Opinion in Organ Transplantation
G F Cittolin-Santos, P A Guazzelli, Y Nonose, R F Almeida, F U Fontella, M V Pasquetti, F J Ferreira-Lima, G Lazzaroto, R M Berlezi, A B Osvaldt, M E Calcagnotto, A M de Assis, D O Souza
Hepatic encephalopathy (HE) represents a brain dysfunction caused by both acute and chronic liver failure, and its severity deeply affects the prognosis of patients with impaired liver function. In its pathophysiology, ammonia levels and glutamatergic system hyperactivity seem to play a pivotal role in the disruption of brain homeostasis. Here, we investigate important outcomes involved in behavioral performance, electroencephalographic patterns, and neurochemical parameters to better characterize the well-accepted animal model of acute liver failure induced by subtotal hepatectomy (92% removal of tissue) that produces acute liver failure (ALF)...
January 14, 2019: Neuroscience
Hai-Tao Shang, Jian-Heng Bao, Xi-Bo Zhang, Hai-Bo Wang, Hong-Tao Zhang, Zhong-Lian Li
OBJECTIVE: To contrast the clinical effects and complications for the treatment of liver carcinoma in laparoscopic partial hepatectomy (LPH) and open partial hepatectomy (OPH). METHODS: The multiple databases were adopted to search relevant studies, and the articles eventually satisfying the inclusion criteria were included. All the meta-analyses were conducted with the Review Manager 5.3, and to estimate the quality of each article risk of bias table was performed...
January 17, 2019: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Seung Jae Lee, Jae Hoon Lee, Young-Joo Lee, Song Cheol Kim, Dae Wook Hwang, Ki Byung Song, Sang Hyun Shin, Jae Woo Kwon, Gui Suk Park, Ye Jong Park, Kwang-Min Park
BACKGROUND: Recent studies report safety and effectiveness of robotic hepatectomy. In present study, we describe our initial experiences with robotic hepatectomy, focusing on left-side procedures. METHODS: A retrospective review was conducted of 13,10, and 11 consecutive patients who underwent robotic, laparoscopic, and open left-side hepatectomy by the single surgeon. RESULTS: There were no significant differences in the estimated blood loss, application of Pringle maneuver, postoperative hospital stays, number of IV analgesic injections, or postoperative complications between the robotic and laparoscopic groups...
January 12, 2019: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Ke Chen, Yu Pan, Yi-Fan Wang, Xue-Yong Zheng, Xiao Liang, Hong Yu, Xiu-Jun Cai
BACKGROUND: The application of laparoscopic hepatectomy is gaining momentum. However, the safety and efficacy of laparoscopic right hepatectomy (LRH) on hepatocellular carcinoma (HCC) are yet to be adequately evaluated. We aimed to assess the surgical and oncological outcomes of LRH for HCC by comparing it with open right hepatectomy (ORH). MATERIALS AND METHODS: Data of patients who underwent hepatectomy for HCC from May 2007 to January 2018 in our hospital were obtained...
January 9, 2019: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
R Liu, F Wang
Surgery of biliary malignant tumors is highly related to the liver and pancreas. The "Liver and pancreas oriented" characteristics are unavoidable challenges when formulating surgical strategies. In the development of minimally invasive surgery for biliary malignant tumors, a comprehensive understanding of the pattern of the biliary surgery can make innovation possible. Both the bleeding prevention in hepatectomy and the exposure in pancreatic surgery are the core of minimally invasive surgery for biliary malignant tumors...
January 1, 2019: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Hui Li, Bo Zhu, Jin Huang, Xing Chen, Jinju Wang, Hong Wu
BACKGROUND: This study aimed to compare the safety and efficacy of the liver hanging maneuver (LHM) versus conventional approach for open hepatectomy. METHODS: A comprehensive medical literature search was performed. Perioperative outcomes and long-term survival outcomes were reported. Subgroup analyses were conducted according to surgical approaches, modification of LHM, geographical region and indications for liver resection. RESULTS: A total of 16 studies including 1109 patients were enrolled...
December 31, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Wontae Cho, Choon Hyuck David Kwon, Jin Yong Choi, Seung Hwan Lee, Jong Man Kim, Gyu Seong Choi, Jae-Won Joh, Sung Joo Kim, Gaab Soo Kim, Kwang Chul Koh
Purpose: Laparoscopic major liver resection (major LLR) remains a challenging procedure because of the technical difficulty. Several significant technical innovations have been applied in our center since 2012. They include routine application of bipolar electrocautery, initiation of temporary increase of intra-abdominal pressure during bleeding events from veins to balance the central venous pressure, and use of temporary inflow control of the Glissonean pedicle. This study evaluated the impact of these technique modifications in patients with major LLR...
January 2019: Annals of Surgical Treatment and Research
Giorgio Rossi, Antonio Tarasconi, Gianluca Baiocchi, Gian Luigi De' Angelis, Federica Gaiani, Francesco Di Mario, Fausto Catena, Raffaele Dalla Valle
The use of fluorescence-guided surgery for benign and malignant hepatobiliary (HPB) neoplasms has significantly increased and improved imaging methods creating new interesting perspectives. A major challenge in HPB surgery is performing radical resection with maximal preservation of the liver parenchyma and obtaining a low rate of complications. Despite the developments, visual inspection, palpation, and intraoperative ultrasound remain the most utilized tools during surgery today.  In laparoscopic and robotic HPB surgery palpation is not possible...
December 17, 2018: Acta Bio-medica: Atenei Parmensis
Young Seok Han, Heontak Ha, Ja Ryung Han, Kyoung Hoon Lim, Jae Min Chun
RATIONALE: Because of the shortage of deceased donors, living donor liver transplantation (LDLT) has become the main procedure to treat patients with end-stage liver disease in Asian countries. However, many potential donors are excluded because of donor safety and graft volume issues. In addition, large abdominal wounds after open surgery for hepatectomy could be a reason for hesitating to agree to liver donation, particularly when attempting to recruit young female donors. PATIENT CONCERNS: On volumetric computed tomography (CT) examination, remnant liver volume was too small to guarantee the safety of the male donor, and the right hemiliver volume of the female donor was not sufficient to meet the recipient's metabolic demand...
December 2018: Medicine (Baltimore)
S Akbulut, B Isik, Y Karipkiz, S Yilmaz
Despite having many advantages, living donor liver transplantation has not been adopted by western countries due to risk of nearly life-threatening complications after living donor hepatectomy (LDH). Herein, we aimed at presenting the management of a 19-year-old patient who suffered life-threatening complications after right lobe LDH. A multiple detector computed tomography (MDCT) revealed a bilioma at the cut surface of the remnant liver, for which a transhepatic drainage catheter was placed. Endoscopic retrograde cholangiopancreatography (ERCP) performed to decompress biliary tract, but the biliary tract could not be cannulized due to post-precut bleeding...
2018: International Journal of Organ Transplantation Medicine
Chao-Wei Lee, Hsin-I Tsai, Hao-Tsai Cheng, Wei-Ting Chen, Heng-Yuan Hsu, Chien-Chih Chiu, Yi-Ping Liu, Tsung-Han Wu, Ming-Chin Yu, Wei-Chen Lee, Miin-Fu Chen
BACKGROUND: Laparoscopic liver resection has been regarded as the standard treatment for liver tumors located at the left lateral liver sector. However, few studies have reported the results of laparoscopic left lateral sectionectomy (LLS) for HCC, not to mention the feasibility of this emerging technique for the less experienced liver surgeons. The current study would reappraise the Louisville statement by examining the outcome of LLS performed by a young liver surgeon. METHODS: We retrospectively reviewed two separate groups of patients who underwent open or laparoscopic left lateral sectionectomies at Chung Gung Memorial Hospital, Linkou...
November 28, 2018: BMC Gastroenterology
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