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Liver And Surgery

Filippo Parolini, Nedim Hadzic, Mark Davenport
AIM OF STUDY: CMV-IgM + ve associated biliary atresia (CMV-BA) is a distinct etiological subgroup characterized by older age at presentation and a greater degree of inflammation and hepatic fibrosis, leading to a worse outcome. We report our experience with adjuvant antiviral therapy after Kasai portoenterostomy (KPE). METHODS: Single-center prospective database identification of CMV-IgM + ve associated BA managed between 2003 and 2017. Since 2011, IV ganciclovir (5 mg/kg b...
January 22, 2019: Journal of Pediatric Surgery
Clifford Akateh, Eliza W Beal, Jung-Lye Kim, Brenda F Reader, Katelyn Maynard, Jay L Zweier, Bryan A Whitson, Sylvester M Black
BACKGROUND: Ischemia/reperfusion injury (IRI) can occur during liver surgery. Endogenous catalase is important to cellular antioxidant defenses and is critical to IRI prevention. Pegylation of catalase (PEG-CAT) improves its therapeutic potential by extending plasma half-life, but systemic administration of exogenous PEG-CAT has been only mildly therapeutic for hepatic IRI. Here, we investigated the protective effects of direct intrahepatic delivery of PEG-CAT during IRI using a rat hilar clamp model...
February 13, 2019: Journal of Surgical Research
Xiao-Long Wu, Zhi-Yu Li, Yong Jiang, Xinyu Bi, Hong Zhao, Jian-Jun Zhao, Zhen Huang, Ye-Fan Zhang, Jian-Qiang Cai
BACKGROUND: In predicting the risk for posthepatectomy complications, hepatectomy is traditionally classified into minor or major resection based on the number of resected segments. Recently, a new hepatectomy complexity classification was proposed. This study aimed to compare the value of the traditional and that of the new classification in perioperative outcomes prediction. METHODS: Demographics, perioperative laboratory tests, intraoperative and postoperative outcomes, and follow-up data of patients with hepatocellular carcinoma who underwent liver resection were retrospectively analyzed...
February 15, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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
Hiroshi Matsuoka, Zenichi Morise, Chihiro Tanaka, Takahiro Hayashi, Yoshiaki Ikeda, Koutarou Maeda, Koji Masumori, Yoshikazu Koide, Hidetoshi Katsuno, Yoshinao Tanahashi, Sanae Nakajima, Tsunekazu Hanai, Yutaro Kato, Atsushi Sugioka, Ichiro Uyama
BACKGROUND: Although hepatectomy for metastatic colorectal cancer (mCRC) prolongs survival in up to 40% of people, recurrence rates approach 70%. We used a multidisciplinary approach to treat recurrent liver metastases, including chemotherapy, surgery, and palliative care. On the other hand, development of chemotherapeutic agents is remarkable and improves long-term survival. However, whether chemotherapy and repeat hepatectomy combination therapy improve survival or not is still unclear...
February 15, 2019: World Journal of Surgical Oncology
Florian Primavesi, Stefan Stättner, Tarkan Jäger, Georg Göbel, Jaroslav Presl, Katerina Tomanová, Selina Buchner, Manuel Maglione, Thomas Resch, Jörg Hutter, Dietmar Öfner, Adam Dinnewitzer
BACKGROUND: Secondary resection rates in first-line chemotherapy trials for metastatic colorectal cancer (mCRC) remain below 15%, representing a clear contrast to reports by specialised surgical centres, where progressive liver, peritoneal-surface, and pulmonary surgery increased access to curative-intent treatment. We present a long-term evaluation of oncosurgical management in a single-centre, analysing the aggregate effect of gradual implementation of surgical subspecialties and systemic treatments on mCRC patients' resection rates and prognosis...
February 14, 2019: Cancers
Chih-Jung Wang, Ying-Jui Chao, Edgar D Sy, Yan-Shen Shan
BACKGROUND: Minimally invasive gastric cancer surgery requires an extended liver retraction in order to provide optimal operative view, working space for lymph node dissection, and esophageojejunal reconstruction. Ideally, it should avoid reposition of the retractor, additional skin incision or puncture, and liver parenchyma injury. Herein, we introduced an intracorporeal W-shaped liver retraction technique (W-LRT) for minimally invasive gastric cancer surgery without an additional incision or abodminal puncture...
February 12, 2019: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Matthew T Moyer, Jayakrishna Chintanaboina, Leonard T Walsh, Justin Loloi, Jennifer Maranki, Benjamin Stern, Abraham Mathew
Background and Aims: GI tract perforations and anastomotic dehiscence are increasingly effectively being repaired endoscopically; however, well-known and long-held surgical principles must still be honored. One important principle is that significant extraluminal contamination must be washed out, debrided, and drained in conjunction with repair of the defect if the wound is to effectively heal and resolve. Here we describe the use of endoscopic washout and debridement of extraluminal contamination at the time of luminal defect closure in a 7-patient series at our institution, with video demonstration of 2 patients in the series...
February 2019: VideoGIE: an official video journal of the American Society for Gastrointestinal Endoscopy
Savas Bayrak, Cihad Tatar, Erdem Kinaci, Ekrem Cakar, Sukru Colak, Mert Mahsuni Sevinc, Hasan Bektas
Introduction: Stent treatment can be applied to avoid surgery in surgically risky patients or to turn a high-risk emergency operation into a lower-risk elective operation and save time. Aim: In this study, the techniques, clinical efficacy, safety and complications of endoscopic stents applied in emergency conditions were evaluated in patients with acute mechanical intestinal obstruction (AMIO) due to colorectal cancer. Material and methods: Between 2013 and 2015, 23 patients with an average age of 69...
January 2019: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Hiroki Kudo, Yasuji Seyama, Hiroyuki Kanomata, Masamichi Takahashi, Tachen Chang, Yujiro Matsuoka, Tomoyo Machida, Yohei Furumoto, Masahiro Warabi, Tooru Tanizawa, Ikuo Wada, Tsuyoshi Maeshiro, Sachio Miyamoto, Nobutaka Umekita
A 72-year-old man with general fatigue was referred, and CT and MRI revealed a pancreatic mass with necrosis that was suspected of invading the stomach, splenic artery, celiac artery, liver, and portal vein. Upper gastrointestinal endoscopy showed an extrinsic mass with ulcer formation in the posterior wall of the upper gastric corpus and irregular mucosa in the lower esophagus incidentally. Biopsy showed squamous cell carcinoma from both lesions, leading to the diagnosis of pancreatic adenosquamous carcinoma and early esophageal cancer...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Makoto Nakai, Yutaro Hara, Shinnosuke Yonaiyama, Hiroyuki Jin, Tomohisa Tokura, Kazunori Aoki, Hiroaki Kawashima, Yoshikazu Toyoki, Masaaki Endo
A 65-year-old man was hospitalized for gastric cancer. Abdominal computed tomography detected lower gastric cancer and invasion of the liver. Initial laboratory data showed high levels of serum AFP(2,688.6 ng/mL). He underwent distal gastrectomy with left lobectomy of the liver and cholecystectomy. Histology confirmed that the tumor consisted of 2 components: primary gastric choriocarcinoma and AFP-producing carcinoma. The pathological staging was pT4b(liver), N3aM0, Stage ⅢC. After surgery, AFP levels decreased to within the normal limits...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Shigeaki Kurihara, Kazunori Nakazawa, Hironari Miyamoto, Takuma Okada, Chihoko Nobori, En Wang, Toshiki Hirakawa, Naoki Aomatsu, Takehiko Iwauchi, Junya Morimoto, Shigehito Yamagata, Yasutake Uchima, Kazuhiro Takeuchi
A67 -year-old man was diagnosed with ascending colon cancer and multiple liver metastases and underwent laparoscopic right hemicolectomy(D3 lymphadenectomy). Pathological examination indicated tubular adenocarcinoma(tub1, pT4apN2H2M1[HEP], pStage Ⅳ). After chemotherapy, he underwent hepatectomy. One year and 9 months after the first operation, obstructive jaundice appeared. Abdominal computed tomography revealed a tumor 2 cm in size in the head of the pancreas. After several detailed examinations, he was diagnosed with pancreatic metastasis of ascending colon cancer...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Tadashi Tsukamoto, Shingo Togano, Eijiro Edagawa, Ryoji Kaizaki, Takaaki Hori, Satoshi Takatsuka
A 68-year-old man presented with generalfatigue due to anemia. Gastrointestinalendoscopy showed a tumor approximately 60mm in diameter in the lesser curvature of the angle of the stomach. Large cell neuroendocrine carcinoma was diagnosed by biopsy of a tumor specimen. Computed tomography revealed bulky regional lymph node metastases, solitary liver metastasis, and left adrenal metastasis. After three courses of combined chemotherapy with S-1 and CDDP, the gastric lesion and lymph node metastases shrunk, but the liver metastasis and left adrenal metastasis enlarged...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Enio Campos Amico, Izadora K de Souza, Juliana R Grigório Trigueiro, Fernanda Cunha Miranda, Rogério Lacerda Sousa, Adriano de Araújo Lima Liguori
BACKGROUND: Focal nodular hyperplasia (FNH) is a frequent benign liver lesion. Its course is considered benign, and there is no recommendation for its treatment. Nevertheless, the literature presents a high incidence of surgery. AIM: To evaluate the results of conservative treatment in a series of patients with presumed FNH. METHODS: The study included patients diagnosed with FNH from May 2007 to July 2017 based on conventional imaging or magnetic resonance imaging with liver-specific contrast (MRI-LSC) or lesion biopsy (histology/immunohistochemical analysis)...
February 14, 2019: Digestive Diseases
Stavroula Papadodima, Ricard Masia, James R Stone
BACKGROUND: Cardiac iron overload following liver transplantation in patients without hemochromatosis but with severe hepatic iron deposition has been reported to result in heart failure and/or death in case reports and small case series. However, the frequency and causes of cardiac iron overload following liver transplantation and its relationship to cardiac dysfunction in patients without severe hepatic iron deposition are unclear. METHODS: The primary inclusion criteria for this study were liver transplantation followed by autopsy or cardiac transplantation within 1 year...
January 3, 2019: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Elisabetta Sanna, Stavros Loukogeorgakis, Thomas Prior, Iris Derwig, Gowrishankar Paramasivam, Muhammad Choudhry, Christoph Lees
Background There is little information on which to base the prognostic counselling as to whether an antenatally diagnosed fetal abdominal cyst will grow or shrink, or need surgery. This study aims to provide contemporary data on prenatally diagnosed fetal abdominal cysts in relation to their course and postnatal outcomes. Methods Fetal abdominal cysts diagnosed over 11 years in a single centre were identified. The gestational age at diagnosis and cyst characteristics at each examination were recorded (size, location, echogenity, septation and vascularity) and follow-up data from postnatal visits were collected...
February 14, 2019: Journal of Perinatal Medicine
Sherif Kandil
PURPOSE OF REVIEW: Liver transplantation in patients with portopulmonary hypertension (POPH) is associated with increased perioperative risk. Important recent advances in the management of liver transplantation recipients with POPH are discussed. RECENT FINDINGS: The presence of POPH at the time of liver transplantation should not be a contraindication for liver transplantation, as POPH is common and may be related to volume overload and/or high cardiac output (CO)...
February 11, 2019: Current Opinion in Organ Transplantation
Michael Karass, Katherine Linder, Anup Agarwal, Alexandra Budhai, Yasmin Yusuf, Oleg Epelbaum
Extramedullary hematopoiesis, which represents ectopic blood cell production, is usually an incidental finding accompanying hematologic pathology. The liver and spleen are the most common sites of extramedullary hematopoiesis, but thoracic involvement is likewise observed. Pleural effusions in the setting of intrathoracic extramedullary hematopoiesis have been attributed to mechanical interactions between the pleural surface and neighboring paravertebral masses consisting of hematopoietic tissue. Rupture of these highly vascularized lesions into the adjacent pleural space has been the putative mechanism in cases complicated by hemothorax...
December 3, 2018: Curēus
Winifred M Lo, Christine M Kariya, Jonathan M Hernandez
Metastatic adrenocortical carcinoma (ACC) is associated with a poor 5-year survival rate and high rate of recurrence. Outcomes after resection for patients with limited disease remain poorly described. We conducted a PubMed search for articles published between 1950 and 2017 using the terms "ACC," "recurrence," and "surgery." Patients with metastatic ACC at any anatomic site who had undergone surgical resection were included. Thirteen studies met the criteria. Patients were grouped according to the recurrence site...
January 1, 2019: American Surgeon
Makoto Takahashi, Hideyuki Yoshitomi, Atsushi Kato, Katsunori Furukawa, Tsukasa Takayashiki, Satoshi Kuboki, Shigetsugu Takano, Kensuke Sugiura, Keishi Kawasaki, Masaru Miyazaki, Masayuki Ohtsuka
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) readily metastasizes to the lymph nodes, liver, lung, and peritoneum; however, gastric and gallbladder metastases are rare. We report a case of metachronous gastric and gallbladder metastases from PDAC. CASE PRESENTATION: The patient is a 71-year-old man who underwent distal pancreatectomy for PDAC. Seventeen months after the surgery, a 30-mm nodule was detected at the lesser curvature of the stomach, which was diagnosed as recurrence of PDAC in the lymph nodes...
February 13, 2019: Surgical Case Reports
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