Xiu-Tao Fu, Zheng Tang, Jia-Feng Chen, Ying-Hong Shi, Wei-Ren Liu, Qiang Gao, Guang-Yu Ding, Kang Song, Xiao-Ying Wang, Jian Zhou, Jia Fan, Zhen-Bin Ding
BACKGROUND: The concurrent presence of liver cirrhosis and hepatocellular carcinoma (HCC) poses a challenge for laparoscopic surgeons to establish a routine practice. The aim of this study was to gather evidence and produce recommendations on the safe and effective practice of laparoscopic hepatectomy for patients with solitary HCC (≤ 5 cm) and liver cirrhosis. METHODS: Between October 2013 and October 2014, 356 curative hepatectomies were performed for patients pathologically diagnosed with solitary HCC (≤ 5 cm) accompanied by cirrhosis (stage 4 fibrosis)...
August 3, 2020: Surgical Endoscopy
Shamir O Cawich, Reyad R A Ali, Michael T Gardner, Janet Charles, Sherrise Sandy, Neil W Pearce, Vijay Naraynsingh
PURPOSE: Hepatic surface grooves (HSGs) are prominent depressions on the antero-superior surface of the liver. We sought to document the prevalence of HSGs in an Eastern Caribbean population. METHODS: We observed all consecutive autopsies performed at a facility in Trinidad and Tobago and recorded the presence, number, location, width, length and depth of any HSG identified. Each liver was then sectioned to document intra-parenchymal abnormalities. RESULTS: Sixty Autopsies were observed...
July 31, 2020: Surgical and Radiologic Anatomy: SRA
Y P Zhang, N Shi, Z X Jian, H S Jin
The Laennec capsule of liver was first discovered and reported by French doctor Rene Theophile Hyacinthe Laennec in 1802.However, it has not received enough attention for more than 200 years since then. In recent years, with the rapid development of liver surgery represented by laparoscopic technology, and the deepening of the theory of precise liver surgery, the fine anatomical structure of liver Laennec capsule has returned to the vision of liver surgeons.Recent studies have demonstrated the presence of Laennec capsule in liver histology, covering the whole liver surface, and lining the surface of liver parenchyma around the Glisson pedicle and the main hepatic vein along the inflow and outflow channels of the liver...
August 1, 2020: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Lyonell B Kone, Vijay K Maker, Mihaela Banulescu, Ajay V Maker
BACKGROUND: The impact of epidural analgesia (EA) on postoperative morbidity and length of stay (LOS) after HPB surgery remains to be determined. These specific outcomes have been highlighted by the implementation of multiple enhanced recovery pathways (ERAS). The authors hypothesized that EA in the current environment may be associated with LOS and other outcomes. METHODS: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) databases from 2014 to 2017 for patients undergoing open hepatopancreaticobiliary (HPB) surgery were included in a retrospective cohort analysis with propensity score matching (PSM) comparing EA with control...
July 28, 2020: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Chester J Donnally, Parthik D Patel, Jose A Canseco, Kartik Shenoy, Srikanth N Divi, Vadim Goz, Abdul R Arain, Alexander R Vaccaro
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aim of this study was to identify whether hepatitis C virus (HCV) diagnosis influences in-hospital lengths of stay (LOS), postoperative complications, readmission rates, or costs following primary posterior lumbar fusions in an elective setting. SUMMARY OF BACKGROUND DATA: Although joint arthroplasty literature has shown increased complication rates and costs for patients seropositive with HCV without liver disease compared to those without HCV, this comorbidity has not been explored in the spine literature...
August 15, 2020: Spine
Guru Prasad Painuly, Mini Singhal
Sub hepatic caecum and appendix is an uncommon condition. It occurs due to incomplete rotation of foetal foregut and mal descent of caecum. This condition may be mistaken for acute cholecystitis, liver abscess, duodenal perforation or right renal calculus. Diagnosis may be delayed when acute appendicitis develops complications - appendicular rupture, perforation or localized abscess. The condition may be missed on ultra sound and CT abdomen may be inconclusive. Thus, surgeon should have a high index of suspicion in such undiagnosed right upper abdominal pain...
2020: International Journal of Surgery Case Reports
Tetsuo Ikeda, Shinji Okano, Naotaka Hashimoto, Koichi Kimura, Kensuke Kudo, Ryosuke Tsutsumi, Shun Sasaki, Junji Kawasaki, Yu Miyashita, Hiroya Wada
BACKGROUND/PURPOSE: Computer-assisted tissue imaging and analytical techniques were used to clarify the histomorphological structure of hepatic connective tissue as a practical guide for surgeons. METHODS: Approximately 5000 histological slides were prepared from liver specimens of five autopsied patients. Three-dimensional (3D) reconstruction was performed and subjected to computer imaging analysis. Scanning electron microscopy was also performed on the liver specimens...
July 22, 2020: Journal of Hepato-biliary-pancreatic Sciences
T J Patterson, P J Currie, J Beck, R A J Spence, G M Spence
BACKGROUND: Throughout the United Kingdom, there have been sweeping changes to the practice of medicine due to the COVID-19 pandemic. For the surgical speciality, there have been changes to both elective and emergency practice. Concern regarding potential aerosolisation during invasive procedures have been raised - including the use of pneumoperitoneum to facilitate laparoscopy. The aim of this study is to systematically review the data available to date regarding the potential risk posed to theatre staff by laparoscopy...
July 17, 2020: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Hoa Viet Nguyen, Dang Hai Do, Hung Van Nguyen, Tuan Hong Vu, Quan Quy Hong, Chung Ta Vo, Trang Huyen Thi Dang, Ngoc Bich Nguyen, Dung Thanh Le, Phuong Ha Tran, Lan Thi Nguyen
INTRODUCTION: Choledochal cyst is a rare benign congenital dilation of the bile duct, which causes recurring disturbing symptoms without totally resection. Nonetheless, postoperative complications are still a common issue. A step up management for patients with complex complications is required to address the problem. CASE PRESENTATION: We report a 10-year-old child who suffered complex postoperative complications after choledochal cyst resection at the age of 5, including cholangitis, bilioenteric stenosis and cystolithiasis in remnant intrapancreatic duct cyst...
July 11, 2020: International Journal of Surgery Case Reports
Qiang Lu, Qing-Shan Li, Wei Zhang, Kang Liu, Tao Li, Jia-Wei Yu, Yi Lv, Xu-Feng Zhang
Purpose: The objective of the current study was to examine the potential effects of surgery start times (morning vs. afternoon) on the long-term prognosis of patients after hepatic resection (HR) for hepatocellular carcinoma (HCC). Methods: All eligible patients were divided into 2 groups according to the start time of surgery: group M (morning surgery, 8 AM-1 PM) and group A (afternoon surgery, 1 PM-6 PM). Clinicopathologic and surgical parameters, as well as oncologic outcomes were compared between the 2 groups...
July 2020: Annals of Surgical Treatment and Research
Antoine Camerlo, Charles Vanbrugghe, Frederic Cohen, Régis Fara
BACKGROUND: Solitary fibrous tumor is a mesenchymal tumor rare in liver parenchyma 1 but must be considered as a differential diagnosis of a single large hepatic mass. Surgical resection is the treatment because of its potential malignancy, and previous interventions reported were open hepatectomy 2. Robotic assets could improve accessibility for difficult liver resection 3. We present the video of a robotic left hepatectomy extended to caudate lobe and median hepatic vein for central liver tumor...
July 15, 2020: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Pierre-Emmanuel Colombo, François Quenet, Pierre Alric, Anne Mourregot, Mathias Neron, Fabienne Portales, Philippe Rouanet, Guillaume Carrier
BACKGROUND: Resectability of pancreatic carcinoma (PC) is directly linked to vascular extension (Tempero MA et al. in J Natl Compr Canc Netw 15(8):1028-1061, 2017.; Isaji S et al. in Pancreatology 18(1):2-11, 2018. Involvement of the celiac axis (CA) is typically a contraindication to surgery. High postoperative morbidity and subsequent poor prognosis have been observed in this case, especially for contact > 180° requiring arterial resection (Tempero MA et al...
June 25, 2020: Annals of Surgical Oncology
Tevfik Tolga Sahin, Sami Akbulut, Sezai Yilmaz
Severe pulmonary disease caused by the novel coronavirus [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)], has devastated many countries around the world. It has overwhelmed the medical system. The priorities of many institutions have changed to manage critically ill corona virus infectious disease-2019 (COVID-19) patients, which affected the working style of many departments. Hepatologists and transplant surgeons look after a very sensitive patient group. Patients with liver disease need special attention and continuous follow-up...
June 14, 2020: World Journal of Gastroenterology: WJG
Bubu A Banini, Yahya Alwatari, Madeline Stovall, Nathan Ogden, Evgeni Gershman, Rachit D Shah, Brian J Strife, Samira Shojaee, Richard K Sterling
Hepatic hydrothorax is the formation of transudative pleural effusion as a consequence of portal hypertension. Only a minority of cases resolve after sodium restriction and diuretics. Despite the relatively low incidence of 5-15% among patients with cirrhotic portal hypertension, the high morbidity and serious clinical implications associated with hepatic hydrothorax necessitate a well-defined treatment strategy to guide patient care. Management is typically multidisciplinary, involving hepatologists, interventional pulmonologists, interventional radiologists, surgeons, and other specialties...
June 25, 2020: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Chong Yang, Hong-Ji Yang, Shao-Ping Deng, Yu Zhang
Hepatic alveolar echinococcosis (HAE) is a cosmopolitan zoonosis distribute widely in the northern hemisphere with high estimated 10-year mortality. Radical resection combined with oral albendazole administration are the major methods for HAE treatment, whereas most patients delayed diagnosis and treatment because which was considered as benign disease. For the cases with end-stage HAE could not be treated through conventional hepatectomy, allograft liver transplantation (LT) was regarded as a life-saving technique previously...
June 12, 2020: Annals of Palliative Medicine
Susumu Eguchi, Akihiko Soyama, Takanobu Hara, Masaaki Hidaka, Shinichiro Ono, Tomohiko Adachi, Takashi Hamada, Tota Kugiyama, Sinichiro Ito, Kengo Kanetaka, Takuji Maekawa, Motohiro Sekino, Tetsuya Hara, Kazuhiro Nagai, Yasushi Miyazaki
We herein report an effective procedure for liver transplantation (LT) for severe cirrhotic patients with hemophilia. Three hemophilic patients suffering from liver cirrhosis due to human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection underwent deceased donor LT in our institute. Basic clotting parameters were measured and evaluated during LT to determine the optimal packing procedure. All patients were treated with a gauze packing procedure to ensure stable hemostasis in relation to hemophilia during the peri-transplant period...
June 22, 2020: Surgery Today
Mabrouka Boukoucha, Fatma Dhieb, Raoudha Ben Khelifa, Hakim Znaidi, Rany Elaifi, Alifa Daghfous
INTRODUCTION: Gallbladder Duplication is an uncommon anomaly of the biliary system that rarely seen during the routine ultrasound examination. It is a challenge that can be encountered by surgeons and associated with an increased risk of complications after cholecystectomy. CASE PRESENTATION: We report the case of a 58-year-old woman, presented to the emergency department with persistent right upper quadrant pain. Ultrasound exam detected Gallbladder Duplication with lithiasic cholecystitis in both of them...
June 12, 2020: International Journal of Surgery Case Reports
Jan Grosek, Žan Čebron, Jurij Janež, Aleš Tomažič
INTRODUCTION: Bicycle accidents are a significant cause of traumatic morbidity in the paediatric population. The handlebar injuries are usually isolated and remain a major source of bicycle related morbidity. We present a case of severe liver laceration with left hepatic duct transection caused by handlebar trauma in a 13-year-old boy. CASE PRESENTATION: An otherwise healthy 13-year-old Caucasian male patient was rushed to the hospital following a blunt abdominal trauma from a bicycle handlebar...
June 12, 2020: International Journal of Surgery Case Reports
Lior Orbach, Ido Nachmany, Yaacov Goykhman, Guy Lahat, Ofer Yossepowitch, Avi Beri, Yanai Ben-Gal, Joseph M Klausner, Nir Lubezky
BACKGROUND: Abdominal tumors invading the inferior vena cava (IVC) present significant challenges to surgeons and oncologists. OBJECTIVES: To describe a surgical approach and patient outcomes. METHODS: The authors conducted a retrospective analysis of surgically resected tumors with IVC involvement by direct tumor encasement or intravascular tumor growth. Patients were classified according to level of IVC involvement, presence of intravascular tumor thrombus, and presence of hepatic parenchymal involvement...
June 2020: Israel Medical Association Journal: IMAJ
Rajeev Redkar, Vinod Raj, Shruti Tewari, Rahul Sharma, Shirin Joshi
INTRODUCTION: Budd-Chiari syndrome (BCS) is a rare condition affecting children. It is characterized by occlusion of venous outflow from liver at the level of hepatic veins (HV) or inferior vena cava (IVC). The management of BCS in children revolves around forming new collaterals for venous outflow or by elimination of blockage in the venous outflow tracts. These can be achieved by balloon venoplasty (BV), transjugular intrahepatic portosystemic shunting (TIPSS) or open shunt surgeries...
May 23, 2020: Journal of Pediatric Surgery
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