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HPB: the Official Journal of the International Hepato Pancreato Biliary Association

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https://www.readbyqxmd.com/read/28629642/splenic-vein-reconstruction-is-unnecessary-in-pancreatoduodenectomy-combined-with-resection-of-the-superior-mesenteric-vein-portal-vein-confluence-according-to-short-term-outcomes
#1
Haruyoshi Tanaka, Akimasa Nakao, Kenji Oshima, Kiyotsugu Iede, Yukiko Oshima, Hironobu Kobayashi, Yasunori Kimura
BACKGROUND: Superior mesenteric vein-portal vein confluence resection combined with pancreatoduodenectomy (SMPVrPD) is occasionally required for resection of pancreatic head tumors. It remains unclear whether such situations require splenic vein (SV) reconstruction for decompression of left-sided portal hypertension (LSPH). METHODS: The data from 93 of 104 patients who underwent pancreatoduodenectomy (PD) for pancreatic head malignancies were reviewed. Surgical outcomes in three groups-standard PD (control group), PD combined with vascular resection and SV preservation (SVp group), and SMPVrPD with SV resection (SVr group)-were compared...
June 16, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28625391/twelve-year-experience-of-radical-but-conservative-liver-surgery-for-colorectal-metastases-impact-on-surgical-practice-and-oncologic-efficacy
#2
Guido Torzilli, Luca Viganò, Andrea Gatti, Guido Costa, Matteo Cimino, Fabio Procopio, Matteo Donadon, Daniele Del Fabbro
BACKGROUND: Liver surgery for colorectal metastases (CLM) is moving toward parenchyma-sparing approaches. The authors reported the technical feasibility of parenchyma-sparing hepatectomy for deeply located tumors, but its impact on daily practice and long-term outcomes remain unclear. METHODS: The patients undergoing liver resection (LR) for CLM with vascular contact (first-/second-order pedicle or hepatic vein (HV) trunk) were considered. Those undergoing major hepatectomy were excluded...
June 16, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28602644/increased-kinetic-growth-rate-during-late-phase-liver-regeneration-impacts-the-risk-of-tumor-recurrence-after-colorectal-liver-metastases-resection
#3
Georgios A Margonis, Kazunari Sasaki, Nikolaos Andreatos, Manijeh Zargham Pour, Nannan Shao, Mounes Aliyari Ghasebeh, Stefan Buettner, Efstathios Antoniou, Christopher L Wolfgang, Matthew Weiss, Ihab R Kamel, Timothy M Pawlik
BACKGROUND: Although experimental data strongly support the pro-tumorigenic role of postoperative liver regeneration, this hypothesis has not been clinically investigated. We aimed to examine the impact of liver regeneration determined by volumetric imaging on recurrence following resection of colorectal liver metastasis (CRLM). METHODS: Resected liver volume was subtracted from total liver volume (TLV) to define postoperative remnant liver volume (RLVp). Early and late kinetic growth rates (KGR) were defined as the postoperative increases in liver volume within 2-3 and 8-10 months from surgery, respectively, divided by the corresponding time interval...
June 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28602643/the-use-of-negative-pressure-wound-therapy-to-prevent-post-operative-surgical-site-infections-following-pancreaticoduodenectomy
#4
Richard A Burkhart, Ammar A Javed, Sean Ronnekleiv-Kelly, Michael J Wright, Katherine E Poruk, Frederic Eckhauser, Martin A Makary, John L Cameron, Christopher L Wolfgang, Jin He, Matthew J Weiss
BACKGROUND: Rates of superficial surgical site infection (SSI) following pancreaticoduodenectomy remain high. Following resection for cancer, complications such as SSI impact adjuvant therapy delivery and portend worse survival. An incisional negative pressure dressing (iVAC) has been demonstrated to reduce SSI in other high-risk cohorts. METHODS: Following a comprehensive effort to identify patients at high risk for SSI, the practice patterns at a single academic center shifted and iVAC use increased...
June 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28599892/comparative-analysis-of-learning-curve-in-complex-robot-assisted-and-laparoscopic-liver-resection
#5
Mikhail Efanov, Ruslan Alikhanov, Victor Tsvirkun, Ivan Kazakov, Olga Melekhina, Pavel Kim, Andrey Vankovich, Konstantin Grendal, Stanislav Berelavichus, Igor Khatkov
BACKGROUND: There is no comparative analysis of the learning curves for robot-assisted and laparoscopic liver resection. We aimed to compare learning curves in complex robotic and conventional laparoscopic liver resections with regards to estimation of the difficulty index score. METHODS: The results of 131 consecutive liver resections were analyzed retrospectively (40 robot-assisted and 91 laparoscopic). The learning curve evaluation was based on calculation of procedures number before significant change of the difficulty index for minimally invasive liver resection or the rate of posterosuperior segments resection...
June 6, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28578825/the-impact-of-a-clinical-pathway-on-patient-postoperative-recovery-following-pancreaticoduodenectomy
#6
Amélie Tremblay St-Germain, Katharine S Devitt, Daniel J Kagedan, Beverly Barretto, Stephanie Tung, Steven Gallinger, Alice C Wei
BACKGROUND: Pancreaticoduodenectomies (PD) are complex surgical procedures. Clinical pathways (CPW) are surgical process improvement tools that guide postoperative recovery and are associated with high quality care. Our objective was to report the quality of surgical care following implementation of a CPW. METHODS: We developed and implemented a CPW for patients undergoing PD at a single high volume hepato-pancreato-biliary (HPB) centre. Patient outcomes were collected prospectively during the implementation period...
June 1, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28566239/a-reduced-time-to-surgery-within-a-fast-track-pathway-for-periampullary-malignancy-is-associated-with-an-increased-rate-of-pancreatoduodenectomy
#7
Keith J Roberts, Pooja Prasad, Yvonne Steele, Francesca Marcon, Thomas Faulkner, Hentie Cilliers, Bobby Dasari, Manuel Abradelo, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, Darius F Mirza, John Isaac
INTRODUCTION: Pancreatoduodenectomy (PD) typically follows preoperative biliary drainage (PBD) despite PBD being potentially harmful. This study evaluated a pathway to avoid PBD within the framework of the UK's NHS. METHOD: A prospective observational study of jaundiced patients undergoing PD for periampullary cancer. A pathway to provide early surgery without PBD was introduced at the start of the study period. RESULTS: Over 12 months 61 and 32 patients underwent surgery with and without PBD respectively; 95% of patients in the PBD group had been stented before referral...
May 26, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28552299/transarterial-chemoembolization-in-hepatocellular-carcinoma-with-portal-vein-tumor-thrombosis-a-systematic-review-and-meta-analysis
#8
REVIEW
Jack P Silva, Nicholas G Berger, Susan Tsai, Kathleen K Christians, Callisia N Clarke, Harveshp Mogal, Sarah White, William Rilling, T Clark Gamblin
BACKGROUND: Transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) remains controversial. This systematic review sought to examine the role of TACE in the treatment of HCC with PVT in either the main portal vein (MPV) or portal vein branches (PVB). METHODS: PubMed was searched for "hepatocellular carcinoma" and "transarterial chemoembolization" from January 1, 2006 to August 31, 2016. Cohorts treated with TACE for HCC with PVT were included...
May 25, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28549744/survival-after-resection-of-perihilar-cholangiocarcinoma-in%C3%A2-patients-with-lymph-node-metastases
#9
Stefan Buettner, Jeroen L A van Vugt, Marcia P Gaspersz, Robert J S Coelen, Eva Roos, Tim A Labeur, Georgios A Margonis, Cecilia G Ethun, Shishir K Maithel, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley A Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Jan N M IJzermans, Thomas M van Gulik, Timothy M Pawlik, Bas Groot Koerkamp
BACKGROUND: The aim of this study was to compare patients with PHC with lymph node metastases (LN+) who underwent a resection with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy. METHODS: Consecutive LN+ patients who underwent a resection for PHC in 12 centers were compared with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy in 2 centers. RESULTS: In the resected cohort of 119 patients, the median overall survival (OS) was 19 months and the estimated 1-, 3- and 5-year OS was 69%, 27% and 13%, respectively...
May 23, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28528269/bariatric-surgery-for-the-obese-patients-undergoing-liver-transplantation-the-case-for
#10
Anya Adair
The incidence of obesity is rising exponentially. This is having a direct impact on liver transplantation due to an increase in NAFLD disease and numbers of overweight and obese patients requiring transplantation. There is now evidence suggesting that obesity has a negative impact on both graft and patient survival. There remains an imbalance between number of donors available and patients requiring transplantation. We therefore need to ensure we make the best use of the organs available, optimizing graft and patient survival in those fortunate enough to receive an organ...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28528268/optimistic-honesty-understanding-surgeon-and-patient-perspectives-on-hopeful-communication-in-pancreatic-cancer-care
#11
Kim Blakely, Paul J Karanicolas, Frances C Wright, Lesley Gotlib Conn
BACKGROUND: Prognosis conversations between surgical oncologists and patients with pancreatic cancer are critically important and challenging. Surgeons and their patients often have discrepant understandings of prognosis despite extensive conversations. Little is known about how surgeons approach prognosis conversations with these patients; patients' experiences with these conversations are also not well understood. This qualitative study sought to better understand surgeon and patient perspectives on communication in pancreatic cancer care with a view toward improvement...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28528267/using-mri-to-non-invasively-and-accurately-quantify-preoperative-hepatic-steatosis
#12
Callisia N Clarke, Haesun Choi, Ping Hou, Catherine H Davis, Jingfei Ma, Asif Rashid, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND: The obesity epidemic has significantly increased the incidence and severity of hepatic steatosis in liver surgery patients and liver donors, potentially impacting postoperative liver regeneration and function. Development of a non-invasive means to quantify hepatic steatosis would facilitate selection of candidates for liver resection and transplant donation. METHODS: An IRB-approved protocol prospectively enrolled 28 patients with liver tumors requiring hepatic resection...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28528266/response-to-altman-et%C3%A2-al
#13
LETTER
Wilson Petrushnko, Justin S Gundara, Philip R De Reuver, Greg O'Grady, Jaswinder S Samra, Anubhav Mittal
No abstract text is available yet for this article.
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28526400/surgeons-opinions-of-legal-practice-in-bile-duct-injury-following-cholecystectomy
#14
Alex Gordon-Weeks, Harsh Samarendra, John de Bono, Zahir Soonawalla, Michael Silva
INTRODUCTION: Litigation for bile duct injury following laparoscopic cholecystectomy places financial strain on the health service, causes significant patient morbidity and adversely affects the patient and surgeon. Claimants argue that the injury itself is evidence of negligence. METHODS: A questionnaire addressing views on BDI causation was sent to members of AUGIS working in the National Health Service, UK. Response themes and responses were compared between groups of surgeons...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28522378/a-comparative-study-of-risk-factors-for-pancreatic-fistula-after-pancreatoduodenectomy-or-distal-pancreatectomy
#15
James M Halle-Smith, Eduardo Vinuela, Rachel M Brown, James Hodson, Zergham Zia, Simon R Bramhall, Ravi Marudanayagam, Robert P Sutcliffe, Darius F Mirza, Paolo Muiesan, John Isaac, Keith J Roberts
BACKGROUND: Evidence associates various biometric and histological variables such as steatosis and absence of fibrosis as risk factors for post-operative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). Following distal pancreatectomy (DP), the association between these factors and POPF is less clear. This study of patients, drawn from the same background population, undergoing PD or DP at a single centre is a comparative study of the risk factors for POPF after these two operations...
May 15, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28499749/a-double-blinded-prospective-randomized-trial-comparing-the-effect-of-anatomic-versus-non-anatomic-resection-on-hepatocellular-carcinoma-recurrence
#16
Xiaobin Feng, Yongjie Su, Shuguo Zheng, Feng Xia, Kuansheng Ma, Jun Yan, Xiaowu Li, Wei Tang, Shuguang Wang, Ping Bie, Jiahong Dong
BACKGROUND: The aim of this study was to determine the effect of anatomic resection (AR) versus non-anatomic resection (NAR) on recurrence rates in patients with hepatocellular carcinoma (HCC). METHODS: Eligible patients were randomized to AR or NAR from January 2006 to July 2007 at a single center. The primary outcome was the 2-year recurrence-free survival (RFS). Secondary outcomes were postoperative complications, time to first recurrence, 1-, 3-, and 5-year RFS, and overall survival (OS)...
May 9, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28495437/case-controlled-study-comparing-peri-operative-and-cancer-related-outcomes-after-major-hepatectomy-and-parenchymal-sparing-hepatectomy-for-metastatic-colorectal-cancer
#17
Jeffrey T Lordan, John K Roberts, James Hodson, John Isaac, Paolo Muiesan, Darius F Mirza, Ravi Marudanayagam, Robert P Sutcliffe
INTRODUCTION: Liver resection is potentially curative in selected patients with colorectal liver metastases (CLM). There has been a trend towards parenchyma sparing hepatectomy (PSH) rather than major hepatectomy (MH) due to lower perioperative morbidity. Although data from retrospective series suggest that long-term survival after PSM are similar to MH, these reports may be subject to selection bias. The aim of this study was to compare outcomes of PSH and MH in a case-controlled study...
May 9, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28495439/the-impact-of-expanded-indications-on-short-term-outcomes-for-resection-of-malignant-tumours-of-the-liver-over-a-30-year-period
#18
Daniel Azoulay, Prashant Bhangui, Gérard Pascal, Chady Salloum, Paola Andreani, Philippe Ichai, Faouzi Saliba, Chetana Lim
BACKGROUND: There are two philosophical approaches to planning liver resection for malignancy: one strives towards zero postoperative mortality by stringent selection of candidates, thus inherently limiting patients selected; the other, accepts a low yet definite postoperative mortality rate, and offers surgery to all those with potential gain in survival. The aim of this study was to retrospectively analyse an alternative and evolving strategy, and its impact on short-term outcomes. METHOD: 3118 consecutive hepatectomies performed in 2627 patients over 3 decades (1980-2011) were analysed...
May 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28495438/african-americans-have-a-lower-prevalence-of-portal-vein-thrombosis-at-the-time-of-liver-transplantation
#19
Dmitri Bezinover, Ethan Reeder, Faisal Aziz, Fuat Saner, Patrick McQuillan, Zakiyah Kadry, Thomas Riley, Dmitri Guvakov, Piotr K Janicki
BACKGROUND: Perioperative vascular thrombotic events in patients undergoing liver transplantation (LT) are associated with significant morbidity and mortality. METHODS: In this retrospective UNOS database analysis, we evaluated the prevalence of portal vein thrombosis (PVT) and factors contributing to PVT development in different ethnic groups. RESULTS: Of the 47 953 LT performed between 2002 and 2015, we identified 3642 cases of PVT. African Americans (AA) had a significantly lower prevalence of PVT compared to other ethnic groups (p = 0...
May 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28495436/factors-relevant-to-persistent-upper-abdominal-pain-after-cholecystectomy
#20
Jing Zhang, Qiang Lu, Yi-Fan Ren, Jian Dong, Yi-Ping Mu, Yi Lv, Xu-Feng Zhang
BACKGROUND: Cholecystectomy is a routine procedure for treatment of upper abdominal pain (UAP) and other atypical symptoms associated with gallstones. UAP, however, persists in some cases postoperatively. The present study was to identify the risk factors relevant to persistent UAP after cholecystectomy. METHODS: 1714 symptomatic patients undergoing cholecystectomy for gallstones were enrolled. All the patients were asked to complete a biliary symptom questionnaire...
May 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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