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Journal of Hepato-biliary-pancreatic Sciences

Daniel Cherqui, Go Wakabayashi, David A Geller, Joseph F Buell, Ho-Seong Han, Olivier Soubrane, Nicholas O'Rourke
In this article, we present the rationale for creating a new society aiming at organizing laparoscopic liver surgery. It has been named International Laparoscopic Liver Society (ILLS). Its main mission is to facilitate the diffusion and education of laparoscopic liver resection for meaningful improvements in patient care. This will include organization of a biannual congress dedicated to laparoscopic liver resection, coordination of international registries, helping in the education of surgeons wishing to learn these techniques including travel grants, provide a website serving as a forum supporting collaboration between surgeons interested in the advancement of laparoscopic liver resection techniques (http://www...
October 21, 2016: Journal of Hepato-biliary-pancreatic Sciences
Martin de Santibañes, Eduardo de Santibañes, Juan Pekolj
The paradigm introduced by William Halsted for surgical residency training has been considered the most appropriate educational system to acquire the knowledge and surgical skills required to become a competent general surgeon. Hepato-pancreato-biliary (HPB) surgery is considered an important part of general surgery training because of its high prevalence and complexity. Nowadays, we are faced with a worldwide shortage of general surgeons candidates, restrictive working hours and less surgical exposure, situations that can undermine the objectives of training in HPB surgery during residency...
October 21, 2016: Journal of Hepato-biliary-pancreatic Sciences
Yuhei Hamaguchi, Akira Mori, Yasuhiro Fujimoto, Takashi Ito, Taku Iida, Shintaro Yagi, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto
BACKGROUND: The present study aimed to investigate the impact of the duration of hepatic pedicle clamping (HPC) on tumor growth after major hepatectomy in a rat model. METHODS: Rats were divided into 4 groups according to the length of HPC during 70% partial hepatectomy followed by N1S1 tumor cell implantation: group 1, without HPC; group 2, with 5-min HPC; group 3, 10-min HPC; and group 4, 15-min HPC. At three weeks after tumor cell implantation, liver tumor growth and its possible mechanisms were investigated...
October 13, 2016: Journal of Hepato-biliary-pancreatic Sciences
Dhananjaya Sharma, Shuji Isaji
Focused pathological attention to tumor invasion of the retroperitoneal resection margin after pancreaticoduodenectomy for cancer of head of the pancreas led to the knowledge of strong tendency of cancer cells to infiltrate into the retropancreatic tissue and to spread along the peripancreatic neural plexuses as the cause of local recurrence. The term 'mesopancreas' was coined to describe perineural lymphatic layer located dorsally to the pancreas and it was suggested that its complete resection will minimize loco-regional recurrence and improve outcome...
October 12, 2016: Journal of Hepato-biliary-pancreatic Sciences
Kayvan Mohkam, Benjamin Darnis, Jean-Yves Mabrut
Porcine models of extended hepatectomy and liver transplantation (LT) of reduced graft have been widely used for studying the small-for-size (SFS) syndrome and the various modalities of portal inflow modulation (PIM). However, considerable heterogeneity exists among the studies and their results. The aim of this review was to assess the main advantages and drawbacks of the different porcine models of SFS LT and SFS hepatectomy, and propose a standardized anatomical nomenclature for the various models. The MEDLINE database was searched for articles reporting porcine models of reduced graft LT or hepatectomy of more than 65%...
October 6, 2016: Journal of Hepato-biliary-pancreatic Sciences
Takeshi Takahara, Go Wakabayashi, Hiroyuki Konno, Mitsukazu Gotoh, Hiroki Yamaue, Katsuhiko Yanaga, Jirou Fujimoto, Hironori Kaneko, Michiaki Unno, Itaru Endo, Yasuyuki Seto, Hiroaki Miyata, Masaru Miyazaki, Masakazu Yamamoto
BACKGROUND: The National Clinical Database (NCD) in Japan is a nationwide registry that collects the data of more than 1,200,000 surgical cases annually from over 3,500 hospitals. Based on the NCD data, this study compared the perioperative outcomes of major laparoscopic liver resection (LLR) with those of major open liver resection (OLR) using the propensity score matching method. METHODS: We collected data on 15,191 major hepatectomy cases (929 major LLR cases and 14,262 major OLR cases), and investigated the short-term outcomes in well-matched groups...
September 29, 2016: Journal of Hepato-biliary-pancreatic Sciences
Takaki Furuyama, Atsushi Kudo, Satoshi Matsumura, Yusuke Mitsunori, Arihiro Aihara, Daisuke Ban, Takanori Ochiai, Shinji Tanaka, Minoru Tanabe
BACKGROUND: The most reliable index to predict the safety of hepatectomy for patients with poor liver function remains unknown. We aimed to construct a novel preoperative index to predict early liver failure (ELF) and mortality due to recurrence-free liver failure (MLF) after hepatectomy. METHODS: Between 2000 and 2012, 385 consecutive patients with hepatocellular carcinoma undergoing curative minor hepatectomy were divided into two sequential cohorts: training set (n = 143) and validation set (n = 242), and observed until 2015...
September 15, 2016: Journal of Hepato-biliary-pancreatic Sciences
Shin Yasui, Keiichi Fujiwara, Yuuki Haga, Masato Nakamura, Rintaro Mikata, Makoto Arai, Tatsuo Kanda, Shigeto Oda, Osamu Yokosuka
BACKGROUND: Corticosteroid (CS) has been introduced in most acute liver failure (ALF) patients for the purpose of suppressing pro-inflammatory cytokines in Japan where a shortage of donor livers exists, whereas CS use is evaluated to be no benefit in Western countries. In the present study, we aimed to clarify the association between infectious complications and CS use in ALF, and determine when to evaluate treatment response and consider the timing for switching to liver transplantation (LT)...
September 15, 2016: Journal of Hepato-biliary-pancreatic Sciences
Chiyoe Shirota, Hiroo Uchida, Yasuyuki Ono, Naruhiko Murase, Takahisa Tainaka, Kazuki Yokota, Kazuo Oshima, Ryo Shirotsuki, Akinari Hinoki, Hisami Ando
BACKGROUND: The indications for and efficacy of revision of portoenterostomy (PE) for biliary atresia (BA) needs to be reassessed in an era of liver transplantation. We therefore reviewed the long-term outcomes following revision of PE. METHODS: This was a retrospective study of the medical records of patients with BA who underwent PE and revision of PE. We investigated the role of revision on outcomes of jaundice-free native liver survival (approval number: 2015-0094)...
September 3, 2016: Journal of Hepato-biliary-pancreatic Sciences
Shohei Komatsu, Shinobu Tsuchida, Tadashi Tsukamoto, Tomoyuki Wakahara, Hiroshi Ashitani, Nozomi Ueno, Akihiro Toyokawa, Akihiko Watanabe, Atsushi Sugahara, Hidekazu Mukai
BACKGROUND: The present study assessed conservative management of acute cholecystitis (AC) with a focus on percutaneous transhepatic gallbladder aspiration (PTGBA). METHODS: Consecutive 275 patients with AC who underwent PTGBA were reviewed. Patients aged ≥80 years and/or with American Society of Anesthesiologists score III to IV and/or performance status 3 to 4 were defined as high risk. Patients were classified according to duration from symptom onset to first PTGBA: within 3 days (early PTGBA) or over 3 days (late PTGBA)...
August 31, 2016: Journal of Hepato-biliary-pancreatic Sciences
Masaji Hashimoto, Tsunao Imamura, Tetsuo Tamura, Rikako Koyama, Yuko Koizumi, Mikio Makuuchi, Masamichi Matsuda, Goro Watanabe
BACKGROUND: The incidence of biliary tract stones has widely been reported to be high after gastrectomy. Treatment of biliary tract stones in post-gastrectomy patients was examined retrospectively, particularly minimally invasive therapy with laparoscopic cholecystectomy for gallbladder stones and endoscopic bile duct lithotomy for common bile duct stones. METHODS: Treatment of 122 post-gastrectomy patients with biliary tract stones was examined retrospectively from 1995 to April 2015...
August 16, 2016: Journal of Hepato-biliary-pancreatic Sciences
Masaki Kaibori, Hiroyuki Nitta, Michihiro Hayashi, Shigekazu Takemura, Hiroaki Nagano, Kosuke Matsui, Hisashi Ikoma, Takuya Nakai, Masafumi Yasunaga, Masahiro Kido, Takeshi Aoki, Toshiki Rikiyama, Keiji Sano, Atsushi Kudo, Satoshi Katagiri, Yuichiro Otsuka, Tamotsu Kuroki, Takeo Nomi, Koichi Yano, Itaru Endo, Masaki Ueno, Akishige Kanazawa, Hiroaki Terajima, Saiho Ko, Goro Honda, Yasuji Seyama, Hiroki Sunagawa, Tsukasa Aibara
BACKGROUND: Among young residents, there seems to be a decreasing desire to become surgeons, resulting in a decrease in the number of surgeons. There is concern regarding a shortage of hepatobiliary pancreatic (HBP) surgery residents in Japan. A questionnaire survey was designed to assess the work motivations of Japanese gastrointestinal (GI) and HBP surgeons. METHODS: Questionnaires assessing seven domains related to motivation (aptitude, satisfaction/dissatisfaction, knowledge/skill, evaluation/approval, self-management, community/expectation from other parties, and emotion) were sent to GI and HBP surgeons throughout Japan...
August 9, 2016: Journal of Hepato-biliary-pancreatic Sciences
Daisuke Ito, Nobuhisa Akamatsu, Junichi Togashi, Junichi Kaneko, Junichi Arita, Kiyoshi Hasegawa, Yoshihiro Sakamoto, Norihiro Kokudo
BACKGROUND: Massive ascites after living donor liver transplantation (LDLT), defined as small-for-size graft syndrome, is a risk factor for a poor prognosis. Few studies have reported factors associated with ascites and the relevant outcome after LDLT. METHODS: Data from 413 adult patients that underwent LDLT were retrospectively analyzed. RESULTS: Recipient age, preoperative albumin level, Child-Pugh score, preoperative ascites, graft volume, intraoperative blood loss, and duration of warm ischemic time and the anhepatic phase were significantly associated with the total amount of ascites between postoperative day (POD) 1 and POD14...
July 30, 2016: Journal of Hepato-biliary-pancreatic Sciences
Raffaele Brustia, Benjamin Granger, Olivier Scatton
Mortality and morbidity in hepatic surgery are affected by blood loss and transfusion. Topical haemostatic agents (THA) are composed by a matrix and/or fibrin sealants, and their association known as "carrier-bound fibrin sealant" (CBFS): despite widely used for secondary haemostasis, the level of evidence remains low. To realize a meta-analysis on the results of CBFS on haemostasis and postoperative complications. Searches in PubMed, PubMed Central, Cochrane and Google Scholar using keywords: "topical_haemostasis" OR "haemostatic_agents" OR "sealant_patch" OR "fibrin_sealant" OR "collagen_sealant" AND "liver_surgery" OR "hepatic_surgery" OR "liver_transplantation"...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Admir Kurtcehajic, Esved Vele, Ahmed Hujdurovic
Highlight Kurtcehajic and colleagues present a rare case of congenital portal vein aneurysm (PVA) with biliopathy. Symptoms associated with PVA occur in less than 10% of cases. Imaging modalities showed the PVA partially compressing the common and right hepatic ducts. Conservative treatment markedly lowered bilirubin levels and relieved the abdominal pain.
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Shuichi Fujioka, Takeyuki Misawa, Katsuhiko Yanaga
Positive surgical margin of extrapancreatic nerve plexus (ENP) is a major cause of non-curative resection during pancreaticoduodenectomy (PD) for periampullary carcinoma (PC), which is difficult to detect at the early stage of PD. We describe a novel surgical technique using an isolating tape (iTape)-oriented ENP-first dissection (IOEFD) during PD. The iTape is firstly passed through the retroperitoneal space between ENP and inferior vena cava. Then, the iTape is further extracted from major vessels such as the common hepatic and superior mesenteric artery...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Takeshi Ogura, Wataru Takagi, Yoshitaka Kurisu, Kazuhide Higuchi
Endoscopic retrograde cholangiopancreatography (ERCP) is the gold-standard modality for diagnosis and therapy of bilio-pancreatic disease. In particular, peroral cholangiography (POCS) is a useful modality not only for diagnosing biliary disease, but also for therapeutic procedures such as electrohydraulic lithotripsy. The SPY-DS single-operator cholangioscope has recently become available, and offers favorable visualization, a wide view, suction function and a larger accessory working channel. However, if the duodenoscope cannot be advanced into the ampulla of Vater for reasons such as surgical anatomy, POCS cannot be performed...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Koichi Teramura, Takehiro Noji, Toru Nakamura, Toshimichi Asano, Kimitaka Tanaka, Yoshitsugu Nakanishi, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
BACKGROUND: The surgical indications for patients with pancreatic head cancer (PHC) with clinical portal vein (PV) invasion (cPV) remain controversial. The present study aimed to determine the ability of computed tomography (CT) to diagnose pathological PV involvement (pPV) in PHC. METHODS: We evaluated the morphological features (length and circumference) and two sets of diagnostic criteria for cPV determined from preoperative CT findings of 112 consecutive patients who underwent pancreatoduodenectomy for PHC...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Tomonari Asano, Seiji Natsume, Yoshiki Senda, Tsuyoshi Sano, Keitaro Matsuo, Yasuhiro Kodera, Kazuo Hara, Seiji Ito, Kenji Yamao, Yasuhiro Shimizu
BACKGROUND: There have been no reports showing the incidence of anastomotic stenosis of continuous hepaticojejunostomy (HJ) and identifying its risk factors for patients who underwent pancreaticoduodenectomy (PD). METHOD: We retrospectively investigated 200 patients whose HJ was established by unified method, single layered continuous suture. HJ stenosis was diagnosed with endoscopic or radiologic examinations. Uni and multivariable unconditional logistic modeling were performed to explore the predictive factors and to estimate odds ratios (ORs) and their 95% confidence intervals (CIs)...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Kazuo Inui, Shinji Suzuki, Hironao Miyoshi, Satoshi Yamamoto, Takashi Kobayashi, Yoshiaki Katano
BACKGROUND: Gallstones are detected in about 5% of healthy Japanese. We followed up individuals showing gallstones upon screening, investigating features of those requiring surgery. METHODS: In 2002 we performed health evaluations for 21,550 persons (13,986 men and 7,564 women), detecting gallstones ultrasonographically in 837 or 3.9% (561 men, or 4.0%; 276 women, or 3.6%). Up until 2012, we followed up 720 of the 837 persons with gallstones (86.0%) and compared individuals requiring or not requiring cholecystectomy as to age, gender, body mass index, diabetes, liver function, lifestyle, abdominal symptoms, and ultrasonographic findings...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
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