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Annals of Hepato-Biliary-Pancreatic Surgery

Giuseppe Bianco, Francesco Frongillo, Salvatore Agnes, Erida Nure, Nicola Silvestrini
Agenesis of the gallbladder and cystic duct represents one of the rarest anomalies of the biliary system, with a reported incidence of 0.007% to 0.027%. Almost half of the patients develop common duct stones and 23% of them manifest signs and symptoms that mimic biliary colic. We present the case of a woman presenting with symptoms of biliary colic. Based on the clinical findings and after abdominal ultrasonography, which showed hyperechoic material in the gallbladder fossa, a laparoscopic cholecystectomy was planned...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Adianto Nugroho, Kwang-Woong Lee, Kyung-Bun Lee, Hyo-Shin Kim, Hyeyoung Kim, Nam-Joon Yi, Kyung-Suk Suh
The incidence of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CC) in a single patient accounts for only 0.4 to 14% of all primary liver cancer. However, the prognosis of its intrahepatic cholangiocarcinoma (ICC) component is poor. We experienced a unique case of a sequentially developed cHCC-CC with adrenal metastasis as the primary presentation and a hidden primary hepatocellular carcinoma. A 65-year-old female with a history of jaundice and abdominal discomfort was diagnosed with S4 ICC measuring 5 cm in diameter, and characterized histologically as papillary adenocarcinoma with intraductal growth, but without any evidence of malignant hepatocyte...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Jia Rui Kwan, Keith Sheng Hng Low, Rahul Lohan, Vishal G Shelat
Percutaneous transhepatic biliary drainage (PTBD) is safe treatment for biliary decompression given certain indications. However, this is temporary until definitive drainage is established. We report on a 76-year-old lady with recurrent pyogenic cholangitis and PTBD catheter fracture. She had hepatitis B virus-related Child-Pugh class A liver cirrhosis, hypothyroidism, hyperlipidaemia, and previous atrial fibrillation with a background of mild mitral, tricuspid and aortic valvular regurgitation. She had history of laparoscopic cholecystectomy in the past...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Yong-Kyu Chung, Shin Hwang, Gi-Young Ko, Sang Min Yoon
It is expected that a combination of transcatheter arterial chemoembolization (TACE) with stereotactic body radiation therapy (SBRT) may induce synergistic therapeutic effects in hepatocellular carcinoma (HCC), which would result in a high rate of complete therapeutic response. In this study, we present the 5-year clinical course of a patient who had HCC at the caudate lobe, which was treated with TACE and SBRT. A 53-year-old male was diagnosed with an 8 cm-sized HCC at the caudate lobe with compression of the inferior vena cava (IVC)...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Sánchez-Morales Germán Esteban, Clemente-Gutiérrez Uriel Emilio, Alvarez-Bautista Francisco Emmanuel, Santes-Jasso Oscar, Carpinteyro-Espin Paulina, Mercado Miguel Angel
Primary sarcomas of the liver are unusual neoplasms developing in adults. They constitute a heterogeneous group of neoplasms including undifferentiated embryonal sarcoma. Patients usually present with an abdominal mass and abdominal pain. Case 1: A 53-year-old woman presented with abdominal pain. Computed tomography showed an occupying mass in the right lobule and an intra-auricular multi-lobulated mass suggestive of a secondary deposit. Biopsy of the hepatic lesion revealed undifferentiated embryonal sarcoma...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Ramkiran Cherukuru, Sanjay Govil, Mukul Vij, Mohamed Rela
Backgrounds/Aims: En-bloc vein resection (VR) for pancreatic ductal adenocarcinoma (PDAC) of the head of pancreas adherent to the portomesenteric axis benefits patients when the vein wall is not infiltrated by tumour and an R0 resection is achieved, albeit at the expense of greater morbidity and mortality. Methods: A retrospective review of pancreaticoduodenectomy for PDAC over 6 years was conducted. Patients were divided into a standard resection group (Group SR) and simultaneous vein resection group (Group VR) and compared for outcome...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Yu-Ni Lee, Woo-Young Kim
Backgrounds/Aims: Pancreatic leakage is a major cause of postoperative death and morbidity after pancreaticoduodenectomy (PD). A recent study introduced Blumgart anastomosis (BA), which minimizes severe complications after PD. This study compares BA with conventional anastomosis (CA) for pancreaticojejunostomy (PJ) after PD at a single institution. Methods: A total of 87 patients who underwent PD at our hospital between January 2003 and October 2015 were enrolled in this study...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Francesco Crafa, Francesco Esposito, Adele Noviello, Nicola Moles, Enrico Coppola Bottazzi, Carmelo Lombardi, Antonio Miro, Giulio Lombardi
Backgrounds/Aims: Despite the advances in identifying risk factors, improving operative technique, and postoperative patient care, pancreatic leakage after pancreatic resection remains a highly debated topic. The aim of this study is to describe our technique and our initial experience with the intraoperative embolization of the main pancreatic duct with an Ethylene Vinyl Alcohol Copolymer (Onyx®). Methods: Two patients of 63 and 64 years underwent pancreaticoduodenectomy for a cholangiocarcinoma of the extrahepatic bile duct and a pancreatic adenocarcinoma, respectively...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Sang Hoon Kim, Hee Chul Yu, Jae Do Yang, Sung Woo Ahn, Hong Pil Hwang
Backgrounds/Aims: The role of prophylactic antibiotics for laparoscopic cholecystectomy in low-risk patients is still unclear. This study aimed to verify the conclusion of previous meta-analyses concerning the effectiveness of antibiotic prophylaxis for elective laparoscopic cholecystectomy in low-risk patients. Methods: Comprehensive literature searches were performed on electric databases and manual searches. Randomized controlled trials (RCTs), prospective studies, and retrospective studies comparing antibiotic prophylaxis to placebo or no antibiotics in low-risk elective laparoscopic cholecystectomy were included...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Jae-Ryong Shim, Seung Duk Lee, Hyung-Min Park, Eung-Chang Lee, Boram Park, Sung-Sik Han, Seong Hoon Kim, Sang Jae Park
Backgrounds/Aims: Colorectal cancer is found with liver metastases about 20-25% due to characteristics of cancer itself. Approximately 20% of liver metastases are found to be resectable. The objective of this study was to evaluate short-term outcomes of patients who received liver resection with colorectal cancer operation in our center by laparoscopic surgery or open surgery. Methods: Short-term outcomes of laparoscopic surgery of liver resection (LSLR) group who underwent liver resection for colorectal liver metastases (CRLM) at a single institute from 2013 to 2016 were compared to those of open surgery of liver resection (OSLR) group...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Darren Chua, Albert Low, Yexin Koh, Brian Goh, Peng Chung Cheow, Juinn Har Kam, Jin Yao Teo, Ek Khoon Tan, Alexander Chung, London Lucien Ooi, Chung Yip Chan, Ser Yee Lee
Backgrounds/Aims: Hilar cholangiocarcinomas (HCCAs) are tumors that involve the biliary confluence; at present, radical surgery offers the only chance of long-term survival, but this can be challenging given the complexity of the hilar anatomy. Blumgart and Jarnagin described a preoperative staging system that incorporates the effect of local tumor extent and its impact on adjacent structures and that has been demonstrated to correlate better with actual surgical resectability. The primary aim of this study is to describe the correlation between preoperative Blumgart-Jarnagin staging and its correlation with surgical resectability...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Sanjay Goja, Sujeet Kumar Saha, Sanjay Kumar Yadav, Anisha Tiwari, Arvinder Singh Soin
Backgrounds/Aims: A wide range of surgical approaches has been described for hepatic hydatidosis aiming primarily at the reduction of disease recurrence and minimization of postoperative morbidity. Methods: A database analysis of patients with liver hydatidosis who underwent different surgical procedures between March 2010 and May 2016 was performed. Results: A total of 21 patients with cystic echinococcosis (CE) and four cases of alveolar echinococcosis (AED) were detected...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Alexandros Giakoustidis, Kyriakos Neofytou, Mafalda Costa Neves, Dimitrios Giakoustidis, Eleni Louri, David Cunningham, Satvinder Mudan
Backgrounds/Aims: It is important to point out that the identification of inflammation is an essential component of the pathogenesis and the progression of cancer. In this study, we analysed the neutrophil-to-lymphocyte ratio (NLR) and the platelets-to-lymphocyte ratio (PLR), with an overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC), who were treated with a resection following or not following a procedure of neoadjuvant chemotherapy/chemoradiation. We intended to identify the significance of the role of NLR and PLR, as prognostic markers in patients undergoing surgery for PDAC...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Ken Min Chin, John Carson Allen, Jin Yao Teo, Juinn Huar Kam, Ek Khoon Tan, Yexin Koh, Kim Poh Brian Goh, Peng Chung Cheow, Prema Raj, Kah Hoe Pierce Chow, Yaw Fui Alexander Chung, London Lucien Ooi, Chung Yip Chan, Ser Yee Lee
Backgrounds/Aims: To determine the prevalence of post-hepatectomy liver failure/insufficiency (PHLF/I) in patients undergoing extensive hepatic resections for hepatocellular carcinoma (HCC) and to assess the predictive value of preoperative factors for post-hepatectomy liver failure or insufficiency (PHLF/I). Methods: A retrospective review of patients who underwent liver resections for HCC between 2001 and 2013 was conducted. Preoperative parameters were assessed and analyzed for their predictive value of PHLF/I...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Yong-Gyu Chung, Eunyoung Tak, Shin Hwang, Joo-Young Lee, Ji-Ye Kim, Ye-Young Kim, Gi-Won Song, Kyoung-Jin Lee, Nayoung Kim
Backgrounds/Aims: Hepatocellular carcinoma (HCC) recurrence remains a great concern following hepatic resection and liver transplantation. We investigated the metformin-induced cytotoxic effects on sorafenib in an in vitro study using HCC cell lines. Methods: This research was conducted through an in vitro study using one HepG2.2.15 liver tumor and two patient-derived graft HCC cell lines. Results: An in vitro study revealed noticeable cytotoxic effects of metformin as well as noticeable synergistic cytotoxic effects of metformin and sorafenib on cell viability...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Shohei Eto, Masashi Ishikawa, Michihito Asanoma, Yoshihiko Tashiro, Kazuo Matsuyama, Takehito Oshio
A 62-year-old man underwent endoscopic mucosal resection for early gastric cancer. The follow-up computed tomography revealed biliary dilatation. The tumor was located in the lower bile duct with biliary dilatation, and no evidence of metastasis in other organs was noted. The patient underwent subtotal stomach-preserving pancreatoduodenectomy with pancreaticogastrostomy and Billroth I anastomosis. At 13 months after the operation, gastrointestinal endoscopy revealed a tumor lesion in the pancreaticogastrostomy site...
May 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Jae Ryong Shim, Sung-Sik Han, Hyung Min Park, Eung Chang Lee, Sang-Jae Park, Joong-Won Park
A bronchobiliary fistula, or a biliobronchial fistula (BBF), is a rare condition. It results from an abnormal connection between the biliary and bronchial trees, and is characterized by pathognomonic bilious sputum with suspicious pneumonia. Traditionally, an infectious disease, such as a hydatid infection, has been known to cause a BBF, but BBFs have recently become associated with tumors. In every case, procedures and treatments differ between centers, from simple conservative management to invasive surgical procedures...
May 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Yongchel Ahn, Ji-Hoon Kim, Cheon-Soo Park, Tae-Eun Kim, Shin Hwang, Sung-Gyu Lee
Choriocarcinoma is a rare malignant germ cell tumor and it usually occurs in the gonads (ovary or testis) and uterus. Primary hepatic choriocarcinoma (PHC) is a variant of choriocarcinoma featuring sole liver presentation without any evidence of gonodal involvements. Adult male patients with PHC carry dismal prognosis and their median survival period was less than 5 months. We herein present a first Korean case of a 54-year-old male patient with adult PHC, who was treated by surgical resection and chemotherapy through a multidisciplinary approach...
May 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Giovanni Pirozzolo, Camilla Cona, Maurizio Rizzo, Fazli Shala, Sadri Berisha, Alfonso Recordare
Primary liver neuroendocrine tumors (PLNETs) are rare tumors of the liver. They share some common characteristics with neuroendocrine tumors (NETs) of the extrahepatic bile ducts, such as slow rise, hormonal, and histological features. Nevertheless, they possess some peculiarities and the major feature is the difference in the metastatic potential between PLNETs and NETs. PLNETs have less metastatic potential compared with NETs, which is the main factor based on which differential diagnosis between the two groups is achieved...
May 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Rajesh S Shinde, Amit Gupta, Mahesh Goel, Shraddha Patkar
Solitary fibrous tumor (SFT) of the liver is a rare entity and its presentation is usually delayed till they grow to a substantial size. Clinico-radiological features are non-specific, contributing to increase in the diagnostic dilemma. Definitive diagnosis of SFT is usually made based on the histological features and immunohistochemistry data of the resected specimen. In this case report, we describe the case of an elderly male who presented with a large mass in the left lobe of the liver with normal level of tumor markers and atypical radiological findings...
May 2018: Annals of Hepato-Biliary-Pancreatic Surgery
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