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Guoqing Jiang, Dousheng Bai, Ping Chen, Jianjun Qian, Shengjie Jin
BACKGROUND: Liver resection was not formerly recommended in patients with both hepatocellular carcinoma (HCC) and portal hypertension because of difficult perioperative bleeding control and postoperative liver failure. Splenectomy is a proven method with which to overcome these problems. To investigate the safety and feasibility of synchronous laparoscopic splenectomy and azygoportal disconnection with hepatectomy (LSDH) for treatment of portal hypertension accompanied with HCC, we describe a clinical cohort of 10 patients who underwent a new technique of synchronous LSDH...
March 1, 2018: Surgical Innovation
Michael R Freund, Petachia Reissman, Ari Zimran, Joseph Alberton
OBJECTIVE: The objective of this article was to demonstrate that Gaucher disease (GD) patients with refractory hypersplenism and massive splenomegaly may successfully undergo hand-assisted laparoscopic splenectomy (HALS). METHODS: This was a retrospective audit conducted at the Gaucher clinic at a national referral center over a 10-year period. PATIENT POPULATION: This study included 8 GD patients who underwent hand-assisted or conventional laparoscopic splenectomy for massive or complicated splenomegaly between the years 2007 and 2017...
March 7, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Chamara Dalugama, Indika Bandara Gawarammana
BACKGROUND: Tuberculosis is a major health problem in the developing world. Diagnosis of extrapulmonary tuberculosis is delayed because the presentation is nonspecific. Extrapulmonary tuberculosis can present with various hematological manifestations, including pancytopenia. Pancytopenia could be due to hypersplenism, maturation arrest, hemophagocytic lymphohistiocytosis, or infiltration of the bone marrow by caseating or noncaseating granulomas causing reversible or irreversible fibrosis...
March 6, 2018: Journal of Medical Case Reports
Christina Kalpadakis, Gerassimos A Pangalis, Maria K Angelopoulou, Sotirios Sachanas, Theodoros P Vassilakopoulos
SMZL is a relatively rare low grade B-cell lymphoma, characterized usually by an indolent clinical behavior. Since there is no prospective randomized trials to establish the best treatment approach, decision on therapeutic management should be based on the available retrospective series. Based on these data, rituximab and splenectomy appear to be the most effective. Splenectomy represented the standard treatment modality until early 2000s. More than 90% of the patients present quick amelioration of splenomegaly related symptoms along with improvement of cytopenias related to hypersplenism...
March 2018: Best Practice & Research. Clinical Haematology
Xiaoli Zhan, Yan Chen, Yuedong Wang
No abstract text is available yet for this article.
January 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Jayant Kumar Banerjee, Ramanathan Saranga Bharathi, S Venkatesan, Giriraj Singh
No abstract text is available yet for this article.
January 2018: Medical Journal, Armed Forces India
Zhaoqing Du, Jian Dong, Jia Zhang, Jianbin Bi, Zheng Wu, Yi Lv, Xufeng Zhang, Rongqian Wu
BACKGROUND: Postoperative complications after splenectomy are not rare and can be serious in cirrhotic patients. The purpose of this study was to assess postoperative complications using the comprehensive complication index (CCI) after splenectomy in cirrhotic patients and identify risk factors for those who developed a high postoperative CCI score. MATERIALS AND METHODS: This retrospective study included 208 adult patients with viral hepatitis-related cirrhosis, who underwent elective splenectomy at our hospital from January 2002 to June 2012...
February 2018: Journal of Surgical Research
Mayank Jain, Jenisha Jain, Gauri Rao Passi, Kamna Jain, Shikhar Jain
Introduction: There is a paucity of data regarding the clinical profile of children with extrahepatic portal venous obstruction (EHPVO) from Central India. Material and methods: Retrospective analysis of 30 children with EHPVO treated between 2002 and 2012. Results: The median age of presentation was 12.5 years (range 5-14 years) and median duration of symptoms was 3.2 years (range 0.3-10 years). Home delivery was noted in 30 cases (100%), umbilical sepsis in 8 (27%) and history of cow dung application over the umbilical cord in 2 cases (6...
December 2017: Clinical and Experimental Hepatology
Yusuke Tanaka, Isao Matsumoto, Daisuke Saito, Syuhei Yoshida, Seiichi Kakegawa, Masaya Tamura, Hirofumi Takemura
It is often difficult to control perioperative bleeding in patients with liver cirrhosis and concurrent thrombocytopenia and coagulation factor deficiency. Partial splenic embolization (PSE), an auxiliary treatment strategy in management of liver cirrhosis and hepatocellular carcinoma, can not only increase platelets but also improve liver function. With advances in interventional radiology, PSE is a safer and more reliable procedure compared to a splenectomy. We present the case of a 69-year-old man diagnosed with left lung cancer, with thrombocytopenia, and hepatitis C virus-related cirrhosis...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Shiv Akshat, Shikha Jain, Puneet Khanna, Ravinder Kumar Batra
No abstract text is available yet for this article.
November 2017: Indian Journal of Anaesthesia
I Maaloul, O Laaroussi, I Jedidi, L Sfaihi, S Kmiha, T Kamoun, H Aloulou, M Hachicha
AIM: Our objectives were to assess the management of patients with major thalassemia and identify the various complications and monitoring means. PATIENTS AND METHODS: A retrospective study was conducted on 26 β-thalassemic patients in the department of paediatrics, Hédi Chaker hospital, Sfax, Tunisia during a period of 25 years (from 1 January 1990 to 31 December 2014). RESULTS: The mean age of the beginning of transfusion was 11.5 months...
February 2018: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
Li Long, Zhang Jinshan, Chen Zhen, Li Qi, Dong Ning, Diao Mei, Cheng Wei
OBJECTIVE: Rex shunt (mesenteric-to-left portal vein bypass) is considered a more physiologically rational treatment for EHPVO than other portosystemic systemic shunts in children. However, about 13.6% of children with EHPVO do not have usable left portal veins and up to 28.1%. Rex operations in children are not successful. Hence, a Rex shunt in these children was impossible. This study reports a novel approach by portal-to-right portal vein bypass for treatment of children with failed Rex shunts...
November 4, 2017: Journal of Pediatric Surgery
Harufumi Maki, Junichi Kaneko, Junichi Arita, Nobuhisa Akamatsu, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Sumihito Tamura, Hidemasa Takao, Eisuke Shibata, Norihiro Kokudo
A Japanese woman with a history of Kasai operation for biliary atresia had living-donor liver transplantation at the age of 22. The first episode of refractory HE and late cellular rejection was treated by a high dose of methylprednisolone. The second episode of refractory HE was treated by balloon-occluded retrograde transvenous obliteration for a spleno-renal shunt. However, the third episode of refractory HE occurred 11 years after liver transplantation. The liver cirrhosis and hypersplenism were present with a Child-Pugh score of C-10...
December 1, 2017: Clinical Journal of Gastroenterology
Masashi Fujita, Kazumichi Abe, Manabu Hayashi, Ken Okai, Atsushi Takahashi, Hiromasa Ohira
Lusutrombopag, a small molecule thrombopoietin receptor agonist, has been approved for the treatment of chronic liver disease-associated thrombocytopenia due to hypersplenism in patients scheduled to undergo elective invasive procedures in Japan. We performed partial splenic embolization (PSE) after administration of lusutrombopag in two patients with thrombocytopenia due to cirrhosis. Case 1 involved a 50-year-old man who developed cirrhosis due to hepatitis B virus (HBV) infection and alcohol consumption...
November 15, 2017: Fukushima Journal of Medical Science
Dou-Sheng Bai, Ping Chen, Sheng-Jie Jin, Jian-Jun Qian, Guo-Qing Jiang
BACKGROUND: Conventional open and conventional laparoscopic splenectomy and azygoportal disconnection (CLSD) result in poor quality of life because of damage to the vagal nerve. We have developed vagus nerve-preserving laparoscopic splenectomy and azygoportal disconnection (VLSD). This study aimed to evaluate whether VLSD is effective and safe, and to determine whether a reduction in the incidence of postoperative complications improves postoperative quality of life compared with CLSD...
November 3, 2017: Surgical Endoscopy
Leire Parapar Álvarez, Sonia Antón García, Carmen Argüelles Martínez de la Vega, Manuel Crespo Sánchez
Simple hepatic cysts (SHCs) are formations that contain serous fluid surrounded by normal hepatic parenchyma with no communication with intrahepatic bile ducts. Symptoms develop as a result of their size or complications such as bleeding, rupture, intracystic infection or compression of adjacent structures.
October 11, 2017: Revista Española de Enfermedades Digestivas
Manjunath Maruti Pol, Latika Uniyal Chawla, Yashwant Singh Rathore, Ritesh Goel
24-year-old woman at 28 weeks gestation was referred from peripheral hospital with diagnosis of pregnancy with portal hypertension. She had received multiple transfusion for pancytopaenia in the past and had undergone endoscopic sclerotherapy for oesophageal varices. Initially, she was admitted in our hospital at 28 weeks gestation for blood transfusion and was evaluated by multispecialty team of doctors. She was advised splenectomy for transfusion-dependent pancytopaenia secondary to hypersplenism in non-cirrhotic portal hypertension...
September 15, 2017: BMJ Case Reports
Toshiaki Komo, Jun Hihara, Mikihiro Kanou, Toshihiko Kohashi, Ichiro Ohmori, Masanori Yoshimitsu, Takuhiro Ikeda, Akira Nakashima, Masashi Miguchi, Ichiko Yamakita, Hidenori Mukaida, Naoki Hirabayashi, Mayumi Kaneko
INTRODUCTION: Hamartomas are rare, benign tumors of the spleen. Few cases of splenic hamartomas associated with thrombocytopenia have been reported. PRESENTATION OF CASE: An asymptomatic 64-year-old man with myelodysplastic syndrome was found to have a splenic tumor. Laboratory tests were significant for thrombocytopenia, with a platelet count of 7.8×10(4)/μL. Ultrasonography showed splenomegaly (10.8×6.6cm), and a hypoechoic splenic mass (8.0×7.0cm). Color doppler ultrasound revealed blood flow within the mass, and the mass density was homogeneous on abdominal computed tomography (CT)...
2017: International Journal of Surgery Case Reports
Lin Zhou, Lin-Zhi Zhang, Jing-Yan Wang, Yong-Wu Li, Hai-Dong Hu, Xiao-Ming Peng, Yun Zhao, Xi-Ming Wang, Hui Xie, Chun-Zi Liu, Hua-Ming Wang
Patients with hepatocellular carcinoma (HCC) exhibit a high incidence of concomitant cirrhosis with leukopenia and/or thrombocytopenia. In the present study, perioperative changes in the white blood cell (WBC) and platelet (PLT) counts and associated complications were investigated to assess the safety of transcatheter arterial chemoembolization (TACE) for HCC patients with preprocedural leukopenia or thrombocytopenia. The records of 1,461 HCC patients who received TACE between January 2012 and December 2013 were retrospectively reviewed...
September 2017: Molecular and Clinical Oncology
Guoqing Jiang, Dousheng Bai, Jianjun Qian, Ping Chen, Shengjie Jin
BACKGROUND: Gastroparesis is a common complication after splenectomy and azygoportal disconnection, remaining a chronic debilitating disorder with considerable treatment challenges. To minimize postoperative gastroparesis, we have developed a new modified laparoscopic pyloroplasty (LP) technique for use during laparoscopic splenectomy and azygoportal disconnection (LSD). METHODS: We retrospectively evaluated the outcomes of 31 cirrhotic patients with portal hypertensive bleeding and secondary hypersplenism who underwent synchronous LSD with modified LP (n = 14) or LSD without modified LP (n = 17) between January 2015 and August 2015...
August 2017: Surgical Innovation
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