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Anatomical liver resection

Davit L Aghayan, Egidijus Pelanis, Åsmund Avdem Fretland, Airazat M Kazaryan, Mushegh A Sahakyan, Bård I Røsok, Leonid Barkhatov, Bjørn Atle Bjørnbeth, Ole Jakob Elle, Bjørn Edwin
Background: Laparoscopic liver resection (LLR) of colorectal liver metastases (CLM) is increasingly performed in specialized centers. While there is a trend towards a parenchyma-sparing strategy in multimodal treatment for CLM, its role is yet unclear. In this study we present short- and long-term outcomes of laparoscopic parenchyma-sparing liver resection (LPSLR) at a single center. Patients and methods: LLR were performed in 951 procedures between August 1998 and March 2017 at Oslo University Hospital, Oslo, Norway...
March 2018: Radiology and Oncology
P Vavra, L Karnik, M Skrobankova, J Jurcikova, P Ihnat, P Zonca, M Peteja, A El-Gendi, S Czudek
Liver resection is the standard treatment for any liver lesion. Laparoscopic liver resection is associated with lower intra-operative blood loss and fewer complications than open resection. Access to the posterior part of the right liver lobe is very uncomfortable and difficult for surgeons due the anatomic position, especially when employing laparoscopic surgery. Based on these experiences, a new laparoscopic device was developed that is capable of bending its long axis and allowing the application of radiofrequency energy in areas that were not technically accessible...
March 1, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Yunhong Tian, Huan Lyu, Yunhong He, Hari Krishna Kanduri
BACKGROUND: Recently, experts proposed subclassification for BCLC B patients. In this study, we aimed to evaluate the efficient of subclassification of patients with hepatitis B virus-related hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) staging system. METHODS: Seven hundred twenty-nine consecutive hepatitis B virus-related HCC patients with BCLC stage B classification who underwent hepatectomy in the period 2006-2012 were retrospectively analyzed...
March 7, 2018: Journal of Gastrointestinal Cancer
Luis Ruso Martinez
Regarding the history of liver surgery, Latin American pioneers have only occasionally been mentioned in the Anglo-Saxon literature. One of such rare cases was Uruguayan surgeon Gerardo Caprio, who in 1931 published a report about a resection of the left lobe of the liver. This was done during an uneventful period in the development of ideas on this surgical technique, following the remarkable advances made in the last quarter of the 19th Century. The anatomic and liver manipulation concepts used by Caprio had been developed by Merola in reports dating back to 1916 and 1920, which revealed well-grounded disagreements with the most renowned anatomists of the time...
March 1, 2018: Digestive Surgery
Mohamed Abdel Wahab, Ayman El Nakeeb, Mahmoud Abdelwahab Ali, Youssef Mahdy, Ahmed Shehta, Mohamed Abdulrazek, Mohamed El Desoky, Rihame Abdel Wahab
BACKGROUND: Hepatic hemangioma (HH) is the most common benign solid tumor of the liver. The aim of this study is to review our experiences of surgical treatment for giant HH and to show the impact of HH size and type of surgical resection on surgical outcomes. PATIENTS AND METHODS: This is a retrospective study of the cases who underwent surgery for giant HH during the period from January 2000 to April 2017. RESULTS: Elective surgery was performed for 144 patients who had giant HH...
February 27, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Tokio Higaki, Tadatoshi Takayama, Yutaka Midorikawa
BACKGROUND: Resection of hepatocellular carcinoma located in the caudate lobe is challenging because this anatomical location is difficult to approach, especially the caval portion. METHODS: We performed resection of the caval portion of the caudate lobe using a ventral approach combined with the resection of segment IV, VII, or VIII for hepatocellular carcinoma in 41 patients (extended segmentectomy group). As a control group, 138 patients with hepatocellular carcinoma who underwent segmentectomy for IV, VII, or VIII (segmentectomy group) were studied...
February 21, 2018: Surgery
Patrice Peyrat, Ellen Blanc, Stéphanie Guillermet, Yao Chen, Céline Ferlay, David Perol, Valéria Basso, Michel Rivoire, Aurélien Dupré
BACKGROUND AND OBJECTIVES: Fluorescence imaging using indocyanine green (ICG) is undergoing extensive development. This study aimed to assess the merits of ICG in regard to hepatic surgery. METHODS: Patients with liver lesions that required a resection were eligible. They received an injection of ICG the day before the surgery. Step 1 allowed assessment of use of the medical device under surgical conditions. Steps 2 and 3 assessed the capacity of the MD to detect known tumorous lesions and to spot a predefined area of the liver following injection of ICG into the portal vein (ICGp)...
February 23, 2018: Journal of Surgical Oncology
Simon Kirste, Gian Kayser, Anne Zipfel, Anca-Ligia Grosu, Thomas Brunner
BACKGROUND: Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors occurring in various anatomic regions. Although diagnostic criteria and treatment management are not established, current treatment options consist of surgery and chemotherapy including mTOR inhibitors. Stereotactic body radiation therapy (SBRT) is a non-invasive ablative treatment which has shown excellent control rates for more common types of unresectable liver tumors and metastases. In this report we present a rare case of PEComa of the liver that was treated by stereotactic radiotherapy followed by resection...
February 20, 2018: Radiation Oncology
Cheng-Maw Ho, Go Wakabayashi, Chi-Chuan Yeh, Rey-Heng Hu, Takanori Sakaguchi, Yasushi Hasegawa, Takeshi Takahara, Hiroyuki Nitta, Akira Sasaki, Po-Huang Lee
Background: Liver resection is a complex procedure for trainee surgeons. Cognitive task analysis (CTA) facilitates understanding and decomposing tasks that require a great proportion of mental activity from experts. Methods: Using CTA and video-based coaching to compare liver resection by open and laparoscopic approaches, we decomposed the task of liver resection into exposure (visual field building), adequate tension made at the working plane (which may change three-dimensionally during the resection process), and target processing (intervention strategy) that can bridge the gap from the basic surgical principle...
2018: Journal of Visualized Surgery
Burak Veli Ülger, Eyüp Savaş Hatipoğlu, Özgür Ertuğrul, Mehmet Cudi Tuncer, Cihan Akgül Özmen, Mesut Gül
PURPOSE: Vascular structures of the liver and the bile ducts are crucial during liver transplantation or liver resection surgery. Here, we report on variations in the vascular structures and bile ducts of 200 patients. MATERIALS AND METHODS: We reviewed magnetic resonance cholangiopancreatographic and multiple-detector computed tomographic data. RESULTS: Michels type 1 was detected in 54% of the patients. The other most common variations were, respectively, Michels type 5 (13%) and type 2 (11%)...
February 12, 2018: Acta Chirurgica Belgica
M Brand, P Gaylard, J Ramos
BACKGROUND: Colorectal cancer (CRC) is the fourth most common cancer in South Africa (SA), and the sixth most lethal. Approximately 25% of patients will have synchronous metastatic disease at the time of their primary CRC diagnosis. Although chemotherapy is used in most stages of the disease, surgical resection of the primary tumour and metastases remains the most successful treatment modality to achieve cure or prolong survival. To date, no data on CRC presentation and management have been published in SA...
February 1, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Knut M Augestad, Deborah S Keller, Paul M Bakaki, Johnie Rose, Siran M Koroukian, Tom Øresland, Conor P Delaney
BACKGROUND: The impact of rectal cancer tumor height on local recurrence and metastatic spread is unknown. The objective was to evaluate the impact of rectal cancer tumor height from the anal verge on metastatic spread and local recurrence patterns. METHODS: The Norwegian nationwide surgical quality registry was reviewed for curative rectal cancer resections from 1/1/1996-12/15/2006. Cancers were stratified into five height groups: 0-3 cm, >3-5 cm, >5-9 cm, >9-12 cm, 12 cm-HI...
January 30, 2018: Cancer Epidemiology
Benedetta Pesi, Luca Moraldi, Ilenia Bartolini, Federica Tofani, Francesco Guerra, Mario Annecchiarico, Andrea Coratti
BACKGROUND: Liver resection may be complicated by unpredictable intraoperative bleeding. Pringle's maneuver was the first attempt to control bleeding,but the main problem is the duration of ischemia. Robotic surgery thanks to the magnified view,three-dimensional visualization associated and fine movement allow to perform good parenchymal dissection and identification of vascular structure. Aim of study is to evaluate blood loss and the need to perform Pringle maneuver in patients underwent robotic liver resection...
February 1, 2018: Minerva Chirurgica
Nicolas Berte, Alya Filfilan, Laurence Mainard, Ludovic Mansuy, Jean-Louis Lemelle
Infantile hepatic hemangioma (IHH) and mesenchymal hamartoma (MH) form the first and second most common benign hepatic tumors in children. In this case report, we present a newborn child in whom a growing hepatic mass was discovered at the age of 7 days. She suffered also from anemia, respiratory and renal failure. No signs of heart disease or cutaneous lesions were detected. Alpha-fetoprotein was elevated for her age (3562.2 ng/ml). Imaging studies showed multifocal large cystic lesions associated with heterogeneous small solid lesions with arterial enhancement of the liver...
January 2018: Journal of Surgical Case Reports
Ji Hoon Kim, Byung Sun Cho, Je-Ho Jang
BACKGROUND: Pure laparoscopic anatomical segmental resection has rarely been reported because this technique frequently presents technical difficulties. We describe the laparoscopic resection of anatomical segment VI using the Glissonian approach and a modified liver hanging maneuver. METHODS: Rouviere's sulcus is identified after retracting superiorly the gallbladder. The Glissonian approach for anatomical resection of segment VI can be performed with minimal dissection of the liver parenchyma around the sulcus...
January 29, 2018: Langenbeck's Archives of Surgery
Michael Vouche, Thierry Degrez, Fikri Bouazza, Philippe Delatte, Maria Gomez Galdon, Alain Hendlisz, Patrick Flamen, Vincent Donckier
Preoperative radioembolization may improve the resectability of liver tumor by inducing tumor shrinkage, atrophy of the embolized liver and compensatory hypertrophy of non-embolized liver. We describe the case of a cirrhotic Child-Pugh A patient with a segment IV hepatocellular carcinoma requiring a left hepatectomy. Preoperative angiography demonstrated 2 separated left hepatic arteries, for segment IV and segments II-III. This anatomic variant allowed sequential radioembolizations, delivering high-dose 90Yttrium (160 Gy) to the tumor, followed 28 d later by lower dose (120 Gy) to segments II-III...
December 28, 2017: World Journal of Hepatology
Joshua D Cohen, Lu Li, Yuxuan Wang, Christopher Thoburn, Bahman Afsari, Ludmila Danilova, Christopher Douville, Ammar A Javed, Fay Wong, Austin Mattox, Ralph H Hruban, Christopher L Wolfgang, Michael G Goggins, Marco Dal Molin, Tian-Li Wang, Richard Roden, Alison P Klein, Janine Ptak, Lisa Dobbyn, Joy Schaefer, Natalie Silliman, Maria Popoli, Joshua T Vogelstein, James D Browne, Robert E Schoen, Randall E Brand, Jeanne Tie, Peter Gibbs, Hui-Li Wong, Aaron S Mansfield, Jin Jen, Samir M Hanash, Massimo Falconi, Peter J Allen, Shibin Zhou, Chetan Bettegowda, Luis A Diaz, Cristian Tomasetti, Kenneth W Kinzler, Bert Vogelstein, Anne Marie Lennon, Nickolas Papadopoulos
Earlier detection is key to reducing cancer deaths. Here we describe a blood test that can detect eight common cancer types through assessment of the levels of circulating proteins and mutations in cell-free DNA. We applied this test, called CancerSEEK, to 1,005 patients with non-metastatic, clinically detected cancers of the ovary, liver, stomach, pancreas, esophagus, colorectum, lung, or breast. CancerSEEK tests were positive in a median of 70% of the eight cancer types. The sensitivities ranged from 69% to 98% for the detection of five cancer types (ovary, liver, stomach, pancreas, and esophagus) for which there are no screening tests available for average-risk individuals...
January 18, 2018: Science
Jai Young Cho, Ho-Seong Han, Go Wakabayashi, Olivier Soubrane, David Geller, Nicholas O'Rourke, Joseph Buell, Daniel Cherqui
Laparoscopic liver resection is rapidly increasing, and certain types of resection are considered standard procedures for liver resection, especially for small malignant tumors located on the liver surface or in the anterolateral segments of the liver. Several specialized centers have performed many types of highly complex hepatectomies, anatomical resections, and laparoscopic donor hepatectomies. Even though several international consensus conferences and expert meetings have been held, until now there have been no practical guidelines for beginners or experts conducting laparoscopic liver resection...
January 6, 2018: Surgical Oncology
X J Zhou, Q Dong, C Z Zhu, X Chen, B Wei, Y H Duan, J Zhao, X W Hao, H Zhang, P Nie, B Hu, W J Xu, R W Shen, Z H Chen, K R Dong, Y Z Bai, Q Shu, W J Luo, F Gao, N Xia, Q Y Yu
Objective: To study the segment of liver according to the large amount of three-dimensional(3D) reconstructive images of normal human livers and the vascular system, and to recognize the basic functional liver unit based on the anatomic features of the intrahepatic portal veins. Methods: The enhanced CT primitive DICOM files of 1 260 normal human livers from different age groups who treated from October 2013 to February 2017 provided by 16 hospitals were analyzed using the computer-aided surgery system.The 3D liver and liver vascular system were reconstructed, and the digital liver 3D model was established...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Rachel E Beard, Yisi Wang, Sidrah Khan, J Wallis Marsh, Allan Tsung, David A Geller
BACKGROUND: Laparoscopic liver resection for hepatocellular carcinoma is well described in early cirrhosis. Less is known regarding outcomes with more advanced cirrhosis, and this study aimed to compare these groups. METHODS: A retrospective review of resections at a high-volume hepatobiliary center over a 15-year period was performed. Primary end-points were 30 and 90-day mortality. Secondary end-points included complications and survival. RESULTS: 80 early (Child's A) were compared to 26 advanced (20 Child's B and 6 Child's C) patients...
January 6, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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