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Anatomical liver resection

Luca Portigliotti, David Fuks, Oleg Slivca, Christophe Bourdeaux, Takeo Nomi, Mostefa Bennamoun, Sergio Gentilli, Brice Gayet
INTRODUCTION: The benefit of by laparoscopic resection for lesions located in postero-superior segments is unclear. The present series aimed at comparing intraoperative and post-operative results in patients undergoing either laparoscopic RPS or laparoscopic RH for colorectal liver metastases located in the right postero-superior segments. METHODS: From 2000 to 2015, patients who underwent laparoscopic resection of segment 6 and/or 7 (RPS group) were compared with those with right hepatectomy (RH group) in terms of tumour characteristics, surgical treatment, and short-term outcomes...
October 17, 2016: Surgical Endoscopy
Le Xiao, Jian-Wei Li, Shu-Guo Zheng
BACKGROUND: The reported protocol was difficult to expose the hepatic veins for laparoscopic anatomical hepatectomy of segments VII and VIII. We introduce a new, convenient, applicable approach with the hepatic vein exposed from the head side. METHODS: This study included 10 patients who underwent laparoscopic liver resection for HCC in the segments VII and VIII between October, 2014 and November, 2015. Their perioperative course and operative techniques were retrospectively evaluated...
October 14, 2016: Journal of Surgical Oncology
Benjamin Sueur, Olivier Pellerin, Thibault Voron, Anne L Pointet, Julien Taieb, Simon Pernot
The objective of the treatment of colorectal cancer patients with unresectable liver metastases should be clearly defined at the outset. Potentially resectable patients should be distinguished from clearly unresectable patients. In defining resectability, it is important to take into account both anatomic characteristics and patient characteristic (comorbidities, symptoms, age). According to this evaluation, treatment should be tailored to each patient. The most widely accepted standard is doublet cytotoxic regimen plus biotherapy (anti-EGFR or anti- VEGF antibodies according to RAS status, but some patients could benefit from an intensified regimen, as triplet chemotherapy +/- bevacizumab, or intraarterial treatments (hepatic arterial infusion, radioembolization or chemoembolization), in order to allow resectability...
October 12, 2016: Minerva Chirurgica
Hui Zhao, Chuang Chen, Xu Fu, Xiaopeng Yan, Wenjun Jia, Liang Mao, Huihan Jin, Yudong Qiu
OBJECTIVES: The present research aimed to evaluate the prognostic value of a novel risk classification of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) after resection. METHODS: A total of 295 consecutive HCC patients underwent hepatectomy were included in our study. We evaluated the degree of MVI according to the following three features: the number of invaded microvessels (≤5 vs >5), the number of invading carcinoma cells (≤ 50 vs >50), the distance of invasion from tumor edge (≤1 cm vs >1 cm)...
October 9, 2016: Oncotarget
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
S-Q Li, T Huang, S-L Shen, Y-P Hua, W-J Hu, M Kuang, B-G Peng, L-J Liang
BACKGROUND: Liver resection is effective for hepatocellular carcinoma (HCC) exceeding the Milan criteria in selected patients. However, the benefit of anatomical resection (AR) versus non-anatomical resection (NAR) has not been clarified in this patient subgroup. This study aimed to compare outcomes between AR and NAR for HCC exceeding the Milan criteria. METHODS: Data on consecutive patients with HCC exceeding the Milan criteria who underwent liver resection with curative intent over a recent 6-year interval were extracted from a prospective single-centre HCC database and examined retrospectively...
October 3, 2016: British Journal of Surgery
Dennis Eurich, S Henze, S Boas-Knoop, J Pratschke, D Seehofer
Biliary leakage is a serious complication after liver resection and represents the major cause of post-operative morbidity. In spite of already identified risk factors, little is known about the role of intra-biliary pressure following liver surgery in the development of biliary leakage. Biliary decompression may have a positive impact and reduce the incidence of biliary leakage at the parenchymal resection site. 397 patients undergoing liver resection without bilioenteric anastomosis were included in the retrospective analysis of the risk factors for the development of biliary leakage focusing on the intra-operative reduction of the biliary pressure by T-tube and liver histology...
September 27, 2016: Updates in Surgery
Ankur Gupta, Praveer Rai, Vivek Singh, Rakesh Kumar Gupta, Vivek Anand Saraswat
BACKGROUND: Knowledge about anatomic variations in intrahepatic biliary ducts (IHBD) is relevant for performing biliary drainage and for avoiding bile duct injury during cholecystectomy and liver resections. Low insertion of cystic duct (LICD) is a common anatomic variant. Pancreas divisum is the commonest congenital anomaly of pancreas; it has been causally linked with recurrent acute pancreatitis (RAP). METHODS: Magnetic resonance cholangiopancreaticography (MRCP) images of 500 consecutive patients were reviewed for anatomic variants of IHBD, cystic duct, and pancreatic duct...
September 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Filippo Banchini, Roberta Santoni, Antonio Banchini, Flavio Cesare Bodini, Patrizio Capelli
INTRODUCTION: Posterior right diaphragmatic hernia is rare in newborn patients but when present, is accompanied by high mortality. Pulmonary hypoplasia seems to be the main cause of death but the presence of liver involvement remains one of the reasons for poor prognosis even when intrauterine surgery is performed. CASE DESCRIPTION: In this article, we will present a rare case that was diagnosed by chance in a 65-year old adult presenting with an adenocarcinoma of the rectosigmoid junction and a right Bochdalek hernia with liver herniation and modification of the hepatic vein outflow with a natural right to left shunt...
2016: SpringerPlus
Christoph A Maurer, Mikolaj Walensi, Samuel A Käser, Beat M Künzli, René Lötscher, Anne Zuse
AIM: To evaluate liver resections without Pringle maneuver, i.e., clamping of the portal triad. METHODS: Between 9/2002 and 7/2013, 175 consecutive liver resections (n = 101 major anatomical and n = 74 large atypical > 5 cm) without Pringle maneuver were performed in 127 patients (143 surgeries). Accompanying, 37 wedge resections (specimens < 5 cm) and 43 radiofrequency ablations were performed. Preoperative volumetric calculation of the liver remnant preceeded all anatomical resections...
August 28, 2016: World Journal of Hepatology
L Chen, H P Luo, S L Dong, X P Chen
OBJECTIVE: To explore the effectiveness of three-dimentional(3D)reconstruction technique in safety assessment of hepatectomy for large hepatocellular carcinoma(HCC). METHODS: The clinical records of 28 patients who underwent resection of HCC greater than 10 cm in diameter from January 2013 to December 2015 at Department of Hepatic Surgery, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology were studied retrospectively. All patients underwent enhanced computer tomography (CT), then 3D images of liver and tumor were reconstructed by uploading the CT imaging data to IQQA-Liver system...
September 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Haowen Tang, Bingmin Li, Haoyun Zhang, Jiahong Dong, Wenping Lu
It remains unclear whether hepatectomy for colorectal liver metastasis (CRLM) should be performed as anatomical resection (AR) or nonanatomical resection (NAR). The aim of this study is to compare the short- and long-term outcomes of AR and NAR for CRLM. PubMed, Web of Science, EMBASE and the Cochrane Library were systematically searched to identify eligible studies. Twenty one studies involving 5207 patients were analyzed: 3034 (58.3%) underwent AR procedure and 2173 (41.7%) underwent NAR procedure. The results showed that overall survival (OS, hazard ratio (HR) 1...
2016: Scientific Reports
Gang Zhang, Xian-Jun Zhou, Cheng-Zhan Zhu, Qian Dong, Lin Su
BACKGROUND: Hepatoblastoma (HB) is the most common malignant liver tumor in childhood. Complete HB surgical resection which is technically demanding is the cornerstone of effective therapy with a good prognosis. The aim of our study is to evaluate the usefulness of 3D simulation software in assisting hepatectomy in pediatric patients with HB. METHODS: 21 children with HB who underwent hepatectomy were enrolled in this study. All patients underwent computer tomography (CT) imaging preoperatively...
September 2016: Surgical Oncology
Abdel Karim Dip Borunda, Alberto Pimentel Renteria, Miguel Pluma Jiménez, Mario Pérez Martínez, Gloria Martínez Martínez, Samuel Rivera Rivera, Rocío Grajales Álvarez, Yolanda Bautista Aragón, Miguel Quintana Quintana, Juan Alejandro Silva
BACKGROUND: Stromal tumors of the digestive tract are uncommon malignant diseases, are subclassified as leiomyosarcomas and Gastrointestinal Stromal Tumors (GIST) depending on the molecular expression of tyrosine kinase receptor KIT (CD117). GISTs represent 1% of malignant tumors affecting this anatomical site. Localized tumours diseases are reasonably well controlled by surgical resection and several criteria define the need for adjuvant therapy. In the case of metastatic disease a poor prognosis has been reported with systemic treatment based on chemotherapy...
August 2016: Journal of Gastrointestinal Oncology
Ron Basuroy, Raj Srirajaskanthan, John K Ramage
Neuroendocrine tumors are increasingly diagnosed, either incidentally as part of screening processes, or for symptoms, which have commonly been mistaken for other disorders initially. The diagnostic workup to characterize tumor behaviour and prognosis focuses on histologic, anatomic, and functional imaging assessments. Several therapeutic options exist for patients ranging from curative and debulking surgery through to liver-directed therapies and systemic treatments. Multimodal therapies are often required over the patient's disease history...
September 2016: Gastroenterology Clinics of North America
Go Wakabayashi
The 2(nd) International Consensus Conference on Laparoscopic Liver Resection (ICCLLR) was held 4(th)-6(th) October, 2014, in Morioka, Japan. The level of evidence appears to be low in the field of laparoscopic liver resection (LLR) to create strong recommendations. Therefore, an independent jury-based consensus model was applied to better define the current role of LLR and to develop internationally accepted recommendations. The three-day conference was very intense with full of insightful discussions on assessment of LLR and its future directions...
August 2016: Hepatobiliary Surgery and Nutrition
Li-Ning Xu, Ying-Ying Xu, De-Wei Gao
This study examined the impact of the operative and peri-operative factors on the long-term prognosis of patients with primary liver cancer undergoing hepatectomy. A total of 222 patients with primary liver cancer who underwent hepatectomy were followed up from January 1986 to December 2010 at Chinese PLA General Hospital. The post-operative complication rate was 14.0% for all cases, 13.7% for hepatocellular carcinoma (HCC), 10.0% for cholangiocarcinoma. The 1-, 3-, 5- and 10-year overall survival rates in patients with primary liver cancer after resection were 76...
August 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Elisa Francone, Elena Muzio, Luigi D'Ambra, Carlo Aschele, Teseo Stefanini, Cinzia Sani, Emilio Falco, Stefano Berti
BACKGROUND: For the treatment of both primary and metastatic liver tumors, laparoscopic parenchyma-sparing surgery is advocated to reduce postoperative liver failure and facilitate reoperation in the case of recurrence. However, atypical and wedge resections are associated with a higher amount of intraoperative bleeding than are anatomical resections, and such bleeding is known to affect short- and long-term outcomes. Beyond the established role of radiofrequency and microwave ablation in the setting of inoperable liver tumors, the application of thermoablative energy along the plane of the liver surface to be transected results in a zone of coagulative necrosis, possibly minimizing bleeding of the cut liver surface during parenchymal transection...
July 21, 2016: Surgical Endoscopy
L C Zattar-Ramos, R O Bezerra, L T Siqueira, D T Marques, M R Menezes, P Herman, M A C Machado, G G Cerri, C C Leite
PURPOSE: Hepatic resection is the only potentially curative treatment for patients with colorectal liver metastasis (CRLM). Many multidisciplinary approaches, including the associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) procedure, have been proposed to increase the resectability rate in these patients. ALPPS is the most recently described staged liver resection technique, representing an advantageous strategy to induce a rapid and marked increase in the future liver remnant (FLR) volume...
July 5, 2016: Abdominal Radiology
Gianni Testino, Silvia Leone, Valentino Patussi, Emanuele Scafato, Paolo Borro
Hepatocellular carcinoma (HCC) ranks third for causes of cancer deaths globally. The most frequent causes are the hepatitis C virus (HCV), a combination of alcohol/HCV and metabolic syndrome (MS). The introduction of new pharmaceutical drugs that inhibit protease will bring a relative increase in the number of cases of HCC that are linked to the consumption of alcohol and MS. The latest development in the diagnostic sector is the total recognition of the CEUS diagnostic algorithm. In the treatment sector we are moving on from the Barcelona criteria...
June 28, 2016: Minerva Medica
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