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Liver resection technique

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https://www.readbyqxmd.com/read/28544979/preoperative-left-hepatic-lobe-devascularisation-to-minimize-perioperative-bleeding-in-a-jehovah-s-witness-undergoing-left-hepatectomy
#1
Laurence Weinberg, Georgina Hanus, Jonathan Banting, Diana Abu-Ssaydeh, Manfred Spanger, Su Kah Goh, Vijayaragavan Muralidharan
INTRODUCTION: Major liver resection in a Jehovah's Witness presents unique clinical challenges requiring multimodal blood minimization strategies to reduce perioperative complications. We report a case where complete left hepatic lobe devascularisation was undertaken to minimize bleeding in a Jehovah's Witness undergoing left hepatectomy. PRESENTATION OF CASE: A 65-year-old male Jehovah's Witness presented for open left hepatectomy for a large left-sided hepatocellular carcinoma involving segment IV of the liver...
May 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28529988/left-hepatectomy-with-simultaneous-hepatic-artery-and-portal-vein-reconstructions-in-the-operation-for-cholangiocarcinoma-the-surgical-techniques-comprised-of-step-by-step-established-procedures
#2
Hideaki Uchiyama, Ken Shirabe, Kenichiro Araki, Keishi Sugimachi, Kazutoyo Morita, Kenji Takenaka, Yoshihiko Maehara
Hepatectomy needing simultaneous reconstruction of the hepatic artery and the portal vein in the operation for cholangiocarcinoma is a challenging procedure. We experienced three cases of left hepatectomy with simultaneous reconstructions of the right hepatic artery (RHA) and the right portal vein (RPV) in all of which the surgical procedures were performed in the same manner. At the initial step of the procedure, we confirmed that the RHA and the RPV at the porta hepatis as well as the proper hepatic artery and the main portal vein (MPV) proximal to the cancer involvement could be controlled by tapes, which meant the cancer could be resected by means of vascular reconstructions...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28528267/using-mri-to-non-invasively-and-accurately-quantify-preoperative-hepatic-steatosis
#3
Callisia N Clarke, Haesun Choi, Ping Hou, Catherine H Davis, Jingfei Ma, Asif Rashid, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND: The obesity epidemic has significantly increased the incidence and severity of hepatic steatosis in liver surgery patients and liver donors, potentially impacting postoperative liver regeneration and function. Development of a non-invasive means to quantify hepatic steatosis would facilitate selection of candidates for liver resection and transplant donation. METHODS: An IRB-approved protocol prospectively enrolled 28 patients with liver tumors requiring hepatic resection...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28528189/long-term-follow-up-after-near-infrared-fluorescence-guided-resection-of-colorectal-liver-metastases-a-retrospective-multicenter-analysis
#4
H J M Handgraaf, L S F Boogerd, D J Höppener, A Peloso, B G Sibinga Mulder, C E S Hoogstins, H H Hartgrink, C J H van de Velde, J S D Mieog, R J Swijnenburg, H Putter, M Maestri, A E Braat, J V Frangioni, A L Vahrmeijer
BACKGROUND: Several studies demonstrated that intraoperative near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG) identifies (sub)capsular colorectal liver metastases (CRLM) missed by other techniques. It is unclear if this results in any survival benefit. This study evaluates long-term follow-up after NIRF-guided resection of CRLM using ICG. METHODS: First, patients undergoing resection of CRLM with or without NIRF imaging were analyzed retrospectively...
May 6, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28498007/are-hybrid-liver-resections-trully-minimally-invasive-a-propensity-score-matching-analysis
#5
Fabricio Ferreira Coelho, Jaime Arthur Pirola Kruger, Vagner Birk Jeismann, Gilton Marques Fonseca, Fábio Ferrari Makdissi, Leandro Augusto Ferreira, Luiz Augusto Carneiro D'Albuquerque, Ivan Cecconello, Paulo Herman
BACKGROUND: Hybrid liver resection is considered a modality of minimally invasive surgery; however, there are doubts regarding loss of benefits of laparoscopy due to the use of an auxiliary incision. We compared perioperative results of patients undergoing hybrid × open and hybrid × pure laparoscopic resections. METHODS: Consecutive patients undergoing liver resection between June 2008 and January 2016 were studied. Study groups were compared after propensity score matching (PSM)...
May 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28495439/the-impact-of-expanded-indications-on-short-term-outcomes-for-resection-of-malignant-tumours-of-the-liver-over-a-30-year-period
#6
Daniel Azoulay, Prashant Bhangui, Gérard Pascal, Chady Salloum, Paola Andreani, Philippe Ichai, Faouzi Saliba, Chetana Lim
BACKGROUND: There are two philosophical approaches to planning liver resection for malignancy: one strives towards zero postoperative mortality by stringent selection of candidates, thus inherently limiting patients selected; the other, accepts a low yet definite postoperative mortality rate, and offers surgery to all those with potential gain in survival. The aim of this study was to retrospectively analyse an alternative and evolving strategy, and its impact on short-term outcomes. METHOD: 3118 consecutive hepatectomies performed in 2627 patients over 3 decades (1980-2011) were analysed...
May 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28480187/application-of-temporary-inflow-control-of-the-glissonean-pedicle-method-provides-a-safe-and-easy-technique-for-totally-laparoscopic-hemihepatectomy-by-glissonean-approach
#7
Nuri Lee, Chan Woo Cho, Jong Man Kim, Gyu-Seong Choi, Choon Hyuck David Kwon, Jae-Won Joh
The Glissonian approach, due to its simplicity of procedure, is a technical procedure widely used in open hepatectomy. However, it is not easily applicable in the setting of the total laparoscopic approach because of movement restriction. We herein propose a new and simple method of performing hemihepatectomy by Glissonian approach called temporary inflow control of the Glissonian pedicle (TICGL) technique. Dissection of the Glisson pedicle from the liver parenchyma is done until the posterior margin of the pedicle is visualized, and is clamped with bulldog clamps...
May 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28480067/radiation-therapy-for-hepatobiliary-malignancies
#8
REVIEW
Jonathan W Lischalk, Michael C Repka, Keith Unger
Hepatobiliary malignancies represent a heterogeneous group of diseases, which often arise in a background of underlying hepatic dysfunction complicating their local management. Surgical resection continues to be the standard of care for hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC); unfortunately the majority of patients are inoperable at presentation. The aggressiveness of these lesions makes locoregional control of particular importance. Historical experience with less sophisticated radiotherapy resulted in underwhelming efficacy and oftentimes prohibitive liver toxicity...
April 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28466653/external-radiotherapy-and-brachytherapy-in-the-management-of-extrahepatic-and-intrahepatic-cholangiocarcinoma-available-evidence
#9
Puja Sahai, Senthil Kumar
This review aims to summarize the currently available evidence for the role of external radiotherapy and brachytherapy in the management of cholangiocarcinoma. High locoregional disease recurrence rates after surgical resection alone for both the extrahepatic cholangiocarcinoma (EHCC) and intrahepatic cholangiocarcinoma (IHCC) provide a rationale for using adjuvant radiotherapy with chemotherapy. We performed a literature search related to radiotherapy in cholangiocarcinoma published between 2000 and 2016. The role of radiation is discussed in the adjuvant, neoadjuvant, definitive and the palliative setting...
May 23, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28457324/liver-autotransplantation-and-retrohepatic-vena-cava-reconstruction-for-alveolar-echinococcosis
#10
Hankui Hu, Bin Huang, Jichun Zhao, Wentao Wang, Qiang Guo, Yukui Ma
BACKGROUND: Alveolar echinococcosis (AE) is characterized by a slow-growing infiltrative neoplasm that is often unresectable by traditional methods because of strong adhesions and invasion to adjacent structures. We present our experience with liver autotransplantation and retrohepatic inferior vena cava (RHIVC) reconstruction using autogenous veins in patients with this end-stage parasitic disease. METHODS: Twelve patients with hepatic AE and extensive RHIVC, hepatic vein, and/or hilar invasion underwent ex vivo liver resection and RHIVC reconstruction using autogenous veins followed by autotransplantation in the West China Hospital of Sichuan University from 2013 to 2016...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28455774/applications-of-fusion-fluorescence-imaging-using-indocyanine-green-in-laparoscopic-hepatectomy
#11
Muga Terasawa, Takeaki Ishizawa, Yoshihiro Mise, Yosuke Inoue, Hiromichi Ito, Yu Takahashi, Akio Saiura
BACKGROUND: Indocyanine green (ICG)-fluorescence imaging has been developed for real-time identification of hepatic tumors and segmental boundaries during hepatectomy. Fusion ICG-fluorescence imaging (real-time visualization of pseudocolor-fluorescence signals on white-light color images) may serve as a reliable navigation tool especially in laparoscopic hepatectomy, in which gross inspection and palpation are limited. METHODS: The study population consisted of 41 patients undergoing laparoscopic hepatectomy...
April 28, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28451728/-laparoscopic-liver-resection
#12
M R Schön, C Justinger
Laparoscopic liver surgery has become an established procedure in the treatment of liver tumors. Due to its short-term and long-term advantages, the number of centers with experience in laparoscopic liver surgery has greatly increased in the last few years. The complexity of the interventions performed has nearly reached the level of open surgery. This article describes the importance of laparoscopic hepatic surgery and discusses the evidence for the procedure. In addition, the indications for the most frequently resected tumors, metastases of colorectal cancer and hepatocellular carcinoma are explained together with important aspects of certain tumor localizations...
April 27, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28427829/systematic-review-and-meta-analysis-of-hepatic-resection-versus-transarterial-chemoembolization-for-solitary-large-hepatocellular-carcinoma
#13
REVIEW
Claire L Stevens, Andrew Awad, Saleh M Abbas, David A K Watters
BACKGROUND: Surgical techniques and pre-operative patient evaluation have improved since the initial development of the Barcelona clinic liver cancer staging system. The optimal treatment for solitary hepatocellular carcinoma ≥5 cm remains unclear. The aim of this study was to review the long-term survival outcomes of hepatic resection versus transarterial chemoembolisation (TACE) for solitary large tumours. METHODS: EMBASE, MEDLINE, Pubmed and the Cochrane database were searched for studies comparing resection with TACE for solitary HCC ≥5 cm...
April 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28421483/update-on-embolization-therapies-for-hepatocellular-carcinoma
#14
REVIEW
Sirish Kishore, Tamir Friedman, David C Madoff
PURPOSE OF REVIEW: The purpose of the review is to summarize the latest applications for embolotherapy in the management of patients with HCC according to BCLC stage. RECENT FINDINGS: While traditionally reserved for patients with unresectable HCC and stage B disease, there is an important role for embolization therapies in earlier stage patients as an adjunct to ablation, bridging, or downstaging therapy, as a means to improve safety of resection, and potentially as an arterial ablative option in the case of radioembolization...
June 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28416757/theranostic-imaging-of-liver-cancer-using-targeted-optical-mri-dual-modal-probes
#15
Qingshan Chen, Wenting Shang, Chaoting Zeng, Kun Wang, Xiaoyuan Liang, Chongwei Chi, Xiao Liang, Jian Yang, Chihua Fang, Jie Tian
The accurate preoperative detection and intraoperative navigation afforded by imaging techniques have had significant impact on the success of liver cancer surgeries. However, it is difficult to achieve satisfactory performance in both diagnosis and surgical treatment processes using any single modality imaging method. Here, we report the synthesis and characteristics of a novel dual-modality magnetic resonance imaging (MRI) and near-infrared fluorescence (NIRF) probe and verify its feasibility in nude mouse models with liver cancer...
May 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28411368/laparoscopy-specific-ventral-approach-in-laparoscopic-hemihepatectomy
#16
Ji Hoon Kim
BACKGROUND: The laparoscopic caudal approach is very different from the open ventral approach, specifically with respect to the surgical view, which is completely different and is the underlying reason for why laparoscopic hepatectomy is technically challenging. We have introduced a new laparoscopy-specific ventral approach in laparoscopic hemihepatectomy. METHODS: The liver was transected from the ventral side to the dorsal side, via a flexible laparoscope, as in open liver resection...
April 14, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28410631/comparison-of-three-caval-reconstruction-techniques-in-orthotopic-liver-transplantation-a-retrospective-review
#17
Tiffany Chan, Kristin DeGirolamo, Stephanie Chartier-Plante, Andrzej K Buczkowski
BACKGROUND: Classic caval reconstruction during liver transplantation involves complete cross-clamping and resection of the recipient inferior vena cava (IVC) followed by donor IVC interposition. Other techniques preserve the IVC, with piggyback (PB) to the hepatic veins or side-to-side (SS) caval anastomosis. Avoidance of cross-clamping may be beneficial for minimizing hemodynamic instability and transfusion requirements. METHODS: Retrospective review of a provincial transplant database (2007-2011)...
April 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28403878/rescue-strategy-for-advanced-liver-malignancy-with-retrohepatic-inferior-vena-cava-thrombi-experience-to-promote-surgical-oncological-benefit
#18
Meng-Hsing Ho, Teng-Wei Chen, Kuang-Wen Ou, Jyh-Cherng Yu, Chung-Bao Hsieh
BACKGROUND: The prognosis of advanced liver malignancy with inferior vena cava (IVC) thrombi is poor. Many therapeutic policies are challenging for long-term prognosis. We performed the modified effective technique of transdiaphragmatic intrapericardial IVC isolation for curative resection of IVC tumors and prolonged survival time. METHODS: Between 2003 and 2015, 10 patients, sustained liver malignancy with IVC thrombi, underwent surgical intervention. Liver resection with thrombectomy under total hepatic vascular exclusion via the transdiaphragmatic intrapericardial IVC isolation method was performed for these 10 patients...
April 12, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28403099/us-guided-percutaneous-laser-ablation-of-refractory-metastatic-retroperitoneal-lesions-a-care-compliant-case-report
#19
Guo Tian, Tian'an Jiang
RATIONALE: Retroperitoneal metastatic lymph node is rare but severe, which has important structures like the gastrointestinal tract and large blood vessels around and may challenge excision, inducing serious complications like hemorrhage, intestinal adhesion, and even death after injury. PATIENT CONCERNS: We described the case of a 60-year-old man with a history of right liver resection in 2010, pulmonary wedge resection in 2012, and transarterial chemoembolization twice in 2014, in which the postoperative pathology suggested the mixed liver cancer, and poorly differentiated lung cancer from liver metastasis...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28392706/pancreatic-solitary-fibrous-tumor-in-a-toddler-managed-by-pancreaticoduodenectomy-a-case-report-and-review-of-the-literature
#20
Qingfeng Sheng, Weijue Xu, Jiangbin Liu, Baiyong Shen, Xiaxing Deng, Yibo Wu, Wei Wu, Shenghua Yu, Xueli Wang, Zhibao Lv
Solitary fibrous tumor (SFT) of the pancreas is rare, with 15 adult cases reported in the English literature. We described a 14-month-old boy who presented with obstructive jaundice. Dominantly elevated serum CA19-9 was detected. Imaging studies revealed a well-circumscribed, solid mass in the pancreatic head. A pancreaticoduodenectomy (child procedure) was performed using Shen's anastomosis technique. After resection of the tumor, liver function and serum tumor markers normalized and clinical signs receded...
2017: OncoTargets and Therapy
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