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Open Hepatectomy

Wei Wei, Pei-En Jian, Shao-Hua Li, Zhi-Xing Guo, Yong-Fa Zhang, Yi-Hong Ling, Xiao-Jun Lin, Li Xu, Ming Shi, Lie Zheng, Min-Shan Chen, Rong-Ping Guo
BACKGROUND: The optimal strategy for adjuvant therapy after curative resection for hepatocellular carcinoma (HCC) patients with solitary tumor and microvascular invasion (MVI) is controversial. This trial evaluated the efficacy and safety of adjuvant transcatheter arterial chemoembolization (TACE) after hepatectomy versus hepatectomy alone in HCC patients with a solitary tumor ≥ 5 cm and MVI. METHODS: In this randomized, open-labeled, phase III trial, HCC patients with a solitary tumor ≥ 5 cm and MVI were randomly assigned (1:1) to receive either 1-2 cycles of adjuvant TACE after hepatectomy (Hepatectomy-TACE) or hepatectomy alone (Hepatectomy Alone)...
October 10, 2018: Cancer communications
Hyo-Jin Kang, Jeong Min Lee, Su Joa Ahn, Jae Seok Bae, Stephan Kannengiesser, Berthold Kiefer, Kyung-Suk Suh
OBJECTIVES: The aim of this study was to evaluate the clinical feasibility of gadoxetic acid-enhanced isotropic high-resolution (IHR) 3-dimensional (3D) T1-weighted (T1W) magnetic resonance cholangiography (MRC) using an iterative denoising (ID) algorithm for evaluation of the biliary anatomy of living liver donors in comparison with conventional 3D multislice T2-weighted (T2W) MRC. MATERIALS AND METHODS: In this institutional review board-approved retrospective study, a total of 75 living liver donors who underwent conventional 3D multislice T2W-MRC and IHR-3D-T1W-MRC on a 3 T scanner and subsequent right hepatectomy for liver donation were included...
October 2, 2018: Investigative Radiology
Satoshi Ogiso, Masayuki Okuno, Junichi Shindoh, Yoshihiro Sakamoto, Takashi Mizuno, Kenichiro Araki, Claire Goumard, Takeo Nomi, Takamichi Ishii, Shinji Uemoto, Yun Shin Chun, Ching-Wei D Tzeng, Jeffrey E Lee, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: While the middle hepatic vein (MHV) guides parenchymal transection during right hepatectomy, its most proximal tributaries can be difficult to identify, and injury to its tributaries can be a source of major bleeding. METHOD: Following simulation modeling of right hepatectomy, reconstructed MHV data was pooled from 40 patients. MHV-tributaries and MHV-relationship to the portal pedicle were mapped out to facilitate their identification from the beginning of parenchymal transection...
September 25, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Jian-Cong Chen, Chun-Yu Huang, Jun-Cheng Wang, Yao-Jun Zhang, Li Xu, Min-Shan Chen, Zhong-Guo Zhou
BACKGROUND: Hepatic caudate lobectomy is considered to be a technically difficult surgery because of the unique anatomy and deep location of the hepatic caudate lobe. Here, we assessed the technical feasibility and safety of robotic partial caudate lobectomy using the da Vinci® Surgical System and compared it with traditional open/laparoscopic surgery. MATERIAL AND METHODS: Six patients diagnosed with liver cancer (primary liver cancer, 5; metastasis of breast cancer, 1) who underwent caudate lobectomy were prospectively enrolled...
September 27, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Takanori Morikawa, Masaharu Ishida, Tatsuyuki Takadate, Takeshi Aoki, Hideo Ohtsuka, Masamichi Mizuma, Hiroki Hayashi, Kei Nakagawa, Fuyuhiko Motoi, Takeshi Naitoh, Michiaki Unno
PURPOSE: The aim of this study was to compare the clinical outcomes between laparoscopic partial liver resection and open partial hepatectomy for tumors in the posterosuperior segments. METHODS: The clinical outcomes of patients who underwent either laparoscopic (n = 20) or open (n = 44) resection in segments 7/8 of the liver were initially evaluated. Because of disparities in the background characteristics, a case-matched study (1:1) was conducted. In addition, a comparative study of the patients who met the institutional criteria for laparoscopic partial hepatectomy was performed...
September 24, 2018: Surgery Today
Jiu-Lin Song, Jian Yang, Hong Wu, Lu-Nan Yan, Tian-Fu Wen, Yong-Gang Wei, Jia-Yin Yang
BACKGROUND: The adoption of laparoscopic techniques for living donor major hepatectomy has been controversial issue. The aim of this study is to present the preliminary experience of laparoscopic right hepatectomy in China. METHODS: All the donors receiving right hepatectomy for adult-to-adult living donor liver transplantation (LDLT) were divided into three groups: pure laparoscopic right hepatectomy (PLRH) group, hand-assisted right hepatectomy (HARH) group and open right hepatectomy (ORH) group...
November 2018: Surgical Endoscopy
Tong Yifan, Xu Ming, Wang Yifan, Ying Hanning, Jiang Guangyi, Yan Peijian, Wu Ke, Cai Xiujun
BACKGROUND: The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) procedure promotes the proliferation of the future liver remnant, but evidence to support the feasibility of ALPPS in livers with fibrosis is needed. Therefore the aim of this study was to establish a fibrotic ALPPS model in the rat to compare the capacity of regeneration in the remnant liver with or without fibrosis. METHODS: In our study we first established a thioacetamide-induced fibrotic ALPPS model in rats...
September 21, 2018: Surgery
Bin Tang, Xiaolin Liu, Fei Xing, Chao Wang, Changjun Jia, Songlin Peng, Yang Zhao, Chaoliu Dai, Feng Xu
Objective: This study aimed to assess whether a single dose of ertapenem prophylaxis was more effective than other antibiotics to prevent surgical site infection (SSI) after selective hepatectomy for hepatocellular carcinoma (HCC). Methods: The data from HCC patients with open hepatectomy between January 2012 and June 2017 in Shengjing Hospital were retrospectively analyzed. These patients were divided into two groups: ertapenem (ER) group, where a single dose of ER was administered; non-ertapenem (NER) group, where NER antibiotics were administered...
2018: BioMed Research International
Takeo Nomi, Daisuke Hokuto, Takahiro Yoshikawa, Yasuko Matsuo, Masayuki Sho
BACKGROUND: Among all laparoscopic liver resection techniques, anatomic liver resection is one of the most challenging procedures, with disorientation readily occurring during the laparoscopic approach compared with the open approach.1 Thus, navigation is warranted for laparoscopic anatomic liver resection. Recent research has remarkably established intraoperative fluorescence imaging techniques using indocyanine green fluorescence (ICG) in the field of liver surgery.2- 4 This report describes real-time navigation for anatomic liver resection using the novel ICG system, PINPOINT (Stryker, Kalamazoo, MI)...
September 14, 2018: Annals of Surgical Oncology
Isabella Reccia, Jayant Kumar, Tomokazu Kusano, Alexandros Giakoustidis, Artur Zanellato, Phil Retsas, Nagy Habib, Long Jiao, Duncan Spalding, Madhava Pai
BACKGROUND: Radiofrequency (RF)-assisted liver resection allows non-anatomical liver resection with reduced blood loss and offers the opportunity for a combination of resection and ablation. However, there are still concerns with regard to postoperative complications related to this technique. In the present study, we discuss the technical aspects of RF-assisted liver resections and analyse the rate of perioperative complications, focusing on post-hepatectomy liver failure (PLF), bile leak and abscess, and mortality...
September 2018: Surgical Oncology
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
Mohammad Raheel Jajja, Marvi Tariq, Daniel W Maxwell, Salila Shoaib Hashmi, Edward Lin, Juan M Sarmiento
BACKGROUND: Minimally invasive approaches for major hepatectomy have been marred by significant rates of conversion and associated morbidity. This study aimed to determine risk factors for conversion as well as postoperative morbidity in patients undergoing minimally invasive right-sided hepatectomy (MIRH). METHODS: Data for patients undergoing MIRH between 2008 and 2017 at Emory University were reviewed. Risk factors for conversion were determined using multivariate regression analysis...
August 29, 2018: American Journal of Surgery
Ke Chen, Yu Pan, Geng-Yuan Hu, Hendi Maher, Xue-Yong Zheng, Jia-Fei Yan
BACKGROUND: Although large series of laparoscopic resections for hepatocellular carcinoma (HCC) were published, reports of laparoscopic major hepatectomy (LMH) are still limited in expert centers because LMH for HCC remains a challenging procedure requiring extensive experience in both laparoscopic and hepatic surgery. We performed a meta-analysis to assess the safety and efficacy of LMH and open major hepatectomy (OMH) for HCC. METHODS: A literature search was performed to identify studies comparing LMH with OMH for HCC...
October 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Kayvan Mohkam, Michel Rayar, Jean-Philippe Adam, Fabrice Muscari, Agnès Rode, Philippe Merle, Pierre Pradat, Stéphanie Bauler, Isabelle Delfour, Laurence Chiche, Christian Ducerf, Karim Boudjema, Mickaël Lesurtel, Christophe Laurent, Jean-Yves Mabrut
BACKGROUND: The majority of patients undergoing hepatectomy for hepatocellular carcinoma (HCC) suffer from underlying liver disease and are exposed to the risk of postoperative ascites, which is favored by an imbalance between portal venous inflow and a diminished hepatic volume. Finding a reversible, non-invasive method for modulating the portal inflow would be of interest as it could be used temporarily during the early postoperative course. Somatostatin, a well-known drug already used in several indications, may limit the risk of postoperative ascites and liver failure by decreasing portal pressure after hepatectomy for HCC in patients with underlying liver disease...
August 23, 2018: BMC Cancer
Fei Liu, Hongwei Xu, Qin Li, Yonggang Wei, Hongyu Li, Wentao Wang, Tianfu Wen, Hong Wu, Jiayin Yang, Mingqing Xu, Bo Li
BACKGROUND: Few studies had been performed to concern the outcomes of pure laparoscopic Glissonian pedicle approach hepatectomy (LGAH) for hepatocellular carcinoma (HCC). The aim of this study was to compare the outcomes of LGAH versus open Glissonian pedicle approach hepatectomy (OGAH) for HCC, especially in patients with cirrhosis. METHODS: Hepatocellular carcinoma patients who underwent pure LGAH and OGAH between January 2015 and July 2017 in our institution were retrospectively enrolled in this study...
August 17, 2018: Surgical Endoscopy
Bao Jin, Shunda Du, Haifeng Xu, Yongchang Zheng, Xin Lu, Xinting Sang, Yilei Mao
Background: Laparoscopic hepatectomy is more conducive to the rapid rehabilitation of patients after surgery compared with open hepatectomy. However, there have been no reports on performing laparoscopic resection for liver metastases in enterostomy patients. Materials: From December 2016 to April 2017, the Liver Surgery Department of the Peking Union Medical College Hospital received three patients who had focal liver lesions after colorectal cancer surgery and enterostomy...
August 7, 2018: Journal of Minimal Access Surgery
Benjamin Samstein, Adam Griesemer, Karim Halazun, Tomoaki Kato, James V Guarrera, Daniel Cherqui, Jean C Emond
OBJECTIVE: In order to minimize the impact of donation, fully laparoscopic donor hepatectomy (LDH) is being investigated at a few centers throughout the world. We report here our experience with 51 living donor pure laparoscopic hepatectomies. BACKGROUND: Adoption of minimal access techniques to living donor liver transplantation (LDLT) has been slowed by concerns about donor safety and the quality of the grafts. METHODS: Of 344 donor hepatectomies (DHs) for living donor liver transplantation (LDLT) since 1998, 51 pure LDH have been performed since 2009...
October 2018: Annals of Surgery
Yuichi Nakaseko, Takeaki Ishizawa, Akio Saiura
In hepatobiliary surgery, fluorescence imaging enables identification of subcapsular liver tumors through accumulation of indocyanine green after preoperative intravenous injection in cancerous tissues of hepatocellular carcinoma and in noncancerous hepatic parenchyma around intrahepatic cholangiocarcinoma and liver metastases. Indocyanine green-fluorescence imaging can also be used for visualizing extrahepatic bile duct anatomy and hepatic segmental boundaries, enhancing the accuracy of open and laparoscopic hepatectomy...
August 2018: Journal of Surgical Oncology
Brian K P Goh, Darren Chua, Nicholas Syn, Jin-Yao Teo, Chung-Yip Chan, Ser-Yee Lee, Prema Raj Jeyaraj, Peng-Chung Cheow, Pierce K H Chow, London L P J Ooi, Alexander Y F Chung
INTRODUCTION: This study aims to evaluate the safety and feasibility of laparoscopic minor hepatectomy (LMH) in elderly patients with hepatocellular carcinoma (HCC). METHODS: A total of 40 consecutive elderly (≥ 70 years) patients were compared with 94 young patients (< 70 years). The 40 patients were also compared with 85 consecutive elderly patients who underwent open minor hepatectomies (OMH). After 1:1 propensity-score matching (PSM), 32 LMHs were compared with 32 OMHs in elderly patients...
July 30, 2018: World Journal of Surgery
Ikuo Watanobe, Hiroko Kida, Yuuki Sekine, Masaya Kawai, Shozo Miyano, Michio Machida, Toshiaki Kitabatake, Hiroyuki Sugo, Yoshifumi Lee, Kuniaki Kojima
Congenital epidermolysis bullosa is a rare, genetic condition in which even slight stimulation can cause blistering of the skin or mucosa. While previous reports of treatments requiring general anesthesia in these patients were focused on anesthesia-related procedures, such as endotracheal intubation, no report has described specific management required for these patients during surgery, such as preparation of the surgical site, fixation of infusion lines and other tubes, and adjustment of the operation table...
2018: Case Reports in Surgery
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