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Open Hepatectomy

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 11, 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
Ke Chen, Yu Pan, Hendi Maher, Bin Zhang, Xue-Yong Zheng
BACKGROUND: As the general population continues to age, there is an increase need for surgical management of elderly patients. Compared to open hepatectomy (OH), laparoscopic hepatectomy (LH) offers earlier mobilization, less blood loss, and shorter postoperative hospital stay. However, whether these advantages of LH over OH are retained in elderly patients remains to be clarified. Therefore, in this study, we sought to evaluate the feasibility, safety, and potential benefits of LH for elderly patients...
July 2018: Medicine (Baltimore)
Shangchun Duan, Xueqin Wang, Gong Chen, Chengxuan Quan, Shuangquan Qu, Jianbin Tong
Neuroinflammation plays a critical role in the pathogenesis of postoperative cognitive dysfunction (POCD) of the elderly patients. Receptor-interacting protein kinase1 (RIPK1) is a key molecular switch modulating inflammation, apoptosis and necroptosis. Here, we investigated whether inhibiting RIPK1 by necrostatin-1 (Nec-1) could limit neuroinflammation and attenuate POCD in D-Galactose (D-Gal)-induced aged mice. The mice were subjected to anesthesia and partial hepatectomy, and necrostatin-1 was administered intraperitoneally 1 h prior to anesthesia and surgery...
2018: Frontiers in Behavioral Neuroscience
Choon Hyuck David Kwon, Gyu-Seong Choi, Jong Man Kim, Chan Woo Cho, Jinsoo Rhu, Gaab Soo Kim, Dong Hyun Sinn, Jae-Won Joh
BACKGROUND: Even after two decades of experience in laparoscopic hepatectomy, data of purely laparoscopic approach for donor hepatectomy in adult living donor liver transplantation is limited. We report our initial experience of purely laparoscopic approach for donor hepatectomy for adult recipients to explore its potential application in the management of donors. METHOD: A retrospective data analysis of consecutive 54 cases performed between May 2013 and February 2015 was done...
July 18, 2018: Liver Transplantation
Jeong-Moo Lee, Kwang-Woong Lee, Suk Kyun Hong, Kyung Chul Yoon, Jae-Hyung Cho, Nam-Joon Yi, Kyung-Suk Suh
BACKGROUND: Status in terms of major vascular structure invasion is a crucial factor for successful major hepatic resection. In particular, surgery for advanced tumors with inferior vena cava (IVC) invasion is difficult and may even be dangerous for the patient, having high risk of massive bleeding and greater chance of embolic complications such as stroke, bowel ischemia, and pulmonary venous thrombosis. For such reasons, many surgeons hesitate to carry out such surgical resection, and even if they do so, may not totally remove the tumor including the part inside the IVC, achieving R1 resection...
July 17, 2018: Annals of Surgical Oncology
Philipp Houben, Elias Khajeh, Ulf Hinz, Phillip Knebel, Markus K Diener, Arianeb Mehrabi
BACKGROUND: The surgical technique used in liver transplantation has undergone constant evolution in an effort to develop a safe, highly standardized procedure. Despite this, the initial step of recipient hepatectomy has not been the focus of clinical research thus far. Due to advanced coagulopathy in liver transplant recipients, this part of the operation still carries the risk of severe hemorrhage. This trial is designed to compare an electrothermal bipolar vessel sealing device (LigaSure™) and an ultrasound dissector (HARMONIC ACE®+7) with standard surgical techniques during the recipients' hepatectomy in liver transplantation...
July 16, 2018: Trials
Ryohei Ono, Hiroyuki Kashiwagi, Jun Kawachi, Naoko Isogai, Katsunori Miyake, Takaaki Murata, Rai Shimoyama, Ryuta Fukai, Hidemitsu Ogino, Nobuaki Shinozaki
INTRODUCTION: Liver gas gangrene is rare and has a low prognosis. This case, reports a successful treatment of hepatic gas gangrene using an open drainage technique, followed by antibiotics and hyperbaric oxygen therapy (HBO). PRESENTATION OF THE CASE: An 82-year-old male with a history of left hepatectomy and bile duct resection for hilar cholangiocarcinoma presented with chilling, lethargy and dyspnea. He had a history of diabetes mellitus, hypertension, atrial fibrillation, and angina pectoris...
June 30, 2018: International Journal of Surgery Case Reports
Chetana Lim, Michael Osseis, Eylon Lahat, Alexandre Doussot, Dobromir Sotirov, Francois Hemery, Marc Lantéri-Minet, Cyrille Feray, Chady Salloum, Daniel Azoulay
BACKGROUND: The laparoscopic approach might increase the number of cirrhotic patients with hepatocellular carcinoma (HCC) indicated for liver resection, otherwise contraindicated due to portal hypertension. The goal of this study was to confirm the safety of laparoscopic liver resection (LLR) in patients with portal hypertension. METHODS: This prospective, single-center, open study ( ID: NCT02145013) included all consecutive cirrhotic patients who underwent LLR for HCC from 2014 to 2017...
July 12, 2018: Surgical Endoscopy
Yoshiko Takahashi, Yoshio Takesue, Masami Fujiwara, Sumiyo Tatsumi, Kaoru Ichiki, Jiro Fujimoto, Takeshi Kimura
Major hepatobiliary and pancreatic (HP) surgeries are complex procedures associated with a high incidence of surgical site infection (SSI) and are commonly performed in patients with cancer in Japan. This study was performed to investigate the risk factors for SSI, including incisional and organ/space SSI, in HP surgery. The following procedures were included in the study: hepatectomy with and without biliary tract resection, pancreatectomy [pancreaticoduodenectomy (PD), others], and open cholecystectomy. In total, 735 patients were analyzed...
July 9, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Sidrah Khan, Rachel E Beard, Peter T Kingham, Yuman Fong, Thomas Boerner, John B Martinie, Dioneses Vrochides, Joseph F Buell, Eren Berber, Bora Kahramangil, Roberto I Troisi, Aude Vanlander, Michele Molinari, Allan Tsung
OBJECTIVE: Robotic liver surgery (RLS) has emerged as a feasible alternative to laparoscopic or open resections with comparable perioperative outcomes. Little is known about the oncologic adequacy of RLS. The purpose of this study was to investigate the long-term oncologic outcomes for patients undergoing RLS for primary hepatobiliary malignancies. METHODS: We performed an international, multicenter, retrospective study of patients who underwent RLS for hepatocellular carcinoma (HCC), cholangiocarcinoma (CC), or gallbladder cancer (GBC) between 2006 and 2016...
July 9, 2018: Annals of Surgical Oncology
Marco Vito Marino, Gaspare Gulotta, Andrzej Lech Komorowski
Robotic liver surgery has been considered as a unique opportunity to overcome the traditional limitations of laparoscopy; thus, it can potentially extend the indications of minimally invasive liver surgery. From April 2015 to May 2017, 35 patients underwent fully robotic left hepatectomy. The mean operative time was 315 min (200-445 min) and the mean estimated blood loss was 245 ml (125-628 ml). Pringle maneuver was required in six cases. Cancer was the indication for surgery in all patients (14 liver metastases, 18 hepatocellular carcinomas and 3 cholangiocarcinomas)...
July 6, 2018: Updates in Surgery
Rajesh Ramanathan, Jeffrey Borrebach, Samer Tohme, Allan Tsung
BACKGROUND: Preoperative biliary drainage (PBD) prior to liver resection for hilar and intrahepatic cholangiocarcinoma (CCA) is common. While PBD for those with distal obstructions has been studied extensively and is associated with increased infectious complications, the impact of PBD among patients undergoing hepatectomy for non-disseminated proximal CCA has yet to be clearly elucidated. METHODS: Patients undergoing liver resection between 2014 and 2016 for non-disseminated hilar and intrahepatic CCA were analyzed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
July 6, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Brian K P Goh, Ser-Yee Lee, Jin-Yao Teo, Juinn-Huar Kam, Prema-Raj Jeyaraj, Peng-Chung Cheow, Pierce K H Chow, London L P J Ooi, Alexander Y F Chung, Chung-Yip Chan
BACKGROUND: Several studies published mainly from pioneers and early adopters have documented the evolution of minimally invasive hepatectomy (MIH). However, questions remain if these reported experiences are applicable and reproducible today. This study examines the changing trends, safety, and outcomes associated with the adoption of MIH based on a contemporary single-institution experience. METHODS: This is a retrospective review of 400 consecutive patients who underwent MIH between 2006 and 2017 of which 360 cases (90%) were performed since 2012...
July 2, 2018: Surgical Endoscopy
Wong Hoi She, Albert C Y Chan, Ka Wing Ma, Wing Chiu Dai, Kenneth S H Chok, Tan To Cheung, Chung Mau Lo
PURPOSE: The aim of this study was to examine the merits of the anterior approach, if any, in colorectal liver metastasis (CRLM) resection. METHODS: Data of patients who underwent partial hepatectomy for CRLM were reviewed. Patients treated by the anterior approach were compared with patients treated by the conventional approach. RESULTS: Ninety-eight patients had right hepatectomy, extended right hepatectomy, or right trisectionectomy. Among them, 71 patients underwent the conventional approach (CA group) and 27 underwent the anterior approach (AA group)...
June 29, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Tsung-Han Yang, Jen-Lung Chen, Yih-Jyh Lin, Ying-Jui Chao, Yan-Shen Shan, Hui-Ping Hsu, Zhe-Min Su, Chung-Ching Chou, Yi-Ting Yen
BACKGROUND: Although laparoscopic hepatectomy has been proven to be safe and reliable, the influence of tumor size on the feasibility of laparoscopic left lateral segmentectomy (LLLS) is unclear. We retrospectively reviewed our surgical results focusing on hepatic tumor located in the left lateral segment. METHODS: From January 2003 to June 2016, patients who underwent left lateral segmentectomy were retrospectively reviewed, and data were collected on patient characteristics, peri-operative outcomes, and pathologic results...
June 29, 2018: Surgical Endoscopy
Daniel J Wong, Michelle J Wong, Gi Hong Choi, Yao Ming Wu, Paul B Lai, Brian K P Goh
BACKGROUND: To date, there are few studies comparing the outcomes of robotic hepatectomy (RH) versus open hepatectomy (OH). We report the first systematic review and meta-analysis comparing the outcomes of RH versus OH. METHODS: A systemic review was performed of all comparative studies of RH versus OH that reported the perioperative outcome(s) of interest. RESULTS: Seven retrospective cohort studies were included. There was no significant difference in patients' baseline characteristics...
June 26, 2018: ANZ Journal of Surgery
Zhe Li, Xuezhao Cao, Hong Ma, Yong Cui, Xiaoqian Li, Na Wang, Yongjian Zhou
Age is the most prominent risk factor for the development of postoperative cognitive dysfunction. The present study investigated the role of CX3CL1-CX3CR1 signaling in age-related differences in surgery-induced cognitive deficits and neuroinflammation. Adult and aged male Sprague-Dawley rats were subjected to partial hepatectomy or partial hepatectomy with intracerebroventricular infusion of CX3CL1. On postoperative days 3, 7, and 14, the rats were subjected to an open field test and the Morris water maze test...
August 1, 2018: Journal of Neuropathology and Experimental Neurology
Zhi-Cheng Deng, Wen-Zhu Jiang, Xiao-Dong Tang, Shuang-Hai Liu, Lei Qin, Hai-Xin Qian
BACKGROUND: The aim of this study was to investigate the long-term outcomes and perioperative outcomes of laparoscopic hepatectomy (LH) versus open hepatectomy (OH) for hepatocellular carcinoma (HCC) between well-matched patient groups. METHODS: We retrospectively reviewed data from 1535 hepatocellular carcinoma patients who underwent liver resection between January 2002 and December 2016 at two Chinese centres. Propensity score matching of patients in a ratio of 1:1 was conducted and 157 patients were matched...
June 20, 2018: International Journal of Surgery
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