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Open Hepatectomy

S Akbulut, B Isik, Y Karipkiz, S Yilmaz
Despite having many advantages, living donor liver transplantation has not been adopted by western countries due to risk of nearly life-threatening complications after living donor hepatectomy (LDH). Herein, we aimed at presenting the management of a 19-year-old patient who suffered life-threatening complications after right lobe LDH. A multiple detector computed tomography (MDCT) revealed a bilioma at the cut surface of the remnant liver, for which a transhepatic drainage catheter was placed. Endoscopic retrograde cholangiopancreatography (ERCP) performed to decompress biliary tract, but the biliary tract could not be cannulized due to post-precut bleeding...
2018: International Journal of Organ Transplantation Medicine
Chao-Wei Lee, Hsin-I Tsai, Hao-Tsai Cheng, Wei-Ting Chen, Heng-Yuan Hsu, Chien-Chih Chiu, Yi-Ping Liu, Tsung-Han Wu, Ming-Chin Yu, Wei-Chen Lee, Miin-Fu Chen
BACKGROUND: Laparoscopic liver resection has been regarded as the standard treatment for liver tumors located at the left lateral liver sector. However, few studies have reported the results of laparoscopic left lateral sectionectomy (LLS) for HCC, not to mention the feasibility of this emerging technique for the less experienced liver surgeons. The current study would reappraise the Louisville statement by examining the outcome of LLS performed by a young liver surgeon. METHODS: We retrospectively reviewed two separate groups of patients who underwent open or laparoscopic left lateral sectionectomies at Chung Gung Memorial Hospital, Linkou...
November 28, 2018: BMC Gastroenterology
Nicholas Cortolillo, Chetan Patel, Joshua Parreco, Srinivas Kaza, Alvaro Castillo
The safety of hepatectomy continues to improve and it holds a key role in the management of benign and malignant hepatic lesions. Laparoscopic and robotic approaches to hepatectomy are increasingly utilized. The purpose of this study was to compare outcomes and costs of laparoscopic and robotic vs. open approaches to hepatectomy and to determine the national nonelective postoperative readmission rate, including readmission to other hospitals. The Nationwide Readmission Database from 2013 to 2014 was queried for all patients undergoing hepatectomy...
November 27, 2018: Journal of Robotic Surgery
Suk Kyun Hong, Eunhye Shin, Kwang-Woong Lee, Kyung Chul Yoon, Jeong-Moo Lee, Jae-Hyung Cho, Nam-Joon Yi, Kyung-Suk Suh
BACKGROUND: Interest in pure laparoscopic donor hepatectomy (PLDH) is increasing worldwide with the donor's cosmetic demands and improvements in surgical techniques. Efficient manipulation of flexible scope is mandatory for successful PLDH, especially in right hepatectomy which requires more mobilization. This study provides guidelines on how to manipulate optimally a flexible scope. METHODS: Data from 158 donors who underwent pure laparoscopic donor right hepatectomy (PLDRH) between November 2015 and December 2017 were retrospectively reviewed...
November 21, 2018: Surgical Endoscopy
Ashwini Tilak, Adriana G Ramirez, Florence E Turrentine, Min-Woong Sohn, Rayford Scott Jones
BACKGROUND: In North America, the prevalence of gastroesophageal reflux disorder ranges from 18.1% to 27.8%. We measured the risk posed by preoperative esophageal disease for patients undergoing abdominal operations. METHOD: American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP; 2005-2015) data were merged with institutional clinical data repository records to identify esophageal disease in surgical patients undergoing intra-abdominal procedures...
December 2018: Journal of Surgical Research
Zachary E Stiles, Evan S Glazer, Jeremiah L Deneve, David Shibata, Stephen W Behrman, Paxton V Dickson
BACKGROUND: Laparoscopic liver resection (LLR) is increasingly utilized for patients with hepatocellular carcinoma (HCC). However, long-term outcomes for patients requiring conversion to an open procedure during LLR have not been examined. METHODS: Patients undergoing attempted LLR for HCC were identified within the National Cancer Database. Patients undergoing successful LLR were compared with those who required unplanned conversion with regard to perioperative outcomes and overall survival (OS)...
November 19, 2018: Annals of Surgical Oncology
Andreas Andreou, Benjamin Struecker, Nathanael Raschzok, Felix Krenzien, Philipp Haber, Simon Wabitsch, Christoph Waldbaur, Eva-Maria Touet, Anne-Christine Eichelberg, Georgi Atanasov, Matthias Biebl, Marcus Bahra, Robert Öllinger, Moritz Schmelzle, Johann Pratschke
BACKGROUND: Minimal-invasive hepatectomy (MIH) has been increasingly performed for benign and malignant liver lesions with most promising results. However, the role of MIH for the treatment of patients with hepatocellular carcinoma (HCC) needs further investigation. METHODS: Clinicopathological data of patients who underwent liver resection for HCC between 2005 and 2016 were assessed. Postoperative outcomes und long-term survivals of patients following MIH were compared with those of patients undergoing conventional open hepatectomy (OH) after 1:1 propensity score matching...
December 2018: Surgical Oncology
Yongjian Zhou, Zhe Li, Xuezhao Cao, Hong Ma, Paul F White, Xiaohan Xu, Yanhua Jiang, Xijia Sun, Yong Cui
Recent studies indicate that glucagon-like peptide 1 (GLP-1) receptor (GLP-1R) agonists exhibit neurotrophic and neuroprotective effects. The aim of this study was to explore whether the GLP-1R agonist exendin-4 can alter surgery-induced behavioral deficits and exert neuroprotective effects via the activation of the hippocampal GLP-1/GLP-1R pathway. 120 male Sprague-Dawley rats (aged 18-20 months old) were randomly divided into four groups: control group, exendin-4 group, surgery group, and surgery + exendin-4 group...
November 5, 2018: Brain Research
Peng Zhu, Wei Liao, Ze-Yang Ding, Lin Chen, Wan-Guang Zhang, Bi-Xiang Zhang, Xiao-Ping Chen
BACKGROUND: The objective of this study was to evaluate the learning curve effect on the safety and feasibility of robot-assisted liver resection (RALR). METHODS: In 140 consecutive cases, all data about demographic, surgical procedure, postoperative course were collected prospectively and analyzed. Risk-adjusted cumulative sum model was used for determining the learning curve based on the need for conversion. RESULTS: Among all 140 patients, no patients suffered from any organ dysfunction postoperatively and the operative mortality was 0%...
November 7, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
T Kobayashi, K Miura, H Ishikawa, D Soma, T Ando, K Yuza, Y Hirose, T Katada, K Takizawa, M Nagahashi, J Sakata, H Kameyama, T Wakai
BACKGROUND: We have introduced and performed laparoscope-assisted surgery in living donor hepatectomy. The objective of this study was to investigate the long-term results of laparoscope-assisted living donor hepatectomy. METHODS: From 2006 to 2016, laparoscope-assisted living donor hepatectomy was performed in 11 patients (laparoscopic group), and conventional open living donor hepatectomy was performed in 40 patients (conventional group). Intraoperative and postoperative complications were evaluated according to the Clavien-Dindo classification and analyzed in the laparoscopic group for comparison with the conventional group...
November 2018: Transplantation Proceedings
J Chen-Xu, R Bessa-Melo, L Graça, J Costa-Maia
PURPOSE: The occurrence of incisional hernia (IH) is one of the main complications after open abdominal surgery. However, its incidence in hepatobiliary and pancreatic surgery is not known. Studies on hepatectomy and necrotizing pancreatitis show that the incidence can reach up to 42%. This study aims at evaluating the incidence of IH and its risk factors. METHODS: Patients submitted to open hepatobiliary and pancreatic surgery at our centre between 2010 and 2016 were selected...
November 3, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Zi Yin, Haosheng Jin, Tingting Ma, Hongxu Wang, Bowen Huang, Zhixiang Jian
BACKGROUND: Previous guidance and consensus have well-addressed the advantages of laparoscopic procedures in the anterolateral segments of II, III, IVb and V of the liver, as for lesions located in the posterosuperior segments of I, IVa, VII and VIII is challenging but has become more practical recently due to progress in operative techniques. METHODS: A systematic review and meta-analysis was conducted to evaluate the safety and efficacy of LH and OH patients with tumors located in posterosuperior segments...
October 31, 2018: International Journal of Surgery
Hiroki Nakajima, Yukihiro Yokoyama, Takayuki Inoue, Motoki Nagaya, Yota Mizuno, Izumi Kadono, Kimitoshi Nishiwaki, Yoshihiro Nishida, Masato Nagino
BACKGROUND: The impact of prehabilitation on physical fitness and postoperative course after hepato-pancreato-biliary (HPB) surgeries for malignancy is unknown. The current study aimed to investigate the effect of preoperative exercise and nutritional therapies on nutritional status, physical fitness, and postoperative outcomes of patients undergoing an invasive HPB surgery for malignancy. METHODS: Patients who underwent open abdominal surgeries for HPB malignancies (major hepatectomy, pancreatoduodenectomy, or hepato-pancreatoduodenectomy) between 2016 and 2017 were subjected to prehabilitation...
October 26, 2018: Annals of Surgical Oncology
Stefano Di Sandro, Maria Danieli, Fabio Ferla, Andrea Lauterio, Riccardo De Carlis, Laura Benuzzi, Vincenzo Buscemi, Isabella Pezzoli, Luciano De Carlis
The use of laparoscopic liver resection (LLR) has progressively spread in the last 10 years. Several studies have shown the superiority of LLR to open liver resection (OLR) in term of perioperative outcomes. With this review, we aim to systematically assess short-term and long-term major outcomes in patients who underwent LLR for hepatocellular carcinoma (HCC) in order to illustrate the advantages of minimally invasive liver surgery. Through an advanced PubMed research, we selected all retrospective, prospective, and comparative clinical trials reporting short-term and long-term outcomes of any series of patients with diagnosis of HCC who underwent laparoscopic or robotic resection...
2018: Translational Gastroenterology and Hepatology
Mohammad R Jajja, Daniel Maxwell, Salila S Hashmi, Rebecca S Meltzer, Edward Lin, John F Sweeney, Juan M Sarmiento
BACKGROUND: With current emphasis on improving cost-quality relationship in medicine, it is imperative to evaluate cost-value relationships for surgical procedures. Previously the authors demonstrated comparable clinical outcomes for minimally invasive right hepatectomy (MIRH) and open right hepatectomy (ORH). MIRH had significantly higher intraoperative cost, though overall costs were similar. METHODS: MIRH was decoded into its component critical steps using value stream mapping, analyzing each associated cost...
October 22, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Huan Wei Chen, Fei Wen Deng, Feng Jie Wang, Jie Yuan Li, Eric C H Lai, Wan Yee Lau
Background and Objectives: In the past, right hepatectomy via the anterior approach has been regarded as one of the many standard approaches for hepatectomy. However, total laparoscopic right hepatectomy from the anterior approach has been regarded as technically challenging. We report our experience in using the anterior approach in total laparoscopic right hepatectomy for hepatocellular carcinoma (HCC). Methods: From June 2013 through December 2015, five consecutive patients underwent total laparoscopic right hepatectomy using the anterior approach, but without the hanging maneuver...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Ji Hoon Kim
BACKGROUND: The caudal approach constitutes a conceptual change in laparoscopic hepatectomy.1- 4 The middle hepatic vein (MHV) located in the midplane of the liver serves as a landmark during hemihepatectomy.5 However, it is difficult to expose the MHV from its peripheral branches toward the main root via the caudal approach because of anatomical variations in branching patterns.6 We present the ventral approach to the MHV during laparoscopic hemihepatectomy. METHOD: The ventral approach involves liver transection from the ventral to the dorsal aspect using a flexible laparoscope, similar to an open hepatectomy...
October 23, 2018: Annals of Surgical Oncology
Cheng Huang, Xiao-Dong Zhu, Guo-Ming Shi, Ying-Hao Shen, Guang-Yu Ding, Jia-Bin Cai, Jian Zhou, Jia Fan, Hui-Chuan Sun
BACKGROUND: Although prophylactic glucocorticoids have been used before liver resection to minimize liver dysfunction, it is unknown whether treatment with glucocorticoids will accelerates recovery from hyperbilirubinemia after liver resection. METHODS: In this open-label, randomized, controlled trial, patients with hyperbilirubinemia (>2.5 × and ≤5 × the upper limit of normal) within 7 days after hepatic resection were assigned randomly to the dexamethasone or control groups...
October 19, 2018: Surgery
Xavier Untereiner, Audrey Cagniet, Riccardo Memeo, Zineb Cherkaoui, Tullio Piardi, François Severac, Didier Mutter, Reza Kianmanesh, Taiga Wakabayashi, Daniele Sommacale, Patrick Pessaux
OBJECTIVES: The aim of this study was to compare the results between laparoscopic hepatectomy and open hepatectomy in two French university hospitals, for the management of hepatocellular carcinoma (HCC) using a propensity score matching. MATERIALS AND METHODS: A patient in the laparoscopic surgery group (LA) was randomly matched with another patient in the open approach group (OA) using a 1:1 allocated ratio with the nearest estimated propensity score. Matching criteria included age, presence of comorbidities, American Society of Anesthesiologists score, and resection type (major or minor)...
October 19, 2018: World Journal of Surgery
Bibek Aryal, Teruo Komokata, Hiroto Yasumura, Daisaku Kamiimabeppu, Maki Inoue, Kota Yoshikawa, Mamoru Kaieda, Yutaka Imoto
BACKGROUND: THUNDERBEAT® (TB) (Olympus Medical Systems Corp., Tokyo, Japan) is a dynamic energy system device that simultaneously delivers ultrasonically generated frictional heat energy and electrically generated bipolar energy. TB is being routinely used in various operative procedures, however, less is known about its utility in liver resection. We, herein, report our early experience of using TB in open liver resection particularly in patients with normal or near-normal liver parenchyma...
October 16, 2018: BMC Surgery
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