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Surgery Hepatic

R A Ibadov, A Kh Babadzhanov, S Kh Irmatov, N R Gizatulina, S Kn Ibragimov, S A Ruziboev
AIM: Here we analyze efficiency of the algorithm for intensive therapy of acute hepatic insufficiency in patients with cirrhosis after portosystemic shunting, based on the experience of the Republican Specialized Scientific and Practical Medical Center of Surgery named after academician V.V. Vakhidov and considering recommendations of the world's leading hepatology schools. MATERIAL AND METHODS: Algorithm efficiency was analyzed based on the results of portosystemic shunting of 556 patients with cirrhosis and acute liver insufficiency...
2018: Khirurgiia
Dong Myung Yeo, Seung Eun Jung
The purpose of this study was to determine the diagnostic value of multidetector computed tomography (MDCT) imaging findings, to identify the most predictive findings, and to assess diagnostic performance in the diagnosis and differentiation of acute cholecystitis from chronic cholecystitis.In this retrospective study, we enrolled 382 consecutive patients with pathologically proven acute or chronic cholecystitis who underwent computed tomography (CT) within 1 month before surgery. The CT findings were compared and logistic regression analysis was used to identify significant CT findings in predicting acute cholecystitis...
August 2018: Medicine (Baltimore)
Robbert S Puijk, Alette H Ruarus, Laurien G P H Vroomen, Aukje A J M van Tilborg, Hester J Scheffer, Karin Nielsen, Marcus C de Jong, Jan J J de Vries, Babs M Zonderhuis, Hasan H Eker, Geert Kazemier, Henk Verheul, Bram B van der Meijs, Laura van Dam, Natasha Sorgedrager, Veerle M H Coupé, Petrousjka M P van den Tol, Martijn R Meijerink
BACKGROUND: Radiofrequency ablation (RFA) and microwave ablation (MWA) are widely accepted techniques to eliminate small unresectable colorectal liver metastases (CRLM). Although previous studies labelled thermal ablation inferior to surgical resection, the apparent selection bias when comparing patients with unresectable disease to surgical candidates, the superior safety profile, and the competitive overall survival results for the more recent reports mandate the setup of a randomized controlled trial...
August 15, 2018: BMC Cancer
A Gils Contreras, A Bonada Sanjaume, M Montero Jaime, A Rabassa Soler, F Sabench Pereferrer, A Molina López, N Becerra Tomás, D Del Castillo Déjardin, J Salas-Salvadó
OBJECTIVE: To assess which type of preoperative dietary strategy is most effective in reducing liver volume and assessing its influence on different biochemical parameters and on surgical complications in individuals undergoing bariatric surgery. METHODS: Parallel randomized trial comparing the effect of a very low calorie diet (VLCD) and a low calorie diet (LCD) for a period of 21 days before surgery on hepatic volume, anthropometric and biochemical parameters...
August 14, 2018: Obesity Surgery
Amber M D'Souza, Yanjun Jiang, Ashley Cast, Leila Valanejad, Mary Wright, Kyle Lewis, Meenasri Kumbaji, Sheeniza Shah, David Smithrud, Rebekah Karns, Soona Shin, Nikolai Timchenko
Background & Aims: Uncontrolled liver proliferation is a key characteristic of liver cancer; however, the mechanisms by which this occurs are not well understood. Elucidation of these mechanisms is necessary for the development of better therapy. The oncogene Gankyrin (Gank) is overexpressed in both hepatocellular carcinoma and hepatoblastoma. The aim of this work was to determine the role of Gank in liver proliferation and elucidate the mechanism by which Gank promotes liver proliferation...
2018: Cellular and Molecular Gastroenterology and Hepatology
Qun Zhang, Renyong Guo, Yu Chen
OBJECTIVE: This study aimed to investigate the relationship between plasma D-dimer level, preoperative complications, and thrombosis in liver transplant recipients. METHODS: The clinical data of 525 liver transplant recipients with end-stage liver disease (ESLD) in the First Affiliated Hospital of Zhejiang University from October 2012 to December 2015 were retrospectively analyzed. The patients were grouped based on thrombosis before and after surgery to determine the risk factors for postoperative thrombosis recurrence...
August 13, 2018: Journal of Clinical Laboratory Analysis
Wei Zheng, Zhong-Guo Zhou, Chong-Hei Wong, Xiao-Qing Pei, Shu-Lian Zhuang, Qing Li, Min-Shan Chen, An-Hua Li, Fu-Jun Zhang
OBJECTIVES: To determine the methodology of non-invasive test for evaluation of liver stiffness (LS) with tumours using two-dimensional (2D) shear wave elastography (SWE). METHODS: One hundred and twenty-seven patients with liver tumours underwent 2D-SWE before surgery to measure liver and spleen stiffness (SS). Two-dimensional SWE values were obtained in the liver at 0-1 cm, 1-2 cm and >2 cm from the tumour edge (PLS-1, PLS-2 and RLS, respectively). The influence of tumour-associated factors was evaluated...
August 13, 2018: European Radiology
Akihiro Yoshida, Kentaro Yamao, Mamoru Takenaka, Atsushi Nakai, Shunske Omoto, Ken Kamata, Kosuke Minaga, Takeshi Miyata, Hajime Imai, Ippei Matsumoto, Yoshihumi Takeyama, Takaaki Chikugo, Masatoshi Kudo
Neurilemmomas are benign tumors arising from the sheaths of peripheral nerves. They appear rarely in the abdominal cavity. We herein report an 80-year-old man with a multilocular cystic neurilemmoma mimicking a liver lesion. Preoperative images showed a lesion in the porta hepatis. Although a preoperative diagnosis was difficult, surgery was undertaken because of the possibility of malignancy. Histologically, the tumor consisted of spindle-shaped cells with positivity for S-100 protein. The final diagnosis was a neurilemmoma...
August 10, 2018: Internal Medicine
Jessica L Schachter, Manisha Patel, Samuel R Horton, A Mike Devane, Alex Ewing, Gary A Abrams
OBJECTIVE: As the population of patients with Fontan circulation surviving into adulthood increases, hepatic cirrhosis has grown to be a significant cause of morbidity and mortality. Early detection of advanced hepatic fibrosis is imperative for proper intervention and consideration for heart or combined heart/liver transplantation. Noninvasive biomarkers and elastography have been evaluated for their diagnostic utility with variable results in the Fontan population. DESIGN: The cohort included 14 patients age 26...
August 12, 2018: Congenital Heart Disease
Manreet K Kanwar, Lisa C Lohmueller, Robert L Kormos, Jeffrey J Teuteberg, Joseph G Rogers, JoAnn Lindenfeld, Stephen H Bailey, Colleen K McIlvennan, Raymond Benza, Srinivas Murali, James Antaki
OBJECTIVES: This study investigates the use of a Bayesian statistical models to predict survival at various time points in patients undergoing left ventricular assist device (LVAD) implantation. BACKGROUND: LVADs are being increasingly used in patients with end-stage heart failure. Appropriate patient selection continues to be key in optimizing post-LVAD outcomes. METHODS: Data used for this study were derived from 10,277 adult patients from the INTERMACS (Inter-Agency Registry for Mechanically Assisted Circulatory Support) who had a primary LVAD implanted between January 2012 and December 2015...
August 7, 2018: JACC. Heart Failure
Michelle A O Kinney, David M Nagorney, Daniel F Clark, Travis D O'Brien, Jonathan D Turner, Mary E Marienau, Darrell R Schroeder, David P Martin
STUDY OBJECTIVE: Partial hepatic resection reduces tumor burden in patients with metastatic neuroendocrine tumors, thereby improving quality and length of life. These procedures can be challenging as well as life-threatening. Our aim was to evaluate our patients' perioperative outcomes and propose a definition for an intraoperative carcinoid crisis relevant to this surgery, given its unique surgical considerations. DESIGN: Retrospective study. SETTING: Mayo Clinic, Rochester, Minnesota...
August 8, 2018: Journal of Clinical Anesthesia
Gu-Wei Ji, Yao-Dong Zhang, Ke Wang, Hui Zhang, Zi-Cheng Shao, Wang-Jie Jiang, Xiang-Cheng Li, Xue-Hao Wang
BACKGROUND: This study aimed to compare clinical outcomes of the middle hepatic vein (MHV)-oriented versus conventional hemihepatectomy for perihilar cholangiocarcinoma (PHC). METHODS: From 2008 to 2017, medical records of patients undergoing hemihepatectomy with caudate lobectomy for advanced PHC were reviewed retrospectively. MHV-oriented hepatectomy was defined as full exposure of the MHV on the dissection plane. Predictors of morbidity and survival were identified...
August 11, 2018: Journal of Surgical Oncology
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
Nicola Imperatore, Giancarlo Micheletto, Gianpiero Manes, Davide Giuseppe Redaelli, Elisa Reitano, Germana de Nucci
BACKGROUND: Hepatic hematoma (HH) is a rare but severe adverse event following endoscopic retrograde cholangiopancreatography (ERCP). AIMS: To perform a systematic literature review and describe two additional cases, one of which presenting multiple subcapsular/intrahepatic hematomas after ERCP. METHODS: The literature review was performed in PubMed/MEDLINE, EMBASE, and SCOPUS to identify all cases reporting on HH after ERCP. RESULTS: A total of 48 cases (females 63%, mean age 58...
July 20, 2018: Digestive and Liver Disease
Milton Halyson Benevides de Freitas, Luciana Cavalcanti Lima, Tania Cursino de Menezes Couceiro, Maria Célia Ferreira da Costa, Márcio Handerson Benevides de Freitas
BACKGROUND AND OBJECTIVES: Conjoined twins are monozygotic twins physically joined at some part of the body. This is a rare phenomenon, estimated between 1:50,000 to 1:200,000 births. The objective of this report is to present the anesthetic management and the perioperative challenges for a separation surgery. CASE REPORT: Thoraco-omphalopagus twins were diagnosed by ultrasound and were followed by the fetal medicine team of the service. After 11hours of cesarean, the pediatric surgical team chose to separate the twins...
August 7, 2018: Revista Brasileira de Anestesiologia
Hsiao-Chen Chiu, Meng-Yu Wu, Chao-Hsu Li, Su-Cheng Huang, Giou-Teng Yiang, Hsuan-Shang Yen, Wei-Lin Liu, Chia-Jung Li, Woei-Yau Kao
Disseminated peritoneal leiomyomatosis (DPL) is a rare condition that is characterized by the presence of multiple subperitoneal or peritoneal smooth muscle nodules of varying sizes on the omentum and peritoneal surfaces, grossly mimicking disseminated carcinoma. DPL usually develops in premenopausal women with a benign course, and it is often found incidentally during abdominal surgery. Malignant transformation is a rare clinical course of DPL. Only a few studies have focused on DPL transformation into a leiomyosarcoma...
August 9, 2018: Journal of Clinical Medicine
Meisheng Li, Qinghan Li, Qiucheng Lei, Jianyuan Hu, Fengjie Wang, Huanwei Chen, Zuojun Zhen
RATIONALE: Ectopic variceal bleeding due to hepaticojejunostomy (HJ) is unusual and difficult to manage. Reports on the use of side-to-side splenorenal shunt for severe bleeding from varices at HJ anastomosis are lacking. PATIENT CONCERNS: A 43-year-old man was admitted to our hospital with repeated episodes of hematemesis. He has a history of right hemihepatectomy with HJ reconstruction to the left hepatic duct for hilar cholangiocarcinoma. Two years after surgery, he presented with repeated episodes of hematemesis and underwent blood transfusion...
August 2018: Medicine (Baltimore)
David R Rutkowski, Scott B Reeder, Luis A Fernandez, Alejandro Roldán-Alzate
This study used magnetic resonance imaging (MRI), computational fluid dynamics (CFD) modeling, and in vitro experiments to predict patient-specific alterations in hepatic hemodynamics in response to partial hepatectomy in living liver donors. 4D Flow MRI was performed on three donors before and after hepatectomy and models of the portal venous system were created. Virtual surgery was performed to simulate (1) surgical resection and (2) post-surgery vessel dilation. CFD simulations were conducted using in vivo flow data for boundary conditions...
2018: Computer Methods in Biomechanics and Biomedical Engineering. Imaging & Visualization
Sabreen Mkalaluh, Marcin Szczechowicz, Saeed Torabi, Anton Sabashnikov, Ahmed Mashhour, Matthias Karck, Alexander Weymann
BACKGROUND:  Cardiac metastases are more common than primary malignant tumors of the heart and are usually treated surgically as a palliative approach. In this study, we reviewed our experience with the surgical treatment of patients with cardiac metastases of various types of malignant tumors. METHODS:  Between 2003 and 2016, 10 patients underwent surgery for cardiac metastases at our institution. RESULTS:  The mean age was 53.5 ± 19 years...
August 9, 2018: Thoracic and Cardiovascular Surgeon
Patricio Rosa, Ihor Pidhorecky
Our patient is a 44 years old woman who underwent exploratory laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy by GYN Oncology for a suspected malignancy. The diagnosis of intravenous leiomyomatosis (IVL) was made instead. She was followed by GYN and remained asymptomatic until two years later when she complained to the GYN of leg heaviness, and two months later also complained of palpitations. She was treated with a short course of megestrol without any clinical response. She was then referred to Vascular Surgery...
August 6, 2018: Annals of Vascular Surgery
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