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https://www.readbyqxmd.com/read/29786890/thrombotic-and-hemorrhagic-complications-during-visceral-transplantation-risk-factors-and-association-with-intraoperative-disseminated-intravascular-coagulation-like-thromboelastographic-qualities-single-center-retrospective-study
#1
Yehuda Raveh, Yiliam Rodriguez, Ernesto Pretto, Fouad Souki, Vadim Shatz, Behrouz Ashrafi, Vinaya Manmohansigh, Michael Demos, Joshua Livingstone, Georges Nasrallah, David Andrews, Thiago Beduschi, Rodrigo Vianna, Ramona Nicolau-Raducu
This study describes the risk of thrombotic and hemorrhagic complications, both intraoperatively, and up to 1-month following visceral transplantation. Data from 48 adult visceral transplants performed between 2010-2017 were retrospectively studied (32 multivisceral (MVTx); 10 isolated intestine; 6 modified-MVTx). Intraoperatively, intracardiac thrombosis (ICT)/pulmonary embolism (PE) occurred in 25%, 0% and 0% of MVTx, isolated intestine and modified MVTx, respectively, and was associated with 50% (4/8) mortality...
May 22, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29784597/the-association-between-portal-system-vein-diameters-and-outcomes-in-acute-pancreatitis
#2
X J N M Smeets, G Litjens, D W da Costa, W Kievit, H C van Santvoort, M G H Besselink, P Fockens, M J Bruno, J J Kolkman, J P H Drenth, T L Bollen, E J M van Geenen
BACKGROUND/OBJECTIVES: Acute pancreatitis (AP) progresses to necrotizing pancreatitis in 15% of cases. An important pathophysiological mechanism in AP is third spacing of fluids, which leads to intravascular volume depletion. This results in a reduced splanchnic circulation and reduced venous return. Non-visualisation of the portal and splenic vein on early computed tomography (CT) scan, which might be the result of smaller vein diameter due to decreased venous flow, is associated with infected necrosis and mortality in AP...
May 15, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29782007/intraportal-transplantation-of-pancreatic-islets-in-mouse-model
#3
Rahul Khatri, Birte Hussmann, Divya Rawat, Ali Osman Gürol, Thomas Linn
Pancreatic islet transplantation to reduce hyperglycemia is highly successful in rodents with chemically-induced diabetes. The most common transplantation site in experimental islet transplantation is the kidney capsule. However, as less is known about the interaction of pancreatic islets with blood constituents, it also makes sense to utilize the portal vein approach in experimental islet transplantation. This protocol demonstrates an intraportal islet transplantation technique in NMRI nude mice. Streptozotocin (180 mg/kg) is injected intraperitoneally to induce hyperglycemia in recipient mice...
May 5, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29780653/isolated-superior-mesenteric-vein-tumor-thrombus-in-a-patient-with-gastric-cancer
#4
Barış Özcan, Metin Çevener, Ayşegül Kargı, Mustafa Özdoğan, Alihan Gürkan
Tumor thrombus in the portal vein can rarely originate from gastric cancer via hematogenous spread, with only few case reports published in the literature. Isolated superior mesenteric vein tumor thrombus in gastric cancer has not been previously reported. A 61-year-old male patient who had undergone distal gastrectomy and gastroenterostomy for gastric ulcer 20 years ago was diagnosed with an obstructive tumor originating from the gastroenterostomy anastomosis site on upper gastrointestinal endoscopy that was performed for complaints of fatigue, oral feeding problems, and anemia...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29780579/managing-portal-hypertension-in-patients-with-liver-cirrhosis
#5
REVIEW
Tilman Sauerbruch, Robert Schierwagen, Jonel Trebicka
Portal hypertension is one cause and a part of a dynamic process triggered by chronic liver disease, mostly induced by alcohol or incorrect nutrition and less often by viral infections and autoimmune or genetic disease. Adequate staging - continuously modified by current knowledge - should guide the prevention and treatment of portal hypertension with defined endpoints. The main goals are interruption of etiology and prevention of complications followed, if necessary, by treatment of these. For the past few decades, shunts, mostly as intrahepatic stent bypass between portal and hepatic vein branches, have played an important role in the prevention of recurrent bleeding and ascites formation, although their impact on survival remains ambiguous...
2018: F1000Research
https://www.readbyqxmd.com/read/29779307/-application-of-perihilar-surgical-techniques-in-perihilar-biliary-tract-tumours
#6
J Wang
Perihilar biliary tract tumours include hilar cholangiocarcinoma, gallbladder cancer invading the hepatic hilum and intrahepatic cholangiocarcioma invading the hepatic hilum.The tumours have the special characteristics such as strong invasion capability, the anatomic variant, the pathophysiological complexity, the biological behavior diversity and the difficulty of preoperative evaluation which result in low R0 resection rate, more postoperative complications, more mortality and poor prognosis.The perihilar surgical techniques system aims to set a reasonable and individual operation procedure on the principle of precision surgery by taking the key technique of hilar dissection and exposing, evaluting the hilar anatomy by the means of three-dimensional digital medical image evaluation system, evaluting the relationship between the tumour and hepatic artery and portal vein under the condition of hepatic hilum complete exposure by combining anterograde and retrograde route from intra and extra-hepatic direction to hepatic hilum...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29778616/routine-portal-vein-resection-for-pancreatic-adenocarcinoma-shows-no-benefit-in-overall-survival
#7
Fritz Klein, Finja Berresheim, Matthäus Felsenstein, Thomas Malinka, Uwe Pelzer, Timm Denecke, Johann Pratschke, Marcus Bahra
BACKGROUND: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these "false negative" resections on operative outcome and long-term survival. METHODS: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified...
May 9, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29774181/embolization-with-ethylene-vinyl-alcohol-copolymer-onyx-%C3%A2-for-peripheral-hemostatic-and-non-hemostatic-applications-a-feasibility-and-safety-study
#8
Romaric Né, Olivier Chevallier, Nicolas Falvo, Olivier Facy, Pierre-Emmanuel Berthod, Christophe Galland, Sophie Gehin, Marco Midulla, Romaric Loffroy
Background: Onyx® is a liquid embolic agent, which is approved for the treatment of cerebral vascular lesions but still rarely used in peripheral interventional radiology. The goal of this study is to report the feasibility and safety of embolization with Onyx® for peripheral hemostatic and non-hemostatic endovascular procedures. Methods: Retrospective study of all consecutive patients who underwent visceral or peripheral embolization with Onyx® for hemostatic or non-hemostatic purpose in our department between May 2014 and November 2016...
April 2018: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29770931/pancreaticoduodenectomy-with-replaced-common-hepatic-artery-and-portal-vein-reconstruction-in-primary-carcinoma-duodenum-a-case-report-and-literature-review
#9
Gunjan S Desai, Prasad Pande, Rajiv C Shah, Palepu Jagannath
No abstract text is available yet for this article.
May 17, 2018: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/29770886/laparoscopic-extended-liver-resection-are-postoperative-outcomes-different
#10
Daniel Pietrasz, David Fuks, Daren Subar, Gianfranco Donatelli, Carlotta Ferretti, Christian Lamer, Luca Portigliotti, Marc Ward, Jane Cowan, Takeo Nomi, Marc Beaussier, Brice Gayet
BACKGROUND: Although laparoscopic major hepatectomy (LMH) is becoming increasingly common in specialized centers, data regarding laparoscopic extended major hepatectomies (LEMH) and their outcomes are limited. The aim of this study was to compare the perioperative characteristics and postoperative outcomes of LEMH to standard LMH. METHODS: All patients who underwent purely laparoscopic anatomical right or left hepatectomy and right or left trisectionectomy between February 1998 and January 2016 are enrolled...
May 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29766730/-splanchnic-vein-thrombosis
#11
Sylva Lajzová, Radek Kroupa, Alena Buliková, Šárka Bohatá, Barbora Packová, Michal Šenkyřík
Splanchnic vein thrombosis (SVT) represents an unusual manifestation of venous thromboembolism. The etiological factors for SVT can be divided into local and systemic, frequently found concurrently. SVT can be the first presenting symptom in myeloproliferative neoplasms. SVT puts the patients affected in jeopardy of developing the intestinal infarction, impairing the liver function and portal hypertension development with the risk of potentially life-threatening gastrointestinal bleeding. The current guidelines emphasise the role of anticoagulation in acute splanchnic thrombosis...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29763951/dynamic-4d-ct-angiography-for-guiding-transarterial-chemoembolization-impact-on-the-reduction-of-contrast-material-operator-radiation-exposure-catheter-consumption-and-diagnostic-confidence
#12
Moritz H Albrecht, Thomas J Vogl, Julian L Wichmann, Simon S Martin, Jan-Erik Scholtz, Sebastian Fischer, Renate M Hammerstingl, Marc Harth, Nour-Eldin A Nour-Eldin, Axel Thalhammer, Stephan Zangos, Ralf W Bauer
PURPOSE:  This study was carried out to investigate the impact of abdominal dynamic four-dimensional CT angiography (4D-CTA) for guiding transarterial chemoembolization (TACE) on the amount of contrast material used, operator radiation exposure, catheter consumption, and diagnostic confidence. MATERIALS AND METHODS:  Written consent was waived for this IRB-approved retrospective study. 29 patients (20 men; mean age: 65.7 ± 11.5 years) with malignant liver lesions underwent 4D-CTA, prior to initial TACE...
June 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/29761937/-mirror-mirror-on-the-wall-%C3%A2-pediatric-liver-transplantation-in-the-case-of-situs-inversus-totalis-with-a-disrupted-inferior-vena-cava
#13
Colston A Edgerton, Megan Gross, Nagraj Kasi, Winston Hewitt, Sara Edmondson, Vinayak S Rohan, Satish N Nadig
We present the unique case of a 15-month-old male born with biliary atresia and situs inversus totalis and disrupted inferior vena cava who underwent a successful liver transplantation. The patient had previously undergone a failed Kasai procedure and presented with persistent hyperbilirubinemia. The patient was transplanted with a left lateral segment donor having standard arterial anatomy. Technical considerations included identifying completely replaced arterial anatomy in the recipient from the superior mesenteric artery and creating a branch patch between the gastroduodenal artery and HA, anastomosing the donor left hepatic vein to confluences of the donor left, middle, and right hepatic veins, using a "lazy-S" configuration of portal vein anastomosis, and suspending the allograft to the abdominal wall...
May 15, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29761927/on-the-potential-role-of-intestinal-microbial-community-in-hepatocarcinogenesis-in-chronic-hepatitis-b
#14
REVIEW
Ashraf Mohamadkhani
The chronic infection of hepatitis B virus (HBV) is the most potent risk factor for the development of cirrhosis and hepatocellular carcinoma (HCC). The association of intestinal microbiota alteration with progressive liver disease has been investigated in recent studies. Overgrowth of potentially pathogenic bacteria of gram-negative species and, in particular, a significant increase in the fecal count of Escherichia coli (E. coli) are characterized in the presence of HCC. This study was conducted to describe the characteristics of the intestinal microbiota related to the presence of HCC in HBV-carrier patients...
May 15, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29756168/transsplenic-splenoportography-and-portal-venous-interventions-in-pediatric-patients
#15
Eric J Monroe, Ethan J Speir, C Matthew Hawkins, Giri Shivaram, Kevin S H Koo, Anne E Gill
BACKGROUND: Data regarding transsplenic portal venous access for diagnostic imaging and endovascular intervention in children are limited, possibly due to concerns regarding high bleeding risks and resultant underutilization. OBJECTIVE: To investigate the safety and utility of transsplenic splenoportography and portal venous interventions in children. MATERIALS AND METHODS: A retrospective review was performed of all pediatric patients undergoing percutaneous transsplenic portal venous access and intervention at two large tertiary pediatric institutions between January 2012 and April 2017 was performed...
May 13, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29755906/rare-forms-of-castleman-disease-mimicking-malignancy-mesenteric-and-pancreatic-involvement
#16
Mustafa Ozsoy, Zehra Ozsoy, Suleyman Sahin, Yuksel Arıkan
Castleman disease is a lymphoproliferative disorder with unknown etiology and pathogenesis. While the disease may involve all parts of the body, the mediastinum appears to be the most common part of involvement. In this study, we present two cases of Castleman disease with different localizations that mimicked malignancy. A 62-year-old female patient presented with jaundice. Laboratory analysis indicated aspartate aminotransferase: 250 U/L, total bilirubin: 4 mg/dl, and carbohydrate antigen (CA) 19-9: 900 U/ml...
March 12, 2018: Curēus
https://www.readbyqxmd.com/read/29754851/treatment-of-hepatocellular-carcinoma-with-tumor-thrombus-with-the-use-of-iodine-125-seed-strand-implantation-and-transarterial-chemoembolization-a-propensity-score-analysis
#17
Zi-Han Zhang, Wen Zhang, Jun-Ying Gu, Qing-Xin Liu, Jing-Qin Ma, Ling-Xiao Liu, Jian-Hua Wang, Jian-Jun Luo, Zhi-Ping Yan
PURPOSE: To evaluate the safety and efficacy of iodine-125 (125 I) seed strand implantation in combination with transarterial chemoembolization for the treatment of hepatitis B-related unresectable hepatocellular carcinoma (HCC) with portal vein invasion. MATERIALS AND METHODS: From January 2013 to June 2016, 76 HCC patients with type II tumor thrombus were included in this single-center retrospective study. Twenty patients underwent 125 I seed strand implantation combined with transarterial chemoembolization (group A; n = 20), while 56 patients underwent transarterial chemoembolization alone (group B; n = 56)...
May 10, 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29753461/hepatic-venous-pressure-gradient-after-portal-vein-embolization-an-accurate-predictor-of-future-liver-remnant-hypertrophy
#18
Kayvan Mohkam, Agnès Rode, Benjamin Darnis, Anne-Frédérique Manichon, Loïc Boussel, Christian Ducerf, Philippe Merle, Mickaël Lesurtel, Jean-Yves Mabrut
BACKGROUND: The impact of portal hemodynamic variations after portal vein embolization on liver regeneration remains unknown. We studied the correlation between the parameters of hepatic venous pressure measured before and after portal vein embolization and future hypertrophy of the liver remnant after portal vein embolization. METHODS: Between 2014 and 2017, we reviewed patients who were eligible for major hepatectomy and who had portal vein embolization. Patients had undergone simultaneous measurement of portal venous pressure and hepatic venous pressure gradient before and after portal vein embolization by direct puncture of portal vein and inferior vena cava...
May 9, 2018: Surgery
https://www.readbyqxmd.com/read/29752425/variability-of-directly-measured-first-pass-hepatic-insulin-extraction-and-its-association-with-insulin-sensitivity-and-plasma-insulin
#19
Isaac Asare-Bediako, Rebecca L Paszkiewicz, Stella P Kim, Orison O Woolcott, Cathryn M Kolka, Miguel A Burch, Morvarid Kabir, Richard N Bergman
While the β-cells secrete insulin, it is the liver with its first-pass insulin extraction (FPE) that regulates the amount of insulin allowed into circulation for action on target tissues. The metabolic clearance rate of insulin, of which FPE is the dominant component, is reported to be a major determinant of insulin sensitivity (SI). We studied the intricate relationship between FPE, SI and fasting insulin. We used a direct method of measuring FPE, the paired portal/peripheral infusion protocol (PPII) where insulin is infused step-wise, either via the portal vein or a peripheral vein in healthy young dogs (n =12)...
May 11, 2018: Diabetes
https://www.readbyqxmd.com/read/29751198/price-to-pay-portal-vein-arterialization-for-hepatic-artery-thrombosis-after-living-donor-liver-transplantation-a-case-report
#20
Worakitti Lapisatepun, Anon Chotirosniramit, Trichak Sandhu, Kanya Udomsin, Wasana Ko-Iam, Phuriphong Chanthima, Warangkana Lapisatepun, Settapong Boonsri, Suraphong Lorsomradee, Quanhathai Kaewpoowat, Sunhawit Junrungsee
OBJECTIVE: Hepatic artery thrombosis (HAT) is one of the most serious complications of liver transplantation that can potentially lead to loss of the allograft. Retransplantation is the only option when revascularization can't be performed but the donor may be not available in the short period of time. We report the technique of using portal vein arterialization (PVA) for bridging before retransplantation. There are few reports in living donor setting. CASE DESCRIPTION: The recipient of the liver was a 59 year old male who received an extended right lobe graft from his son...
May 2, 2018: International Journal of Surgery Case Reports
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