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Liver anatomy

G Mbatshi, E J Macken, H U De Schepper, H Piessevaux, P H Deprez, T G Moreels
Endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II patients is challenging and different endoscopes can be used. We retrospectively analysed 67 ERCP procedures in 38 Billroth II patients focussing on endoscope type and respective technical success and adverse event rate. 33 (49.2 %) ERCPs were performed using a duodenoscope, 87.9 % were successful and 3 were completed with the single-balloon enteroscope. 28 (41.8 %) ERCPs were performed with the single-balloon enteroscope, 82.1 % were successful and 2 were completed with a paediatric colonoscope...
October 2017: Acta Gastro-enterologica Belgica
I C Sormaz, L Avtan
INTRODUCTION: The gold standard treatment for hydatid cyst (HC) is surgery. In surgical practice, open procedures still remain as the first option but in this minimally-invasive era, the frequency of laparoscopic procedures is increasing. The aim of this study is to evaluate the results of 42 patients with HC who underwent surgery with Perforator-Grinder-Aspirator-Apparatus (PGAA) and demonstrate the success and reliability of this technique. METHODS: The datas of 42 patients, who underwent laparoscopic surgery with PGAA between Jan 2010 and Feb 2016 were evaluated retrospectively...
October 2017: Acta Gastro-enterologica Belgica
Adrián Róbert Gál, Károly Kalmár-Nagy, András Fincsur, Örs Péter Horváth, András Vereczkei
The authors present a case of a 67-year-old male patient, who previously had been diagnosed with a malignant liver tumor localized in segment II. He underwent bisegmentectomy (II and III) and partial IV segmentectomy. After the primary surgery jaundice developed, the level of bilirubin increased and after several imaging modalities reoperation was indicated. During the surgery a rare bile duct anatomy variant was found. The right hepatic duct joined the left duct in the parenchyma of the left lobe, and was ligated at the resection...
March 2018: Magyar Sebészet
Vikas Gupta, Yibing Wang, Alejandra Méndez Romero, Andriy Myronenko, Petr Jordan, Calvin Maurer, Ben Heijmen, Mischa Hoogeman
PURPOSE: To validate a novel deformable image registration (DIR) method for online adaptation of planning organ-at-risk (OAR) delineations to match daily anatomy during hypo-fractionated RT of abdominal tumors. MATERIALS AND METHODS: For 20 liver cancer patients, planning OAR delineations were adapted to daily anatomy using the DIR on corresponding repeat CTs. The DIR's accuracy was evaluated for the entire cohort by comparing adapted and expert-drawn OAR delineations using geometric (Dice Similarity Coefficient (DSC), Modified Hausdorff Distance (MHD) and Mean Surface Error (MSE)) and dosimetric (Dmax and Dmean ) measures...
March 8, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Jennifer M Watchmaker, Andrew J Lipnik, Micah R Fritsche, Jennifer C Baker, Samdeep K Mouli, Sunil Geevarghese, Filip Banovac, Reed A Omary, Daniel B Brown
BACKGROUND AND OBJECTIVES: Prophylactic antibiotics are frequently administered for transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). In patients without previous biliary instrumentation, infection risk from TACE is low. We hypothesized that there is a negligible rate of infection in these patients without prophylactic antibiotics. METHODS: We reviewed consecutive patients undergoing TACE between 7/1/2013-6/15/2016. All patients had an intact Sphincter of Oddi, received no peri-procedural antibiotics, and had 30+ days follow-up...
March 7, 2018: Journal of Surgical Oncology
Wolf B Kratzert, Eva K Boyd, Johanna C Schwarzenberger
Survival of adults with congenital heart disease (CHD) has improved significantly over the last 2 decades, leading to an increase in hospital and intensive care unit (ICU) admissions of these patients. Whereas most of the ICU admissions in the past were related to perioperative management, the incidence of medical emergencies from long-term sequelae of palliative or corrective surgical treatment of these patients is rising. Intensivists now are confronted with patients who not only have complex anatomy after congenital cardiac surgery, but also complex pathophysiology due to decades of living with abnormal cardiac anatomy and diseases of advanced age...
November 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Jason S Hawksworth, Chirag S Desai, Khalid M Khan, Stuart S Kaufman, Nada Yazigi, Raffaele Girlanda, Alexander Kroemer, Thomas M Fishbein, Cal S Matsumoto
Intestine failure-associated liver disease (IFALD) is widely recognized as a lethal complication of long-term parenteral nutrition. The pathophysiology of IFALD is poorly understood but appears to be multifactorial and related to the inflammatory state in the patient with intestinal failure (IF). Visceral transplantation for IFALD includes variants of intestine, liver, or combined liver and intestine transplantation. Graft selection for an individual patient depends on the etiology of intestinal failure, abdominal and vascular anatomy, severity of IFALD, and potential for intestinal rehabilitation...
March 2, 2018: American Journal of Transplantation
Matias E Czerwonko, Pablo Huespe, Cristina M Elizondo, Juan Pekolj, Adrian Gadano, Laura Barcán, Sung-Ho Hyon, Eduardo de Santibañes, Martín de Santibañes
BACKGROUND: Adult liver recipients (ALR) differ from the general population with pyogenic liver abscess (PLA) as they exhibit: reconstructed biliary anatomy, recurrent hospitalizations, poor clinical condition and are subjected to immunosuppression. The aim of this study was to identify risk factors associated with PLA in ALR and to analyze the management experience of these patients. METHODS: Between 1996 and 2016, 879 adult patients underwent liver transplantation (LT), 26 of whom developed PLA...
February 26, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Kotaro Yoshida, Osamu Matsui, Shiro Miyayama, Kenji Ibukuro, Norihide Yoneda, Dai Inoue, Kazuto Kozaka, Tetsuya Minami, Wataru Koda, Toshifumi Gabata
Isolated hepatic arteries are defined as hepatic terminal arterioles that are not accompanied by portal venules or bile ductules and penetrate the liver parenchyma and distribute to the hepatic capsule and intrahepatic hepatic veins. Abundant communications exist between intra- and extrahepatic arteries through isolated arteries and capsular arterial plexus. They play a principal role in the development of subcapsular hemorrhage and arterial collateral formation following transcatheter arterial chemoembolization for liver cancers...
February 22, 2018: Journal of Vascular and Interventional Radiology: JVIR
Roberta Angelico, Undine A Gerlach, Bridget K Gunson, Desley Neil, Hynek Mergental, John Isaac, Paolo Muiesan, Darius Mirza, M Thamara Pr Perera
BACKGROUND: Causes of severe cholestasis following liver transplantation(LT) are multi-factorial; whilst the aetiology is predictable in some, others culminate in graft/patient loss without a definitive cause identified. Severe cholestasis is usually associated with overlapped histological findings of rejection and biliary features, and diagnostic interpretation may pose a challenge. METHODS: This is 10-year retrospective analysis of patients with unexplained severe cholestasis resulting in death/graft loss within 90-days of LT...
February 20, 2018: Transplantation
Ophélie Cojean, Claire Vergneau-Grosset, Isabelle Masseau
Captive leopard geckos (Eublepharis macularius) often present to the exotic clinic for gastrointestinal impactions, follicular stasis, or dystocia. To our knowledge, normal ultrasonographic anatomy of these lizards has not been described. The objectives of this prospective, anatomic, analytical study were to develop ultrasound techniques for this species and to describe the normal sonographic anatomy of the head, coelomic cavity, and tail. Eleven, healthy, female leopard geckos were included. A linear array 13-18 MHz transducer was used...
February 19, 2018: Veterinary Radiology & Ultrasound
Jei Hee Lee, Bohyun Kim, Hye Jin Kim, Bong-Wan Kim, Hee-Jung Wang, Jai Keun Kim
PURPOSE: To determine the feasibility of high-resolution navigated three-dimensional (3D) T1-weighted hepatobiliary MR cholangiography (Nav T1 MRC) using Gd-EOB-DTPA for biliary visualization in living liver donors and to assess added value of 3D T1-weighted hepatobiliary MRCs in improving the confidence and diagnostic accuracy of biliary anatomy in complementary to T2-weighted MRCs. METHODS: Twenty-nine right liver donors underwent 3D T2 MRC, 2D T2 MRC, breath-hold T1-weighted hepatobiliary MRC (BH T1 MRC), and Nav T1 MRC...
February 15, 2018: Abdominal Radiology
Tianyou Yang, Tianbao Tan, Jiliang Yang, Jing Pan, Chao Hu, Jiahao Li, Yan Zou
Objective To investigate the impact of using a three-dimensional (3D) printed liver model for patient education. Methods Children with hepatic tumours who were scheduled for hepatectomy were enrolled, and patient-specific 3D liver models were printed with photosensitive resin, based on computed tomography (CT) images. Before surgery, their parents received information regarding liver anatomy, physiology, tumour characteristics, planned surgery, and surgical risks using these CT images. Then, parents completed questionnaires regarding this information...
January 1, 2018: Journal of International Medical Research
Suk Kyun Hong, Kyung-Suk Suh, Hyo-Sin Kim, Kyung Chul Yoon, Sung-Woo Ahn, Hyeyoung Kim, Nam-Joon Yi, Kwang-Woong Lee
BACKGROUND: Improvements in laparoscopic imaging systems and instruments have increased the performance of pure laparoscopic living donor hepatectomy. This operation is no longer limited to left lateral sectionectomy but is used for left hepatectomy and right hepatectomy.1-5 This report describes a donor who underwent pure laparoscopic left lateral sectionectomy and in situ reduction using 3D laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography to obtain a monosegment...
February 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Burak Veli Ülger, Eyüp Savaş Hatipoğlu, Özgür Ertuğrul, Mehmet Cudi Tuncer, Cihan Akgül Özmen, Mesut Gül
PURPOSE: Vascular structures of the liver and the bile ducts are crucial during liver transplantation or liver resection surgery. Here, we report on variations in the vascular structures and bile ducts of 200 patients. MATERIALS AND METHODS: We reviewed magnetic resonance cholangiopancreatographic and multiple-detector computed tomographic data. RESULTS: Michels type 1 was detected in 54% of the patients. The other most common variations were, respectively, Michels type 5 (13%) and type 2 (11%)...
February 12, 2018: Acta Chirurgica Belgica
Bruno Oliveira, Sandro Queirós, Pedro Morais, Helena R Torres, João Gomes-Fonseca, Jaime C Fonseca, João L Vilaça
Anatomical evaluation of multiple abdominal and thoracic organs is generally performed with computed tomography images. Owing to the large field-of-view of these images, automatic segmentation strategies are typically required, facilitating the clinical evaluation. Multi-atlas segmentation (MAS) strategies have been widely used with this process, requiring multiple alignments between the target image and the set of known datasets, and subsequently fusing the alignment results to obtain the final segmentation...
February 2, 2018: Medical Image Analysis
Ravi Kishore, Sundeep M C Kisku, Reju Joseph Thomas, Srinivasa Kishore Jeenipalli
INTRODUCTION: The study describes a refinement in the gallbladder hitch stitch and assesses the value of the laparoscopic cholangiogram in children with suspected biliary atresia. METHODS: Twenty children with neonatal jaundice and no drainage as shown on the HIDA scan underwent a diagnostic laparoscopy through an umbilical 5 mm port. A 3 mm laparoscopic needle holder inserted through a 3.5 mm port to the left of the umbilicus was used to hitch the gallbladder to the abdominal wall...
February 9, 2018: Pediatric Surgery International
Sandeep Kumar Vishwakarma, Avinash Bardia, Chandrakala Lakkireddy, Raju Nagarapu, Md Aejaz Habeeb, Aleem Ahmed Khan
AIM: To develop appropriate humanized three-dimensional ex-vivo model system for drug testing. METHODS: Bioengineered humanized livers were developed in this study using human hepatic stem cells repopulation within the acellularized liver scaffolds which mimics with the natural organ anatomy and physiology. Six cytochrome P-450 probes were used to enable efficient identification of drug metabolism in bioengineered humanized livers. The drug metabolism study in bioengineered livers was evaluated to identify the absorption, distribution, metabolism, excretion and toxicity responses...
January 27, 2018: World Journal of Hepatology
Sha-Sha Zhao, Li-Xun Guan, Zhe Gao, Fei-Yan Wang, Li-Li Wang, Chun-Ji Gao
OBJECTIVE: To establish the animal model of luciferase-transfected A20 murine B cell lymphoma, so as to provide experimental tools to explore the effect of graft versus tumor. METHODS: Luciferase- labeled A20 cells were cloned with puromycin selection. Transfected A20 cells and C57BL/6 bone marrow were inoculated into the irradiated BALB/c mice by injection in tailvein to establish the transplantation model. The bioluminescent imaging technique was used to monitor the tumor growth, and then the survival, body weight, tumor formation and pathological characteristics of target organs were observed...
February 2018: Zhongguo Shi Yan Xue Ye Xue za Zhi
Decheng Chen
Based on the sancai (literally three talents referring to "earth", "human" and "heaven") and wuti (literally five organs referring to skin, muscle, vessel, tendon and bone, which correspond to five internal organs: lungs, spleen, heart, liver and kidney respectively) in Neijing (Internal Classic), as well as the tissue structure theory of modern anatomy, and in combination with the clinical practice of acupuncture by the author in the past over 30 years, it is proposed that four layers are divided in needling depth of acupuncture...
November 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
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