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https://www.readbyqxmd.com/read/28424126/the-novel-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-to-explore-a-retroperitoneal-hematoma-in-a-hemodynamically-unstable-patient
#1
Martin D Rosenthal, Ahsan Raza, Stephanie Markle, Chasen A Croft, Alicia M Mohr, R Stephen Smith
Balloon occlusion of the aorta was first described by C.W. Hughes in 1954, when it was used as a tamponade device for three wounded soldiers during the Korean War suffering from intra-abdominal hemorrhage. Currently, the device is indicated in trauma patients as a surrogate for resuscitative thoracotomy. Brenner et al. reported a case series describing the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in advanced hemorrhagic shock. Their conclusion was that "it is a feasible method for proximal aortic control...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28408311/validation-of-a-difficulty-scoring-system-for-laparoscopic-liver-resection-a-multicenter-analysis-by-the-endoscopic-liver-surgery-study-group-in-japan
#2
Shogo Tanaka, Shoji Kubo, Akishige Kanazawa, Yutaka Takeda, Fumitoshi Hirokawa, Hiroyuki Nitta, Takayoshi Nakajima, Takashi Kaizu, Hironori Kaneko, Go Wakabayashi
BACKGROUND: Laparoscopic liver resection (LLR) is widely used for hepatic disease treatment. Preoperative prediction of operative difficulty can be beneficial as a roadmap for surgeons advancing from simple to highly technical LLR. We performed a multicenter analysis to investigate a "difficulty scoring system" for predicting the difficulty of LLR. STUDY DESIGN: The proposed "difficulty scoring system" includes three difficulty levels based on five factors. The system was validated in a cohort of 2,199 patients who underwent LLR at 74 Japanese centers between 2010 and 2014; the difficulty level was rated as low (n = 965), intermediate (n = 891), and high (n = 343)...
April 10, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28399882/liver-necrosis-shortly-after-pancreaticoduodenectomy-with-resection-of-the-replaced-left-hepatic-artery
#3
Michihiro Yamamoto, Masazumi Zaima, Hidekazu Yamamoto, Hideki Harada, Junichiro Kawamura, Masahiro Yamada, Tekefumi Yazawa, Junya Kawasoe
BACKGROUND: Surgeons, in general, underestimate the replaced left hepatic artery (rLHA) that arises from the left gastric artery (LGA), compared with the replaced right hepatic artery (rRHA), especially in standard gastric cancer surgery. During pancreaticoduodenectomy (PD), preservation of the rRHA arising from the superior mesenteric artery (SMA) is widely accepted to prevent critical postoperative complications, such as liver necrosis, bile duct ischemia, and biliary anastomotic leakage...
April 11, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28384848/surgical-implications-of-portal-vein-variations-and-liver-segmentations-a-recent-update
#4
REVIEW
Showkathali Iqbal, Raiz Iqbal, Faiz Iqbal
The Couinaud's liver segmentation is based on the identification of portal vein bifurcation and origin of hepatic veins. It is widely used clinically, because it is better suited for surgery and is more accurate in localizing and monitoring various intra parenchymal lesions. According to standard anatomy, the portal vein bifurcates into right and left branches; the left vein drains segment II, III and IV and the right vein divides into two secondary branches - the anterior portal vein drains segments V and VIII, and the posterior drains segments VI and VII...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28360525/the-importance-of-a-multidisciplinary-approach-to-hepatocellular-carcinoma
#5
REVIEW
Osama Siddique, Eric R Yoo, Ryan B Perumpail, Brandon J Perumpail, Andy Liu, George Cholankeril, Aijaz Ahmed
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. The rising incidence, genetic heterogeneity, multiple etiologies, and concurrent chronic liver diseases make diagnosis, staging, and selection of treatment options challenging in patients with HCC. The best approach to optimize the management of HCC is one that utilizes a core multidisciplinary liver tumor board, consisting of hepatologists, pathologists, interventional radiologists, oncologists, hepatobiliary and transplant surgeons, nurses, and general practitioners...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28357815/agenesis-of-the-left-hepatic-lobe-undergoing-laparoscopic-hepatectomy-for-hepatocellular-carcinoma-a-case-report
#6
Katsunori Matsushita, Kunihito Gotoh, Hidetoshi Eguchi, Yoshihumi Iwagami, Daisaku Yamada, Tadafumi Asaoka, Takehiro Noda, Hiroshi Wada, Koichi Kawamoto, Yuichiro Doki, Masaki Mori
BACKGROUND: Agenesis of the left hepatic lobe is a rare anomaly. It is defined as the absence of liver tissue to the left of the gallbladder fossa. Additionally, agenesis of the left hepatic lobe accompanied by hepatocellular carcinoma is quite rare. We experienced the case of a patient with agenesis of the left hepatic lobe, undergoing laparoscopic hepatectomy for HCC. CASE PRESENTATION: A 79-year-old man was referred to our department with epigastralgia. Abdominal computed tomography revealed agenesis of the left hepatic lobe, accompanied by hepatocellular carcinoma in segments 7 and 8...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28355772/-progress-in-application-of-three-dimensional-imaging-technique-in-complex-hepatobiliary-surgery
#7
G W Ji, F P Zhu, X C Li
Hepatobiliary surgery is considered to be technically challenging because of complex intrahepatic and perihilar anatomical structures and variations.Nowadays, three-dimensional imaging technique plays an important role in the time of precise liver surgery.Three-dimensional images depict the spatial location of tumor, and the course, confluence pattern and variation of portal vein, hepatic artery, biliary system and hepatic vein distinctly while showing involved hepatic segments and the relationship with adjacent vessels from omnidirectional view, measuring the length of margin and future remnant liver...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28328863/surgical-outcomes-of-laparoscopic-versus-open-liver-resection-for-hepatocellular-carcinoma-for-various-resection-extent
#8
Junhua Chen, Hongyu Li, Fei Liu, Bo Li, Yonggang Wei
Although the number of laparoscopic liver resections (LRRs) has increased, studies of surgical outcomes in comparison with the conventional open approach are limited. The purpose of this study was to analyze the surgical outcomes (safety and efficacy) of LLR versus open liver resection (OLR) for hepatocellular carcinoma (HCC).We collected data on all patients who received liver resection for HCC between April 2015 and September 2016 in our institution, and retrospectively investigated the demographic and perioperative data, and also surgical outcomes...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28326402/total-joint-arthroplasty-in-patients-with-chronic-infectious-liver%C3%A2-disease
#9
Jeremy N Truntzer, Kalpit N Shah, Derek R Jenkins, Lee E Rubin
The opportunity for total joint arthroplasty (TJA) in patients with chronic infectious liver disease is rapidly expanding. This is the product of both superior survival of chronic hepatitis patients, evolving implant technologies, and improvement of techniques in TJA. Unfortunately, treating this group of patients is not without significant challenges that can stem from both intrahepatic and extrahepatic clinical manifestations. Moreover, many subclinical changes occur in this cohort that can alter hemostasis, wound healing, and infection risk even in the asymptomatic patient...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28321173/synchronous-coexistence-of-liver-metastases-from-cecal-leiomyosarcoma-and-rectal-adenocarcinoma-a-case-report
#10
Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Rie Yamasaki
Multiple liver tumors represent a challenging condition for abdominal surgeons both in the selection of technique and the rarity of diagnosis. There are no case reports on co-existence of liver metastases from both intestinal leiomyosarcoma and adenocarcinoma. The patient described in this report successfully underwent resection of both primary lesions and liver metastases in combination with chemotherapy. As for the leiomyosarcoma, the primary cecal lesion was revealed more than three years after the patient's first visit...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28302657/vascular-challenges-from-pancreatoduodenectomy-in-the-setting-of-coeliac-artery-stenosis
#11
Joal D Beane, Roderich E Schwarz
Coeliac artery stenosis due to median arcuate ligament compression or atherosclerotic disease is a frequently unrecognised challenge to recovery after pancreatoduodenectomy. The described case illustrates management with intraoperative superior mesenteric artery to hepatic artery bypass graft that led to haemorrhagic challenges postoperatively but ultimately a good recovery. Aspects of preoperative diagnosis, preoperative intervention and intraoperative management options are reviewed. Surgeons need to possess these tools to prevent complications from coeliac artery stenosis when pancreatoduodenectomy is required...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28293742/the-accumulation-of-regulatory-t-cells-in-the-hepatic-hilar-lymph-nodes-in-biliary-atresia
#12
Naoya Sakamoto, Toshihiro Muraji, Haruo Ohtani, Kouji Masumoto
PURPOSE: A proposed etiopathogenesis of biliary atresia (BA) involves T-cell-mediated inflammatory bile duct damage and progressive hepatic fibrosis. Pediatric surgeons often observe swelling of the hepatic hilar lymph nodes during the Kasai procedure. Given the importance of regulatory mechanisms in immune responses, the present study was designed to analyze the quantitative changes of regulatory T cells (T reg cells) in the hepatic hilar lymph nodes (hepatic hilar LNs) and peripheral blood (PB) in BA...
March 14, 2017: Surgery Today
https://www.readbyqxmd.com/read/28281726/anastomotic-loop-between-common-hepatic-artery-and-gastroduodenal-artery-in-coexistence-with-an-aberrant-right-hepatic-artery
#13
Konstantinos Natsis, Maria Piagkou, Theodosis Stamatopoulos, Ioannis Spyridakis, Stylianos Apostolidis
Anatomical variations of the hepatic arteries are not uncommon. The anomalous hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic or liver transplantation and in laparoscopic surgery. We describe an unusual case of a 66-year-old Greek male cadaver, where a rare anastomosis (in the form of an enlarged arterial loop, 4.84 mm in diameter) between the common hepatic artery (6.42 mm) and the gastroduodenal artery (GDA) (4.82 mm) coexisted with an aberrant right hepatic artery (ARHA) (6...
March 10, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28275581/clinical-anatomy-of-the-liver-review-of-the-19th-meeting-of-the-japanese-research-society-of-clinical-anatomy
#14
REVIEW
Yoshihiro Sakamoto, Norihiro Kokudo, Yoshikuni Kawaguchi, Keiichi Akita
Precise clinical knowledge of liver anatomy is required to safely perform a hepatectomy, for both open and laparoscopic surgery. At the 19th meeting of the Japanese Research Society of Clinical Anatomy (JRSCA), we conducted special symposia on essential issues of liver surgery, such as the history of hepatic segmentation, the glissonean pedicle approach, application of 3-D imaging simulation and fluorescent imaging using indocyanine green solution, a variety of segmentectomies including caudate lobectomy, the associating liver partition and portal vein embolization for stage hepatectomy and harvesting liver grafts for living donor liver transplantation...
February 2017: Liver Cancer
https://www.readbyqxmd.com/read/28258743/loco-regional-treatment-of-hcc-current-status
#15
REVIEW
L Crocetti, I Bargellini, R Cioni
Hepatocellular carcinoma (HCC) represents one of the few cancers for which locoregional treatments are recognised as being able to cure and/or prolong survival and are included in international guidelines. This is due to the unique nature of HCC, in most cases occurring in patients with underlying virus- or alcohol-related cirrhosis. The treatment choice in patients with HCC is therefore driven not only by tumour staging, as in the great majority of cancers, but also by careful evaluation of liver function and physical status...
February 28, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28258614/safety-related-outcomes-of-the-japanese-society-of-hepato-biliary-pancreatic-surgery-board-certification-system-for-expert-surgeons
#16
Takehito Otsubo, Shinjiro Kobayashi, Keiji Sano, Takayuki Misawa, Takehiro Ota, Satoshi Katagiri, Katsuhiko Yanaga, Hiroki Yamaue, Norihiro Kokudo, Michiaki Unno, Jiro Fujimoto, Fumihiko Miura, Masaru Miyazaki, Masakazu Yamamoto
PURPOSE: We investigated safety-related outcomes of HBP surgeries performed after establishment of the Japanese Society of Hepato-Biliary-Pancreatic Surgery board certification system for expert surgeons. METHODS: We analyzed post-HBP surgery mortality data obtained from annual safety reports provided by board-certified training institutions between 2012 and 2015. RESULTS: The 90-day mortality rate for the 53,929 high-level HBP surgeries performed at board-certified training institutions was 1...
March 3, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28250667/adult-to-adult-living-donor-liver-transplantation-operative-techniques-to-optimize-the-recipient-s-outcome
#17
REVIEW
Peng Soon Koh, See Ching Chan
Adult-to-adult living donor liver transplantation (LDLT) is widely accepted today with good outcomes and safety reported worldwide for both donor and recipient. Nonetheless, it remained a highly demanding technical and complex surgery if undertaken. The last two decades have seen an increased in adult-to-adult LDLT following our first report of right lobe LDLT in overcoming graft size limitation in adults. In this article, we discussed the operative techniques and challenges of adult right lobe LDLT incorporating the middle hepatic vein, which is practiced in our center for the recipient operation...
January 2017: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/28247305/virtual-laparoscopic-training-system-based-on-vch-model
#18
Jiangzhou Tang, Lang Xu, Longjun He, Songluan Guan, Xing Ming, Qian Liu
Laparoscopy has been widely used to perform abdominal surgeries, as it is advantageous in that the patients experience lower post-surgical trauma, shorter convalescence, and less pain as compared to traditional surgery. Laparoscopic surgeries require precision; therefore, it is imperative to train surgeons to reduce the risk of operation. Laparoscopic simulators offer a highly realistic surgical environment by using virtual reality technology, and it can improve the training efficiency of laparoscopic surgery...
April 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28237643/adjunctive-role-of-preoperative-liver-magnetic-resonance-imaging-for-potentially-resectable-pancreatic-cancer
#19
Hyoung Woo Kim, Jong-Chan Lee, Kyu-Hyun Paik, Jingu Kang, Young Hoon Kim, Yoo-Seok Yoon, Ho-Seong Han, Jaihwan Kim, Jin-Hyeok Hwang
BACKGROUND: The adjunctive role of magnetic resonance imaging of the liver before pancreatic ductal adenocarcinoma has been unclear. We evaluated whether the combination of hepatic magnetic resonance imaging with multidetector computed tomography using a pancreatic protocol (pCT) could help surgeons select appropriate candidates and decrease the risk of early recurrence. METHODS: We retrospectively enrolled 167 patients in whom complete resection was achieved without grossly visible residual tumor; 102 patients underwent pCT alone (CT group) and 65 underwent both hepatic magnetic resonance imaging and pCT (magnetic resonance imaging group)...
February 22, 2017: Surgery
https://www.readbyqxmd.com/read/28221166/prevalence-of-needlestick-injuries-attitude-changes-and-prevention-practices-over-12-years-in-an-urban-academic-hospital-surgery-department
#20
Jessica M Hasak, Christine B Novak, Jennifer Megan M Patterson, Susan E Mackinnon
OBJECTIVE: Needlestick injury prevalence, protection practices, and attitudes were assessed. Current medical students were compared with 2003 data to assess any changes that occurred with engineered safety feature implementation. BACKGROUND: Risk of occupational exposure to bloodborne pathogens is elevated in the operating room particularly with surgeons in training and nurses. METHODS: A cross-sectional survey was distributed to medical students (n = 358) and Department of Surgery staff (n = 247)...
February 17, 2017: Annals of Surgery
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