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Two stage hepatectomy

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https://www.readbyqxmd.com/read/28419692/associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-after-pre-operative-chemotherapy
#1
Florian W R Vondran, Felix Oldhafer, Kristina I Ringe, Thomas C Wirth, Moritz Kleine, Mark D Jäger, Juergen Klempnauer, Hueseyin Bektas
BACKGROUND: Recently a procedure termed 'Associating Liver Partition and Portal vein ligation for Staged hepatectomy' (ALPPS) was developed to increase the resectability of marginally resectable or locally unresectable liver tumours. This study focused on the application of ALPPS in patients with advanced colorectal liver metastases (CRLM) and pre-operative chemotherapy, with the aim to investigate whether the latter still allows for sufficient hypertrophy of the future liver remnant (FLR) following the first step of ALPPS...
April 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28398026/associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-versus-conventional-staged-hepatectomy-a-meta-analysis
#2
Yin Zhang, Yidi Zheng, Xuesong Dong, Xuepu Sun, Xian Jiang, Zhuozhong Wang, Haiquan Qiao
INTRODUCTION: Controversies persist between associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and conventional staged hepatectomy. This meta-analysis aims to compare completion, regeneration capacity, and surgical outcomes between the two strategies. EVIDENCE ACQUISITION: We systematically searched PubMed, Embase, Cochrane Library, Medline. The main endpoints consisted of completion rate, future liver remnant (FLR) hypertrophy ratio, morbidity, major complication, minor complication, posthepatectomy liver failure (PHLF) and mortality...
April 11, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28343889/feasibility-safety-and-efficacy-of-two-stage-hepatectomy-for-bilobar-liver-metastases-of-colorectal-cancer-a-livermetsurvey-analysis
#3
Jean Marc Regimbeau, Cyril Cosse, Gernot Kaiser, Catherine Hubert, Christophe Laurent, Real Lapointe, Helen Isoniemi, Rene Adam
BACKGROUND: The combination of liver resection and chemotherapy has become the standard of care for colorectal liver metastases (LM). The objective of the present study was to evaluate the impact of TSH on the long-term survival of patients with bilobar LM. METHODS: We included adult (over-18) patients from the LiverMetSurvey registry with confirmed multiple colorectal LM and having undergone either one-stage hepatectomy or TSH with curative intent. The "TSH (2/2)" group (n = 625) comprised patients having completed both stages of TSH; the "TSH (1/2)" group (n = 244) comprised patients having undergone only the first stage of TSH; the "hepatectomy" group...
March 23, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28293094/competing-risk-analysis-on-outcome-after-hepatic-resection-of-hepatocellular-carcinoma-in-cirrhotic-patients
#4
Alessandro Cucchetti, Carlo Sposito, Antonio Daniele Pinna, Davide Citterio, Matteo Cescon, Marco Bongini, Giorgio Ercolani, Christian Cotsoglou, Lorenzo Maroni, Vincenzo Mazzaferro
AIM: To investigate death for liver failure and for tumor recurrence as competing events after hepatectomy of hepatocellular carcinoma. METHODS: Data from 864 cirrhotic Child-Pugh class A consecutive patients, submitted to curative hepatectomy (1997-2013) at two tertiary referral hospitals, were used for competing-risk analysis through the Fine and Gray method, aimed at assessing in which circumstances the oncological benefit from tumour removal is greater than the risk of dying from hepatic decompensation...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28279621/high-mortality-after-alpps-for-perihilar-cholangiocarcinoma-case-control-analysis-including-the-first-series-from-the-international-alpps-registry
#5
Pim B Olthof, Robert J S Coelen, Jimme K Wiggers, Bas Groot Koerkamp, Massimo Malago, Roberto Hernandez-Alejandro, Stefan A Topp, Marco Vivarelli, Luca A Aldrighetti, Ricardo Robles Campos, Karl J Oldhafer, William R Jarnagin, Thomas M van Gulik
INTRODUCTION: Resection of perihilar cholangiocarcinoma (PHC) entails high-risk surgery with postoperative mortality reported up to 18%, even in specialized centers. The aim of this study was to compare outcomes of PHC patients who underwent associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) to patients who underwent resection without ALPPS. METHODS: All patients who underwent ALPPS for PHC were identified from the international ALPPS registry and matched controls were selected from a standard resection cohort from two centers based on future remnant liver size...
March 6, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28270160/alpps-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-does-not-affect-proliferation-apoptosis-or-angiogenesis-as-compared-to-standard-liver-resection-for-colorectal-liver-metastases
#6
Katharina Joechle, Christian Moser, Petra Ruemmele, Katharina M Schmidt, Jens M Werner, Edward K Geissler, Hans J Schlitt, Sven A Lang
BACKGROUND: ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) is a novel two-stage strategy to induce rapid hypertrophy of the future liver remnant (FLR) when patients are in danger of postoperative liver failure due to insufficient FLR. However, the effects of ALPPS on colorectal liver metastases (CRLM) are not clear so far. The aim of our study was to determine whether ALPPS induces proliferation, apoptosis, or vascularization compared to standard (one-stage) liver resection...
March 7, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28162213/-clinicopathologic-features-of-hepatocellular-carcinoma-patients-surviving-more-than-10-years-after-radical-hepatectomy
#7
L Q Wu, Z S Wang, J Y Cao, W Y Hu, B Han, C D Sun, B Y Zhang, F B Qiu, S Zhang, J Y Yang, Z J Cui
Objective: To clarify the clinicopathologic features of hepatocellular carcinoma (HCC) patients survived more than 10 years after radical hepatectomy. Methods: Two hundreds and fifty-two patients who underwent curative resection for HCC between January 1999 and March 2006 at Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qingdao University were included.There were 217 male cases and 35 female cases aging from 17 to 82 years with median age of (53.8±10.5)years. Followed by March 31 2016, clinicopathologic factors in 10-year survivors and patients who died within 10 years were compared by χ(2) test, Kaplan-Meier survival analysis and Cox proportional hazards model and the prognostic factors affecting survival were identified...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28105517/-meta-analysis-of-induction-of-hypertrophy-in-two-stage-hepatectomy
#8
O Strobel, M W Büchler
No abstract text is available yet for this article.
February 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28058712/two-stage-hepatectomy-in-two-regional-district-community-hospitals-perioperative-safety-and-long-term-survival
#9
Guido Griseri, Michela Ceriotti, Andrea Percivale, Angelo Franceschi, Gregorio Santori, Marco Benasso, Riccardo Pellicci
INTRODUCTION: Surgical resection offers the best chance of cure for patients with colorectal liver metastases (CRLMs). Two-stage hepatectomy (TSH) has been demonstrated to be safe and effective to obtain curative resection in patients with multiple, bilobar CRLMs that are unresectable in a single procedure. Up to now TSH has been the prerogative of dedicated liver surgery centers. The aim of this study was to assess the safety and effectiveness of TSH also in community hospitals. METHODS: Of 294 patients operated on for CRLMs between September 1997 and June 2012 in 2 district community hospitals (belonging to the same regional healthcare district), 43 (14...
March 24, 2017: Tumori
https://www.readbyqxmd.com/read/28058554/prognosis-of-intrahepatic-cholangiocarcinomas-with-hbv-infection-is-better-than-those-with-hepatolithiasis-after-r0-liver-resection-a-propensity-score-matching-analysis
#10
Qing Wang, Jun Li, Zhengqing Lei, Dong Wu, Anfeng Si, Kui Wang, Yizhou Wang, Xuying Wan, Wan Yee Lau, Feng Shen
BACKGROUND: The impact of different causative factors of intrahepatic cholangiocarcinoma (ICC) on disease outcome remains largely unknown. This study aimed to evaluate the prognosis of ICC patients with different pathogenic factors after hepatectomy. METHODS: Data of 731 consecutive patients undergoing R0 liver resection for ICC at The Eastern Hepatobiliary Surgery Hospital between 2004 and 2010 were analyzed. These patients were divided into the hepatitis B virus-related (HBV-ICC, n = 519), hepatolithiasis-related (stone-ICC, n = 87), HBV plus hepatolithiasis-related (HBV/stone-ICC, n = 45), and other etiologies-related (other-ICC, n = 80) ICC groups...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28042245/viral-hepatitis-status-does-not-affect-survival-in-patients-with-hepatocellular-carcinoma
#11
Eyas Alkhalili, Alissa Greenbaum, Li Luo, Rodrigo Rodriguez, Katharine Caldwell, Oscar Munoz Estrada, Jacqueline O'Neill, Itzhak Nir, Katherine T Morris
BACKGROUND: There have been few studies on the impact of viral etiology on the prognosis in patients with hepatocellular carcinoma (HCC). The aim of this study was to evaluate the clinical characteristics and survival of patients with viral hepatitis-associated HCC (V-HCC), compared to patients with HCC of non-hepatitis B, non-hepatitis C (NBNC-HCC) etiology. METHODS: We performed a retrospective analysis of all patients with HCC treated at our comprehensive cancer center from 2000 through 2014...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28039607/hepatobilio-pancreatic-robotic-surgery-initial-experience-from-a-single-center-institute
#12
Yolanda Quijano, Emilio Vicente, Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Luis Malave, Valentina Ferri, Carlos Plaza, Jan Lammel Lindemann, Vito D'Andrea, Riccardo Caruso
The use of robotic surgery in the hepatobilio-pancreatic (HBP) field is still limited. Our aim is to present our early experience of robotic liver resection. A retrospective review of robotic pancreatic and liver resection was performed at Sanchinarro University hospital from October 2010 to April 2016. Since the beginning of the robotic program in our center, 22 hepatic procedures and 45 pancreatic robotic procedures have been performed. Of the 21 patients subjected to liver resection, 13 (65%) were for malignancy...
December 30, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28038862/survival-after-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-for-advanced-colorectal-liver-metastases-a-case-matched-comparison-with-palliative-systemic-therapy
#13
Pim B Olthof, Joost Huiskens, Dennis A Wicherts, Pablo E Huespe, Victoria Ardiles, Ricardo Robles-Campos, René Adam, Michael Linecker, Pierre-Alain Clavien, Miriam Koopman, Cornelis Verhoef, Cornelis J A Punt, Thomas M van Gulik, Eduardo de Santibanes
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows the resection of colorectal liver metastases with curative intent which would otherwise be unresectable and only eligible for palliative systemic therapy. This study aimed to compare outcomes of ALPPS in patients with otherwise unresectable colorectal liver metastases with matched historic controls treated with palliative systemic treatment. METHODS: All patients with colorectal liver metastases from the international ALPPS registry were identified and analyzed...
April 2017: Surgery
https://www.readbyqxmd.com/read/28032566/rabbit-model-provides-new-insights-in-liver-regeneration-after-transection-with-portal-vein-ligation
#14
Mingheng Liao, Tao Zhang, Haichuan Wang, Ying Liu, Minxun Lu, Jiwei Huang, Yong Zeng
BACKGROUND: The rabbit model of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has not been reported before. MATERIALS AND METHODS: New Zealand white rabbits were allocated to two protocols. Protocol 1 involved either liver parenchymal transection (LPT, n = 5) or portal vein ligation (PVL, n = 5). Protocol 2 involved the ligation of different portal vein branches combined with liver partition, including the LPT + 20% PVL group (n = 5; the caudate portal vein was ligated), the LPT + 50% PVL group (n = 5; the left portal vein was ligated), and the LPT + 70% PVL group (n = 10; both veins were ligated)...
November 2, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27995092/surgery-of-colorectal-liver-metastases-pushing-the-limits
#15
REVIEW
Guido Torzilli, René Adam, Luca Viganò, Katsunori Imai, Jeremias Goransky, Andrea Fontana, Christian Toso, Pietro Majno, Eduardo de Santibañes
BACKGROUND: The recent advent of more effective chemotherapy and the development of surgical procedures have expanded the pool of resectable patients with colorectal liver metastases (CLM). Two-stage hepatectomy (TSH), associated liver partition and portal vein ligation for staged hepatectomy (ALPPS), and ultrasound-guided enhanced one-stage hepatectomy (e-OSH) are the surgical solutions proposed for these patients, but the range of indications for these procedures vary from institution to institution...
November 2016: Liver Cancer
https://www.readbyqxmd.com/read/27982760/two-dimensional-shear-wave-elastography-performance-in-the-noninvasive-evaluation-of-liver-fibrosis-in-patients-with-chronic-hepatitis-b-comparison-with-serum-fibrosis-indexes
#16
Yuan Zhuang, Hong Ding, Yue Zhang, Huichuan Sun, Chen Xu, Wenping Wang
Purpose To investigate the value of two-dimensional (2D) shear-wave elastography (SWE) in the assessment of hepatic fibrosis in patients with chronic hepatitis B (CHB) and to compare the diagnostic performance of this modality with that of liver fibrosis indexes. Materials and Methods The ethics committee approved this study, and informed consent was obtained. From July 2015 to May 2016, 539 subjects who underwent partial hepatectomy were divided into groups according to the Scheuer system by using a resected liver specimen...
December 13, 2016: Radiology
https://www.readbyqxmd.com/read/27919852/prognosis-of-hepatocellular-carcinoma-with-bile-duct-tumor-thrombus-after-r0-resection-a-matched-study
#17
Ding-Ding Wang, Li-Qun Wu, Zu-Sen Wang
BACKGROUND: Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare. The present study aimed to determine post-surgical prognoses in HCC patients with BDTT, as outcomes are currently unclear. METHODS: We compared the prognoses of 110 HCC patients without BDTT (group A) to 22 cases with BDTT (group B). The two groups were matched in age, gender, tumor etiology, size, number, portal vascular invasion, and TNM stage. Additionally, 28 HCC patients with BDTT were analyzed to identify prognostic risk factors...
December 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27895412/metabolic-imaging-for-guidance-of-curative-treatment-of-isolated-pelvic-implantation-metastasis-after-resection-of-spontaneously-ruptured-hepatocellular-carcinoma-a-case-report
#18
Bing Hao, Wei Guo, Na-Na Luo, Hao Fu, Hao-Jun Chen, Long Zhao, Hua Wu, Long Sun
Spontaneous rupture of hepatocellular carcinoma (HCC) is a life-threatening complication and its prognosis is significantly poor because of the high recurrence rate after initial hepatectomy. Resection of isolated extrahepatic metastasis of HCC has been advocated to obtain a possibility of long-term survival. However, it is a challenge for clinicians to detect implantation metastasis of spontaneously ruptured HCC. Accurate re-staging plays the most important role in making a decision on isolated metastasis resection...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27816312/transition-from-open-to-laparoscopic-alpps-for-patients-with-very-small-flr-the-initial-experience
#19
Marcel A C Machado, Fábio F Makdissi, Rodrigo C Surjan, Tiago Basseres, Erik Schadde
BACKGROUND: Laparoscopic ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) has previously been reported but has been the authors' default option since 2015 in patients with small future liver remnant. METHODS: A retrospective analysis of all consecutive patients undergoing ALPPS at a single referral center was performed using a prospective database from July 2011 to June 2016. Feasibility was studied by assessing conversions. The 90-day mortality and complications were analyzed using a Dindo-Clavien score and the comprehensive complication index...
January 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27811506/hepatopancreaticoduodenectomy-for-biliary-cancer-strategies-for-near-zero-operative-mortality-and-acceptable-long-term-outcome
#20
Taku Aoki, Yoshihiro Sakamoto, Yoshiharu Kohno, Nobuhisa Akamatsu, Junichi Kaneko, Yasuhiko Sugawara, Kiyoshi Hasegawa, Masatoshi Makuuchi, Norihiro Kokudo
OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of hepatopancreaticoduodenectomy (HPD) for patients with biliary cancer. BACKGROUND: HPD is thought to be the only curative treatment for widespread bile duct cancer and for some advanced cases of gallbladder cancer; however, HPD has not yet been accepted as a standard operative procedure because of concerns over morbidity and mortality. METHODS: Fifty-two patients undergoing HPD were retrospectively reviewed...
November 1, 2016: Annals of Surgery
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