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Two stage hepatectomy

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https://www.readbyqxmd.com/read/28058712/two-stage-hepatectomy-in-two-regional-district-community-hospitals-perioperative-safety-and-long-term-survival
#1
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...
December 26, 2016: 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
#2
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
#3
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
#4
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
#5
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...
December 27, 2016: Surgery
https://www.readbyqxmd.com/read/28032566/rabbit-model-provides-new-insights-in-liver-regeneration-after-transection-with-portal-vein-ligation
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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 been reported in individual reports, but has been the authors' default option since 2015. 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...
November 2, 2016: 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
#12
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
https://www.readbyqxmd.com/read/27789131/apocynin-and-enzymatically-modified-isoquercitrin-suppress-the-expression-of-a-nadph-oxidase-subunit-p22phox-in-steatosis-related-preneoplastic-liver-foci-of-rats
#13
Toshinori Yoshida, Hirotada Murayama, Masahi Kawashima, Rei Nagahara, Yumi Kangawa, Sayaka Mizukami, Masayoshi Kimura, Hajime Abe, Shim-Mo Hayashi, Makoto Shibutani
We determined effects of the NADPH oxidase (NOX) inhibitor apocynin (APO) or the antioxidant enzymatically modified isoquercitrin (EMIQ) on an early stage of hepatocarcinogenesis in the liver with steatosis. Male rats were given a single intraperitoneal injection of N-diethylnitrosamine (DEN) and fed a high-fat diet (HFD) to subject to a two-stage hepatocarcinogenesis model. Two weeks later, rats were fed a HFD containing the lipogenic substance malachite green (MG), which were co-administered with EMIQ or APO in drinking water for 6 weeks...
January 2017: Experimental and Toxicologic Pathology: Official Journal of the Gesellschaft Für Toxikologische Pathologie
https://www.readbyqxmd.com/read/27771454/hedgehog-pathway-mediates-early-acceleration-of-liver-regeneration-induced-by-a-novel-two-staged-hepatectomy-in-mice
#14
Magda Langiewicz, Andrea Schlegel, Enrica Saponara, Michael Linecker, Pieter Borger, Rolf Graf, Bostjan Humar, Pierre A Clavien
BACKGROUND & AIMS: ALPPS, a novel two-staged approach for the surgical removal of large/multiple liver tumors, combines portal vein ligation (PVL) with parenchymal transection. This causes acceleration of compensatory liver growth, enabling faster and more extensive tumor removal. We sought to identify the plasma factors thought to mediate the regenerative acceleration following ALPPS. METHODS: We compared a mouse model of ALPPS against PVL and additional control surgeries (n=6 per group)...
October 19, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27734177/total-laparoscopic-reversal-alpps
#15
M A Machado, R Surjan, T Basseres, F Makdissi
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows R0 resection even for patients with extremely small future liver remnants. The ALPPS procedure was initially described for two-stage right trisectionectomy. Reversal ALPPS is a denomination in which the future liver remnant is the right posterior section of the liver. PATIENT: A 42-year-old woman with colorectal metastases in all segments except segment 1 underwent chemotherapy with objective response and was referred for surgical treatment...
October 12, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27667105/-application-of-laparoscopic-transection-of-median-hepatic-fissure-in-difficult-laparoscopic-liver-resections
#16
L X Cai, S L He, F Q Wei, Y C Yu, X J Cai
Objective: The aim was to explore the strategy and clinical value of laparoscopic transection of median hepatic fissure (MHF) in difficult laparoscopic liver resections. Methods: First the MHF was located and marked, then the transection plane of the MHF was set. Next, the laparoscopic Multifuctional Operative Dissector (LPMOD) and the technique of curettage and aspiration were utilized to transect the liver beginning from the middle portion of the gallbladder fossa, in a caudal-to-cranial and anterior-to-posterior direction, until the clear exposure of the anterior surface of the intrahepatic inferior vena cava...
September 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27633328/meta-analysis-of-associating-liver-partition-with-portal-vein-ligation-and-portal-vein-occlusion-for-two-stage-hepatectomy
#17
REVIEW
D Eshmuminov, D A Raptis, M Linecker, A Wirsching, M Lesurtel, P-A Clavien
BACKGROUND: Discussion is ongoing regarding whether associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) or portal vein occlusion is better in staged hepatectomy. The aim of this study was to compare available strategies using a two-stage approach in extended hepatectomy. METHODS: A literature search was performed in MEDLINE, Scopus, the Cochrane Library and Embase, and additional articles were identified by hand searching. Data from the international ALPPS registry were extracted...
December 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27630320/parenchymal-congestion-is-important-for-rapid-regeneration-of-the-future-liver-remnant-following-the-alpps-procedure
#18
Daisuke Kawaguchi, Yukihiko Hiroshima, Kenichi Matsuo, Itaru Endo, Keiji Koda, Kuniya Tanaka
AIM: To evaluate whether the congested area that develops in associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) contributes to rapid future liver remnant (FLR) hypertrophy. PATIENTS AND METHODS: Eight patients undergoing liver partition and right portal vein (RPV) ligation within the FLR in the first operation of ALPPS were compared with eight patients undergoing RPV embolization in the FLR as the first operation of classical two-stage (CTS) hepatectomy...
2016: Anticancer Research
https://www.readbyqxmd.com/read/27587212/-the-application-value-of-two-dimensional-image-technology-and-three-dimensional-visualization-technology-in-hepatocellular-carcinoma-treated-by-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-a-preliminary-study
#19
Z G Hu, P B Huang, Z Y Zhou, C C He, H Y Zhang, W B Li, Z Y Xiao, J L Zhang, Y Y Xu, K Xu, C H Fang, J Wang
OBJECTIVE: To preliminarily explore the application value of two-dimensional image technology and three-dimensional visualization technology in hepatocellular carcinoma(HCC) treated by associating liver partition and portal vein ligation for staged hepatectomy(ALPPS). METHODS: Clinical data of nineteen HCC patients treated by ALPPS were retrospectively analyzed in Sun-Yat-Sen Memorial Hospital of Sun Yat-Sen University from August 2013 to May 2015.Preoperative assessment, surgical planning and intraoperative guidance were assisted by traditional two-dimensional imaging technology(group 2D) in 15 cases, and the rest 4 cases were assisted by three-dimensional visualization technology(group 3D)...
September 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27587210/-application-of-liver-visualization-technologies-in-hilar-tumor-resection-at-the-second-hepatic-portal-area
#20
P P Li, H Liu, S Y Fu, C Lin, Z Y Pan, J Zhang, J S Ni, S X Yuan, W P Zhou
OBJECTIVE: To discuss the application of liver visualization technology in complex liver tumor resection at the second hepatic portal area. METHODS: Clinical data of 80 cases who received surgery at the second hepatic portal area from August 2014 to September 2015 in the Third Department of Hepatic Surgery of Eastern Hepatobiliary Surgery Hospital were analyzed retrospectively. There were 58 male and 22 female patients aged from 21 to 70 years with median age of 52 years...
September 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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