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Liver surgery

Jennifer Luk, Yong Lu, Amanda Ackermann, Xiaoxue Peng, Diane Bogdan, Michelino Puopolo, David E Komatsu, Simon Tong, Iwao Ojima, Mario J Rebecchi, Martin Kaczocha
Background: Metabolism of the endocannabinoid 2-arachidonoylglycerol (2-AG) yields arachidonic acid (AA), the precursor to proalgesic eicosanoids including prostaglandin E2 (PGE2 ). Diacylglycerol lipase β (DAGLβ) is an enzyme that synthesizes 2-AG and its inhibition reduces eicosanoid levels and produces antinociceptive effects in models of inflammatory pain. Here we test whether inhibition of DAGLβ produces antinociceptive effects in a model of postoperative pain. Methods: Rats were administered the selective DAGLβ inhibitor KT109 or vehicle and underwent plantar incision...
2018: Journal of Pain Research
Micha Pfeiffer, Hannes Kenngott, Anas Preukschas, Matthias Huber, Lisa Bettscheider, Beat Müller-Stich, Stefanie Speidel
PURPOSE: The data which is available to surgeons before, during and after surgery is steadily increasing in quantity as well as diversity. When planning a patient's treatment, this large amount of information can be difficult to interpret. To aid in processing the information, new methods need to be found to present multimodal patient data, ideally combining textual, imagery, temporal and 3D data in a holistic and context-aware system. METHODS: We present an open-source framework which allows handling of patient data in a virtual reality (VR) environment...
March 17, 2018: International Journal of Computer Assisted Radiology and Surgery
Yoshihiro Inoue, Kensuke Fujii, Keitaro Tashiro, Masatsugu Ishii, Shinsuke Masubuchi, Masashi Yamamoto, Tetsunosuke Shimizu, Mitsuhiro Asakuma, Fumitoshi Hirokawa, Michihiro Hayashi, Yoshihumi Narumi, Kazuhisa Uchiyama
BACKGROUND: Various chemotherapy regimens have been shown to improve outcomes when administered before tumor excision surgery. However, there is no consensus on the utility of multidisciplinary treatment with preoperative chemotherapy for treating colorectal liver metastasis (CLM). MATERIALS AND METHODS: Two hundred-fifty patients who underwent hepatectomy were retrospectively analyzed using propensity score matching. Postoperative outcomes were evaluated with a focus on the effect of pre-hepatectomy chemotherapy on regeneration of the remnant liver in patients with CLM...
March 16, 2018: World Journal of Surgery
Eva Roos, Lowiek M Hubers, Robert J S Coelen, Marieke E Doorenspleet, Niek de Vries, Joanne Verheij, Ulrich Beuers, Thomas M van Gulik
BACKGROUND: Distinguishing perihilar cholangiocarcinoma (PHC) from benign forms of sclerosing cholangitis affecting the hilar bile ducts is challenging, since histological confirmation of PHC is difficult to obtain and accurate non-invasive diagnostic tests are not available. IgG4-associated cholangitis (IAC), an imitator of PHC, may present with clinical and radiographical signs of PHC. IAC can be accurately diagnosed with a novel qPCR test. The aim of this study was to investigate the incidence and long-term activity of IAC in patients resected for PHC in a single tertiary center over a period of 30 years...
March 16, 2018: American Journal of Gastroenterology
Antonio De Leo, Margherita Nannini, Giulia Dondi, Donatella Santini, Milena Urbini, Elisa Gruppioni, Pierandrea De Iaco, Anna Myriam Perrone, Maria Abbondanza Pantaleo
BACKGROUND: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract and liver and peritoneum are the main sites of recurrence. Ovarian metastases from GIST are very rare. CASE PRESENTATION: A 50 years-old woman was found to have a pelvic mass on transvaginal ultrasound (TV-US) and computed tomography (CT)-scan, considered as a right ovarian mass. The patient underwent surgical abdominal exploration that showed an ileal mass, a normal right ovary and an irregular and vascularized surface of the left ovary...
March 16, 2018: BMC Cancer
Amelia Swanson, Jessica Geller, Kelly DeMartini, Anne Fernandez, Dwain Fehon
Without a transplant, end-stage liver disease is associated with significant morbidity and mortality. Transplant candidates endure physical and psychological stress while awaiting surgery, yet little is known about the relationship between physical health and psychological resilience during the wait-list period. This study examined predictors of psychological resilience and mediators of the relationship between physical health and psychological resilience in liver transplant candidates. Wait-listed candidates (N = 120) from a single Northeast transplant center completed assessments of physical functioning, coping, perceived social support, and resilience...
March 15, 2018: Journal of Clinical Psychology in Medical Settings
Ryota Matsuki, Masanori Sugiyama, Shinya Yoshiike, Junji Shibahara, Masaharu Kogure, Masaaki Yokoyama, Yutaka Suzuki, Nobutsugu Abe, Tadahiko Masaki, Toshiyuki Mori
A 72-year-old woman with advanced ascending colon cancer and an intraductal papillary mucinous neoplasm (IPMN) of the pancreatic head was treated by right hemicolectomy (RHC) and pylorus-preserving pancreaticoduodenectomy (PpPD). Adjuvant chemotherapy was not administered. Multimodal examinations at 5 months after surgery detected a solitary metastatic liver tumor derived from cancer of the ascending colon. Liver resection proceeded at 7 months after the first surgery. A pathological study of a surgical specimen of the liver identified a necrotic nodule that did not contain viable tumor cells...
March 15, 2018: Clinical Journal of Gastroenterology
Mohamed A Mohamed, Rohit Abraham, Tareq I Maraqa, Samir Elian
Aortic dissection is a rare and fatal complication of cocaine-induced hypertension. The injury mechanism is through shear stress that penetrates the intimal vessel layer, allowing blood flow to separate intimal and medial layers. Due to its scarcity and the paucity of related literature, our knowledge of this condition is limited. We present a rare case of a cocaine-induced aortic dissection, which extended continuously from the aortic root to the common iliacs, along with a literature review of similar cases...
January 12, 2018: Curēus
Yuehong Li, Binbin Li, Wei Wang, Jiaxuan Lv
The aim of the present study was to analyze the risk factors for new-onset chronic kidney disease (CKD) in patients who have received a liver transplant. A total of 190 patients who underwent liver transplantation between March 2001 and January 2015 were followed up, and analyzed retrospectively. Sex, age, primary disease, preoperative laboratory findings (hemoglobin, albumin, creatinine and glomerular filtration rate), surgical approach, blood loss during the surgery and transfusion volume, postoperative complications, and the average levels of calcineurin inhibitors (CNIs) (from liver transplantation to the onset of CKD) were analyzed...
April 2018: Experimental and Therapeutic Medicine
Zhen Bao, Weijun Chen, Fan Pan, Bo Peng, Jin Gong
The purpose of the present study was to investigate the effect of breviscapine injection on hepatic ischemia/reperfusion (I/R) injury in rats. To explore the relevance and discuss the underlying mechanism of mitofusin 2 (Mfn2) in hepatic I/R injury, 40 Sprague-Dawley male rats were randomly and equally divided into five groups (n=8 per group) as follows: Sham, I/R + normal saline 1 (NS1), I/R + breviscapine 1 (Bre1), I/R + NS2 and I/R + Bre2 groups. Groups 1 and 2 represented ischemia for 20 and 60 min, respectively...
April 2018: Experimental and Therapeutic Medicine
Karol Polom, Christine Böger, Elizabeth Smyth, Daniele Marrelli, Hans-Michael Behrens, Luigi Marano, Thomas Becker, Florian Lordick, Christoph Röcken, Franco Roviello
BACKGROUND: Current guidelines recommend that metastatic gastric cancer should not be treated with surgery unless this is required for symptom control. We hypothesized that patients with mismatch repair deficiency (MMRd) gastric cancer and metastatic disease detected at the timepoint of surgical resection would have superior survival compared to patients with MMRd cancers in the same setting. METHODS: Clinicopathological details and survival data were collected from prospective databases at two large European centers on patients who had undergone surgery and were diagnosed with synchronous stage IV gastric cancer (distant lymph nodes, positive peritoneal cytology, peritoneal, and distant metastases) at the timepoint of surgery...
March 2, 2018: European Journal of Surgical Oncology
Xiaopeng Yang, Jae Do Yang, Hee Chul Yu, Younggeun Choi, Kwangho Yang, Tae Beom Lee, Hong Pil Hwang, Sungwoo Ahn, Heecheon You
BACKGROUND AND OBJECTIVE: Manual tracing of the right and left liver lobes from computed tomography (CT) images for graft volumetry in preoperative surgery planning of living donor liver transplantation (LDLT) is common at most medical centers. This study aims to develop an automatic system with advanced image processing algorithms and user-friendly interfaces for liver graft volumetry and evaluate its accuracy and efficiency in comparison with a manual tracing method. METHODS: The proposed system provides a sequential procedure consisting of (1) liver segmentation, (2) blood vessel segmentation, and (3) virtual liver resection for liver graft volumetry...
May 2018: Computer Methods and Programs in Biomedicine
Yuichi Goto, Yoshihiro Uchino, Shin Sasaki, Nobuhisa Shirahama, Yoriko Nomura, Jun Akiba, Hiroto Ishikawa, Yoshito Akagi, Hiroyuki Tanaka, Koji Okuda
INTRODUCTION: We report a rare case of complete spontaneous necrosis of a hepatocellular carcinoma (HCC) accompanied by portal vein tumor thrombosis (PVTT), as confirmed by resection. CASE PRESENTATION: A 64-year-old man was referred to our hospital for suspected HCC. Contrast-enhanced computed tomography (CECT) findings before admission revealed a 53-mm tumor in the posterior segment of the liver and were suspicious for PVTT in the right posterior PV. Both alpha-fetoprotein (AFP) and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) were elevated at 17,562 ng/mL and 153 mAU/mL, respectively...
March 7, 2018: International Journal of Surgery Case Reports
Myung Han Hyun, Young-Sun Lee, Ji Hoon Kim, Chan Uk Lee, Young Kul Jung, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun
According to the American Association for the Study of Liver Disease treatment guidelines for hepatocellular carcinoma (HCC), the role of surgery has been expanded beyond the Barcelona Clinic Liver Cancer (BCLC) algorithm. We compared primary hepatectomy (PH) with transarterial chemoembolization (TACE) in patients with intermediate to advanced (BCLC stage-B/C) stage HCC to determine the current evidence. Through database search, we included 18 high-quality studies (1 randomized controlled trial [RCT], 5 propensity-score matching non-randomized comparative trials [NRCT], and 12 NRCTs) that compared survival outcomes of 5,986 patients after PH and TACE...
March 15, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
N Pinsker, M Papoulas, M Sodergren, P Harrison, N Heaton, K Menon
Introduction A bronchobiliary fistula (BBF) following liver directed therapy (resection/ablation) is a rare complication in which an abnormal communication between the biliary tract and bronchial tree is formed. This case report describes the successful management of a persistent BBF following multiple liver wedge resections and microwave ablation in a patient with a metastatic neuroendocrine tumour of the terminal ileum. Case history A 69-year-old man presented with unexplained weight loss and was subsequently diagnosed with a neuroendocrine tumour of the terminal ileum and liver metastasis...
March 15, 2018: Annals of the Royal College of Surgeons of England
Didem Onk, Fatih Özçelik, Oruç Alper Onk, Murat Günay, Tülin Akarsu Ayazoğlu, Ethem Ünver
BACKGROUND The present study sought to assess the renal and liver protective effect of N-acetylcysteine through NH3 and urea metabolism in patients with chronic obstructive pulmonary disease who were scheduled for coronary artery bypass grafting surgery. MATERIAL AND METHODS Patients with chronic obstructive pulmonary disease (COPD) who were scheduled for coronary artery bypass grafting were divided into 2 groups so as to receive (Group 1, n=35) or not receive (Group 2, n=35) 900 mg/day of n-acetylcysteine for 7 days before the operation starting from their admission to the service by a pulmonologist with the purpose of treating COPD until the day of surgery...
March 15, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Marco Vito Marino, Galyna Shabat, Domenico Guarrasi, Gaspare Gulotta, Andrzej Lech Komorowski
BACKGROUND: Despite potential benefits of robotic liver surgery, it is still considered a "development in progress" technique. METHODS: The outcomes of 14 patients undergoing robotic right hepatectomy were analyzed and compared with the results of 20 laparoscopic right hepatectomies consecutively performed by the same young surgeon. RESULTS: The overall mean operative time was less in robotic arm (425 ± 139 vs. 565.18 ± 183.73, p = 0...
March 14, 2018: Digestive Surgery
Rong-Xing Zhou, Hai-Jie Hu, Wen-Jie Ma, Yong Jiang, Fu-Yu Li
RATIONALE: Pancreatic alveolar echinococcosis (AE) is an exceptionally rare disease; no more than 10 cases have been published to date. It is characterized as extensive local tissue infringement and destruction; thus, extended surgical resection, such as duodenopancreatectomy, is often needed to obtain a negative resection margin so as to improve the long-term outcome and prognosis. PATIENT CONCERNS: A middle-aged Tibetan man was admitted due to a 16-year history of recurrent pain in the right upper abdomen...
March 2018: Medicine (Baltimore)
P Cordero, J Li, J A Oben
Obesity is the pandemic of the 21st century. Obesity comorbidities, including hypertension, dyslipidaemia and glucose intolerance define metabolic syndrome, which increases mortality risk and decreases the quality of life. Compared with lifestyles (diet and physical activity) and pharmacological interventions, bariatric surgery is by far the most effective treatment for obesity and its comorbidities. This minimally invasive surgical treatment is based on an increase of satiety (by hormonal regulation and decreasing stomach volume) or a decrease in nutrient retention (gastric and/or intestinal resection)...
December 2017: Journal of the Royal College of Physicians of Edinburgh
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
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