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Progress in hepatobiliary surgery and transplantation

Yoshito Tomimaru, Shogo Kobayashi, Hiroshi Wada, Naoki Hama, Koichi Kawamoto, Hidetoshi Eguchi, Toshihiko Kira, Eiichi Morii, Yuichiro Doki, Masaki Mori, Hiroaki Nagano
A 40-year-old Japanese man visited our hospital after test results indicated elevated hepatobiliary enzymes. He had worked at a printing plant for 8 years and been exposed to organic solvents, including 1,2-dichloropropane (1,2-DCP) and dichloromethane (DCM). Abdominal computed tomography (CT) showed an intrahepatic tumor with dilation of the intrahepatic bile duct. He was diagnosed with intrahepatic cholangiocarcinoma. He had no known risk factors for cholangiocarcinoma. Extended left hepatectomy with lymph node dissection was performed and the tumor was histologically diagnosed as well-differentiated adenocarcinoma...
April 2015: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Meir Mizrahi, Gadi Lalazar, Yuval Horwich, Tomer Adar, Rifaat Safadi
Direct hyperbilirubinemia, may result from a variety of pathologies, including structural obstructions with biliary tract occlusions (as in cholelithiasis), infections (e.g. hepatitis) and genetic disorders (Rotor's and Dubin-Johnson's syndrome). One of the less common and probably more frequently underdiagnosed causes is benign recurrent intrahepatic cholestasis (BRIC). First described in 1959, BRIC was further classified into two subgroups which differ in their pathogenesis and clinical manifestation. Both BRIC types originate from impaired function bile salt excretion from hepatocytes to the canaliculi which is mediated by the bile salt export pump (BSEP) which is located on the hepatyocyte membrane, unevenly distributed within the membrane lipid bilayer...
May 2008: Harefuah
Woubet Tefera Kassahun, Thomas Kahn, Christian Wittekind, Joachim Mössner, Karel Caca, Johann Hauss, Peter Lamesch
BACKGROUND: The aim of this study was to review and discuss our observations on 33 patients who underwent surgical treatment for Caroli's disease (CD), focusing on diagnosis, current surgical management, and long-term outcome. METHODS: Between May 1993 and June 2004, 642 liver resections and 286 liver transplantations in 252 patients were performed in our department of surgery. Thirty-three patients were referred to our center for diagnostic and therapeutic management of CD...
November 2005: Surgery
L Chiche
More than half a century ago, Ton That Tung, then Lortat-Jacob performed the first anatomic hepatectomies, marking the onset of the conquest of liver surgery. Shortly thereafter, a few pioneers took the leap, making the first attempts at total hepatectomy and liver transplantation. Within years, considerable progress was made in hepatobiliary surgery which rapidly became a full-fledged surgery specialty. Techniques were equally improved with new advances in imaging and technology. The last 15 years have been so rich at in the strict sense of the word, little is new in liver surgery in 2000...
October 2000: Journal de Chirurgie
H Bismuth, P E Majno
The transformation of liver and biliary tract surgery into a full speciality began with the application of functional anatomy to segmental surgery in the 1950's, reinforced by ultrasound and new imaging techniques. The spectrum of gall-stone disease encountered by the hepatobiliary surgeon has changed with the laparoscopic approach to cholecystectomy. There is increased need for conservation techniques to repair the bile duct injuries that arise more often in the laparoscopic approach to cholecystectomy. These and other surgical interventions on the bile ducts should be selected as a function of risk versus benefit in relation to the patient's requirements and the institutional expertise...
2000: Journal of Hepatology
N F Larusso
Primary sclerosing cholangitis is a generally progressive, sometimes fatal, chronic hepatobiliary disorder for which no effective medical or surgical therapy now exists. The syndrome occurs most frequently in young men and is characterized by chronic cholestasis, frequent association with CUC, a paucity of serologic markers, hepatic copper overload, and characteristic abnormalities in some liver biopsy specimens and in virtually all cholangiograms. The natural history of the syndrome is still somewhat unclear; the disease likely progresses slowly and relentlessly over a decade or longer from an asymptomatic stage to a condition characterized by symptoms of cholestasis and complicated by cirrhosis and portal hypertension and carcinoma of the bile ducts...
March 1999: Puerto Rico Health Sciences Journal
Y Nimura, J Kamiya, M Nagino, M Kanai, K Uesaka, S Kondo, N Hayakawa
Recent progress in surgical techniques for and the perioperative management of hilar cholangiocarcinoma has led to improved outcomes for aggressive liver and bile duct resections, which, however, still show considerable morbidity and mortality. In this article, the results of pioneers' attempts in hepatobiliary surgery for difficult hilar cholangiocarcinomas are reviewed. It is recommended that curative hepatobiliary resection should be performed for hilar cholangiocarcinoma, with careful preoperative management of patients complicated with several difficult conditions...
1998: Journal of Hepato-biliary-pancreatic Surgery
B Ringe, H Lang, G Tusch, R Pichlmayr
The management of esophageal variceal hemorrhage ranges from conservative to surgical modalities. Before introduction of liver transplantation as a potentially curative therapy of the underlying etiology, decompressive portosystemic shunt operations have been the mainstay of mostly palliative procedures. Our own experience with surgery for advanced hepatic disease and portal hypertension over 20 years includes 803 liver transplantations and 201 portosystemic shunts, emphasizing our primary objective of treatment...
March 1994: World Journal of Surgery
V J Desmet
This paper reviews cholestatic liver diseases which are characterized by disappearance of the intrahepatic bile ducts ("vanishing bile duct" diseases). In neonates and children, the most important entities are extrahepatic bile duct atresia and paucity of intrahepatic bile ducts, including syndromatic and nonsyndromatic varieties. Immunological mechanisms play a role in the bile duct obstruction observed in primary biliary cirrhosis, graft-versus-host disease and chronic liver transplant rejection, and possibly also in primary sclerosing cholangitis and sarcoidosis with chronic intrahepatic cholestasis...
June 1990: Recenti Progressi in Medicina
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