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liver resection and postoperative complication

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https://www.readbyqxmd.com/read/28058552/complications-after-hepatectomy-for-hepatocellular-carcinoma-independently-shorten-survival-a-western-single-center-audit
#1
Alexandre Doussot, Chetana Lim, Eylon Lahat, Chady Salloum, Michael Osseis, Concepción Gómez Gavara, Eric Levesque, Cyrille Feray, Philippe Compagnon, Daniel Azoulay
BACKGROUND: The impact of postoperative complications (POCs) on long-term outcomes following hepatocellular carcinoma (HCC) resection remains to be ascertained. METHODS: All consecutive HCC resected at a single center were analyzed. Patients with POCs, classified according to Clavien classification, were compared to those without in terms of demographics, pathology, management, overall survival (OS), and disease-free survival (DFS). Independent prognostic factors of POCs were identified using multivariable regression models...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28052154/association-of-remnant-liver-ischemia-with-early-recurrence-and-poor-survival-after-liver-resection-in-patients-with-hepatocellular-carcinoma
#2
Jai Young Cho, Ho-Seong Han, YoungRok Choi, Yoo-Seok Yoon, Sungho Kim, Jang Kyu Choi, Jae Seong Jang, Seong Uk Kwon, Haeryoung Kim
Importance: The remnant liver after hepatectomy may have inadequate blood supply, especially following nonanatomical resection or vascular damage. Objective: To evaluate whether remnant liver ischemia (RLI) may have an adverse effect on long-term survival and morbidity after liver resection in patients with hepatocellular carcinoma. Design, Setting, and Participants: This study was a retrospective analysis at Seoul National University Bundang Hospital...
January 4, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28051804/%C3%A2-complications-of-liver-resection-in-geriatric-patients
#3
Ivana Dedinská, Ludovít Laca, Juraj Miklusica, Blazej Palkoci, Petra Skálová, Slavomíra Lauková, Denisa Osinová, Simona Strmenová, Ján Janík, Marián Mokán
:  Introduction and aims. Liver resection is the treatment of choice for many primary and secondary liver diseases. Most studies in the elderly have reported resection of primary and secondary liver tumors, especially hepatocellular carcinoma and colorectal metastatic cancer. However, over the last two decades, hepatectomy has become safe and is now performed in the older population, implying a paradigm shift in the approach to these patients. MATERIAL AND METHODS: We retrospectively evaluated the risk factors for postoperative complications in patients over 65 years of age in comparison with those under 65 years of age after liver resection (n = 360)...
January 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28045238/secure-low-cost-technique-for-laparoscopic-hepatic-resection-using-the-crush-clamp-method-with-a-bipolar-sealer
#4
Takatsugu Yamamoto, Takahiro Uenishi, Kazuhisa Kaneda, Masato Okawa, Shogo Tanaka, Shoji Kubo
INTRODUCTION: Laparoscopic hepatectomy is difficult because surgeons must perform the transection using many (four and more) energy devices and without direct manual maneuvers. Here we introduce hepatic transection by the classical method with a few (two or three) energy devices. MATERIALS AND SURGICAL TECHNIQUE: We performed laparoscopic hepatectomy for 40 patients with hepatic tumor and liver dysfunction. For parenchymal transection, we used bipolar radiofrequency coagulation forceps connected to a voltage-controlled electrosurgical generator and ultrasonic dissector...
February 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28039607/hepatobilio-pancreatic-robotic-surgery-initial-experience-from-a-single-center-institute
#5
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/28011503/surgical-resection-of-giant-pheochromocytomas-arising-behind-the-retrohepatic-inferior-vena-cava
#6
Yuji Soejima, Tomoharu Yoshizumi, Toru Ikegami, Norifumi Harimoto, Shinji Ito, Noboru Harada, Takashi Motomura, Akihisa Nagatsu, Tetsuo Ikeda, Yoshihiko Maehara
BACKGROUND: Surgical resection of retrocaval giant pheochromocytomas (PCs) and of extra-adrenal paragangliomas (EAPs) is a technically challenging procedure but data on these procedures are scarce. The purpose of this study was to present and evaluate our surgical results for such tumors. PATIENTS AND METHODS: We retrospectively analyzed four consecutive patients who had surgery for giant retro-caval PCs and EAPs in terms of surgical technique, resectability of the tumor, requirement for bypass, and postoperative complications...
January 2017: Anticancer Research
https://www.readbyqxmd.com/read/27993362/factors-associated-with-decisional-regret-among-patients-undergoing-major-thoracic-and-abdominal-operations
#7
Ana Wilson, Megan Winner, Alexander Yahanda, Nikolaos Andreatos, Sean Ronnekleiv-Kelly, Timothy M Pawlik
BACKGROUND: No study has specifically investigated patient attitudes on decisional regret concerning major operative procedures. The objective of the present study was to define the prevalence of regret among patients who had undergone a major abdominal or thoracic operative procedure and to identify factors associated with postoperative regret. METHODS: Decisional regret was assessed using the validated Decision Regret Scale, which consisted of 5 items with Likert-scale responses...
December 16, 2016: Surgery
https://www.readbyqxmd.com/read/27958619/evaluation-of-urgent-multivisceral-resections-due-to-complications-resulting-from-an-advanced-ovarian-cancer
#8
Tomasz Miłek, Witold Woźniak, Piotr Porzycki, Alkalayla Habib, Agnieszka Timorek, Piotr Ciostek, Włodzimierz Sawicki, Krzysztof Cendrowski
BACKGROUND: Unlike other solid tumors (i.e. pancreas, gallbladder, stomach), an ovarian cancer is responsive to a systemic treatment with platinum derivates in 80% of patients. This apparent chemosensitivity justifies a broader surgical approach. A cytoreductive, "tumor-debulking" surgery is defined as an attempt to remove in a maximum degree all visible and detect-able lesions. Despite treatment, the advancement of the disease very often leads to complications defined as "surgical" and life-threatening...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27941333/randomized-controlled-trial-of-hepatic-portal-reocclusion-as-a-new-option-for-detecting-bile-leakage-during-hepatic-resection
#9
Jun-Yong Ma, Xi-Feng Li, Zhen-Lin Yan, Mohammad Mahboob Hasan, Kui Wang, Yu Wang, Wen-Chao Wang, Qiang Yan, Feng Shen, Le-Hua Shi, Xiao-Feng Zhang
BACKGROUND/AIMS: To explore the possibility and feasibility of hepatic portal reocclusion for detecting bile leakage during hepatectomy. METHODS: Data were prospectively collected from 200 patients who underwent hepatectomy alone for removal of various benign or malignant tumors between March 2014 and November 2014. The surgical procedure used a conventional method for all patients, and one additional step (hepatic portal reocclusion) was included in group B. The postoperative outcomes of the patients in group A (subjected to the traditional procedure) and group B (subjected to hepatic portal reocclusion) were compared during the same period, and the incidence rates of postoperative bile leakage and other complications in the 2 groups were also analyzed...
December 10, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27931579/harm-and-benefits-of-salvage-transplantation-for-hepatocellular-carcinoma-an-updated-meta-analysis
#10
Q Xiong, T-T Geng, L He, H Gao
OBJECTIVE: The aim of this work was to compare salvage liver transplantation (SLT) and primary liver transplantation (PLT) in terms of the harm and benefits. METHODS: The authors searched Pubmed, Embase, and the Cochrane Library from their dates of establishment to December 2015. Based on selection and exclusion criteria, 2 researchers screened the literature independently. The meta-analysis was performed with the use of the Review Manager software. Meta-analysis of the pooled standard mean difference (SMD) and odds ratio (OR) with 95% confidence interval (CI) were calculated based on either a fixed-effects or a random-effects model...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27930526/models-predicting-the-risks-of-six-life-threatening-morbidities-and-bile-leakage-in-14-970-hepatectomy-patients-registered-in-the-national-clinical-database-of-japan
#11
Hideki Yokoo, Hiroaki Miyata, Hiroyuki Konno, Akinobu Taketomi, Tatsuhiko Kakisaka, Norimichi Hirahara, Go Wakabayashi, Mitsukazu Gotoh, Masaki Mori
To construct a robust morbidity risk-prediction model based on a Japanese nationwide web-based database of patients who underwent liver surgery.Although liver resection has become safer, patient mortality and morbidity still occur. This study investigated postoperative morbidity risks in patients who underwent hepatectomy in Japan at institutions registered in the National Clinical Database.This analysis involved 14,970 patients who underwent hepatectomy of more than 1 section, except for left lateral sectionectomy, during 2011 and 2012 at 1192 hospitals in Japan...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27928780/elective-laparoscopic-deroofing-to-treat-the-spontaneous-rupture-of-a-large-simple-liver-cyst-a-case-report
#12
Yuki Imaoka, Masahiro Ohira, Tsuyoshi Kobayashi, Seiichi Shimizu, Hiroyuki Tahara, Shintaro Kuroda, Kentaro Ide, Kohei Ishiyama, Hideki Ohdan
BACKGROUND: The spontaneous rupture of nonparasitic liver cysts (NLC) is sometimes seen in clinical practice. However, there are no guidelines that describe the optimal treatment strategy and the surgical indications for an NLC rupture due to a small number of reports. Here, we present a case who underwent elective laparoscopic deroofing to treat a spontaneously ruptured NLC that had undergone conservative treatment. CASE PRESENTATION: A 67-year-old woman was referred to our hospital for the evaluation of acute abdominal pain after the conservative treatment of an NLC at another hospital...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27928672/pure-laparoscopic-right-anterior-sectionectomy-for-hepatocellular-carcinoma-with-great-vascular-exposure
#13
Varvara A Kirchner, Ki-Hun Kim, Seok-Hwan Kim, Sang-Kyung Lee
BACKGROUND: Laparoscopic hepatectomy is a common procedure that has been reported frequently [1-3]. However, laparoscopic resection of tumors located in hepatic segments 5 and/or 8 remains a technically difficult procedure as it requires two transection planes [4]. Furthermore, there are a greater number of hepatic vein and glissonian pedicle branches that require a division as compared to other hepatectomy operations. In this report, we present a pure laparoscopic right anterior sectionectomy (RAS) for hepatocellular carcinoma (HCC)...
December 7, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27921278/bronchobiliary-fistula-caused-after-hepatectomy-for-hepatocellular-carcinoma-a-case-report
#14
Seikan Hai, Yuji Iimuro, Tadamichi Hirano, Kazuhiro Suzumura, Akito Yada, Jiro Fujimoto
BACKGROUND: A bronchobiliary fistula, an intercommunication between the biliary tract and bronchial trees, is an extremely rare complication after hepatectomy. CASE PRESENTATION: A 70-year-old male underwent partial resection of the liver for recurrent hepatocellular carcinoma under a thoracoabdominal approach. The immediate postoperative clinical course was uneventful, but the patient was febrile and laboratory examinations revealed leukocytosis on the 15th postoperative day...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27920414/morbidity-and-mortality-and-predictors-of-outcome-following-hepatectomy-at-a-saudi-tertiary-care-center
#15
Faisal Al-Alem, Rafif Essam Mattar, Ola Abdelmonem Fadl, Abdulsalam Alsharabi, Faisal Al-Saif, Mazen Hassanain
BACKGROUND: Hepatic resection is a major surgical procedure. Data on outcomes of hepatectomy in Saudi Arabia are scarce. OBJECTIVE: To measure morbidity and mortality and assess predictors of outcome after hepatectomy. DESIGN: Descriptive study. SETTING: Tertiary care center in Saudi Arabia with well established hepatobiliary surgery unit. PATIENTS AND METHODS: All patients undergoing liver resection in our institute during 2006-2014...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27914024/laparoscopic-hepatectomy-for-hcc-in-elderly-patients-risks-and-feasibility
#16
Bruno Amato, Giovanni Aprea, Davide De Rosa, Marco Milone, Lorenza di Domenico, Maurizio Amato, Rita Compagna, Mario Santoro, Louis Banka Johnson, Alessandro Sanguinetti, Andrea Polistena, Nicola Avenia
BACKGROUND: Laparoscopic liver resection (LLR) appears to be safe and effective as open liver resection (OLR) for hepatocellular carcinoma (HCC). However, studies comparing LLR with ORL in elderly patients are limited. The purpose of this study is to compare the clinical outcomes of LLR versus OLR for HCC in elderly patients. METHODS: A retrospective analysis was made comparing laparoscopic (n = 11) and open (n = 18) liver resections in elderly patients performed at the University of Naples "Federico II" between January 2010 and December 2014...
December 2, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27902606/preoperative-aspartate-aminotransferase-to-platelet-ratio-index-apri-is-a-predictor-on-postoperative-outcomes-of-hepatocellular-carcinoma
#17
JiWen Cheng, Pu Zhao, JiangBo Liu, Xi Liu, XuanLin Wu
Preoperative aspartate aminotransferase-to-platelet ratio index (APRI) has been identified as a biochemical marker for histological fibrogenesis and fibrosis in cirrhosis and prognosis of hepatocellular carcinoma (HCC). Whether preoperative APRI can predict postoperative short-term outcomes has not been studied. The purpose of this study was to investigate the ability of preoperative APRI to predict short-term outcomes following liver resection for HCC. APRI was evaluated in 360 patients undergoing liver resection for HCC...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27891251/the-role-of-the-single-incision-laparoscopic-approach-in-liver-and-pancreatic-resectional-surgery
#18
REVIEW
Nikolaos A Chatzizacharias, Khaled Dajani, Jun Kit Koong, Asif Jah
Introduction. Single incision laparoscopic surgery (SILS) has gained increasing support over the last few years. The aim of this narrative review is to analyse the published evidence on the use and potential benefits of SILS in hepatic and pancreatic resectional surgery for benign and malignant pathology. Methods. Pubmed and Embase databases were searched using the search terms "single incision laparoscopic", "single port laparoscopic", "liver surgery", and "pancreas surgery". Results. Twenty relevant manuscripts for liver and 9 for pancreatic SILS resections were identified...
2016: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/27885425/intrathecal-morphine-versus-intravenous-opioid-administration-to-impact-postoperative-analgesia-in-hepato-pancreatic-surgery-a-randomized-controlled-trial
#19
Sara Dichtwald, Menahem Ben-Haim, Laila Papismedov, Shoshana Hazan, Anat Cattan, Idit Matot
PURPOSE: Inadequate analgesia following abdominal surgery may affect outcome. Data in patients undergoing liver surgery suggested that postoperative coagulopathy might delay epidural catheter removal. Thus, alternative analgesic techniques should be evaluated. METHODS: We compared the analgesic efficacy of intraoperative intrathecal morphine [single injection 4 µg/kg before skin incision (ITM group, n = 23)] to intravenous opioids [iv remifentanil infusion during surgery followed by i...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27885325/current-role-of-minimally-invasive-radical-cholecystectomy-for-gallbladder-cancer
#20
REVIEW
Giuseppe Zimmitti, Alberto Manzoni, Francesca Guerini, Marco Ramera, Paola Bertocchi, Francesca Aroldi, Alberto Zaniboni, Edoardo Rosso
Background. For Tis and T1a gallbladder cancer (GbC), laparoscopic cholecystectomy can provide similar survival outcomes compared to open cholecystectomy. However, for patients affected by resectable T1b or more advanced GbC, open approach radical cholecystectomy (RC), consisting in gallbladder liver bed resection or segment 4b-5 bisegmentectomy, with locoregional lymphadenectomy, is considered the gold standard while minimally invasive RC (MiRC) is skeptically considered. Aim. To analyze current literature on perioperative and oncologic outcomes of MiRC for patients affected by GbC...
2016: Gastroenterology Research and Practice
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