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Operative complication for Hepatectomy

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https://www.readbyqxmd.com/read/28328863/surgical-outcomes-of-laparoscopic-versus-open-liver-resection-for-hepatocellular-carcinoma-for-various-resection-extent
#1
Junhua Chen, Hongyu Li, Fei Liu, Bo Li, Yonggang Wei
Although the number of laparoscopic liver resections (LRRs) has increased, studies of surgical outcomes in comparison with the conventional open approach are limited. The purpose of this study was to analyze the surgical outcomes (safety and efficacy) of LLR versus open liver resection (OLR) for hepatocellular carcinoma (HCC).We collected data on all patients who received liver resection for HCC between April 2015 and September 2016 in our institution, and retrospectively investigated the demographic and perioperative data, and also surgical outcomes...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28320486/left-jackknife-position-a-novel-position-for-laparoscopic-hepatectomy
#2
Jian-Cong Chen, Rong-Xin Zhang, Min-Shan Chen, Li Xu, Jin-Bin Chen, Ke-Li Yang, Yao-Jun Zhang, Zhong-Guo Zhou
BACKGROUND: Laparoscopic hepatectomy for hepatocellular carcinoma (HCC) located in segment VI, VII, or VIII of the liver is usually difficult because of poor operative exposure, due to the unique anatomical structure. In this study, we evaluated the practice of laparoscopic hepatectomy with the left jackknife position for patients with HCC located in segment VI, VII, or VIII. METHODS: A total of 10 patients were enrolled to undergo laparoscopic hepatectomy with the left jackknife position...
March 20, 2017: Chinese Journal of Cancer
https://www.readbyqxmd.com/read/28319941/short-term-outcomes-after-simultaneous-colorectal-and-major-hepatic-resection-for-synchronous-colorectal-liver-metastases
#3
Yoshihiro Ono, Akio Saiura, Junichi Arita, Yu Takahashi, Michiro Takahashi, Yosuke Inoue
BACKGROUND/AIMS: Resection of the liver is the standard therapeutic approach for patients with hepatic metastasis and is the only therapy with curative potential. The optimal timing of surgical resection for synchronous metastases has remained controversial. METHODS: From January 1993 to December 2008, our strategy has been to use simultaneous resection for resectable synchronous colorectal and liver metastases. During this period, 115 patients underwent simultaneous colorectal and hepatic resection...
March 21, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28314307/post-hepatectomy-refractory-ascites-in-cirrhotic-patients-with-hepatocellular-carcinoma-risk-factor-analysis-to-overcome-this-problematic-complication
#4
Shinji Itoh, Hideaki Uchiyama, Yasuharu Ikeda, Kazutoyo Morita, Noboru Harada, Keishi Sugimachi, Hirofumi Kawanaka, Daisuke Korenaga, Tomoharu Yoshizumi, Kenji Takenaka, Yoshihiko Maehara
BACKGROUND: Refractory ascites is a serious post-hepatectomy complication in cirrhotic patients with hepatocellular carcinoma (HCC). In order to avoid this complication, surgeons should preserve as much liver parenchyma as possible in performing hepatectomy in such patients. However, we still occasionally encounter refractory ascites even after limited or small hepatectomy. The aim of this study was to identify risk factors for post-hepatectomy refractory ascites in cirrhotic patients, focusing on limited or small hepatectomy...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28296776/totally-laparoscopic-associating-liver-tourniquet-and-portal-vein-occlusion-for-staged-hepatectomy-combined-with-simultaneous-left-hemicolectomy-for-bilateral-liver-metastases-of-the-primary-colon-cancer-a-case-report
#5
Hong-Wei Xu, Hong-Yu Li, Fei Liu, Yong-Gang Wei, Bo Li
BACKGROUND: Resection of the liver is often limited to the insufficient future liver remnant (FLR). To address this problem, the modification surgical technique "associating liver tourniquet and portal vein occlusion for staged hepatectomy" (ALTPS) was developed and led to quick hypertrophy in a short interval. In some colorectal cancer patients with multiple and bilobar metastases, the resection of the primary is often protracted immensely to the unpredictable postoperative complications for whom is to be treated with a liver-first approach...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28281121/short-term-outcomes-of-laparoscopic-vs-open-liver-resection-for-hepatocellular-adenoma-a-multicenter-propensity-score-adjustment-analysis-by-the-afc-hca-2013-study-group
#6
Filippo Landi, Nicola De' Angelis, Olivier Scatton, Xavier Vidal, Ahmet Ayav, Fabrice Muscari, Safi Dokmak, Guido Torzilli, Nicolas Demartines, Olivier Soubrane, Daniel Cherqui, Jean Hardwigsen, Alexis Laurent
BACKGROUND: Patients with hepatocellular adenomas are, in selected cases, candidates for liver resection, which can be approached via laparoscopy or laparotomy. The present study aimed to investigate the effects of the surgical approach on the postoperative morbidities of both minor and major liver resections. METHODS: In this multi-institutional study, all patients who underwent open or laparoscopic hepatectomies for hepatocellular adenomas between 1989 and 2013 in 27 European centers were retrospectively reviewed...
March 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28274510/can-contrast-enhanced-mri-with-gadoxetic-acid-predict-liver-failure-and-other-complications-after-major-hepatic-resection
#7
A F Costa, A Tremblay St-Germain, M Abdolell, R L Smoot, S Cleary, K S Jhaveri
AIM: To determine whether a combination of clinical factors, the future liver remnant (FLR) ratio, and hepatic uptake of gadoxetic acid can be used to predict post-hepatectomy liver failure (PHLF) and other major complications (OMC). MATERIALS AND METHODS: Sixty-five consecutive patients who underwent pre-hepatectomy gadoxetic acid-enhanced magnetic resonance imaging (MRI) between October 2010 and December 2013 were included. The relative liver enhancement (RLE) of gadoxetic acid was calculated from regions of interest on MRI, and FLR ratios were obtained from computed tomography (CT)...
March 5, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28272201/effectiveness-of-hepatic-parenchyma-lithotomy-of-hepatolithiasis-a-single-center-experience
#8
En Liang Li, Qian Feng, Qing Ping Yang, Wen Jun Liao, Wang Wei Liu, Yong Huang, Lin Quan Wu, Xiang Bao Yin, Jiang Hua Shao
To investigate the clinical significance of hepatic parenchyma incision by lithotomy near the second hepatic portal area for the treatment of complex hepatolithiasis.A retrospective study was conducted with 35 patients who had complicated hepatolithiasis in our hospital from January 2008 to December 2013, who underwent hepatic parenchyma incision by lithotomy near the second hepatic portal area. The perioperative and long-term outcomes included the stone clearance rate, operative morbidity and mortality, and the stone recurrence rate...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28271263/the-effect-of-three-dimensional-preoperative-simulation-on-liver-surgery
#9
Ken Nakayama, Yukio Oshiro, Ryoichi Miyamoto, Keisuke Kohno, Kiyoshi Fukunaga, Nobuhiro Ohkohchi
BACKGROUND: In the past decade, three-dimensional (3D) simulation has been commonly used for liver surgery. However, few studies have analyzed the usefulness of this 3D simulation. The aim of this study was to evaluate the effect of 3D simulation on the outcome of liver surgery. METHODS: We retrospectively analyzed 240 consecutive patients who underwent liver resection. The patients were divided into two groups: those who received 3D preoperative simulation ("3D group", n = 120) and those who did not undergo 3D preoperative simulation ("without 3D group", n = 120)...
March 7, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28254607/laparoscopic-left-sided-hepatectomy-for-the-treatment-of-hepatolithiasis-a-comparative-study-with-open-approach
#10
Long Peng, Jian Xiao, Zhanying Liu, Jisheng Zhu, Renhua Wan, Weidong Xiao, Yong Li
BACKGROUND: Hepatolithiasis is a prevalent disease in some regions of China. Left-sided hepatectomy is an effective treatment for left intrahepatic bile duct stones with irreversible disease, such as biliary strictures, severe parenchymal fibrosis or atrophy. However, the advantages of laparoscopic left-sided hepatectomy (LLH) over open approach (OLH) are still controversial. The aim of this study was to compare the clinical outcomes of LLH to those of OLH in the treatment of hepatolithiasis...
February 28, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28219600/tert-butylhydroquinone-protects-liver-against-ischemia-reperfusion-injury-in-rats-through-nrf2-activating-anti-oxidative-activity
#11
X-P Zeng, X-J Li, Q-Y Zhang, Q-W Liu, L Li, Y Xiong, C-X He, Y-F Wang, Q-F Ye
BACKGROUND: Hepatic ischemia/reperfusion (I/R) injury is a serious complication that occurs in surgical operations such as hepatectomy and liver transplantation. NF-E2-related factor 2 (Nrf2) is a transcription factor that has been proven against inflammatory and oxidative injury. Tert-butylhydroquinone (tBHQ), a widely used Nrf2 activator, is a common food preservative. In this study, we attempt to investigate the potential protective role of tBHQ in hepatic I/R injury. METHODS: Twenty adult male rats were randomly divided into four groups: (1) sham+vehicle group; (2) I/R+vehicle group; (3) sham+tBHQ group; and (4) I/R+tBHQ group...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28207553/laparoscopic-living-donor-right-hemihepatectomy-with-venous-outflow-reconstruction-using-cadaveric-common-iliac-artery-allograft-case-report-and-literature-review
#12
Jiaxin Li, Jiwei Huang, Hong Wu, Yong Zeng
RATIONALE: With the development of laparoscopic technique, the total laparoscopic living donor right hemihepatectomy (LLDRH) procurement surgery has been successfully performed in many liver transplant centers all over the world, and the number of cases is continuing to increase. We report our case of laparoscopic right graft resection with venous outflow reconstruction using cadaveric common iliac artery allograft in our center and review literatures about total LLDRH surgery. PATIENT CONCERNS AND DIAGNOSES: A 40-year-old male living donor for right hepatectomy was selected after pretransplant evaluation including laboratory tests, liver volume, anatomy of hepatic vein, artery, portal vein, and bile duct...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205284/prognostic-impact-of-complications-after-resection-of-early-stage-hepatocellular-carcinoma
#13
Georgios Antonios Margonis, Kazunari Sasaki, Nikolaos Andreatos, Yujiro Nishioka, Toshitaka Sugawara, Neda Amini, Stefan Buettner, Masaji Hashimoto, Junichi Shindoh, Timothy M Pawlik
BACKGROUND: Resection is the most effective treatment for HCC. However, postoperative morbidity is common and its impact on long-term oncological outcome remains unclear. METHODS: Long-term outcomes of 774 patients who underwent curative resection for early stage HCC at Johns Hopkins Hospital and Toranomon Hospital were investigated after stratifying by the development of postoperative overall and infectious complications. RESULTS: A minor or major postoperative complication developed in 281 and 65 patients, respectively, while postoperative mortality was 1...
February 15, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28187867/clinicopathologic-study-on-metachronous-double-cholangiocarcinomas-of-perihilar-and-subsequent-distal-bile-duct-origin
#14
Kentaro Shinohara, Yoshie Shimoyama, Tomoki Ebata, Yukihiro Yokoyama, Takashi Mizuno, Masato Nakaguro, Masato Nagino
BACKGROUND: Despite an increasing number of long-term survivors after the resection of perihilar cholangiocarcinoma, metachronous carcinoma in the remnant distal bile duct has not been well documented because of its rarity. The aim of this study was to clarify the feasibility of operative resection and the pathologic features for metachronous double cholangiocarcinomas. METHODS: Between 2003 and 2013, 6 patients underwent resections for both a primary perihilar cholangiocarcinoma and a metachronous distal cholangiocarcinoma...
February 7, 2017: Surgery
https://www.readbyqxmd.com/read/28187043/difficulty-of-laparoscopic-liver-resection-proposal-for-a-new-classification
#15
Yoshikuni Kawaguchi, David Fuks, Norihiro Kokudo, Brice Gayet
OBJECTIVE: We propose an objective and practical classification system to predict difficulty of different laparoscopic liver resections (LLRs). BACKGROUND: Surgical difficulty is highly subjective and is not influenced only by surgical factors. Consequently, few series have described the degree of difficulty of LLR or attempted to objectively assess the surgical difficulty. METHODS: From a prospectively maintained database between 1995 and 2015, patients undergoing LLR without simultaneous procedures were selected, and LLR procedures were divided into 3 groups according to scores based on operative time (< or ≥190 minutes), blood loss (< or ≥100 mL), and conversion rate (< or ≥4...
February 9, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28185289/effect-of-epidural-compared-to-patient-controlled-intravenous-analgesia-on-outcomes-for-patients-undergoing-liver-resection-for-neoplastic-disease
#16
Shelby Allen, Amy DeRoche, Lu Adams, Karen Valerie Slocum, Clancy J Clark, Nora F Fino, Perry Shen
BACKGROUND: Epidural analgesia is routinely used for postoperative pain control following abdominal surgeries, yet data regarding the safety and efficacy of epidural analgesia is controversial. METHODS: Pain-related and clinical perioperative data were extracted and correlated with baseline clinicopathologic data and method of analgesia (epidural vs. intravenous patient-controlled analgesia) in patients who underwent hepatectomy from 2012 to 2014. Chronic pain was defined by specific narcotic requirements preoperatively...
February 10, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28182632/clinical-outcomes-of-patients-with-and-without-diabetes-mellitus-after-hepatectomy-a-systematic-review-and-meta-analysis
#17
Qingshan Li, Yue Wang, Tao Ma, Yi Lv, Rongqian Wu
BACKGROUND: Clinical data regarding the influence of diabetes mellitus (DM) on the outcomes of patients undergoing hepatectomy are conflicting. To determine the impact of DM on the clinical outcomes of patients undergoing hepatectomy, we systematically reviewed published studies and carried out a meta-analysis. METHODS: A systematic literature search of Pubmed, Sciencedirect, Web of Science, and Chinese Biomedical Database was conducted from their inception through February 2, 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28163089/comparative-effectiveness-of-minimally-invasive-surgery-and-conventional-approaches-to-major-or-challenging-hepatectomy
#18
Lucas W Thornblade, Xu Shi, Alex Ruiz, David R Flum, James O Park
BACKGROUND: The benefits of minimally invasive surgery (MIS) for low-risk or minor liver resection are well established. There is growing interest in MIS for major hepatectomy (MH) and other challenging resections, but there remain unanswered questions of safety that prevent broad adoption of this technique. STUDY DESIGN: Retrospective cohort study of patients undergoing hepatectomy at 65 hospitals participating in the NSQIP Hepatopancreatobiliary Collaborative in 2014...
February 2, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28157736/the-first-comparative-study-of-the-perioperative-outcomes-between-pure-laparoscopic-donor-hepatectomy-and-laparoscopy-assisted-donor-hepatectomy-in-a-single-institution
#19
Takeshi Takahara, Go Wakabayashi, Hiroyuki Nitta, Yasushi Hasegawa, Hirokatsu Katagiri, Akira Umemura, Daiki Takeda, Kenji Makabe, Koki Otsuka, Keisuke Koeda, Akira Sasaki
BACKGROUND: In a statement from the second International Consensus Conference for Laparoscopic Liver Resection, adult-to-adult laparoscopic donor surgery was the earliest phase of development. It was recommended that the procedure be performed under institutional ethical approval and a reporting registry. METHOD: At our institute, we started laparoscopy-assisted donor hepatectomy (LADH) in 2007 and changed to pure laparoscopic donor hepatectomy (PLDH) in 2012. This study included 40 living donors who underwent LADH and 14 live donors who underwent PLDH...
February 3, 2017: Transplantation
https://www.readbyqxmd.com/read/28130585/infrahepatic-inferior-vena-cava-clamping-with-pringle-maneuvers-for-laparoscopic-extracapsular-enucleation-of-giant-liver-hemangiomas
#20
Wanguang Zhang, Jian Wang, Changhai Li, Zhanguo Zhang, Najib Isse Dirie, Hanhua Dong, Shuai Xiang, Wei Zhang, Zhiwei Zhang, Bixiang Zhang, Xiaoping Chen
BACKGROUND: This study aimed to determine the feasibility of the extracapsular enucleation method for giant liver hemangiomas by infrahepatic inferior vena cava (IVC) clamping and the Pringle maneuver to control intraoperative bleeding under laparoscopic hepatectomy. METHODS: From January 2012 to January 2016, 36 patients underwent laparoscopic extracapsular enucleation of giant liver hemangiomas. Patients were divided into two groups: infrahepatic IVC clamping + Pringle maneuvers group (IVCP group, n = 15) and the Pringle maneuvers group (Pringle group, n = 21)...
January 27, 2017: Surgical Endoscopy
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