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Operative complication for Hepatectomy

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https://www.readbyqxmd.com/read/27928672/pure-laparoscopic-right-anterior-sectionectomy-for-hepatocellular-carcinoma-with-great-vascular-exposure
#1
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/27920414/morbidity-and-mortality-and-predictors-of-outcome-following-hepatectomy-at-a-saudi-tertiary-care-center
#2
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/27916352/robotic-liver-resection-including-the-posterosuperior-segments-initial-experience
#3
Carolijn L M A Nota, I Quintus Molenaar, Richard van Hillegersberg, Inne H M Borel Rinkes, Jeroen Hagendoorn
BACKGROUND: Robot-assisted laparoscopy has been introduced to overcome the limitations of conventional laparoscopy. This technique has potential advantages over laparoscopy, such as increased dexterity, three-dimensional view, and a magnified view of the operative field. Therefore, improved dexterity may make a robotic system particularly suited for liver resections, which require nonlinear manipulation, such as curved parenchymal transection, hilar dissection, and resection of posterosuperior segments...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27914765/operative-morbidity-and-survival-following-hepatectomy-for-colorectal-liver-metastasis-in-octogenarians-a-contemporary-case-matched-series
#4
Julie N Leal, Eran Sadot, Mithat Gonen, Stuart Lichtman, T Peter Kingham, Peter J Allen, Ronald P DeMatteo, William R Jarnagin, Michael I D'Angelica
BACKGROUND: Clinical outcomes of octogenarians undergoing hepatectomy for colorectal liver metastases (CRLM) are poorly characterized. The current study evaluated operative morbidity, mortality and survival outcomes among a contemporary cohort of octogenarians. METHODS: Patients undergoing their first hepatectomy for CRLM were identified from institutional databases and those ≥80 years old (y) were matched 1:1 to a group of patients <80 y. Data pertaining to surgical morbidity/mortality and survival were compared using standard statistical methods...
November 30, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27914024/laparoscopic-hepatectomy-for-hcc-in-elderly-patients-risks-and-feasibility
#5
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/27884801/effect-of-flexible-duty-hour-policies-on-length-of-stay-for-complex-intra-abdominal-operations-a-flexibility-in-duty-hour-requirement-for-surgical-trainees-first-trial-analysis
#6
Jonah J Stulberg, Emily Pavey, Mark E Cohen, Clifford Y Ko, David B Hoyt, Karl Y Bilimoria
BACKGROUND: Changes to resident duty hour policies in the Flexibility in Duty Hour Requirements for Surgical Trainees ("FIRST") Trial could impact hospitalized patients' length of stay (LOS) by altering care coordination. LOS may also serve as a reflection of all complications, particularly those not captured in the FIRST Trial (eg, pneumothorax from central line). Programs were randomized to either maintaining current ACGME duty hour policies ("Standard Arm") or more flexible policies waiving rules on maximum shift lengths and time off between shifts ("Flexible Arm")...
November 8, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27869486/enucleation-versus-hepatectomy-for-giant-hepatic-haemangiomas-a-meta-analysis
#7
W L Cheng, Y Q Qi, B Wang, L Tian, W Huang, Y Chen
INTRODUCTION Hepatic haemangiomas are the most common benign liver tumours. They can be treated with surgical resection such as enucleation or hepatectomy if necessary. However, controversy remains over the clinical outcome and safety of these two methods. In this study, we performed a comprehensive meta-analysis to compare the efficacy of liver resection with enucleation for giant haemangiomas. METHODS The online databases PubMed, Embase and CNKI (China National Knowledge Infrastructure) were searched for relevant original articles...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27862779/elective-hepatic-resection-is-feasible-and-safe-in-a-regional-centre
#8
Andrew D Gray, George Petrou, Pratik Rastogi, Stephen Begbie
BACKGROUND: Hepatic resectional surgery remains a highly specialized area of general surgery usually reserved for completion at tertiary metropolitan referral centres. Port Macquarie, on the Mid North Coast of New South Wales, is the only regionally based hospital offering surgery of this nature in mainland Australia. The purpose of this study is to review the data for patients undergoing hepatic resectional surgery in this non-metropolitan centre in order to illustrate that these operations can be carried out safely in a regional setting with comparable results to tertiary-level centres...
November 14, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27849659/a-new-proposal-of-criteria-for-the-future-remnant-liver-volume-in-older-patients-undergoing-major-hepatectomy-for-biliary-tract-cancer
#9
Yoshihiro Watanabe, Satoshi Kuboki, Hiroaki Shimizu, Masayuki Ohtsuka, Hideyuki Yoshitomi, Katsunori Furukawa, Masaru Miyazaki
OBJECTIVE: To evaluate whether advanced age increases the risk of severe complications after major hepatectomy with bile duct resection (BDR) in patients with biliary tract cancer, and to establish new criteria for the percentage of the future remnant liver volume (%FLV) in older patients undergoing this operation. BACKGROUND: Advanced age is reported to inhibit liver regeneration and suppress immune function; however, little is known about the risk of aging in high-stress surgery, such as biliary tract surgery...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27835570/prognostic-nutritional-index-predicts-short-term-outcomes-after-liver-resection-for-hepatocellular-carcinoma-within-the-milan-criteria
#10
Mengyun Ke, Tao Xu, Na Li, Yifan Ren, Aihua Shi, Yi Lv, Haiqi He
BACKGROUND: The prognostic nutritional index (PNI) is calculated based on the serum albumin concentration and the total lymphocyte count. The aim of this study was to investigate the prognostic ability of the PNI for postoperative complications after liver resection to treat hepatocellular carcinoma (HCC) within the Milan criteria. RESULTS: Postoperative complications were observed in 166 (44.6%) patients. The optimal cutoff value of the PNI was set at 45.6 for postoperative complications...
November 7, 2016: Oncotarget
https://www.readbyqxmd.com/read/27830178/diaphragmatic-hernia-after-living-donor-right-hepatectomy-proposal-for-a-screening-protocol
#11
Scott M Livingstone, Axel Andres, A M James Shapiro, Norman N Kneteman, David L Bigam
BACKGROUND: Living donor hepatectomy (LDH) is increasingly being used to improve access to liver transplantation for those with end-stage liver disease. Although recipient outcomes are equivalent, donor complication rates range from 10% to 41%. A rare, but potentially serious complication is occurrence of a diaphragmatic hernia (DH), of which 9 cases have been reported so far in the literature. The purpose of this work was to review the clinical impact of DH post-LDH, including risk factors (RF) in hope of mitigating impact...
July 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27816312/transition-from-open-to-laparoscopic-alpps-for-patients-with-very-small-flr-the-initial-experience
#12
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
#13
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/27809402/ligation-cut-as-a-method-for-bile-duct-division-in-living-donor-right-hepatectomy
#14
Seong Hoon Kim, Eung Chang Lee, Seung Duk Lee, Sang Jae Park
: The importance of bile duct division cannot be overemphasized in living donor surgery. The ligation & cut (LC) as a method for bile duct division in living donor right hepatectomy (LDRH) has never been reported. The purpose of this study was to introduce the LC method of bile duct division in LDRH. All LDRH donors were identified through a prospectively maintained database at the authors' institution between September 2009 and March 2013, and the two methods, LC and cut & oversewing (CO), were compared both in terms of donor and recipient outcomes of right lobe living donor liver transplantation (LDLT)...
November 3, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27807846/borderline-operability-in-hepatectomy-patients-is-associated-with-higher-rates-of-failure-to-rescue-after-severe-complications
#15
Bradford J Kim, Ching-Wei D Tzeng, Amanda B Cooper, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND/OBJECTIVE: To understand the influence of age and comorbidities, this study analyzed the incidence and risk factors for post-hepatectomy morbidity/mortality in patients with "borderline" (BL) operability, defined by the preoperative factors: age ≥75 years, dependent function, lung disease, ascites/varices, myocardial infarction, stroke, steroids, weight loss >10%, and/or sepsis. METHODS: All elective hepatectomies were identified in the 2005-2013 ACS-NSQIP database...
November 3, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27796073/short-and-long-term-outcomes-of-elderly-patients-undergoing-liver-resection-for-colorectal-liver-metastasis
#16
Robert C Gandy, Timothy Stavrakis, Koroush S Haghighi
BACKGROUND: Metastatic colorectal cancer is a disease of advancing age. Increased life expectancy has dramatically increased the number of older patients being assessed for hepatectomy. The objective of the study is to assess the safety and survival of hepatic resection in older patients, with colorectal liver metastases (CLM) and compare that with younger patients. METHODS: All patients undergoing hepatic resection of CLM were included. Patients were divided in groups, less than 75 and 75 and over...
October 30, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27788808/comparison-of-upper-midline-incision-with-and-without-laparoscopic-assistance-for-living-donor-right-hepatectomy
#17
S Shen, W Zhang, L Jiang, L Yan, J Yang
BACKGROUND: Since minimally invasive procedures for living-donor right hepatectomy (LDRH) became popular in recent years, several studies comparing the outcomes of donors undergoing an upper midline incision (UMI) under laparoscopic assistance for LDRH with those undergoing the traditional open LDRH have been published. However, there are very few comparative studies of outcomes for a UMI for LDRH with and without laparoscopic-assistance. We designed the present study to compare the benefits and shortcomings of a UMI for LDRH with and without laparoscopic assistance...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788201/meta-analysis-of-laparoscopic-versus-open-hepatectomy-for-live-liver-donors
#18
Jun Xu, Chen Hu, Hua-Li Cao, Mang-Li Zhang, Song Ye, Shu-Sen Zheng, Wei-Lin Wang
OBJECTIVE: To document the safety and efficacy of laparoscopic living donor hepatectomy in comparison with open liver resection for living donor liver transplantation. METHODS: Medline database, EMASE and Cochrane library were searched for original studies comparing laparoscopic living donor hepatectomy (LLDH) and open living donor hepatectomy (OLDH) by January 2015. Meta-analysis was performed to evaluate donors' perioperative outcomes. RESULTS: Nine studies met selection criteria, involving 1346 donors of whom 318 underwent LLDH and 1028 underwent OLDH...
2016: PloS One
https://www.readbyqxmd.com/read/27785554/trends-and-hospital-variations-in-surgical-outcomes-for-cholangiocarcinoma-in-new-york-state
#19
Han Liu, Xi Cen, Tao Suo, Xueya Cai, Xuewen Yuan, Sheng Shen, Houbao Liu, Yue Li
BACKGROUND: This population-based study examined surgical outcomes and hospital and post-acute care resource use after operations of cholangiocarcinoma during 2005-2012. STUDY DESIGN: Using New York State hospital claims, we identified subjects with intrahepatic tumor who underwent hepatectomy only (n = 2089), subjects with perihilar tumor who underwent hepatectomy and biliary-enteric anastomosis (BEA; n = 389) or BEA only (n = 3721), and subjects with distal cholangiocarcinoma undergoing pancreatectomy or pancreaticoduodenectomy (n = 228)...
October 26, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27778128/robotic-versus-open-hepatectomy-for-hepatocellular-carcinoma-a-matched-comparison
#20
Po-Da Chen, Chao-Ying Wu, Rey-Heng Hu, Wei-Han Chou, Hong-Shiee Lai, Jin-Tung Liang, Po-Huang Lee, Yao-Ming Wu
BACKGROUND: Robotic hepatectomy has been suggested to be a safe and effective approach for liver disease; however, studies comparing robotic hepatectomy with the conventional open approach regarding oncologic outcomes for hepatocellular carcinoma (HCC) are limited. Accordingly, we performed a matched comparison of surgical and oncological outcomes between robotic and open hepatectomy. METHODS: Between January 2012 and October 2015, a total of 183 patients underwent robotic hepatectomy and 275 patients underwent open hepatectomy by the same surgical team in our center...
October 24, 2016: Annals of Surgical Oncology
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