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Right trisectionectomy

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https://www.readbyqxmd.com/read/28675369/good-to-know-the-alpps-procedure-embracing-a-new-technique
#1
George-Andrei Popescu, Sorin Tiberiu Alexandrescu, Razvan Tudor Grigorie, Luminiţa Stoica, Cristian Alexandru Apavaloaie, Doina Hrehoreţ
BACKGROUND: Hepatic resection is the only potentially curative treatment for primary liver tumors and hepatic metastases. The most frightening postoperative complication of extensive hepatectomies is liver failure due to insufficient future liver remnant (FLR). The ALPPS technique (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy) effectively increased the resectability of otherwise inoperable liver tumors (primary or secondary malignant liver tumor) by achieving a rapid and an effective hypertrophy of the FLR, which lowers postoperative liver failure risk...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28675366/curative-intent-surgery-for-perihilar-cholangiocarcinoma-with-and-without-portal-vein-resection-a-comparative-analysis-of-early-and-late-outcomes
#2
Traian Dumitraşcu, Cezar Stroescu, Vladislav Braşoveanu, Vlad Herlea, Mihnea Ionescu, Irinel Popescu
Introduction: The safety of portal vein resection (PVR) during surgery for perihilar cholangiocarcinoma (PHC) has been demonstrated in Asia, America, and Western Europe. However, no data about this topic are reported from Eastern Europe. The aim of the present study is to comparatively assess the early and long-term outcomes after resection for PHC with and without PVR. PATIENTS AND METHODS: The data of 21 patients with PVR were compared with those of 102 patients with a curative-intent surgery for PHC without PVR...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28667434/the-pitfalls-of-left-trisectionectomy-or-central-bisectionectomy-for-biliary-cancer-anatomical-classification-based-on-the-ventral-branches-of-segment-vi-portal-vein-relative-to-the-right-hepatic-vein
#3
Yusuke Yamamoto, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Takeshi Aramaki, Katsuhiko Uesaka
BACKGROUNDS: Some patients have P6a running on the ventral side (Ventral-P6a), relative to the right hepatic vein (RHV). STUDY DESIGN: Forty-one patients who underwent left trisectionectomy or central bisectionectomy for biliary cancer were enrolled. We compared the anatomical features using 3D images and surgical outcomes between patients with Ventral-P6a (n = 17) and those with P6a running on the dorsal side relative to the RHV (Dorsal-P6a; n = 25). Moreover, the liver volume by hand-tracing 2D axial images was compared to the volume calculated using the 3D images...
June 30, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28258614/safety-related-outcomes-of-the-japanese-society-of-hepato-biliary-pancreatic-surgery-board-certification-system-for-expert-surgeons
#4
Takehito Otsubo, Shinjiro Kobayashi, Keiji Sano, Takeyuki Misawa, Takehiro Ota, Satoshi Katagiri, Katsuhiko Yanaga, Hiroki Yamaue, Norihiro Kokudo, Michiaki Unno, Jiro Fujimoto, Fumihiko Miura, Masaru Miyazaki, Masakazu Yamamoto
BACKGROUND: We investigated safety-related outcomes of hepatobiliary pancreatic (HBP) surgeries performed after establishment of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) board certification system for expert surgeons. METHODS: We analyzed post-HBP surgery mortality data obtained from annual safety reports provided by board-certified training institutions between 2012 and 2015. RESULTS: The 90-day mortality rate for the 53,929 high-level HBP surgeries performed at board-certified training institutions was 1...
May 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28144858/a-case-of-adult-undifferentiated-embryonal-sarcoma-of-the-liver-successfully-treated-with-right-trisectionectomy-a-case-report
#5
Akiko Mori, Koji Fukase, Kunihiro Masuda, Naoaki Sakata, Masamichi Mizuma, Hideo Ohtsuka, Takanori Morikawa, Kei Nakagawa, Hiroki Hayashi, Fuyuhiko Motoi, Takeshi Naitoh, Keigo Murakami, Michiaki Unno
BACKGROUND: Undifferentiated embryonal sarcoma of the liver (UESL) is a rare malignant mesenchymal tumor that usually occurs in children and is rarely diagnosed in adults. CASE PRESENTATION: Here, we describe the case of a 65-year-old woman who presented with a huge cystic lesion in the liver. Laboratory studies performed on admission showed modest inflammation, poor nutrition, and elevated levels of total bilirubin, alkaline phosphatase, and γ-glutamyl transferase...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28031549/clinicopathological-features-and-prognosis-of-hepatic-epithelioid-hemangioendothelioma-after-liver-resection-and-transplantation
#6
Dong-Hwan Jung, Shin Hwang, Seung-Mo Hong, Ki-Hun Kim, Young-Joo Lee, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Gil-Chun Park, Eunsil Yu, Sung-Gyu Lee
BACKGROUND Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor. We present a single-center study on hepatic EHE cases treated by hepatic resection (HR) or liver transplantation (LT). MATERIAL AND METHODS Six HR patients with hepatic EHE were identified during 5 years from 2010 to 2014; EHE represented 0.13% (6 of 4572) of all primary liver tumors. Two LT recipients were also identified during 12 years from 2003 to 2014, who represented 0.06% (2 of 3576) of all adult LT patients. RESULTS Mean age of the patients was 42...
December 29, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28008345/major-hepatectomy-using-the-glissonean-approach-in-cases-of-right-umbilical-portion
#7
Yusuke Ome, Kazuyuki Kawamoto, Tae Bum Park, Tadashi Ito
Right umbilical portion (RUP) is a rare congenital anomaly associated with anomalous ramifications of the hepatic vessels and biliary system. As such, major hepatectomy requires a careful approach. We describe the usefulness of the Glissonean approach in two patients with vessel anomalies, such as RUP. The first patient underwent a right anterior sectionectomy for intrahepatic cholangiocarcinoma. We encircled several Glissonean pedicles that entered the right anterior section along the right side of the RUP...
December 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27960221/-extended-left-hemihepatectomy-with-reconstruction-of-the-right-liver-vein-in-a-patient-with-an-intrahepatic-cholangiocellular-carcinoma
#8
F Bartsch, T Huber, H Lang
Extended left hemihepatectomy (left trisectionectomy) with resection of liver segments 1, 2, 3, 4 a/b, 5 and 8 is a challenging procedure. In well-selected patients, the indication for this procedure may offer the chance of curative resection for primary or secondary liver tumours in complicated locations. Morbidity and mortality are increased compared to non-extended liver resections. This procedure requires precise imaging and accurate surgical planning in due consideration of the remaining liver volume and additional factors such as preliminary damage of the liver parenchyma caused by chemotherapy or fibrosis/cirrhosis...
December 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27884614/robotic-major-hepatectomy-is%C3%A2-there-a-learning-curve
#9
Po-Da Chen, Chao-Yin Wu, Rey-Heng Hu, Chiung-Nien Chen, Ray-Hwang Yuan, Jin-Tung Liang, Hong-Shiee Lai, Yao-Ming Wu
BACKGROUND: Robotic hepatectomy has been suggested as a safe and effective management of liver disease. However, no large case series have documented the learning curve for robotic major hepatectomy. METHOD: We conducted a retrospective study for robotic major hepatectomy performed by the same operative team between January 2012 and October 2015 and evaluated the learning curve for operation time using the cumulative sum method, presented as cumulative sumoperation time...
March 2017: Surgery
https://www.readbyqxmd.com/read/27826578/early-multifocal-recurrence-of-hepatoblastoma-in-the-residual-liver-after-r0-liver-resection-with-alpps-procedure-a-case-report
#10
Abid Q Qazi, Aamir Ali Syed, Ahsun W Khan, Faisal Hanif
Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been successfully employed in adults to avoid potential liver insufficiency in patient with small future liver volume (FLV) when subjected to conventional right trisectionectomy. We are reporting an infant with hepatoblastoma, who underwent a technically successful ALPPS procedure with R0 resection. However he developed very early recurrence within the first month after the procedure. We present this report with a view to share our unexpected finding of early multifocal recurrence of hepatoblastoma in the residual liver after ALPPS procedure in a very young patient...
October 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27811506/hepatopancreaticoduodenectomy-for-biliary-cancer-strategies-for-near-zero-operative-mortality-and-acceptable-long-term-outcome
#11
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/27734177/total-laparoscopic-reversal-alpps
#12
M A Machado, R Surjan, T Basseres, F Makdissi
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows R0 resection even for patients with extremely small future liver remnants. The ALPPS procedure was initially described for two-stage right trisectionectomy. Reversal ALPPS is a denomination in which the future liver remnant is the right posterior section of the liver. PATIENT: A 42-year-old woman with colorectal metastases in all segments except segment 1 underwent chemotherapy with objective response and was referred for surgical treatment...
April 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27714983/porcine-models-for-the-study-of-small-for-size-syndrome-and-portal-inflow-modulation-literature-review-and-proposal-for-a-standardized-nomenclature
#13
REVIEW
Kayvan Mohkam, Benjamin Darnis, Jean-Yves Mabrut
Porcine models of extended hepatectomy and liver transplantation (LT) of reduced graft have been widely used for studying the small-for-size (SFS) syndrome and the various modalities of portal inflow modulation (PIM). However, considerable heterogeneity exists among the studies and their results. The aim of this review was to assess the main advantages and drawbacks of the different porcine models of SFS LT and SFS hepatectomy, and propose a standardized anatomical nomenclature for the various models. The MEDLINE database was searched for articles reporting porcine models of reduced graft LT or hepatectomy of more than 65%...
November 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27692569/anatomic-features-of-independent-right-posterior-portal-vein-variants-implications-for-left-hepatic-trisectionectomy
#14
COMPARATIVE STUDY
Nobuyuki Watanabe, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
BACKGROUND: No authors have reported on the anatomic features of the independent right posterior portal vein variant and its relevance to left hepatic trisectionectomy. The purpose of this study was to review vasculobiliary systems according to portal vein anatomy, to clarify the anatomic features of the right posterior portal vein variant, and to discuss its operative implications for left hepatic trisectionectomy. METHODS: In a radiologic study, the 3-dimensional anatomy of the portal vein, hepatic artery, and bile duct were studied in 200 patients who underwent computed tomography...
February 2017: Surgery
https://www.readbyqxmd.com/read/27587210/-application-of-liver-visualization-technologies-in-hilar-tumor-resection-at-the-second-hepatic-portal-area
#15
P P Li, H Liu, S Y Fu, C Lin, Z Y Pan, J Zhang, J S Ni, S X Yuan, W P Zhou
OBJECTIVE: To discuss the application of liver visualization technology in complex liver tumor resection at the second hepatic portal area. METHODS: Clinical data of 80 cases who received surgery at the second hepatic portal area from August 2014 to September 2015 in the Third Department of Hepatic Surgery of Eastern Hepatobiliary Surgery Hospital were analyzed retrospectively. There were 58 male and 22 female patients aged from 21 to 70 years with median age of 52 years...
September 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27442648/first-totally-laparoscopic-alpps-procedure-with-selective-hepatic-artery-clamping-case-report-of-a-new-technique
#16
Rodrigo C Surjan, Fabio F Makdissi, Tiago Basseres, Denise Leite, Luiz F Charles, Regis O Bezerra, Erik Schadde, Marcel Autran Machado
BACKGROUND: ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) is a new surgical approach for the treatment of liver tumors. It is indicated in cases where the future liver remnant is not sufficient to maintain postoperative liver function. We report a totally laparoscopic ALPPS with selective hepatic artery clamping. Pneumoperitoneum itself results in up to 53% of portal vein flow and selective hepatic artery clamping can reduce blood loss while maintaining hepatocellular function...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27431416/liver-and-vena-cava-en-bloc-resection-for-an-invasive-leiomyosarcoma-causing-budd-chiari-syndrome-under-veno-venous-bypass-and-liver-hypothermic-perfusion-liver-hypothermic-perfusion-and-veno-venous-bypass-for-inferior-vena-cava-leiomyosarcoma
#17
Matteo Ravaioli, Matteo Serenari, Matteo Cescon, Carlo Savini, Alessandro Cucchetti, Giorgio Ercolani, Massimo Del Gaudio, Alberto Casati, Antonio Daniele Pinna
BACKGROUND: Leiomyosarcoma of vascular origin is a rare tumor, occurring mainly in the inferior vena cava (IVC). When involving the hepatic vein confluence, it often causes Budd-Chiari syndrome, and IVC removal with a complex hepatectomy is required (Mingoli in J Am Coll Surg 211:145-146, 2010; Griffin in J Surg Oncol 34:53-60, 1987; Heaney in Ann Surg 163:237-241, 1966; Fortner in Ann Surg 180:644-652, 1974). METHODS: A 57-year-old male, without previous oncological history, presented with Budd-Chiari syndrome due to a leiomyosarcoma extending to the supra-diaphragmatic IVC and involving the right and middle hepatic veins...
July 18, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27342988/a-case-of-advanced-intrahepatic-cholangiocarcinoma-accidentally-but-successfully-treated-with-capecitabine-plus-oxaliplatin-capox-therapy-combined-with-bevacizumab-a-case-report
#18
Masahito Uji, Takashi Mizuno, Tomoki Ebata, Gen Sugawara, Tsuyoshi Igami, Keisuke Uehara, Masato Nagino
Although surgical resection is the only way to cure biliary tract cancer (BTC), most BTCs are unresectable by the time they are diagnosed. Chemotherapy is usually used to treat unresectable BTC, but its impact on survival is small. Here, we report the case of a 70-year-old woman with a locally advanced intrahepatic cholangiocarcinoma that was initially diagnosed as an unresectable liver metastasis from colon cancer that had invaded all of the major hepatic veins. However, the tumor was noticeably reduced after treatment with CAPOX plus bevacizumab, which is an uncommon therapy for BTC...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27212996/management-of-portal-hypertension-derived-from-uncommon-causes
#19
Sung Hyun Kim, Hae Min Lee, Seung Ho Lee, Jong Yoon Won, Kyung Sik Kim
Portal hypertension can arise from any condition interfering with normal blood flow at any level within the portal system. Herein, we presented two uncommon cases of the portal hypertension and its treatment with brief literature review. A 71-year-old man who underwent right hemihepatectomy revealed a tumor recurrence adjacent to the inferior vena cava (IVC). After radiofrequency ablation (RFA) with lymph node dissection, he was referred for abdominal distension. The abdomen computed tomography scan showed severe ascites with a narrowing middle hepatic vein (MHV) and IVC around the RFA site...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
https://www.readbyqxmd.com/read/27135865/-posthepatectomy-liver-failure-in-extended-liver-resections-an-overview-based-on-a-retrospective-single-centre-analysis
#20
B Stoffels, S J Enkirch, M W von Websky, T O Vilz, D Pantelis, S Manekeller, N Schäfer, J C Kalff
BACKGROUND: Posthepatectomy liver failure (PHLF) is one of the most serious complications after major liver resections and an important factor in terms of perioperative morbidity and mortality. Despite many advances in the understanding and grading of PHLF, the definitions found in literature are very heterogeneous, which complicates the identification of high-risk patients. In this study we analysed the results of extended liver resections and potential risk factors for PHLF based on patient data derived from our tertiary referral centre...
August 2016: Zentralblatt Für Chirurgie
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