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caudate lobectomy

Masaaki Shimatani, Makoto Takaoka, Kazuichi Okazaki
We report a successful endoscopic stone extraction using a short type double-balloon endoscope (DBE) (EI-530 B; FUJIFILM Co, Tokyo, Japan) combined with long-type ultra-slim endoscope (L-USE) (EC-530XP; FUJIFILM Co, Tokyo, Japan) without using contrast media for intrahepatic stones in patient allergic to iodine with post-operation. A 43 year-old man with a history of congenital biliary dilatation who had undergone choledocojejunostomy and Roux-en Y reconstruction 37 years previously (Fig. 1-A) and posterior lateral hepatic segmentectomy and caudate lobectomy for intrahepatic stone 10 years previously was admitted for acute cholangitis caused by recurrence of intrahepatic stone and stenosis in choledochojejunal anastomosis (Fig...
September 8, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Dongkyu Oh, Choon Hyuck David Kwon, Byung Gon Na, Kyo Won Lee, Won Tae Cho, Seung Hwan Lee, Jin Yong Choi, Gyu Seong Choi, Jong Man Kim, Jae-Won Joh
OBJECTIVES: The purpose of this study is to identify the safety and feasibility of laparoscopic caudate lobectomy. BACKGROUND: Caudate lobectomy has been considered as technically difficult because of the deep location of the caudate lobe and its proximity to great vessels. Due to the technical difficulty, laparoscopic caudate lobectomy was not feasible in patients with malignancy in the caudate lobe. METHODS: Six consecutive patients with caudate hepatic malignancy received laparoscopic caudate lobectomy at Samsung Medical Center from September 2007 to May 2014...
September 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Catalina Correa, Juan P Luengas, Scott C Howard, Galo Veintemilla
A 2-year-old boy presented with pneumonia and an abdominal mass was noted incidentally. A right lobe hepatic mass classified as PRETEXT III and congenital absence of the portal vein with drainage of the superior mesenteric vein to the inferior vena cava (Abernethy malformation type I) were confirmed by computed tomography and angiography. After a clinical diagnosis of hepatoblastoma had been made, he was treated with 4 cycles of doxorubicin and cisplatin and hepatic arterial chemoembolization with doxorubicin, after which the tumor was classified as POSTEXT III...
July 27, 2016: Journal of Pediatric Hematology/oncology
Qihong Ni, Haolu Wang, Xiaowen Liang, Yunhe Zhang, Wei Chen, Jian Wang
The combination of hilar cholangiocarcinoma and anatomic variation constitutes a rare and complicated condition. Precise understanding of 3-dimensional position of tumor in the intrahepatic structure in such cases is important for operation planning and navigation. We report a case of a 61-year woman presenting with hilar cholangiocarcinoma. Anatomic variation and tumor location were well depicted on preoperative multidetector computed tomography (MDCT) combined with 3-dimensional reconstruction as the right posterior segmental duct drained to left hepatic duct...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Z Lu, D D Wang
Hilar cholangiocarcinoma (HCCA) is also known as cancer at the upper part of bile duct, perihilar cholangiocarcinoma or Klatskin tumor, etc.Bismuth-Corlette type Ⅲ hilar cholangiocarcinoma refers to tumor invading right hepatic duct (Ⅲa) or left hepatic duct (Ⅲb). While Bismuth-Corlette type Ⅳ hilar cholangiocarcinoma refers to both left and right intrahepatic bile ducts being invaded. Under the premise of strictly grasping the indications of surgery, if preoperative management is conducted carefully, extended hepatic resection is a safe and feasible surgery to remove Bismuth-Corlette type Ⅲ and type Ⅳ hilar cholangiocarcinoma...
July 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Shuichi Aoki, Masamichi Mizuma, Hiroki Hayashi, Kei Nakagawa, Takanori Morikawa, Fuyuhiko Motoi, Takeshi Naitoh, Shinichi Egawa, Michiaki Unno
BACKGROUND: Lymph node dissection in Rouviere's sulcus (RS) is essential during left-sided hepatectomy and caudate lobectomy for hilar cholangiocarcinoma. However, the small segmental or subsegmental arteries (SA/SSA) are often encountered in RS and must be preserved to prevent critical complications, such as liver infarction or liver failure. The aim of this study is to elucidate the anatomy of SA/SSA around RS, which should be understood preoperatively. METHODS: Between January 2008 and April 2013 from a total of 124 consecutive patients with hilar cholangiocarcinoma, preoperative multidetector-row computed tomography (MDCT) images were obtained at our institution and evaluated...
2016: BMC Surgery
Yinzhe Xu, Hongguang Wang, Webin Ji, Maosheng Tang, Hao Li, Jianjun Leng, Xuan Meng, Jiahong Dong
BACKGROUND: Radical resection for hilar cholangiocarcinoma (HCa) is one of the most challenging abdominal procedures. Robotic-assisted approach is gaining popularity in hepatobiliary surgery but scarcely tried in the management of HCa. We herein report our initial experience of robotic radical resection for HCa. METHODS: Between May 2009 and October 2012, 10 patients underwent fully robotic-assisted radical resection for HCa in a single institute. The perioperative and long-term outcomes were analyzed and compared with a contemporaneous 32 patients undergoing traditional open surgery...
July 2016: Surgical Endoscopy
Toshiya Ochiai, Hiromichi Ishii, Atsushi Toma, Takeshi Ishimoto, Yusuke Yamamoto, Ryo Morimura, Hisashi Ikoma, Eigo Otsuji
BACKGROUND: Isolated anatomic total caudate lobectomy is indicated in patients who have liver tumors limited to the caudate lobe. However, isolated caudate lobe resection is a challenging surgical procedure that required safe and reliable techniques. All portal and hepatic veins that connect this area originate from the first branch of the portal vein or vena cava; therefore, the operator must be cautious of the potential for massive bleeding. METHODS: The important points regarding the safety of our procedure include creating an optimal surgical view and preparing for accidental bleeding before parenchymal dissection...
2016: World Journal of Surgical Oncology
B Juntermanns, C D Fingas, G C Sotiropoulos, D Jaradat, A Dechêne, H Reis, S Kasper, A Paul, G M Kaiser
BACKGROUND: Perihilar cholangiocarcinoma (Klatskin tumor) is a rare tumor entity with an unfavorable prognosis despite optimal treatment. OBJECTIVES: The aim of the study is to investigate beneficial histopathological features and recommendations for surgery in perihilar cholangiocarcinoma to improve patients' long term survival. MATERIAL AND METHODS: 192 patients suffering from perihilar cholangiocarcinoma underwent attempted tumor resection between 1998 and 2008 at our clinic...
June 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Ryota Higuchi, Takehisa Yazawa, Shuichiro Uemura, Masakazu Yamamoto
BACKGROUND: To evaluate the significance of the anterior approach without the Pringle maneuver during right hepatectomies with caudate lobectomies for perihilar cholangiocarcinomas (PHCs). MATERIALS AND METHODS: From January 2011 to 2015, 25 consecutive patients underwent right hepatectomies with caudate lobectomies using the anterior approach without the Pringle maneuver for PHC (group A). Between 2003 and 2011, 44 patients were operated on for PHC using the classic right approach (group B)...
May 1, 2016: Journal of Surgical Research
Jung-Hye Choi, Young-Woong Won, Hyun Sung Kim, Young-Ha Oh, Sanghyeok Lim, Han-Joon Kim
Oxaliplatin is an effective chemotherapeutic agent for the treatment of colorectal cancer; however, it may cause liver injury, particularly sinusoidal obstruction syndrome (SOS). Although SOS does not usually present with focal lesions on radiological images, the present study describes the case of a 22-year-old woman with oxaliplatin-induced SOS mimicking metastatic colon cancer in the liver. An abdominal computed tomography revealed a novel 1 cm, low-density lesion in segment 1 of the liver following the administration of the fourth round of oxaliplatin-based adjuvant chemotherapy for stage III colon cancer...
April 2016: Oncology Letters
Yukihiko Hiroshima, Kenichi Matsuo, Daisuke Kawaguchi, Yutaro Kikuchi, Itaru Endo, Keiji Koda, Shinji Togo, Robert M Hoffman, Kuniya Tanaka
BACKGROUND: A right-sided hepatectomy with total caudate lobectomy is indicated for colorectal-cancer liver metastases (CLM) and hepatocellular carcinomas (HCC) located in the caudate lobe with extension to the right lobe of the liver. Caudate-lobe resection (i.e. segmentectomy 1 according to the Brisbane terminology) is one of the most difficult types of hepatectomy to carry out radically and safely. The deep portion of hepatic transection around the caudate lobe, hepatic veins and inferior vena cava is a critical source of massive bleeding...
April 2016: Anticancer Research
Tung Yu Tsui, Asmus Heumann, Yogesh K Vashist, Jakob R Izbicki
PURPOSE: Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) has increased the rate of liver resections in patients with marginal future liver remnant. We here describe a modified ALPPS procedure with splitting-off the central liver segments for staged mesohepatectomy in patients with advanced gall bladder cancer. METHODS: A double in situ split for ALPPS (DALPPS) is performed with splitting-off the central liver segments (segments 1, 4, 5, and 8)...
June 2016: Langenbeck's Archives of Surgery
Hermien Hartog, Jan N M Ijzermans, Thomas M van Gulik, Bas Groot Koerkamp
Perihilar cholangiocarcinoma presents at the biliary and vascular junction of the hepatic hilum with a tendency to extend longitudinally into segmental bile ducts. Most patients show metastatic or unresectable disease at time of presentation or surgical exploration. In patients eligible for surgical resection, challenges are to achieve negative bile duct margins, adequate liver remnant function, and adequate portal and arterial inflow to the liver remnant. Surgical treatment is characterized by high rates of postoperative morbidity and mortality...
April 2016: Surgical Clinics of North America
Mihoko Yamada, Tomoki Ebata, Gen Sugawara, Tsuyoshi Igami, Takashi Mizuno, Yuji Shingu, Masato Nagino
Surgical resection is the only curative treatment for biliary tract cancer (BTC); however, the recurrence rate remains high even after curative resection. There are limited data regarding the effectiveness of surgical resection for recurrent BTC. We report the favorable survival outcome of a patient who underwent a hepatopancreatoduodenectomy for local recurrence of cholangiocarcinoma after excision of a type IV-A congenital choledochal cyst. The patient, a 25-year-old woman, had undergone excision of a type IV-A congenital choledochal cyst with hepaticojejunostomy...
December 2016: Surgical Case Reports
Gen Takahashi, Shintaro Kuroda, Hirotaka Tashiro, Tsuyoshi Kobayashi, Kohei Ishiyama, Kentaro Ide, Hiroyuki Tahara, Masahiro Ohira, Koji Arihiro, Hideki Ohdan
Intraductal papillary neoplasm of the bile duct (IPNB) is classified as a biliary cystic tumor with a tendency of causing obstruction. Neoplastic cases involving hemobilia are rarely reported. We herein describe a case of biliary cystic tumor with repeated hemobilia. A 57-year-old woman was histologically diagnosed with cavernous hemangioma. During the follow-up period after transcatheter arterial embolization (TAE), she experienced repeated hemobilia, and multiple other TAE sessions were performed for hemostasis...
December 2015: Surgical Case Reports
Xu-Guang Hu, Wei Mao, Sung Yeon Hong, Bong-Wan Kim, Wei-Guang Xu, Hee-Jung Wang
PURPOSE: There is still some debate on surgical procedures for hepatocellular carcinoma (HCC) patients with bile duct tumor thrombi (BDTT, Ueda type 3 or 4). What is adequate extent of liver resection for curative treatment? Is extrahepatic bile duct resection mandatory for cure? The aim of this study is to answer these questions. METHODS: Between February 1994 and December 2012, 877 consecutive HCC patients underwent hepatic resection at Ajou University Hospital...
March 2016: Annals of Surgical Treatment and Research
Hai-Jie Hu, Hui Mao, Anuj Shrestha, Yong-Qiong Tan, Wen-Jie Ma, Qin Yang, Jun-Ke Wang, Nan-Sheng Cheng, Fu-Yu Li
AIM: To evaluate the prognostic factors of hilar cholangiocarcinoma in a large series of patients in a single institution. METHODS: Eight hundred and fourteen patients with a diagnosis of hilar cholangiocarcinoma that were evaluated and treated between 1990 and 2014, of which 381 patients underwent curative surgery, were included in this study. Potential factors associated with overall survival (OS) and disease-free survival (DFS) were evaluated by univariate and multivariate analyses...
February 28, 2016: World Journal of Gastroenterology: WJG
Tsuneyuki Uchida, Yusuke Yamamoto, Takaaki Ito, Yukiyasu Okamura, Teiichi Sugiura, Katsuhiko Uesaka, Yasuni Nakanuma
We report a case of a 75-year-old man with cystic micropapillary neoplasm of peribiliary glands detected preoperatively by radiologic examination. Enhanced computed tomography showed a low-density mass 2.2 cm in diameter in the right hepatic hilum and a cystic lesion around the common hepatic duct. Under a diagnosis of perihilar cholangiocarcinoma, right hepatectomy with caudate lobectomy and bile duct resection were performed. Pathological examination revealed perihilar cholangiocarcinoma mainly involving the right hepatic duct...
February 21, 2016: World Journal of Gastroenterology: WJG
Keisuke Ohta, Yoshihiro Tokuhisa, Takao Tamesa, Masao Nakajima, Satoshi Matsukuma, Yukio Tokumitsu, Kazuhiko Sakamoto, Shigeru Takeda, Tomio Ueno, Shigefumi Yoshino, Shoichi Hazama, Hiroaki Nagano
We report a case of hepatocellular carcinoma (HCC) with a Vp4 tumor thrombus treated successfully with multidisciplinary therapy. A 59-year-old woman who complained of abdominal distension was diagnosed as having HCC associated with hepatitis B virus (HBV) infection. The tumor was located in the left lobe, caudate lobe, and S6, and the tumor thrombus extended into the main portal and right portal veins. Extended left lobectomy with thrombectomy and S6 partial hepatectomy were performed after intrahepatic arterial infusion chemotherapy with radiation...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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