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anesthesia for hepatectomy

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https://www.readbyqxmd.com/read/27593591/the-significance-of-underlying-cardiac-comorbidity-on-major-adverse-cardiac-events-after-major-liver-resection
#1
Thuy B Tran, David J Worhunsky, David A Spain, Monica M Dua, Brendan C Visser, Jeffrey A Norton, George A Poultsides
BACKGROUND: The risk of postoperative adverse events in patients with underlying cardiac disease undergoing major hepatectomy remains poorly characterized. METHODS: The NSQIP database was used to identify patients undergoing hemihepatectomy and trisectionectomy. Patient characteristics and postoperative outcomes were evaluated. RESULTS: From 2005 to 2012, 5227 patients underwent major hepatectomy. Of those, 289 (5.5%) had prior major cardiac disease: 5...
September 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27557726/strict-blood-glucose-control-by-an-artificial-endocrine-pancreas-during-hepatectomy-may-prevent-postoperative-acute-kidney-injury
#2
Naoji Mita, Shinji Kawahito, Tomohiro Soga, Kazumi Takaishi, Hiroshi Kitahata, Munehide Matsuhisa, Mitsuo Shimada, Hiroyuki Kinoshita, Yasuo M Tsutsumi, Katsuya Tanaka
The aim of the present study was to evaluate the usefulness of a closed-loop system (STG-55; Nikkiso, Tokyo, Japan), a type of artificial endocrine pancreas for the continuous monitoring and control of intraoperative blood glucose, for preventing postoperative acute kidney injury (AKI) in patients undergoing hepatectomy. Thirty-eight patients were enrolled in this study. Glucose concentrations were controlled with either a manual injection of insulin based on a commonly used sliding scale (manual insulin group, n = 19) or the programmed infusion of insulin determined by the control algorithm of the artificial endocrine pancreas (programmed insulin group, n = 19)...
August 24, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27554332/epidural-anesthesia-and-analgesia-in-liver-resection-safety-and-effectiveness
#3
N Esteve, A Ferrer, C Sansaloni, M Mariscal, M Torres, C Mora
OBJECTIVES: Perioperative epidural analgesia in liver resection provides optimal dynamic pain relief. Coagulation disorders occurring in the postoperative period can lead to greater risk of complications during epidural catheter removal. The aim of this study is to evaluate the effectiveness and complications of epidural analgesia and delayed epidural catheter removal due to postoperative coagulopathy. METHODS: A retrospective study of 114 patients undergoing open liver resection and epidural analgesia, from March 2012 to February 2015...
August 20, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27291965/effects-of-different-anesthetic-methods-on-cellular-immune-and-neuroendocrine-functions-in-patients-with-hepatocellular-carcinoma-before-and-after-surgery
#4
Hui-Zhen Sun, Yan-Ling Song, Xiang-Yun Wang
BACKGROUND: Many anesthesia methods have been studies in hepatocellular carcinoma (HCC). We aimed to explore the effects of combined intravenous and inhalation anesthesia and combined general and epidural anesthesia on cellular immune function and neuroendocrine function in patients with HCC before and after surgery. METHODS: Between September 2012 and April 2014, 72 patients who underwent a hepatectomy in our hospital were enrolled. RESULTS: Compared with the combined intravenous and inhalation anesthesia group, the combined general and epidural anesthesia group demonstrated increased CD4(+) /CD8(+) T cells 0 hr after surgery, increased CD3(+) , CD4(+) , CD4(+) /CD8(+) cells, and IFN-γ levels 12 hr after surgery, and increased CD3(+) , CD4(+) , and CD4(+) /CD8(+) cells 24 hr after surgery (all P < 0...
June 13, 2016: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/27097513/-a-case-of-rocuronium-induced-anaphylaxis-in-which-surgery-was-subsequently-performed-under-general-anesthesia-without-neuromuscular-blocking-agents
#5
Tatsuo Horiuchi, Tomonori Takazawa, Shigeru Saito
We report here a case of rocuronium-induced anaphylactic shock in a 41-year-old woman. She was scheduled for partial hepatectomy due to liver metastasis of a pheochromocytoma. Anesthesia was induced with propofol, remifentanil, and rocuronium. Bag-mask ventilation was difficult, and her blood pressure fell to around 40 mmHg just after induction. Subsequently, her trachea was intubated and adrenaline was injected. However, due to the subsequent persistence of severe hypotension and hypoxia, cardiopulmonary resuscitation was necessary...
March 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26877612/interleukin-22-contributes-to-liver-regeneration-in-mice-with-concanavalin-a-induced-hepatitis-after-hepatectomy
#6
Ya-Min Zhang, Zi-Rong Liu, Zi-Lin Cui, Chao Yang, Long Yang, Yang Li, Zhong-Yang Shen
AIM: To investigate the therapeutic effects and mechanisms of interleukin (IL)-22 in liver regeneration in mice with concanavalin A (ConA)-induced liver injury following 70% hepatectomy. METHODS: Mice were injected intravenously with ConA at 10 μg/g body weight 4 d before 70% hepatectomy to create a hepatitis model, and recombinant IL-22 was injected at 0.125 μg/g body weight 30 min prior to 70% hepatectomy to create a therapy model. Control animals received an intravenous injection of an identical volume of normal saline...
February 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/26648150/video-assisted-resections-increasing-access-to-minimally-invasive-liver-surgery
#7
Fabricio Ferreira Coelho, Marcos Vinícius Perini, Jaime Arthur Pirola Kruger, Renato Micelli Lupinacci, Fábio Ferrari Makdissi, Luiz Augusto Carneiro D'Albuquerque, Ivan Cecconello, Paulo Herman
OBJECTIVE: To evaluate perioperative outcomes, safety and feasibility of video-assisted resection for primary and secondary liver lesions. METHODS: From a prospective database, we analyzed the perioperative results (up to 90 days) of 25 consecutive patients undergoing video-assisted resections in the period between June 2007 and June 2013. RESULTS: The mean age was 53.4 years (23-73) and 16 (64%) patients were female. Of the total, 84% were suffering from malignant diseases...
September 2015: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/26611799/patient-reported-outcomes-accurately-measure-the-value-of-an-enhanced-recovery-program-in-liver-surgery
#8
Ryan W Day, Charles S Cleeland, Xin S Wang, Sharon Fielder, John Calhoun, Claudius Conrad, Jean-Nicolas Vauthey, Vijaya Gottumukkala, Thomas A Aloia
BACKGROUND: Enhanced recovery (ER) pathways have become increasingly integrated into surgical practice. Studies that compare ER and traditional pathways often focus on outcomes confined to inpatient hospitalization and rarely assess a patient's functional recovery. The aim of this study was to compare functional outcomes for patients treated on an Enhanced Recovery in Liver Surgery (ERLS) pathway vs a traditional pathway. STUDY DESIGN: One hundred and eighteen hepatectomy patients rated symptom severity and life interference using the validated MD Anderson Symptom Inventory preoperatively and postoperatively at every outpatient visit until 31 days after surgery...
December 2015: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26488080/pain-management-with-bilateral-continuous-thoracic-paravertebral-block-in-a-patient-with-fontan-associated-hepatocellular-carcinoma-undergoing-hepatectomy
#9
Akihiko Maeda, Sho C Shibata, Kenta Okitsu, Tatsuyuki Imada, Ayako Takahashi, Akinori Uchiyama, Takahiko Kamibayashi, Yuji Fujino
OBJECTIVE: We report a case of perioperative management of a single-ventricle patient with Fontan-associated liver disease undergoing hepatectomy. CASE REPORT: A 12-year-old boy with Fontan circulation was scheduled for partial hepatectomy to remove a liver mass in segment 6. He received stent implantation to relieve conduit stenosis 6 months before the operation. The operation was performed under general anesthesia and with a bilateral thoracic paravertebral block (PVB)...
November 2015: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26419103/-a-case-of-postoperative-paraplegia-caused-by-idiopathic-spinal-cord-infarction-following-hepatectomy-under-both-general-and-epidural-anesthesia
#10
Yukari Koga, Teruyuki Hiraki, Kazuo Ushijima
A 73-year-old woman (height : 155 cm, weight : 55 kg) was scheduled to undergo a laparotomic hepatectomy and radiofrequency ablation for hepatocellular carcinoma. Her medical history did not include any relevant conditions such as cardiovascular or neurological disorders. A thoracic epidural catheter was introduced at T8-9 before the induction of anesthesia with intravenous propofol. General anesthesia was maintained with the inhalation of oxygen, air, and desflurane, and the continuous infusion of remifentanil...
April 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26194122/a-case-of-perioperative-glucose-control-by-using-an-artificial-pancreas-in-a-patient-with-glycogen-storage-disease
#11
Tomoaki Yatabe, Ryu Nakamura, Hiroyuki Kitagawa, Masaya Munekage, Kazuhiro Hanazaki
A 57-year-old woman was diagnosed with type I glycogen storage disease in her twenties. She had undergone hepatectomy under general anesthesia with epidural anesthesia. Fifty minutes after the induction of anesthesia, a 20-gauge venous catheter was inserted in the patient's right hand, and an artificial pancreas (STG-55, Nikkiso Co., Tokyo, Japan) was connected for continuous glucose monitoring and automatic glucose control. Insulin was infused when the blood glucose level reached 120 mg/dL or higher, and glucose was infused when the level fell to 100 mg/dL or lower...
March 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/25992300/concurrent-biliary-drainage-and-portal-vein-embolization-in-preparation-for-extended-hepatectomy-in-patients-with-biliary-cancer
#12
Jan Nilsson, Sam Eriksson, Peter Nørgaard Larsen, Inger Keussen, Susanne Christiansen Frevert, Gert Lindell, Christian Sturesson
BACKGROUND: Patients with perihilar cholangiocarcinoma and gallbladder cancer extending into the hilum often present with jaundice and a small future liver remnant (FLR). If resectable, preoperative biliary drainage and portal vein embolization (PVE) are indicated. Classically, these measures have been performed sequentially, separated by 4-6 weeks. PURPOSE: To report on a new regime where percutaneous transhepatic biliary drainage (PTBD) and PVE are performed simultaneously, shortening the preoperative process...
May 2015: Acta Radiologica Open
https://www.readbyqxmd.com/read/25769593/comparison-of-antioxidant-effects-of-isoflurane-and-propofol-in-patients-undergoing-donor-hepatectomy
#13
RANDOMIZED CONTROLLED TRIAL
M Ucar, U Ozgül, A Polat, H I Toprak, M A Erdogan, M S Aydogan, M Durmus, M O Ersoy
BACKGROUND: The safety of healthy volunteer donors is one of the most important issues in living-donor liver transplantation. Use of the Pringle maneuver during donor hepatectomy can result in liver ischemia-reperfusion (IR) injury. The objective of this study was to examine the effects of isoflurane and propofol on IR injury caused by the Pringle maneuver during donor hepatectomy. METHODS: A total of 70 American Society of Anesthesiology I-II donors aged 18-65 years who underwent hepatectomy were included in the study...
March 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/25763776/reverse-trendelenburg-position-is-a-safer-technique-for-lowering-central-venous-pressure-without-decreasing-blood-pressure-than-clamping-of-the-inferior-vena-cava-below-the-liver
#14
Godai Yoneda, Satoshi Katagiri, Masakazu Yamamoto
BACKGROUND: Bleeding remains an important intraoperative complication in patients who undergo hepatectomy. It is generally believed that a reduction in central venous pressure will decrease bleeding from the hepatic venous system. To our knowledge, however, no study has compared the effectiveness of these techniques for controlling bleeding. So we compared the effectiveness of central venous pressure control techniques, such as infrahepatic inferior vena cava clamping, changes in surgical position of the patient, and hypoventilation anesthesia, for lowering central venous pressure...
June 2015: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/25597148/initial-experience-of-surgical-microwave-tissue-precoagulation-in-liver-resection-for-hepatocellular-carcinoma-in-cirrhotic-liver
#15
A Abdelraouf, H Hamdy, A M El Erian, M Elsebae, S Taha, H E Elshafey, S Ismail, M Hassany
Surgical hepatic resection has been considered as the first-line treatment which is most effective and radical treatment for HCC, however, HCC is usually associated with poor liver function owing to chronic hepatitis or liver cirrhosis. Techniques that can eradicate the tumor and also preserve liver function are needed. Moreover, hepatic resection, in the presence of cirrhosis, raises special problem of high risk as hemorrhage and liver failure, thus, good clinical results can only be achieved by minimizing operative blood loss, time of the intervention as well as the hepatic reserve...
August 2014: Journal of the Egyptian Society of Parasitology
https://www.readbyqxmd.com/read/25538332/optimal-single-dose-epidural-neostigmine-for-postoperative-analgesia-after-partial-hepatectomy
#16
Qiao Sheng Zhong, Sheng Jin Ge, Bei Wang, Zhang Gang Xue
OBJECTIVE: Neostigmine can produce analgesia by acting on the spinal cord. This study was to determine the optimal single-dose of epidural neostigmine for postoperative analgesia after partial hepatectomy. PATIENTS AND METHODS: Twenty-six patients undergoing elective partial hepatectomy under general anesthesia combined with epidural block were studied. The dose of epidural neostigmine was determined using Dixon's up-and-down method, starting from neostigmine 100 μg with an interval of 25 μg...
November 2014: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/25513115/hybrid-laparoscopic-complete-untinatectomy-of-pancreas-by-shuriken-shaped-umbilicoplasty-with-sliding-windows-method
#17
Yoshinobu Sato, Naruhiko Sawada, Mari Shimada, Daisuke Takayanagi, Shunpei Mukai, Chiyo Maeda, Shoji Shimada, Hiroyuki Kida, Fumio Ishida, Shin-Ei Kudo
In this study, we demonstrated the complete resection of untinate process that was performed by the hybrid laparoscopic surgery using our original new technique of Shuriken shaped umbilicoplasty with sliding window`s method. A 70-year-old weman was hospitalized for surgery of intraductal papillary mucinous neoplasm located in the uncinate process of pancreas. Under general anesthesia, a Shuriken shaped umbilical skin incision was made by 7 cm in horizontal and 4cm longitudinal width with 3cm round skin incision...
September 2014: Hepato-gastroenterology
https://www.readbyqxmd.com/read/25436330/hybrid-laparoscopic-complete-untinatectomy-of-pancreas-by-shuriken-shaped-umbilicoplasty-with-sliding-windows-method
#18
Yoshinobu Sato, Naruhiko Sawada, Mari Shimada, Daisuke Takayanagi, Shunpei Mukai, Chiyo Maeda, Shoji Shimada, Hiroyuki Kida, Fumio Ishida, Shin-Ei Kudo
In this study, we demonstrated the complete resection of untinate process that was performed by the hybrid laparoscopic surgery using our original new technique of Shuriken shaped umbilicoplasty with sliding window`s method. A 70-year-old weman was hospitalized for surgery of intraductal papillary mucinous neoplasm located in the uncinate process of pancreas. Under general anesthesia, a Shuriken shaped umbilical skin incision was made by 7 cm in horizontal and 4cm longitudinal width with 3cm round skin incision...
September 2014: Hepato-gastroenterology
https://www.readbyqxmd.com/read/25297646/independent-effects-of-sham-laparotomy-and-anesthesia-on-hepatic-microrna-expression-in-rats
#19
Wiebke Werner, Hannes Sallmon, Annekatrin Leder, Steffen Lippert, Anja Reutzel-Selke, Mehmet Haluk Morgül, Sven Jonas, Christof Dame, Peter Neuhaus, John Iacomini, Stefan G Tullius, Igor M Sauer, Nathanael Raschzok
BACKGROUND: Studies on liver regeneration following partial hepatectomy (PH) have identified several microRNAs (miRNAs) that show a regulated expression pattern. These studies involve major surgery to access the liver, which is known to have intrinsic effects on hepatic gene expression and may also affect miRNA screening results. We performed two-third PH or sham laparotomy (SL) in Wistar rats to investigate the effect of both procedures on miRNA expression in liver tissue and corresponding plasma samples by microarray and qRT-PCR analyses...
2014: BMC Research Notes
https://www.readbyqxmd.com/read/25260685/the-effect-of-preoperative-renal-insufficiency-on-postoperative-outcomes-after-major-hepatectomy-a-multi-institutional-analysis-of-1-170%C3%A2-patients
#20
MULTICENTER STUDY
Malcolm H Squires, Neha L Lad, Sarah B Fisher, David A Kooby, Sharon M Weber, Adam Brinkman, Charles R Scoggins, Michael E Egger, Kenneth Cardona, Clifford S Cho, Robert C G Martin, Maria C Russell, Emily Winslow, Charles A Staley, Shishir K Maithel
BACKGROUND: Renal insufficiency adversely affects outcomes after cardiac and vascular surgery. The effect of preoperative renal insufficiency on outcomes after major hepatectomy is unknown. STUDY DESIGN: All patients who underwent major hepatectomy (≥3 segments) at 3 institutions from 2000 to 2012 were identified. Resections were performed using low central venous pressure anesthesia. Renal function was analyzed by preoperative serum creatinine (sCr) level. Primary outcomes were major complications (Clavien grade III to V), respiratory failure, renal failure requiring hemodialysis, and 90-day mortality...
November 2014: Journal of the American College of Surgeons
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