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Portal vein thrombosis

Zhi-Hua Zhang, Li Xin Li, Ping Li, Shao-Cheng Lv, Bing Pan, Qiang He
Previous studies have indicated that sirolimus (SRL) may be effective for HCC patients undergoing liver transplantation (LT). However, the following results are still contradictory and do not have a clear conclusion. Therefore, we conducted an updated meta-analysis by retrieving published data in EMBASE, PubMed, and the Cochrane Library up to October 2017. Both efficiency and safety of SRL were analyzed using pooled odds ratio (ORs) with 95% confidence interval (CIs). A total of 11 studies involving 7,695 HCC patients were included...
March 20, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Dong Jae Shim, Gi-Young Ko, Kyu-Bo Sung, Dong Il Gwon, Heung Kyu Ko
PURPOSE: To evaluate the long-term efficacy of stent placement versus balloon angioplasty for portal vein (PV) stenosis in pediatric liver transplant (LT) recipients. MATERIALS AND METHODS: Fifty patients (<18 years old; median, 14 months) who underwent percutaneous transhepatic balloon angioplasty (n = 12), transhepatic stent placement (n = 18), or intraoperative transmesenteric stent placement (n = 20) between 1994 and 2015 were retrospectively analyzed...
March 13, 2018: Journal of Vascular and Interventional Radiology: JVIR
Yuichi Goto, Yoshihiro Uchino, Shin Sasaki, Nobuhisa Shirahama, Yoriko Nomura, Jun Akiba, Hiroto Ishikawa, Yoshito Akagi, Hiroyuki Tanaka, Koji Okuda
INTRODUCTION: We report a rare case of complete spontaneous necrosis of a hepatocellular carcinoma (HCC) accompanied by portal vein tumor thrombosis (PVTT), as confirmed by resection. CASE PRESENTATION: A 64-year-old man was referred to our hospital for suspected HCC. Contrast-enhanced computed tomography (CECT) findings before admission revealed a 53-mm tumor in the posterior segment of the liver and were suspicious for PVTT in the right posterior PV. Both alpha-fetoprotein (AFP) and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) were elevated at 17,562 ng/mL and 153 mAU/mL, respectively...
March 7, 2018: International Journal of Surgery Case Reports
Agazi Gebreselassie, Majidah Bukhari, Ahmad Awan, Mouen Khashab
Portal vein thrombosis with cavernous transformation is a rare cause of biliary obstruction. Portal biliopathy is a term that refers to abnormalities in the intrahepatic and extrahepatic biliary tract, gall bladder, and cystic duct secondary to portal hypertension. Patients may be asymptomatic, but they can also present with abdominal pain, jaundice, and fever. We present the case of a 61-year-old Caucasian female who presented with generalized weakness, dark urine, and yellow skin for three days' duration...
January 9, 2018: Curēus
H Abdella, M K Shaker, Iman Fawzy Montasser, M Sobhi, H Aly, A Sayed, S Saleh, A El Dorry
BACKGROUND/AIM: Portal vein tumor thrombosis (PVTT) is a common complication in hepatocellular carcinoma (HCC) and it was considered a relative contraindication for transarterial chemoembolization (TACE) by many centers. This study aimed to assess the outcomes after TACE in patients with branch PVT regarding Child classification, radiological response, and 1-year survival. METHODS: Thirty HCC patients (24 male, 6 females) Child A cirrhotics with branch PVT underwent TACE...
March 13, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Arata Hibi, Kazumasa Mogi
Portal vein thrombosis is a rare but life-threatening complication during pregnancy and postpartum period. Color Doppler ultrasound is useful for prompt diagnosis. Although the risk of complications should be considered, successful pregnancy with comorbid portal vein thrombosis is possible with appropriate anticoagulation therapy and close monitoring.
March 2018: Clinical Case Reports
Kakharman Yesmembetov, Zhansaya Muratova, Sergey Borovskiy, Irina Ten, Kulpash Kaliaskarova
We report the clinical case of 23-year-old patient with liver cirrhosis of unknown genesis, significant resistant ascites, and 2 episodes of bleeding from esophageal varices. Evaluation did not find any cause of liver disease, and the patient was placed on the transplant wait list due to subcompensated liver function (Model for End-Stage Liver Disease score of 16, Child-Pugh class B) and poorly controlled severe portal hypertension. After treatment with diuretics, largevolume paracentesis, antibiotics, and vasoconstrictors, hepatorenal syndrome and spontaneous bacterial peritonitis resolved and liver function improved significantly...
March 2018: Experimental and Clinical Transplantation
Atsushi Aikawa, Masaki Muramatsu, Yusuke Takahashi, Yuko Hamasaki, Junya Hashimoto, Mai Kubota, Takeshi Kawamura, Yoshihiro Itabashi, Yoiji Hyodou, Seiichiro Shishido
During pediatric kidney transplant, surgical challenges occasionally occur. In particular, vascular anastomosis should be considered for children with small body weight < 12 kg, multiple renal arteries, vascular anomaly, and inferior vena cava occlusion. In pediatric patients, a living-donor renal graft is usually donated from a parent. Therefore, the renal artery and vein are too large to be anastomosed with the recipient's internal iliac artery and external iliac vein. In children who are > 12 kg, the renal artery and vein could be anastomosed with the external iliac artery and the external iliac vein...
March 2018: Experimental and Clinical Transplantation
Michael R Freund, Petachia Reissman, Ari Zimran, Joseph Alberton
OBJECTIVE: The objective of this article was to demonstrate that Gaucher disease (GD) patients with refractory hypersplenism and massive splenomegaly may successfully undergo hand-assisted laparoscopic splenectomy (HALS). METHODS: This was a retrospective audit conducted at the Gaucher clinic at a national referral center over a 10-year period. PATIENT POPULATION: This study included 8 GD patients who underwent hand-assisted or conventional laparoscopic splenectomy for massive or complicated splenomegaly between the years 2007 and 2017...
March 7, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Jong Man Kim, Nam-Joon Yi, Choon Hyuck David Kwon, Kwang-Woong Lee, Kyung-Suk Suh, Jae-Won Joh
Purpose: Although few hepatectomy patients develop unexpected early diffuse and multinodular recurrence in the remnant liver, the prognosis in such cases is often dismal. The aim of this study was to evaluate the risk factors of early disseminated multinodular hepatocellular carcinoma (HCC) recurrence within 3 months after liver resection for solitary HCC. Methods: Eighty-four patients who were diagnosed with recurrent HCC within 3 months after hepatectomy for solitary HCC were retrospectively reviewed...
March 2018: Annals of Surgical Treatment and Research
Zhong-Wu Chen, Zheng-Yu Lin, Yi-Ping Chen, Jian Chen, Jin Chen
Objective: The objective of this study is to investigate the clinical efficacy and safety of Habib™ VesOpen, a new intravascular radiofrequency ablation (RFA) catheter in percutaneous puncture of portal vein tumor thrombus (PVTT) in patients with primary hepatocellular carcinoma. Materials and Methods: Collected data of patients with primary hepatocellular carcinoma with portal vein trunk or main branch who were treated by the RFA of portal vein tumor ablation with Habib™ VesOpen, a new intravascular RFA catheter...
January 2018: Journal of Cancer Research and Therapeutics
Jonathan G Stine, Blake A Niccum, Alex N Zimmet, Nicolas Intagliata, Stephen H Caldwell, Curtis K Argo, Patrick G Northup
OBJECTIVE: Patients with cirrhosis are at increased risk for venous thromboembolism (VTE) and portal vein thrombosis (PVT). Cirrhosis due to non-alcoholic steatohepatitis (NASH) appears to be particularly prothrombotic. We investigated hospitalized patients with NASH cirrhosis to determine if they are at increased risk for VTE. METHODS: Data on adult hospitalized patients with cirrhosis and VTE (deep vein thrombosis and/or pulmonary embolism) between November 1, 2010 and December 31, 2015 were obtained...
March 6, 2018: Clinical and Translational Gastroenterology
Hadrien Tranchart, Martin Gaillard, Papa Saloum Diop, Sylvie Goulinet, Panagiotis Lainas, Ibrahim Dagher
BACKGROUND: Hepatocyte transplantation is a potentially less invasive alternative to liver transplantation for treating inherited metabolic liver diseases. We developed an autotransplantation protocol of ex vivo genetically modified hepatocytes combining lentiviral transduction and transplantation after liver preconditioning by partial portal vein embolization. We investigated the metabolic efficiency of this approach in Watanabe rabbits, animal model of familial hypercholesterolemia...
April 2018: Journal of Surgical Research
Pierce K H Chow, Mihir Gandhi, Say-Beng Tan, Maung Win Khin, Ariunaa Khasbazar, Janus Ong, Su Pin Choo, Peng Chung Cheow, Chanisa Chotipanich, Kieron Lim, Laurentius A Lesmana, Tjakra W Manuaba, Boon Koon Yoong, Aloysius Raj, Chiong Soon Law, Ian H Y Cua, Rolley R Lobo, Catherine S C Teh, Yun Hwan Kim, Yun Won Jong, Ho-Seong Han, Si-Hyun Bae, Hyun-Ki Yoon, Rheun-Chuan Lee, Chien-Fu Hung, Cheng-Yuan Peng, Po-Chin Liang, Adam Bartlett, Kenneth Y Y Kok, Choon-Hua Thng, Albert Su-Chong Low, Anthony S W Goh, Kiang Hiong Tay, Richard H G Lo, Brian K P Goh, David C E Ng, Ganesh Lekurwale, Wei Ming Liew, Val Gebski, Kenneth S W Mak, Khee Chee Soo
Purpose Selective internal radiation therapy or radioembolization (RE) shows efficacy in unresectable hepatocellular carcinoma (HCC) limited to the liver. This study compared the safety and efficacy of RE and sorafenib in patients with locally advanced HCC. Patients and Methods SIRveNIB (selective internal radiation therapy v sorafenib), an open-label, investigator-initiated, phase III trial, compared yttrium-90 (90 Y) resin microspheres RE with sorafenib 800 mg/d in patients with locally advanced HCC in a two-tailed study designed for superiority/detriment...
March 2, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Toshiaki Aida, Masayuki Shiobara, Kazuo Wakatsuki, Shuka Arai, Kosuke Suda, Kotaro Miyazawa, Tetsutaro Miyoshi, Yoshihisa Takahashi, Shigeru Yoshioka
The patient was a 70-year-old man. He was diagnosed with advanced transverse colon cancer. A computed tomography (CT)revealed liver metastasis and tumor thrombosis of portal vein. We started combination chemotherapy with capecita- bine/oxaliplatin(CapeOX). Perforation of the tumor was observed 5 days after CapeOX therapy was started. Treatment with abscess drainage and ileostmy, infection was controlled and general condition was improved. After 9 courses of CapeOX, we changed chemotherapy regimen to irinotecan/tegafur-gimeracil-oteracilpotassium (IRIS)due to strong side effects...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Angel Mier-Hicks, Michael Raj, Richard Kinh Do, Kenneth H Yu, Maeve A Lowery, Anna Varghese, Eileen M O'Reilly
BACKGROUND: Visceral or splanchnic thrombosis is defined as thrombi within the hepatoportal venous system, including portal (PV), mesenteric (MV), and splenic vein (SV), as well as thrombi in renal or gonadal veins. There are limited data to evaluate the prognostic significance, incidence, and clinical management of visceral thromboses in patients with pancreatic ductal adenocarcinoma (PDAC). PATIENTS AND METHODS: We conducted an analysis of 95 patients treated at Memorial Sloan Kettering Cancer Center with PDAC who had a visceral thrombosis...
January 31, 2018: Clinical Colorectal Cancer
Y-H Li, Z-Y Xu, H-M Wu, L-H Yang, Y Xu, X-N Wu, Y-M Wan
AIM: To investigate the long-term shunt patency and overall survival of transjugular intrahepatic portosystemic shunt (TIPS) placement using covered stents with or without bare stents over a follow-up period up to 7 years. MATERIALS AND METHODS: A total of 154 patients undergoing TIPS placement were enrolled and analysed retrospectively. They were divided into two groups: those undergoing TIPS placement using covered with bare stents (group A, n=42) and those without bare stents (group B, n=112)...
February 20, 2018: Clinical Radiology
Jonel Trebicka
Does transjugular intrahepatic portosystemic shunt stent (TIPS) improve survival in a subgroup of patients? Yes. TIPS nearly halves portal pressure and increases the effective blood volume. In cases of acute variceal hemorrhage and with a high risk of treatment failure, defined as either hepatic venous pressure gradient higher than 20 mm Hg, Child B with active bleeding at the endoscopy, or Child C with less than 14 points, early or preemptive placement of TIPS (within 72 hours) improves survival. Also, in suitable patients with intractable or refractory ascites, TIPS improves survival if placed early in the course of treatment...
February 2018: Seminars in Liver Disease
Avesh J Thuluvath, Po-Hung Chen, Paul J Thuluvath, Sergey Kantsevoy, Yulia Savva
BACKGROUND: Nonalcoholic steatohepatitis (NASH) cirrhosis is a common indication for liver transplantation (LT) in the U.S. There is a paucity of data on retransplantation (re-LT) in those who were initially transplanted for NASH. METHODS: We queried the UNOS data sets from 2002-2016 to analyze the outcomes of adults with NASH (n=128) and compared them to groups that received re-LT for cryptogenic cirrhosis (CC, n=189), alcoholic cirrhosis (AC, n=300) or autoimmune hepatitis cirrhosis (AIH-C, n=118) after excluding multiple-organ re-LT and individuals with HCC...
February 20, 2018: Transplantation
Marcello Bianchini, Giulia Cavani, Ambra Bonaccorso, Laura Turco, Francesco Vizzutti, Alessandro Sartini, Stefano Gitto, Alberto Merighi, Federico Banchelli, Erica Villa, Filippo Schepis
INTRODUCTION: Anticoagulants are commonly indicated in cirrhotic patients due to high rate of (pro)thrombotic conditions. Low molecular weight heparin (LMWH) is safe in patients with esophageal varices. However, the safety of LMWH is unknown in patients undergoing prophylactic endoscopic variceal ligation (EVL). AIM: To define the 4-week risk of bleeding and death after prophylactic EVL in cirrhotic patients continuously treated with LMWH. METHODS: All EVLs performed at a tertiary Italian Center from 2009 to 2016 were retrospectively reviewed...
February 22, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
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