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https://www.readbyqxmd.com/read/28207553/laparoscopic-living-donor-right-hemihepatectomy-with-venous-outflow-reconstruction-using-cadaveric-common-iliac-artery-allograft-case-report-and-literature-review
#1
Jiaxin Li, Jiwei Huang, Hong Wu, Yong Zeng
RATIONALE: With the development of laparoscopic technique, the total laparoscopic living donor right hemihepatectomy (LLDRH) procurement surgery has been successfully performed in many liver transplant centers all over the world, and the number of cases is continuing to increase. We report our case of laparoscopic right graft resection with venous outflow reconstruction using cadaveric common iliac artery allograft in our center and review literatures about total LLDRH surgery. PATIENT CONCERNS AND DIAGNOSES: A 40-year-old male living donor for right hepatectomy was selected after pretransplant evaluation including laboratory tests, liver volume, anatomy of hepatic vein, artery, portal vein, and bile duct...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28193543/reduction-of-manganese-intake-improves-neuropsychological-manifestations-in-rats-with-minimal-hepatic-encephalopathy
#2
Ying Li, Lihong Mei, Jinwei Qiang, Changxue Ji, Shuai Ju
Brain manganese deposition is led by liver dysfunction and/or portal-systemic shunting in minimal hepatic encephalopathy (MHE). Manganese is toxic and can cause cognitive disorders and extrapyramidal symptoms. Thus, reduction of manganese intake might be considered as a potential treatment strategy for MHE. In this study we aimed to investigate whether low- or no-manganese feed can improve the neuropsychological manifestations in MHE rats. Rats with MHE were established by partially ligating the portal vein and fed a manganese diet (MHE-M, 10 mg per kg feed; n=24), a no-manganese diet (MHE-N; n=24) and a half-manganese diet (MHE-H; n=24) for 2, 4, 6 and 8 weeks, with six rats in each subgroup...
February 10, 2017: Neuroscience
https://www.readbyqxmd.com/read/28173999/hepatic-parenchymal-transection-increases-liver-volume-but-not-function-after-portal-vein-embolization-in-rabbits
#3
Pim B Olthof, Erik Schadde, Krijn P van Lienden, Michal Heger, Kora de Bruin, Joanne Verheij, Roelof J Bennink, Thomas M van Gulik
BACKGROUND: Associating liver partition with portal vein ligation for staged hepatectomy induces more extensive liver hypertrophy than ligation alone; however, the mechanisms underlying the accelerated liver regrowth and the functional quality of the hypertrophic liver are presently elusive. This study, therefore, investigated the effect of parenchymal transection on liver volume and function after portal vein embolization in a standardized rabbit model. METHODS: Twelve rabbits were subjected to portal vein embolization of the cranial liver lobes and randomized between parenchymal transection of the left lateral liver lobe versus no transection (portal vein embolization only)...
February 4, 2017: Surgery
https://www.readbyqxmd.com/read/28154774/portal-vein-embolization-for-induction-of-selective-hepatic-hypertrophy-prior-to-major-hepatectomy-rationale-techniques-outcomes-and-future-directions
#4
David Li, David C Madoff
The ability to modulate the future liver remnant (FLR) is a key component of modern oncologic hepatobiliary surgery practice and has extended surgical candidacy for patients who may have been previously thought unable to survive liver resection. Multiple techniques have been developed to augment the FLR including portal vein embolization (PVE), associating liver partition and portal vein ligation (ALPPS), and the recently reported transhepatic liver venous deprivation (LVD). PVE is a well-established means to improve the safety of liver resection by redirecting blood flow to the FLR in an effort to selectively hypertrophy and ultimately improve functional reserve of the FLR...
December 2016: Cancer Biology & Medicine
https://www.readbyqxmd.com/read/28119254/associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-the-current-role-and-development
#5
Wan Yee Lau, Eric Ch Lai, Stephanie Hy Lau
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been developed to induce rapid liver hypertrophy and reduce post-hepatectomy liver failure in patients with insufficient future liver remnant (FLR). ALPPS is still considered to be in an early developmental phase because surgical indications and techniques have not been standardized. This article aimed to review the current role and future developments of ALPPS. DATA SOURCES: Studies were identified by searching MEDLINE and PubMed for articles from January 2007 to October 2016 using the keywords "associating liver partition and portal vein ligation for staged hepatectomy" and "ALPPS"...
February 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28109616/hammer-versus-swiss-army-knife-developing-a-strategy-for-the-management-of-bilobar-colorectal-liver-metastases
#6
REVIEW
Jordan M Cloyd, Thomas A Aloia
For patients with bilobar colorectal liver metastases, the recent increase in surgical approaches has resulted in more opportunities to extend the benefits of surgery to patients who were previously deemed unresectable. Surgical options now include anatomic hepatectomy, 1-stage parenchymal sparing hepatectomy, traditional 2-stage hepatectomy with or without portal vein embolization, associated liver partition and portal vein ligation for staged hepatectomy, local ablative techniques, and hepatic arterial infusion therapy...
January 18, 2017: Surgery
https://www.readbyqxmd.com/read/28039607/hepatobilio-pancreatic-robotic-surgery-initial-experience-from-a-single-center-institute
#7
Yolanda Quijano, Emilio Vicente, Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Luis Malave, Valentina Ferri, Carlos Plaza, Jan Lammel Lindemann, Vito D'Andrea, Riccardo Caruso
The use of robotic surgery in the hepatobilio-pancreatic (HBP) field is still limited. Our aim is to present our early experience of robotic liver resection. A retrospective review of robotic pancreatic and liver resection was performed at Sanchinarro University hospital from October 2010 to April 2016. Since the beginning of the robotic program in our center, 22 hepatic procedures and 45 pancreatic robotic procedures have been performed. Of the 21 patients subjected to liver resection, 13 (65%) were for malignancy...
December 30, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28038862/survival-after-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-for-advanced-colorectal-liver-metastases-a-case-matched-comparison-with-palliative-systemic-therapy
#8
Pim B Olthof, Joost Huiskens, Dennis A Wicherts, Pablo E Huespe, Victoria Ardiles, Ricardo Robles-Campos, René Adam, Michael Linecker, Pierre-Alain Clavien, Miriam Koopman, Cornelis Verhoef, Cornelis J A Punt, Thomas M van Gulik, Eduardo de Santibanes
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows the resection of colorectal liver metastases with curative intent which would otherwise be unresectable and only eligible for palliative systemic therapy. This study aimed to compare outcomes of ALPPS in patients with otherwise unresectable colorectal liver metastases with matched historic controls treated with palliative systemic treatment. METHODS: All patients with colorectal liver metastases from the international ALPPS registry were identified and analyzed...
December 27, 2016: Surgery
https://www.readbyqxmd.com/read/28032566/rabbit-model-provides-new-insights-in-liver-regeneration-after-transection-with-portal-vein-ligation
#9
Mingheng Liao, Tao Zhang, Haichuan Wang, Ying Liu, Minxun Lu, Jiwei Huang, Yong Zeng
BACKGROUND: The rabbit model of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has not been reported before. MATERIALS AND METHODS: New Zealand white rabbits were allocated to two protocols. Protocol 1 involved either liver parenchymal transection (LPT, n = 5) or portal vein ligation (PVL, n = 5). Protocol 2 involved the ligation of different portal vein branches combined with liver partition, including the LPT + 20% PVL group (n = 5; the caudate portal vein was ligated), the LPT + 50% PVL group (n = 5; the left portal vein was ligated), and the LPT + 70% PVL group (n = 10; both veins were ligated)...
November 2, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27995092/surgery-of-colorectal-liver-metastases-pushing-the-limits
#10
REVIEW
Guido Torzilli, René Adam, Luca Viganò, Katsunori Imai, Jeremias Goransky, Andrea Fontana, Christian Toso, Pietro Majno, Eduardo de Santibañes
BACKGROUND: The recent advent of more effective chemotherapy and the development of surgical procedures have expanded the pool of resectable patients with colorectal liver metastases (CLM). Two-stage hepatectomy (TSH), associated liver partition and portal vein ligation for staged hepatectomy (ALPPS), and ultrasound-guided enhanced one-stage hepatectomy (e-OSH) are the surgical solutions proposed for these patients, but the range of indications for these procedures vary from institution to institution...
November 2016: Liver Cancer
https://www.readbyqxmd.com/read/27993716/the-fxr-agonist-px20606-ameliorates-portal-hypertension-by-targeting-vascular-remodelling-and-sinusoidal-dysfunction
#11
Philipp Schwabl, Eva Hambruch, Berit A Seeland, Hubert Hayden, Michael Wagner, Lukas Garnys, Bastian Strobel, Tim-Lukas Schubert, Florian Riedl, Dieter Mitteregger, Michael Burnet, Patrick Starlinger, Georg Oberhuber, Ulrich Deuschle, Nataliya Rohr-Udilova, Bruno K Podesser, Markus Peck-Radosavljevic, Thomas Reiberger, Claus Kremoser, Michael Trauner
BACKGROUND & AIMS: Steroidal farnesoid X receptor (FXR) agonists demonstrated potent anti-fibrotic activities and lowered portal hypertension in experimental models. The impact of the novel non-steroidal and selective FXR agonist PX20606 on portal hypertension and fibrosis was explored in this study. METHODS: In experimental models of non-cirrhotic (partial portal vein ligation, PPVL, 7days) and cirrhotic (carbon tetrachloride, CCl4, 14weeks) portal hypertension, PX20606 (PX,10mg/kg) or the steroidal FXR agonist obeticholic acid (OCA,10mg/kg) were gavaged...
December 18, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27989547/graft-inflow-modulation-in-adult-to-adult-living-donor-liver-transplantation-a-systematic-review
#12
REVIEW
Roberto I Troisi, Giammauro Berardi, Federico Tomassini, Mauricio Sainz-Barriga
INTRODUCTION: Small-for-size syndrome (SFSS) has an incidence between 0 and 43% in small-for-size graft (SFSG) adult living donor liver transplantation (LDLT). Portal hypertension following reperfusion and the hyperdynamic splanchnic state are reported as the major triggering factors of SFSS. Intra- and postoperative strategies to prevent or to reduce its onset are still under debate. We analyzed graft inflow modulation (GIM) during adult LDLT considering the indications, efficacy of the available techniques, changes in hemodynamics and outcomes...
December 8, 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/27921207/pattern-of-venous-collateral-development-after-splenic-vein-occlusion-in-an-extended-whipple-procedure-whipple-at-the-splenic-artery-and-long-term-results
#13
Ismael Dominguez Rosado, Sanjeev Bhalla, Luis A Sanchez, Ryan C Fields, William G Hawkins, Steven M Strasberg
BACKGROUND: Extended Whipple procedures may require division of the splenic vein (SV). Controversy exists regarding the risk of sequelae of sinistral portal hypertension when the SV is ligated without reimplantation. The aim of this study was to identify postoperative venous collateral patterns and sequelae of SV ligation, as well as long-term results in an extended Whipple procedure. STUDY DESIGN: Patients who had an extended Whipple procedure (Whipple at the Splenic Artery or WATSA) were entered in an institutional database...
December 5, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27875796/development-of-extensive-inferior-vena-cava-thrombosis-due-to-the-ligation-of-a-large-mesenteric-caval-shunt-during-liver-transplantation-a-case-report
#14
Hideya Kamei, Yasuharu Onishi, Masatoshi Ishigami, Yoji Ishizu, Kojiro Suzuki, Yasuhiro Ogura
INSTRUCTION: Inferior vena cava (IVC) thrombosis can be a life-threatening complication after liver transplantation (LT). Although this complication is usually related to technical problems associated with vascular anastomosis, we report a case of IVC thrombosis which developed from a ligated large mesenteric-caval shunt. PRESENTATION OF CASE: A 35-year-old man underwent LT from a brain-dead donor for primary sclerosing cholangitis. Enhanced computed tomography (CT) before LT showed a huge collateral vessel of the inferior mesenteric vein (IMV) draining into the infra-renal IVC directly...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27861920/comparison-of-computed-tomographic-angiography-and-intraoperative-mesenteric-portovenography-for-extrahepatic-portosystemic-shunts
#15
A T Parry, R N White
OBJECTIVES: Comparison of intra-operative mesenteric portovenography and computed tomographic angiography for the documentation of the portal vasculature in patients with single extrahepatic portosystemic shunts. METHODS: Retrospective study of patients with extrahepatic portosystemic shunts that underwent preoperative computed tomographic angiography and intra-operative mesenteric portography. Studies were compared for identification of the intra- and extrahepatic portal vasculature...
January 2017: Journal of Small Animal Practice
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
#16
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/27816312/transition-from-open-to-laparoscopic-alpps-for-patients-with-very-small-flr-the-initial-experience
#17
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 previously been reported but has been the authors' default option since 2015 in patients with small future liver remnant. 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...
January 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27776486/bleeding-downhill-esophageal-varices-associated-with-benign-superior-vena-cava-obstruction-case-report-and-literature-review
#18
REVIEW
Michael Loudin, Sharon Anderson, Barry Schlansky
BACKGROUND: Proximal or 'downhill' esophageal varices are a rare cause of upper gastrointestinal hemorrhage. Unlike the much more common distal esophageal varices, which are most commonly a result of portal hypertension, downhill esophageal varices result from vascular obstruction of the superior vena cava (SVC). While SVC obstruction is most commonly secondary to malignant causes, our review of the literature suggests that benign causes of SVC obstruction are the most common cause actual bleeding from downhill varices...
October 24, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27771454/hedgehog-pathway-mediates-early-acceleration-of-liver-regeneration-induced-by-a-novel-two-staged-hepatectomy-in-mice
#19
Magda Langiewicz, Andrea Schlegel, Enrica Saponara, Michael Linecker, Pieter Borger, Rolf Graf, Bostjan Humar, Pierre A Clavien
BACKGROUND & AIMS: ALPPS, a novel two-staged approach for the surgical removal of large/multiple liver tumors, combines portal vein ligation (PVL) with parenchymal transection. This causes acceleration of compensatory liver growth, enabling faster and more extensive tumor removal. We sought to identify the plasma factors thought to mediate the regenerative acceleration following ALPPS. METHODS: We compared a mouse model of ALPPS against PVL and additional control surgeries (n=6 per group)...
October 19, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27766595/a-literature-review-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-so-far-so-good
#20
Martin de Santibañes, Luis Boccalatte, Eduardo de Santibañes
Recently, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) emerged as a novel surgical strategy to induce a rapid and large hypertrophy of the future liver remnant (FLR). We conducted a computerized search using PubMed and Google Scholar for reports published between March 2012 and July 2016 using mesh headings and key words relating to the ALPPS surgical procedure. The promising results obtained up to date are difficult to interpret due to the heterogeneous group of patients with different underlying pathologies and different chemotherapy schemes...
October 20, 2016: Updates in Surgery
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