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https://www.readbyqxmd.com/read/29629320/combined-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-followed-by-left-trisectionectomy-and-whipple-operation-for-pnet
#1
Ren Ji, Shi Zuo, Siyuan Qiu, Ping Li, Albert Chan, William Sharr, Chung Mau Lo
Pancreatic neuroendocrine tumor (PNET) is slow-growing, and account only for 2% of all pancreatic primary tumors. Surgical resection is still the only curative treatment for PNET patients. Unfortunately, most of PNETs was found with unresectable multiple liver metastases and extrahepatic metastasis as their characteristics of non-functional and asymptomatic. With advances in liver surgery in these years, especially combined associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), provide a new curative surgical treatment for PNET with liver metastases patient...
February 2018: Gland Surgery
https://www.readbyqxmd.com/read/29629319/liver-transplantation-for-unresectable-pancreatic-neuroendocrine-tumors-with-liver-metastases-in-an-era-of-transplant-oncology
#2
REVIEW
Keita Shimata, Yasuhiko Sugawara, Taizo Hibi
Patients with pancreatic neuroendocrine tumors (pNETs) very often present with a metastatic disease at the first diagnosis. Liver transplantation (LT) for unresectable pNET with liver metastases (pNETLM) has been described to prolong survival in highly selected patients, although outcomes were worse than those of patients who underwent LT for gastrointestinal NETLM (GI-NETLM). In this review, several proposed criteria are described with their rationale and controversies. Most of the data used to establish these criteria do not reflect the recent improvements of non-surgical treatments that has changed the landscape of treatment for pNETs, including the development of peptide receptor radionuclide therapy and molecular-targeted agents (sunitinib and everolimus)...
February 2018: Gland Surgery
https://www.readbyqxmd.com/read/29621745/associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-in-the-treatment-of-colorectal-liver-metastases-current-scenario
#3
Hauke Lang, Janine Baumgart, Jens Mittler
Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has expanded the surgical armamentarium for patients with advanced and bilateral colorectal liver metastases. However, the enthusiasm that the medical fraternity had about ALPPS was hampered by a high mortality rate and early and frequent tumor recurrence. While surgical safety has improved, mainly due to technical refinements and a better patient selection, the oncological value in the face of early tumor recurrence remains unclear...
April 5, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29616108/liver-regeneration-during-the-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-procedure-in-sus-scrofa-is-positively-modulated-by-stem-cells
#4
Martin Bartas, Jiri Červeň, Jan Oppelt, Matus Peteja, Petr Vávra, Pavel Zonča, Vaclav Procházka, Vaclav Brázda, Petr Pečinka
This present study investigated the impact of the application of stem cells to liver regeneration following the first stage of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). The experiment was conducted on a pig model (n=6, 3 that did not receive application of stem cells, 3 that received application stem cells). Collected samples of liver (day 0 and 9 following surgery) were subjected to complete transcriptome sequencing. In total, 39 differentially expressed genes were found in the group without the application of the stem cells (genes of unwanted processes such as fibrosis and inflammation)...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29599836/acute-kidney-injury-following-the-first-stage-of-the-alpps-procedure-a-case-report
#5
Weijie Tao, Xiaoju Shi, Guangyi Wang
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel approach for performing liver resection, and the number of clinical applications of this technique has rapidly increased within recent years. ALPPS is important in patients who have insufficient residual liver volume and cannot undergo radical hepatic resection. The most common postoperative complications of ALPPS include biliary fistula and infection. To date, postoperative acute kidney injury following ALPPS has not been reported...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29574179/external-validation-and-optimization-of-the-french-association-of-hepatopancreatobiliary-surgery-and-transplantation-s-score-to-predict-severe-postoperative-biliary-leakage-after-open-or-laparoscopic-liver-resection
#6
Kayvan Mohkam, David Fuks, Eric Vibert, Takeo Nomi, François Cauchy, Yoshikuni Kawaguchi, Emmanuel Boleslawski, Jean-Marc Regimbeau, Brice Gayet, Jean-Yves Mabrut
BACKGROUND: Biliary leakage is a major contributor to morbidity after hepatectomy. A score to predict severe posthepatectomy biliary leakage (PHBL) was recently developed by the French Association of Hepatopancreatobiliary Surgery and Transplantation (ACHBT). The aim of the study was to validate and optimize the score upon an external cohort. STUDY DESIGN: The ACHBT score uses 5 factors (blood loss, remnant ischemia, anatomical resection of segment 8, transection along right aspect of left intersectional plane and associating liver partition and portal vein ligation for staged hepatectomy) to predict severe PHBL...
March 21, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29571618/insight-on-alpps-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-mechanisms-activation-of-mtor-pathway
#7
Mario Uribe, Sebastián Uribe-Echevarría, Carlos Mandiola, María I Zapata, Francisco Riquelme, Pamela Romanque
BACKGROUND: ALPPS procedure has been introduced to increase the volume of future liver remnant. The mechanisms underlying the accelerated regeneration observed with ALPPS are unknown. It was hypothesized that AMPK/mTOR is activated as an integrating pathway for metabolic signals leading to proliferation and cell growth. Our aim was to analyze increase in liver volume, proliferation parameters and expression of AMPK/mTOR pathway-related molecules in patients undergoing ALPPS. METHODS: A single center prospective study of patients undergoing ALPPS was performed from 2013 to 2015...
March 20, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29571617/alcohol-injection-into-the-portal-vein-prior-to-ligation-increases-liver-regeneration-rate
#8
Nadia Russolillo, Serena Langella, Serena Perotti, Annalisa Balbo Mussetto, Roberto Lo Tesoriere, Stefano Cirillo, Giovanni De Rosa, Alessandro Ferrero
BACKGROUND: Failure of portal vein ligation (PVL) to induce hypertrophy is not uncommon. The aim of the study was to evaluate the impact of intraportal alcohol injection prior to ligation on liver regeneration. METHOD: Forty-two patients with colorectal liver metastases who underwent PVL between 01/2004 and 06/2014 were analyzed. Beginning in 09/2011, alcohol was injected prior to PVL. Patients treated with PVL alone (Alc- group) were compared with those treated with alcohol injection plus PVL (Alc+ group)...
March 20, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29563755/maturity-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-derived-liver-regeneration-in-a-rat-model
#9
Yi-Fan Tong, Ning Meng, Miao-Qin Chen, Han-Ning Ying, Ming Xu, Billy Lu, Jun-Jie Hong, Yi-Fan Wang, Xiu-Jun Cai
AIM: To establish a rat model for evaluating the maturity of liver regeneration derived from associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). METHODS: In the present study, ALPPS, partial hepatecotmy (PHx), and sham rat models were established initially, which were validated by significant increase of proliferative markers including Ki-67, proliferating cell nuclear antigen, and cyclin D1. In the setting of accelerated proliferation in volume at the second and fifth day after ALPPS, the characteristics of newborn hepatocytes, as well as specific markers of progenitor hepatic cell, were identified...
March 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29562418/-current-status-of-alpps-in-the-treatment-of-advanced-liver-cancer-with-insufficient-future-liver-remnant
#10
Y L Cao, W Li
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) which represented a new two-steps liver resection procedures has been considered a revolutionary innovation for liver surgery technique in recent 10 years, it was first discovered by Professor Lang in Germany in 2007.The first step of the classic surgical procedures for portal vein ligation and liver parenchyma, until the future liver remnant (FLR) increased to a sufficient remnant then resect the right three-leaf liver.With the development of ALPPS, the method of hepatic parenchyma separation and isolation materials have been modified, which improves the safety of operation...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29544184/complete-spontaneous-necrosis-of-hepatocellular-carcinoma-accompanied-by-portal-vein-tumor-thrombosis-a-case-report
#11
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
https://www.readbyqxmd.com/read/29538356/abdominal-near-infrared-spectroscopy-in-a-piglet-model-of-gastrointestinal-hypoxia-produced-by-graded-hypoxia-or-superior-mesenteric-artery-ligation
#12
May W Chen, Michael Reyes, Ewa Kulikowicz, Laura Martin, David J Hackam, Raymond C Koehler, Jennifer K Lee
BACKGROUND: Abdominal near-infrared spectroscopy (aNIRS) may detect gastrointestinal hypoxia before necrotizing enterocolitis develops. We sought to validate aNIRS during splanchnic hypoxia and hypoperfusion in neonatal piglets. METHODS: Anesthetized piglets underwent systemic hypoxia or 3-h superior mesenteric artery (SMA) ligation with aNIRS monitoring. RESULTS: During progressive hypoxia, gastrointestinal tissue oxyhemoglobin saturation measured by aNIRS decreased linearly with oxyhemoglobin saturation measured directly in the portal vein...
March 14, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29536551/surgical-management-of-a-cat-with-hepatic-arterioportal-fistula
#13
A Phillips, E R Kulendra, R Lam, N J Kulendra, D J Brockman
A 9-month-old domestic short-haired cat presented with stunted growth and chronic gastrointestinal signs. Tachypnoea, a heart murmur and cranial abdominal bruit were detected on physical examination. Echocardiography revealed volume overload in all heart chambers. CT angiography identified an abnormal communication between the hepatic arterial circulation and the portal vein, along with multiple acquired shunts. The abnormal vascular communication was surgically ligated. Echocardiography documented improvement in cardiac parameters following surgery and the cat continues to have no clinical signs 39 months after surgery...
March 14, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29512261/initial-experience-with-robotic-hepatectomy-in-singapore-analysis-of-48-resections-in-43-consecutive-patients
#14
Brian K P Goh, Lip-Seng Lee, Ser-Yee Lee, Pierce K H Chow, Chung-Yip Chan, Adrian K H Chiow
BACKGROUND: Presently, the adoption of laparoscopic hepatectomy is rapidly increasingly worldwide. However, the application of robotic hepatectomy (RH) remains limited and its role remains undefined today. METHODS: A retrospective review of 43 consecutive patients who underwent RH at two institutions in the Singapore Health Services Group. RESULTS: Forty-three consecutive patients underwent 48 resections during the study period. Seven (16...
March 7, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29469530/-percutaneous-transsplenic-varices-embolization-in-treatment-of-upper-gastrointestinal-hemorrhage-of-schistosomiasis-cirrhosis
#15
Ji Chang-Xue, Li Ying, Ju Shuai, Qiang Jin-Wei
OBJECTIVE: To evaluate the application value of percutaneous transsplenic varices embolization (PTSVE) in the treatment of upper gastrointestinal hemorrhage in patients with schistosomiasis cirrhosis. METHODS: Sixteen schistosomiasis cirrhosis patients (12 males and 4 females) with portal hypertension complicated with esophageal and upper gastrointestinal hemorrhage were selected as the investigation subjects, all the patients had been treated by esophageal vein ligation and sclerotherapy, but with bleeding again post-operation...
March 27, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
https://www.readbyqxmd.com/read/29469184/low-molecular-weight-heparin-does-not-increase-bleeding-and-mortality-post-endoscopic-variceal-band-ligation-in-cirrhotic-patients
#16
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
https://www.readbyqxmd.com/read/29460877/-associated-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-in-focal-liver-diseases-management
#17
S E Voskanyan, E S Chuchuyev, A I Artemiyev, D A Zabezhinsky, A N Bashkov, A S Zhurbin, V S Rudakov, S V Cholakyan
AIM: To determine ALPPS advisability in small future remnant liver. MATERIAL AND METHODS: 22 ALPPS procedures were performed at the Center for Surgery and Transplantology for the period from 2011 to 2016. Indications were both tumoral and non-tumoral unresectable liver diseases. Postoperative complications were classified according to Clavien-Dindo, ISGLS. RESULTS: According to CT-volumetry future remnant liver before the 1st stage of ALPPS was from 17 to 25%, before the 2nd stage - from 28 to 49%...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29453782/unusual-spontaneous-porto-systemic-shunt-the-importance-of-diagnosing-non-anatomical-porto-systemic-shunts-to-improve-portal-flow-in-pediatric-living-related-liver-transplantation-case-report
#18
Juan S Rubio, Carolina Rumbo, Pablo A Farinelli, Nicolás Aguirre, Diego A Ramisch, Hugo Paladini, Pablo D Angelo, Pablo Barros Schelotto, Gabriel E Gondolesi
Collateral circulation secondary to liver cirrhosis may cause the development of large PSSs that may steal flow from the main portal circulation. It is important to identify these shunts prior to, or during the transplant surgery because they might cause an insufficient portal flow to the implanted graft. There are few reports of "steal flow syndrome" cases in pediatrics, even in biliary atresia patients that may have portal hypoplasia as an associated malformation. We present a 12-month-old female who received an uneventful LDLT from her mother, and the GRWR was 4...
February 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29434696/tmem16a-regulates-portal-vein-smooth-muscle-cell-proliferation-in-portal-hypertension
#19
Xi Zeng, Ping Huang, Mingkai Chen, Shiqian Liu, Nannan Wu, Fang Wang, Jing Zhang
The aim of the present study was to elucidate the effect of transmembrane protein 16A (TMEM16A) on portal vein smooth muscle cell (PVSMC) proliferation associated with portal vein remodeling in portal hypertension (PHT). Sprague-Dawley rats were subjected to bile duct ligation to establish a rat model of liver cirrhosis and PHT. Sham-operated animals served as controls. At 8 weeks after bile duct ligation, the extent of liver fibrosis and the portal vein wall thickness were assessed using hematoxylin-eosin staining...
January 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29433876/autogenous-hepatic-tissue-transplantation-into-the-omentum-in-a-novel-ectopic-liver-regeneration-murine-model
#20
Francisco Igor Macedo, Joseph J Eid, Milessa Decker, Barry Herschman, Edsa Negussie, Vijay K Mittal
BACKGROUND: Liver regeneration involves hyperplasia and hypertrophy of hepatic cells. The capacity of macroscopic liver tissue to regenerate in ectopic sites is unknown. We aim to develop a novel in vivo model of ectopic liver survivability and regeneration and assess its functionality. METHODS: Adult male Sprague-Dawley rats (n = 23) were divided into four groups: (1) single-stage (SS) group, wedge liver resection was performed, and the parenchyma was directly implanted into the omentum; (2) double-stage (DS) group, omentum pedicle was transposed over the left hepatic lobe followed by wedge liver resection along with omental flap; (3) Biogel + DS group, rats received intraperitoneal injection of inert polymer particles prior to DS; (4) Biogel + DS + portal vein ligation (PVL) group, Biogel + DS rats underwent subsequent PVL...
March 2018: Journal of Surgical Research
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