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portal vein ligation

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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
#1
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...
November 15, 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
#2
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...
November 14, 2016: 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
#3
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
#4
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 been reported in individual reports, but has been the authors' default option since 2015. 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...
November 2, 2016: 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
#5
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
#6
Magda Langiewicz, Andrea Schlegel, Enrica Saponara, Michael Linecker, Pieter Borger, Rolf Graf, Bostjan Humar, Pierre A Clavien
BACKGROUND & AIMS: Occlusion of one liver section by portal vein ligation (PVL) induces compensatory liver regeneration in the remaining part. PVL-induced liver growth is being exploited for the surgical removal of large/multiple liver tumors. A novel approach coined ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) combines PVL with parenchymal transection and massively accelerates compensatory growth, enabling much faster and more extensive tumor removal...
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
#7
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
https://www.readbyqxmd.com/read/27761713/rescue-alpps-is-efficient-and-safe-after-failed-portal-vein-occlusion-in-patients-with-colorectal-liver-metastases
#8
Ernesto Sparrelid, Stefan Gilg, Torkel B Brismar, Lars Lundell, Bengt Isaksson
PURPOSE: The aim of this study was to investigate whether associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can be used as an effective and safe rescue procedure in patients with colorectal liver metastases (CRLM) and insufficient effect on the future liver remnant (FLR) after previous portal vein occlusion (PVO). METHODS: Eleven patients with bilobar CRLM treated with neoadjuvant chemotherapy and previous PVO with insufficient effect on the FLR were analyzed retrospectively from a prospective database...
October 19, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27761198/percutaneous-transhepatic-embolization-of-bleeding-rectal-varices-using-a-new-embolic-and-sclerotic-mixture-augmented-by-amplatzer-vascular-plug-2
#9
Ahmed Kamel Abdel-Aal, Nabila Dawoud, Amr Soliman Moustafa, Maysoon F Hamed, Souheil Saddekni
We report a case of 59-year-old female with non-alcoholic-steato-hepatitis (NASH) induced cirrhosis, who presented with hematochezia. The patient had a history of bleeding esophageal varices treated with endoscopic variceal ligation (EVL). Colonoscopy showed large rectal varices which were the source of her lower gastrointestinal bleeding (LGIB). Since endoscopic treatment for LGIB are limited, and because the patient had portal vein thrombosis which contraindicated transjugular intrahepatic portosystemic shunt (TIPS), we performed percutaneous transhepatic embolization of her rectal varices using a new mixture of embolic and sclerotic agents, followed by Amplatzer plug 2 (AVP 2)...
September 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/27756893/first-left-hepatic-trisectionectomy-including-segment-one-with-new-associated-liver-partition-and-portal-vein-ligation-with-staged-hepatectomy-alpps-modification-how-to-do-it
#10
Aiman Obed, Anwar Jarrad, Abdalla Bashir
BACKGROUND Associated Liver Partition and Portal vein ligation with Staged hepatectomy (ALPPS) leads to rapid hepatic hypertrophy and decreases incidence of post-hepatectomy liver failure in patients with a marginal future liver remnant. Various procedural ALPPS modifications were previously described. Here, we present the first case of a new ALPPS modification, carrying out a left hepatic trisectionectomy with segment 1. CASE REPORT We present the case of a 36-year-old woman with locally advanced sigmoid adeno-carcinoma and extensive left liver metastases extending to segment V and VIII, who received state-of-the-art systemic conversion chemotherapy...
October 19, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27752816/perioperative-hepatocyte-growth-factor-hgf-infusions-improve-hepatic-regeneration-following-portal-branch-ligation-pbl-in-rodents
#11
Christopher W Mangieri, Jason C McCartt, Matthew A Strode, John E Lowry, Prasad M Balakrishna
BACKGROUND: As hepatic surgery has become safer and more commonly performed, the extent of hepatic resections has increased. When there is not enough expected hepatic reserve to facilitate primary resection of hepatic tumors, a clinical adjunct to facilitating primary resection is portal vein embolization (PVE). PVE allows the hepatic remnant to increase to an appropriate size prior to resection via hepatocyte regeneration; however, PVE is not always successful in facilitating adequate regeneration...
October 17, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27734177/total-laparoscopic-reversal-alpps
#12
M A Machado, R Surjan, T Basseres, F Makdissi
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows R0 resection even for patients with extremely small future liver remnants. The ALPPS procedure was initially described for two-stage right trisectionectomy. Reversal ALPPS is a denomination in which the future liver remnant is the right posterior section of the liver. PATIENT: A 42-year-old woman with colorectal metastases in all segments except segment 1 underwent chemotherapy with objective response and was referred for surgical treatment...
October 12, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27729629/decreased-c-reactive-protein-induces-abnormal-vascular-structure-in-a-rat-model-of-liver-dysfunction-induced-by-bile-duct-ligation
#13
Ji Hye Jun, Jong Ho Choi, Si Hyun Bae, Seh Hoon Oh, Gi Jin Kim
BACKGROUND/AIMS: Chronic liver disease leads to liver fibrosis, and although the liver does have a certain regenerative capacity, this disease is associated with dysfunction of the liver vessels. C-reactive protein (CRP) is produced in the liver and circulated from there for metabolism. CRP was recently shown to inhibit angiogenesis by inducing endothelial cell dysfunction. The objective of this study was to determine the effect of CRP levels on angiogenesis in a rat model of liver dysfunction induced by bile duct ligation (BDL)...
September 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/27706456/evaluation-of-primary-prophylaxis-with-propranolol-and-elastic-band-ligation-in-variceal-bleeding-in-cirrhotic-children-and-adolescents
#14
Júlio Rocha Pimenta, Alexandre Rodrigues Ferreira, Paulo Fernando Souto Bittencourt, Camilo Brandão de Resende, Eleonora Druve Tavares Fagundes, Isabela Maria Lopes da Silva
Background: The efficacy of nonselective β-blocker and endoscopic procedures, such as endoscopic variceal ligation, as primary prophylaxis of variceal hemorrhage in cirrhotic adults was demonstrated by numerous controlled trials, but in pediatric population, few are the number of studies. Objective: The objective of this study is to evaluate the primary prophylaxis with β-blocker in cirrhotic children and adolescents with portal hypertension. Methods: This is a cohort study encompassing 26 cirrhotic patients...
October 2016: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/27697318/surgical-strategy-according-to-the-anatomical-types-of-congenital-portosystemic-shunts-in-children
#15
Toshiharu Matsuura, Yoshiaki Takahashi, Yusuke Yanagi, Koichiro Yoshimaru, Kenichiro Yamamura, Eiji Morihana, Hazumu Nagata, Kiyoshi Uike, Hidetoshi Takada, Tomoaki Taguchi
BACKGROUND: Congenital portosystemic shunts (CPSS) with intrahepatic portal vein (IHPV) hypoplasia or absence cause encephalopathy or pulmonary hypertension (PH). Acute shunt closure may result in postoperative portal hypertension. The aim of this study was to propose a surgical strategy according to the anatomical types of CPSS and IHPV. METHODS: Twenty-three CPSS patients were diagnosed from1990 to 2015. All patients were evaluated by computed tomography, angiography, and PV pressure monitoring under a shunt occlusion test...
September 21, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27679549/pancreaticoduodenectomy-for-ductal-adenocarcinoma-of-the-pancreatic-head-with-venous-resection
#16
Vojko Flis, Stojan Potrc, Nina Kobilica, Arpad Ivanecz
BACKGROUND: Recent reports have shown that patients with vascular tumour invasion who undergo concurrent vascular resection can achieve long-term survival rates equivalent to those without vascular involvement requiring pancreaticoduodenectomy alone. There is no consensus about which patients benefit from the portal-superior mesenteric vein resection and there is no consensus about the best surgical technique of vessel reconstruction (resection with or without graft reconstruction). As published series are small the aim of this study was to evaluate our experience in pancreatectomies with en bloc vascular resection and reconstruction of vessels...
September 1, 2016: Radiology and Oncology
https://www.readbyqxmd.com/read/27672282/mechanistic-insights-of-rapid-liver-regeneration-after-associating-liver-partition-and-portal-vein-ligation-for-stage-hepatectomy
#17
Demetrios Moris, Spyridon Vernadakis, Alexandros Papalampros, Michail Vailas, Nikolaos Dimitrokallis, Athanasios Petrou, Dimitrios Dimitroulis
AIM: To highlight the potential mechanisms of regeneration in the Associating Liver Partition and Portal vein ligation for Stage hepatectomy models (clinical and experimental) that could unlock the myth behind the extraordinary capability of the liver for regeneration, which would help in designing new therapeutic options for the regenerative drive in difficult setup, such as chronic liver diseases. Associating Liver Partition and Portal vein ligation for Stage hepatectomy has been recently advocated to induce rapid future liver remnant hypertrophy that significantly shortens the time for the second stage hepatectomy...
September 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27667105/-application-of-laparoscopic-transection-of-median-hepatic-fissure-in-difficult-laparoscopic-liver-resections
#18
L X Cai, S L He, F Q Wei, Y C Yu, X J Cai
Objective: The aim was to explore the strategy and clinical value of laparoscopic transection of median hepatic fissure (MHF) in difficult laparoscopic liver resections. Methods: First the MHF was located and marked, then the transection plane of the MHF was set. Next, the laparoscopic Multifuctional Operative Dissector (LPMOD) and the technique of curettage and aspiration were utilized to transect the liver beginning from the middle portion of the gallbladder fossa, in a caudal-to-cranial and anterior-to-posterior direction, until the clear exposure of the anterior surface of the intrahepatic inferior vena cava...
September 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27651335/management-of-the-splenic-vein-during-a-pancreaticoduodenectomy-with-venous-resection-for-malignancy
#19
REVIEW
Pietro Addeo, Gennaro Nappo, Emanuele Felli, Constantin Oncioiu, François Faitot, Philippe Bachellier
Nowadays, pancreaticoduodenectomies (PD) with an "en-bloc" resection of the spleno-mesenterico-portal (SMP) venous axis are safely performed at tertiary centers for patients presenting venous invasion. However, for tumors infiltrating the SMP confluence optimal management of the splenic vein (SV) remains a matter of debate. Simple SV ligation has been associated with the development of sinistral portal hypertension, gastrointestinal bleeding and hypersplenism over the long term. To avoid these complications, reconstructive methods such as the direct implantation of the SV into a SMP "neoconfluence", the inferior mesenteric vein-SV anastomosis and the distal spleno-renal shunt have been reported...
September 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27633328/meta-analysis-of-associating-liver-partition-with-portal-vein-ligation-and-portal-vein-occlusion-for-two-stage-hepatectomy
#20
REVIEW
D Eshmuminov, D A Raptis, M Linecker, A Wirsching, M Lesurtel, P-A Clavien
BACKGROUND: Discussion is ongoing regarding whether associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) or portal vein occlusion is better in staged hepatectomy. The aim of this study was to compare available strategies using a two-stage approach in extended hepatectomy. METHODS: A literature search was performed in MEDLINE, Scopus, the Cochrane Library and Embase, and additional articles were identified by hand searching. Data from the international ALPPS registry were extracted...
December 2016: British Journal of Surgery
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