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portal vein ligation

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https://www.readbyqxmd.com/read/29018183/a-case-of-left-renal-vein-ligation-in-a-patient-with-solitary-left-kidney-undergoing-liver-transplantation-to-control-splenorenal-shunt-and-improve-portal-venous-flow
#1
Rodrigo B Martino, Eserval Rocha Júnior, Valdano Manuel, Vinicius Rocha-Santos, Luis Augusto C D'Albuquerque, Wellington Andraus
BACKGROUND Adequate portal venous flow is required for successful liver transplantation. Reduced venous flow and blood flow 'steal' by collateral vessels are a concern, and when there is a prominent splenorenal shunt present, ligation of the left renal vein has been recommended to improve portal venous blood flow. CASE REPORT A 51-year-old man who had undergone right nephrectomy in childhood required liver transplantation for liver cirrhosis and hepatocellular carcinoma due to hepatitis C virus (HCV) infection...
October 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28990002/two-cases-of-alpps-procedure-simultaneous-alpps-and-colorectal-resection-and-alpps-procedure-for-hepatic-malignancy-larger-than-15-centimeter
#2
Young Il Choi, Hyung Hwan Moon, Dong Hoon Shin
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been introduced as a new surgical technique to increase future liver remnant in patients with marginal liver volume contemplating major liver resection. We herein present two cases. Case 1: a 68-year-old male patient with colorectal liver metastasis was referred to our department. The future liver remnant (FLR) was 22%. We performed first-stage ALPPS and colorectal surgery concurrently and second stage operation was performed 8 days later...
August 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28970291/covered-tips-versus-endoscopic-band-ligation-plus-propranolol-for-the-prevention-of-variceal-rebleeding-in-cirrhotic-patients-with-portal-vein-thrombosis-a-randomised-controlled-trial
#3
Yong Lv, Xingshun Qi, Chuangye He, Zhengyu Wang, Zhanxin Yin, Jing Niu, Wengang Guo, Wei Bai, Hongbo Zhang, Huahong Xie, Liping Yao, Jianhong Wang, Tao Li, Qiuhe Wang, Hui Chen, Haibo Liu, Enxing Wang, Dongdong Xia, Bohan Luo, Xiaomei Li, Jie Yuan, Na Han, Ying Zhu, Jielai Xia, Hongwei Cai, Zhiping Yang, Kaichun Wu, Daiming Fan, Guohong Han
OBJECTIVE: Limited data are available on the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis (PVT). This study aimed to compare transjugular intrahepatic portosystemic shunt (TIPS) with covered stents versus endoscopic band ligation (EBL) plus propranolol for the prevention of variceal rebleeding among patients with cirrhosis and PVT. DESIGN: Consecutive cirrhotic patients (94% Child-Pugh class A or B) with PVT who had variceal bleeding in the past 6 weeks were randomly assigned to TIPS group (n=24) or EBL plus propranolol group (EBL+drug, n=25), respectively...
September 28, 2017: Gut
https://www.readbyqxmd.com/read/28958473/expression-of-hypoxia-inducible-factor-1%C3%AE-and-its-correlation-with-phosphoenolpyruvate-carboxykinase-after-portal-vein-ligation-in-rats
#4
Changjun Jia, Hua Yang, Chaoliu Dai, Feng Xu, Songlin Peng, Yang Zhao, Chuang Zhao, Liang Zhao
AIMS: Portal vein ligation (PVL) has been used to effectively increase future liver remnant (FLR) in hepatectomy for treatment of liver cancer. However, the underlying molecular mechanisms have not been well characterized. The present study aimed to determine expression of hypoxia inducible factor-1alpha (HIF-1α) in response to PVL and assess the correlation of HIF-1α and phosphoenolpyruvate carboxykinase (PEPCK). MAIN METHODS: Male Sprague-Dawley rats underwent PVL and were sacrificed at different time points (12, 24, 48, 72, and 168h) after surgery...
September 26, 2017: Life Sciences
https://www.readbyqxmd.com/read/28902669/alpps-improves-resectability-compared-with-conventional-two-stage-hepatectomy-in-patients-with-advanced-colorectal-liver-metastasis-results-from-a-scandinavian-multicenter-randomized-controlled-trial-ligro-trial
#5
Per Sandström, Bård I Røsok, Ernesto Sparrelid, Peter N Larsen, Anna L Larsson, Gert Lindell, Nicolai A Schultz, Bjorn A Bjørnbeth, Bengt Isaksson, Magnus Rizell, Bergthor Björnsson
OBJECTIVE: The aim of the study was to evaluate if associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) could increase resection rates (RRs) compared with two-stage hepatectomy (TSH) in a randomized controlled trial (RCT). BACKGROUND: Radical liver metastasis resection offers the only chance of a cure for patients with metastatic colorectal cancer. Patients with colorectal liver metastasis (CRLM) and an insufficient future liver remnant (FLR) volume are traditionally treated with chemotherapy with portal vein embolization or ligation followed by hepatectomy (TSH)...
September 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28882970/management-of-a-fulminant-upper-gastrointestinal-bleeding-exteriorized-through-hemobilia-due-to-arteriobiliary-fistula-between-the-common-bile-duct-and-a-right-hepatic-artery-aneurysm-a-case-report
#6
Nicolae Bacalbasa, Iulian Brezean, Claudiu Anghel, Ion Barbu, Mihai Pautov, Irina Balescu, Vladislav Brasoveanu
Right hepatic artery aneurysms are rare events that might remain asymptomatic for a long period of time. However, in cases presenting large lesions, symptoms might develop especially due to the association of compression of the surrounding elements. Most often these symptoms and signs include diffuse abdominal pain, jaundice or portal vein compression signs. In rare cases life-threatening complications might develop due to the aneurysmal erosion of the biliary duct, portal vein or due to the aneurysmal rupture in the peritoneal cavity...
September 2017: In Vivo
https://www.readbyqxmd.com/read/28882969/successful-resection-and-vascular-ligation-of-a-large-hepatic-artery-aneurysm-a-case-report-and-literature-review
#7
Nicolae Bacalbasa, Iulian Brezean, Claudiu Anghel, Ion Barbu, Mihai Pautov, Irina Balescu, Vladislav Brasoveanu
The occurrence of hepatic artery aneurysms is rare and might be incidentally diagnosed, as the patient remains asymptomatic for a long period of time. However, due to the fact that these lesions are associated with a high risk of developing life threatening complications, such as intraperitoneal rupture, it has been stated that all cases should be submitted to treatment by endovascular or surgical approach. We present the case of a 68-year-old patient, who presented with recurrent upper digestive tract bleedings and was diagnosed with a large aneurysm of the common and the proper hepatic artery, and the gastroduodenal artery...
September 2017: In Vivo
https://www.readbyqxmd.com/read/28870051/-choices-of-methods-in-dividing-the-neck-of-pancreas-in-laparoscopic-pancreaticoduodenectomy
#8
R G Lin, H G Huang, Y C Chen, F C Lu, X C Lin, Y Y Yang, H Z Fang, C F Wang
Objective: To discuss the methods, skills and experiences of dividing the neck of pancreas in laparoscopic pancreaticoduodenectomy(LPD). Methods: The clinical data of 58 patients with periampullary tumors who received LPD at the Union Hospital of Fujian Medical University from December 2014 to January 2017 were retrospectively analyzed.There were 26 males and 32 females, ranged from 18 to 65 years, with a mean age of (46±12)years. Results: All of the 58 patients underwent operation smoothly.Three cases underwent open anastomosis via an auxiliary incision after the total resection of specimen laparoscopically, due to the early learning curve of LPD...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28859921/greater-hypertrophy-can-be-achieved-with-associating-liver-partition-with-portal-vein-ligation-for-staged-hepatectomy-compared-to-conventional-staged-hepatectomy-but-with-a-higher-price-to-pay
#9
Daryl K A Chia, Zachery Yeo, Stanley E K Loh, Shridhar Ganpathi Iyer, Glenn Kunnath Bonney, Krishnakumar Madhavan, Alfred W C Kow
BACKGROUND: Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) and conventional staged hepatectomy (CSH) are options for patients with unresectable liver tumors due to insufficient future liver remnant (FLR). METHODS: A retrospective comparison of clinical data, liver volumetry and surgical outcomes between 10 ALPPS and 29 CSH patients was performed. RESULTS: Patient demographics and disease characteristics were similar between both groups...
August 26, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28846946/surgical-treatment-for-the-excluded-bile-leakage-from-spiegel-lobe-after-right-hemihepatectomy-a-case-report
#10
Haruhi Fukuhisa, Masahiko Sakoda, Kiyokazu Hiwatashi, Satoshi Iino, Koji Minami, Motoyuki Hashiguchi, Yota Kawasaki, Hiroshi Kurahara, Yuko Mataki, Kosei Maemura, Hiroyuki Shinchi, Shinichi Ueno, Shoji Natsugoe
INRODUCTION: The treatments of excluded bile duct leakage after hepatectomy are not easy and various strategies have been reported, such as surgery, ethanol or fibrin glue injection, and portal vein embolization. PRESENTATION OF CASE: A 72-year-old man with a surgical history of laparoscopic ileocecal resection for diverticular bleeding was diagnosed as having hepatocellular carcinoma. Right hemihepatectomy was performed, and computed tomography examination on postoperative day 9 showed abdominal fluid collection in the right subphrenic space...
August 18, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28841539/salvage-transhepatic-arterial-embolization-after-failed-stage-i-alpps-in-a-patient-with-a-huge-hcc-with-chronic-liver-disease-a-case-report
#11
Zheng Wang, Yuanfei Peng, Qiman Sun, Xudong Qu, Min Tang, Yajie Dai, Zhaoyou Tang, Wan Yee Lau, Jia Fan, Jian Zhou
INTRODUCTION: The degree of hypertrophy of the future liver remnant (FLR) induced by associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in patients with HCC and chronic liver disease is often limited as compared with patients with a healthy liver. PRESENTATION OF CASE: We reported a 53-year-old male who had a huge HCC (14.8×12×9.4cm) arising from a background of hepatitis B liver fibrosis (METAVIR score F3). The ratio of the FLR/standard liver volume (SLV) was 23...
July 22, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28837779/portal-vein-ligation-alters-coding-and-non-coding-gene-expression-in-rat-livers
#12
Bin Li, Yan Zhu, Lei Xie, Shuyang Hu, Shupeng Liu, Xiaoqing Jiang
Portal vein occlusion increases the resectability of initially unresectable HCC by inducing the hypertrophy of non-occluded liver lobes. However, the mechanisms of how portal vein occlusion induces hepatic hypertrophy remains unclear. cDNA microarray was used to identify gene expression signatures of ligated and non-ligated lobes at different time after PVL. Bioinformatics analysis found that ligated liver lobes (LLL) and non-ligated liver lobes (NLLL) displayed different gene expression profiles. And expression of both coding and non-coding RNA were also different at the different time in LLL or NLLL after PVL...
August 24, 2017: Biochemistry and Cell Biology, Biochimie et Biologie Cellulaire
https://www.readbyqxmd.com/read/28829432/rat-model-of-the-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-procedure
#13
Erik Schadde, Martin Hertl, Stefan Breitenstein, Beatrice Beck-Schimmer, Martin Schläpfer
Recent clinical data support an aggressive surgical approach to both primary and metastatic liver tumors. For some indications, like colorectal liver metastases, the amount of liver tissue left behind after liver resection has become the main limiting factor of resectability of large or multiple liver tumors. A minimal amount of functional tissue is required to avoid the severe complication of post-hepatectomy liver failure, which has high morbidity and mortality. Inducing liver growth of the prospective remnant prior to resection has become more established in liver surgery, either in the form of portal vein embolization by interventional radiologists or in the form of portal vein ligation several weeks prior to resection...
August 14, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28809736/monosegmental-alpps-after-bilateral-hepatectomy
#14
Klaus Steinbrück, Marcelo D'Oliveira, Renato Cano, Marcelo Enne
Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) has emerged as an alternative for patients with bilobar colorectal liver metastasis and a small future liver remnant (FLR). In cases of extensive disease, ALPPS can be performed, leaving only one segment of the liver as FLR. We describe a case of monosegmental ALPPS using segment 4 as FLR. In conclusion, ALPPS should be reserved for a selected group of patients. Monosegmental ALPPS is feasible, but should be performed by hepatobiliary surgeons in specialized centers...
September 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28807245/portal-vein-ligation-versus-portal-vein-embolization-for-induction-of-hypertrophy-of-the-future-liver-remnant-a-systematic-review-and-meta-analysis
#15
REVIEW
C J Isfordink, M Samim, M N G J A Braat, A M Almalki, J Hagendoorn, I H M Borel Rinkes, I Q Molenaar
An important risk of major hepatic resection is postoperative liver failure, which is directly related to insufficient future liver remnant (FLR). Portal vein embolization (PVE) and portal vein ligation (PVL) can minimize this risk by inducing hypertrophy of the FLR. The aim of this systematic review and meta-analysis was to compare the efficacy and safety of PVE and PVL for FLR hypertrophy. A systematic search was conducted on the17(th) of January 2017. The methodological quality of the studies was assessed using the Oxford Critical Appraisal Skills Program for cohort studies...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28806301/risk-adjustment-in-alpps-is-associated-with-a-dramatic-decrease-in-early-mortality-and-morbidity
#16
Michael Linecker, Bergthor Björnsson, Gregor A Stavrou, Karl J Oldhafer, Georg Lurje, Ulf Neumann, René Adam, Francois-René Pruvot, Stefan A Topp, Jun Li, Ivan Capobianco, Silvio Nadalin, Marcel Autran Machado, Sergey Voskanyan, Deniz Balci, Roberto Hernandez-Alejandro, Fernando A Alvarez, Eduardo De Santibañes, Ricardo Robles-Campos, Massimo Malagó, Michelle L de Oliveira, Mickael Lesurtel, Pierre-Alain Clavien, Henrik Petrowsky
OBJECTIVE: To longitudinally assess whether risk adjustment in Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) occurred over time and is associated with postoperative outcome. BACKGROUND: ALPPS is a novel 2-stage hepatectomy enabling resection of extensive hepatic tumors. ALPPS has been criticized for its high mortality, which is reported beyond accepted standards in liver surgery. Therefore, adjustments in patient selection and technique have been performed but have not yet been studied over time in relation to outcome...
November 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28798996/operative-results-and-oncologic-outcomes-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-versus-two-stage-hepatectomy-tsh-in-patients-with-unresectable-colorectal-liver-metastases-a-systematic-review-and-meta-analysis
#17
REVIEW
Dimitrios Moris, Sean Ronnekleiv-Kelly, Ioannis D Kostakis, Diamantis I Tsilimigras, Eliza W Beal, Alexandros Papalampros, Dimitrios Dimitroulis, Evangelos Felekouras, Timothy M Pawlik
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently emerged as a treatment choice for patients with colorectal liver metastases (CLM) and inadequate future liver remnant (FLR). The aim of this study was to define the results of ALPPS compared with two-stage hepatectomy (TSH) for patients with CLM. MATERIALS AND METHODS: A meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines...
August 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28795384/contribution-of-hepatobiliary-scintigraphy-in-assessing-alpps-most-suited-timing
#18
Stéphanie Truant, Clio Baillet, Anne Claire Deshorgue, Mehdi El Amrani, Damien Huglo, François-René Pruvot
To reduce post-hepatectomy liver failure (PHLF), associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been recently developed for patients with a limited future remnant liver (FRL). Nevertheless, high morbi-mortality rates have been reported . The current study aimed to analyze the kinetics of FRL function in patients who were offered ALPPS. Serial SPECT (99 m)Tc-mebrofenin hepatobiliary scintigraphy (HBS) was performed in all patients before and after surgery as well as at inter-stage to quantitatively assess hepatic function [total liver (TL) and FRL]...
August 9, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28774330/the-paradigm-of-tumor-shrinkage-and-rapid-liver-remnant-hypertrophy-for-conversion-of-initially-unresectable-colorectal-liver-metastasis-a-case-report-and-literature-review
#19
Nan Xiao, Kailin Yu, Shaojun Yu, Jianjun Wu, Jian Wang, Siyang Shan, Shuchun Zheng, Liuhong Wang, Jianwei Wang, Shuyou Peng
BACKGROUND: For colorectal liver metastasis (CRLM) patients, hepatic resection is currently the sole cure offering the chance of long-term survival. Tumor shrinkage and planned liver remnant hypertrophy are the two key strategies for conversion of initially unresectable CRLM. First conducted in 2012, associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows rapid liver growth. As a means to induce hypertrophy, portal vein embolization (PVE) has been widely applied before extending hepatectomy...
August 3, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28767916/transection-of-the-hepatic-parenchyma-associated-or-not-with-the-contralateral-portal-vein-branch-ligature-and-its-effect-in-liver-regeneration
#20
Henrique de Aguiar Wiederkehr, Julio Cesar Wiederkehr, Luiz Martins Collaço, Eros Luiz de Sousa, Paolo Salvalaggio, Caroline Aragão de Carvalho, Barbara de Aguiar Wiederkehr, Camila Aparecida Moraes Marques, Francielle França da Rosa, Felipe de Negreiros Nanni, Taíse Fuchs
Objective: To analyze the influence of portal vein ligation in hepatic regeneration by immunohistochemical criteria. Methods: Ten pigs divided into two groups of five animals underwent hepatectomy in two stages, and the groups were differentiated by ligation or not of the left portal vein tributary, which is responsible for vascularization of the left lateral and medial lobes of the pig liver. Five days after the procedure, the animals underwent liver biopsies for further analysis of histological and immunohistochemical with marker Ki67...
April 2017: Einstein
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