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portal vein ligation

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https://www.readbyqxmd.com/read/29916882/paradigm-shift-in-the-management-of-irresectable-colorectal-liver-metastases-living-donor-auxiliary-partial-orthotopic-liver-transplantation-in-combination-with-two-stage-hepatectomy-ld-rapid
#1
Alfred Königsrainer, Silke Templin, Ivan Capobianco, Ingmar Königsrainer, Michael Bitzer, Lars Zender, Bence Sipos, Lothar Kanz, Silvia Wagner, Silvio Nadalin
OBJECTIVE: to report the first case of resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (RAPID) from living donor in a patient affected of irresectable colorectal liver metastases (i-CRLM) BACKGROUND:: A renaissance of liver transplantation (LT) for i-CRLM has been recently observed. The Norwegian SECA trial demonstrated a 5-year overall survival rate of approximately 60%, notwithstanding early tumor recurrence. The RAPID technique was recently introduced as alternative to whole deceased donor LT, but it is limited by poor availability of splittable organs and many organisational aspects...
June 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29904893/portal-vein-aneurysm-associated-with-arterioportal-fistula-after-hepatic-anterior-segmentectomy-thought-provoking-complication-after-hepatectomy
#2
Yusuke Kimura, Tomohide Hori, Takafumi Machimoto, Tatsuo Ito, Toshiyuki Hata, Yoshio Kadokawa, Shigeru Kato, Daiki Yasukawa, Yuki Aisu, Yuichi Takamatsu, Taku Kitano, Tsunehiro Yoshimura
BACKGROUND: Few cases of postoperative arterioportal fistula (APF) have been documented. APF after hepatectomy is a very rare surgery-related complication. CASE PRESENTATION: A 62-year-old man was diagnosed with hepatocellular carcinoma in segments 5 and 8, respectively. Anterior segmentectomy was performed as a curative surgery. Each branch of the hepatic artery, portal vein, and biliary duct for the anterior segment was ligated together as the Glissonean bundle...
June 15, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29902244/upregulation-of-krebs-cycle-and-anaerobic-glycolysis-activity-early-after-onset-of-liver-ischemia
#3
Tom S Chan, Shamir Cassim, Valérie-Ann Raymond, Sven Gottschalk, Grégory Merlen, Claudia Zwingmann, Pascal Lapierre, Peter Darby, Cyril David Mazer, Marc Bilodeau
The liver is a highly vascularized organ receiving a dual input of oxygenated blood from the hepatic artery and portal vein. The impact of decreased blood flow on glucose metabolism and how hepatocytes could adapt to this restrictive environment are still unclear. Using the left portal vein ligation (LPVL) rat model, we found that cellular injury was delayed after the onset of liver ischemia. We hypothesized that a metabolic adaptation by hepatocytes to maintain energy homeostasis could account for this lag phase...
2018: PloS One
https://www.readbyqxmd.com/read/29881460/the-diagnostic-value-of-99m-tc-gsa-scintigraphy-for-liver-function-and-remnant-liver-volume-in-hepatic-surgery-a-retrospective-observational-cohort-study-in-27-patients
#4
Naokazu Chiba, Kei Yokozuka, Shigeto Ochiai, Takahiro Gunji, Masaaki Okihara, Toru Sano, Koichi Tomita, Rina Tsutsui, Shigeyuki Kawachi
Background: The aim was to analyze hepatic hypertrophy after portal vein embolization (PVE) and Associating Liver Partition with Portal vein ligation for Staged hepatectomy (ALPPS) to determine whether clinical circumstances associated with major hepatic resections correlated with remnant growth. Methods: Data was abstracted from a retrospectively maintained database on 27 patients undergoing hepatic resection followed by PVE and the ALPPS procedure between October 1, 2007 and December 31, 2016...
2018: Patient Safety in Surgery
https://www.readbyqxmd.com/read/29880798/in-situ-splitting-after-selective-partial-portal-vein-ligation-or-simultaneous-hepatic-artery-ligation-promotes-liver-regeneration
#5
Li-Bin Yao, Chong-Hui Li, Xiao-Juan Wu, Xue-Dong Wang, Xin-Lan Ge, Ai-Qun Zhang, Xiao-Cheng Zhu, Yong Shao, Jia-Hong Dong
This study seeks to compare the impact of selective partial portal vein ligation (PPVL) or the combination of simultaneous hepatic artery ligation (PPVAL) with in situ splitting (ISS) on liver regeneration and injury. Rats were randomized into three groups; namely: selective PVL, PPVL + ISS and PPVAL + ISS. The changes in hepatic hemodynamics, liver regeneration and hepatocytic injury were examined. Blood flow to the left portal branch and the microcirculation of the left median lobe after PPVL or PPVAL was significantly reduced...
June 7, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29863152/glissonean-pedicle-approach-in-liver-surgery
#6
REVIEW
Masakazu Yamamoto, Shun-Ichi Ariizumi
Glisson's capsule was discovered by Johannis Walaeus in 1640 and described by Francis Glisson in 1654. The capsule wraps the hepatic artery, the portal vein and the bile duct in the liver and forms bundles at the hepatic hilus and in the liver as the Glissonean pedicle tree. Glisson's capsule does not connect to the proper membrane of the liver, which was discovered by Laennec; therefore, the Glissonean pedicles can be detached from the liver parenchyma without liver dissection. Couinaud described three main approaches to control the inflow system at the hepatic hilus in liver surgery; the intrafascial approach, the extrafascial and transfissural approach, and the extrafascial approach...
March 2018: Annals of gastroenterological surgery
https://www.readbyqxmd.com/read/29803563/indicating-alpps-for-colorectal-liver-metastases-a-critical-analysis-of-patients-in-the-international-alpps-registry
#7
Andreas A Schnitzbauer, Erik Schadde, Michael Linecker, Marcel A Machado, Rene Adam, Massimo Malago, Pierre A Clavien, Eduardo de Santibanes, Wolf O Bechstein
OBJECTIVES: In the international associating liver partition and portal vein ligation for staged hepatectomy registry, more than 50% of patients underwent associating liver partition and portal vein ligation for staged hepatectomy with a right hepatectomy. This study evaluated the necessity of two-stage hepatectomies being performed as right hepatectomy associating liver partition and portal vein ligation for staged hepatectomy in patients with colorectal liver metastases versus right trisectionectomy associating liver partition and portal vein ligation for staged hepatectomy...
May 23, 2018: Surgery
https://www.readbyqxmd.com/read/29795479/role-of-kupffer-cells-in-the-progression-of-crc-liver-metastases-after-the-first-stage-of-alpps
#8
Rocio García-Pérez, Joana Ferrer Fábrega, Aranzazu Varona-Bosque, Carlos Manuel Martínez, Beatriz Revilla-Nuin, Laia Cabellos, Romina Pena, Ramón Vilana, Carolina Gonzalez-Abós, Juan Carlos García-Valdecasas, José Fuster Obregón
Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been suggested as a potential therapy for extensive bilobar liver tumors, although in some circumstances this technique may induce tumor progression, a fact still not well studied. Our aim was to study tumor hepatic progression induced by the first step of ALPPS in a WAG/Rij rat syngenic model of metastatic colorectal carcinoma by subcapsular CC531 cell line inoculation. ALPPS induced: tumor progression on deportalized lobe and metastases; expression of hepatic vasculogenic factors (HIF1-α and VEGF); and a dramatic increase of Kupffer cells (KCs) and tumor-associated macrophages (TAMs)...
May 24, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29792723/-experimental-promotion-of-liver-regeneration-after-portal-vein-branch-ligation
#9
V Liška, V Třeška, H Mírka, O Vyčítal, J Brůha, L Haidingerová, J Beneš, Z Tonar, R Pálek, J Rosendorf
INTRODUCTION: Portal vein embolization or ligation (PVE/PVL) is part of most multi-stage liver procedures in the case of low future liver remnant volume (FLRV). PVE initiates compensatory hypertrophy of non-occluded liver parenchyma. This hypertrophy is stimulated by an increased volume of portal blood in the non-occluded veins. PVE results in adequate FLRV growth necessary for resection only in 63-96% patients. The aim of this publication is to summarize the possibilities of influencing liver regeneration after PVE/PVL in an experiment using cytokines (TNF-α, IL-6), a monoclonal antibody against TGF-β1 (MAB TGF-β1) and mesenchymal stem cells (MSC)...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29748815/improved-hemodynamic-and-liver-function-in-portal-hypertensive-cirrhotic-rats-after-administration-of-b-pseudocatenulatum-cect-7765
#10
Isabel Gómez-Hurtado, Pedro Zapater, Kevin Portune, Oriol Juanola, Anabel Fernández-Iglesias, José M González-Navajas, Jordi Gracia-Sancho, Yolanda Sanz, Rubén Francés
PURPOSE: Evaluating whether changes in gut microbiota induced by a bifidobacterial strain may have an effect on the hepatic vascular function in portal hypertensive cirrhotic rats. METHODS: Bile duct ligation (BDL) was performed in rats. A subgroup of animals received B. pseudocatenulatum CECT7765 (109  cfu/daily ig.) for 1 week prior to laparotomy. Hemodynamic, biochemical and inflammatory markers were evaluated. Ileal microbiota composition was identified. Statistical analysis was performed...
May 10, 2018: European Journal of Nutrition
https://www.readbyqxmd.com/read/29744337/monosegment-alpps-hepatectomy-preserving-segment-4-for-colorectal-liver-metastases-literature-review-and-our-experience
#11
Fiammetta Soggiu, Francesco Giovinazzo, Jack Straiton, Giulia Turri, Jim Phillips, Bassam Al-Kari, Irfan Ahmed, Mohammad Habib
Monosegment 4±1 Associating Liver Partition and Portal Vein ligation for Staged hepatectomy (ALPPS) for bilateral colorectal liver metastases decreases the risk of drop-out of two stage hepatectomy, triggering a rapid and significant increase in future liver remnant (FLR) with promising oncological outcomes. We report two cases of segment 4+1 monosegment ALPPS for multiple colorectal liver metastases performed at our institution. In the literature, seven similar cases have been reported. Short and long term outcomes of our two patients were reported along with a review of data from the literature...
April 2018: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29744336/laparoscopic-liver-resection-the-current-status-and-the-future
#12
REVIEW
Xiujun Cai
Dramatic progresses had been made in the operation in the past 26 years. Procedure was extended to major liver resection, isolated resection of caudate lobe, living donor liver resection and associating liver partition with portal vein ligation for staged hepatectomy (ALPPS). Laparoscopic liver resection became a new group of HPB surgery and the international laparoscopic liver society was established in Paris followed by the first international congress of the society held in Paris in July 2017. This biannual congress would be top convention for surgeons specialized in laparoscopic liver surgery...
April 2018: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29727331/10th-anniversary-of-alpps-lessons-learned-and-quo-vadis
#13
Hauke Lang, Eduardo de Santibañes, Hans J Schlitt, Massimo Malagó, Thomas van Gulik, Marcel A Machado, Elio Jovine, Stefan Heinrich, Giuseppe Maria Ettorre, Albert Chan, Roberto Hernandez-Alejandro, Ricardo Robles Campos, Per Sandström, Michael Linecker, Pierre-Alain Clavien
OBJECTIVE: Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has been tested in various indications and clinical scenarios, leading to steady improvements in safety. This report presents the current status of ALPPS. SUMMARY BACKGROUND DATA: ALPPS offers improved resectability, but drawbacks are regularly pointed out regarding safety and oncologic benefits. METHODS: During the 12th biennial congress of the European African-Hepato-Pancreato-Biliary Association (Mainz, Germany, May 23-26, 2017) an expert meeting "10th anniversary of ALPP" was held to discuss indications, management, mechanisms of regeneration, as well as pitfalls of this novel technique...
May 1, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29719286/serial-assessment-of-growth-factors-associated-with-liver-regeneration-in-patients-operated-with-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy
#14
Ernesto Sparrelid, Helene Johansson, Stefan Gilg, Greg Nowak, Ewa Ellis, Bengt Isaksson
BACKGROUND: There is limited knowledge about the mechanisms behind the unparalleled growth of the future liver remnant (FLR) linked to associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). In this study, liver regenerative markers were examined in patients subjected to ALPPS. METHODS: Ten patients with colorectal liver metastases treated with neoadjuvant chemotherapy and ALPPS were included. Plasma was sampled at 6 time points and biopsies from both liver lobes were collected at both stages of ALPPS...
May 2, 2018: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/29709677/jnk1-induces-hedgehog-signaling-from-stellate-cells-to-accelerate-liver-regeneration-in-mice
#15
Magda Langiewicz, Rolf Graf, Bostjan Humar, Pierre A Clavien
BACKGROUND & AIMS: To improve outcomes of two-staged hepatectomies for large/multiple liver tumors, portal vein ligation (PVL) has been combined with parenchymal transection (coined ALPPS; Associated Liver Partition and Portal vein ligation for Staged hepatectomy) to greatly accelerate liver regeneration. In a novel ALPPS mouse model, we have reported paracrine Indian hedgehog (IHH) signaling from stellate cells as an early contributor to augmented regeneration. Here, we sought to identify upstream regulators of IHH...
April 27, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29698885/the-use-of-a-nhs-peg-coated-collagen-based-sealant-in-a-patient-undergoing-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps
#16
Pim B Olthof, Fadi Rassam, Thomas M van Gulik
INTRODUCTION: ALPPS (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy) is a new two-stage hepatectomy for patients in whom conventional treatment is not feasible due to insufficient future liver remnant (FLR). During stage one of ALPPS, accelerated growth of the FLR is induced by ligation of the portal vein and in situ split of the liver, which prevents interlobar collateral portal circulation and attributes to the accelerated hypertrophy response. This can present a risk for postoperative haemorrhage...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29683437/re-arterialized-rat-partial-liver-transplantation-with-an-in-vivo-vessel-oriented-70-hepatectomy
#17
Xuehai Chen, Rong Yu, Ziqiang Xu, Yan Zhang, Chengyang Liu, Bicheng Chen, Hao Jin
Split liver transplantation and living liver donor liver transplantation were developed in the clinic to utilize liver organs in a more efficient manner. To better understand the mechanism behind these surgical procedures, a rat partial liver transplantation (PLTx) model was established for relevant surgical studies. Because of the complexity of the rat PLTx model, a protocol with detailed descriptions is required. An article published previously reported a protocol in which ex vivo hepatectomy was used to achieve 50% rat PLTx...
April 8, 2018: Journal of Visualized Experiments: JoVE
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
#18
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
#19
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
#20
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
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