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portal vein ligation

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https://www.readbyqxmd.com/read/29239077/high-incidence-of-biliary-stricture-after-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy
#1
Srinivas Sanjeevi, Ernesto Sparrelid, Stefan Gilg, Eduard Jonas, Bengt Isaksson
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a two-stage procedure most frequently applied in the setting of an extended right-sided hemi-hepatectomy. Initial reports of high mortality have sparked debate regarding the safety and efficacy of the procedure. We describe a higher incidence of early post-operative bile duct strictures after ALPPS, a complication rarely seen after conventional liver resection. METHODS: An institutional review was conducted to assess the incidence of post-operative biliary strictures following conventional right-sided or extended right-sided hemi-hepatectomy and ALPPS...
December 14, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29218663/laparoscopic-extended-cholecystectomy-for-t3-gallbladder-cancer
#2
Sungho Kim, Yoo-Seok Yoon, Ho-Seong Han, Jai Young Cho, YoungRok Choi
BACKGROUND: Gallbladder cancer (GBC) has been contraindicated for laparoscopic surgery since this procedure was introduced [1, 2]. Recently, however, there have been several reports of laparoscopic extended cholecystectomy for GBC, but most cases involved early GBC confined to the GB [3, 4]. This video describes our technique of laparoscopic extended cholecystectomy for T3 GBC. METHODS: A 77-year-old female presented with a gallbladder mass, which was incidentally detected during evaluation of back pain...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29203284/intermediate-term-survival-and-quality-of-life-outcomes-in-patients-with-advanced-colorectal-liver-metastases-undergoing-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy
#3
Kerollos Nashat Wanis, Victoria Ardiles, Fernando A Alvarez, Mauro Enrique Tun-Abraham, David Linehan, Eduardo de Santibañes, Roberto Hernandez-Alejandro
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is an innovative, 2-staged hepatectomy which has elicited controversy within the international hepatobiliary community. Uptake of ALPPS has been limited due to concerns related to evidence of high morbidity and mortality and scant oncologic and quality of life outcome data and quality of life (Ool). Demonstrating reasonable long-term benefits with a short-term risk is necessary to support more widespread endorsement of ALPPS...
December 1, 2017: Surgery
https://www.readbyqxmd.com/read/29198493/impact-of-associating-liver-partition-and-portal-vein-occlusion-for-staged-hepatectomy-on-tumor-growth-in-a-mouse-model-of-liver-metastasis
#4
Yutaro Kikuchi, Yukihiko Hiroshima, Kenichi Matsuo, Takashi Murakami, Daisuke Kawaguchi, Kohei Kasahara, Kuniya Tanaka
BACKGROUND: The impact of associating liver partition and portal vein occlusion for staged hepatectomy (ALPPS) on tumor growth activity was investigated. METHODS: A BALB/c mouse model (male, 8-10 weeks old) of liver metastasis labeled by red fluorescent protein was established. Changes in future liver remnant (FLR) volumes, tumor growth activity, and levels of cytokines and growth factors in liver tissues during the treatment period were compared among the models involving ALPPS, portal vein ligation (PVL), or sham operation...
November 23, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29173259/optimizing-associated-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-outcomes-surgical-experience-or-appropriate-patient-selection
#5
Ibrahim Al Hasan, Mauro Enrique Tun-Abraham, Kerollos N Wanis, Carlos Garcia-Ochoa, Mark A Levstik, Bandar Al-Judaibi, Roberto Hernandez-Alejandro
BACKGROUND: Early reports of associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) outcomes have been suboptimal. The literature has confirmed that learning curves influence surgical outcomes. We have 54 months of continuous experience performing ALPPS with strict selection criteria. This study aimed to evaluate the impact of the learning curve on ALPPS outcomes. METHODS: We retrospectively compared patients who underwent ALPPS between April 2012 and March 2016...
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29171668/post-temporary-ligation-intraoperative-mesenteric-portovenography-comparison-with-ct-angiography-for-investigation-of-portosystemic-shunts
#6
A T Parry, R N White
OBJECTIVES: Comparison of pre-operative CT angiography and post-temporary, full-ligation, intraoperative, mesenteric portovenography for the characterisation of intrahepatic portal vasculature in patients with single extrahepatic portosystemic shunts. METHODS: Descriptive analysis of previously collected images from 14 dogs and five cats. RESULTS: With the exception of shunts involving the right gastric vein, intrahepatic arborisation appeared similar on both modalities...
November 24, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29131413/the-effect-of-epitope-based-ligation-of-icam-1-on-survival-and-retransplantation-of-pig-islets-in-nonhuman-primates
#7
Jae-Il Lee, Jiyeon Kim, Yun-Jung Choi, Hi-Jung Park, Hye-Jin Park, Hae Joo Wi, Sunok Yoon, Jun-Seop Shin, Jin Kyun Park, Kyeong Cheon Jung, Eun Bong Lee, Hee Jung Kang, Eung Soo Hwang, Sang-Joon Kim, Chung-Gyu Park, Seong Hoe Park
BACKGROUND: Pig islet xenotransplantation is a promising alternative to allogeneic transplantation. However, the wide immunologic barrier between pigs and primates limits the long-term survival of the graft. MD-3, a novel monoclonal antibody (mAb) that recognizes a particular epitope of human ICAM-1, can render T cells tolerant to a xenograft by arresting dendritic cell maturation. We report the long-term survival of adult wild-type pig islets and successful retransplantation in nonhuman primates using a protocol comprising induction with MD-3 mAb and maintenance with anti-CD154 mAb and sirolimus...
November 12, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/29131313/risk-score-to-predict-biliary-leakage-after-elective-liver-resection
#8
K Mohkam, O Farges, E Vibert, O Soubrane, R Adam, F-R Pruvot, J-M Regimbeau, M Adham, E Boleslawski, J-Y Mabrut
BACKGROUND: Biliary leakage remains a major cause of morbidity after liver resection. Previous prognostic studies of posthepatectomy biliary leakage (PHBL) lacked power, population homogeneity, and model validation. The present study aimed to develop a risk score for predicting severe PHBL. METHODS: In this multicentre observational study, patients who underwent liver resection without hepaticojejunostomy in one of nine tertiary centres between 2012 and 2015 were randomly assigned to a development or validation cohort in a 2 : 1 ratio...
November 13, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29118687/renoportal-anastomosis-in-left-lateral-lobe-living-donor-liver-transplantation-a-pediatric-case
#9
Hiroyuki Ogasawara, Chikashi Nakanishi, Shigehito Miyagi, Kazuaki Tokodai, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Hiroyuki Kumata, Hitoshi Goto, Masafumi Goto, Michiaki Unno, Takashi Kamei
In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29110056/efficacy-and-safety-of-balloon-occluded-retrograde-transvenous-obliteration-of-gastric-varices-with-lauromacrogol-foam-sclerotherapy-initial-experience
#10
Xuefeng Luo, Huaiyuan Ma, Jiaze Yu, Ying Zhao, Xiaoze Wang, Li Yang
PURPOSE: Balloon-occluded retrograde transvenous obliteration (BRTO) is a widely-accepted treatment for gastric varices (GVs). The purpose of this study was to evaluate the efficacy and safety of BRTO with lauromacrogol foam sclerotherapy. MATERIALS AND METHODS: Between May 2014 and June 2015, 32 patients were treated with lauromacrogol foam. Lauromacrogol foam was made using a combination of agents, with a 2:1:1 ratio of room air: lauromacrogol: contrast media...
November 6, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29093528/therapeutic-sirna-targeting-endothelial-kdr-decreases-portosystemic-collateralization-in-portal-hypertension
#11
Javier Gallego, Ester Garcia-Pras, Marc Mejias, Nuria Pell, Ute Schaeper, Mercedes Fernandez
Development of portosystemic collateral vessels and gastroesophageal varices is responsible for the most serious clinical consequences of portal hypertension, but effective clinical therapies are limited. Here we developed and investigated the therapeutic potential of an innovative liposomally-formulated short-interfering RNA (siRNA) technology based on clinical stage components, capable to attenuate production of the endothelial kinase insert domain receptor (KDR), which controls portosystemic collateralization and contributes to disease progression and aggravation...
November 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29064029/the-portal-hypertension-syndrome-etiology-classification-relevance-and-animal-models
#12
REVIEW
Jaime Bosch, Yasuko Iwakiri
BACKGROUND: Portal hypertension is a key complication of portal hypertension, which is responsible for the development of varices, ascites, bleeding, and hepatic encephalopathy, which, in turn, cause a high mortality and requirement for liver transplantation. AIM: This review deals with the present day state-of-the-art preventative treatments of portal hypertension in cirrhosis according to disease stage. Two main disease stages are considered, compensated and decompensated cirrhosis, the first having good prognosis and being mostly asymptomatic, and the second being heralded by the appearance of bleeding or non-bleeding complications of portal hypertension...
October 24, 2017: Hepatology International
https://www.readbyqxmd.com/read/29046260/assessment-of-liver-regeneration-after-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-a-comparative-study-with-portal-vein-ligation
#13
Ruo-Fan Sheng, Li Yang, Kai-Pu Jin, He-Qing Wang, Hao Liu, Yuan Ji, Cai-Xia Fu, Meng-Su Zeng
BACKGROUND: To investigate the diagnostic value of diffusion kurtosis imaging (DKI) and diffusion-weighted imaging (DWI) in assessing liver regeneration after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) compared with portal vein ligation (PVL). METHODS: Thirty rats were divided into the ALPPS, PVL, and control groups. DKI and DWI were performed before and 7 days after surgery. Corrected apparent diffusion (D), kurtosis (K) and apparent diffusion coefficient (ADC) were calculated and compared, radiologic-pathologic correlations were evaluated...
October 15, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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
#14
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
#15
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
#16
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
#17
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...
December 1, 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
#18
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
#19
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
#20
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
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