Castleman's disease, also known as vascular follicular lymph node hyperplasia. The patient, a 23-year-old male, was admitted to the hospital 2 days after a physical examination revealed a space occupying the abdominal cavity. Enhanced CT shows a lumpy mass between the liver and the inferior vena cava, with a clear boundary. It is a retroperitoneal mass closely related to the head of the pancreas and duodenum, and the preoperative diagnosis is unknown. Laparoscopic surgery is performed, using a "posterior approach" to separate the tumor from surrounding organs and only perform tumor resection. The postoperative pathological diagnosis was Castleman's disease, and the patient recovered well after the surgery.
{"title":"Retrograde approach to the retroperitoneal Castleman disease: a case report and literature review","authors":"Jian-Ji Ke, Feiqi Liu, Wei Han, L. Meng, Yahui Liu","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.016","url":null,"abstract":"Castleman病又称血管滤泡性淋巴结增生症。患者男性，23岁，因体检发现腹腔占位2 d入院。增强CT提示肝脏与下腔静脉之间团块状肿物，边界清。为腹膜后肿物，并与胰头部、十二指肠等关系密切，术前诊断不明。行腹腔镜手术治疗，手术采用\"后入路\"，术中分离肿物与周围脏器，仅行肿物切除。术后病理诊断为Castleman病，术后患者恢复良好。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"221-222"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42030339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.03.003
J. Kong, Zhiyong Sun, W. Shi, Y. Ye, Hui Li, Haiwang Zhao, Quan Xu
Objective To study the prognostic factors in patients with occult ruptured hepatocellular carcinoma (HCC) after hepatectomy. Methods The clinical data of 31 patients with occult ruptured HCC who underwent hepatectomy at the Heze Multiple Hospital from January 2001 to December 2014 were retrospectively analyzed. There were 27 males and 4 females, with ages ranging from 29 to 73 years. Kaplan-Meier survival analysis was carried out for survival analysis, and compared by the log-rank test. Multivariate analysis was conducted using the Cox proportional hazards regression model. Results Of 31 patients in this study, 27(87.1%) had died, and 25(80.6%) had developed tumor recurrence and metastasis. The median overall survival was 8 months and the median tumor-free survival was 4 months. On Cox regression analysis, non-R0 resection was an independent risk factor of overall survival (RR=2.816, 95%CI: 1.006-7.887) and disease-free survival (RR=3.295, 95%CI: 1.215-8.940). Poor tumor differentiation was an independent risk factor of overall survival (RR=3.120, 95%CI: 1.193-8.160). Conclusions The prognosis of patients with occult rupture HCC who underwent no R0 resection was poor. However, the prognosis of patients who underwent non-R0 resection was even poorer. Key words: Carcinoma, hepatocellular; Hepatectomy; Rupture; Prognosis; Influencing factor
{"title":"Prognostic factors in patients with occult ruptured hepatocellular carcinoma after hepatectomy","authors":"J. Kong, Zhiyong Sun, W. Shi, Y. Ye, Hui Li, Haiwang Zhao, Quan Xu","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.003","url":null,"abstract":"Objective \u0000To study the prognostic factors in patients with occult ruptured hepatocellular carcinoma (HCC) after hepatectomy. \u0000 \u0000 \u0000Methods \u0000The clinical data of 31 patients with occult ruptured HCC who underwent hepatectomy at the Heze Multiple Hospital from January 2001 to December 2014 were retrospectively analyzed. There were 27 males and 4 females, with ages ranging from 29 to 73 years. Kaplan-Meier survival analysis was carried out for survival analysis, and compared by the log-rank test. Multivariate analysis was conducted using the Cox proportional hazards regression model. \u0000 \u0000 \u0000Results \u0000Of 31 patients in this study, 27(87.1%) had died, and 25(80.6%) had developed tumor recurrence and metastasis. The median overall survival was 8 months and the median tumor-free survival was 4 months. On Cox regression analysis, non-R0 resection was an independent risk factor of overall survival (RR=2.816, 95%CI: 1.006-7.887) and disease-free survival (RR=3.295, 95%CI: 1.215-8.940). Poor tumor differentiation was an independent risk factor of overall survival (RR=3.120, 95%CI: 1.193-8.160). \u0000 \u0000 \u0000Conclusions \u0000The prognosis of patients with occult rupture HCC who underwent no R0 resection was poor. However, the prognosis of patients who underwent non-R0 resection was even poorer. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, hepatocellular; Hepatectomy; Rupture; Prognosis; Influencing factor","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"170-172"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48438196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.03.004
Yi-ming Wu, Liyun Zhou, Lifang Zhang, Lu Xu, Minfang Chen, Jun Fang
Objective To evaluate the efficacy of laparoscopic splenectomy plus pericardial devascularization combined with gastroscopic (double endoscopy) treatment of patients with cirrhosis and portal hypertension presenting with bleeding esophagogastric varices. Methods To retrospectively analyze 108 patients who presented with bleeding esophageal and gastric varices at the First Hospital of Jiaxing from March 2013 to March 2018. Of 108 patients, there were 61 males and 47 females, with an average age of 61 years. According to the disease and desires of patients and family members, 28 patients underwent laparoscopic splenectomy plus devascularization (the laparoscopic group), 43 endoscopic treatment (the endoscopic group) and 37 double endoscopic treatment (the double endoscopic group). The liver function, renal function, hemoagglutination and degrees of recurrence of the three groups were compared after operation. Results The renal function, coagulation function, HbA1c in the double endoscopic group was significantly better than that in the other two groups (P<0.05). In the laparoscopic group, there were 4 patients who presented with rebleeding within 36 months, compared with 3 in the endoscopic group, and no patients in the combined group. At 36 months after operation, gastroscopy performed in the laparoscopic group showed mild varices in 8(28.6%) patients, moderate in 9(32.1%), and severe in 11(39.3%). In the endoscopic group, there were 7(16.3%) patients with mild, 26(60.5%) with moderate, and 10(23.2%) with severe. In the double endoscopic group, there were 32(86.5%) patients with mild and 5(13.5%) with moderate. The degrees of recurrence and postoperative esophageal and gastric varices rebleeding in the double endoscopic group were significantly better than those in the laparoscopic group and the endoscopic group (P<0.05). Conclusion Laparoscopic combined with endoscopic treatment was more effective in patients with cirrhosis and portal hypertension who presented with bleeding esophageal varices. Key words: Laparoscopy; Esophageal and gastric varices; Pericardial devascularization; Splenectomy; Gastroscopy
{"title":"Combined laparoscopic and gastroscopic treatment of patients with cirrhosis and portal hypertension presenting with bleeding esophageal varices","authors":"Yi-ming Wu, Liyun Zhou, Lifang Zhang, Lu Xu, Minfang Chen, Jun Fang","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.004","url":null,"abstract":"Objective \u0000To evaluate the efficacy of laparoscopic splenectomy plus pericardial devascularization combined with gastroscopic (double endoscopy) treatment of patients with cirrhosis and portal hypertension presenting with bleeding esophagogastric varices. \u0000 \u0000 \u0000Methods \u0000To retrospectively analyze 108 patients who presented with bleeding esophageal and gastric varices at the First Hospital of Jiaxing from March 2013 to March 2018. Of 108 patients, there were 61 males and 47 females, with an average age of 61 years. According to the disease and desires of patients and family members, 28 patients underwent laparoscopic splenectomy plus devascularization (the laparoscopic group), 43 endoscopic treatment (the endoscopic group) and 37 double endoscopic treatment (the double endoscopic group). The liver function, renal function, hemoagglutination and degrees of recurrence of the three groups were compared after operation. \u0000 \u0000 \u0000Results \u0000The renal function, coagulation function, HbA1c in the double endoscopic group was significantly better than that in the other two groups (P<0.05). In the laparoscopic group, there were 4 patients who presented with rebleeding within 36 months, compared with 3 in the endoscopic group, and no patients in the combined group. At 36 months after operation, gastroscopy performed in the laparoscopic group showed mild varices in 8(28.6%) patients, moderate in 9(32.1%), and severe in 11(39.3%). In the endoscopic group, there were 7(16.3%) patients with mild, 26(60.5%) with moderate, and 10(23.2%) with severe. In the double endoscopic group, there were 32(86.5%) patients with mild and 5(13.5%) with moderate. The degrees of recurrence and postoperative esophageal and gastric varices rebleeding in the double endoscopic group were significantly better than those in the laparoscopic group and the endoscopic group (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Laparoscopic combined with endoscopic treatment was more effective in patients with cirrhosis and portal hypertension who presented with bleeding esophageal varices. \u0000 \u0000 \u0000Key words: \u0000Laparoscopy; Esophageal and gastric varices; Pericardial devascularization; Splenectomy; Gastroscopy","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"173-176"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47253077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.03.019
Xingchen Li, Zhi-yu Li, X. Bi
Surgical resection is the best therapeutic option for patients with colorectal cancer liver metastasis. As patients with synchronous liver metastases from colorectal cancer, simultaneous resection of primary and metastatic lesions has been widely used. With the gradual maturation of laparoscopic technology, its minimally invasive, safe and effective characteristics make it better for simultaneous resection of colorectal cancer with liver metastasis. On the basis of grasping the principles of surgical treatment for colorectal cancer with liver metastasis, reasonable and full combination of the advantages of laparoscopy can enable patients get greater benefits with minimal trauma. Key words: Laparoscopy; Colorectal cancer; Liver metastasis; Simultaneous resection
{"title":"Application of laparoscopy in liver metastasis of colorectal cancer","authors":"Xingchen Li, Zhi-yu Li, X. Bi","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.019","url":null,"abstract":"Surgical resection is the best therapeutic option for patients with colorectal cancer liver metastasis. As patients with synchronous liver metastases from colorectal cancer, simultaneous resection of primary and metastatic lesions has been widely used. With the gradual maturation of laparoscopic technology, its minimally invasive, safe and effective characteristics make it better for simultaneous resection of colorectal cancer with liver metastasis. On the basis of grasping the principles of surgical treatment for colorectal cancer with liver metastasis, reasonable and full combination of the advantages of laparoscopy can enable patients get greater benefits with minimal trauma. \u0000 \u0000Key words: \u0000Laparoscopy; Colorectal cancer; Liver metastasis; Simultaneous resection","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"226-229"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42956678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.03.011
Yi-lei Deng, Menghao Zhou, Longshuan Zhao
Objective To investigate the efficacy of two different percutaneous transhepatic biliary drainage (PTBD) procedures for malignant obstructive jaundice. Methods The clinical data of 132 patients with malignant obstructive jaundice who underwent PTBD were retrospectively analyzed. According to whether the tip of the catheter was placed in the intestine, 132 patients were divided into the external drainage group and the internal-external drainage group. The effect on decrease in jaundice (total bilirubin, direct bilirubin levels), postoperative complications, and hospitalization costs of the two drainage methods were compared. Results Of the 132 patients who were included in this study, there were 91 males and 41 females, aged 18 to 85 years. The external drainage group included 81 patients, and the internal and external drainage group included 51 patients. The total bilirubin [(190.2±41.8)μmol/L vs. (294.9±38.3) μmol/L] and direct bilirubin [(155.4±30.9)μmol/L vs. (242.1±39.6) μmol/L] levels in the external drainage group and the total bilirubin [(179.3±37.1)μmol/L vs. (288.1±35.4)μmol/L] and direct bilirubin [(147.7±32.5)μmol/L vs. (233.7±36.1)μmol/L] levels in the internal-external drainage group were significantly decreased after surgery (all P<0.05). The incidences of reoperation, re-intubation or bilateral catheterization [15.6%(8/51) vs. 3.7%(3/81)] and biliary tract infection [50.9%(26/51) vs. 27.1%(22/81)] in the internal-external drainage group was significantly higher than that in the external drainage group (all P<0.05). The mortality rate due to biliary tract infection in the internal-external drainage group was significantly higher than that of the external drainage group [7.8%(4/51) vs. 0, P<0.05]. Intestinal-derived bacteria such as Escherichia coli, Enterococcus faecium, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the main bacteria in the biliary tract infections of the two groups. The hospitalization cost of patients in the internal-external drainage group was significantly higher than that in the external drainage group [(34 928.0±3 693.0) yuan vs. (29 360.0±3 219.0) yuan, P<0.05]. Conclusion Both PTBD external drainage and internal and external drainage could alleviate the symptoms of jaundice quickly and effectively. Key words: Jaundice, obstructive; Percutaneous transhepatic biliary drainage; Biliary tract infection
{"title":"Therapeutic efficacy of external and internal-external percutaneous transhepatic biliary drainage in patients with malignant obstructive jaundice","authors":"Yi-lei Deng, Menghao Zhou, Longshuan Zhao","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.011","url":null,"abstract":"Objective \u0000To investigate the efficacy of two different percutaneous transhepatic biliary drainage (PTBD) procedures for malignant obstructive jaundice. \u0000 \u0000 \u0000Methods \u0000The clinical data of 132 patients with malignant obstructive jaundice who underwent PTBD were retrospectively analyzed. According to whether the tip of the catheter was placed in the intestine, 132 patients were divided into the external drainage group and the internal-external drainage group. The effect on decrease in jaundice (total bilirubin, direct bilirubin levels), postoperative complications, and hospitalization costs of the two drainage methods were compared. \u0000 \u0000 \u0000Results \u0000Of the 132 patients who were included in this study, there were 91 males and 41 females, aged 18 to 85 years. The external drainage group included 81 patients, and the internal and external drainage group included 51 patients. The total bilirubin [(190.2±41.8)μmol/L vs. (294.9±38.3) μmol/L] and direct bilirubin [(155.4±30.9)μmol/L vs. (242.1±39.6) μmol/L] levels in the external drainage group and the total bilirubin [(179.3±37.1)μmol/L vs. (288.1±35.4)μmol/L] and direct bilirubin [(147.7±32.5)μmol/L vs. (233.7±36.1)μmol/L] levels in the internal-external drainage group were significantly decreased after surgery (all P<0.05). The incidences of reoperation, re-intubation or bilateral catheterization [15.6%(8/51) vs. 3.7%(3/81)] and biliary tract infection [50.9%(26/51) vs. 27.1%(22/81)] in the internal-external drainage group was significantly higher than that in the external drainage group (all P<0.05). The mortality rate due to biliary tract infection in the internal-external drainage group was significantly higher than that of the external drainage group [7.8%(4/51) vs. 0, P<0.05]. Intestinal-derived bacteria such as Escherichia coli, Enterococcus faecium, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the main bacteria in the biliary tract infections of the two groups. The hospitalization cost of patients in the internal-external drainage group was significantly higher than that in the external drainage group [(34 928.0±3 693.0) yuan vs. (29 360.0±3 219.0) yuan, P<0.05]. \u0000 \u0000 \u0000Conclusion \u0000Both PTBD external drainage and internal and external drainage could alleviate the symptoms of jaundice quickly and effectively. \u0000 \u0000 \u0000Key words: \u0000Jaundice, obstructive; Percutaneous transhepatic biliary drainage; Biliary tract infection","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"203-207"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41460014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.03.006
Xie Zhantao, Zhao Huibo, W. Weiwei, Yuan Zhenhua, Cheng Yongfeng, Sun Jianjun, Wei Sidong, Cheng Guoyong
Objective To report on 3 patients who presented with rupture of hepatic artery pseudoaneurysm after liver transplantation. Methods From April 2010 to April 2019, 3 patients with hepatic artery pseudoaneurysm rupture after liver transplantation treated at the Department of Hepatobiliary and Pancreatic Surgery, Henan Provincial People's Hospital were studied. The possible causes, clinical manifestations, diagnosis and treatment were retrospectively analyzed. Results Rupture of hepatic artery pseudoaneurysm occurred on the19th, 28th and 63th days after transplantation. The 3 patients all presented with hematochezia and abdominal pain, while 2 patients presented with hematemesis. Two patients had bile leakage and abdominal infection. All the 3 patients presented with fever. Patient 1 who was diagnosed by laparotomy died of liver failure. Patient 2 underwent interventional embolization of hepatic artery and died of liver failure also. Patient 3 underwent surgical resection of the pseudoaneurysm followed by hepatic artery reconstruction, but died of repeat abdominal hemorrhage. Conclusion Hepatic artery pseudoaneurysm after liver transplantation has a long latent period and is difficult to diagnose at an early stage. Early detection of this life-threatening complication is the key to improve survival. Early treatment of biliary leakage, abdominal infection and other complications help to prevent development of pseudoaneurysms. Key words: Liver transplantation; Pseudoaneurysm; Abdominal infection
{"title":"Rupture of hepatic artery pseudoaneurysm after liver transplantation: a report of three patients","authors":"Xie Zhantao, Zhao Huibo, W. Weiwei, Yuan Zhenhua, Cheng Yongfeng, Sun Jianjun, Wei Sidong, Cheng Guoyong","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.006","url":null,"abstract":"Objective \u0000To report on 3 patients who presented with rupture of hepatic artery pseudoaneurysm after liver transplantation. \u0000 \u0000 \u0000Methods \u0000From April 2010 to April 2019, 3 patients with hepatic artery pseudoaneurysm rupture after liver transplantation treated at the Department of Hepatobiliary and Pancreatic Surgery, Henan Provincial People's Hospital were studied. The possible causes, clinical manifestations, diagnosis and treatment were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000Rupture of hepatic artery pseudoaneurysm occurred on the19th, 28th and 63th days after transplantation. The 3 patients all presented with hematochezia and abdominal pain, while 2 patients presented with hematemesis. Two patients had bile leakage and abdominal infection. All the 3 patients presented with fever. Patient 1 who was diagnosed by laparotomy died of liver failure. Patient 2 underwent interventional embolization of hepatic artery and died of liver failure also. Patient 3 underwent surgical resection of the pseudoaneurysm followed by hepatic artery reconstruction, but died of repeat abdominal hemorrhage. \u0000 \u0000 \u0000Conclusion \u0000Hepatic artery pseudoaneurysm after liver transplantation has a long latent period and is difficult to diagnose at an early stage. Early detection of this life-threatening complication is the key to improve survival. Early treatment of biliary leakage, abdominal infection and other complications help to prevent development of pseudoaneurysms. \u0000 \u0000 \u0000Key words: \u0000Liver transplantation; Pseudoaneurysm; Abdominal infection","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"180-182"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45124998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The patient is a male, 59 years old, Han Chinese, from Hebei. Due to liver occupying lesions, I sought medical attention from a local hospital and considered liver echinococcosis. I came to the People's Hospital of Xinjiang Uygur Autonomous Region for diagnosis and treatment. There is no history of life in a hydatid infected area, and all hydatid antibody tests are negative. Abdominal CT diagnosis: huge mixed density mass in the liver: teratoma? Hydatid? The patient underwent a right hemihepatectomy. After surgery, mature hair, fat, cartilage, and bones can be seen in the gross specimen. Pathological diagnosis shows that liver mature teratoma with malignant transformation is composed of squamous cell carcinoma and adenocarcinoma.
{"title":"Primary mature teratoma of the liver with malignant transformation: a case report and literature review","authors":"Xiong-fei Chen, Guanglei Tian, Y. Meng, Jinguo Wang, Kalifu Baheti","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.017","url":null,"abstract":"患者男性，59岁，汉族，河北人。因肝占位就诊于当地医院，考虑肝包虫病，来新疆维吾尔自治区人民医院诊治。无包虫疫区生活史，包虫抗体检查均阴性。腹部CT诊断：肝内巨大混杂密度占位：畸胎瘤？包虫？患者行右半肝切除术。术后大体标本可见成熟毛发、脂肪、软骨和骨骼等，病理诊断肝成熟型畸胎瘤伴恶变，成分为鳞状细胞癌及腺癌。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"222-223"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45257432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.03.002
W. Kang, Jing Wu, Ju-shan Wu, Shichun Lu, Q. Meng
Objective To investigate the effect and mechanism of silent information regulator 6 (SIRT6) and gluconeogenesis-dependent rate-limiting enzymes in hepatocytes in oxidative stress injury rats and chronic-on-acute (sub-acute) liver failure (ACLF) patients. Methods From August 2016 to May 2018, 10 patients with ACLF from Beijing Youan Hospital Affiliated to Capital Medical University were included in the ACLF group, and 10 normal donors were included in the normal control group. Level of fasting blood glucose, total bilirubin, albumin, and alanine aminotransferase (ALT) were studied. Sprague Dawley rat hepatocytes were isolated and divided into control group (without any intervention), model group (H2O2 intervention for 6 h), mammalian rapamycin target protein (mTOR) activation group (mTOR activation was added to the model group), mTOR inhibition group (mTOR inhibitor was added on the basis of the model group). Protein electrophoresis and polymerase chain reaction was used to detect the relative expression of glucose-6-phosphatase (G6P), phosphoenolpyruvate (PEPCK), SIRT6, and mTOR. Results The ALT and total bilirubin level in ACLF group were significantly higher than those in the normal control group, and the differences were statistically significant (all P<0.05). In ACLF group, level of SIRT6 (0.15±0.07) μg/L and fasting blood glucose (3.19±0.59) mmol/L were significantly lower than those in the normal control group (0.46±0.15) μg/L and (7.07±2.07) mmol/L, the difference was statistically significant (all P<0.05). The relative expression of PEPCK and G6P protein in liver tissue of ACLF group was significantly lower than that of normal control group. The relative expression of SIRT6, PEPCK, and G6P in the model group were lower than those in the control group, and the differences were statistically significant (all P<0.05). When mTOR is activated, the relative expression of PEPCK, G6P, and SIRT6 was higher than those in the model group, and after mTOR inhibition, the relative expression of PEPCK, G6P, and SIRT6 was lower than in the model group. Conclusion ACLF, SIRT6 may inhibit gluconeogenesis, and increased the occurrence of hypoglycemia through activating mTOR signaling pathway. Blocking of SIRT6 levels may slow down the progress of ACLF. Key words: Acute-on-chronic liver failure; Glucose-6-phosphatase; Phosphoenolpyruvate carboxykinase; Silent information regulator 6; Mammalian rapamycin target protein
{"title":"Effect and mechanism of silent information regulator 6 on gluconeogenesis in chronic-on-acute liver failure","authors":"W. Kang, Jing Wu, Ju-shan Wu, Shichun Lu, Q. Meng","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.002","url":null,"abstract":"Objective \u0000To investigate the effect and mechanism of silent information regulator 6 (SIRT6) and gluconeogenesis-dependent rate-limiting enzymes in hepatocytes in oxidative stress injury rats and chronic-on-acute (sub-acute) liver failure (ACLF) patients. \u0000 \u0000 \u0000Methods \u0000From August 2016 to May 2018, 10 patients with ACLF from Beijing Youan Hospital Affiliated to Capital Medical University were included in the ACLF group, and 10 normal donors were included in the normal control group. Level of fasting blood glucose, total bilirubin, albumin, and alanine aminotransferase (ALT) were studied. Sprague Dawley rat hepatocytes were isolated and divided into control group (without any intervention), model group (H2O2 intervention for 6 h), mammalian rapamycin target protein (mTOR) activation group (mTOR activation was added to the model group), mTOR inhibition group (mTOR inhibitor was added on the basis of the model group). Protein electrophoresis and polymerase chain reaction was used to detect the relative expression of glucose-6-phosphatase (G6P), phosphoenolpyruvate (PEPCK), SIRT6, and mTOR. \u0000 \u0000 \u0000Results \u0000The ALT and total bilirubin level in ACLF group were significantly higher than those in the normal control group, and the differences were statistically significant (all P<0.05). In ACLF group, level of SIRT6 (0.15±0.07) μg/L and fasting blood glucose (3.19±0.59) mmol/L were significantly lower than those in the normal control group (0.46±0.15) μg/L and (7.07±2.07) mmol/L, the difference was statistically significant (all P<0.05). The relative expression of PEPCK and G6P protein in liver tissue of ACLF group was significantly lower than that of normal control group. The relative expression of SIRT6, PEPCK, and G6P in the model group were lower than those in the control group, and the differences were statistically significant (all P<0.05). When mTOR is activated, the relative expression of PEPCK, G6P, and SIRT6 was higher than those in the model group, and after mTOR inhibition, the relative expression of PEPCK, G6P, and SIRT6 was lower than in the model group. \u0000 \u0000 \u0000Conclusion \u0000ACLF, SIRT6 may inhibit gluconeogenesis, and increased the occurrence of hypoglycemia through activating mTOR signaling pathway. Blocking of SIRT6 levels may slow down the progress of ACLF. \u0000 \u0000 \u0000Key words: \u0000Acute-on-chronic liver failure; Glucose-6-phosphatase; Phosphoenolpyruvate carboxykinase; Silent information regulator 6; Mammalian rapamycin target protein","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"165-169"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45813811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The patient is a 57-year-old male who underwent laparoscopic liver segment VII resection and left lateral lobe resection, with abdominal enhanced CT showing liver segment II and VII masses. After resection of the left outer lobe of the liver, the liver parenchyma and right hepatic venous reflux branch were severed along the root of the right hepatic vein through a dorsal approach. Subsequently, the anterior approach was used, and the liver parenchyma was gradually severed from the edge of the liver towards the second hepatic portal along the ischemic boundary, until the dorsal approach liver detachment section. Complete anatomical resection of segment VII. The duration of the seventh segment resection surgery was approximately 150 minutes, with 4 hepatic portal blockages for a total of 60 minutes. The bleeding volume was 100 ml, and no blood transfusion was performed. There was no recurrence or metastasis of liver cancer during an 8-month follow-up.
{"title":"Laparoscopic anatomical hepatectomy of segment VII for hepatocellular carcinoma by the dorsal right hepatic vein first approach: a case report","authors":"Hui Zhang, Xiaohui Duan, X. Mao, Xiaoti Liu, Y. Shen","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.018","url":null,"abstract":"患者男性，57岁，腹部增强CT提示肝Ⅱ段、Ⅶ段占位，行腹腔镜肝Ⅶ段切除及左肝外叶切除。切除左肝外叶后，从背侧入路沿肝右静脉根部离断肝实质及肝右静脉回流支。随后转为前入路，沿缺血分界线自肝边缘向第二肝门逐步离断肝实质，直至背侧入路肝离断面。完成Ⅶ段解剖性切除。Ⅶ段切除手术时间约150 min，肝门阻断4次，共60 min，出血量100 ml，未输血。随访8个月无肝癌复发或转移。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"224-225"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44056394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2020.03.012
Lei Yuan, Yingjun Wu, Yun X. Xu, Kaijian Chu, F. Feng, Xiaobing Wu, B. Yi, Yefa Yang, Xiaoqing Jiang
Objective To compare preoperative portal vein embolization (PVE) using tris-acryl gelatin microspheres (TAGM) versus coils. Methods From March 2016 to June 2018, 21 consecutive patients with a future liver remnant (FLR) ratio of less than 45% before planned major hepatectomy for malignant or benign liver diseases were enrolled from the First Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital into this study. The patients were divided to receive portal vein embolization (PVE) using TAGM distally and coils proximally (the TC group) and PVE using multiple coils (the CC group). Post-PVE complications, liver function, routine blood tests; FLR hyperplasia, types of liver resection, operation time, intraoperative blood loss, and postoperative complications were compared between the two groups. Results Eight patients were included in the TC group. There were 4 males and 4 females, with a mean age of (55.3±7.7) years. Of 13 patients included into the CC group, there were 11 males and 2 females, with a mean age of (52.6±11.3) years. There were no significant differences in sex, age, types of hepatic diseases, volume of FLR, ratio of FLR, ratio of standard FLR, types of surgery, operation duration, blood loss, major complications, and liver failure rates between the two groups. All patients in the two groups had successful PVE. The TC group developed effective growth of volume of FLR with one patient who failed to undergo surgery because of tumor progression. In the CC group, four patients failed to undergo liver resection: one patient developed thrombosis of the left branch and main trunk of portal vein; tumor progression occurred in one patient and two patients had insufficient FLR growth. Compared with the CC group, the TC group had a significantly higher volume of FLR hyperplasia [(9.0±2.8) % vs. (5.2±3.8) %, P 0.05], a greater but insignificant increase in percentage of proliferation [(33.6±20.1) % vs. (20.9±15.1) %, P>0.05]. Conclusions This study showed that PVE with TAGM plus coils is safe and effective. It induced a better degree of hypertrophy of FLR compared to PVE using multiple coils. Key words: Liver diseases; Portal vein embolization; Tris-acryl gelatin microsphere; Coils; Major hepatectomy
{"title":"A comparative study on preoperative portal vein embolization using tris-acryl gelatin microspheres versus coils","authors":"Lei Yuan, Yingjun Wu, Yun X. Xu, Kaijian Chu, F. Feng, Xiaobing Wu, B. Yi, Yefa Yang, Xiaoqing Jiang","doi":"10.3760/CMA.J.ISSN.1007-8118.2020.03.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2020.03.012","url":null,"abstract":"Objective \u0000To compare preoperative portal vein embolization (PVE) using tris-acryl gelatin microspheres (TAGM) versus coils. \u0000 \u0000 \u0000Methods \u0000From March 2016 to June 2018, 21 consecutive patients with a future liver remnant (FLR) ratio of less than 45% before planned major hepatectomy for malignant or benign liver diseases were enrolled from the First Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital into this study. The patients were divided to receive portal vein embolization (PVE) using TAGM distally and coils proximally (the TC group) and PVE using multiple coils (the CC group). Post-PVE complications, liver function, routine blood tests; FLR hyperplasia, types of liver resection, operation time, intraoperative blood loss, and postoperative complications were compared between the two groups. \u0000 \u0000 \u0000Results \u0000Eight patients were included in the TC group. There were 4 males and 4 females, with a mean age of (55.3±7.7) years. Of 13 patients included into the CC group, there were 11 males and 2 females, with a mean age of (52.6±11.3) years. There were no significant differences in sex, age, types of hepatic diseases, volume of FLR, ratio of FLR, ratio of standard FLR, types of surgery, operation duration, blood loss, major complications, and liver failure rates between the two groups. All patients in the two groups had successful PVE. The TC group developed effective growth of volume of FLR with one patient who failed to undergo surgery because of tumor progression. In the CC group, four patients failed to undergo liver resection: one patient developed thrombosis of the left branch and main trunk of portal vein; tumor progression occurred in one patient and two patients had insufficient FLR growth. Compared with the CC group, the TC group had a significantly higher volume of FLR hyperplasia [(9.0±2.8) % vs. (5.2±3.8) %, P 0.05], a greater but insignificant increase in percentage of proliferation [(33.6±20.1) % vs. (20.9±15.1) %, P>0.05]. \u0000 \u0000 \u0000Conclusions \u0000This study showed that PVE with TAGM plus coils is safe and effective. It induced a better degree of hypertrophy of FLR compared to PVE using multiple coils. \u0000 \u0000 \u0000Key words: \u0000Liver diseases; Portal vein embolization; Tris-acryl gelatin microsphere; Coils; Major hepatectomy","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"26 1","pages":"208-212"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47319152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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