Acute calculous cholecystitis causing liver hematoma is a rare clinical manifestation, which is a special manifestation of liver bleeding caused by perforation of gallbladder stones. For patients with simple liver hematoma, close observation can be conducted clinically and appropriate treatment methods can be chosen according to the timing. Patients with gallstones and acute inflammatory perforation who develop liver hematoma should undergo surgery as soon as possible, remove the hematoma, remove necrotic and inactive liver tissue, ligate or repair the ruptured bile ducts and/or blood vessels, and provide sufficient drainage to reduce hematoma infection and serious complications. This article reports on the diagnosis and treatment of a patient with acute calculous cholecystitis and occult gallbladder perforation leading to liver hematoma, and reviews relevant literature for discussion.
{"title":"A case of hepatic hematoma caused by acute calculous cholecystitis with occult gallbladder perforation","authors":"Ningjie Zhou, J. Yao, Jian Wang","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.017","url":null,"abstract":"急性结石性胆囊炎致肝血肿临床罕见，是胆囊结石穿孔造成肝脏出血的一个特殊表现。对于单纯性肝血肿患者临床可密切观察，择机采取合适的治疗方式。而胆囊结石并急性炎症穿孔出现肝脏血肿的患者，应尽早手术、清除血肿、切除坏死失活肝组织，对破裂的胆管和(或)血管进行结扎或修补，充分引流，以减少血肿感染及严重并发症的发生。本文报道一例急性结石性胆囊炎并隐匿性胆囊穿孔致肝血肿患者的诊疗情况，并查阅相关文献进行讨论。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"865-866"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49661898","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 : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.011
Qingmin Chen, Yingchao Wang, Songyang Liu, Wei Zhang, Kai Liu, B. Ji
Objective To evaluate the efficacy and safety of Hong's pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy. Methods A retrospective analysis was carried out on 184 patients who underwent laparoscopic pancreaticoduodenectomy using Hong's pancreaticojejunostomy (the Hong’s pancreaticojejunostomy group) compared with 100 patients who underwent laparoscopic pancreaticoduodenectomy using traditional pancreaticojejunostomy (the traditional pancreaticojejunostomy group) at Department of Second Hepatobiliary and Pancreatic Surgery, the First Bethune Hospital of Jilin University, from April 2016 to December 2018. The differences between the two anastomotic methods in operation time, pancreaticojejunostomy time, intraoperative blood loss, postoperative hospital stay, postoperative complications, and incidences of pancreatic fistula were compared. Results The operation time, pancreaticojejunostomy time and intraoperative blood loss of the Hong's pancreaticojejunostomy group were significantly less than the traditional pancreaticojejunostomy group [(278.2±49.3) min vs. (337.3±67.4) min, (33.7±6.6) min vs. (46.8±8.5) min, (123.1±44.7) ml vs. (203.8±138.6) ml], respectively, (all P 0.05). Conclusions Hong's pancreaticojejunostomy was safe, rapid and effective compared with traditional pancreaticojejunostomy. It did not increase the incidence of pancreatic fistula. Key words: Pancreaticoduodenectomy; Laparoscopes; Pancreaticojejunostomy
{"title":"Application of Hong's pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy on 184 patients","authors":"Qingmin Chen, Yingchao Wang, Songyang Liu, Wei Zhang, Kai Liu, B. Ji","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.011","url":null,"abstract":"Objective \u0000To evaluate the efficacy and safety of Hong's pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was carried out on 184 patients who underwent laparoscopic pancreaticoduodenectomy using Hong's pancreaticojejunostomy (the Hong’s pancreaticojejunostomy group) compared with 100 patients who underwent laparoscopic pancreaticoduodenectomy using traditional pancreaticojejunostomy (the traditional pancreaticojejunostomy group) at Department of Second Hepatobiliary and Pancreatic Surgery, the First Bethune Hospital of Jilin University, from April 2016 to December 2018. The differences between the two anastomotic methods in operation time, pancreaticojejunostomy time, intraoperative blood loss, postoperative hospital stay, postoperative complications, and incidences of pancreatic fistula were compared. \u0000 \u0000 \u0000Results \u0000The operation time, pancreaticojejunostomy time and intraoperative blood loss of the Hong's pancreaticojejunostomy group were significantly less than the traditional pancreaticojejunostomy group [(278.2±49.3) min vs. (337.3±67.4) min, (33.7±6.6) min vs. (46.8±8.5) min, (123.1±44.7) ml vs. (203.8±138.6) ml], respectively, (all P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Hong's pancreaticojejunostomy was safe, rapid and effective compared with traditional pancreaticojejunostomy. It did not increase the incidence of pancreatic fistula. \u0000 \u0000 \u0000Key words: \u0000Pancreaticoduodenectomy; Laparoscopes; Pancreaticojejunostomy","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"842-845"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49440252","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}
Report the first intraoperative emergency Meso Rex shunt for the treatment of irreparable portal vein rupture. The patient, a 68 year old male, was admitted due to "recurrence after liposarcoma resection". Diagnosed as recurrent liposarcoma, surgical resection is planned. The tumor is located behind the main portal vein and is surrounded by important blood vessels such as the inferior vena cava, abdominal trunk, and superior mesenteric artery. During the surgical separation of the tumor, the posterior wall of the portal vein ruptured, leading directly to the confluence of the splenic vein and the superior mesenteric vein, which could not be repaired and forced to seal the main portal vein. To correct acute prehepatic portal hypertension, a Meso Rex shunt was performed using an artificial blood vessel to successfully restore portal vein blood flow. The postoperative patient recovered smoothly and has been followed up for more than 1 year with good survival.
{"title":"Emergent Meso-Rex shunt to treat intraoperative unrepairable portal vein rupture: a case report","authors":"Xiangfei Meng, W. Duan, Yingwei Pan, X. Shi, Zhiqiang Wang, Ya-dong Sun, Shi-xin Lu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.016","url":null,"abstract":"报道首例术中紧急Meso-Rex分流术治疗不可修复的门静脉破裂。患者男性，68岁，因\"脂肪肉瘤切除术后复发\"入院。诊断为复发性脂肪肉瘤拟行手术切除。肿瘤位于门静脉主干后方，被下腔静脉、腹腔干、肠系膜上动脉等重要血管包绕。术中分离肿瘤时，门静脉后壁破裂，破口直达脾静脉汇合至肠系膜上静脉处，无法修复，被迫封闭门静脉主干。为纠正急性肝前型门静脉高压，以人工血管行Meso-Rex分流术，成功恢复门静脉血流。术后患者恢复顺利，至今随访1年余生存良好。","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"863-864"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47756031","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 : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.019
Ning Zhang
Liver transplantation is the unique effective life-saving procedure for patients suffering from end-stage liver diseases. The gap between the number of donor graft and patients in waiting lists dramatically increased and the shortage of donors becomes a severe challenge in liver transplantation. At present, the organ donation after death is the only source of organ transplantation in China. Ischemia-reperfusion injury significantly affects the quality of donor liver and the prognosis of recipient transplantation. Therefore, reasonable and effective organ protection techniques and strategies have received much concern in recent years. Here we reviewed the new progress in donor liver preservation and retrieval, surgical ischemia conditioning, drug intervention as well as gene therapy. Key words: Liver transplantation; Reperfusion injury; Donor protection
{"title":"New progress in donor protection for liver transplantation","authors":"Ning Zhang","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.019","url":null,"abstract":"Liver transplantation is the unique effective life-saving procedure for patients suffering from end-stage liver diseases. The gap between the number of donor graft and patients in waiting lists dramatically increased and the shortage of donors becomes a severe challenge in liver transplantation. At present, the organ donation after death is the only source of organ transplantation in China. Ischemia-reperfusion injury significantly affects the quality of donor liver and the prognosis of recipient transplantation. Therefore, reasonable and effective organ protection techniques and strategies have received much concern in recent years. Here we reviewed the new progress in donor liver preservation and retrieval, surgical ischemia conditioning, drug intervention as well as gene therapy. \u0000 \u0000 \u0000Key words: \u0000Liver transplantation; Reperfusion injury; Donor protection","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"868-871"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42079214","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 : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.008
Q. Xin, Xiaoyuan Yu, Xing-kai Liu, Ping Zhang
Objective To compare the Bismuth-Corlette typing, modified T-staging and Mayo staging system in predicting the radical resection rates and prognosis of patients with hilar cholangiocarcinoma (HCC). Methods The clinical data of 138 patients with hilar cholangiocarcinoma treated in the First Bethune Hospital of Jilin University were retrospectively analyzed. Three different staging methods were used. Results With increase in the classification level of the Bismuth-Corlette classification, the radical resection rate did not significantly decrease (P>0.05). The radical resection rates of stage T1, T2 and T3 in the modified T-staging system were 60.0% (27/45), 36.0% (10/28) and 14.0% (9/65) respectively (all P 0.05). However, there were significant differences among the survival rates in the various tumor staging levels using the Mayo Staging System. Conclusions The modified T-staging system and the Mayo staging system were more accurate than the Bismuth-Corlette typing system in predicting radical resection rates in patients with hilar cholangiocarcinoma. The Mayo staging system was superior to the Bismuth-Corlette typing system and the modified T-staging system in predicting prognosis of patients with hilar cholangiocarcinoma. Key words: Bile duct neoplasms; Prognosis; Bismuth-Corlette typing system; Modified T-staging system; Mayo staging system; Hilar cholangiocarcinoma; Radical resection
{"title":"Evaluation of different staging methods on radical resection rate and prognosis of patients with hilar cholangiocarcinoma","authors":"Q. Xin, Xiaoyuan Yu, Xing-kai Liu, Ping Zhang","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.008","url":null,"abstract":"Objective \u0000To compare the Bismuth-Corlette typing, modified T-staging and Mayo staging system in predicting the radical resection rates and prognosis of patients with hilar cholangiocarcinoma (HCC). \u0000 \u0000 \u0000Methods \u0000The clinical data of 138 patients with hilar cholangiocarcinoma treated in the First Bethune Hospital of Jilin University were retrospectively analyzed. Three different staging methods were used. \u0000 \u0000 \u0000Results \u0000With increase in the classification level of the Bismuth-Corlette classification, the radical resection rate did not significantly decrease (P>0.05). The radical resection rates of stage T1, T2 and T3 in the modified T-staging system were 60.0% (27/45), 36.0% (10/28) and 14.0% (9/65) respectively (all P 0.05). However, there were significant differences among the survival rates in the various tumor staging levels using the Mayo Staging System. \u0000 \u0000 \u0000Conclusions \u0000The modified T-staging system and the Mayo staging system were more accurate than the Bismuth-Corlette typing system in predicting radical resection rates in patients with hilar cholangiocarcinoma. The Mayo staging system was superior to the Bismuth-Corlette typing system and the modified T-staging system in predicting prognosis of patients with hilar cholangiocarcinoma. \u0000 \u0000 \u0000Key words: \u0000Bile duct neoplasms; Prognosis; Bismuth-Corlette typing system; Modified T-staging system; Mayo staging system; Hilar cholangiocarcinoma; Radical resection","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"828-833"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46978249","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 : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.003
Pan He, S. Su, Cheng Fang, K. He, Chongwei Chi, X. Xia, Jie Tian, Bo Li
Objective To investigate the clinical application of indocyanine green fluorescence imaging in open hepatectomy. Methods A total of forty-five patients who underwent liver resection in Department of Hepatobiliary Surgery, Affiliated Hospital of Southwest Medical University from July 2017 to December 2018 were included in this prospective study. There were 26 males and 19 females, aged between 29 to 74 (51±10) years. Indocyanine green was injected intravenously 72~96 hours prior to surgery in all these patients. An intraoperative fluorescence imaging system was used to locate and remove the tumor, the liver parenchymal transection planes and surgical margins were detected by fluorescence again after tumor resection. The fluorescence profiles of the tumor specimens in relation to the tumor differentiation were analyzed. Results Indocyanine green fluorescence imaging was performed in 45 patients. A total of 66 lesions were detected by preoperative CT (or MRI), abdominal ultrasound and intraoperative fluorescence imaging. After excision of the primary liver cancer, the surgical margins of the remnant liver stumps and fluorescence in the excised liver specimens were studied. Thirteen small lesions were found in 10 patients, most of which were located at the surgical margin, and the smallest tumors detected were less than 5 mm in diameter. Five venous cancer emboli were found in 5 patients, 3 of which were not detected by preoperative imaging examinations. The fluorescence profile images of the excised hepatocellular carcinoma specimens showed homogeneous fluorescence in most highly differentiated hepatocellular carcinoma, and partial fluorescence or ring fluorescence in moderately differentiated hepatocellular carcinoma. Conclusion Indocyanine green fluorescence imaging technology can identify liver surface lesions, as well as detect small residual lesions at the cutting edge and venous thrombus, which improves the efficiency of hepatocellular carcinoma resection. Key words: Hepatectomy; Margins of excision; Indocyanine green; Fluorescence imaging
{"title":"Application of indocyanine green fluorescence imaging in open hepatectomy","authors":"Pan He, S. Su, Cheng Fang, K. He, Chongwei Chi, X. Xia, Jie Tian, Bo Li","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.003","url":null,"abstract":"Objective \u0000To investigate the clinical application of indocyanine green fluorescence imaging in open hepatectomy. \u0000 \u0000 \u0000Methods \u0000A total of forty-five patients who underwent liver resection in Department of Hepatobiliary Surgery, Affiliated Hospital of Southwest Medical University from July 2017 to December 2018 were included in this prospective study. There were 26 males and 19 females, aged between 29 to 74 (51±10) years. Indocyanine green was injected intravenously 72~96 hours prior to surgery in all these patients. An intraoperative fluorescence imaging system was used to locate and remove the tumor, the liver parenchymal transection planes and surgical margins were detected by fluorescence again after tumor resection. The fluorescence profiles of the tumor specimens in relation to the tumor differentiation were analyzed. \u0000 \u0000 \u0000Results \u0000Indocyanine green fluorescence imaging was performed in 45 patients. A total of 66 lesions were detected by preoperative CT (or MRI), abdominal ultrasound and intraoperative fluorescence imaging. After excision of the primary liver cancer, the surgical margins of the remnant liver stumps and fluorescence in the excised liver specimens were studied. Thirteen small lesions were found in 10 patients, most of which were located at the surgical margin, and the smallest tumors detected were less than 5 mm in diameter. Five venous cancer emboli were found in 5 patients, 3 of which were not detected by preoperative imaging examinations. The fluorescence profile images of the excised hepatocellular carcinoma specimens showed homogeneous fluorescence in most highly differentiated hepatocellular carcinoma, and partial fluorescence or ring fluorescence in moderately differentiated hepatocellular carcinoma. \u0000 \u0000 \u0000Conclusion \u0000Indocyanine green fluorescence imaging technology can identify liver surface lesions, as well as detect small residual lesions at the cutting edge and venous thrombus, which improves the efficiency of hepatocellular carcinoma resection. \u0000 \u0000 \u0000Key words: \u0000Hepatectomy; Margins of excision; Indocyanine green; Fluorescence imaging","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"809-811"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42369824","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 : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.021
H. Wen, Lin-wei Wu
Epithelioid Hemangioendotheliomais a rare, low-grade malignant vascular tumour. It’scalled hepatic epithelioid hemangioendothelioma(HEHE), when it occurs in liver. It can be metastatic and postoperative recurrence. There are few cases have been reported in the literature at home and abroad because of its rarity. The treatment of HEHE is also controversial. With the continuous improvement of surgical techniques of liver transplantation, it is increasingly applied to treat liver failure patients caused by HEHE. Our paper reviews the literature on disease characteristics of HEHE, and liver transplantation for HEHE indications, immunotherapy and prognosis, to illustrate the status and progress of liver transplantation for HEHE. Key words: Liver transplantation; Neoplasm metastasis; Recurrence; Epithelioid hemangioendothelioma
{"title":"Progress of liver transplantation in treating hepatic epithelioid hemangioendothelioma","authors":"H. Wen, Lin-wei Wu","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.021","url":null,"abstract":"Epithelioid Hemangioendotheliomais a rare, low-grade malignant vascular tumour. It’scalled hepatic epithelioid hemangioendothelioma(HEHE), when it occurs in liver. It can be metastatic and postoperative recurrence. There are few cases have been reported in the literature at home and abroad because of its rarity. The treatment of HEHE is also controversial. With the continuous improvement of surgical techniques of liver transplantation, it is increasingly applied to treat liver failure patients caused by HEHE. Our paper reviews the literature on disease characteristics of HEHE, and liver transplantation for HEHE indications, immunotherapy and prognosis, to illustrate the status and progress of liver transplantation for HEHE. \u0000 \u0000 \u0000Key words: \u0000Liver transplantation; Neoplasm metastasis; Recurrence; Epithelioid hemangioendothelioma","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"875-878"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42719314","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 : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.002
Li Chunhong, Deng Mingwu, Qiu Siyuan, Zhu Hongtao, Xu Bangren, Hong Xiaoming, Ji-hua Ren, Wu Guoji, Chen Zhi-ren, Zhang Dantu, Lu Chongmao
Objective To study the application of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma with mild-to-moderate liver cirrhosis. Methods There are 14 patients with hepatocellular carcinoma underwent ALPPS at the Department of Hepatobiliary and Pancreatic Surgery, Hong Kong University-Shenzhen Hospital from April 2014 to December 2017. The clinical data was retrospectively studied. The studying objects consisted of 9 males and 5 females, aged from 26 to 71 years old with the average age of 51, all cases were of Child-Pugh grade A. The degree of liver cirrhosis, operation and postoperative complications were analyzed. Results All 14 patients completed the ALPPS, 1 patient died post stage 2 operation with liver failure. Comparing the groups with no liver cirrhosis (n=4) with the groups of mild liver cirrhosis (n=5) and moderate liver cirrhosis (n=5), the future liver remnant liver volume growth rates were 58%, 46% and 45.6%, respectively. The average operation intervals were 9.0, 11.2 and 12.8 days, respectively. Postoperative complications occurred in 4 patients: 2 patients with liver failure, 1 patient with intestinal obstruction, and 1 patient with hepatic ascites. Conclusion ALPPS for Child-Pugh grade A, hepatocellular carcinoma with mild-to-moderate liver cirrhosis treatment is safe and feasible. Key words: Liver cirrhosis; Carcinoma, hepatocelluar; Hepatectomy; Associating liver partition and portal vein ligation for staged hepatectomy
{"title":"Analysis of clinical application of ALPPS for hepatocellular carcinoma with mild-to-moderate liver cirrhosis","authors":"Li Chunhong, Deng Mingwu, Qiu Siyuan, Zhu Hongtao, Xu Bangren, Hong Xiaoming, Ji-hua Ren, Wu Guoji, Chen Zhi-ren, Zhang Dantu, Lu Chongmao","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.002","url":null,"abstract":"Objective \u0000To study the application of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma with mild-to-moderate liver cirrhosis. \u0000 \u0000 \u0000Methods \u0000There are 14 patients with hepatocellular carcinoma underwent ALPPS at the Department of Hepatobiliary and Pancreatic Surgery, Hong Kong University-Shenzhen Hospital from April 2014 to December 2017. The clinical data was retrospectively studied. The studying objects consisted of 9 males and 5 females, aged from 26 to 71 years old with the average age of 51, all cases were of Child-Pugh grade A. The degree of liver cirrhosis, operation and postoperative complications were analyzed. \u0000 \u0000 \u0000Results \u0000All 14 patients completed the ALPPS, 1 patient died post stage 2 operation with liver failure. Comparing the groups with no liver cirrhosis (n=4) with the groups of mild liver cirrhosis (n=5) and moderate liver cirrhosis (n=5), the future liver remnant liver volume growth rates were 58%, 46% and 45.6%, respectively. The average operation intervals were 9.0, 11.2 and 12.8 days, respectively. Postoperative complications occurred in 4 patients: 2 patients with liver failure, 1 patient with intestinal obstruction, and 1 patient with hepatic ascites. \u0000 \u0000 \u0000Conclusion \u0000ALPPS for Child-Pugh grade A, hepatocellular carcinoma with mild-to-moderate liver cirrhosis treatment is safe and feasible. \u0000 \u0000 \u0000Key words: \u0000Liver cirrhosis; Carcinoma, hepatocelluar; Hepatectomy; Associating liver partition and portal vein ligation for staged hepatectomy","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"806-808"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47350705","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 : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.022
Xiaofan Li
Compared with other tumors of digestive system such as colorectal cancer, the overall survival for advanced biliary tract carcinoma has not been prolonged greatly although some progress has been made on the optimization of the treatment. One of the reasons is that there is no effective chemotherapy for biliary tract cancer yet. In this review, we summarized the recent research findings on chemotherapy for BTC , thereby providing guidance on clinical practice. Key words: Biliary tract neoplasms; Antineoplastic combined chemotherapy protocols; Review
{"title":"The progress and advances of biliary tract carcinoma chemotherapy","authors":"Xiaofan Li","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.022","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.022","url":null,"abstract":"Compared with other tumors of digestive system such as colorectal cancer, the overall survival for advanced biliary tract carcinoma has not been prolonged greatly although some progress has been made on the optimization of the treatment. One of the reasons is that there is no effective chemotherapy for biliary tract cancer yet. In this review, we summarized the recent research findings on chemotherapy for BTC , thereby providing guidance on clinical practice. \u0000 \u0000 \u0000Key words: \u0000Biliary tract neoplasms; Antineoplastic combined chemotherapy protocols; Review","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"878-880"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46435623","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 : 2019-11-28DOI: 10.3760/CMA.J.ISSN.1007-8118.2019.11.004
Shunyun Zhao, Yamin Guo, A. Jide, Zhe Peng, Xiang-Tian Wang, Wei Gao, R. Jin, Zhanxue Zhao
Objective To evaluate the efficacy and safety of reduced volume hepatectomy in treatment of advanced hepatic alveolar echinococcosis. Methods The clinical data of 90 patients with advanced hepatic alveolar echinococcosis treated at the Qinghai Provincial People's Hospital from January 2017 to January 2019 were retrospectively analyzed. There were 41 males and 49 females, with an average age of 32 (range 11 to 58) years. The locations of the lesions, operations, complications and follow-up were analyzed. Results 90 patients were treated with reduced volume focal hepatectomy, 38 with radical resection and 52 with quasi radical resection. The operation time was (361±22) min. The hospital stay was (22±2) day, and the blood loss was (781±37) ml. Red blood cells were transfused in 19 patients and plasma in 39 patients. Pringle’s maneuver was used in 12 patients, regional hepatic blood flow occlusion in 42 patients, and Glisson sheath occlusion in 26 patients. The total bilirubin, alanine aminotransferase and aspartate aminotransferase returned to normal in 3 to 14 days after operation. There were 12 patients who developed bile leakage, 41 pleural effusion and 26 effusion in the operation sites. A total of ninety patients were followed up for 2 to 24 months. There was no recurrence of echinococcosis after radical resection and no enlargement of residual lesions after quasi-radical resection. Conclusion Reduced-volume hepatectomy reduced the risk and difficulty of operation. The follow-up results were good. This approach provides a feasible scheme for treatment of advanced hepatic alveolar echinococcosis. Key words: Echinococcosis, hepatic; Treatment outcome; Reduced-volume focal hepatectomy; Safety
{"title":"Safety and efficacy of reduced-volume hepatectomy for advanced hepatic alveolar echinococcosis","authors":"Shunyun Zhao, Yamin Guo, A. Jide, Zhe Peng, Xiang-Tian Wang, Wei Gao, R. Jin, Zhanxue Zhao","doi":"10.3760/CMA.J.ISSN.1007-8118.2019.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-8118.2019.11.004","url":null,"abstract":"Objective \u0000To evaluate the efficacy and safety of reduced volume hepatectomy in treatment of advanced hepatic alveolar echinococcosis. \u0000 \u0000 \u0000Methods \u0000The clinical data of 90 patients with advanced hepatic alveolar echinococcosis treated at the Qinghai Provincial People's Hospital from January 2017 to January 2019 were retrospectively analyzed. There were 41 males and 49 females, with an average age of 32 (range 11 to 58) years. The locations of the lesions, operations, complications and follow-up were analyzed. \u0000 \u0000 \u0000Results \u000090 patients were treated with reduced volume focal hepatectomy, 38 with radical resection and 52 with quasi radical resection. The operation time was (361±22) min. The hospital stay was (22±2) day, and the blood loss was (781±37) ml. Red blood cells were transfused in 19 patients and plasma in 39 patients. Pringle’s maneuver was used in 12 patients, regional hepatic blood flow occlusion in 42 patients, and Glisson sheath occlusion in 26 patients. The total bilirubin, alanine aminotransferase and aspartate aminotransferase returned to normal in 3 to 14 days after operation. There were 12 patients who developed bile leakage, 41 pleural effusion and 26 effusion in the operation sites. A total of ninety patients were followed up for 2 to 24 months. There was no recurrence of echinococcosis after radical resection and no enlargement of residual lesions after quasi-radical resection. \u0000 \u0000 \u0000Conclusion \u0000Reduced-volume hepatectomy reduced the risk and difficulty of operation. The follow-up results were good. This approach provides a feasible scheme for treatment of advanced hepatic alveolar echinococcosis. \u0000 \u0000 \u0000Key words: \u0000Echinococcosis, hepatic; Treatment outcome; Reduced-volume focal hepatectomy; Safety","PeriodicalId":10021,"journal":{"name":"Chinese Journal of Hepatobiliary Surgery","volume":"25 1","pages":"812-814"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47355694","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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