{"title":"Liver Trauma: Review of Management, and Patient Outcomes at Our Major Trauma Centre","authors":"RW Laing, M. Edwards, T. Faulkner, K. Roberts","doi":"10.36959/879/385","DOIUrl":"https://doi.org/10.36959/879/385","url":null,"abstract":"","PeriodicalId":309104,"journal":{"name":"Journal of Gastrointestinal and Hepatic Surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120951519","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}
Simões João, Amaral Maria João, Serôdio Marco, Tralhão José Guilherme
Intraperitoneal metastases of a non-ruptured HCC are rare. Metastatic disease is an expression of an advanced disease, is associated with poor prognosis and can occur at the time of hepatic recurrence. We present the case of a female patient who underwent surgery for a big hepatic adenoma that suffered malignant transformation. Fifteen months later, she had HCC liver recurrence with peritoneal metastases, being submitted to a new surgery with complete resection of the hepatic mass and peritoneal implants. In the absence of HCC rupture, peritoneal dissemination is not common. Aggressive surgical treatment and adjuvant treatment with sorafenib could prolong patients’ overall survival but there is still no standard management for these patients.
{"title":"Hepatocellular Carcinoma Recurrence with Metachronous Peritoneal Metastasis - A Controversial Surgical Indication","authors":"Simões João, Amaral Maria João, Serôdio Marco, Tralhão José Guilherme","doi":"10.36959/879/381","DOIUrl":"https://doi.org/10.36959/879/381","url":null,"abstract":"Intraperitoneal metastases of a non-ruptured HCC are rare. Metastatic disease is an expression of an advanced disease, is associated with poor prognosis and can occur at the time of hepatic recurrence. We present the case of a female patient who underwent surgery for a big hepatic adenoma that suffered malignant transformation. Fifteen months later, she had HCC liver recurrence with peritoneal metastases, being submitted to a new surgery with complete resection of the hepatic mass and peritoneal implants. In the absence of HCC rupture, peritoneal dissemination is not common. Aggressive surgical treatment and adjuvant treatment with sorafenib could prolong patients’ overall survival but there is still no standard management for these patients.","PeriodicalId":309104,"journal":{"name":"Journal of Gastrointestinal and Hepatic Surgery","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134435633","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}
Background: Intrahepatic pancreatic pseudocysts (IHPP) are a rare clinical entity which results from migration of amylase rich proteolytic pancreatic fluid along hepatogastric or hepatoduodenal ligaments into the hepatic parenchyma. There are no current management guidelines, and definitive management depends on varying features within each individual case. We report a rare case presenting with features of acute gastric outlet obstruction on a background of chronic pancreatitis. The rapid formation of this IHPP does not appear to have been previously reported in the literature. Methods: We conducted a comprehensive literature search of both PubMed and the Cochrane library to identify cases of IHPPs in recent literature. This review article aims at comparing the clinical features and management of the reported case with those reported in world literature. Results: Diagnosis and clinical management of IHPP is challenging. A combination of CT scanning and aspirate sampling are the most useful in establishing a diagnosis. Clinical management includes a conservative approach, percutaneous/ endoscopic drainage, ERCP and pancreatic duct stenting. Open surgical management is reserved for cases where serious complications have occurred. Conclusion: This is the first documented rapid formation of an IHPP in current literature. The most common approach for the management of IHPPs is through radiologically guided percutaneous drainage. Early diagnosis and successful definitive management are probably best determined by the size of the lesion and severity of the clinical presentation.
{"title":"Intrahepatic Pancreatic Pseudocysts: A Review of Recent Literature and Case Report","authors":"Reed-Embleton Hamish, Paraicz Tamas, Mukherjee Arijit","doi":"10.36959/879/382","DOIUrl":"https://doi.org/10.36959/879/382","url":null,"abstract":"Background: Intrahepatic pancreatic pseudocysts (IHPP) are a rare clinical entity which results from migration of amylase rich proteolytic pancreatic fluid along hepatogastric or hepatoduodenal ligaments into the hepatic parenchyma. There are no current management guidelines, and definitive management depends on varying features within each individual case. We report a rare case presenting with features of acute gastric outlet obstruction on a background of chronic pancreatitis. The rapid formation of this IHPP does not appear to have been previously reported in the literature. Methods: We conducted a comprehensive literature search of both PubMed and the Cochrane library to identify cases of IHPPs in recent literature. This review article aims at comparing the clinical features and management of the reported case with those reported in world literature. Results: Diagnosis and clinical management of IHPP is challenging. A combination of CT scanning and aspirate sampling are the most useful in establishing a diagnosis. Clinical management includes a conservative approach, percutaneous/ endoscopic drainage, ERCP and pancreatic duct stenting. Open surgical management is reserved for cases where serious complications have occurred. Conclusion: This is the first documented rapid formation of an IHPP in current literature. The most common approach for the management of IHPPs is through radiologically guided percutaneous drainage. Early diagnosis and successful definitive management are probably best determined by the size of the lesion and severity of the clinical presentation.","PeriodicalId":309104,"journal":{"name":"Journal of Gastrointestinal and Hepatic Surgery","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134120035","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}
A 41 years old patient underwent total colectomy and ileal pouch-anal anastomosis with derivative ileostomy for a familiar adenomatous polyposis coli in June 2008. Pathologic examination of the specimen showed a pT1 N1 adenocarcinoma of the rectum. The patient underwent chemo-radiation and subsequent adjuvant chemotherapy. A stenosis of the pouch-anal anastomosis developed. The patient underwent several endoscopic dilations. The ileostomy was taken down in March 2016. A recurrence of the stenosis and a peri-anastomotic collection were observed. An endoscopic drainage of the collection was performed on October 3rd, 2016.
{"title":"What Shall We Do Now? Report of Unexpected CT Finding and Its Management","authors":"G. Capolupo, G. Mascianá, M. Caricato","doi":"10.36959/879/375","DOIUrl":"https://doi.org/10.36959/879/375","url":null,"abstract":"A 41 years old patient underwent total colectomy and ileal pouch-anal anastomosis with derivative ileostomy for a familiar adenomatous polyposis coli in June 2008. Pathologic examination of the specimen showed a pT1 N1 adenocarcinoma of the rectum. The patient underwent chemo-radiation and subsequent adjuvant chemotherapy. A stenosis of the pouch-anal anastomosis developed. The patient underwent several endoscopic dilations. The ileostomy was taken down in March 2016. A recurrence of the stenosis and a peri-anastomotic collection were observed. An endoscopic drainage of the collection was performed on October 3rd, 2016.","PeriodicalId":309104,"journal":{"name":"Journal of Gastrointestinal and Hepatic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130310677","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}
Zengwu Yao, Yanbing Zhou, Jiang Lixin, Zhang Yifei, Jinchen Hu, Zhiliang Wei, S. Teng, Li Yi, Xiaojie Wang, Z. Dawei, Huiyuan Zhai, Wang Dong, Zhenbin Zhang, Miaomiao Li, Menglai Zhang
International guidelines do not recommend routine systemic antibiotic prophylaxis in thyroidectomy patients as post-operative wound infections are rare, though many surgeons prefer to give preoperative antibiotics. However, the molecular-based short-term consequences of one dose of antibiotics on the human intestinal microbiota are rarely explored.
{"title":"What is the Short-Term Effect of a Dose of Antibiotics on Gut Microbiota in Thyroid Cancer Patients After Surgery? An Observational Clinical Study","authors":"Zengwu Yao, Yanbing Zhou, Jiang Lixin, Zhang Yifei, Jinchen Hu, Zhiliang Wei, S. Teng, Li Yi, Xiaojie Wang, Z. Dawei, Huiyuan Zhai, Wang Dong, Zhenbin Zhang, Miaomiao Li, Menglai Zhang","doi":"10.36959/879/376","DOIUrl":"https://doi.org/10.36959/879/376","url":null,"abstract":"International guidelines do not recommend routine systemic antibiotic prophylaxis in thyroidectomy patients as post-operative wound infections are rare, though many surgeons prefer to give preoperative antibiotics. However, the molecular-based short-term consequences of one dose of antibiotics on the human intestinal microbiota are rarely explored.","PeriodicalId":309104,"journal":{"name":"Journal of Gastrointestinal and Hepatic Surgery","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129484092","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}
Dardon Arturo Torices, F SaldingerPierre, D. Anthony
Small bowel intussusception is an uncommon condition with cases of duodenoduodenal intussusception. (DDI) being exceptionally rare. DDI is very unusual due to the fixed position of the duodenum within the retroperitoneum. In this case, the presence of an ampullary mass caused DDI with sub mucosal elongation of the common bile duct and obstructive jaundice in a patient with pancreas divisum. Methods
{"title":"Common Bile Duct Elongation and Obstruction Secondary to Duodenal Intussusception and Ampullary Adenoma in a Patient with Pancreas Divisum","authors":"Dardon Arturo Torices, F SaldingerPierre, D. Anthony","doi":"10.36959/879/374","DOIUrl":"https://doi.org/10.36959/879/374","url":null,"abstract":"Small bowel intussusception is an uncommon condition with cases of duodenoduodenal intussusception. (DDI) being exceptionally rare. DDI is very unusual due to the fixed position of the duodenum within the retroperitoneum. In this case, the presence of an ampullary mass caused DDI with sub mucosal elongation of the common bile duct and obstructive jaundice in a patient with pancreas divisum. Methods","PeriodicalId":309104,"journal":{"name":"Journal of Gastrointestinal and Hepatic Surgery","volume":"70 Suppl4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127421531","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}
Cancer begins when cells in the body start to grow out of control. As a matter of fact, cells in nearly any part of the body can become cancer and can spread to other parts of the body. It is very vital to know that if the cancer is an exocrine or endocrine because they have distinct risk, causes and they also have different signs and symptoms; they are diagnosed, treated different ways and have different viewpoint. The two major types of cancer in pancreas are exocrine pancreatic cancer and endocrine pancreatic tumors which are also called as neuroendocrine tumors (Figure 1) [1,2].
{"title":"Pancreatic Cancer and its Treatment","authors":"Manu Mitra","doi":"10.36959/879/373","DOIUrl":"https://doi.org/10.36959/879/373","url":null,"abstract":"Cancer begins when cells in the body start to grow out of control. As a matter of fact, cells in nearly any part of the body can become cancer and can spread to other parts of the body. It is very vital to know that if the cancer is an exocrine or endocrine because they have distinct risk, causes and they also have different signs and symptoms; they are diagnosed, treated different ways and have different viewpoint. The two major types of cancer in pancreas are exocrine pancreatic cancer and endocrine pancreatic tumors which are also called as neuroendocrine tumors (Figure 1) [1,2].","PeriodicalId":309104,"journal":{"name":"Journal of Gastrointestinal and Hepatic Surgery","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126700064","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}
Robledo Andrea Boscà, Seller Ana Navío, NavasquilloTamarit Mireia, Ibáñez Javier Maupoey, Rosellón Raquel Jiménez, Orón Eva María Montalvá, Domínguez Rafael García, Mizrahi David Calatayud, Andújar Rafael López
The use of biological hemostatic and sealing agents over the edge of the liver resection has been increasing exponentially for over 30 years but without solid literature review. The aim of this study was to produce a meta-analysis including only prospective and randomized studies to know real effect using hemostatic sealants on the resection edge after elective hepatic resection, especially regarding biliary fistula and hematoma. A literature search of the Medline and EMBASE was carried out to find prospective and randomized trials related to the use of hemostatic sealant in the surface of the liver resection compared with not using products after the usual revision of hemostasis. Six studies were included involving a total of 1,002 patients in this meta-analysis. After analyzing the results, the risk of developing hematoma/abscess or biliary leak was not related to the use of sealants. Odds Ratio (OR): 1.19; 95% Confidence Interval (CI): 0.79 to 1.81; p=0.40 and OR: 1.02; 95% CI: 0.65 to 1.61; p=0.92 respectively. The use of sealants over the edge of the liver resection does not currently provide any benefit and its cost is not really justified. Andrea Boscà Robledo*, Ana Navío Seller, Mireia Navasquillo Tamarit, Javier Maupoey Ibáñez, Raquel Jiménez Rosellón, Eva María Montalvá Orón, Rafael García Domínguez, David Calatayud Mizrahi and Rafael López Andújar Hepatobiliary Pancreatic Surgery and Transplantation Unit, La Fe University and Polytechnic Hospital, Valencia, Spain
30多年来，在肝切除边缘使用生物止血和封闭剂呈指数增长，但没有可靠的文献综述。本研究的目的是进行一项荟萃分析，仅包括前瞻性和随机研究，以了解选择性肝切除术后使用止血密封剂对切除边缘的实际效果，特别是对胆道瘘和血肿的影响。我们对Medline和EMBASE进行了文献检索，以寻找在肝切除表面使用止血密封剂与在常规止血改良后不使用止血密封剂相关的前瞻性和随机试验。这项荟萃分析纳入了6项研究，共涉及1002名患者。在分析结果后，发生血肿/脓肿或胆道泄漏的风险与使用密封剂无关。优势比(OR): 1.19;95%置信区间(CI): 0.79 ~ 1.81;p=0.40, OR: 1.02;95% CI: 0.65 ~ 1.61;分别p = 0.92。在肝切除边缘使用密封剂目前没有任何好处，其成本也不合理。Andrea bosc Robledo*， Ana Navío Seller, Mireia Navasquillo Tamarit, Javier Maupoey Ibáñez, Raquel jimsamnez Rosellón, Eva María montalv Orón, Rafael García Domínguez, David Calatayud Mizrahi和Rafael López Andújar西班牙巴伦西亚拉菲大学和理工医院肝胆胰外科和移植科
{"title":"Is the Use of Sealing and Hemostatic Agents Justified in Hepatic Resections? Review and Meta-analysis","authors":"Robledo Andrea Boscà, Seller Ana Navío, NavasquilloTamarit Mireia, Ibáñez Javier Maupoey, Rosellón Raquel Jiménez, Orón Eva María Montalvá, Domínguez Rafael García, Mizrahi David Calatayud, Andújar Rafael López","doi":"10.36959/879/380","DOIUrl":"https://doi.org/10.36959/879/380","url":null,"abstract":"The use of biological hemostatic and sealing agents over the edge of the liver resection has been increasing exponentially for over 30 years but without solid literature review. The aim of this study was to produce a meta-analysis including only prospective and randomized studies to know real effect using hemostatic sealants on the resection edge after elective hepatic resection, especially regarding biliary fistula and hematoma. A literature search of the Medline and EMBASE was carried out to find prospective and randomized trials related to the use of hemostatic sealant in the surface of the liver resection compared with not using products after the usual revision of hemostasis. Six studies were included involving a total of 1,002 patients in this meta-analysis. After analyzing the results, the risk of developing hematoma/abscess or biliary leak was not related to the use of sealants. Odds Ratio (OR): 1.19; 95% Confidence Interval (CI): 0.79 to 1.81; p=0.40 and OR: 1.02; 95% CI: 0.65 to 1.61; p=0.92 respectively. The use of sealants over the edge of the liver resection does not currently provide any benefit and its cost is not really justified. Andrea Boscà Robledo*, Ana Navío Seller, Mireia Navasquillo Tamarit, Javier Maupoey Ibáñez, Raquel Jiménez Rosellón, Eva María Montalvá Orón, Rafael García Domínguez, David Calatayud Mizrahi and Rafael López Andújar Hepatobiliary Pancreatic Surgery and Transplantation Unit, La Fe University and Polytechnic Hospital, Valencia, Spain","PeriodicalId":309104,"journal":{"name":"Journal of Gastrointestinal and Hepatic Surgery","volume":"55 66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124768311","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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