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Current status of associating liver partition with portal vein ligation for staged hepatectomy: Comparison with two-stage hepatectomy and strategies for better outcomes

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World Journal of Gastroenterology 2019年第43期25卷 6373-6385页

作者： Kin Pan Au albert chi Yan chan Department of Surgery Queen Mary HospitalHong KongChina Department of Surgery and State Key Laboratory for Liver Research The University of Hong KongHong KongChina

Since its introduction in 2012,associating liver partition with portal vein ligation for staged hepatectomy(ALPPS)has significantly expanded the pool of candidates for liver *** offers patients with insufficient liver function a chance of a *** is most controversial when its high morbidity and mortality is *** mortality is usually a result of posthepatectomy liver failure and can be minimized with careful patient *** patients have limited reserve for tolerating the demanding *** with colorectal liver metastasis have normal liver and are ideal *** for cholangiocarcinoma is technically challenging and associated with fair *** with hepatocellular carcinoma have chronic liver disease and limited parenchymal ***,in selected patients with limited hepatic fibrosis satisfactory outcomes have been *** the inter-stage period,serum bilirubin and creatinine level and presence of surgical complication predict mortality after stage *** growth rate and hepatobiliary scintigraphy also guide the decision whether to postpone or omit stage II *** outcomes of ALPPS have been improved by a combination of technical *** patients with challenging anatomy,partial ALPPS potentially reduces morbidity,but remnant hypertrophy may compare unfavorably to a complete *** compared to conventional two-stage hepatectomy with portal vein embolization or portal vein ligation,ALPPS offers a higher resection rate for colorectal liver metastasis without increased morbidity or *** ALPPS has obvious theoretical oncological advantages over two-stage hepatectomy,the long-term outcomes are yet to be determined.

关键词： Associating liver partition with portal vein ligation for staged hepatectomy Two-stage hepatectomy Patient selection Surgical outcomes

Simultaneous portohepatic vein embolization a radiological:a short cut to associating liver partition and portal vein ligation for staged hepatectomy?

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Hepatobiliary Surgery and Nutrition 2021年第3期10卷 373-375页

作者： Ka Wing Ma albert chi Yan chan Department of Surgery Li Ka Shing Faculty of Medicinethe University of Hong KongHong KongChina

Insufficient future liver remnant(FLR)represented one of the most common contraindications for major hepatectomy as post-hepatectomy liver failure(PHLF)was associated with high mortality with no effective *** the description of portal vein embolization(PVE)by Makucchi in 1984(1),FLR volumetric modulation was made *** of PVE before major hepatectomy for patients with insufficient FLR(i.e.,<30%of estimated standard liver volume)had greatly improved resectability.

关键词： hepatectomy mortality liver

Initial experience with stereotactic body radiotherapy for intrahepatic hepatocellular carcinoma recurrence after liver transplantation

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World Journal of Clinical Cases 2020年第13期8卷 2758-2768页

作者： Kin Pan Au chi Leung chiang albert chi Yan chan Tan To Cheung Chung Mau Lo Kenneth Siu Ho Chok Department of Surgery Queen Mary HospitalThe University of Hong KongHong Kong 999077China Department of Clinical Oncology Queen Mary Hospitalthe University of Hong KongHong Kong 999077China

BACKGROUND Graft hepatocellular carcinoma(HCC)recurrence after liver transplant is more frequently *** hepatectomy is technically challenging and is associated with high *** body radiation therapy(SBRT)has been shown to be safe and effective for the treatment of primary ***,its role in HCC recurrence in a liver graft remains *** To evaluate the safety and efficacy of SBRT for the treatment of graft HCC recurrence after liver *** A retrospective study was *** 2012 to 2018,6 patients with intrahepatic HCC recurrence after liver transplant were treated with SBRT at Queen Mary Hospital,the University of Hong *** primary outcome was time to overall disease progression and secondary outcomes were time to local progression and best local response,as assessed with the Modified response Evaluation Criteria for Solid Tumours *** were monitored for treatment related toxicities and graft *** A total of 9 treatment courses were given for 13 *** median tumour size was 2.3 cm(range 0.7-3.6 cm).Two(22%)patients had inferior vena cava tumour *** best local treatment response was:5(55%)complete response,1(11%)partial response and 3(33%)stable *** a median follow up duration of 15.5 mo,no local progression or mortality was yet *** median time to overall disease progression was 6.5 *** were 6 regional progression in the liver graft(67%)and 2 distant progression in the lung(22%).There was no grade 3 or above toxicity and there was no graft dysfunction after *** SBRT appears to be safe in this *** progression is the mode of failure.

关键词： Stereotactic body radiotherapy Hepatocellular carcinoma Liver transplantation Recurrence Radiosurgery Outcomes

Highly efficient synthesis of β-amino esters via Mannich-type reaction under solvent-free conditions using ZnCl_2 catalyst

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chinese Chemical Letters 2009年第4期20卷 407-410页

作者： albert S.C.chan School of Pharmaceutical Science Sun Yat-Sen University

β-Amino esters were synthesized via ZnCl2-catalyzed Mannich-type reaction of imines and malonate esters under solvent-free conditions in 6 min. The β-amino ester was converted into the corresponding aspartic acid de... 详细信息

关键词： β-Amino esters Aspartic acid derivativates Mannich-type reaction Solvent-free Krapcho decarboxylation reaction Zinc chloride

The ‘Unsigned highway’:An alternative route for portal vein anastomosis for non-malignant portal vein thrombosis during pediatric re-transplantation

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Hepatobiliary & Pancreatic Diseases International 2021年第2期20卷 193-195页

作者： albert chi Yan chan Wing chiu Dai Patrick Ho Yu Chung Wong Hoi She Sui Ling Sin Division of Liver Transplantation Department of SurgeryThe University of Hong KongHong KongChina Division of Paediatric Surgery Department of SurgeryThe University of Hong KongHong KongChina

To the Editor:Non-malignant portal vein thrombosis(PVT)remains an important issue in liver transplantation due to the technical challenges in re-establishing the portal flow to the liver *** prevalence of complex PVT(*** grade 4)was reported to be around 2.0%[1].In the early history of liver transplantation,PVT was regarded as a contraindication.

关键词： malignant thrombosis anastomosis

Solitary extraovarian primary peritoneal carcinoma with direct invasion into the liver,diaphragm and lung without peritoneal dissemination or distant metastasis

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 322-325页

作者： Billy Ho Hung Cheung Wong Hoi She Siu Lun Ho albert chi Yan chan Chung Mau Lo Tan To Cheung Department of Surgery The University of Hong KongHong KongChina Department of Pathology The University of Hong KongHong KongChina

To the Editor:Extraovarian primary peritoneal carcinoma(EOPPC)is an uncommon malignancy with many similarities to epithelial ovarian carcinoma in histological,clinical,and etiological aspects[1].This phenomenon is explained by their common embryonal origin,in which both develop from the coelomic epithelium in the early embryological *** their similarities,the incidence of EOPPC is significantly lower than that of epithelial ovarian carcinoma(6.78 cases per million vs.120.5 cases per million)[1].

关键词： peritoneal invasion metastasis

Survival outcomes of liver transplantation for hepatocellular carcinoma in patients with normal, high and very high preoperative alpha-fetoprotein levels

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World Journal of Hepatology 2018年第2期10卷 308-318页

作者： Wong Hoi She albert chi Yan chan Tan To Cheung Chung Mau Lo Kenneth Siu Ho Chok Department of Surgery University of Hong Kong Department of Surgery and State Key Laboratory for Liver Research University of Hong Kong

AIM To investigate the impact of alpha-fetoprotein(AFP) on long-term recurrence rate and overall survival and we also aimed to define the level of AFP leading to a higher risk of disease recurrence and affecting patient *** Data of adult patients who received liver transplant(LT) for hepatocellular carcinoma(HCC) at our hospital from January 2000 to December 2013 were reviewed. Reviewed data included demographic characteristics, preoperative AFP level, operative details, follow-up details, and survival outcomes. Patients were mostly listed for LT based on Milan or UCSF criteria. For the purpose of this study, normal AFP level was defined as AFP value < 10 ng/m L, high AFP level was defined as AFP value ≥ 10 to < 400 ng/m L, and very highAFP level was defined as AFP ≥ 400 ng/m L. The patients were divided into these 3 groups accordingly. Survival rates were plotted as Kaplan-Meier curves and compared by log-rank analysis. Continuous variables were expressed as median(interquartile range). Categorical variables were compared by Spearman's test. Discriminative analysis was used to define the lowest value of AFP that could affect the overall survival in study population. Statistical significance was defined by a P value of < *** Totally 250 adult patients underwent LT for HCC in the study period. Eight-four of them received deceaseddonor LT and 166 had living-donor LT. The patients were divided into 3 groups: Group A, AFP < 10 ng/m L(n = 83); Group B, AFP ≥ 10 to < 400 ng/m L(n = 131); Group C, AFP ≥ 400 ng/m L(n = 36). The commonest etiology was hepatitis-B-related cirrhosis. The Model for End-stage Liver Disease scores in these groups were similar(median, 13 vs 13 vs 12; P = 0.745). The time to operation in Group A was longer(median, 94 vs 31 vs 35 d; P = 0.001). The groups were similar in hospital mortality(P = 0.626) and postoperative complication(P = 0.702). Pathology of explants showed that the 3 groups had similar numbers of tumor nodules, b

关键词： Alpha-fetoprotein Liver transplantation Recurrence Survival

Little girl who conquered the "ALPPS''

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World Journal of Gastroenterology 2014年第29期20卷 10208-10211页

作者： albert chan Patrick HY Chung Ronnie TP Poon Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation Department of SurgeryQueen Mary HospitalThe University of Hong Kong Division of Pediatric Surgery Department of SurgeryQueen Mary Hospitalthe University of Hong Kong

An insufficient future liver remnant(FLR)is associated with post-hepatectomy liver *** liver partition and portal vein ligation for stage hepatectomy(ALPPS)has been shown to be effective for the induction of rapid FLR hypertrophy so as to improve the resectability in patients with insufficient *** hereby report our experience of this novel approach for a 6-year-old patient with *** tomography showed a hepatoblastoma measuring12.5 cm×9.9 cm×11.7 cm in the right liver(Couinaud segmentⅣ,ⅤandⅧ).Volumetric assessment of the FLR i.e.,left lateral section was 112.6 mL i.e.,21.2%of the estimated total liver *** view of the small-for-size FLR,ALPPS was *** anterior approach was adopted for the in-situ parenchymal split without mobilisation of the right *** volumetry on the seventh postoperative day was 160.7 mL,which represented a 46.1%gain in volume,and a FLR/ESLV ratio of 30.2%.A right trisectionectomy was performed on the eighth postoperative *** recovery was *** was discharged on day 16 after the first *** our knowledge,this was the first report that showed the applicability of ALPPS to a paediatric patient.

关键词： Associating liver partition and portal vein ligation for stage hepatectomy Hepatectomy Portal vein Hepatoblastoma In-situ split

Resection of T4 hepatocellular carcinomas with adjacent structures, is it justified？

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Hepatobiliary & Pancreatic Diseases International 2017年第1期16卷 52-57页

作者： Kenneth SH Chok Ka Kin Ng Tan To Cheung albert CY chan See ching chan Chung Mau Lo Department of Surgery The University of Hong Kong

BACKGROUND： T4 hepatocellular carcinoma （HCC） with invasion to adjacent structure（s） may require resection of not only the tumor but also the invaded structure（s）. This study aims to assess whether such combined resection for T4 HCC is justifiable. METHODS： Adult patients with T4 HCC were divided into three groups. Group 1： tumors and invaded adjacent structures were resected together if histopathologically confirmed tumor invasion; group 2： same as group 1 but histopathologically confirmed tumor adhesion; group 3： tumor resection only. Group comparisons were made. RESULTS： Totally 144 patients were included in the study. There were 71, 14 and 59 patients in groups 1, 2 and 3, respec- tively. The groups were comparable in demographics, compli- cation and survival. Ten hospital deaths occurred （5, 0 and 5 in groups 1, 2 and 3, respectively; P=0.533）. The 5-year overall survival （hospital mortality excluded） was 17.8% in group 1, 14.3% in group 2, and 28.9% in group 3 （P=0.191）. The 5-year disease-free survival was 10.4% in group 1 and 14.5% in group 3 （no data for group 2 yet）（P=0.565）. On multivariate analysis, macrovascular invasion and poor differentiation were risk factors for survival whereas combined resection did not impact patients＇ survival. CONCLUSIONS： Combined resection achieved survival outcomes similar to tumor resection only. Patients with tumor invasion and those with tumor adhesion had comparable survival after combined resection. At centers with the required expertise, combined resection should be attempted to treat T4 HCCs with clinically suspected invasion of adjacent structures.

关键词： desmosplastic reaction en-bloc resection hepatocellular carcinoma invasion recurrence