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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

Indications of pro-inflammatory cytokines in laparoscopic and open liver resection for early-stage hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 257-264页

作者： Kevin Tak-Pan Ng Li Pang Jia-Qi Wang Wong Hoi She Simon Hing-Yin Tsang chung mau lo Kwan Man Tan To Cheung Department of Surgery HKU-SZH&School of Clinical MedicineLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina State Key Laboratory of Liver Research The University of Hong KongHong KongChina

Background:Our clinical practice of laparoscopic liver resection(LLR)had achieved better short-term and long-term benefits for patients with hepatocellular carcinoma(HCC)over open liver resection(OLR),but the underlying mechanisms are not *** study was to find out whether systemic inflammation plays an important ***:A total of 103 patients with early-stage HCC under liver resection were enrolled(LLR group,n=53;OLR group,n=50).The expression of 9 inflammatory cytokines in patients at preoperation,postoperative day 1(POD1)and POD7 was quantified by Luminex Multiplex *** relationships of the cytokines and the postoperative outcomes were compared between LLR and ***:Seven of the circulating cytokines were found to be significantly upregulated on POD1 after LLR or OLR compared to their preoperative *** to OLR,the POD1 levels of granulocytemacrophage colony-stimulating factor(GM-CSF),interleukin-6(IL-6),IL-8,and monocyte chemoattractant protein-1(MCP-1)in the LLR group were significantly *** POD1 levels of these cytokines were significantly correlated with longer operative time and higher volume of blood loss during *** levels of these cytokines were positively associated with postoperative liver injury,and the length of hospital ***,a high level of IL-6 at POD1 was a risk factor for HCC recurrence and poor disease-free survival after liver ***:Significantly lower level of GM-CSF,IL-6,IL-8,and MCP-1 after liver resection represented a milder systemic inflammation which might be an important mechanism to offer better short-term and long-term outcomes in LLR over OLR.

关键词： Laparoscopic liver resection Open liver resection Hepatocellular carcinoma Postoperative cytokines Inflammatory responses

Role of Intrahepatic Regional Immunity in Post-Transplant Cancer Recurrence

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Engineering 2022年第3期8卷 57-64页

作者： Jiang Liu chung mau lo Kwan Man Hepatopancreatobiliary Center Beijing Tsinghua Changgung HospitalTsinghua UniversityBeijing 102218China Department of Surgery HKU-Shenzhen Hospital&LKS Faculty of MedicineThe University of Hong KongHong Kong 999077China

Hepatic malignancy is a major indication for liver transplantation;however,post-tra ns plant cancer recurrence is an emerging clinical challenge affecting long-term ***-tra ns plant tumor biology,staging,and post-transplant immunosuppression regimens have been elucidated as risk factors for recurrent liver ***,increasing evidence indicates that hepatic ischemia and reperfusion(IR)injury to allografts are crucial to providing a favorable immunologic microenvironment for cancer cell invasiveness and metastasis after liver *** association of severe graft injury in marginal grafts,such as small-for-size or fatty grafts,with lower recurrence-free survival rates in living donor liver transplantations,substantiates the correlation between hepatic IR injury and cancer *** has been demonstrated to trigger intrahepatic immunological microenvironment remodeling,including pro-inflammatory responses exacerbating graft injury and anti-inflammatory responses promoting tissue ***,the role of regional immunity in post-transplant cancer recurrence is not comprehensively *** review describes the up-to-date evidence of the intrahepatic humoral microenvironment and regional regulatory immunological microenvironment induced by IR injury,as well as their roles in cancer recurrence after liver transplantation.A comprehensive understanding of regional immunity will provide novel precise diagnostic,therapeutic,and prognostic strategies for post-transplant cancer recurrence.

关键词： Liver transplantation Liver cancer Recurrence Immunology

Prevention of recurrent hepatitis B infection after liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2013年第5期12卷 465-472页

作者： Tiffany CL Wong James YY Fung chung mau lo Department of Surgery Queen Mary Hospital The University of Hong Kong102 Pokfulam Road Department of Medicine Queen Mary Hospital The University of Hong Kong102 Pokfulam Road

BACKGROUND:Recurrence of hepatitis B virus(HBV) infection after liver transplantation can lead to graft loss and a reduction in long-term *** purpose of this review is to summarize the current therapeutic options for preventing HBV recurrence in liver transplant *** SOURCES:Up to January 2013,studies that were published in MEDLINE and EMBASE on prevention of HBV recurrence after liver transplantation were ***:There have been remarkable advancements in the past two decades on the prevention of HBV recurrence after liver transplantation,from the discovery of hepatitis B immune globulin(HBIG) and lamivudine monotherapy to the combination therapy using HBIG and *** the development of newer and stronger antiviral agents,the need for life-long HBIG is *** their low resistance profile,oral antiviral prophylaxis using these new agents alone is sufficient and is associated with excellent ***:Restoration of host HBV immunity with adoptive immunity transfer and vaccination may represent the ultimate strategy to withdraw prophylactic treatment and to achieve a drug free regimen against HBV recurrence after liver transplantation.

关键词： hepatitis B liver transplantation hepatitis B immune globulin antiviral therapy adoptive immunity transfer HBV vaccination

Simplifying living donor liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2010年第1期9卷 9-14页

作者： See Ching Chan chung mau lo Sheung Tat Fan Department of Surgery The University of Hong KongQueen Mary Hospital

BACKGROUND: Living donor liver transplantation is a complex surgical operation. Treatment policies and operative techniques evolved in the last two decades. DATA SOURCES: Our center's experience in living donor liver transplantation was reviewed in conjunction with relevant publications in the literature. RESULTS: The surgical techniques and perioperative surgical therapeutics could be modified towards simplicity. Examples include regular inclusion of the middle hepatic vein without compromising the venous outflow of the donor's remnant left liver. This provides excellent venous outflow, which is crucial for a small-for-size graft. Immunosuppression and hepatitis B suppression are steroid free and hepatitis B immunoglobulin free respectively. CONCLUSION: The most practical way to achieve high graft and recipient survival rates with an acceptably low donor risk is through design of a protocol that simplifies the surgery and postoperative management.

关键词： simplifying right liver living donor liver transplantation

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)—pushing the envelope in modulation of future liver remnant before major hepatectomy

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Hepatobiliary Surgery and Nutrition 2020年第1期9卷 80-82页

作者： Albert C.Y.Chan chung mau lo Department of Surgery Queen Mary HospitalThe University of Hong KongHong KongChina Department of Surgery The University of Hong Kong-Shenzhen HospitalShenzhen 518053China

Insufficient future liver remnant (FLR) is an important factor that precludes patient from upfront major liver resection as it predisposes to post-hepatectomy liver failure and mortality. As such, augmentation of FLR by portal vein embolization (PVE) was the conventional approach to improve the safety profile of major hepatectomy. In recent years, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been popularized as an alternative approach for FLR augmentation (1,2). However, the initial inception of the ALPPS procedure was met by criticism for its high incidence of procedure-related morbidity, such as bile leakage and sepsis (3). In light of this issue, an international registry was set up for collection of cases and experience around the world and soon after that, the first International Expert Meeting was held in Hamburg in 2015 that led to the publication of eight recommendations on terminology of the procedures, indications and techniques for ALPPS (4). Two years later, a pre-congress meeting was held during the EHPBA (European Hepatopancreatobiliary Association) 12th Annual Congress in Mainz, Germany to celebrate the 10th Anniversary of ALPPS (5) since the first case was performed by Prof. Hans Schlitt a decade ago (1). During this meeting, ten different aspects on ALPPS were covered including surgical anatomy, underlying mechanisms, perioperative assessment of liver function, technical approach, indications and its effectiveness in comparison to two-stage hepatectomy.

关键词： hepatectomy ALPPS anatomy

Combined cavo-atrial thrombectomy and hepatectomy in hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2017年第3期16卷 329-333页

作者： Julian Tsang Albert Chan Kenneth Chok Flora Tsang chung mau lo Division of Hepatobiliary & Pancreatic Surgery and Liver Transplantation Queen Mary Hospital University of Hong Kong Hong Kong China Division of Cardiothoracic Surgery Queen Mary Hospital University of Hong Kong Hong Kong China

To the Editor： Hepatocellular carcinoma （HCC） remains one of the commonest cancers worldwide especially in hepatitis B endemic regions. Its aggressive behavior is characterised by the natural history of increasing size, a tendency for vascular invasion into the hepatic veins and portal veins. Further growth into the inferior vena cava （IVC） and right atrium （RA） is an infrequent finding but signifies a pre-terminal event with a dismal prognosis.

关键词： in on as or HCC IVC Combined cavo-atrial thrombectomy and hepatectomy in hepatocellular carcinoma

Emergency re-routing of anterior sector venous outflow for right lobe living donor liver transplantation including the middle hepatic vein

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Hepatobiliary & Pancreatic Diseases International 2011年第3期10卷 325-327页

作者： Kenneth SH Chok See Ching Chan chung mau lo Sheung Tat Fan Department of Surgery Queen Mary Hospital The University of Hong Kong State Key Laboratory for Liver Research

BACKGROUND:Controversy remains over whether the middle hepatic vein should be included in the liver graft in right liver living donor liver *** in the anterior sector of a right liver graft can cause graft malfunction,which is especially devastating in the case of a graft with marginal size in relation to recipient body size on top of poor pre-transplant recipient *** case we report here highlighted the importance of the middle hepatic vein in right liver living donor liver ***:We illustrated the rectification of outflow obstruction of the middle hepatic vein in the anterior sector of right liver graft caused by technical error during *** rectification was performed with emergency re-routing using an artificial ***:Congestion in the anterior sector of the graft improved immediately and the patient’s postoperative liver function test results improved ***:The middle hepatic vein is important for effective drainage of the anterior sector of a right liver *** re-routing technique described in the report can also be applied to cases in which the middle hepatic vein is injured during hepatectomy requiring immediate reconstruction.

关键词： Gore-Tex graft vein graft liver graft cirrhosis hepatitis B infection

Liver Transplantation for Hepatitis B Virus-related Hepatocellular Carcinoma in Hong Kong

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Journal of Clinical and Translational Hepatology 2018年第3期6卷 283-288页

作者： Ka Wing Ma Kenneth Siu Ho Chok James Yan Yue Fung chung mau lo Department of Surgery The University of Hong KongHong KongChina State Key Laboratory for Liver Research The University of Hong KongHong KongChina Department of Medicine The University of Hong KongHong KongChina

Hepatocellular carcinoma(HCC)is the fifth most common cancer and the third most common cause of cancer-related deaths *** resection is frequently limited in Hong Kong by hepatitis B virus-related cirrhosis,and liver transplantation is the treatment of *** transplanta-tion has been shown to produce superior oncological benefits,when compared to hepatectomy for *** developments in the context of patient selection criteria,modification of organ allocation,bridging therapy,salvage liver transplanta-tion and pharmaceutical breakthrough have improved the survival of HCC *** this article,we will share our experience in transplanting hepatitis B virus-related HCC patients in Hong Kong and discuss the recent progress in several areas of liver transplantation.

关键词： Liver transplantation Hepatitis B Hepatocel ular carcinoma Review

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