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Analysis of surgical and perioperative complications in seventy-five right hepatectomies for living donor liver transplantation

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World Journal of Gastroenterology 2008年第20期14卷 3159-3164页

作者： Salvatore Gruttadauria James Wallis Marsh giovan Battista Vizzini Fabrizio di Francesco Angelo Luca Riccardo Volpes Amadeo Marcos Bruno Gridelli Department of Abdominal Transplant Surgery Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione Department of Abdominal Transplant Surgery University of Pittsburgh Medical Center

AIM: To present an analysis of the surgical and perioperative complications in a series of seventy- five right hepatectomies for living-donation (RHLD) performed in our center. METHODS: From January 2002 to September 2007, we performed 75 RHLD, defined as removal of a portion of the liver corresponding to Couinaud segments 5-8, in order to obtain a graft for adult to adult living-related liver transplantation (ALRLT). Surgical complications were stratified according to the most recent version of the Clavien classification of postoperative surgical complications. The perioperative period was defined as within 90 d of surgery. RESULTS: No living donor mortality was present in this series, no donor operation was aborted and no donors received any blood transfusion. Twenty- three (30.6%) living donors presented one or more episodes of complication in the perioperative period. Seven patients (9.33%) out of 75 developed biliary complications, which were the most common complications in our ***: The need to define, categorize and record complications when healthy individuals, such as living donors, undergo a major surgical procedure, such as a right hepatectomy, reflects the need for prompt and detailed reports of complications arising in this particular category of patient. Perioperative complications and post resection liver regeneration are not influenced by anatomic variations or patient demographic.

关键词： Right hepatectomy Surgery Living-relatedliver transplantation Surgical complications

Common bile duct schwannoma:A case report and review of literature

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World Journal of Gastroenterology 2007年第8期13卷 1275-1278页

作者： Luigi Fenoglio Sara Severini Paola Cena Elena Migliore Christian Bracco Fulvio Pomero Sergio Panzone giovan Battista Cavallero Alberto Silvestri Rodolfo Brizio Felice Borghi Department of Internal Medicine Santa Croce and Carle Hospital Cuneo Italy Department of Pathology Santa Croce and Carle Hospital Cuneo Italy Department of General Surgery Santa Croce and Carle Hospital Cuneo Italy

Schwannoma is a myelin sheath tumor complicated with neurofibroma, neurofibromatosis and neurogenic sarcoma. Peripheral nerve sheath tumors represent 2%-6% of gastrointestinal tract stromal tumors (GIST), but there are deficient data about location of neurogenic tumors in the biliary system and only nine cases of schwannoma of the extrahepatic biliary tract have been reported. These tumors are clinically non-specific. They are usually symptomatic by compressing the close or adjacent structures when being retroperitoneal, and their preoperative diagnosis is extremely difficult. This paper reviews the literature data and describes a case of schwannoma of the common bile duct associated with cholestasis in a healthy young woman, diagnosed and treated in our department. This case is of interest on account of the complexity of its diagnosis and the atypical macroscopic growth pattern of the tumor.

关键词： Schwannoma Neurinoma Common bile duct Biliary tract

Thermal ablation of large unresectable hepatocellular carcinoma in cirrhotic patients

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Hepatoma Research 2018年第9期4卷 30-36页

作者： giovan Giuseppe Di Costanzo Raffaella Tortora Anna Opramolla Marco Guarracino Transplantation Department Liver UnitA Cardareli HospitalNaples 80131Italy

Hepatocellular carcinoma (HCC) is one of the most common and lethal malignancies worldwide. Surgery is the mainstay of treatment, but less than 20%-30% of patients are good candidates. Actually, thermal ablation is considered the best treatment with curative intent for cirrhotic patients with unresectable HCC≤ 3 cm. Unfortunately, radio frequency efficacy in obtaining the complete ablation of HCC nodules diminishes with increasing tumor size and local tumor progression is more frequent in larger nodules. To overcome these problems, higher-powered generators, different devices and techniques have been attempted. Furthermore, microwave ablation has been introduced with the promise of a large ablative capacity. The aim of this review is to describe the role of thermal ablation for the treatment of large unresectable HCC.

关键词： Hepatocellular carcinoma hypertermic ablation radiofrequency microwave ablation

Intermediate hepatocellular carcinoma: How to choose the best treatment modality?

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World Journal of Hepatology 2015年第9期7卷 1184-1191页

作者： giovan Giuseppe Di Costanzo Raffaella Tortora Department of Transplantion Liver Unit Cardarelli Hospital

Intermediate stage, or stage B according to Barcelona Clinic Liver Cancer classification, of hepatocellular carcinoma(HCC) comprises a heterogeneous population with different tumor burden and liver function. This heterogeneity is confirmed by the large variability of treatment choice and disease-relate survival. The aim of this review was to highlight the existing evidences regarding this specific topic. In a multidisciplinary evaluation, patients with large(> 5 cm) solitary HCC should be firstly considered for liver resection(LR). When LR is unfeasible, locoregional treatments are evaluable therapeutic options, being transarterial chemoembolization(TACE), the most used procedure. Percutaneous ablation can be an evaluable treatment for large HCC. However, the efficacy of all ablative procedures decrease as tumor size increases over 3 cm. In clinical practice, a combination treatment strategy [TACE or transarterial radioembolization(TARE)-plus percutaneous ablation] is "a priori" preferred in a relevant percentage of these patients. On the other hands, sorafenib is the treatment of choice in patients who are unsuitable to surgery and/or with a contraindication to locoregional treatments. In multifocal HCC, TACE is the first-line treatment. The role of TARE is still undefined. Surgery may have also a role in the treatment of multifocal HCC in selected cases(patients with up to three nodules, multifocal HCC involving 2-3 adjacent liver segments). In some patients with bilobar disease the combination of LR and ablative treatment may be a valuable option. The choice of the best treatment in the patient with intermediate stage HCC should be "patient-tailored" and made by a multidisciplinary team.

关键词： Hepatocellular carcinoma Percutaneousablation Hepatectomy Chemoembolization Livertransplantation Combination therapy

Laser ablation for small hepatocellular carcinoma: State of the art and future perspectives

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World Journal of Hepatology 2014年第10期6卷 704-715页

作者： giovan Giuseppe Di Costanzo Giampiero Francica Claudio Maurizio Pacella Liver Unit Antonio Cardarelli Hospital Interventional Ultrasound Unit Pineta Grande Hospital Department of Diagnostic Imaging and Interventional Radiology Regina Apostolorum Hospital

During the last two decades, various local thermal ablative techniques for the treatment of unresectable hepatocellular carcinoma(HCC) have been developed. According to internationally endorsed guidelines, percutaneous thermal ablation is the mainstay of treatment in patients with small HCC who are not candidates for surgical resection or transplantation. Laser ablation(LA) represents one of currently available loco-ablative techniques. In this article, the general principles, technique, image guidance, and patient selection are reported. Primary effectiveness, long-term outcome, and complications are also discussed. A review of published data suggests that LA is equivalent to the more popular and widespread radiofrequency ablation in both local tumor control and long-term outcome in the percutaneous treatment of early HCC. In addition, the LA technique using multiple thin laser fibres allows improved ablative effectiveness in HCCs greater than 3 cm. Reference centres should be equipped with all the available techniques so as to be able to use the best and the most suitable procedure for each type of lesion for each patient.

关键词： Liver Hepatocellular carcinoma Minimally invasive procedures Laser Laser ablation

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意大利Milla Montis酒店

现代装饰 2021年第2期 50-57页

作者： Peter Pichler Silvana Ordinas Cem Ozbasaran giovan Paterlini Marco Caprani Aessandro Alitamura Simona Alu Gustav Willeit Daniel Zangerl Jorgen Camrath 郭映琴(编译) Peter Pichler Architecture

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关键词：徒步旅行自然风光酒店旅游胜地意大利