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Machine learning in liver surgery:Benefits and pitfalls

World Journal of Clinical Cases 2024年第12期12卷 2134-2137页

作者： Rafael Calleja man.el durán.maría dolores ayllón.ruben.ciria Javier Briceño Hepatobiliary Surgery and Liver Transplantation Unit Hospital Universitario Reina SofíaMaimonides Biomedical Research Institute of CordobaCórdoba 14004Spain

The application of machine learning(ML)algorithms in various fields of hepatology is an issue of ***,we must be cautious with the *** this letter,based on a published ML prediction model for acute kidney injury after liver surgery,we discuss some limitations of ML models and how they may be addressed in the *** the future faces significant challenges,it also holds a great potential.

关键词： Machine learning Liver surgery Artificial intelligence Random forest Prediction model

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Machine perfusion and the prevention of ischemic type biliary lesions following liver transplant:What is the evidence?

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World Journal of Gastroenterology 2023年第20期29卷 3066-3083页

作者： man.el durán Rafael Calleja Angus Hann George Clarke ruben ciria Anisa nutu Rebeca Sanabria-Mateos maría dolores ayllón Pedro López-Cillero Hynek Mergental Javier Briceño M Thamara P R Perera Department of Liver Transplantation Reina Sofía University HospitalCórdoba 14004Spain The Liver Unit Queen Elizabeth Hospital BirminghamBirmingham B152THUnited Kingdom Centre for Liver and Gastrointestinal Research Institute of Immunology and ImmunotherapyUniversity of BirminghamBirmingham B152THUnited Kingdom

The widespread uptake of different machine perfusion(MP)strategies for liver transplant has been driven by an effort to minimize graft *** to the cholangiocytes during the liver donation,preservation,or early posttransplant period may result in stricturing of the biliary tree and inadequate biliary *** problem continues to trouble clinicians,and may have catastrophic consequences for the graft and *** injury,as a result of compromised hepatic artery flow,is a well-known cause of biliary strictures,sepsis,and graft ***,very similar lesions can appear with a patent hepatic artery and these are known as ischemic type biliary lesions(ITBL)that are attributed to microcirculatory dysfunction rather than main hepatic arterial *** the warm and cold ischemic period duration appear to influence the onset of *** of the commonly used MP techniques deliver oxygen to the graft cells,and therefore may minimize the cholangiocyte injury and subsequently reduce the incidence of *** clinical experience and published evidence grows for these modalities,the impact they have on ITBL rates is important to *** this review,the evidence for the three commonly used MP strategies(abdominal normothermic regional perfusion[A-nRP],hypothermic oxygenated perfusion[HOPE],and normothermic machine perfusion[nMP])for ITBL prevention has been critically *** with ITBL definitions used in trials,coupled with variations in techniques of MP,make interpretation ***,the evidence suggests that both HOPE and A-nRP prevent ITBL in donated after circulatory death grafts compared to cold *** evidence for ITBL prevention in donor after brain death grafts with any MP technique is weak.

关键词： Liver transplant Ischemic type biliary lesions Hypothermic oxygenated machine perfusion normothermic machine perfusion Abdominal normothermic regional perfusion Donation after circulatory death

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Short-term outcomes of robotic liver resection: An initial singleinstitution experience

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World Journal of Hepatology 2022年第1期14卷 224-233页

作者： man.el durán Javier Briceño Ana Padial Ferdinando Massimiliano Anelli Juan man.el Sánchez-Hidalgo maría dolores ayllón Rafael Calleja-Lozano Carmen García-Gaitan Unit of Hepatobiliary Surgery and Liver Transplantation General and Digestive Surgery DepartmentReina Sofia University HospitalCordoba 14004Spain GC18 Translational Research in Surgery of Solid Organ Transplantation Maimonides Biomedical Research InstituteCórdoba 14004Spain GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery Maimonides Biomedical Research InstituteCórdoba 14004Spain Department of Anesthesiology and Resuscitation Reina Sofia University HospitalCordoba 14004Spain

BACKGROUnD Liver surgery has traditionally been characterized by the complexity of its procedures and potentially high rates of morbidity and mortality in inexperienced *** robotic approach has gradually been introduced in liver surgery and has increased notably in recent ***,few centers currently perform robotic liver surgery and experiences in robot-assisted surgical procedures continue to be limited compared to the laparoscopic *** To analyze the outcomes and feasibility of an initial robotic liver program implemented in an experienced laparoscopic hepatobiliary *** A total of forty consecutive patients underwent robotic liver resection(da Vinci Xi,***,United States)between June 2019 and January *** were prospectively followed and retrospectively *** characteristics and perioperative and short-term outcomes were *** are expressed as mean and standard *** study was approved by the Institutional Review *** The mean age of patients was 59.55 years,of which 18(45%)were *** mean body mass index was 29.41 kg/m^(2).nine patients(22.5%)were *** were divided by type of resection as follows:Ten segmentectomies,three wedge resections,ten left lateral sectionectomies,six bisegmentectomies(two VVI bisegmentectomies and four IVb-V bisegmentectomies),two right anterior sectionectomies,five left hepatectomies and two right *** lesions occurred in twenty-nine(72.5%)of the *** mean operative time was 258.11 min and two patients were transfused intraoperatively(5%).Inflow occlusion was used in thirty cases(75%)and the mean total clamping time was 32.62 *** was a single conversion due to uncontrollable *** postoperative complications(Clavien–Dindo>Ⅲb)occurred in three patients(7.5%)and mortality in one(2.5%).no patient required readmission to the *** mean hospital stay was 5.6 *** Althou

关键词： Robotics Hepatectomy Minimally invasive surgery Liver surgery Da vinci

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Is there a relationship between dopamine and rhegmatogenous retinal detachment?

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neural Regeneration Research 2020年第2期15卷 311-314页

作者： Alessio martucci Massimo Cesareo maria dolores Pinazo-durán Michela Di Pierro Matteo Di marino Carlo nucci Massimiliano Coletta Raffaele mancino Ophthalmology Unit Department of Experimental MedicineUniversity of Rome Tor VergataRomeItaly Ophthalmic Research Unit "Santiago Grisolia"/FISABIO and Cellular-Molecular Ophthalmobiology Group/University of Valencia ValenciaSpain Department of Clinical Sciences and Translational Medicine University of Rome Tor VergataRomeItaly

Dopamine and its receptors have been widely studied in the neurological conditions and in the retina. In this study, we evaluated the possible role of dopamine in rhegmatogenous retinal detachment(RRD) by comparing the amount of 3,4-dihydroxyphenylacetic acid(DOPAC), a surrogate index of retinal dopamin levels, in the vitreous sample of patients affected by RRD with those affected by macular pucker and vitre ous hemorrhage. Our results showed that significantly higher levels of DOPAC were found in the vitreou sample of patients affected by RRD compared with those affected by vitreous hemorrhage and macula pucker(P = 0.002). Specifically, no trace of the substance was found in vitreous hemorrhage and macula pucker samples. A slightly significant positive correlation was found among DOPAC and post-operativ best corrected visual acuity(r = 0.470, P = 0.049). no correlation was found between DOPAC and the day elapsed between diagnosis and surgery(P = 0.317). For the first time our findings suggest that DOPAC i released in RRD, but not in other retinal diseases such as vitreous hemorrhage and macular pucker. More over, we showed a correlation between visual acuity outcome and the amount of DOPAC in the vitreous This might have a potential, although still unknown, implication in the pathogenesis of the disease and/o in the associated photoreceptors loss. This study was approved by the Ethics Committee of Rome Tor Ver gata University Hospital(R.S.92.10) on September 24, 2010.

关键词： 3,4-dihydroxyphenylacetic acid DOPAC dopamine dopaminergic amacrine cells dopaminergic neurotoxicity macular pucker oxidative stress photoreceptor degeneration rhegmatogenous retinal detachment vitreous hemorrhage

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