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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 417-420页

作者： Daniele Del fabbro fabio Procopio Jacopo Galvanin Guido Costa Simone famularo Angela Palmisano Matteo donadon Guido Torzilli Division of Hepatobiliary Surgery Department of SurgeryIRCCS Humanitas Research HospitalVia A.Manzoni 56Rozzano 20089MilanItaly Department of Biomedical Sciences Humanitas UniversityVia Rita Levi Montalcini 4Pieve Emanuele 20072MilanItaly

Intraoperative ultrasonography(IOUS)in hepatobiliary surgery is well known as an essential tool for radical and safe hepatectomies,allowing to perform parenchymal sparing surgery and,as consequence,to expand the surgical indications for patients otherwise considered ***,since many years,despite its effectiveness in the study of vascular anatomy of the liver,the gold standard for the assessment of biliary anatomy during surgery is intraoperative cholangiography(IOC),which is used for the validation of preoperative imaging as well as for guiding reconstruction in case of bile duct injury or resection.

关键词： anatomy biliary ultrasonography

Chronic pelvic pain,psychiatric disorders and early emotional traumas:Results of a cross sectional case-control study

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World Journal of Psychiatry 2016年第3期6卷 339-344页

作者： flávia L Osório Ana Carolina f Carvalho mariana f donadon André L Moreno Omero Polli-Neto Medical School of Ribeir?o Preto S?o Paulo University

AIM To compare the prevalence of psychiatric disorders and early emotional traumas between women with chronic pelvic pain(CPP) and healthy *** One hundred women in reproductive age,50 of them had CPP(according to the criteria set by the International Association for Study of Pain),and 50 were considered healthy after the gynecological *** eligibility criteria were defined as follows:chronic or persistent pain perceived in the pelvis-related structures(digestive,urinary,genital,myofascial or neurological systems).Only women in reproductive age with acyclic pain for 6 mo,or more,were included in the present *** was the exclusion *** participants were grouped according to age,school level and socioeconomic status and were individually assessed through DSM-IV Structured Clinical Interview(SCID-I) and Early Trauma Inventory Self-report-short form(ETISR-Sf Brazilian version).Descriptive statistics,group comparison tests and multivariate logistics regression were used in the data *** The early emotional traumas are highly prevalent,but their prevalence did not differ between the two *** current Major Depressive Disorder was more prevalent in women with *** CPP was associatedwith endometriosis in 48% of the *** was no difference in the prevalence of disorders when endometriosis was taken into account(endometriosis vs other diseases:P > 0.29).The current Major Depressive Disorder and the Bipolar Disorder had greater occurrence likelihood in the group of women with CPP(ODDS = 5.25 and 9.0).CONCLUSION The data reinforce the link between mood disorders and *** preview evidences about the association between CPP and early traumas tended not to be significant after a stronger methodological control was implemented.

关键词： Pelvic pain Psychiatric disorder Early trauma Emotional Depression

Reply to "Application of contrast-enhanced intraoperative ultrasonography in the decision-making about hepatocellular carcinoma operation"

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World Journal of Gastroenterology 2010年第30期16卷 3857-3858页

作者： Matteo donadon Guido Torzilli Liver Surgery Unit Third Department of SurgeryUniversity of Milan School of MedicineIRCCS Istituto Clinico HumanitasVia Manzoni 5620089RozzanoMilanItaly

The use of contrast-enhanced intraoperative ultrasound for hepatocellular carcinoma has been already proposed as a novel technique to stage the disease during surgical resection. In the herein presented "letter to the editor", the authors underline some important points, which have been raised following paper published in the January issue of World Journal of Gastroenterology.

关键词： Hepatocellular carcinoma Liver surgery Contrast-enhanced intraoperative ultrasound Cirrhosis

Is the exposure to liver transplantation worthwhile for trainees in liver surgery?

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Hepatobiliary Surgery and Nutrition 2022年第5期11卷 746-748页

作者： Matteo donadon Paolo Baroffio Department of Health Sciences Universitàdel Piemonte OrientaleNovaraItaly Department of General Surgery University Maggiore Hospital Della CaritàNovaraItaly

In the May 2022 issue of Annals of Surgery,Albert *** and colleagues reported interesting results on the effect of liver transplantation(LT)experience in performing complex liver resection(CLR)(1).By considering 1,452 LT and 222 CLR over a period of 24 years,performed in a worldwide recognized center for LT and liver surgery,they had 25.2%major complications and 6.3%mortality after ***,they found that the more experience in LT,the less risk of postoperative complications after *** also indicated the cutoff of 95 LT;meaning that at below such number,the rate of complications after CLR significantly increased(1).

关键词： surgery Surgery liver

Glycated hemoglobin and antidiabetic strategies as risk factors for hepatocellular carcinoma

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World Journal of Gastroenterology 2010年第24期16卷 3025-3032页

作者： Valter donadon Massimiliano Balbi francesca Valent Angelo Avogaro Department of Medicine Internal Medicine 3rdPordenone Hospital Institute of Hygiene and Epidemiology Udine University Hospital Department of Clinical and Experimental Medicine Padova University

AIM: To evaluate the relationship between glycemic control [assessed by glycated hemoglobin (HbA1c)], antidiabetic therapies and the risk of hepatocellular carcinoma (HCC).METHODS: We recruited 465 patients with HCC, 618 cases with liver cirrhosis and 490 controls with no liver disease. Among subjects with type 2 diabetes mellitus (DM2), the associations between the antidiabetic strategies and HbA1c level with HCC were determined through 2 series of multivariate logistic regression models using cirrhotic patients and controls as comparison groups. RESULTS: DM2 prevalence was 31.2% in patients with HCC, 23.2% in cirrhotic patients and 12.6% in controls (P f study subjects, DM2 had been diagnosed for more than 1 year before the HCC diagnosis. HCC patients with DM2 had a 1.52.5fold increased risk of liver cancer. The HbA1c mean levels were signif icantly higher in DM2 patients with HCC than in cirrhoticand control DM2 patients. Antidiabetic treatment with metformin was more common among cirrhotic and control DM2 subjects than among cases with HCC. In both series of multivariate analyses, treatment with metformin signif icantly reduced the risk of HCC by more than 80% compared with sulphonylureas and insulin therapy. No signif icant differences were seen between sulphonylureas and insulin treatment. Elevated HbA1c levels were positively related to the risk for HCC in diabetic patients, with a 26%50% increase in risk for each 1% increase in HbA1c ***: In patients with preexisting DM2, the risk of HCC is positively associated with poor chronic glycemic control and significantly decreased by metformin therapy.

关键词： Hepatocellular carcinoma Type 2 diabetes mellitus Glycemic control Metformin therapy HbA1c level

Post-hepatectomy biliary fistula: from risk factors to the role of drain placement and management—still a lot to be answered

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Hepatobiliary Surgery and Nutrition 2019年第4期8卷 417-418页

作者： Guido Costa Matteo donadon Guido Torzilli Department of Hepatobiliary and General Surgery Humanitas University & Humanitas Clinical and Research Center – IRCCS Rozzano Milan Italy

Hepatic resection represents the gold-standard treatment for different liver diseases. Among postoperative complications, bile leak remains one of the most common sources of morbidity, which can lead to an increase of hospital stay, need of invasive procedure and potentially death (1). The definition and acknowledge of risk factors for the development of biliary fistula as well as its early detection and optimal management is, in this sense, of crucial importance.

关键词： fistula biliary death

Association between hepatocellular carcinoma and type 2 diabetes mellitus in Italy:Potential role of insulin

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World Journal of Gastroenterology 2008年第37期14卷 5695-5700页

作者： Valter donadon Massimiliano Balbi Pietro Casarin Alessandro Vario Alfredo Alberti Department of Medicine and Internal Medicine 3rd Pordenone HospitalPordenone 33170 Italy Department of Clinical and Experimental Medicine University of PadovaPadova 35100 Italy

AIM: To investigate the relationships between Type 2 diabetes mellitus (DM2) and the risk of hepatocellular carcinoma (HCC). METHODS: We studied the association between DM2 and HCC in a large case-control study that enrolled 465 consecutive Caucasian patients with HCC (78.3% males, mean age 68.5 ± 8.9 years) compared with an age and sex matched control group of 490 subjects. RESULTS: Prevalence of DM2 was significantly higher in HCC patients (31.2% vs 12.7%; OR = 3.12, 95% CI: 2.22-4.43) and in HCC cases with alcohol abuse. DM2 has been diagnosed before the appearance of HCC in 84.1% of diabetic HCC subjects with mean duration of 141.5 mo, higher in cases treated with insulin than in those with oral antidiabetic agents (171.5 vs 118.7 mo). Compared to controls, males DM2 with HCC were more frequently treated with insulin (38.1% vs 17.6%, P = 0.009) and with sulfonylurea with or without metformin than with diet with or without metformin (84% vs 68.3%, P = 0.049). CONCLUSION: DM2 in our patients is associated with a 3-fold increase risk of HCC. In most of our cases DM2 pre-existed to HCC. Patients with DM2 and chronic liver disease, particularly insulin treated males, should be considered for HCC close surveillance programs.

关键词： Hepatocellular carcinoma Type 2 diabetesmellitus Hepatitis virus B and C Insulin Antidiabetic therapy

Unravel hepatic artery infusion chemotherapy in patients with resected colorectal liver metastases

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Hepatobiliary Surgery and Nutrition 2021年第2期10卷 257-260页

作者： Matteo donadon Lorenza Rimassa Guido Torzilli Department of Biomedical Sciences Humanitas UniversityPieve EmanueleMilanItaly Department of Hepatobiliary and General Surgery IRCCS Humanitas Research HospitalRozzanoMilanItaly Humanitas Cancer Center IRCCS Humanitas Research HospitalRozzanoMilanItaly

Over the past years,important progresses have been made in the treatment of patients with colorectal liver metastases(CLM).Now,5-year overall survival rate may exceed 50%by using the combination of multimodality therapies among which modern systemic chemotherapy,with or without monoclonal antibodies,and hepatic resection are the cornerstones(1,2).In such multimodality,hepatic artery infusion(HAI)has been proposed since many years with the rationale of increasing the concentration of chemotherapy agents in the liver(3).However,HAI still remains infrequently used,in particular in the adjuvant setting mainly because of the requirement of a multidisciplinary team to manage therapy,and the more widespread use of systemic chemotherapy-in particular following the perioperative“sandwich”schema(4).

关键词： infusion chemotherapy hepatic

lmmunotherapy in hepatobiliary tumors: search for the missing pieces of the puzzle

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Hepatobiliary Surgery and Nutrition 2020年第1期9卷 86-88页

作者： Matteo donadon federica Marchesi Lorenza Rimassa Guido Torzilli Department of Hepatobiliary and General Surgery Humanitas Clinical and Research Center-IRCCSRozzanoMilanItaly Department of Biomedical Sciences Humanitas UniversityPieve EmanueleMilanItaly Department of Immunology and Inflammation Humanitas Clinical and Research Center-IRCCSRozzanoMilanItaly Department of Biotechnology and Translational Medicine University of MilanMilanItaly Humanitas Cancer Center Humanitas Clinical and Research Center-IRCCSRozzanoMilanItaly

In the current era of immunotherapy, the treatment of hepatobiliary cancers is rapidly evolving. The use of immunotherapeutic approaches, which include peptide-based vaccines, checkpoint inhibitors and antibodies, particularly applies to advanced hepatobiliary cancers, for which the availability of limited therapeutic options encourages the adoption of alternative strategies. Thanks to the published/presented, although conflicting, results of some of the clinical trials on this topic together with the incoming results of some other trials, clinicians involved in the cure of hepatobiliary cancer patients need to understand the basic and advanced applications of immunotherapies (1-6).

关键词： hepato biliary therapeutic

Portal thrombosis and steatosis after preoperative chemotherapy with fOLfIRI-bevacizumab for colorectal liver metastases

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World Journal of Gastroenterology 2006年第40期12卷 6556-6558页

作者： Matteo donadon Jean-Nicolas Vauthey Evelyne M Loyer Chusilp Charnsangavej Eddie K Abdalla The University of Texas MD Anderson Cancer Center Department of Surgical Oncology Houston Texas 77030 United States The University of Texas MD Anderson Cancer Center Diagnostic Radiology Houston Texas 77030 United States

In order to discuss the role of preoperative chemo- therapy for colorectal liver metastases, which is used frequently before hepatic resection, even in patients with resectable disease at presentation, we herein report the development of two complications, partial portal vein thrombosis and hepatic steatosis with Iobular inflammation, during the course of preoperative chemotherapy with fOLfIRI plus bevacizumab for colorectal liver metastases, which recognition led to timely discontinuation of chemotherapy as well as a change in the surgical strategy to resect the tumors and the damaged liver through advanced techniques. We conclude that duration of treatment and drug doses and combinations may impact the development of chemotherapy-induced liver injury. Surgeons and medical oncologists must work together to devise safe, rational, and oncologically appropriate treatments for patients with multiple colorectal liver metastases, and to improve the understanding of the pathogenesis of chemotherapyinduced liver injury.

关键词： Chemotherapy Colorectal liver metastases Resection