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Current management of hepatocellular carcinoma

World Journal of Gastroenterology 2014年第30期20卷 10223-10237页

作者： parissa tabrizian Sasan Roayaie Myron E Schwartz Mount Sinai Liver Cancer Program Mount Sinai Medical CenterNew YorkNY 10029United States

Hepatocellular carcinoma(HCC)is the sixth most common cancer worldwide and leading cause of death among patients with *** guidelines are based according to the Barcelona Clinic Liver Cancer staging *** choice among therapeutic options that include liver resection,liver transplantation,locoregional,and systemic treatments must be individualized for each *** aim of this paper is to review the outcomes that can be achieved in the treatment of HCC with the heterogeneous therapeutic options currently available in clinical practice.

关键词： Hepatocellular carcinoma Management Barcelona Clinic Liver Cancer guidelines Therapeutic options Outcome

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Gallbladder volvulus

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Hepatobiliary Surgery and Nutrition 2021年第2期10卷 249-253,I0003,I0004页

作者： Laureline Moser Gaëtan-Romain Joliat parissa tabrizian Luca Di Mare David Petermann Nermin Halkic Nicolas Demartines Ismail Labgaa Department of General and Visceral Surgery EHC HospitalMorgesSwitzerland Department of Visceral Surgery Lausanne University Hospital CHUVLausanneSwitzerland Department of Liver Surgery Recanati/Miller Transplantation InstituteIcahn School of Medicine at Mount SinaiNew YorkNYUSA

Background Like colon or stomach,gallbladder can twist,leading to a volvulus;an entity first described by Wendel in 1898(1).Gallbladder volvulus(GV)is a relatively rare disease occurring when the gallbladder rotates on its own axis,along the cystic duct(Figure 1).Different types of rotation have been described:incomplete ***(≤180°vs.>180°)and clockwise ***(2).As the rotation might involve the cystic artery,blood supply may be compromised,resulting in ischemia and eventually *** constitutes an acute abdominal condition associated with poor outcomes,if not diagnosed and treated in time.

关键词： stomach gallbladder acute

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Critical care management and intensive care unit outcomes following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

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World Journal of Critical Care Medicine 2017年第2期6卷 116-123页

作者： Sumit Kapoor Adel Bassily-Marcus Rafael Alba Yunen parissa tabrizian Sabrine Semoin Joseph Blankush Daniel Labow John Oropello Anthony Manasia Roopa Kohli-Seth Department of Pulmonary Critical Care and SleepBaylor College of Medicine Department of Surgery Critical Care DivisionIcahn School of Medicine at Mount Sinai Department of Pulmonary and Critical Care Medical College of GeorgiaAugusta University Department of Surgery Icahn School of Medicine at Mount Sinai General Surgery Resident Vanderbilt University Medical Center

AIM To study the early postoperative intensive care unit(ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC).METHODS Our study is a retrospective, observational study per-formed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied. Fifty-one patients came to the ICU postoperatively out of 170 who underwent CRS and HIPEC therapy during the study period. Data analysis was performed using descriptive *** Of the 170 patients who underwent CRS and HIPEC therapy, 51(30%) came to the ICU postoperatively. Mean ICU length of stay was 4 d(range 1-60 d) and mean APACHE Ⅱ score was 15(range 7-23). Thirtyone/fifty-one(62%) patients developed postoperative complications. Aggressive intraoperative and postoperative fluid resuscitation is required in most patients. Hypovolemia was seen in all patients and median amount of fluids required in the first 48 h was 6 L(range 1-14 L). Thirteen patients(25%) developed postoperative hypotension with seven requiring vasopressor support. The major cause of sepsis was intraabdominal, with 8(15%) developing anastomotic leaks and 5(10%) developing intraabdominal abscess. The median survival was 14 mo with 30 d mortality of 4%(2/51) and 90 d mortality of 16%(8/51). One year survival was 56.4%(28/51). Preoperative medical co morbidities, extent of surgical debulking, intraoperative blood losses, amount of intra op blood products required and total operative time are the factors to be considered while deciding ICU vs non ICU *** Overall, ICU outcomes of this study population are excellent. Triage of these patients should consider preoperative and intraoperative factors. Intensivists should be vigilant to aggressive postop fluid resuscitation,

关键词： Hyperthermic Abdominal sepsis Cytoreduction Carcinomatosis Respiratory failure Vasopressors

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