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Comprehensive review of hepatocellular carcinoma with portal vein tumor thrombus:State of art and future perspectives

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 221-227页

作者： paschalis Gavriilidis Timothy M Pawlik Daniel Azoulay Department of Surgery Colchester General HospitalTurner RoadColchester CO45JLUK Department of Surgery The Ohio State Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA Department of Hepato-Biliary and Liver Transplantation surgery Paul Brousse University HospitalParis-Saclay UniversityVillejuif 94800France

Background:Despite advances in the diagnosis of patients with hepatocellular carcinoma(HCC),70%-80%of patients are diagnosed with advanced stage *** vein tumor thrombus(PVTT)is among the most ominous signs of advanced stage disease and has been associated with poor survival if *** sources:A systematic search of MEDLINE(PubMed),Embase,Cochrane Library and Database for Systematic Reviews(CDSR),Google Scholar,and National Institute for Health and Clinical Excellence(NICE)databases until December 2022 was conducted using free text and MeSH terms:hepatocellular carcinoma,portal vein tumor thrombus,portal vein thrombosis,vascular invasion,liver and/or hepatic resection,liver transplantation,and systematic ***:Centers of surgical excellence have reported promising results related to the individualized surgical management of portal thrombus versus arterial chemoembolization or systemic *** elements to the individualized surgical management of HCC and portal thrombus include precise classification of the portal vein tumor thrombus,accurate identification of the subgroups of patients who may benefit from resection,as well as meticulous surgical *** review addressed five specific areas:(a)formation of PVTT;(b)classifications of PVTT;(c)controversies related to clinical guidelines;(d)surgical treatments versus non-surgical approaches;and(e)characterization of surgical techniques correlated with classifications of ***:Current evidence from Chinese and Japanese high-volume centers demonstrated that patients with HCC and associated PVTT can be managed with surgical resection with acceptable results.

关键词： Hepatectomy Liver surgery Liver neoplasms Portal vein tumor thrombus

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Inflammatory indicators such as systemic immune inflammation index(SIII),systemic inflammatory response index(SIRI),neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)as prognostic factors of curative hepatic resections for hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 509-511页

作者： paschalis Gavriilidis Timothy M.Pawlik Department of Surgery Colchester General HospitalColchesterUK Department of Surgery The Ohio State University Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA

As the fifth most common gastrointestinal cancer worldwide,hepatocellular carcinoma(HCC)often presents at advanced stages of *** the subset of patients who present with tumor and liver-related features amenable to surgery,hepatic resection—in addition to transplantation—offers the best chance at curative-intent *** can be associated,however,with risk of complications and perioperative death especially among individuals with concomitant portal hypertension,liver fibrosis,cirrhosis,and portal vein thrombosis(1-3).Post-resection liver failure is also a major concern and can be a devasting complication following hepatic resection(4,5).Overall survival following hepatic resection of HCC ranges from only 30–50%,and recurrence can be common depending on the stage of *** turn,there is considerable interest in identifying markers to help stratify patients relative to risk of recurrence and prognosis to define which groups of patients may benefit the most from hepatic resection of HCC(1-5).

关键词： Hepatocellular carcinoma(HCC) systemic immune inflammation index(SIII) systemic inflammatory index neutrophil-to-lymphocyte ratio(NLR) platelet-to-lymphocyte ratio(PLR)

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Mathematical Modeling and Optimization of the Microwave Assisted Extraction of the Natural Polyphenols and Flavonoids from the Raw Solid Waste of the Orange Juice Industry

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Journal of Food Science and Engineering 2020年第2期10卷 83-102页

作者： Konstantinos Petrotos Ioannis Giavasis Konstantinos Gerasopoulos Chrysanthi Mitsagga Chryssoula Papaioannou paschalis gkoutsidis Department of Agrotechnology School of Agricultural SciencesUniversity of ThessalyGeopolis CampusPeriferiaki Odos Larisas TrikalonLarisa 41500Greece Department of Food Science and Nutrition School of Agricultural SciencesUniversity of ThessalyKarditsa CampusEnd of N.Temponera StreetKarditsa 43100Greece

Orange pomace is the solid waste of the orange juice industry which accounts for approximately 50%of the quantity of the fruits processed into juice and is a good raw material for production of high added value products with diverse *** pomace is rich in polyphenols and flavonoids which can substitute the potentially hazardous or less desirable chemical antioxidants/antimicrobials used in agro-food and cosmetics *** this work,an eco-friendly aqueous microwave assisted extraction of orange pomace was investigated and optimized in order to produce aqueous bioactive antioxidant/antimicrobial extracts.A three factorial Response Surface Optimization methodology with centered Box&Behnken experimental design was used to obtain optimum values of total polyphenols and total flavonoids and build predictive models for their optimal extraction *** three optimization factors in terms of applied process parameters were(a)water/solid ratio,(b)extraction temperature and(c)extraction *** effectiveness and statistical soundness of the two corresponding models regarding optimal total polyphenols and flavonoids were verified by Analysis of Variance(ANOVA).

关键词： Orange pomace microwave assisted extraction response surface optimization Box&Behnken polyphenols flavonoids

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Simultaneous portal and hepatic vein embolization is better than portal embolization or ALPPS for hypertrophy of future liver remnant before major hepatectomy: A systematic review and network meta-analysis

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Hepatobiliary & Pancreatic Diseases International 2023年第3期22卷 221-227页

作者： paschalis Gavriilidis Gabriele Marangoni Jawad Ahmad Daniel Azoulay Department of Hepatobiliary and Pancreatic Surgery University Hospitals of Coventry and Warwickshire NHS TrustClifford Bridge RoadCoventry CV22DXUK Department of Hepato-Biliary and Liver Transplantation Surgery Paul Brousse University HospitalParis-Saclay UniversityVillejuif 94800France

Background:Post-hepatectomy liver failure(PHLF)is the Achilles’heel of hepatic resection for colorectal liver *** most commonly used procedure to generate hypertrophy of the functional liver remnant(FLR)is portal vein embolization(PVE),which does not always lead to successful *** liver partition and portal vein ligation for staged hepatectomy(ALPPS)has been proposed to overcome the limitations of *** venous deprivation(LVD),a technique that includes simultaneous portal and hepatic vein embolization,has also been proposed as an alternative to *** present study aimed to conduct a systematic review as the first network meta-analysis to compare the efficacy,effectiveness,and safety of the three regenerative *** sources:A systematic search for literature was conducted using the electronic databases Embase,PubMed(MEDLINE),Google Scholar and ***:The time to operation was significantly shorter in the ALPPS cohort than in the PVE and LVD cohorts by 27 and 22 days,*** parameters of blood loss and the Pringle maneuver demonstrated non-significant differences between the PVE and LVD *** was evidence of a significantly higher FLR hypertrophy rate in the ALPPS cohort when compared to the PVE cohort,but non-significant differences were observed when compared to the LVD ***,the LVD cohort demonstrated a significantly better FLR/body weight(BW)ratio compared to both the ALPPS and PVE *** the PVE and LVD cohorts demonstrated significantly lower major morbidity rates compared to the ALPPS *** LVD cohort also demonstrated a significantly lower 90-day mortality rate compared to both the PVE and ALPPS ***:LVD in adequately selected patients may induce adequate and profound FLR hypertrophy before major *** evidence demonstrated significantly lower major morbidity and mortality rates in the LVD cohort than in the ALPPS and PVE coho

关键词： Portal vein embolization Hepatic vein embolization Future liver remnant ALPPS

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Alternatives to left lateral sector in paediatric liver transplantation-a systematic review on monosegmental and reduced grafts

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Hepatobiliary Surgery and Nutrition 2022年第4期11卷 567-576,I0005页

作者： paschalis Gavriilidis Ernest Hidalgo Department of Hepatopanceaticobiliary Surgery.Imperial College Healthcare NHS Trust Hammersmith HospitalLondonUK Department of Hepato-Pancreatic-Biliary Surgery and Liver Transplantation Hospital Universitari Vall d’HebronBarcelonaSpain

Background: Paediatric liver transplantation (pLT) is the treatment of choice for many liver conditions. However, it still poses relevant challenges, mainly related to the size of the recipients. Unlike in adults, excessive graft volume might represent an issue when the estimated graft-recipient-weight-ratio (GRWR) is significantly disproportionate. In this situation, the traditional left lateral sector (LLS) grafts are too big and other alternatives are required, such as monosegmental or reduced (including hyper-reduced) grafts (RLLS/HRLLS). Results with conventional LLS-pLT are excellent and replicating them with monosegmental or RLLS is challenging given (I) the technical complexity and (II) the need to overcome the large-for-size scenario. This article is to review the existing experience with monosegmental, RLLS/HRLLS grafts and appraise its results. Methods: Systematic search of the electronic databases, conducted from their inception until May 2020. Results: After scrutiny of the available literature, 16 studies were included reporting 330 patients transplanted with monosegmental and RLLS/HRLLS grafts. There were 10 re-grafts (6 of them <90 days);90% of grafts were LDLT. Overall, median recipient’s age and weight were 7 months (range, 5 days-22 months) and 5.8 kg (range, 2.6-8 kg) respectively. Median graft weight was 209 grams (range, 124-264 grams) and median GRWR was 3.5% (range, 2.7-5.6%). Hepatic artery and portal vein thrombosis overall incidence were 1.5% and 4.2%;120 out of the 330 pLT were monosegmental (37%) producing a smaller graft (median of 164 grams) and accordingly a lower GRWR (median 3.2%) compared to reduced LLS. With a median follow-up of 39 months (range, 6-87 months), the overall graft and patient survival were 84% (285/340) and 89% (295/330). Discussion: Monosegmental and RLLS/HRLLS grafts provide access to liver transplantation for very small recipients with excellent results comparable to the standard LLS.

关键词： Monosegmental monosegment(MSG) reduced hyper-reduced left lateral sector graft liver transplantation

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Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: A case report and literature review

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World Journal of Gastroenterology 2007年第38期13卷 5158-5163页

作者： Charitini Salla paschalis Chatzipantelis Panagiotis Konstantinou Ioannis Karoumpalis Akrivi Pantazopoulou Victoria Dappola Department of Cytology Athens General Hospital Athens 11635 Greece Department of Pathology Areteion University Hospital Athens 11635 Greece Department of Gastroenterology Athens General Hospital Athens 11635 Greece

We describe the clinical, imaging and cytopathological features of solid pseudopapillary tumor of the pancreas (SPTP) diagnosed by endoscopic ultrasound- guided (EUS-guided) fine-needle aspiration (FNA). A 17-year-old woman was admitted to our hospital with complaints of an unexplained episodic abdominal pain for 2 mo and a short history of hypertension in the endocrinology clinic. Clinical laboratory examinations revealed polycystic ovary syndrome, splenomegaly and low serum amylase and carcinoembryonic antigen (CEA) levels. Computed tomography (CT) analysis revealed a mass of the pancreatic tail with solid and cystic consistency. EUS confirmed the mass, both in body and tail of the pancreas, with distinct borders, which caused dilation of the peripheral part of the pancreatic duct (major diameter 3.7 mm). The patient underwent EUS-FNA. EUS-FNA cytology specimens consisted of single cells and aggregates of uniform malignant cells, forming microadenoid structures, branching, papillary clusters with delicate fibrovascular cores and nuclear overlapping. Naked capillaries were also seen. The nuclei of malignant cells were round or oval, eccentric with fine granular chromatin, small nucleoli and nuclear grooves in some of them. The malignant cells were periodic acid Schiff (PAS)-Alcian blue (+) and immunocytochemically they were vimentin (+), CA 19.9 (+), synaptophysin (+), chromogranin (-), neuro-specific enolase (-), a1- antitrypsin and a1-antichymotrypsin focal positive. Cytologic findings were strongly suggestive of SPTP. Biopsy confirmed the above cytologic diagnosis. EUS- guided FNA diagnosis of SPTP is accurate. EUS findings,cytomorphologic features and immunostains of cell block help distinguish SPTP from pancreatic endocrine tumors, acinar cell carcinoma and papillary mucinous carcinoma.

关键词： Endosonography Fine-needle aspiration Solid pseudopapillary tumor Pancreas Cytology

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Recurrence and survival following microwave, radiofrequency ablation, and hepatic resection of colorectal liver metastases: A systematic review and network meta-analysis

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Hepatobiliary & Pancreatic Diseases International 2021年第4期20卷 307-314页

作者： paschalis Gavriilidis Keith J Roberts Nicola de’Angelis Luca Aldrighetti Robert P Sutcliffe Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery Queen Elizabeth University Hospitals Birmingham NHS Foundation TrustB152THUnited Kingdom Department of Digestive Surgery University Hospital Henri Mondor(AP-HP)94010 Créteil and University of Paris EstCréteilFrance Division of Hepatobiliary surgery San Raffaele HospitalVia Olgettina 60Milan 20132Italy

Background: Gold standard for colorectal liver metastases(CRLM) remains hepatic resection(HR). However, patients with severe comorbidities, unresectable or deep-situated resectable CRLM are candidates for ablation. The aim of the study was to compare recurrence rate and survival benefit of the microwave ablation(MWA), radiofrequency ablation(RFA) and HR by conducting the first network meta-analysis. Data sources: Systematic search of the literature was conducted in the electronic databases. Both updated traditional and network meta-analyses were conducted and the results were compared between them. Results: HR cohort demonstrated significantly less local recurrence rate and better 3-and 5-year diseasefree(DFS) and overall survival(OS) compared to MWA and RFA cohorts. HR cohort included significantly younger patients and with significantly lower preoperative carcinoembryonic antigen(CEA) by 10.28 ng/m L compared to RFA cohort. Subgroup analysis of local recurrence and OS of solitary and ≤3 cm CRLMs did not demonstrate any discrepancies when compared with the whole sample. Conclusions: For resectable CRLM the treatment of choice still remains HR. MWA and RFA can be used as a single or adjunct treatment in patients with unresectable CRLM and/or prohibitive comorbidities.

关键词： Microwave ablation Radiofrequency ablation Hepatic resection Liver resection

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Terlipressin versus placebo in living donor liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 76-79页

作者： paschalis Gavriilidis Ernest Hidalgo Robert P Sutcliffe Keith J Roberts Department of Hepato-Pancreato-Biliary and Liver Transplant surgery Queen Elizabeth University Hospitals Birmingham NHS Foundation TrustBirmingham B152THUK Department of Hepato-Pancreatico-Biliary Surgery and Transplantation Hospital Universitari Vall d’HebronBarcelona 08035Spain

To the Editor:Terlipressin is a long-acting synthetic analogue of vasopressin,demonstrating several potential benefits in the context of living donor liver transplantation(LDLT).During the recipient hepatec-tomy,terlipressin reduces the portal ***,it may mitigate the extent of bowel congestion following portal vein *** decreasing portal hyperperfusion and hypertension,it protects the graft from further injury and improves renal blood flow.

关键词： donor liver Terlipressin

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Deployment of wireless sensor network in dispersed renewable energy sources for increasing efficiency of power distribution networks

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Journal of Modern Power Systems and Clean Energy 2015年第4期3卷 610-618页

作者： Theodoros A.TSIFTSIS paschalis C.SOFOTASIOS Nick PAPANIKOLAOU Michael I.LOUPIS Technological Educational Institute(T.E.I.)of Central Greece 35100 LamiaGreece Tampere University of Technology 33101 TampereFinland Democritus University of Thrace Kimmeria67100 XanthiGreece

In this work,a novel performance analysis method for evaluating the robustness of emerging power distribution networks(PDNs),which involve deployable renewable energy sources,is *** is realized with the aid of the outage probability(OP)criterion in the context of cooperative communications,which is widely considered in modern wireless communication *** main usefulness of this method is that it allows the involved components to communicate to each-other by means of a robust and flexible wireless sensor network *** this context,any conventional medium voltage(MV)bus of the PDN is represented as a wireless relay node where data signals gathered from each MV bus can be forwarded reliably to a control station for the subsequent *** received signals at wireless nodes are decoded and then forwarded to ensure minimal errors and maximal robustness at the receiving *** considered OP analysis denotes the probability that the power of a received information signal drops below a pre-defined threshold which satisfies the acceptable Quality of Service requirements of a reliable signal *** this end,simple closed-form expressions are proposed for the OP of a regenerative cooperative-based PDN in the presence of various multipath fading effects,which degrade information signals during wireless *** offered results are rather simple and provide meaningful insights for the design and deployment of smart grid systems.

关键词： Smart grid Cooperative communications(CCs) Power distribution network(PDN) Outage probability Renewable energy source(RES) Wireless sensor network(WSN)

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Associating liver partition and portal vein ligation or combined transarterial chemo-embolisation and portal vein embolisation for staged hepatectomy for HBV-related hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2023年第2期12卷 272-275页

作者： paschalis Gavriilidis Timothy M.Pawlik Tomer Meirson Daniel Azoulay Department of Surgery Colchester General HospitalColchesterUK Department of Surgery The Ohio State University Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA Davidoff Cancer Center Rabin Medical Center-Bellinson HospitalPetah TikyaIsrael Department of Hepato-Biliary and Liver Transplantation Surgery Paul Brousse University HospitalParis-Saclay UniversityVillejuifFrance

Many patients with hepatocellular carcinoma are diagnosed with large tumours at an advanced *** addition,conditions such as liver fibrosis,cirrhosis,portal hypertension,viral load,and portal vein thrombosis due to either non-neoplastic or portal vein tumour thrombus limit the indications for surgical management to a select subset of individuals(1).

关键词： Associating liver partition and portal vein ligation(ALPPS) transarterial chemoembolization(TACE) portal vein embolisation(PVE)

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