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Hepatobiliary Surgery and Nutrition 2020年第4期9卷 508-510页

作者： tan To cheung Department of Surgery The University of Hong KongHong KongChina Department of Surgery The University of Hong Kong Shenzhen HospitalShenzhenChina

Malignant biliary obstruction is a sinister condition that require radical treatment in order to provide the hope of a *** from complex surgery,the major clinical challenge remains the difficulty in making a conclusive diagnosis(1).There is a long list of differential diagnosis for obstruction of the bile duct including benign condition like primary sclerosing cholangitis,iatrogenic injury,infection and IgG 4 related conditions to malignant condition like carcinoma involving the whole course of bile duct,pancreatic carcinoma and adenocarcinoma in the periampullary regions(2-5).

关键词： diagnosis malignant biliary

Laparoscopic liver resection in patients with liver cirrhosis—the path towards standard of care

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Hepatobiliary Surgery and Nutrition 2018年第1期7卷 68-69页

作者： tan To cheung Department of Surgery The University of Hong KongHong KongChina

I am writing in response to Professor Taizo Hibi's Editorial"Laparoscopic liver resection for hepatocellular carcinoma in cirrhotic patients:a potential game changer toward global standardization of care".

关键词： Laparoscopic liver care

Technical note on complete excision of choledochal cysts

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Hepatobiliary & Pancreatic Diseases International 2013年第2期12卷 218-221页

作者： tan To cheung Sheung Tat Fan Department of Surgery The University of Hong Kong State Key Laboratory for Liver Research The University of Hong Kong

BACKGROUND: Choledochal cysts are congenital cystic dilatations of the extrahepatic or intrahepatic portion of the biliary tree. Complete excision of choledochal cysts is currently regarded as the gold standard treatment, while less extensive procedures including cystoduodenostomy have become obsolete due to the potential for malignant change in the remnant cyst. For type-1 choledochal cysts, which sometimes extend to the main pancreatic duct closely, some surgeons may adopt a less aggressive approach in order to avoid damage to the main pancreatic duct as such damage can lead to serious consequences. However, incomplete excision of choledocha cysts may also cause problems. METHOD: Here we report on a reoperation treating incomplete excision of a choledochal cyst with focus on the technical aspect. RESULTS: In the reoperation, meticulous dissection of the live hilum which had been previously operated on was performed The hepaticojejunostomy was left intact. With the assistance o intraoperative cholangiography, the residual pancreatic portion of the choledochal cyst was completely excised. The pancreatic opening and the lower end of the common bile duct were reconstructed. Whipple operation was avoided. CONCLUSION: Careful planning with the aid of precise imaging before and during the operation largely enhanced the accuracy of the excision of the choledochal cyst.

关键词： choledochal cyst re-excision incomplete excision

Options and survival benefits of conversion therapy for unresectable hepatocellular carcinoma

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World Journal of Gastroenterology 2024年第18期30卷 2479-2481页

作者： Wong Hoi She tan To cheung Department of Surgery The University of Hong KongHong Kong 999077China

In the study by Wu et al,patients with unresectable hepatocellular carcinoma were subjected to transarterial chemoembolization(TACE)as a conversion therapy in order to render their tumors suitable for resection.A nomogram was devised and shown to be effective in predicting the survival of these *** of the results,however,is questionable since the study subjects consisted of patients who had resection after TACE while excluding patients with the same disease but not suitable for *** can be considered to be an option for conversion ***,markers for determining responses to a conversion therapy and for guiding the decision between TACE and sequential immunotherapy have been *** question of whether effective conversion therapy can truly enhance overall survival remains unanswered.

关键词： Conversion therapy Immunotherapy Liver resection Survival Transarterial chemoembolization Unresectable hepatocellular carcinoma

Confounders in developing a machine learning model for colorectal liver metastasis post-hepatectomy prognostications

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Hepatobiliary Surgery and Nutrition 2024年第2期13卷 389-390页

作者： Kin Pan Au tan To cheung Department of Surgery School of Clinical MedicineLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina

We extend our gratitude to *** and colleagues for their valuable feedback and comments on our article(1).We developed a machine learning model which predicted the outcomes of surgical treatment for colorectal liver metastasis(CRLM)with good discriminative *** analyzing the data,we found that patients who underwent neoadjuvant chemotherapy before resection had lower rates of overall survival and disease-free *** agree that the negative impact of neoadjuvant chemotherapy on survival is probably a confounding factor due to a more advanced disease status at the time of *** is supported by our data,which show that patients who received neoadjuvant therapy were more likely to have had bilobar liver metastasis(45.2%vs.23.3%,P<0.001)and multiple liver lesions(64.9%vs.42.3%,P<0.001)when compared to those who underwent upfront hepatectomy.

关键词： metastasis chemotherapy colorectal

Nine-year experience of doxorubicin-eluting beads chemoembolization for hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2016年第5期15卷 493-498页

作者： Alvin Ho-Kwan cheung Colin Siu-Chi Lam Henry Shiu-cheung Tam tan-to cheung Roberta Pang Ronnie Tung-Ping Poon Department of Surgery University of Hong Kong and Queen Mary Hospital

BACKGROUND: Chemoembolization with doxorubucin-eluting beads (DEB) has been used to treat hepatocellular carcinoma (HCC) since 2007. This study compared the efifcacy and sur-vival between transarterial chemoembolization (TACE) with DEB and conventional approach (cTACE) in HCC treatment. METHODS: This retrospective case-control study compared the overall survival and tumor response of HCC patients to cTACE (n=190) and DEB (n=143) by the reassessment of com-puted tomography and serum alpha-fetoprotein (AFP). Mul-tivariate analysis was used to determine the factors affecting tumor response. RESULTS: The median post-treatment to pre-treatment AFP level was 0.8 for a DEB session (n=258) and 1.0 for a cTACE session (n=452), showing a signiifcantly greater decrease in AFP after DEB (P80 months after the ifrst TACE session in the DEB group. CONCLUSION: DEB is a safe alternative to cTACE in HCC pa-tients with better therapeutic efifcacy.

关键词： doxorubicin-eluting beads transarterial chemoembolization hepatocellular carcinoma

Technical note on ALPPS for a patient with advanced hepatocellular carcinoma associated with invasion of the inferior vena cava

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Hepatobiliary & Pancreatic Diseases International 2016年第3期15卷 319-323页

作者： tan To cheung Tiffany Cho Lam Wong See Ching Chan Department of Surgery The University of Hong Kong

Patients with hepatocellular carcinoma have a very short life expectancy if they receive no surgical interven- tion. A relatively new surgical technique termed ＂Associating Liver Partition and Portal Vein Ligation for Staged Hepa- tectomy＂（ALPPS） has been employed for inducing rapid hypertrophy of the future liver remnant for patients waiting for hepatectomy. As portal vein embolization may not result in satisfactory hypertrophy before tumor progression occurs, ALPPS can be an alternative for patients with advanced hepa- tocellular carcinoma. Herein we describe an ALPPS procedure with tumor thrombectomy for a patient who had a small left liver lobe and a large hepatocellular carcinoma involving the whole right liver lobe and the middle hepatic vein and extend- ing into the inferior vena cava. In the first-stage operation, the right portal vein was controlled and divided with a Hemolock. The right hepatic artery was well protected. Hepatic transec- tion was performed with a 1-cm margin from the tumor. The middle hepatic vein trunk was preserved. Ten days afterwards, there was significant hypertrophy of the left lateral section of the liver, and the second-stage operation was conducted. Ex- tended right hepatectomy and tumor thrombectomy were per- formed under sternotomy and total vascular exclusion. The patient had good recovery and was free of disease 10 months after the operation. ALPPS may be a good treatment option even for patients with advanced disease if carried out at high- volume centers.

关键词： anatomy hepatocellular carcinoma therapeutics survival surgical procedure

Laparoscopic pancreaticoduodenectomy for pancreatic cancer:a hope or hype?

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Hepatobiliary Surgery and Nutrition 2020年第3期9卷 388-390页

作者： Weiwei Jin Tom tan To cheung Yiping Mou Department of Gastroenterology and Pancreatic Surgery Zhejiang Provincial People's Hospitaland Key Laboratory of Gastroenterology of Zhejiang ProvinceHangzhou 310014China Department of Surgery Mary HospitalUniversity of Hong KongHong KongChina

Pancreaticoduodenectomy(PD)is the optimal treatment for resectable pancreatic head *** the development of laparoscopic skills,laparoscopic PD(LPD)has been considered safe and feasible with advantages of the minimally ... 详细信息

关键词： Laparoscopic cancer feasible

Update in management of hepatocellular carcinoma in Eastern population

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World Journal of Hepatology 2015年第11期7卷 1562-1571页

作者： Kevin Ka Wan Chu tan To cheung Department of Surgery the University of Hong Kong

Hepatocellular carcinoma(HCC) is one of the commonest malignant tumours in the East. Although the management of HCC in the West is mainly based on the Barcelona Clinic for Liver Cancer staging, it is considered too conservative by Asian countries where the number of HCC patients is huge. Scientific and clinical advances were made in aspects of diagnosis, staging, and treatment of HCC. HCC is well known to be associated with cirrhosis and the treatment of HCC must take into account the presence and stage of chronic liver disease. The major treatment modalities of HCC include:(1) surgical resection;(2) liver transplantation;(3) local ablation therapy;(4) transarterial locoregional treatment; and(5) systemic treatment. Among these, resection, liver transplantation and ablation therapy for small HCC are considered as curative treatment. Portal vein embolisation and the associating liver partition with portal vein ligation for staged hepatectomy may reduce dropout in patients with marginally resectable disease but the midterm and long-term results are still to be confirmed. Patient selection for the best treatment modality is the key to success of treatment of HCC. The purpose of current review is to provide a description of the current advances in diagnosis, staging, preoperative liver function assessment and treatment options for patients with HCC in the east.

关键词： Hepatocellular carcinoma Liver cirrhosis Treatment Management Evidence Survival Update

A review on radiofrequency,microwave and high-intensity focused ultrasound ablations for hepatocellular carcinoma with cirrhosis

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Hepatobiliary Surgery and Nutrition 2021年第2期10卷 193-209页

作者： tan To cheung Ka Wing Ma Wong Hoi She Department of Surgery The University of Hong Kong102 Pok Fu Lam RoadHong KongChina

Importance:Hepatocellular carcinoma(HCC)is usually accompanied by liver cirrhosis,which makes treatment of this disease *** transplantation theoretically provides an ultimate solution to the disease,but the maximal surgical stress and the scarcity of liver graft make this treatment option impossible for some *** an ideal situation,a treatment that is safe and effective should provide a better outcome for patients with the ***:This article aims to give a comprehensive review of various types of loco-ablative treatment for *** Review:Loco-ablative treatment bridges the gap between surgical resection and transarterial *** types of ablative therapy have their unique ability,and evidence-based outcome analysis is the most important key to assisting clinicians to choose the most suitable treatment modality for their ***:Radiofrequency ablation(RFA)has a relatively longer history and more evidence to support its *** ablation(MWA)is gaining momentum because of its shorter ablation time and consistent ablation ***-intensity focused ultrasound(HIFU)ablation is a relatively new technology that provides non-invasive treatment for patients with *** has been carried out at centers of excellence and it is a safe and effective treatment option for selected patients with HCC and liver *** and Relevance:Selective use of different loco-ablative therapies will enhance clinicians’treatment options for treatment of HCC.

关键词： High-intensity focused ultrasound(HIFU) hepatocellular carcinoma(HCC) liver cancer radiofrequency ablation(RFA) microwave ablation(MWA) survival non-invasive treatment ablation cirrhosis complication