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Hepatobiliary & Pancreatic Diseases International 2020年第4期19卷 324-327页

作者： tsan-shiun lin Jeffrey Samuel Co Chao-Long Chen Aldwin D.Ong Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial Hospital123 Ta-Pei RoadNiao SungKaohsiung 833TaiwanChina

Biliary complications have always been a dreaded cause of morbidity after living donor liver *** intrinsic variations in both graft and recipient biliary anatomy remain a significant factor to the difficulty of biliary reconstruction,our institution has taken advantage of its high volume of cases to critically review and evaluate modifiable operative risk factors,in particular,our surgical *** present herein,the evolution of our reconstructive biliary technique from conventional methods to our current standard of microsurgical biliary reconstruction for both graft and recipient *** this period of transition,our center has created a classification system for biliary reconstruction that decreased the biliary complication rates from 40.0%to 10.2%.

关键词： Living donor liver transplantation Biliary reconstruction Microsurgical biliary reconstruction Biliary classification Biliary complications

Bilateral proficiency over time leads to reduced donor morbidity in living donor hepatectomy

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Hepatobiliary Surgery and Nutrition 2019年第5期8卷 459-469页

作者： Viola Huang Chao-Long Chen Yu-Hung lin tsan-shiun lin Chih-Che lin Shih-Ho Wang Chee-Chien Yong Chih-Yi Chen Yu-Fan Cheng Liver Transplantation Center and Department of Surgery Kaohsiung Chang Gung Memorial HospitalKaohsiungTaiwan Department of General Surgery Dartmouth Hitchcock Medical CenterLebanonNew HampshireUSA Liver Transplantation Center and Department of Diagnostic Radiology Kaohsiung Chang Gung Memorial HospitalKaohsiungTaiwan

Background:Although left-lobe donation is considered safer,right-sided donor hepatectomy predominatesin adult living donor liver transplantation(LDLT).We hypothesized that bilateral proficiency with donorhepatectomy reduces overall donor ***:A retrospective review of 834 adult LDLT donors(221 left lobes)from January 2004 toDecember 2014 was performed,dividing cases into two eras based on left-graft *** within 6 months were investigated,focusing on graft side and surgical ***:The overall complication rate was 17.6%,and was higher in right-lobe *** Era 2,duringwhich left-lobe donation rates were three times higher,total complications decreased(14.7%vs.20.9%,P=0.02).A significant reduction in postoperative ascites accounted for the lower overall complication *** proportion of major biliary complications(BCs)was halved from 62.5%to 25.0%.Right-lobe donorcomplications also decreased significantly(15.8%vs.22.9%,P=0.032),demonstrating that it was not onlyincreased left-lobe donations leading to lowered complication rates,but also greater experience with donorhepatectomy in ***:Accumulating experience with bilateral donor hepatectomy leads to decreased donormorbidity and comparable outcomes for right and left lobes,further enhancing the goal of donor safety whilebalancing recipient needs.

关键词： Living donor liver transplantation(LDLT) donor safety biliary complications(BCs)

Complete portal vein occlusion after cyanoacrylate sclerotherapy in biliary atresia treated by living donor liver transplantation with intraoperative portal vein stenting via segment 4 portal vein stump

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Hepatobiliary Surgery and Nutrition 2018年第4期7卷 313-316页

作者： Chao-Long Chen Yu-Fan Cheng Hsin-You Ou Chee-Chien Yong tsan-shiun lin Shih-Ho Wang Chih-Che lin Allan M.Concejero Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan Liver Transplantation Center Department of Diagnostic RadiologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan Department of Surgery University of the Philippines College of MedicineManilaPhilippines

IntroductionLiving donor liver transplantation(LDLT)is a durable treatment for end-stage liver disease due to biliary atresia(BA)with excellent graft and patient survivals as shown in our previous study(1).Vascular complications are a major cause of graft failure in LDLT,particularly in children,where size disparity between donor and recipient vessels is often unavoidable.

关键词： liver donor biliary

Dextrose in the banked blood products does not seem to affect the blood glucose levels in patients undergoing liver transplantation

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World Journal of Gastroenterology 2005年第18期11卷 2789-2791页

作者： Kwok-Wai Cheng Chia-Chih Tseng Chih-Hsien Wang Yaw-Sen Chen Chih-Chi Wang Tung-Liang Huang Hock-Liew Eng King-Wah Chiu Shih-Hor Wang Chih-Che lin tsan-shiun lin Yueh-Wei Liu Bruno Jawan Department of Anesthesiology and Liver Transplantation Program Chang Gung Memorial Hospital Kaohsiung Medical Center Taiwan China Chang Gung University Ta-pei Taiwan China

AIM: Hyperglycemia commonly seen in liver transplantation (LT) has often been attributed to the dextrose in the storage solution of blood transfusion products. The purpose of the study is to compare the changes of the blood glucose levels in transfused and non-transfused patients during LT. METHODS: A retrospective study on 60 biliary pediatric patients and 16 adult patients undergoing LT was carried out. Transfused pediatric patients were included in Group Ⅰ (GⅠ), those not transfused in Group Ⅱ (GⅡ). Twelve adult patients were not given transfusion and assigned to Group Ⅲ(GⅢ); whereas, four adult patients who received massive transfusion were assigned to Group Ⅳ (GⅣ). The blood glucose levels, volume of blood transfused, and the volume of crystalloid infused were recorded, compared and analyzed. RESULTS: Results showed that the changes in blood glucose levels during LT for both non-transfused and minimally transfused pediatric groups and non-transfused and massively-transfused adult groups were almost the same. CONCLUSION: We conclude that blood transfusion does not cause significant changes in the blood glucose levels in this study.

关键词： Organ Liver surgery Transplantation Anesthesia General monitoring Blood glucose transfusion Bank blood component Infusion 5% dextrose in 1/4 saline

Effect of autologous blood donation on the central venous pressure, blood loss and blood transfusion during living donor left hepatectomy

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World Journal of Gastroenterology 2005年第27期11卷 4233-4236页

作者： Bruno Jawan Yu-Fan Cheng Chia-Chi Tseng Yaw-Sen Chen Chih-Chi Wang Tung-Liang Huang Hock-Liew Eng Po-Ping Liu King-Wah Chiu Shih-Hor Wang Chih-Che lin tsan-shiun lin Yueh-Wei Liu Chao-Long Chen Department of Anesthesiology Chang Gung Memorial Hospital Kaohsiung Medical Center TaiwanChina Liver Transplantation Program Chang Gung Memorial Hospital Kaohsiung Medical Center Taiwan China

AIM： Autologous blood donation （ABD） is mainly used to reduce the use of banked blood. In fact, ABD can be regarded as acute blood loss. Would ABD 2-3 d before operation affect the CVP level and subsequently result in less blood loss during liver resection was to be ***： Eighty-four patients undergoing living donor left hepatectomy were retrospectively divided as group Ⅰ （GⅠ） and group Ⅱ （GⅡ） according to have donated 250-300 mL blood 2-3 d before living donor hepatectomy or not. The changes of the intraoperative CVP, surgical blood loss,blood products used and the changes of perioperative hemoglobin （Hb） between groups were analyzed and compared by using Mann-Whitney ***： The results show that the intraoperative CVP changes between GⅠ （n = 35） and GⅡ （n = 49） up to graft procurement were the same, subsequently the blood loss,but ABD resulted in significantly lower perioperative Hb levels in ***： Since none of the patients required any blood products perioperatively, all the predonated bloods were discarded after the patients were discharged from the hospital. It indicates that ABD in current series had no any beneficial effects, in term of cost, lowering the CVP, blood loss and reduce the use of banked blood products, but resulted in significant lower Hb in perioperative period.

关键词： Blood Transfusion, Autologous Central Venous Pressure Hepatectomy Liver Transplantation Living Donors Adult Blood Loss, Surgical control Female Humans Intraoperative Care Male Retrospective Studies

What happened in 133 consecutive hepatic artery reconstruction in liver transplantation in 1 year?

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Hepatobiliary Surgery and Nutrition 2019年第1期8卷 10-18页

作者： tsan-shiun lin Nelamangala Ramakrishnaiah Vishnu Prasad Chao-Long Chen Johnson Chia-Shen Yang Yuan-Cheng Chiang Pao-Jen Kuo Chih-Chi Wang Shih-Ho Wang Yueh-Wei Liu Chee-Chien Yong Yu-Fan Cheng Liver Transplantation Program and Departments of Surgery and Diagnostic RadiologyKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan

Background:The immediate challenges during microvascular reconstruction of hepatic artery(HAR)during liver transplantation(LT)can be ***,in order to give a cross sectional view of these problems this study over a period of 1 year,showing our routine practice,was taken ***:From January 2015 to December 2015,a total of 133 LTs were performed in Kaohsiung Chang Gung Memorial Hospital,*** hepatic artery(HA)reconstructions were performed by a microvascular surgeon under an operating ***:In the 133 patients,one artery was anastomosed in 123(92.5%)patients,two in 9(6.8%)patients and three in 1(0.7%)of the ***(8.3%)arteries were less than 2 mm in size(1–1.9 mm).There were intimal dissections(IDs)involving either the donor or the recipient arteries of mild to severe nature in 9(6.8%)*** following graft arterial anastomosis,either there was no flow or an intraoperative hepatic artery thrombosis(HAT)was found in nine(7.1%—8 LDLT,4.8%—1 DDLT)*** re-do anastomosis was done in all of these patients who did well in the *** overall post-operative success rate was 99.2%.One patient(0.8%)developed postoperative HAT due to infection during follow up and died due to ***:Small vessels or HA injury are the frequently encountered problems by a micro vascular *** other problems could be ID,need to do multiple reconstructions,immediate HAT and ability to re-do the HAR immediately.

关键词： Hepatic artery(HA) thrombosis liver transplantation(LT) microvascular surgery reconstruction

Interventional radiology in living donor liver transplant

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World Journal of Gastroenterology 2014年第20期20卷 6221-6225页

作者： Yu-Fan Cheng Hsin-You Ou Chun-Yen Yu Leo Leung-Chit tsang Tung-Liang Huang Tai-Yi Chen Hsien-Wen Hsu Allan M Concerjero Chih-Chi Wang Shih-Ho Wang tsan-shiun lin Yueh-Wei Liu Chee-Chien Yong Yu-Hung lin Chih-Che lin King-Wah Chiu Bruno Jawan Hock-Liew Eng Chao-Long Chen Department of Diagnostic Radiology Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine Department of Surgery Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine Division of Hepatogastroenterology Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine Department of Anesthesiology Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine Department of Pathology Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine

The shortage of deceased donor liver grafts led to the use of living donor liver transplant(LDLT).Patients who un-dergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantation(LT).Interventional radiology has acquired a key role in every LT program by treating the majority of vascular and nonvascular post-transplant complications,improving graft and patient survival and avoiding,in the majority of cases,surgical revision and/or *** aim of this paper is to review indications,diagnostic modalities,technical considerations,achievements and potential complications of interventional radiology procedures after LDLT.

关键词： Portal vein Hepatic artery Hepatic vein Bile duct Living donor liver transplantation Liver transplant

The influence of primary posterior continuous curvilinear capsulorhexis on posterior capsular opacification development in dogs

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畜牧与兽医 2012年第S2期44卷 57-58页

作者： Zih-ling Lai Shu-Hao Chang Chu-Yu Tsai shiun-Long lin Department of Veterinary Medicine College of Veterinary MedicineNational Chung Hsing University Mackay Memorial Hospital

The posterior capsular opacification(PCO)is by far the most common complication following *** continuous curvilinear capsulorhexis(PCCC)is performed to prevent this complication in human *** PCCC,the central part of the posterior capsule is removed during cataract surgery to prevent equatorial lens cell migration onto the posterior capsule from reaching the visual *** to now,there has no any report about PCCC in veterinary *** aim of this study is to evaluate the efficacy of primary PCCC on the severity of posterior capsular opacification in dogs.

关键词： opacification capsular equatorial cataract migration removed capsule severity reaching intraoperative

Metabolic dysfunction associated fatty liver disease: The new nomenclature and its impact

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World Journal of Gastroenterology 2023年第3期29卷 549-560页

作者： Si-Ying Tang Jian shiun Tan Xian-Zheng Pang Guan-Huei Lee Division of Gastroenterology and Hepatology National University HospitalSingapore 119228Singapore Yong Loo lin School of Medicine Singapore 117597Singapore

BACKGROUND In 2020,an international expert panel proposed a new definition of fatty liver:Metabolic dysfunction-associated fatty liver disease(MAFLD).The MAFLD added the criteria for defining metabolic dysfunctions,which are high-risk factors for liver-related and cardiovascular *** to the non-alcoholic fatty liver disease(NAFLD)definition,it allows the coexistence of MAFLD and significant alcohol use in the same *** To review the existing data that evaluate the clinical profile and long-term outcome difference between the patients identified as MAFLD and *** Databases MEDlinE via PubMed and EMBASE were searched and relevant publications up to June 28,2022 were *** were included if they involved human participants diagnosed with *** A total of 2324 records were reviewed,of which 1575 duplicate citations were *** the 2324 records screened,207 articles were excluded,and 542 articles were assessed for their eligibility,for which 511 were *** remaining 31 articles were selected for *** diagnostic criteria were able to identify more individuals with fatty *** have shown that patients included using the MAFLD criteria were associated with higher risks of hepatic fibrosis when compared to ***-cause mortality,cardiovascular diseaserelated,and cancer-related mortality were shown to be higher in MAFLD *** patients also had higher baseline metabolic derangement,and risks of developing obesity,diabetes,and cardiovascular *** the 3 subtypes,diabetes mellitus has the strongest association with negative outcomes,followed by metabolic dysfunction and elevated body mass *** the subtypes of MAFLD,patients with more metabolic conditions at the time of diagnosis had worse hepatic and liver injury compared to those with a single metabolic *** MAFLD is a new definition of fatty liver disease that is gaining increasing *** is based on empirical

关键词： Hepatic steatosis Liver fibrosis Cardiovascular events Alcohol liver disease Obesity

The Omni-directional Dipole Antenna Structure and Design

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The Omni-directional Dipole Antenna Structure and Design