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Advances in endoscopic management of biliary complications after living donor liver transplantation: Comprehensive review of the literature

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World Journal of Gastroenterology 2016年第27期22卷 6173-6191页

作者： Milljae Shin Jae-won joh Department of Surgery Konkuk University Medical Center Konkuk University School of Medicine Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine

Apart from noticeable improvements in surgical techniques and immunosuppressive agents, biliary complications remain the major causes of morbidity and mortality after living donor liver transplantation(LDLT). Bile leakage and stricture are the predominant complications. The reported incidence of biliary complications is 15%-40%, and these are known to occur more frequently in living donors than in deceased donors. Despite the absence of a confirmed therapeutic algorithm, many approaches have been used for treatment, including surgical, endoscopic, and percutaneous transhepatic techniques. In recent years, nonsurgical approaches have largely replaced reoperation. Among these, the endoscopic approach is currently the preferred initial treatment for patients who undergo duct-to-duct biliary reconstruction. Previously, endoscopic management was achieved most optimally through balloon dilatation and single or multiple stents placement. Recently, there have been significant developments in endoscopic devices, such as novel biliary stents, as well as advances in endoscopic technologies, including deep enteroscopy, the rendezvous technique, magnetic compression anastomosis, and direct cholangioscopy. These developments have resulted in almost all patients being managed by the endoscopic approach. Multiple recent publications suggest superior long-term results, with overall success rates ranging from 58% to 75%. This article summarizes the advances in endoscopic management of patients with biliary complications after LDLT.

关键词： Biliary complication Endoscopic retrograde cholangiography Endoscopic management Living donor Liver transplantation

Surgical treatment for rectal cancer:An international perspective on what the medical gastroenterologist needs to know

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World Journal of Gastroenterology 2008年第21期14卷 3281-3289页

作者： Rolv-Ole Lindsetmo yong-Geul joh Conor P Delaney Department of Gastrointestinal Surgery University Hospital of North Norway and Institute of Clinical MedicineUniversity of TromsTromsN-9036Norway Department of Surgery Hansol HospitalSeoul 138-844South Korea Division of Colorectal Surgery University Hospital Case Medical CenterClevelandOhio 44106-5047United States

Rectal cancer accounts for one third of all colorectal *** age adjusted death rates from colorectal cancer have declined over recent decades due to a combination of colorectal cancer screening,improved diagnostic tests,improved standardized surgical technique,improved medical support,neoadjuvant chemotherapies and radiation treatment or combinations of *** of complex treatment algorithms,use of multidisciplinary teams in the management of rectal cancer patients has also been *** gastroenterologists performing colonoscopies are frequently the first health care provider to raise the suspicion of a rectal *** the diagnosis depends on histological confirmation,the endoscopic presentation is almost diagnostic in many *** order to meet the patient's immediate needs for information,it is important that the endoscopist has knowledge about the investigations and treatment options that will be required for their *** aim of this paper is to describe the modern preoperative investigations and operative procedures commonly offered to rectal cancer patients taking into account perspectives of three colorectal surgeons,practicing in the USA,Europe and Asia.

关键词： Rectal cancer management Evaluation Staging Neoadjuvant Adjuvant Surgical treatment Surveillance

Hepatic resection vs percutaneous radiofrequency ablation of hepatocellular carcinoma abutting right diaphragm

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World Journal of Gastrointestinal Oncology 2019年第3期11卷 227-237页

作者： Kyoung Doo Song Hyo Keun Lim Hyunchul Rhim Min Woo Lee Tae Wook Kang yong Han Paik Jong Man Kim Jae-won joh Department of Radiology Samsung Medical Center Sungkyunkwan University School of Medicine Department of Radiology Samsung Medical Center Sungkyunkwan University School of Medicine Department of Health Sciences and Technology SAIHSTSungkyunkwan University Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine

BACKGROUND It is usually difficult to adequately conduct percutaneous ultrasound-guided radiofrequency(RF) ablation for hepatocellular carcinomas(HCCs) abutting the diaphragm. Our hypothesis was that the subphrenic location of HCC could have an effect on the long-term therapeutic outcomes after hepatic resection and RF *** To compare the long-term therapeutic outcomes of hepatic resection and percutaneous RF ablation for HCCs abutting the *** A total of 143 Child-Pugh class A patients who had undergone hepatic resection(n = 80) or percutaneous ultrasound-guided RF ablation(n = 63) for an HCC(≤ 3 cm) abutting the right diaphragm were included. Cumulative local tumor progression(LTP), cumulative intrahepatic distant recurrence(IDR), disease-free survival(DFS), and overall survival(OS) rates were estimated. Prognostic factors for DFS and OS were analyzed. Complications were *** The cumulative IDR rate, DFS rate, and OS rate for the hepatic resection group and RF ablation group at 5 years were "35.9% vs 65.8%", "64.1% vs 18.3%", and"88.4% vs 68.7%", respectively. Hepatic resection was an independent prognostic factor for DFS(P ≤ 0.001; hazard ratio, 0.352; 95%CI: 0.205, 0.605; with RF ablation as the reference category); however, treatment modality was not an independent prognostic factor for OS. The LTP rate was 46.6% at 5 years for the RF ablation group. The major complication rate was not significantly different between the groups(P = 0.630). The rate of occurrence of peritoneal seeding was higher in the RF ablation group(1.3% vs 9.5%, P = 0.044).CONCLUSION Although OS was not significantly different between patients who had gone hepatic resection or percutaneous RF ablation for HCCs abutting the diaphragm,DFS was better in the hepatic resection group.

关键词： Hepatic resection Radiofrequency ablation Hepatocellular carcinoma Diaphragm Treatment outcome

Hepatobiliary scintigraphy for detecting biliary strictures after living donor liver transplantation

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World Journal of Gastroenterology 2011年第21期17卷 2626-2631页

作者： Yu Jin Kim Kyu Taek Lee Young Cheol Jo Kwang Hyuck Lee Jong Kyun Lee Jae-won joh Choon Hyuck David Kwon Department of Medicine Samsung Medical CenterSungkyunkwan University School of Medicine Department of Surgery Samsung Medical CenterSungkyunkwan University School of Medicine

AIM:To investigate the diagnostic accuracy of hepatobiliary scintigraphy(HBS) in detecting biliary strictures in living donor liver transplantation(LDLT) ***:We retrospectively reviewed 104 adult LDLT recipients of the right hepatic lobe with duct-toduct anastomosis,who underwent HBS and *** HBS results were categorized as normal,parenchymal dysfunction,biliary obstruction,or bile leakage without *** presence of biliary strictures was determined by percutaneous cholangiography or endoscopic retrograde cholangiopancreatography(ERCP).RESULTS:In 89 patients with biliary strictures,HBS showed biliary obstruction in 50 and no obstruction in 39,for a sensitivity of 56.2%.Of 15 patients with no biliary strictures,HBS showed no obstruction in 11,for a specificity of 73.3%.The positive predictive value(PPV) was 92.6%(50/54) and the negative predictive value(NPV) was 22%(11/50).We also analyzed the diagnostic accuracy of the change in bile duct *** sensitivity,NPV,specificity,and PPV were 65.2%,27.9%,80% and 95%,***:The absence of biliary obstruction on HBS is not ***,when post-LDLT biliary strictures are suspected,early ERCP may be considered.

关键词： Living donor liver transplantation Tc99m mebrofenin Radionucleotide imaging Hepatobiliary scintigraphy Biliary stricture

Surgical treatment outcomes of primary hepatic sarcomas: A singlecenter experience

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World Journal of Hepatology 2021年第5期13卷 584-594页

作者： Sang Jin Kim Jinsoo Rhu Jong Man Kim Gyu Seung Choi Jae-won joh Department of Surgery Korea University College of MedicineSeoulRepublic of KoreaDivision of Hepatobiliopancreas and Transplant SurgeryKorea University Ansan HospitalAnsan 15355South Korea Department of Surgery Samsung Medical CenterSeoul 06351South Korea

BACKGROUND Primary hepatic sarcoma is a rare tumor originated from mesenchymal *** are various pathologic types of primary hepatic sarcoma and the treatment outcome of this tumor was usually *** hepatocellular carcinoma,outcome of primary hepatic sarcoma is not well-known due to it’s ***,with development of medical technology,surgical treatment may lead to better *** To investigate the surgical outcomes of primary hepatic sarcoma,we gathered and analyzed the cases of a single *** From August 2001 to September 2016,a total of nine patients were surgically treated for primary hepatic sarcoma after exclusion of cases with open and closure,early loss to follow-up and sarcomatoid hepatocellular carcinoma and sarcomatoid cholangiocellular *** characteristics,tumor characteristics such as tumor pathology,size and number,surgical and adjuvant treatments were *** recurrence,and patient survival were analyzed with retrospective *** The enrolled participants included five patients with angiosarcoma and four patients with undifferentiated *** patients experienced tumor recurrence at a median of 52 post-operative *** two patients survived and the 5-year survival rate was 29.6%.One patient with angiosarcoma who received central hepatectomy for primary tumor and received radiofrequency ablation for recurrent tumor still lives for 11 *** patient with undifferentiated sarcoma received *** for primary tumor followed by chemotherapy and radiation therapy still lives around 30 mo even though she got additional operation for recurrent *** patients who received living donor liver transplantation due to angiosarcoma *** adjuvant therapy was associated with survival gain(P=0.002).CONCLUSION Patients with primary hepatic sarcoma may gain survival benefit with surgical resection followed by adjuvant therapy,even though the outcome remains relatively poor

关键词： Liver Angiosarcoma Undifferentiated sarcoma Operation Survival Recurrence

Rapid hemostasis of the residual inguinal access sites during endovascular procedures:A case report

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World Journal of Clinical Cases 2022年第34期10卷 12684-12689页

作者： Hyangkyoung Kim Kwangjin Lee Sungsin Cho Jin Hyun joh Department of Vascular Surgery Kyung Hee University Hospital at GangdongSeoul 05278South Korea Department of Surgery Kyung Hee University Hospital at GangdongSeoul 05278South Korea

BACKGROUND In endovascular procedures including total percutaneous endovascular aneurysm repair(pEVAR),percutaneous access through the common femoral artery is most commonly ***-site bleeding is a major concern in percutaneous ***,we present a case of successful control of continuous oozing using a vascular closure device(VCD)and the application of Surgicel(johnson&johnson,United States)over the access *** SUMMARY An 82-year-old man presented with an unruptured abdominal aortic aneurysm measuring 83 mm×75 *** patient had a medical history of atrial fibrillation and was receiving rivaroxaban(15 mg/d).Routine pEVAR was performed using the preclose technique with ProGlide(Abbott,Santa Clara,CA,United States).Significant amount of bleeding was observed at the end of the procedure after the deployment of the closure device at the access site.A sheet of Surgicel was applied to the suture thread using a surgical *** was applied to the surface of the artery along the access tract using a pusher,and hemostasis was immediately *** This simple technique is an excellent adjunct to control residual bleeding from the access site following VCD use.

关键词： Endovascular procedures Punctures Hemostasis Hemostatic techniques Femoral artery Case report

Single hepatocellular carcinoma ≤ 3 cm in left lateral segment:Liver resection or radiofrequency ablation?

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World Journal of Gastroenterology 2014年第14期20卷 4059-4065页

作者： Jong Man Kim Tae Wook Kang Choon Hyuck David Kwon Jae-won joh Justin Sangwook Ko Jae Berm Park Hyunchul Rhim Joon Hyeok Lee Sung Joo Kim Seung Woon Paik Department of Surgery Samsung Medical CenterSungkyunkwan University School of Medicine Department of Radiology and Center for Imaging Science Samsung Medical CenterSungkyunkwan University School of Medicine Department of Anesthesiology and Pain Medicine Samsung Medical CenterSungkyunkwan University School of Medicine Division of Gastroenterology Department of MedicineSamsung Medical CenterSungkyunkwan University School of Medicine

AIM: To evaluate the long-term results of radiofrequency ablation (RFA) compared to left lateral sectionectomy (LLS) in patients with Child-Pugh class A disease for the treatment of single and small hepatocellular car... 详细信息

关键词： Small hepatocellular carcinoma Left lateral segment Radiofrequency ablation Liver resection Tumor recurrence Survival

Development and validation of a simple and multifaceted instrument,GERD-TEST,for the clinical evaluation of gastroesophageal reflux and dyspeptic symptoms

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World Journal of Gastroenterology 2017年第28期23卷 5216-5228页

作者： Koji Nakada Nobuyuki Matsuhashi Katsuhiko Iwakiri Atsushi Oshio Takashi joh Kazuhide Higuchi Ken Haruma Department of Laboratory Medicine Daisan Hospital Jikei University School of Medicine Department of Gastroenterology NTT Medical Center Tokyo Department of Gastroenterology Nippon Medical School Graduate School of Medicine Faculty of Letters Arts and SciencesWaseda University Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences Second Department of Internal Medicine Osaka Medical College Department of General Internal Medicine 2 Kawasaki Medical School Kawasaki Hospital

To evaluate the psychometric properties of a newly developed questionnaire, known as the gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test (GERD-TEST), in patients with *** patients with predominant GERD symptoms recruited according to the Montreal definition were treated for 4 wk using a standard dose of proton pump inhibitor (PPI). The GERD-TEST and the Medical Outcome Study Short Form-8 Health Survey (SF-8) were administered at baseline and after 4 wk of treatment. The GERD-TEST contains three domains: the severity of GERD and functional dyspepsia (FD) symptoms (5 items), the level of dissatisfaction with daily life (DS) (4 items), and the therapeutic efficacy as assessed by the patients and medication compliance (4 items).RESULTSA total of 290 patients were eligible at baseline; 198 of these patients completed 4 wk of PPI therapy. The internal consistency reliability as evaluated using the Cronbach’s α values for the GERD, FD and DS subscales ranged from 0.75 to 0.82. The scores for the GERD, FD and DS items/subscales were significantly correlated with the physical and mental component summary scores of the SF-8. After 4 wk of PPI treatment, the scores for the GERD items/subscales were greatly reduced, ranging in value from 1.51 to 1.87 and with a large effect size (P < 0.0001, Cohen’s d; 1.29-1.63). Statistically significant differences in the changes in the scores for the GERD items/subscales were observed between treatment responders and non-responders (P < 0.0001).CONCLUSIONThe GERD-TEST has a good reliability, a good convergent and concurrent validity, and is responsive to the effects of treatment. The GERD-TEST is a simple, easy to understand, and multifaceted PRO instrument applicable to both clinical trials and the primary care of GERD patients.

关键词： Gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test Patient-reported outcome Gastroesophageal reflux disease Validity Reliability

Advances in refractory ulcerative colitis treatment: A new therapeutic target, Annexin A2

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World Journal of Gastroenterology 2015年第29期21卷 8776-8786页

作者： Satoshi Tanida Tsutomu Mizoshita Keiji Ozeki Takahito Katano Hiromi Kataoka Takeshi Kamiya Takashi joh Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences Nagoya city Aichi prefecture

Medical treatment has progressed significantly over the past decade towards achieving and maintaining clinical remission in patients with refractory ulcerative colitis(UC). Proposed mediators of inflammation in UC include pro-inflammatory cytokines such as tumor necrosis factor-α(TNF-α) and interleukin-2, and the cellsurface adhesive molecule integrin α4β7. Conventional therapeutics for active UC include 5-aminosalicylic acid, corticosteroids and purine analogues(azathioprine and 6-mercaptopurine). Patients who fail to respond to conventional therapy are treated with agents such as the calicineurin inhibitors cyclosporine and tacrolimus, the TNF-α inhibitors infliximab or adalimumab, or a neutralizing antibody(vedolizumab) directed against integrin α4β7. These therapeutic agents are of benefit for patients with refractory UC, but are not universally effective. Our recent research on TNF-α shedding demonstrated that inhibition of annexin(ANX) A2 may be a new therapeutic strategy for the prevention of TNF-α shedding during inflammatory bowel disease(IBD) inflammation. In this review, we provide an overview of therapeutic treatments that are effective and currently available for UC patients, as well as some that are likely to be available in the near future. We also propose the potential of ANX A2 as a new molecular target for IBD treatment.

关键词： Tumor necrosis factor-α Shedding Integrin α4β7 Epidermal growth factors