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Extended central hepatectomy with preservation of segment 6 for patients with centrally located hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2015年第1期14卷 63-68页

作者： Mahmoud Abdelwahab Ali Jung-Fang Chuang chee-chien yong Chih-Chi Wang Chi-Ying Lin Chao-Long Chen Division of General Surgery Department of SurgeryKaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine Department of Surgery PingT ung Christian Hospital

BACKGROUND： In order to preserve functional liver parenchyma, extended central hepatectomy （segments 4, 5, 7 and 8 resection） was proposed for the management of centrally located hepatocellular carcinoma invading the right and middle hepatic veins, reconstructing segment 6 outflow in the absence of the thick inferior right hepatic vein. The present study was to describe our surgical techniques of extended central ***： Between 2008 and 2012, 5 patients with centrally located hepatocellular carcinoma invading or in the vicinity of the right and middle hepatic veins underwent extended central hepatectomy. The thick inferior right hepatic vein was preserved during dissection. Gore-Tex graft was used for segment 6 outflow reconstruction in the absence of the thick inferior right hepatic ***： The mean future remnant liver volume for segments 2 and 3 was 28% versus 45% on segment 6 preservation. The mean tumor diameter was 7.4 cm. The thick inferior right hepatic vein was found in 1 patient. Outflow reconstruction from segment 6 was performed in 4 patients. Postoperative complications included bile leakage （1 patient）, pleural effusion （2） and liver failure （1）. The rate of graft patency was 75%. There was no perioperative ***： Extended central hepatectomy is a safe alternative for extended hepatic resection in selected patients attempting to preserve the functional liver parenchyma.

关键词： hepatectomy hepatic vein thrombosis hepatocellular carcinoma liver cirrhosis liver imaging

Prevent bile duct injury by indocyanine green guide fluorescent imaging during laparoscopic cholecystectomy in liver transplantation recipient

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Hepatobiliary Surgery and Nutrition 2020年第6期9卷 817-819页

作者： chee-chien yong Shih-Min Yin Yi-Ping Sng Chao-Long Chen Liver Transplantation Center and Department of Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung

Cholecystolithiasis with acute cholecystitis is a rare,late biliary complication occurring in liver transplantation(LT)recipients who received the liver graft with preserved donor’s *** laparoscopic cholecystectomy(LC)is not contraindicated after upper abdominal surgery,misunderstanding of the biliary anatomy due to inflammatory phenomena or severe adhesion might increase the risk of bile duct injury(BDI)(1).

关键词： injury anatomy bile

Segment 6 monosegment-preserving hepatectomy for hepatoblastoma:individualizing treatment beyond the resectability criteria

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Hepatobiliary Surgery and Nutrition 2021年第1期10卷 142-145页

作者： chee-chien yong Chao-Long Chen Zhihao Li Aldwin D.Ong Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial HospitalKaohsiung

Monosegment-preserving hepatic resections are very rarely considered in patients with locally advanced tumors given the high risk of liver failure from an inadequate liver remnant(1,2).Where this is considered,the associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)technique,a two-staged procedure in order to induce remnant volume hypertrophy,have been reported(1,2).However,ALPPS has been known to have a high complication rate,hence even more infrequently,this complicated technique has been contemplated for pediatric patients(2).In the case we present,we identified an infant with a locally advanced hepatoblastoma with a unique anatomic presentation,that certainly precludes the possibility of ALPPS,but which otherwise provided the team with the opportunity to perform a single-staged monosegment-preserving hepatectomy with curative intent,in lieu of the alternative of liver transplantation(LT).

关键词： hepatectomy hepato preserving

Segment 8 hepatic vein reconstruction in a living donor after left hepatectomy

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Hepatobiliary Surgery and Nutrition 2021年第4期10卷 579-582页

作者： Chih-Yi Chen Chao-Long Chen chee-chien yong Aldwin D.Ong Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial HospitalKaohsiungTaiwanChina

Liver transplantation(LT)has been accepted worldwide as standard of treatment for end-stage liver *** to expanding indications for LT and shortage of cadaveric donors,living donor liver transplantation(LDLT)has emerged as an important alternative to augment the donor pool(1).Justifiably,donor safety is the fundamental priority in LDLT.

关键词： donor Liver hepatic

Peri-operative extracorporeal membrane oxygenation in adult and pediatric living donor liver transplantation:a single-center experience

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 898-908,I0011页

作者： Itsuko Chih-Yi Chen Leona Bettina PDungca chee-chien yong Wei Ho Jiunn-Jye Sheu Chao-Long Chen Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial HospitalKaohsiung Cardiovascular Surgery Kaohsiung Chang Gung Memorial HospitalKaohsiung

Background:Extracorporeal membrane oxygenation(ECMO)is a potential rescue therapy for patients with acute cardiopulmonary dysfunction refractory to conventional *** this study,we described the clinical profiles and outcomes of adult and pediatric living donor liver transplantation(LDLT)patients who received ECMO support during the peri-operative ***:From June 1994 to December 2020,eleven out of the 1,812 LDLTs performed at Kaohsiung Chang Gung Memorial Hospital required ECMO support:six for respiratory failure,three for cardiogenic shock,and two for refractory septic *** between the survivor and non-survivor groups was ***:The survival rate for liver transplantation(LT)patients on ECMO support is 36.4%-40%in adults and 33.3%in pediatrics,while the survival rate per indication is as follows:acute respiratory distress syndrome(ARDS)(50%),cardiogenic shock(33.3%),and sepsis(0%).Shorter durations of LT-to-ECMO and pre-ECMO mechanical ventilation were observed in the survivor *** the other hand,we observed persistently elevated total bilirubin levels in non-survivors,while none of the survivors had aspartate aminotransferase(AST)/alanine aminotransferase(ALT)levels>1,000 U/L.A higher proportion of non-survivors were on concurrent continuous renal replacement therapy(CRRT).Conclusions:Our experience has proven ECMO’s utility during the peri-operative period for both adult and pediatric LDLT patients,more specifically for indications other than septic *** studies are needed to better understand the factors leading to poor outcomes in order to identify patients who will more likely benefit from ECMO.

关键词： Extracorporeal membrane oxygenation(ECMO) living donor liver transplantation(LDLT) respiratory failure cardiogenic shock septic shock

Staged ligation of large portosystemic collaterals in living donor liver transplantation using a small-for-size graft

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Hepatobiliary Surgery and Nutrition 2020年第4期9卷 555-557页

作者： Chao-Long Chen chee-chien yong Jeffrey Samuel Co Chih-Yi Chen Aldwin Ong Chih-Che Lin Yu-Fan Cheng Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial HospitalKaohsiung Diagnostic Radiology Kaohsiung Chang Gung Memorial HospitalKaohsiung

The success of using a partial graft for liver transplantation depends highly on portal venous flow as it is the primary determinant of graft *** collaterals(PSCs)are not uncommon,with an incidence reported to be as h... 详细信息

关键词： collateral graft donor

Proton beam therapy to bridge or downstage locally advanced hepatocellular carcinoma to living donor liver transplantation

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 103-111页

作者： Chao-Long Chen Aldwin D.Ong Jen-Yu Cheng chee-chien yong Chih-Che Lin Chih-Yi Chen Yu-Fan Cheng Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwanChina Liver Transplantation Center Department of Radiation OncologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwanChina Liver Transplantation Center Department of Diagnostic RadiologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwanChina

Introduction Within the last decade,progress in transplant and surgical oncology has been *** liver oncology alone,there has been concurrent technological innovation across the different adjunct fields and tiers of oncology related to hepatocellular carcinoma(HCC),progressing in quite an unprecedented *** improvements in our capacity to diagnose and prognosticate HCC with increasing sensitivity,specificity,and predictability is being *** now better understand that staging,treatment and prognostication cannot be determined on a static basis of tumor burden(i.e.,tumor size and number)alone and a“one size fits all”*** individualized assessment is now mandatory in consideration of intra-and intertumoral heterogeneity and tumor biology in order to more precisely guide diagnostics and treatment options(1).

关键词： hepatocellular alone donor

Proton beam therapy for downstaging hepatocellular carcinoma with lobar portal vein tumor thrombosis to living donor liver transplantation

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 966-974页

作者： Chao-Long Chen Leona Bettina PDungca chee-chien yong Itsuko Chih-Yi Chen Yu-Fan Cheng Jen-Yu Cheng Yen-Yang Chen Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Liver Transplantation Center Department of Diagnostic RadiologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Liver Transplantation Center Department of Radiation OncologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Liver Transplantation Center Department of Hematology-OncologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung

Introduction Liver transplantation(LT)is considered as the definitive standard treatment for hepatocellular carcinoma(HCC)with the advantage of addressing both malignancy and the underlying cirrhosis,thus,providing th... 详细信息

关键词： Proton beam therapy(PBT) hepatocellular carcinoma(HCC) portal vein tumor thrombosis(PVTT) living donor liver transplantation(LDLT) downstaging therapy

Active vaccination to prevent de novo hepatitis B virus infection in liver transplantation

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World Journal of Gastroenterology 2015年第39期21卷 11112-11117页

作者： Chih-Che Lin chee-chien yong Chao-Long Chen Liver Transplantation Center Department of Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

The shortage of organ donors mandates the use of liver allograft from anti-HBc(+) donors, especially in areas highly endemic for hepatitis B virus(HBV) infection. Theincidence of de novo hepatitis B infection(DNH) is over 30%-70% among recipients of hepatitis B core antibody(HBcA b)(+) grafts without any prophylaxis after liver transplantation(LT). Systematic reviews showed that prophylactic therapy [lamivudine and/or hepatitits B immunoglobulin(HBIG)] dramatically reduces the probability of DNH. However, there are limited studies regarding the effects of active immunization to prevent DNH, and the role of active vaccination is not welldefined. This review focuses on the feasibility and efficacy of pre- and post-LT HBV vaccination to prevent DNH in HBsA g(-) recipient using HBcA b(+) grafts. The presence of HBs Ab in combination with lamivudine or HBIG results in lower incidence of DNH and may reduce the requirement of HBIG. There was a trend towards decreasing incidence of DNH with higher titers of HBs Ab. High titers of HBs Ab(> 1000 IU/L) achieved after repeated vaccination could eliminate the necessity for additional antiviral prophylaxis in pediatric recipients. In summary, active vaccination with adequate HBsA b titer is a feasible, cost-effective strategy to prevent DNH in recipients of HBc Ab(+) grafts. HBV vaccination is advised for candidates on waiting list and for recipients after withdrawal of steroids and onset of low dose immunosuppression after transplantation.

关键词： De novo hepatitis B Vaccination Liver transplantat