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Improved anterior hepatic transection for isolated hepatocellular carcinoma in the caudate

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Hepatobiliary & Pancreatic Diseases International 2014年第2期13卷 219-222页

作者： TanTo Cheung WaiKey Yuen Ronnie TP Poon SeeChing Chan Sheung Tat Fan chung mau lo Department of Surgery The University of Hong Kong Department of Surgery State Key Laboratory for Liver Research The University of Hong Kong

BACKGROUND: One of the best treatments for isolated hepatocellular carcinoma in the caudate lobe is major hepatectomy with caudate lobectomy, but it is not suitable for patients with poor liver function reserve. Isolated caudate lobectomy, which is a very difficult operation, is thus an alternative ***: Here we report an isolated caudate lobectomy with an anterior approach in the treatment of a large hepatocellular carcinoma with underlying cirrhosis, with focus on the technical ***: In the operation, both the left and right lobes of the liver were mobilized. Hepatotomy was done along the round ligament where parenchymal transection was minimal. After exposure of the left and middle hepatic veins and the hilar plate the caudate lobe and the tumor were resected en bloc with a5-mm ***: Isolated caudate lobectomy can be performed safely with this anterior approach on patients with poor liver function reserve.

关键词： hepatocellular carcinoma hepatectomy liver cirrhosis

Recurrent pyogenic cholangitis:An indication for liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 396-398页

作者： Wong Hoi She Wing Chiu Dai James YY Fung Tan To Cheung Albert CY Chan chung mau lo Department of Surgery The University of Hong Kong102 Pok Fu Lam RoadHong KongChina

To the Editor:Recurrent pyogenic cholangitis(RPC),also known as Hong Kong disease[1],is an unique disease entity with a decreasing *** is characterized by the formation of intrahepatic biliary pigmented stones,which r... 详细信息

关键词： cholangitis obstruction liver

Acute pancreatitis induced by transarterial chemoembolization:a single-center experience of over 1500 cases

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Hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 93-98页

作者： Wong Hoi She Albert CY Chan Tan To Cheung Kenneth SH Chok See Ching Chan Ronnie TP Poon chung mau lo Division of Hepatobiliary & Pancreatic Surgery and Liver Transplantation Department of SurgeryThe University of Hong Kong

BACKGROUND： Acute pancreatitis is a relatively rare but po- tentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma. METHODS： A total of 1632 patients with hepatocellular car- cinoma who had undergone transarterial chemoembolization from ]anuary 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential com- plications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications. RESULTS： Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these pa- tients was 61 years. Most （79.6%） of the patients suffered from HBV-related hepatoceUular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin elut- ing bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven （0.4%） patients suffered from acute pancre- atitis post-chemoembolization. Six patients had chemoembo- lization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxornbicin eluting bead had a higher risk of acute pancreatitis [6/145 （4.1%） vs 1/1487 （0.1%）, P〈0.0001]. Two patients had anatomical arterial variations. Four patients developed acute pancreatitis- related complications including necrotizing pancreatitis （n=3） and pseudocyst formation （n=1）. All of the 4 patients resolved after the use of antibiotics and other conservative treatment. Three patients had further transarterial chemoembolization without any complication. CONCLUSIONS： Acute pancreatitis after transarterial chemo- embolization could result in serious complications, especially after treatment wit

关键词： transarterial chemoembolization acute pancreatitis hepatocellular carcinoma

Rapid onset Chilaiditi's sign on top of fulminant hepatic failure

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Hepatobiliary & Pancreatic Diseases International 2004年第3期3卷 476-477页

作者： See-Ching Chan Chi-Leung Liu chung-mau lo Sheung-Tat Fan Centre for the Study of Liver Disease and Departmentof Surgery the University of Hong Kong Pokfulam Hong Kong China

ABSTRACT: Fulminant hepatic failure is a medical emer-gency. When this condition declared itself irreversible, atimely liver transplantation is the only effective treatment.A 34-year-old Chinese with fulminant hepatic failure wasevaluated as a potential liver transplantation candidate. Onthe erect chest radiograph, Chilaiditi' s sign has developedover a very short period of a week due to rapid shrinkage ofthe liver. Awareness of Chilaiditi' s sign facilitated distin-guishing the condition of free gas under the diaphragm dueto bowel perforation and subphrenic abscess by gas formingmicro-organisms. Rapidity of onset of this sign parallels thedeterioration of liver function and reflects the urgency ofcondition.

关键词： Chilaiditi's sign fulminant hepatic failure

Solitary extraovarian primary peritoneal carcinoma with direct invasion into the liver,diaphragm and lung without peritoneal dissemination or distant metastasis

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 322-325页

作者： Billy Ho Hung Cheung Wong Hoi She Siu Lun Ho Albert Chi Yan Chan chung mau lo Tan To Cheung Department of Surgery The University of Hong KongHong KongChina Department of Pathology The University of Hong KongHong KongChina

To the Editor:Extraovarian primary peritoneal carcinoma(EOPPC)is an uncommon malignancy with many similarities to epithelial ovarian carcinoma in histological,clinical,and etiological aspects[1].This phenomenon is explained by their common embryonal origin,in which both develop from the coelomic epithelium in the early embryological *** their similarities,the incidence of EOPPC is significantly lower than that of epithelial ovarian carcinoma(6.78 cases per million vs.120.5 cases per million)[1].

关键词： peritoneal invasion metastasis

Initial experience with stereotactic body radiotherapy for intrahepatic hepatocellular carcinoma recurrence after liver transplantation

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World Journal of Clinical Cases 2020年第13期8卷 2758-2768页

作者： Kin Pan Au Chi Leung Chiang Albert Chi Yan Chan Tan To Cheung chung mau lo Kenneth Siu Ho Chok Department of Surgery Queen Mary HospitalThe University of Hong KongHong Kong 999077China Department of Clinical Oncology Queen Mary Hospitalthe University of Hong KongHong Kong 999077China

BACKGROUND Graft hepatocellular carcinoma(HCC)recurrence after liver transplant is more frequently *** hepatectomy is technically challenging and is associated with high *** body radiation therapy(SBRT)has been shown to be safe and effective for the treatment of primary ***,its role in HCC recurrence in a liver graft remains *** To evaluate the safety and efficacy of SBRT for the treatment of graft HCC recurrence after liver *** A retrospective study was *** 2012 to 2018,6 patients with intrahepatic HCC recurrence after liver transplant were treated with SBRT at Queen Mary Hospital,the University of Hong *** primary outcome was time to overall disease progression and secondary outcomes were time to local progression and best local response,as assessed with the Modified response Evaluation Criteria for Solid Tumours *** were monitored for treatment related toxicities and graft *** A total of 9 treatment courses were given for 13 *** median tumour size was 2.3 cm(range 0.7-3.6 cm).Two(22%)patients had inferior vena cava tumour *** best local treatment response was:5(55%)complete response,1(11%)partial response and 3(33%)stable *** a median follow up duration of 15.5 mo,no local progression or mortality was yet *** median time to overall disease progression was 6.5 *** were 6 regional progression in the liver graft(67%)and 2 distant progression in the lung(22%).There was no grade 3 or above toxicity and there was no graft dysfunction after *** SBRT appears to be safe in this *** progression is the mode of failure.

关键词： Stereotactic body radiotherapy Hepatocellular carcinoma Liver transplantation Recurrence Radiosurgery Outcomes

Indications of pro-inflammatory cytokines in laparoscopic and open liver resection for early-stage hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 257-264页

作者： Kevin Tak-Pan Ng Li Pang Jia-Qi Wang Wong Hoi She Simon Hing-Yin Tsang chung mau lo Kwan Man Tan To Cheung Department of Surgery HKU-SZH&School of Clinical MedicineLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina State Key Laboratory of Liver Research The University of Hong KongHong KongChina

Background:Our clinical practice of laparoscopic liver resection(LLR)had achieved better short-term and long-term benefits for patients with hepatocellular carcinoma(HCC)over open liver resection(OLR),but the underlying mechanisms are not *** study was to find out whether systemic inflammation plays an important ***:A total of 103 patients with early-stage HCC under liver resection were enrolled(LLR group,n=53;OLR group,n=50).The expression of 9 inflammatory cytokines in patients at preoperation,postoperative day 1(POD1)and POD7 was quantified by Luminex Multiplex *** relationships of the cytokines and the postoperative outcomes were compared between LLR and ***:Seven of the circulating cytokines were found to be significantly upregulated on POD1 after LLR or OLR compared to their preoperative *** to OLR,the POD1 levels of granulocytemacrophage colony-stimulating factor(GM-CSF),interleukin-6(IL-6),IL-8,and monocyte chemoattractant protein-1(MCP-1)in the LLR group were significantly *** POD1 levels of these cytokines were significantly correlated with longer operative time and higher volume of blood loss during *** levels of these cytokines were positively associated with postoperative liver injury,and the length of hospital ***,a high level of IL-6 at POD1 was a risk factor for HCC recurrence and poor disease-free survival after liver ***:Significantly lower level of GM-CSF,IL-6,IL-8,and MCP-1 after liver resection represented a milder systemic inflammation which might be an important mechanism to offer better short-term and long-term outcomes in LLR over OLR.

关键词： Laparoscopic liver resection Open liver resection Hepatocellular carcinoma Postoperative cytokines Inflammatory responses

High-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients awaiting liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 542-544页

作者： Tan To Cheung Kenneth SH Chok Regina CL lo William W Sharr See Ching Chan Ronnie TP Poon Sheung Tat Fan chung mau lo Department of Surgery The University of Hong Kong Department of Pathology The University of Hong Kong State Key Laboratory for Liver Research The University of Hong Kong

The scarcity of liver grafts in Asia leads to a significant dropout of patients from liver transplant waiting lists, particularly patients with hepatocellular carcinoma and a low model for end-stage liver disease score. In order to reduce dropping out, different bridging therapies are employed. We report the use of high-intensity focused ultrasound ablation as a bridging therapy for a patient with hepatocellular carcinoma of stage two and an extremely low platelet count (20×10 9 /L). The ablation was successful. Blood tests showed that his liver function was similar before and after the treatment. No adhesion was encountered in the liver transplantation performed six months later.

关键词： high-intensity focused ultrasound hepatocellular carcinoma liver cirrhosis liver transplantation bridging therapy

Survival analysis of breast cancer liver metastasis treated by hepatectomy: A propensity score analysis for Chinese women in Hong Kong

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Hepatobiliary & Pancreatic Diseases International 2019年第5期18卷 452-457页

作者： Tan To Cheung Kenneth SH Chok Albert CY Chan Simon HY Tsang Wing Chiu Dai Thomas CC Yau Ava Kwong chung mau lo Department of Surgery Queen Mary HospitalThe University of Hong Kong102 Pok Fu Lam RoadHong KongChina Department of Medicine Queen Mary HospitalThe University of Hong Kong102 Pok Fu Lam RoadHong KongChina

Background: Survival of patients with breast cancer liver metastasis is very poor. This study aimed to analyze the survival outcome of hepatectomy for this patient population. Methods: From January 1995 to December 2014, 2522 patients with liver cancer received hepatectomy at our hospital. Twenty-one of them, all female, received the operation for breast cancer liver metastasis. Performance was compared with patients with colorectal liver metastasis treated with hepatectomy after propensity score analysis in a ratio of 1:3. Results: Twenty-one patients received hepatectomy for breast cancer. After propensity score matching, 63 patients who had hepatectomy for colorectal cancer were selected for comparison. There was no significant difference in immediate or short-term outcomes between the two groups of patients in terms of operative time, blood loss and surgical morbidities. All patients with breast cancer had R0 resection. No hospital death occurred. After hepatectomy, the 1-, 3- and 5-year overall survival rates were 100.0%, 58.9% and 58.9% respectively in patients with breast cancer. The 1-, 3- and 5-year overall survival rates were 95.0%, 57.2% and 39.7% respectively in patients with colorectal cancer (P = 0.572). On multivariate analysis, triple negative status was the only independent poor prognostic factor in breast cancer liver metastasis (OR = 6.411;95% CI: 1.351–30.435;P = 0.019). Conclusions: Hepatectomy is a safe and effective way of treating breast cancer liver metastasis at experienced centers where multidisciplinary adjuvant treatments are available. It can be considered more frequently as part of the multidisciplinary care for this patient population.

关键词： Liver cancer Breast cancer Hepatectomy Metastases