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Alfapump®implantable device in management of refractory ascites:An update

World Journal of Hepatology 2022年第7期14卷 1344-1356页

作者： delphine weil-verhoeven Vincent Di Martino Guido Stirnimann Jean Paul Cervoni Eric Nguyen-Khac Thierry Thévenot Service d’Hépatologie Et Soins Intensifs Digestifs CHRU Jean MinjozBesançon 25030France EA 4266 EPILAB Universitéde Bourgogne Franche-ComtéBesançon 25030France Department of Visceral Surgery and Medicine Inselspital University Hospital and University of BernBern 3010Switzerland Service d’Hépato-Gastroentérologie CHU Amiens-PicardieAmiens 80080France

Refractory ascites(RA)is a frequent and life-threatening complication of *** selected patients with RA,transjugular intrahepatic portosystemic shunt(TIPS)placement and liver transplantation(LT)are currently considered the best therapeutic alternatives to repeated large volume *** patients with a contraindication to TIPS or LT,the alfapump®system(Sequana Medical,Ghent,Belgium)has been developed to reduce the need for iterative paracentesis,and consequently to improve the quality of life and nutritional *** report here recent data on technical progress made since the first implantation,the efficacy and tolerance of the device,the position of the pump in the therapeutic arsenal for refractory ascites,and the grey areas that remain to be clarified regarding the optimal selection of patients who are potential candidates for this treatment.

关键词： Alfapump Refractory ascites Automated low flow ascites pump Cirrhosis Liver

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Clinical characteristics and outcomes of patients with hepatic angiomyolipoma:A literature review

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World Journal of Gastroenterology 2021年第19期27卷 2299-2311页

作者： Paul Calame Gaelle Tyrode delphine weil verhoeven Sophie Felix Anne Julia Klompenhouwer Vincent Di Martino Eric Delabrousse Thierry Thevenot Department of Radiology Jean Minjoz University HospitalBesançon 25030France Department of Hepatology Jean Minjoz University HospitalBesançon 25030France Department of Pathology Jean Minjoz University HospitalBesançon 25000France Department of Surgery Erasmus University Medical CenterRotterdam PO Box 2040The Netherlands

First reported in 1976,hepatic angiomyolipoma(HAML)is a rare mesenchymal liver tumor occurring mostly in middle-aged *** of the liver mass is often incidental on abdominal imaging due to the frequent absence of specific *** 10%of HAMLs are associated with tuberous sclerosis *** contains variable proportions of blood vessels,smooth muscle cells and adipose tissue,which renders radiological diagnosis *** express positivity for HMB-45 and actin,thus these tumors are integrated into the group of perivascular epithelioid cell ***,a HAML appears on magnetic resonance imaging(or computed tomography scan)as a hypervascular solid tumor with fatty areas and with washout,and can easily be misdiagnosed as other liver tumors,particularly hepatocellular *** therapeutic strategy is not clearly defined,but surgical resection is indicated for symptomatic patients,for tumors showing an aggressive pattern(i.e.,changes in size on imaging or high proliferation activity and atypical epithelioid pattern on liver biopsy),for large(>5 cm)biopsy-proven HAML,and if doubts remain on imaging or *** management may be justified in other conditions,since most cases follow a benign clinical *** summary,the correct diagnosis of HAML is challenging on imaging and relies mainly on pathological findings.

关键词： Angiomyolipoma Liver Tuberous sclerosis complex Imaging Pathology Potentially malignant

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New prognostic markers in liver cirrhosis

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World Journal of Hepatology 2015年第9期7卷 1244-1250页

作者： Vincent Di Martino delphine weil Jean-Paul Cervoni Thierry Thevenot Service D’hépatologie Et De Soins Intensifs Digestifs

Determining the prognosis of cirrhotic patients is not an easy task. Prognostic scores, like Child-Pugh and Model of End-stage Liver Disease scores, are commonly used by hepatologists, but do not always reflect superimposed events that may strongly influence the prognosis. Among them, bacterial intestinal translocation is a key phenomenon for the development of cirrhosis-related complications. Several biological variables(C-reactive protein, serum free cortisol, copeptin, von Willebrand factor antigen) are surrogates of "inflammatory stress" and have recently been identified as potential prognostic markers in cirrhotic patients. Most of these above mentioned markers were investigated in pilot studies with sometimes a modest sample size but allow us to catch a glimpse of the pathophysiological mechanisms leading to the worsening of cirrhosis. These new data should generate further well-designed studies to better assess the benefit for liver function of preventing intestinal bacterial translocation and microvascular thrombosis. The control of infection is vital and among all actors of immunity, vitamin D also appears to act as an anti-infective agent and therefore has probably a prognostic value.

关键词： Cirrhosis C-reactive protein Copeptin Vitamin D Serum free cortisol Von Willebrand factorantigen

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