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Optimization of the future remnant liver:review of the current strategies in Europe

Hepatobiliary Surgery and Nutrition 2021年第3期10卷 350-363页

作者： Riccardo Memeo Maria Conticchio emmanuel deshayes Silvio Nadalin Astrid Herrero Boris Guiu Fabrizio Panaro Division of Hepato-Pancreato-Biliary Surgery Department of Surgery“F.Miulli”General HospitalAcquaviva delle FontiBariItaly Policlinico di Bari Aldo Moro UniversityBariItaly Department of Nuclear Medicine Institute du Cancer de Montpellier(ICM)MontpellierFrance INSERM U1194 Montpellier Cancer Research InstituteMontpellier UniversityMontpellierFrance Department of General Visceral and Transplant SurgeryUniversity Hospital TübingenGermany Department of Surgery Division of HBP Surgery and Liver TransplantationSt-Eloi University HospitalMontpellierFrance Department of Radiology St-Eloi University HospitalMontpellierFrance

Liver resection still represent the treatment of choice for liver malignancies,but in some cases inadequate future remnant liver(FRL)can lead to post hepatectomy liver failure(PHLF)that still represents the most common cause of death after *** strategies in recent era have been developed in order to generate a compensatory hypertrophy of the FRL,reducing the risk of post hepatectomy liver *** vein embolization,portal vein ligation,and ALLPS are the most popular techniques historically adopted up to *** liver venous deprivation and the radio-embolization are the most recent promising *** even more precise tools to calculate the relationship among volume and function,such as scintigraphy with^(99m)Tc-mebrofenin(HBS),no consensus is still available to define which of the above mentioned augmentation strategy is more adequate in terms of kind of surgery,complexity of the pathology and quality of liver *** aim of this article is to analyse these different strategies to achieve sufficient FRL.

关键词： Liver resection future remnant liver(FRL) liver failure liver volume liver function hypertrophy

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Perioperative impact of liver venous deprivation compared with portal venous embolization in patients undergoing right hepatectomy: preliminary results from the pioneer center

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Hepatobiliary Surgery and Nutrition 2019年第4期8卷 329-337页

作者： Fabrizio Panaro Fabio Giannone Benjamin Riviere Olivia Sgarbura Caterina Cusumano emmanuel deshayes Francis Navarro Boris Guiu Francois Quenet Division of HBP Surgery and Transplantation Department of SurgerySt.Eloi Hospital2Department of PathologyGui de Celiac HospitalMontpellier University Hospital-School of Medicine34090 MontpellierFrance Department of Surgical Oncology 4Department of Nuclear MedicineCancer Institute of Montpellier(ICM)20834298 MontpellierFrance Division of Interventional Radiology Department of RadiologySt.Eloi HospitalMontpellier University Hospital-School of Medicine34090 MontpellierFrance

Background: Preoperative portal vein embolization (PVE) is currently the standard technique used routinely to increase the size of the future remnant liver (FRL) before major hepatectomies. The degree of hypertrophy (DH) is approximatively 10% and requires on average six weeks. ALPPS is faster and achieves a good DH but with a higher morbidity and mortality. One method recently proposed to increase the FRL is liver venous deprivation (LVD), but its clinical and operative impact is still unknown. The aim of this study is to compare intra- and postoperative morbidity/mortality and the histological evaluation of the liver parenchyma between PVE and LVD in patients undergoing anatomic right hepatectomy. Methods: Fifty-three consecutive patients undergoing PVE and LVD before a major hepatectomy were retrospectively analysed between 2015 and 2017. In order to reduce the bias, only potential standard right hepatectomies were selected. Surgical resections and the radiologic procedures were performed by the same Institution. Intra-operative parameters (transfusions, perfusions, bleeding, operative time), postoperative complications (Clavien-Dindo and ISGLS criteria), and histological findings were compared. Results: To induce FRL growth 16 patients underwent PVE and 13 LVD. One patient of the PVE group was not resected due to peritoneal metastases. Surgery was performed for hepatocellular carcinoma (PVE =9, LVD=3), metastases (PVE =5, LVD =10), or others diseases (PVE =2, LVD =0). Per- and post-operative morbidity/mortality rates after PVE and LVD procedures were null. No differences between the two groups were found in terms of intraoperative bleeding (median: 550 vs. 1,200 mL;P=0.36), hepatic pedicle clamping (5 vs. 3 patients;P=0.69), intraoperative red blood cells transfusions (median: 622 vs. 594;P=0.42) and operative time (median:270 vs. 330 min;P=0.34). Post-operative course was similar when comparing both medical and surgical complications in the two arms (PVE n=7, L

关键词： Liver venous deprivation (LVD) portal embolization liver failure hepatectomy

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Liver venous deprivation versus portal vein embolization before major hepatectomy:future liver remnant volumetric and functional changes

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Hepatobiliary Surgery and Nutrition 2020年第5期9卷 564-576页

作者： Boris Guiu François Quenet Fabrizio Panaro Lauranne Piron Christophe Cassinotto Astrid Herrerro François-Régis Souche Margaux Hermida Marie-Ange Pierredon-Foulongne Ali Belgour Serge Aho-Glele emmanuel deshayes Department of Radiology St-Eloi University HospitalMontpellierFrance Department of Surgery Institut du Cancer de Montpellier(ICM)MontpellierFrance Department of Surgery St-Eloi University HospitalMontpellierFrance Department of Epidemiology Dijon University HospitalDijonFrance Department of Nuclear Medicine Institut de Recherche en Cancérologie de Montpellier(IRCM)INSERM U1194MontpellierFrance

Background:We previously showed that embolization of portal inflow and hepatic vein(HV)outflow(liver venous deprivation,LVD)promotes future liver remnant(FLR)volume(FLR-V)and function(FLR-F)***,we compared FLR-V and FLR-F changes after portal vein embolization(PVE)and ***:This study included all patients referred for liver preparation before major hepatectomy over 26 *** criteria were:unavailable baseline/follow-up imaging,cirrhosis,Klatskin tumor,two-stage hepatectomy.99mTc-mebrofenin SPECT-CT was performed at baseline and at day 7,14 and 21 after PVE or ***-V and FLR-F variations were compared using multivariate generalized linear mixed models(joint modelling)with/without missing data ***:Baseline FLR-F was lower in the LVD(n=29)than PVE group(n=22)(P<0.001).Technical success was 100%in both groups without any major *** in FLR-V at day 14 and 21(+14.2%vs.+50%,P=0.002;and+18.6%vs.+52.6%,P=0.001),and in FLR-F at day 7,14 and 21(+23.1%vs.+54.3%,P=0.02;+17.6%vs.+56.1%,P=0.006;and+29.8%vs.+63.9%,P<0.001)differed between PVE and LVD ***(P=0.009),age(P=0.027)and baseline FLR-V(P=0.001)independently predicted FLR-V variations,whereas only LVD(P=0.01)predicted FLR-F *** missing data handling,LVD remained an independent predictor of FLR-V and FLR-F ***:LVD is safe and provides greater FLR-V and FLR-F increase than *** results are now evaluated in the HYPERLIV-01 multicenter randomized trial.

关键词： Portal vein embolization(PVE) liver venous deprivation(LVD) resection hepatectomy mebrofenin

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Cyclin-dependent kinase inhibitors p21 and p27 function as critical regulators of liver regeneration following 90%hepatectomy in the rat

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World Journal of Hepatology 2020年第12期12卷 1198-1210页

作者： Nicolas Moniaux Laurence Lacaze Adelie Gothland Alice deshayes Didier Samuel Jamila Faivre INSERM U1193Paul-Brousse University HospitalHepatobiliary CentreVillejuif 94800France UniversitéParis-Saclay Facultéde Médecine Le KremlinBicêtre 94270France Department of Pôle de Biologie Médicale Laboratoire d’Onco-HématologieAssistance Publique-Hôpitaux de Paris(AP-HP)Paul-Brousse University HospitalVillejuif 94800France

BACKGROUND Liver reduction is the main curative treatment for primary liver cancer,but its use remains limited as liver regeneration requires a minimum of 30%functional *** To study the dynamics of the liver regeneration process and consequent behavior of cell cycle regulators in rats after extended hepatectomy(90%)and postoperative glucose *** Post-hepatectomy liver failure was triggered in 84 Wistar rats by reducing their liver mass by 90%.The animals received a post-operative glucose infusion and were randomly assigned to two groups:One to investigate the survival rate and the other for biochemical *** that underwent laparotomy or 70%hepatectomy were used as *** and liver samples were collected on postoperative days 1 to *** morphology,function,and regeneration were studied with histology,immunohistochemistry,and western *** Postoperative mortality after major resection reached 20%and 55%in the first 24 h and 48 h,respectively,with an overall total of 70%7 d after *** apparent signs of apoptotic cell death were detected in the extended hepatectomy rat livers,but hepatocytes displaying a clear cytoplasm and an accumulation of hyaline material testified to changes affecting their functional *** regeneration started properly,as early events initiating cell proliferation occurred within the first 3 h,and the G1 to S transition was detected in less than 12 ***,a rise in p27(Kip1)followed by p21(Waf1/Cip1)cell cycle inhibitor levels led to a delayed S phase progression and ***,liver regeneration in rats with a 90%hepatectomy was delayed by 24 h and associated with a delayed onset and lower peak magnitude of hepatocellular deoxyribonucleic acid *** This work highlights the critical importance of the cyclin/cyclin-dependent kinase inhibitors of the Cip/Kip family in regulating the liver regeneration timeline following extended hepatectomy.

关键词： Major hepatectomy Liver failure Liver regeneration Post-hepatectomy liver failure p21 p27

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γ,δ-不饱和β-酮酯和羟基酸衍生的酰氯酰化反应

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华东化工学院学报 1991年第3期17卷 324-329页

作者：钟家伟 Bernard Chantgrel Christion deshayes 华东化工学院精细化工系法国里昂国立应用科学学院有机化学实验室

叙述了由γ,δ-不饱和β-酮酯与羟基酸衍生的酰氯,经酰化生成了6-酰氧基取代的5-乙酯基-2,3-二氢-4H-4-吡喃酮的衍生物,其中有些化合物可以转变为7-烷基或羟基取代的2,3-二氢-4,5-二氧(7H)呋喃并[3,4-b]吡喃衍生物。

关键词：酰氯酰化酮酯羟基酸衍生物

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修饰性化妆在皮肤病患者管理中的作用

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中华皮肤科杂志 2017年第12期50卷 939-940页

作者： S Seit #x000e9 , B Dr #x000e9 no, La Roche-Posay Pharmaceutical Laboratories Asni&#x000e8 res France Service de Dermatologie Caen France Hô tel-Dieu Nantes France CHU de Brest-Hô pital Morvan Brest France Centre Sabouraud H&#x000f4 pital Saint-Louis Paris France CHU Ambroise Paré Boulogne France Department of Dermatology Buenos Aires Argentina

皮肤病，尤其是损容性皮肤病（disfiguringdermatoses），如白癜风和其他色素性疾病、血管畸形、痤疮和手术或创伤后的瘢痕，能够引起患者心理障碍。它们对患者的生活质量（QOL），即与他人的关系、自身形象和自尊可产生显著影响，并能... 详细信息

皮肤病，尤其是损容性皮肤病（disfiguringdermatoses），如白癜风和其他色素性疾病、血管畸形、痤疮和手术或创伤后的瘢痕，能够引起患者心理障碍。它们对患者的生活质量（QOL），即与他人的关系、自身形象和自尊可产生显著影响，并能够导致抑郁和（或）情绪低落。这些心理因素对皮肤科医生在优化管理患者方面具有重要影响：患者满意度差可导致对治疗依从性差，最终出现不良的健康状况。

关键词：损容性皮肤病患者管理修饰性化妆色素性疾病患者满意度皮肤科医生血管畸形

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