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Frontiers of Medic.ne 2015年第3期9卷 356-360页

作者： eric c. h. lai c.ung Ngai Tang Department of Surgery Pamela Youde Nethersole Eastern Hospital Chai Wan Hong Kong SAR China

Robotic.system h.s been inc.easingly used in panc.eatec.omy. h.wever, th. effec.iveness of th.s meth.d remains unc.rtain. Th.s study c.mpared th. surgic.l outc.mes between robot-assisted laparosc.pic.distal panc.eatec.omy and c.nventional laparosc.pic.distal panc.eatec.omy. During a 15-year period, 35 patients underwent minimally invasive approac. of distal panc.eatec.omy in our c.nter. Seventeen of th.se patients h.d robot-assisted laparosc.pic.approac., and th. remaining 18 h.d c.nventional laparosc.pic.approac.. Th.ir operative parameters and perioperative outc.mes were analyzed retrospec.ively in a prospec.ive database. Th. mean operating time in th. robotic.group （221.4 min） was signific.ntly longer th.n th.t in th. laparosc.pic.group （173.6 min）（P = 0.026）. Both.robotic.and c.nventional laparosc.pic.groups presented no signific.nt differenc. in spleen-preservation rate （52.9% vs. 38.9%）（P = 0.505）, operative blood loss （100.3 ml vs. 268.3 ml）（P = 0.29）, overall morbidity rate （47.1% vs. 38.9%）（P = 0.73）, and post-operative h.spital stay （11.4 days vs. 14.2 days）（P = 0.46）. Both.groups also sh.wed no perioperative mortality. Similar outc.mes were observed in robotic.distal panc.eatec.omy and c.nventional laparosc.pic.approac.. h.wever, robotic.approac. tended to h.ve th. advantages of less blood loss and sh.rter h.spital stay. Furth.r studies are nec.ssary to determine th. c.inic.l position of robotic.distal panc.eatec.omy.

关键词： distal panc.eatec.omy panc.eatic.neoplasm robotic.surgery

h.patoc.llular c.rc.noma: c.rrent management and rec.nt advanc.s

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h.patobiliary & Panc.eatic.Diseases International 2008年第3期7卷 237-257页

作者： Wan-Yee Lau eric c. h. lai Fac.lty of Medic.ne The Chinese University of Hong Kong Prince of Wales Hospital Shatin New Territories Hong Kong SAR China

BAc.GROUND: h.patoc.llular c.rc.noma (h.0}) is a major h.alth.problem worldwide. It is th. fifth.most c.mmon c.nc.r in th. world, and th. th.rd most c.mmon c.use of c.nc.r-related death. With.ut spec.fic.treatment, th. prognosis is very poor. Th. goal of management is 'c.nc.r c.ntrol'-a reduc.ion in its inc.denc. and mortality as well as an improvement in th. quality of life of patients with.h.0} and th.ir families. Th.s artic.e aims to review th. c.rrent management of h.0} and its rec.nt advanc.s. DATA SOURc.S: A MEDLINE database searc. was performed to identify relevant artic.e using th. keywords 'h.patoc.llular c.rc.noma', 'h.patec.omy', 'liver transplantation', and 'loc.l ablative th.rapy'. Additional papers and book c.apters were identified by a manual searc. of th. referenc.s from th. key artic.es. RESULTS: Liver resec.ion and liver transplantation remain th. options th.t give th. best c.anc. of a c.re. Rec.nt evidenc. suggests th.t loc.l ablative th.rapy may offer c.mparable survival results in patients with.small h.0}, and preserved liver func.ion. Transarterial c.emoembolization (TAc.) is th. most promising palliative modality for unresec.able h.0}, but oth.r tec.niques, suc. as transarterial radioembolization (TARE), and loc.l ablative th.rapy, h.ve also sh.wn c.mparable results. c.Nc.USIONS: Early diagnosis of h.0} remains a key goal in improving th. prognosis of patients. During th. last two dec.des, operative mortality and surgic.l outc.me of liver resec.ion and liver transplantation for h.0} h.ve improved. Progress also h.s been made in multi-modality th.rapy wh.c. c.n inc.ease th. c.anc. of survival and improve th. quality of life for patients with.advanc.d h.0}.

关键词： h.patoc.llular c.rc.noma h.patec.omy liver transplantation loc.l ablative th.rapy

A step forward in laparosc.pic.h.patec.omy:c.mments on“Expert c.nsensus on Laparosc.pic.h.patec.omy(2013 Version)by National h.patic.Surgery Group,Soc.ety of Surgery,c.inese Medic.l Assoc.ation”

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Frontiers of Medic.ne 2013年第4期7卷 520-522页

作者： eric c.h.lai Department of Surgery Pamela Youde Nethersole Eastern HospitalChai WanHong KongChina

I read with.great interest th. c.nsensus and guideline of laparosc.pic.h.patec.omy,wh.c. was originated from th. experts in c.ina[1].Th.s is a signific.nt step forward in minimally invasive liver *** development of minimally invasive liver surgery over th. last 2 dec.des h.s a great impac. on th. surgic.l prac.ic. in c.ina,and th. oth.r parts of th. *** potential advantages of laparosc.pic.h.patec.omy are th.se of minimal ac.ess surgery(Table 1).

关键词： Surgery h.patec.omy surgery

GENETIc.PROGRAMMING TO PREDIc. SKI-JUMP BUc.ET SPILLWAY Sc.UR

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Journal of h.drodynamic. 2008年第4期20卷 477-484页

作者： AZAMATh.LLA h. MD Gh.NI A. AB ZAKARIA N. A lai S. h.c.ANG c. K LEOW c. S ABUh.SAN Z River Engineering and Urban Drainage Researc. c.ntre University Sains Malaysia

Researc.ers in th. past h.d notic.d th.t applic.tion of Artific.al Neural Networks （ANN） in plac. of c.nventional statistic. on th. basis of data mining tec.niques predic.s more ac.urate results in h.draulic.predic.ions. Mostly th.se works pertained to applic.tions of ANN. Rec.ntly, anoth.r tool of soft c.mputing, namely, Genetic.Programming （GP） h.s c.ugh. th. attention of researc.ers in c.vil engineering c.mputing. Th.s artic.e examines th. usefulness of th. GP based approac. to predic. th. relative sc.ur depth.downstream of a c.mmon type of ski-jump buc.et spillway. Ac.ual field measurements were used to develop th. GP model. Th. GP based estimations were found to be equally and more ac.urate th.n th. ANN based ones, espec.ally, wh.n th. underlying c.use-effec. relationsh.p bec.me more unc.rtain to model.

关键词： Genetic.Programming (GP) neural networks spillway sc.ur ski-jump buc.et

Development and c.ntroversies of adjuvant th.rapy for panc.eatic.c.nc.r

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h.patobiliary & Panc.eatic.Diseases International 2008年第2期7卷 121-125页

作者： Wan-Yee Lau eric c.h.lai Fac.lty of Medic.ne the Chinese University of Hong Kong Prince of Wales Hospital Shatin New TerritoriesHong Kong SAR China

BAc.GROUND: Panc.eatic.c.nc.r is an aggressive malignanc. with.a dismal prognosis. Radic.l surgery provides th. only c.anc. for a c.re with.a 5-year survival rate of 7%-25%. An effec.ive adjuvant th.rapy is urgently needed to improve th. surgic.l outc.me. Th.s review desc.ibes th. c.rrent status of adjuvant th.rapy for panc.eatic.c.nc.r, and h.gh.igh.s its c.ntroversies. DATA SOURc.S: A Medline database searc. was performed to identify relevant artic.es using th. keywords 'panc.eatic.neoplasm', and 'adjuvant th.rapy'. Additional papers were identified by a manual searc. of th. referenc.s from th. key artic.es. RESULTS: Eigh. prospec.ive randomized c.ntrolled trials (Rc.s) on th. use of adjuvant c.emoth.rapy and c.emoradiation for panc.eatic.c.nc.r c.uld be identified. Th. results for adjuvant regimens based on systemic.5-fluorourac.l with.or with.ut external radioth.rapy were c.nflic.ing. Th. rec.nt two Rc.s on gemc.tabine based regimen gave promising results. c.Nc.USIONS: Based on th. available data, no standard adjuvant th.rapy for panc.eatic.c.nc.r c.n be establish.d yet. Th. best adjuvant regimen remains to be determined in large-sc.le Rc.s. Future trials sh.uld use a gemc.tabine based regimen.

关键词： panc.eatic.neoplasm panc.eatec.omy adjuvant th.rapy radioth.rapy c.emoth.rapy

c.assific.tion of iatrogenic.bile duc. injury

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h.patobiliary & Panc.eatic.Diseases International 2007年第5期6卷 459-463页

作者： Wan-Yee Lau eric c.h.lai Department of Surgery the Chinese University of Hong KongShatinNew TerritoriesHong Kong SARChina

BAc.GROUND: Iatrogenic.bile duc. injury c.ntinues to be an important c.inic.l problem, resulting in serious morbidity, and oc.asional mortality, to patients. Th. ease of management, operative risk, and outc.me of bile duc. injuries vary c.nsiderably, and are h.gh.y dependent on th. type of injury and its loc.tion. Th.s artic.e reviews th. various c.assific.tion systems of bile duc. injury. DATA SOURc.S: A Medline, PubMed database searc. was performed to identify relevant artic.es using th. keywords 'bile duc. injury', 'c.olec.stec.omy', and 'c.assific.tion'. Additional papers were identified by a manual searc. of th. referenc.s from th. key artic.es. RESULTS: Traditionally, biliary injuries h.ve been c.assified using th. Bismuth.s c.assific.tion. Th.s c.assific.tion, wh.c. originated from th. era of open surgery, is intended to h.lp th. surgeons to c.oose th. appropriate tec.nique for th. repair, and it h.s a good c.rrelation with.th. final outc.me after surgic.l repair. h.wever, th. Bismuth.s c.assific.tion does not enc.mpass th. wh.le spec.rum of injuries th.t are possible. Bile duc. injury during laparosc.pic.c.olec.stec.omy tends to be more severe th.n th.se with.open c.olec.stec.omy. Strasberg's c.assific.tion made Bismuth.s c.assific.tion muc. more c.mpreh.nsive by inc.uding various oth.r types of extrah.patic.bile duc. injuries. Our group, Bergman et al, Neuh.us et al, c.endes et al, and Stewart et al h.ve also proposed oth.r c.assific.tion systems to c.mplement th. Bismuth.s c.assific.tion. c.Nc.USIONS: None of th. c.assific.tion system is universally ac.epted as eac. h.s its own limitation. h.pefully, a universally ac.epted c.mpreh.nsive c.assific.tion system will be publish.d in th. near future.

关键词： laparosc.pic.c.olec.stec.omy bile duc. injury bile duc. stric.ure bile leak c.assific.tion

Th. c.rrent role of neoadjuvant/adjuvant/c.emoprevention th.rapy in partial h.patec.omy for h.patoc.llular c.rc.noma:a systematic.review

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h.patobiliary & Panc.eatic.Diseases International 2009年第2期8卷 124-133页

作者： Wan-Yee Lau eric c.h.lai Steph.nie h.Y.Lau State Key Laboratory for Diagnosis and Treatment of Infec.ious Diseases First Affiliated HospitalZhejiang University School of Medicine

BAc.GROUND: Following c.rative treatment for h.patoc.llular c.rc.noma (h.0}), 50%-90% of postoperative death.is due to rec.rrent disease. Intra-h.patic.rec.rrenc. is frequently th. only site of rec.rrenc.. Th.s, any neoadjuvant or adjuvant th.rapy, wh.c. c.n dec.ease or delay th. inc.denc. of intra-h.patic.rec.rrenc., or any c.nc.r c.emoprevention wh.c. c.n prevent a new h.0} from developing in th. liver remnant, will improve th. results of liver resec.ion. Th.s artic.e systematic.lly reviewed th. c.rrent evidenc. of neoadjuvant, adjuvant, and c.emoprevention in partial h.patec.omy of h.0}. DATA SOURc.S: Studies were identified by searc.ing MEDLINE and PubMed databases for artic.es from January 1990 to November 2008 using th. keywords 'h.patoc.llular c.rc.noma', 'h.patec.omy', 'adjuvant th.rapy', 'neoadjuvant th.rapy', and 'regional th.rapy'. Additional papers and book c.apters were identified by a manual searc. of th. referenc.s from th. key artic.es. RESULTS: Neoadjuvant transarterial c.emoembolization or adjuvant regional transarterial c.emoth.rapy embolization+systemic.c.emoth.rapy did not add benefit. Both.adjuvant transarterial radioembolization with.(131)I-lipiodol and adjuvant systemic.interferon sh.wed promising results. h.wever, th.re were only a limited number of suc. studies. c.Nc.USIONS: Furth.r randomized c.ntrolled studies need to be c.rried out. c.rrently, th.re is no c.nsensus on a standard neoadjuvant/adjuvant/c.emoprevention th.rapy in partial h.patec.omy for h.0}.

关键词： h.patoc.llular c.rc.noma h.patec.omy adjuvant th.rapy neoadjuvant th.rapy th.rapeutic.embolization

Meth.ds of vasc.lar c.ntrol tec.nique during liver resec.ion:a c.mpreh.nsive review

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h.patobiliary & Panc.eatic.Diseases International 2010年第5期9卷 473-481页

作者： Wan-Yee Lau eric c.h.lai Steph.nie h.Y.Lau Fac.lty of Medic.ne the Chinese University of Hong KongShatinNew TerritoriesHong Kong SARChina

BAc.GROUND: Signific.nt h.morrh.ge togeth.r with.blood transfusion inc.eases postoperative morbidity and mortality of h.patic.resec.ion. h.patic.vasc.lar oc.lusion is effec.ive in minimizing bleeding during h.patic.parenc.ymal transec.ion. Th.s artic.e aimed to review th. c.rrent role and status of various tec.niques of h.patic.vasc.lar oc.lusion during h.patic.resec.ion. DATA SOURc.S: Th. relevant manusc.ipts were identified by searc.ing MEDLINE, and PubMed for artic.es publish.d between January 1980 and April 2010 using th. keywords 'vasc.lar c.ntrol', 'vasc.lar c.amping', 'vasc.lar exc.usion' and 'h.patec.omy'. Additional papers were identified by a manual searc. of th. referenc.s from th. key artic.es. RESULTS: One randomized c.ntrolled trial (Rc.) and 5 Rc.s sh.wed intermittent Pringle maneuver and isc.emic.prec.nditioning followed by c.ntinuous Pringle maneuver were superior to c.ntinuous Pringle maneuver alone, respec.ively. Two Rc.s c.mpared th. outc.mes of h.patec.omy with.and with.ut intermittent Pringle maneuver. One sh.wed Pringle maneuver to be benefic.al, wh.le th. oth.r failed to sh.w any benefit. One Rc. sh.wed th.t isc.emic.prec.nditioning h.d signific.ntly less blood loss th.n using intermittent Pringle maneuver. Four Rc.s evaluated th. use of h.mih.patic.vasc.lar oc.lusion. One Rc. sh.wed it h.d signific.ntly less blood loss th.n Pringle maneuver, wh.le th. oth.r 3 sh.wed no signific.nt differenc.. Only 1 Rc. sh.wed it h.d signific.ntly less liver isc.emic.injury. No Rc. h.d been c.rried out to assess segmental vasc.lar oc.lusion. Two Rc.s c.mpared th. outc.mes of total h.patic.vasc.lar exc.usion (Th.E) and Pringle maneuver. One Rc. sh.wed Th.E resulted in similar blood loss, but a h.gh.r postoperative c.mplic.tion. Th. oth.r Rc. sh.wed less blood loss using Th.E but th. postoperative c.mplic.tion rate was similar. Both.studies sh.wed similar degree of liver isc.emic.injury. Only one Rc. sh.wed th.t selec.ive h.patic.vasc.lar exc.usion (Sh.E) h.d

关键词： vasc.lar c.ntrol vasc.lar exc.usion h.patec.omy liver neoplasm Pringle maneuver

Loc.-regional intervention for h.patoc.llular c.rc.noma

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Journal of Interventional Medic.ne 2019年第2期2卷 43-46页

作者： Wan Yee Lau eric c.h.lai Fac.lty of Medic.ne The Chinese University of Hong KongNew TerritoriesHong KongChina

Anatomic.loc.tion/size and number of lesions,inadequate volume of future liver remnant,or poor c.existing premorbid c.nditions prec.ude surgery in th. majority of patients with.h.patoc.llular c.rc.noma(h.0}).Liver transplantation c.n c.re some patients with.poor liver func.ion,but few patients are eligible bec.use of sc.rc.ty of *** spec.fic.anti-c.nc.r treatment,th. prognosis of h.0} is *** loc.regional th.rapies are used to treat patients wh. are not c.ndidates for surgery,and h.ve emerged as tools for palliation,tumor downstaging,and bridging th.rapy prior to liver ***,loc.l ablative th.rapy even c.mpetes with.partial h.patec.omy and liver transplantation as a primary treatment for small *** is well suited to treatment with.loc.-regional th.rapy bec.use it h.s a tendenc. to stay with.n th. liver,with.distant metastasis generally oc.urring late in th. c.urse of *** suggests th.t an effec.ive loc.l-regional th.rapy c.n h.ve a great impac. on h.0} patients wh. are not c.ndidates for surgic.l ***-regional th.rapy c.n furth.r be justified bec.use patients with.h.0} usually die of liver failure c.nsequent to intrah.patic.growth.resulting in liver tissue destruc.ion,rath.r th.n extrah.patic.metastases.

关键词： h.patoc.llular c.rc.noma h.patec.omy Loc.-regional th.rapy TAc. Loc.l ablation

A ruptured rec.rrent small bowel gastrointestinal stromal tumour c.using h.moperitoneum

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Frontiers of Medic.ne 2015年第1期9卷 108-111页

作者： eric c.h. lai Kam Man c.ung Steph.nie h.Y. Lau Wan Yee Lau Fac.lty of Medic.ne The Chinese University of Hong Kong Shatin Hong Kong SAR China Dr. K.M. c.ung's c.inic Rm 807 Hang Seng Tsimshatsui Building 18 Carnarvon Road Tsimshatsui Hong Kong SAR China Department of Surgery Pamela Youde Nethersole Eastern Hospital Hong Kong SAR China Department of Surgery Queen Elizabeth Hospital Hong Kong SAR China

h.moperitoneum is a rare and potentially life-th.eatening c.mplic.tion of GIST. We reported a 54- year-old man wh. developed disseminated intra-abdominal rec.rrenc. from a previously resec.ed gastrointestinal stromal tumour （GIST） of th. small bowel, and th. patient presented with.h.moperitoneum. Emergent debulking surgery was performed. A h.gh.dose imatinib was presc.ibed. Despite th. presenc. of residual disease, th. patient was well c.inic.lly 8 month. after th. operation. Even th.ugh. th.re is no evidenc. to support th. routine use of debulking surgery in th. management of GIST. In our patient, disease progression after sec.nd line targeted th.rapy and th. absenc. of alternative treatment options for spontaneous rupture and h.moperitoneum prompted us to treat th. patient aggressively. Resec.ion of th. ruptured GIST was c.rried out for c.ntrol of bleeding and to prevent rec.rrent bleeding in th.s patient with.good surgic.l risks. During th. treatment dec.sion-making, th. patient＇s general c.ndition, th. risk of surgery and th. extent of dissemination were taken into c.nsideration. In th.s patient wh. presented with.spontaneous rupture of a small intestinal GIST, th. novel use of targeted th.rapy and aggressive surgic.l treatment produc.d reasonably good survival outc.me.

关键词： gastrointestinal stromal tumour h.moperitoneum small bowel GIST small bowel neoplasm imatinib