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腹腔镜下左肝叶切除术：1例肝细胞癌合并肝硬化患者的视频报道

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中国普通外科杂志 2015年第1期24卷 10-11页

作者： giovanni Battista Levi Sandri giovanni vennarecci Roberto Santoro Pasquale Lepiane Marco Colasanti Giuseppe Maria Ettorre 意大利圣卡米洛医院肝移植与普通外科罗马

视频中的患者是1名51岁因肝细胞癌收治于外科和肝移植病房的患者。该患者合并HCV感染引起的肝硬化并门静脉高压形成及食管曲张形态为F1。Child-Pugh评分为B级7分,终末期肝病模型评分为11分,BMI指数为26.7,ASA评分为2分。既往无腹部手术... 详细信息

视频中的患者是1名51岁因肝细胞癌收治于外科和肝移植病房的患者。该患者合并HCV感染引起的肝硬化并门静脉高压形成及食管曲张形态为F1。Child-Pugh评分为B级7分,终末期肝病模型评分为11分,BMI指数为26.7,ASA评分为2分。既往无腹部手术史。多学科诊疗团队意见是为患者实施腹腔镜下左肝叶切除术。术中未采用Pringle法行肝门阻断。手术时间为193 min,失血量约为100 mL,术中无输血。患者术后恢复平稳,Clavien-Dindo分级为1级,并于术后第8天出院。笔者的经验是有经验的手术团队可以在需要手术的肝硬化患者中适当地实施腹腔镜手术。

关键词：癌,肝细胞肝切除术,腹腔镜肝硬化

Laparoscopic left liver lobectomy for hepatocellular carcinoma in a cirrhotic patient： a video report

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Chinese Journal of Cancer Research 2014年第6期26卷 735-736页

作者： giovanni Battista Levi Sandri giovanni vennarecci Roberto Santoro Pasquale Lepiane Marco Colasanti Giuseppe Maria Ettorre Division of General Surgery and Liver Transplantation San Camillo Hospital Rome Lazio Italy

We present a video case of a 51-year-old man admitted to our surgical and liver transplantation unit for hepatocellular cancer（HCC）. Patient has a HCV cirrhosis with portal hypertension and esophageal varices F1. Child Pugh score was B7 and model of end staged liver disease（MELD） was 11. Body mass index（BMI） was 26.7 and ASA score was 2. No previous abdominal surgery. According with our multidisciplinary group we suggest a laparoscopic left lobectomy for the patient. Pringle manoeuvre was not performed. Operation time was 193 min and blood loss estimation was 100 cc. No transfusion was required. Postoperative course was uneventful, grade I of Clavien-Dindo Classification. Patient was discharged in day 8. In our experience laparoscopic resection in cirrhotic liver should be performed in selected patients and in an experienced team.

关键词： Laparoscopic liver resection hepatocellular cancer(HCC) cirrhosis laparoscopic HCC liver transplantation

Complete resection of the hepatic veins: The role of right inferior vein

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Hepatobiliary & Pancreatic Diseases International 2018年第1期17卷 88-90页

作者： emanuele felli roberto l.meniconi marco colasanti giovanni vennarecci giuseppe m.ettorre division of general surgery and liver transplantation san camillo hospitalCirc.ne Gianicolense 87Rome 00152Italy

To the editor:In the recent years liver surgery has been dramatically improved because of technical and technological innovations,perioperative and intraoperative intensive care,better knowledge of liver physiology an... 详细信息

关键词： The role of right inferior vein Complete resection of the hepatic veins

Nerve growth factor involvement in liver cirrhosis and hepatocellular carcinoma

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World Journal of Gastroenterology 2007年第37期13卷 4986-4995页

作者： Guido Rasi Annalucia Serafino Lia Bellis Maria Teresa Lonardo Federica Andreola Manuela Zonfrillo giovanni vennarecci Pasquale Pierimarchi Paola Sinibaldi Vallebona Giuseppe Maria Ettorre Eugenio Santoro Claudio Puoti Institute of Neurobiology and Molecular Medicine National Research Council Rome Italy Hepatic Haemodynamic Unit Marino Hospital Rome Italy Division of Surgical Oncology and Liver Transplantation Regina Elena Cancer Institute Rome Italy Department of Experimental Medicine and Biochemical Science University of Rome "Tor Vergata" Rome Italy Department of Internal Medicine and DigestiveDiseases Marino Hospital Rome Italy

AIM: To define NGF (nerve growth factor) and its high- affinity receptor trkANGF presence and distribution in fibrotic liver and in HCC, and to verify if NGF might have a role in fibrosis and HCC. METHODS: Intracellular distribution of NGF and trkANGF were assessed by immunohistochemistry and immuno- electron microscopy in liver specimens from HCC, cirrhosis or both. ELISA was used to measure circulating NGF levels. RESULTS: NGF and trkANGF were highly expressed in HCC tissue, mainly localized in hepatocytes, endothelial and some Kupffer cells. In the cirrhotic part of the liver they were also markedly expressed in bile ducts epithelial and spindle-shaped cells. Surprisingly, in cirrhotic tissue from patients without HCC, both NGF and trkANGF were negative. NGF serum levels in cirrhotic and/or HCC patient were up to 25-fold higher than in controls. CONCLUSION: NGF was only detected in liver tissue with HCC present. Intracellular distribution suggests paracrine and autocrine mechanisms of action. Better definition of mechanisms may allow for therapeutic and diagnostic/prognostic use of NGF.

关键词： Nerve growth factor Hepatocellular carcinoma Liver cirrhosis Confocal microscopy Transmission electron microscopy

Left hepatectomy with concomitant cavo-atrial and biliary tumor thrombectomy for invasive hepatocellular carcinoma:a video report

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Hepatobiliary Surgery and Nutrition 2018年第2期7卷 116-119页

作者： Lidia Castagneto Gissey Layla Musleh Germano Mariano giovanni vennarecci Andrea Scotti Marco Colasanti Roberto Luca Meniconi Alessandra Campanelli Cristian Astudillo Diaz Giuseppe Maria Ettorre Division of General Surgery and Liver Transplantation San Camillo-Forlanini HospitalRomeItaly Department of Surgical Sciences Sapienza University of RomeRomeItaly

Introduction Representing the prevalent primary hepatic malignancy,hepatocellular carcinoma(HCC)is concurrently the sixth most common cancer worldwide and the third dominant cause of mortality due to cancer(1,2).The preponderance of such neoplasms is secondary to cirrhosis,primarily induced by viral hepatitis,alcohol abuse or exposure to other *** the last decades,however,metabolic disorders such as obesity and insulin resistance,have established as key players in the chronic damage of liver parenchyma,eventually contributing to the development of the large spectrum of chronic hepatopathies known as non-alcoholic fatty liver disease(NAFLD)(3).

关键词： neoplasms hepatocellular mortality

Effectiveness and versatility of biological prosthesis in transplanted patients

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World Journal of Transplantation 2017年第1期7卷 43-48页

作者： giovanni vennarecci Gianluca Mascianà Edoardo De Werra giovanni Battista Levi Sandri Daniele Ferraro Mirco Burocchi giovanni Tortorelli Nicola Guglielmo Giuseppe Maria Ettorre Division of Surgical Oncology and Liver Transplantation San Camillo Hospital POIT San Camillo-INMI Lazzaro Spallanzani

AIM To emphasize the effectiveness and versatility of prosthesis, and good tolerance by patients with incisional hernia(IH). METHODS From December 2001 to February 2016, 270 liver transplantations were performed at San Camillo Hospital. IH occurred in 78 patients(28.8%). IH usually appeared early within the first year post-orthotopic liver transplantation. In the first era, fascial defect was repaired by primary closure for defects smaller than 2.5 cm or with synthetic mesh for greater defects. Recently, we started using biological mesh(Permacol?, Covidien). We present a series of five transplanted patients submitted to surgery for abdominal wall defect correction repaired with biological mesh(Permacol?, Covidien). RESULTS In our cases, the use of biological prosthesis(Permacol?, Covidien) have proven to be effective and versatile in repairing hernia defects of different kinds; patients did not suffer infections of the prosthesis and no recurrence was observed. Furthermore, the prosthesis remains intact even in the years after surgery. CONCLUSION The cases that we presented show that the use of biological mesh(Permacol?, Covidien) in transplanted patients may be safe and effective, being careful in the management of perioperative immunosuppression andrenal and graft function, although the cost of the product itself has been the main limiting factor and there is need for prospective studies for further evaluations.

关键词： Incisional hernia Liver transplantation Heart transplantation Biological mesh Surgery Morbidity Risk factors Immunosuppression Infection Recurrence

Liver transplantation for recurrent hepatic adenoma

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World Journal of Hepatology 2013年第3期5卷 145-148页

作者： giovanni vennarecci Roberto Santoro Mario Antonini Cecilia Ceribelli Andrea Laurenzi Enrico Moroni Mirco Burocchi Pasquale Lepiane Giuseppe Maria Ettorre Division of Liver Transplantation San Camillo Hospital Intensive Care Unit National Institute for Infectious Disease "Lazzaro Spallanzani"

Hepatic adenoma (HA) is a rare indication for liver transplantation (LTx). So far 20 cases of LTx for HA are reported in PubMed. In rare cases HA presents as multiple hepatic adenomas or recurrent adenoma after initial liver resection and in such cases LTx is the only potential cure and prevents the risk of bleeding or cancer transformation into hepatocellular carcinoma. We report the case of a 56 years old lady who underwent a left hepatectomy for giant adenoma in 2005 and resection of segment Ⅴ-Ⅵ for recurrence of liver adenoma in 2007. She developed a second recurrence of HA with 3 new lesions in the right liver in 2008. The patient underwent LTx. After 3 years the patient is alive with no evidence of disease. LTx is indicated in patients with HA in which resection is not technically feasible.

关键词： Liver transplantation Liver adenoma Liver resection Recurrent disease Immunosuppression