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Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis

World Journal of Gastrointestinal Oncology 2021年第5期13卷 424-439页

作者： Omar Elshaarawy Aya Aman hazem Mohamed zakaria Talaat Zakareya Asmaa Gomaa Esam Elshimi Eman Abdelsameea Department of Hepatology Gastroenterology and Liver TransplantationNational Liver InstituteMenoufia UniversityShebine Elkom 32511MenoufiaEgypt Department of Hepatobiliary Pancreatic Surgery National Liver InstituteMenoufia UniversityShebine Elkom 32511MenoufiaEgypt

BACKGROUND Given the poor synthetic function of cirrhotic liver,successful resection for patients with hepatocellular carcinoma(HCC)necessitates the ability to achieve resections with tumor free *** To validate post hepatectomy liver failure score(PHLF),compare it to other established systems and to stratify risks in patients with cirrhosis who underwent curative liver resection for *** Between December 2010 and January 2017,120 patients underwent curative resection for HCC in patients with cirrhosis were included,the pre-operative,operative and post-operative factors were recorded to stratify patients'risks of decompensation,survival,and *** The preoperative model for end-stage liver disease(MELD)score[odds ratio(OR)=2.7,95%CI:1.2-5.7,P=0.013],tumor diameter(OR=5.4,95%CI:2-14.8,P=0.001)and duration of hospital stay(OR=2.5,95%CI:1.5-4.2,P=0.001)were significant independent predictors of hepatic decompensation after *** the preoperative MELD score[hazard ratio(HR)=1.37,95%CI:1.16-1.62,P<0.001]and different grades of PHLF(grade A:HR=2.33,95%CI:0.59-9.24;Grade B:HR=3.15,95%CI:1.11-8.95;Grade C:HR=373.41,95%CI:66.23-2105.43;P<0.001)and HCC recurrence(HR=11.67,95%CI:4.19-32.52,P<0.001)were significant independent predictors for *** Preoperative MELD score and tumor diameter can independently predict hepatic ***,preoperative MELD score,different grades of PHLF and HCC recurrence can precisely predict survival.

关键词： Cirrhosis Liver Resection Scores Hepatocellular carcinoma

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Small for size syndrome difficult dilemma: Lessons from 10 years single centre experience in living donor liver transplantation

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World Journal of Hepatology 2017年第21期9卷 930-944页

作者： Hany Shoreem Emad Hamdy Gad Hosam Soliman Osama Hegazy Sherif Saleh hazem zakaria Eslam Ayoub Yasmin Kamel Kalid Abouelella Tarek Ibrahim Ibrahim Marawan Hepatobiliary Surgery Department National Liver InstituteMenoufiya Univer-sity Anesthesia Department National Liver InstituteMenoufiya University

AIM To analyze the incidence, risk factors, prevention, treatment and outcome of small for size syndrome(SFSS) after living donor liver transplantation(LDLT). METHODS Through-out more than 10 years: During the period from April 2003 to the end of 2013, 174 adult-to-adults LDLT(A-ALDLT) had been performed at National Liver Institute, Menoufiya University, Shibin Elkoom, Egypt. We collected the data of those patients to do this cohort study that is a single-institution retrospective analysis of a prospectively collected database analyzing the incidence, risk factors, prevention, treatment and outcome of SFSS in a period started from the end of 2013 to the end of 2015. The median period of follow-up reached 40.50 m, range(0-144 m). RESULTS SFSS was diagnosed in 20(11.5%) of our recipients. While extra-small graft [small for size graft(SFSG)], portal hypertension, steatosis and left lobe graft were significant predictors of SFSS in univariate analysis(P = 0.00, 0.04, 0.03, and 0.00 respectively); graft size was the only independent predictor of SFSS on multivariate analysis(P = 0.03). On the other hand, there was lower incidence of SFSS in patients with SFSG who underwent splenectomy [4/10(40%) SFSS vs 3/7(42.9%) no SFSS] but without statistical significance, However, there was none significant lower incidence of the syndrome in patients with right lobe(RL) graft when drainage of the right anterior and/or posterior liver sectors by middle hepatic vein, V5, V8, and/or right inferior vein was done [4/10(28.6%) SFSS vs 52/152(34.2%) no SFSS]. The 6-mo, 1-, 3-, 5-, 7-and 10-year survival in patients with SFSS were 30%, 30%, 25%, 25%, 25% and 25% respectively, while, the 6-mo, 1-, 3-, 5-, 7-and 10-year survival in patients without SFSS were 70.1%, 65.6%, 61.7%, 61%, 59.7%, and 59.7% respectively, with statistical significant difference(P = 0.00). CONCLUSION SFSG is the independent and main factor for occurrence of SFSS after A-ALDLT leading to poor outcome. However, the mana

关键词： Living donor liver transplantation Outcome after living donor liver transplantation Small for size syndrome Small for size graft Portal inflow Venous outflow

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Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center

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World Journal of Gastrointestinal Surgery 2016年第9期8卷 634-642页

作者： hazem M zakaria John A Stauffer Massimo Raimondo Timothy A Woodward Michael B Wallace Horacio J Asbun Department of Hepatopancreatobiliary and Liver Transplantation Surgery National Liver Institute Menoufia University Al-Minufya 22732 Egypt Department of Surgery Mayo Clinic Jacksonville FL 32224 United States Department of Gastroenterology Mayo Clinic Jacksonville FL 32224 United States

AIM To identify the current indications and outcomes of total pancreatectomy at a high-volume center. METHODS A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was *** One hundred and three patients underwent totalpancreatectomy for indications including: Pancreatic ductal adenocarcinoma(n = 42, 40.8%), intraductal papillary mucinous neoplasms(n = 40, 38.8%), chronic pancreatitis(n = 8, 7.8%), pancreatic neuroendocrine tumors(n = 7, 6.8%), and miscellaneous(n = 6, 5.8%). The mean age was 66.2 years, and 59(57.3%) were female. Twenty-four patients(23.3%) underwent a laparoscopic total pancreatectomy. Splenic preservation and portal vein resection and reconstruction were performed in 24(23.3%) and 18 patients(17.5%), respectively. The 90 d major complications, readmission, and mortality rates were 32%, 17.5%, and 6.8% respectively. The 1-, 3-, 5-, and 7-year survival for patients with benign indications were 84%, 82%, 79.5%, and 75.9%, and for malignant indications were 64%, 40.4%, 34.7% and 30.9%, *** Total pancreatectomy, including laparoscopic total pancreatectomy, appears to be an appropriate option for selected patients when treated at a high-volume pancreatic center and through a multispecialty approach.

关键词： Intraductal papillary mucinous neoplasms Laparoscopic total pancreatectomy Pancreatic ductal adenocarcinoma Laparoscopy Pancreas cyst Pancreas cancer

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