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Improved anterior hepatic transection for isolated hepatocellular carcinoma in the caudate

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Hepatobiliary & Pancreatic Diseases International 2014年第2期13卷 219-222页

作者： TanTo Cheung WaiKey Yuen ronnie tp poon SeeChing Chan Sheung Tat Fan Chung Mau Lo Department of Surgery The University of Hong Kong Department of Surgery State Key Laboratory for Liver Research The University of Hong Kong

BACKGROUND: One of the best treatments for isolated hepatocellular carcinoma in the caudate lobe is major hepatectomy with caudate lobectomy, but it is not suitable for patients with poor liver function reserve. Isolated caudate lobectomy, which is a very difficult operation, is thus an alternative ***: Here we report an isolated caudate lobectomy with an anterior approach in the treatment of a large hepatocellular carcinoma with underlying cirrhosis, with focus on the technical ***: In the operation, both the left and right lobes of the liver were mobilized. Hepatotomy was done along the round ligament where parenchymal transection was minimal. After exposure of the left and middle hepatic veins and the hilar plate the caudate lobe and the tumor were resected en bloc with a5-mm ***: Isolated caudate lobectomy can be performed safely with this anterior approach on patients with poor liver function reserve.

关键词： hepatocellular carcinoma hepatectomy liver cirrhosis

Acute pancreatitis induced by transarterial chemoembolization:a single-center experience of over 1500 cases

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Hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 93-98页

作者： Wong Hoi She Albert CY Chan Tan To Cheung Kenneth SH Chok See Ching Chan ronnie tp poon Chung Mau Lo Division of Hepatobiliary & Pancreatic Surgery and Liver Transplantation Department of SurgeryThe University of Hong Kong

BACKGROUND： Acute pancreatitis is a relatively rare but po- tentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma. METHODS： A total of 1632 patients with hepatocellular car- cinoma who had undergone transarterial chemoembolization from ]anuary 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential com- plications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications. RESULTS： Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these pa- tients was 61 years. Most （79.6%） of the patients suffered from HBV-related hepatoceUular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin elut- ing bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven （0.4%） patients suffered from acute pancre- atitis post-chemoembolization. Six patients had chemoembo- lization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxornbicin eluting bead had a higher risk of acute pancreatitis [6/145 （4.1%） vs 1/1487 （0.1%）, P〈0.0001]. Two patients had anatomical arterial variations. Four patients developed acute pancreatitis- related complications including necrotizing pancreatitis （n=3） and pseudocyst formation （n=1）. All of the 4 patients resolved after the use of antibiotics and other conservative treatment. Three patients had further transarterial chemoembolization without any complication. CONCLUSIONS： Acute pancreatitis after transarterial chemo- embolization could result in serious complications, especially after treatment wit

关键词： transarterial chemoembolization acute pancreatitis hepatocellular carcinoma

High-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients awaiting liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 542-544页

作者： Tan To Cheung Kenneth SH Chok Regina CL Lo William W Sharr See Ching Chan ronnie tp poon Sheung Tat Fan Chung Mau Lo Department of Surgery The University of Hong Kong Department of Pathology The University of Hong Kong State Key Laboratory for Liver Research The University of Hong Kong

The scarcity of liver grafts in Asia leads to a significant dropout of patients from liver transplant waiting lists, particularly patients with hepatocellular carcinoma and a low model for end-stage liver disease score. In order to reduce dropping out, different bridging therapies are employed. We report the use of high-intensity focused ultrasound ablation as a bridging therapy for a patient with hepatocellular carcinoma of stage two and an extremely low platelet count (20×10 9 /L). The ablation was successful. Blood tests showed that his liver function was similar before and after the treatment. No adhesion was encountered in the liver transplantation performed six months later.

关键词： high-intensity focused ultrasound hepatocellular carcinoma liver cirrhosis liver transplantation bridging therapy

Rapid measurement of indocyanine green retention by pulse spectrophotometry: a validation study in 70 patients with Child-Pugh A cirrhosis before hepatectomy for hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2012年第3期11卷 267-271页

作者： Tan To Cheung See Ching Chan Kenneth SH Chok Albert CY Chan Wan Ching Yu ronnie tp poon Chung Mau Lo Sheung Tat Fan Department of Surgery the University of Hong Kong Department of Surgery and State Key Laboratory for Liver Research the University of Hong Kong

BACKGROUND: The indocyanine green (ICG) retention test is the most popular liver function test for selecting patients for major hepatectomy. Traditionally, it is done using spectrophotometry with serial blood sampling. The newly- developed pulse spectrophotometry is a faster alternative, but its accuracy on Child-Pugh A cirrhotic patients undergoing hepatectomy for hepatocellular carcinoma has not been well documented. This study aimed to assess the accuracy of the LiMON , one of the pulse spectrophotometry systems, in measuring preoperative ICG retention in these patients and to devise an easy formula for conversion of the results so that they can be compared with classical literature records where ICG retention was measured by the traditional method. METHODS: We measured the liver function of 70 Child-Pugh A cirrhotic patients before hepatectomy for hepatocellular carcinoma from September 2008 to January 2009. ICG retention at 15 minutes measured by traditional spectrophotometry (ICGR15) was compared with ICG retention at 15 minutes measured by the LiMON (ICGR15(L)). RESULTS: The median ICGR15 was 14.7% (5.6%-32%) and the median ICGR15(L) was 10.4% (1.2%-28%). The mean difference between them was -4.3606. There was a strong correlation between ICGR15 and ICGR15(L) (correlation coefficient, 0.844; 95% confidence interval, 0.762-0.899). The following formula was devised: ICGR15=1.16×ICGR15(L)+***: The LiMON provides a fast and repeatable way to measure ICG retention at 15 minutes, but with constant underestimation of the real value. Therefore, when comparing results obtained by traditional spectrophotometry and the LiMON, adjustment of results from the latter is necessary, and this can be done with a simple mathematical calculation using the above formula.

关键词： Child-Pugh A liver cirrhosis hepatocellular carcinoma indocyanine green clearance LiMON pulse spectrophotometry

The impact of family history of hepatocellular carcinoma on its patients' survival

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Hepatobiliary & Pancreatic Diseases International 2012年第2期11卷 160-164页

作者： Wing Chiu Dai Sheung Tat Fan Tan To Cheung Kenneth SH Chok Albert CY Chan Simon HY Tsang ronnie tp poon Chung Mau Lo Department of Surgery The University of Hong Kong 102 Pokfulam Road Hong Kong China State Key Laboratory for Liver Research The University of Hong Kong 102 Pokfulam Road Hong Kong China

BACKGROUND:Family history of hepatocellular carcinoma(HCC) has been identified as a risk factor for the development of the *** aim of this study is to evaluate the impact of such a history on HCC patients’ ***:Data of all HCC patients(n=4532) managed at our center from 1989 to 2008 were prospectively *** patients were quizzed on their various characteristics including family HCC ***:Totally 475(10.48%) patients had a family history of *** presented the disease at a significantly earlier age(median 53 vs 59 years,P<0.0001) and at an earlier stage(the United Network for Organ Sharing staging system).They had significantly better liver function in terms of ChildPugh classification and serum albumin and bilirubin *** more of them presented the disease without symptoms(44.0% vs 29.4%,P<0.0001).They also had significantly better overall survival under these specifications:patients in the whole study cohort,patients who had minor hepatectomy,patients with stage I disease,patients with stage II disease,and patients with stage III ***:Contrary to what is generally believed,we found in this study cohort that patients with a family history of HCC had better overall survival than those without such a *** believe this was in part due to earlier diagnosis of the disease and better liver function in this group of ***,the effects of genetic factors on the risk of HCC cannot be overlooked and are yet to be identified.

关键词： hepatocellular carcinoma family history resection survival risk factor

Pancreaticoduodenectomy with vascular reconstruction for adenocarcinoma of the pancreas with borderline resectability

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World Journal of Gastroenterology 2014年第46期20卷 17448-17455页

作者： Tan To Cheung ronnie tp poon Kenneth SH Chok Albert CY Chan Simon HY Tsang Wing Chiu Dai See Ching Chan Sheung Tat Fan Chung Mau Lo Department of Surgery Queen Mary HospitalUniversity of Hong Kong

AIM: To analyze whether pancreaticoduodenectomy with simultaneous resection of tumor-involved vessels is a safe approach with acceptable patient survival.

关键词： Adjuvant therapy Head of pancreas Liver transplant Morbidity Mortality Portal vein resection Survival analysis Whipple operation

Outcome of transarterial chemoembolization in patients with inoperable hepatocellular carcinoma eligible for radiofrequency ablation

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World Journal of Gastroenterology 2005年第29期11卷 4465-4471页

作者： Mike SL Liem ronnie tp poon Chung Mau Lo Wai Kuen Tso Sheung Tat Fan the Dutch Cancer Society Queen Wilhelmina Fund Amsterdam The Netherlands Centre for the Study of Liver Disease and Departments of Surgery and Radiology The University of Hong Kong Pokfulam Hong Kong China Department of Radiology The University of Hong Kong Pokfulam Hong Kong China

AIM： To evaluate the outcome of transarterial chemoembolization （TACE）in patients with unresectable hepatocellular cardnoma （HCC）〈5 cm in diameter eligible for radiofrequency ablation （RFA）. METHODS： The treatment-related mortality, morbidity, long-term survival, and prognostic factors of HCC patients who had TACE and fulfilled the present inclusion criteria for RFA were evaluated. RESULTS： Of the 748 patients treated with TACE between January 1990 and December 2002, 114 patients were also eligible for RFA. The treatment-related mortality and morbidity were 1% and 19%, respectively. Survival at 1, 3, and 5 years was 80%, 43%, and 23%, respectively. Older age and a high albumin level were associated with a better survival, whereas a high α-fetoprotein level （AFP） and the size of the largest tumor 〉3 cm in diameter were adverse prognostic factors in multivariate analysis. CONCLUSION： The morbidity, mortality, and survival data after TACE for small HCCs eligible for RFA are comparable to those reported after RFA in the literature. Our data suggest the need for a randomized comparison of the two treatment modalities for small HCCs.

关键词： Hepatocellular carcinoma Radiofrequency ablation Transarterial chemoembolization

Spreadsheet quality assurance:a literature review

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Frontiers of Computer Science 2024年第2期18卷 61-82页

作者： Pak-Lok poon Man Fai LAU Yuen Tak YU Sau-Fun TANG School of Engineering and Technology Central Queensland UniversityMelbourne 3000Australia Department of Computing Technologies Swinburne University of TechnologyHawthorn 3122Australia Department of Computer Science City University of Hong KongHong Kong SAR 999077China The Royal Victorian Eye and Ear Hospital East Melbourne 3002Australia

Spreadsheets are very common for information processing to support decision making by both professional developers and non-technical end ***,business intelligence and artificial intelligence are increasingly popular in the industry nowadays,where spreadsheets have been used as,or integrated into,intelligent or expert systems in various application ***,it has been repeatedly reported that faults often exist in operational spreadsheets,which could severely compromise the quality of conclusions and decisions based on the *** a view to systematically examining this problem via survey of existing work,we have conducted a comprehensive literature review on the quality issues and related techniques of spreadsheets over a 35.5-year period(from January 1987 to June 2022)for target journals and a 10.5-year period(from January 2012 to June 2022)for target *** other findings,two major ones are:(a)Spreadsheet quality is best addressed throughout the whole spreadsheet life cycle,rather than just focusing on a few specific stages of the life cycle.(b)Relatively more studies focus on spreadsheet testing and debugging(related to fault detection and removal)when compared with spreadsheet specification,modeling,and design(related to development).As prevention is better than cure,more research should be performed on the early stages of the spreadsheet life *** by our comprehensive review,we have identified the major research gaps as well as highlighted key research directions for future work in the area.

关键词： decision support system end-user computing end-user programming Excel spreadsheet

High-intensity focused ultrasound ablation:An effective bridging therapy for hepatocellular carcinoma patients

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World Journal of Gastroenterology 2013年第20期19卷 3083-3089页

作者： Tan To Cheung Sheung Tat Fan See Ching Chan Kenneth SH Chok Ferdinand SK Chu Caroline R Jenkins Regina CL Lo James YY Fung Albert CY Chan William W Sharr Simon HY Tsang Wing Chiu Dai ronnie tp poon Chung Mau Lo Department of Surgery the University of Hong Kong State Key Laboratory for Liver Research the University of Hong Kong Department of Diagnostic Radiology the University of Hong Kong Department of Anaesthesiology The University of Hong Kong Department of Pathology the University of Hong Kong Department of Medicine the University of Hong Kong

AIM:To analyze whether high-intensity focused ultrasound(HIFU) ablation is an effective bridging therapy for patients with hepatocellular carcinoma(HCC).METHODS:From January 2007 to December 2010,49 consecutive HCC patients were listed for liver transplantation(UCSF criteria).The median waiting time for transplantation was 9.5 ***-nine patients received transarterial chemoembolization(TACE) as a bringing therapy and 16 patients received no treatment before *** patients received HIFU ablation as a bridging *** five patients with the same tumor staging(within the UCSF criteria) who received HIFU ablation but not on the transplant list were included for *** were comparable in terms of Child-Pugh and model for end-stage liver disease scores,tumor size and number,and cause of ***:The HIFU group and TACE group showed no difference in terms of tumor size and tumor *** patient in the HIFU group and no patient in the TACE group had gross *** median hospital stay was 1 d(range,1-21 d) in the TACE group and two days(range,1-9 d) in the HIFU group(P < 0.000).No HIFU-related complication *** the HIFU group,nine patients(90%) had complete response and one patient(10%) had partial response to the *** the TACE group,only one patient(3%) had response to the treatment while 14 patients(48%) had stable disease and 14 patients(48%) had progressive disease(P = 0.00).Seven patients in the TACE group and no patient in the HIFU group dropped out from the transplant waiting list(P = 0.559).CONCLUSION:HIFU ablation is safe and effective in the treatment of HCC for patients with advanced *** may reduce the drop-out rate of liver transplant candidate.

关键词： Ablation Bridging therapy Cirrhosis Hepatocellular carcinoma High-intensity focused ultrasound Liver transplant New technology