检索结果-南通市图书馆

Early control of short hepatic portal veins in isolated or combined hepatic caudate lobectomy

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2012年第4期11卷 377-382页

作者： wan-yee lau Faculty of Medicine The Chinese University of Hong KongShatinNew TerritoriesHong Kong SARChina

BACKGROUND:Caudate lobectomy has long been considered technically *** study aimed to elaborate the significance of early control of short hepatic portal veins(SHPVs) in isolated hepatic caudate lobectomy or in hepatic caudate lobectomy combined with major partial hepatectomy,and to describe the anatomical characteristics of ***:The data of 117 patients who underwent either isolated or combined caudate lobectomy by the same team of surgeons from 2005 to 2009 were retrospectively *** 2005 to 2007(group A,n=55),we carried out early control of short hepatic veins(SHVs) only;from 2008 to 2009(group B,n=62),we carried out early control of both SHVs and *** two groups were compared to evaluate which surgical procedure was better.A detailed anatomical study was then carried out on the last 25 consecutive patients in group B to study the number and distribution of SHPVs during ***:Patients in group B had less intra-operative blood loss,less impairment of liver function,shorter postoperative hospital stay,fewer postoperative complications and required less blood transfusion(P<0.05).The number of SHPVs in the 25 patients was 183,with 7.3±2.7 per *** diameters of SHPVs were 1 to 4 *** average,3.4 SHPVs/patient came from the left portal vein,2.2 from the bifurcation,1.4 from the right portal vein,and 0.3 from the main portal *** average,3.3 SHPVs/patient supplied segment I of the liver,0.4 for segment II,2.1 for segment IV,1.4 for segment V and 0.1 for segment ***:Early control of SHPVs in isolated or combined hepatic caudate lobectomy may be a useful method to decrease surgical risk and improve postoperative recovery.

关键词： short hepatic portal vein caudate lobe anatomy

Current controversies and challenges for resection of pancreatic ductal adenocarcinoma in pancreatic head aiming at cure

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2023年第2期22卷 111-112页

作者： wan yee lau Faculty of Medicine the Chinese University of Hong KongPrince of Wales HospitalShatinHong Kong SARChina

Pancreatic ductal adenocarcinoma(PDAC) is a very common but a highly lethal malignancy due to its biological aggressive behavior. PDAC more commonly affects the head than other parts of the pancreas. As PDAC in the head of pancreas is located at an anatomical position with a lot of adjacent vital structures, and the cornerstone of treatment aiming at cure is pancreaticoduodenectomy(PD).

关键词： adenocarcinoma ductal pancreas

Modified conventional clamp-crushing technique in liver parenchymal transection

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2012年第4期11卷 442-445页

作者： wan-yee lau Faculty of Medicine The Chinese University of Hong KongShatinHong Kong SARChina

Significant intraoperative bleeding and injuries to vital structures in the liver remnant can occur during liver parenchymal transection using the conventional clampcrushing *** performed liver resection on 242 patients using a mosquito clamp-crushing technique combined with a self-assembled saline-linked diathermy for liver parenchymal *** mean blood loss was 215 mL(range 20-1100).There was no damage to the vital structures in the liver *** mean liver transection time was 53 minutes(range 15-125).Our technique has the advantages of reducing blood loss,exposing vessles clearly and being simple,cheap and efficacious.

关键词： hepatectomy hepatocellular carcinoma liver neoplasm

Modifications of ALPPS–from complex to more complex or from complex to less complex operations

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2017年第4期16卷 346-352页

作者： wan yee lau Eric CH Lai Faculty of Medicine The Chinese University of Hong KongShatinNew TerritoriesHong Kong SARChina Department of Surgery Pamela Youde Nethersole Eastern HospitalHong Kong SARChina

BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been developed to induce rapid liver hypertrophy to reduce the chance of post-hepatectomy liver failure in patients with borderline or insufficient future liver remnant. ALPPS is still in an early developmental stage and its techniques have not been standardized. This study aimed to review the technical modifications of the conventional ALPPS procedure. DATA SOURCES: Studies were identified by searching MEDLINE and PubMed for articles published from January 2007 to December 2016 using the keywords 'associating liver partition and portal vein ligation for staged hepatectomy' and 'ALPPS'. Additional articles were identified by a manual search of references from key articles. RESULTS: There have been a lot of modifications of the conventional ALPPS. These are classified as: (1) modifications aiming to improve surgical results; (2) modifications aiming to expand surgical indications; (3) salvage ALPPS; (4) ALPPS using the minimally invasive approach. Some of these modifications have made the conventional ALPPS procedure to become even more complex, although there have also been other attempts to make the procedure less complex. The results of most of these modifications have been reported in small case series or case reports. We need better well-designed studies to establish the true roles of these modifications. However, it is interesting to see how this conventional ALPPS procedure has evolved since its introduction. CONCLUSIONS: There is a trend for the use of minimally invasive procedure in the phase 1 or 2 of the conventional ALPPS procedure. Some of these modifications have expanded the use of ALPPS in patients who have been considered to have unresectable liver tumors. The long-term oncological outcomes of these modifications are still unknown.

关键词： associating liver partition and portal vein ligation for stage hepatectomy hepatocellular carcinoma hepatectomy liver metastasis portal vein embolization

Associating liver partition and portal vein ligation for staged hepatectomy： the current role and development

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2017年第1期16卷 17-26页

作者： wan yee lau Eric CH Lai Stephanie HY lau Faculty of Medicine The Chinese University of Hong Kong Shatin New Territories Department of Surgery Pamela Youde Nethersole Eastern Hospital Department of Surgery Queen Elizabeth Hospital Hong Kong China

BACKGROUND： Associating liver partition and portal vein ligation for staged hepatectomy （ALPPS） has recently been developed to induce rapid liver hypertrophy and reduce posthepatectomy liver failure in patients with insufficient future liver remnant （FLR）. ALPPS is still considered to be in an early developmental phase because surgical indications and techniques have not been standardized. This article aimed to review the current role and future developments of ALPPS. DATA SOURCES： Studies were identified by searching MED- LINE and PubMed for articles from January 2007 to October 2016 using the keywords ＂associating liver partition and portal vein ligation for staged hepatectomy＂ and ＂ALPPS＂ Addi- tional papers were identified by a manual search of references from key articles. RESULTS： ALPPS induces more hypertrophy of the FLR in less time than portal vein embolization or portal vein ligation. The benefits of ALPPS include rapid hypertrophy 47%-110% of the liver over a median of 6-16.4 days, and 95%-100% com- pletion rate of the second stage of ALPPS. The main criticisms of ALPPS are centered on its high morbidity and mortality rates. Morbidity rates after ALPPS have been reported to be 15.3%-100%, with ≥ the Clavien-Dindo grade III morbidity of 13.6%-44%. Mortality rates have been reported to be 0%-29%. The important questions to ask even if oncologic long-term results are acceptable are： whether the gain in quality and quantity of life can be off balance by the substantial risks of morbidity and mortality, and whether stimulation of rapid liver hypertrophy also accelerates rapid tumor progression and spread. Up till now, the documentations of the ALPPS procedure come mainly from case series, and most of these series include heterogeneous groups of malignancies. The numbers are also too small to separately evaluate survival for different tumor etiologies. CONCLUSIONS： Currently, knowledge on ALPPS is limited, and prospective randomized studies are lacking. From th

关键词： associating liver partition and portal vein ligation for staged hepatectomy portal vein embolization laparoscopy colorectal liver metastases hepatocellular carcinoma

Current therapy of hilar cholangiocarcinoma

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2012年第1期11卷 12-17页

作者： Stephanie Hiu Yan lau wan yee lau Faculty of Medicine The Chinese University of Hong Kong

BACKGROUND: Hilar cholangiocarcinoma (HC) is an adeno-carcinoma of the extrahepatic biliary tree arising from the main left or right hepatic ducts or their confluence. This tumor is still considered to be difficult to treat or to cure. DATA SOURCES: We reviewed the medical literature on HC. Relevant and updated information on this tumor was analyzed in a concise and easy-to-read manner. The article is not intended to be a systematic review, but an extensive search was conducted on PubMed and MEDLINE using the keywords 'hilar cholangiocarcinoma' and 'Klatskin tumor' until July 2011. RESULTS: The selection and the timing of management options for patients with HC are determined by the degree of certainty of the diagnosis, the general condition of the patients, the underlying liver function and the stage of the disease. Current treatment of HC can be divided into curative and palliative treatment. For the curative treatment, local excision should only be used on small tumors which are confined to the bile duct wall and Bismuth I papillary carcinoma. Partial hepatectomy should be combined with caudate lobe resection and porta-hepatis lymph node dissection. The results of these major resections can be improved with portal vein embolization, and staging laparoscopy and laparoscopic ultrasound. The role of preoperative biliary drainage is controversial. Autotransplantation for HC gave disappointing results while the Mayo Protocol of chemoradiation for selecting patients with unresectable HC for orthotopic liver transplantation has been widely accepted. Palliative treatment included bypass surgery, endoscopic or percutaneous stenting, photodynamic therapy, intraluminal brachytherapy, and external radiation and systemic therapy. CONCLUSIONS: Adequate surgery with R0 resection should be the main goal of treatment. For patients with unresectable HC, treatment aims to improve the quality and quantity of their survival.

关键词： hilar cholangiocarcinoma Klatskin tumor resection liver transplantation palliative treatment

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and its further developments in the last decade

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary Surgery and Nutrition 2019年第3期8卷 258-259页

作者： wan yee lau Faculty of Medicine The Chinese University of Hong KongHong KongChina

The Editor-in-Chief of Hepatobiliary Surgery and Nutrition invited me to write an Editorial on the article entitled"10th Anniversary of ALPPS-Lessons Learned and quo Vadis"by Lang et *** was published in the 2019 January issue of Annals of Surgery(1).This article was coauthored by 15 world-renowned experts in associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)who met during the 12th Biennial Congress of the European-African Hepato-Pancreato-Biliary Association in Mainz,Germany from 23 to 26 May,*** aim of the meeting and the subsequently published article was to make"the most updated inventory of what has been achieved,and what remains unclear in ALPPS".

关键词： Surgery ALPPS partition

The current role of radiofrequency ablation in the treatment of hepatocellular carcinoma

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2017年第2期16卷 122-126页

作者： wan yee lau Stephanie Hiu Yan lau Faculty of Medicine The Chinese University of Hong Kong Shatin New Territories Hong Kong SAR China

Local ablative therapy is used in treating liver tumors by either injection of cytotoxic agents（chemicals,radioactive isotopes,hyperthermic agents or chemotherapeutic agents）or application of an energy source to ach... 详细信息

关键词： HCC The current role of radiofrequency ablation in the treatment of hepatocellular carcinoma RFA

Hemodynamics and oxygen transport dynamics during hepatic resection at different central venous pressures in a pig model

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2011年第5期10卷 516-520页

作者： wan-yee lau Eric CH Lai Department of Hepatic and Biliary Surgery First Affiliated Hospital Guangxi Medical University Faculty of Medicine the Chinese University of Hong Kong Shatin New Territories Hongkong SAR China

BACKGROUND: Although low central venous pressure (CVP) has been used to minimize blood loss during hepatectomy the impact of variations of CVP on the rate of blood loss and on the perfusion of end-organs has not been evaluated This animal study aimed to evaluate the hemodynamics and oxygen transport changes during hepatic resection at different CVP levels. METHODS: Forty-eight anesthetized Bama miniature pigs were divided into 8 groups with CVP during hepatic resection controlled at 0 to <1, 1 to <2, 2 to <3, 3 to <4, 4 to <5, 5 to <6, 6 to <7, and 7 to <8 cmH 2 O. Intergroup comparisons were made for hemodynamic parameters, oxygen transport dynamics, and the rate of blood loss. RESULTS: The rate of blood loss and the hepatic venous pressure during hepatic resection were almost linearly related to the CVP. A significant drop in the mean arterial pressure cardiac output, and cardiac index occurred between CVP ≥2 and <2 cmH 2 O. Oxygen delivery (DO 2 ), oxygen consumption (VO 2 ) and oxygen extraction ratio (ERO 2 ) remained relatively constant between CVPs of 2 to <8 cmH 2 O. There was a significant drop in DO 2 when the CVP was <2 cmH 2 O. There was also a significant drop in VO 2 and ExO 2 when the CVP was <1 cmH 2 ***: The optimal CVP for hepatic resection is 2to 3 cmH2O.

关键词： hepatectomy hemorrhage central venous pressure tissue oxygenation hemodynamics