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Systematic sequential therapy for ex vivo liver resection and autotransplantation: A case report and review of literature

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World Journal of Gastrointestinal Surgery 2023年第11期15卷 2663-2673页

作者： Chen-Lu Hu Xin Han Zhen-Zhen Gao Bo Zhou Jin-Long Tang Xiang-Ru Pei Jie-Nan Lu Qin Xu Xiao-Ping Shen Sheng Yan Yuan Ding Department of Nursing The Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009Zhejiang ProvinceChina Department of Hepatobiliary and Pancreatic Surgery The Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009Zhejiang ProvinceChina Department of Pathology Zhejiang University School of MedicineThe Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009Zhejiang ProvinceChina

BACKGROUND Perihilar cholangiocarcinoma(pCCA)is a highly malignant tumor arising from the biliary *** surgery is the only treatment offering a chance of long-term ***,limited by the tumor’s anatomic location and peri-vascular invasion,most patients lose the chance for curative ***,more methods to increase the resectability of tumors as well as to improve outcomes are *** SUMMARY A 68-year-old female patient had a hepatic hilar mass without obvious *** results showed hepatitis B *** resonance imaging indicated that the mass(maximum diameter:41 mm)invaded the left and right branches of the main portal vein,as well as the middle,left and right hepatic veins;enlarged lymph nodes were also detected in the *** patient was diagnosed with pCCA,and the clinical stage was determined to be T4N1M0(stage IIIC).Considering the tumor’s anatomic location and vascular invasion,systematic conversion therapy followed by ex vivo liver resection and autotrans-plantation(ELRA)was determined as personalized treatment for this *** original systemic sequential therapeutic strategy(lenvatinib and tislelizumab in combination with gemcitabine and cisplatin)was successfully adopted as conversion therapy because she achieved partial response after three cycles of treatment,without severe ***,anastomotic reconstruction of the middle hepatic vein,right hepatic vein,root of portal vein,inferior vena cava and right hepatic artery,and lymph node dissection were performed at one month after systemic *** and immunohistochemical examination confirmed the diagnosis of pCCA with lymph node *** the middle hepatic vein was partially obstructed four months later,hepatic vein stent implantation successfully addressed this *** patient has survived for 22 mo after the diagnosis,with no evidence of recurrence or *** An effective therapeutic strategy for

关键词： Perihilar cholangiocarcinoma ex vivo liver resection and autotransplantation Systemic sequential therapy Conversion therapy Case report

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Complex inferior vena cava reconstruction during ex vivo liver resection and autotransplantation:A case report

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世界临床病例杂志 2023年第23期11卷 5602-5609页

作者： Jiayidaer Humaerhan Tie-Min Jiang Tuerganaili Aji Ying-Mei Shao Hao Wen Department of Hepatobiliary&Hydatid Diseases Digestive&Vascular Surgery CenterThe First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054Xinjiang Uygur Autonomous RegionChina State Key Laboratory of Pathogenesis Prevention and Management of High Incidence Diseases in Central AsiaThe First Clinical Medical College of Xinjiang Medical UniversityUrumqi 830054Xinjiang Uygur Autonomous RegionChina Xinjiang Clinical Research Center for Echinococcosis and Hepatobiliary Diseases First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054Xinjiang Uygur Autonomous RegionChina

BACKGROUND ex vivo liver resection and autotransplantation(ELRA)is an essential approach for treating patients with end-stage hepatic alveolar echinococcosis(AE),and its surgical indications involve severe invasion of important hepatic vessels,which makes in vivo resection *** is a major step in the process of ELRA,which is extremely challenging when the invaded vessels have huge *** SUMMARY Herein,we have reported the case of a 26-year-old patient with hepatic AE in an autologous liver graft who underwent complex inferior vena cava(IVC)reconstruction using disease-free IVC,autologous portal vein fragments,and umbilical vein within the ligamentum teres *** patient showed good surgical recovery without vascular-related complications during the long-term *** We reviewed three studies that have reported complex revascularization of the *** case report and systematic review showed that the use of autologous perihepatic vessels prevents donor-area trauma,immune rejection,and other adverse *** the blood vessel is severely invaded and a single vascular material cannot repair and reconstruct the defect,ELRA may provide a safe and feasible surgical approach,which has good prospects for clinical application.

关键词： Hepatic alveolar echinococcosis ex vivo liver resection and autotransplantation Inferior vena cava Revascularization Case report

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ex vivo liver resection and auto-transplantation and special systemic therapy in perihilar cholangiocarcinoma treatment

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 635-640页

作者： Konstantin Y Tchilikidi Department of Surgery with Postgraduate Education Altai State Medical UniversityBarnaul 656031Russia

This editorial contains comments on the article“Systematic sequential therapy for ex vivo liver resection and autotransplantation:A case report and review of li-terature”in the recent issue of World Journal of Gastrointestinal *** points out the actuality and importance of the article and focuses primarily on the role and place of ex vivo liver resection and autotransplantation(ELRAT)and systemic therapy,underlying molecular mechanisms for targeted therapy in perihilar cho-langiocarcinoma(pCCA)*** is a tough malignancy with a high proportion of advanced disease at the time of *** only curative option is radical *** excision and reconstruction become extremely com-plicated and not always could be performed even in localized *** the other hand,ELRAT takes its place among surgical options for carefully selected pCCA *** advanced disease,systemic therapy becomes a viable option to prolong *** editorial describes current possibilities in chemotherapy and reveals underlying mechanisms and projections in targeted therapy with ki-nase inhibitors and immunotherapy in both palliative and adjuvant ***-broblast grow factor and fibroblast grow factor receptor,human epidermal grow-th factor receptor 2,isocitrate dehydrogenase,and protein kinase cAMP activated catalytic subunit alpha(PRKACA)and beta(PRKACB)pathways have been ac-tively investigated in CCA in last *** agents were introduced and approved by the Food and Drug *** all demonstrated mean-ingful activity in CCA patients with no global change in *** is why every successfully treated patient counts,especially those with advanced *** conclusion,pCCA is still hard to treat due to late diagnosis and extremely complicated surgical *** also brings some hope,but it could be performed in very carefully selected *** disease requires systemic anticancer treatment,which is supposed to be indivi

关键词： Perihilar cholangiocarcinoma Klatskin’tumor ex vivo liver resection and autotransplantation Chemotherapy Immunotherapy Targeted therapy

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