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Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma

World Journal of Clinical Oncology 2024年第3期15卷 381-390页

作者： Maryam Makki Malak Bentaleb Mohammed Abdulrahman Amal Abdulla Suhool Salem Al Harthi Marcelo AF Ribeiro Jr Department of surgery Division of TraumaCritical Care and Acute Care SurgerySheikh Shakhbout Medical CityAbu Dhabi 11001United Arab Emirates Department of surgery College of Medicine and Health SciencesKhalifa UniversityAbu Dhabi 11001United Arab Emirates Department of surgery Division of Hepato-Pancreato-Biliary(HPB)SurgerySheikh Shakhbout Medical CityAbu Dhabi 91888United Arab Emirates

Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or *** tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced ***,several palliative treatment options are available for primary biliary tract *** include percutaneous transhepatic biliary drainage(PTBD),biliary stenting,and surgical interventions such as biliary *** therapy is also commonly used for the palliative treatment of primary biliary tract *** involves the administration of chemotherapy drugs,such as gemcitabine and cisplatin,which have shown promising results in improving overall survival in patients with advanced biliary tract *** is another palliative treatment option for patients with unresectable or inoperable malignant biliary *** stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary *** interventions,such as biliary diversion,have traditionally been used as palliative options for primary biliary tract ***,biliary diversion only provides temporary relief and does not remove the *** biliary tract tumors often present in advanced stages,making palliative treatment the primary option for improving the quality of life of patients.

关键词： Cholangiocarcinoma Palliative care Endoscopic treatment surgery Complications Interventional radiology

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Choice of approach for hepatectomy for hepatocellular carcinoma located in the caudate lobe:Isolated or combined lobectomy?

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World Journal of Gastroenterology 2012年第29期18卷 3904-3909页

作者： Peng Liu Bao-An Qiu Gang Bai Hong-Wei Bai Nian-Xin Xia Ying-Xiang Yang Jian-Yong Zhu Yang An Bing Hu Department of Hepato-biliary surgery anti liver Transplantation surgery Navy General Hospital Beijing 100048 China

AIM:To investigate the significance of the surgical approaches in the prognosis of hepatocellular carcinoma(HCC) located in the caudate lobe with a multivariate regression analysis using a Cox proportional hazard ***:Thirty-six patients with HCC underwent caudate lobectomy at a single tertiary referral center between January 1995 and June *** this series,left-sided,right-sided and bilateral approaches were *** outcomes of patients who underwent isolated caudate lobectomy or caudate lobectomy combined with an additional partial hepatectomy were *** survival curves of the isolated and combined resection groups were generated by the Kaplan-Meier method and compared by a log-rank ***:Sixteen(44.4%) of 36 patients underwent isolated total or partial caudate lobectomy whereas 20(55.6%) received a total or partial caudate lobectomy combined with an additional partial *** median diameter of the tumor was 6.7 cm(range,2.1-15.8 cm).Patients who underwent an isolated caudate lobectomy had significantly longer operative time(240 min vs 170 min),longer length of hospital stay(18 d vs 13 d) and more blood loss(780 mL vs 270 mL) than patients who underwent a combined caudate lobectomy(P < 0.05).There were no perioperative deaths in both groups of *** complication rate was higher in the patients who underwent an isolated caudate lobectomy than in those who underwent combined caudate lobectomy(31.3% vs 10.0%,P < 0.05).The 1-,3-and 5-year disease-free survival rates for the isolated caudate lobectomy and the combined caudate lobectomy groups were 54.5%,6.5% and 0% and 85.8%,37.6% and 0%,respectively(P < 0.05).The corresponding overall survival rates were 73.8%,18.5% and 0% and 93.1%,43.6% and 6.7%(P < 0.05).CONCLUSION:The caudate lobectomy combined with an additional partial hepatectomy is preferred because this approach is technically less demanding and offers an adequate surgical margin.

关键词： Hepatocellular carcinoma Hepatectomy Caudate lobectomy Caudate lobe Combined resection

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Retroaortic left renal vein associated to variations of liver vasculature and biliary system in a patient submitted to total pancreatectomy

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 526-529页

作者： Alessandro Fancellu Mario Maiore Lavinia Grasso Miriam Ferrara Alberto Porcu Department of Medicine Surgery and PharmacyUnit of General Surgery 2-Clinica ChirurgicaUniversity of SassariSassari 07100Italy Department of Medicine Surgery and PharmacyUnit of RadiologyUniversity of SassariSassari 07100Italy

Total pancreatectomy(TP) is a surgical procedure which includes the complete removal of the pancreatic gland, the spleen, the duodenum, the gallbladder, and the distal part of the stomach. TP represents the curative treatment of pancreatic cancer which simultaneously involves the head and the body/tail of the pancreas. Other possible indications for TP comprise multifocal parenchymal diseases, such as intraductal papillary mucinous neoplasms, pancreatic neuroendocrine tumors, multiple endocrine neoplasms, and chronic pancreatitis. Sometimes, TP is carried out in patients scheduled for pancreaticoduodenectomy(where only the head of the pancreas is removed) when a cancer located in the pancreatic head is intraoperatively found to also extend to the pancreatic body [1].

关键词： neoplasms stomach spleen

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COVID-19 in liver Transplant Recipients-A Series with Successful Recovery

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Journal of Clinical and Translational Hepatology 2020年第4期8卷 467-473页

作者： Ashok Choudhury Golamari Srinivasa Reddy Shantan Venishetty Viniyendra Pamecha Saggere Muralikrishna Shasthry Arvind Tomar Lalita Gauri Mitra Venkata Siva Tez Prasad Rajendra Prasad Mathur Debajyoti Bhattacharya Shiv Kumar Sarin Department of Hepatology and liver Transplant Institute of Liver and Biliary SciencesNew DelhiIndia Department of HPB surgery and liver Transplant Institute of Liver and Biliary SciencesNew DelhiIndia Department of Pulmonary Medicine Institute of Liver and Biliary SciencesNew DelhiIndia Department of Critical Care Medicine Institute of Liver and Biliary SciencesNew DelhiIndia Department of Nephrology Institute of Liver and Biliary SciencesNew DelhiIndia

The severe acute respiratory syndrome corona virus-2 (referred to as SARS-CoV-2) pandemic had a great impact on public life in general as well as on populations with pre-existing disease and co-morbidities. liver transplant and immunosuppressant medication predisposes to more severe disease and is often associated with poor outcome. The clinical features, disease course, treatment and process of modulating the immunosuppression is challenging. Here, we describe the clinical presentation, treatment and outcomes in six liver transplant recipients. Out of those six patients, three had mild, one had moderate and one had severe COVID-19, and one was asymptomatic. The immunosup-pression minimization or withdrawal was done based upon the clinical severity. Consideration of tocilizumab and/or convalescent plasma as well as antivirals i.e. remdesvir done in severe cases. The routine practice of prophylactic anti-coagulation, consideration of repurposed drugs (i.e. teico-planin and doxycycline), and watchful monitoring of asymptomatic recipients helped to achieve an uneventful recovery.

关键词： liver transplant COVID-19 SARS-CoV-2 liver injury Remdesivir Convalescent plasma

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Selective internal radiation therapy segmentectomy:A new minimally invasive curative option for primary liver malignancies?

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World Journal of Gastroenterology 2024年第18期30卷 2379-2386页

作者： Riccardo Inchingolo Francesco Cortese Antonio Rosario Pisani Fabrizio Acquafredda Roberto Calbi Riccardo Memeo Fotis Anagnostopoulos Stavros Spiliopoulos Unit of Interventional Radiology “F.Miulli”Regional General HospitalBari 70021Italy Interdisciplinary Department of Medicine Section of Nuclear MedicineUniversity of Bari“Aldo Moro”Bari 70121Italy Department of Radiology General Regional Hospital“F.Miulli”Acquaviva delle Fonti 70021Italy Unit of Hepato-Pancreatic-biliary surgery “F.Miulli”Regional General HospitalBari 70021Italy The Second Radiology Department National and Kapodistrian University of AthensChaidari Athens 12461Greece

Transarterial radioembolization or selective internal radiation therapy(SIRT)has emerged as a minimally invasive approach for the treatment of *** percutaneous technique involves the local,intra-arterial delivery of radioactive microspheres directly into the *** employed as a palliative measure for liver malignancies,SIRT has gained traction over the past decade as a potential curative option,mirroring the increasing role of radiation *** latest update of the BCLC hepatocellular carcinoma guidelines recognizes SIRT as an effective treatment modality comparable to other local ablative methods,particularly well-suited for patients where surgical resection or ablation is not *** segmentectomy is a more selective approach,aiming to deliver high-dose radiation to one to three specific hepatic segments,while minimizing damage to surrounding healthy *** research efforts in radiation segmentectomy should prioritize optimizing radiation dosimetry and refining the technique for super-selective administration of radiospheres within the designated hepatic segments.

关键词： Transarterial radioembolization Selective internal radiation therapy Radiation segmentectomy Hepatocellular carcinoma Primary liver malignancies Personalised dosimetry

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Unveiling hidden outcomes in malignant gastric outlet obstruction research–insights from a"Pancreas 2000"review

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World Journal of Gastrointestinal Endoscopy 2024年第8期16卷 451-461页

作者： Filipe Vilas-Boas Giacomo Emanuele Maria Rizzo Charles De Ponthaud Stuart Robinson Sebastien Gaujoux Gabriele Capurso Giuseppe Vanella Bahadır Bozkırlı Department of Gastroenterology São João University HospitalPorto 4200Portugal Endoscopy Service Department of Diagnostic and Therapeutic ServicesScientific Institute for ResearchHospitalization and Healthcare-The Mediterranean Institute for Transplantation and Highly Specialized TherapiesPalermo 90127SiciliaItaly Department of Digestive Hepato-Biliary and Pancreatic Surgery and Liver TransplantationAP-HP Pitié-SalpêtriereSorbonne UniversitéParis 75013Île-de-FranceFrance Department of Hepatobiliary Pancreatic and Transplant SurgeryFreeman HospitalNewcastle NE77DNNewcastle upon TyneUnited Kingdom Division of Pancreato-biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy Department of General surgery HPB-UnitAcıbadem Maslak HospitalIstanbul 34398Türkiye

Malignant gastric outlet obstruction(mGOO)is a major condition affecting patients with periampullary tumors,including pancreatic *** current treatment options include surgical gastroenterostomy,endoscopic stenting and more recently EUS-guided *** studies comparing the outcomes of the three procedures focus on technical success,clinical success and ***“occult”outcomes relevant to the patient’s viewpoints and perspective may ultimately impact on cancer-related and overall survival,such as body mass composition,nutritional biomarkers,chemotherapy tolerance and patient-reported quality of *** aim of this review is to provide an overview of potential key outcomes that should be explored in future comparative research around mGOO treatment options.

关键词： Malignant gastric outlet obstruction Endoscopic ultrasound-guided gastroenterostomy Patient-reported outcomes Body composition Nutrition Quality of life

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Imaging panorama in postoperative complications after liver transplantation

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Gastroenterology Report 2016年第2期4卷 96-106,I0001页

作者： Binit Sureka Kalpana Bansal S Rajesh Amar Mukund Viniyendra Pamecha Ankur Arora Department of Radiology/Interventional Radiology Institute of Liver and Biliary SciencesVasant KunjNew DelhiIndia Department of Hepatobiliary surgery Institute of Liver and Biliary SciencesVasant KunjNew DelhiIndia

The liver is the second most-often transplanted solid organ after the kidney,so it is clear that liver disease is a common and serious problem around the *** the advancements in surgical,oncological and imaging techniques,orthotopic liver transplantation has become the first-line treatment for many patients with end-stage liver ***,and Doppler are the most economical and cost-effective imaging modalities for evaluating postoperative fluid collections and vascular *** tomography(CT)is used to confirm the findings of ultrasound and look for pulmonary *** resonance imaging(MRI)is used for the diagnosis of biliary complications,bile leaks and neurological *** article illustrates the imaging options for diagnosing the various complications that can be encountered in the postoperative period after liver transplantation.

关键词： liver transplant postoperative complications imaging

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Is biliary bile acid a good predictor for acute cellular rejection in living donor liver transplantation?

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Hepatobiliary & Pancreatic Diseases International 2009年第5期8卷 474-478页

作者： Mohammed Saied Hedaya Walid M.El Moghazy Yamamoto Yasutomo Tomioka Kiyoshi oshimi Kaido Hiroto Egawa Shinji Uemoto Yasutsugu Takada Department of Hepato-pancreatic-biliary surgery and liver Transplantation Kyoto University HospitalKyotoJapan

BACKGROUND:In liver transplantation,acute cellular rejection(ACR)is still a major complication that can lead to *** secretion has been considered as a marker of early graft function. METHODS:The study included 41 adults who received living donor liver transplantation(LDLT)at Kyoto University Hospital between April 2007 and February 2008. The patients were stratified according to the presence or absence of *** samples were collected from donors once and from recipients every other day for the first 2 weeks after *** bile acid(BA)and taurine-conjugated bile acid(TCBA)in bile were measured by magnetic resonance *** recipient/donor (R/D)BA ratio and R/D TCBA ratio were calculated. RESULTS:The ACR group(n=12)showed a greater decrease in BA post-transplantation than the non-ACR group,but this difference was not statistically significant. On both day 7 and day 9 post-transplantation the R/D TCBA was significantly different between the two groups (P=0.038 on day 7 and P=0.036 on day 9).The R/D TCBA ratio≥0.5 on days 7 and 9,and≥0.38 on day 11 post- transplantation were associated with better ACR-free survival. CONCLUSION:The recipient/donor TCBA ratio can be a predictor for ACR after LDLT as early as post- transplantation day 7.

关键词： biliary bile acids acute cellular rejection living donor liver transplantation

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Danhongqing formula alleviates cholestatic liver fibrosis by downregulating long non-coding RNA H19 derived from cholangiocytes and inhibiting hepatic stellate cell activation

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Journal of Integrative Medicine 2024年第2期22卷 188-198页

作者： Meng Li Yang Zhou Hui Zhu Lie-ming Xu Jian Ping Institute of liver Diseases Shuguang HospitalShanghai University of Traditional Chinese MedicineShanghai 201203China Preventive Treatment Center Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 200437 China Department of Gastroenterology Suzhou Traditional Chinese Medicine HospitalSuzhou 215000Jiangsu ProvinceChina Shanghai Key Laboratory of Traditional Chinese Medicine Shanghai 201203China Key Laboratory of liver and Kidney Diseases(Ministry of Education) Shanghai 201203China

Objective:This study explores the mechanism of action of Danhongqing formula(DHQ),a compoundbased Chinese medicine formula,in the treatment of cholestatic liver ***:In vivo experiments were conducted using 8-week-old multidrug resistance protein 2 knockout(Mdr2-/-)mice as an animal model of cholestatic liver *** was administered orally for 8 weeks,and its impact on cholestatic liver fibrosis was evaluated by assessing liver function,liver histopathology,and the expression of liver fibrosis-related ***-time polymerase chain reaction,Western blot,immunohistochemistry and other methods were used to observe the effects of DHQ on long non-coding RNA H19(H19)and signal transducer and activator of transcription 3(STAT3)phosphorylation in the liver tissue of Mdr2-/-*** addition,cholangiocytes and hepatic stellate cells(HSCs)were cultured in vitro to measure the effects of bile acids on cholangiocyte injury and H19 *** overexpressing H19 were constructed,and a conditioned medium containing H19 was collected to measure its effects on STAT3 protein expression and cell *** intervention effect of DHQ on these processes was also *** overexpressing H19 were constructed to measure the impact of H19 on cell activation and assess the intervention effect of ***:DHQ alleviated liver injury,ductular reaction,and fibrosis in Mdr2-/-mice,and inhibited H19expression,STAT3 expression and STAT3 *** formula also reduced hydrophobic bile acid-induced cholangiocyte injury and the upregulation of H19,inhibited the activation of HSCs induced by cholangiocyte-derived conditioned medium,and decreased the expression of activation markers in *** overexpression of H19 in a human HSC line confirmed that H19 promoted STAT3 phosphorylation and HSC activation,and DHQ was able to successfully inhibit these ***:DHQ effectively alleviated spontaneous cholestatic liver fibrosis in Md

关键词： liver cirrhosis biliary Long non-coding RNA H19 Danhongqing formula Cholangiocyte Hepatic stellate cells STAT3 transcription factor

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Hepatocellular carcinoma presenting as an extrahepatic mass:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 2241-2252页

作者： Wei Kelly Wu Krutika Patel Chandrasekhar Padmanabhan Kamran Idrees Department of surgery Vanderbilt University Medical CenterNashvilleTN 37232United States Department of Pathology Microbiology and ImmunologyVanderbilt University Medical CenterNashvilleTN 37232United States Division of Surgical Oncology and Endocrine surgery Department of SurgeryVanderbilt University Medical CenterNashvilleTN 37232United States

BACKGROUND Hepatocellular carcinoma(HCC)is a primary liver tumor generally diagnosed based on radiographic *** disease is typically associated with increased tumor diameter,multifocality,and vascular *** report a case of a patient who presented with extrahepatic HCC metastasis to a portocaval lymph node with occult hepatic primary on computed tomography(CT).We review the literature for cases of extrahepatic HCC presentation without known hepatic lesions and discuss strategies to differentiate between metastatic and ectopic *** SUMMARY A 67-year-old male with remotely treated hepatis C was referred for evaluation of an enlarging portocaval,mixed cystic-solid *** CT evaluations demonstrated steatosis,but no cirrhosis or liver *** ultrasound demonstrated a normal-appearing pancreas,biliary tree,and *** needle aspiration yielded atypical *** differential diagnosis included duodenal or pancreatic cyst,lymphoproliferative cyst,stromal or mesenchymal lesions,nodal involvement from gastrointestinal or hematologic malignancy,or duodenal gastrointestinal stromal *** review by a multidisciplinary tumor board,the patient underwent open surgical resection of a 5.2 cm×5.5 cm retroperitoneal mass with pathology consistent with moderately-differentiated *** resonance imaging(MRI)subsequently demonstrated a 1.2 cm segment VIII hepatic lesion with late arterial enhancement,fatty sparing,and intrinsic T1 *** fetoprotein was 23.3 ng/*** patient was diagnosed with HCC with portocaval nodal ***:We surveyed the literature for HCC presenting as extrahepatic masses without history of concurrent or prior intrahepatic *** identified 18 cases of extrahepatic HCC ultimately found to represent metastatic lesions,and 30 cases of extrahepatic HCC found to be primary,ectopic *** Hepatocellular carcinoma can seldomly present with extrahepatic metastasis in the setting of

关键词： Extrahepatic Metastasis Portocaval Lymph node Case report

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