检索结果-南通市图书馆

General-motors diet: A quick fix for steatotic live liver donors

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

iliver 2023年第3期2卷 151-155页

作者： Anish Gupta Abhideep Chaudhary Gaurav Sood Niteen Kumar Imtiakum Jamir Aditya Shriya Vipin Pal Singh Rekha Subramaniyam Hitesh Soni Milind Mandwar Department of Hepato-Pancreato-biliary surgery and liver Transplantation BLK MAX Super Specialty HospitalNew DelhiIndia

Background and aims:GM(General-Motors)diet is a low-calorie 7-day diet plan using complex carbohydrates used for quick weight *** optimisation is known to decrease steatosis and improve outcomes in liver *** evaluated the efficacy and feasibility of using GM diet in steatotic live liver donors(LLD).Methods:LLDs who either had BMI>30 kg/m^(2),Computerised tomography liver attenuation index(CT-LAI)10%were started on GM diet for 1 *** of these LLDs and their recipients were retrieved retrospectively and ***,liver function tests(LFT),MR fat-frac-tion,CT-LAI,hospital-stay and complications were analysed in LLDs while early graft dysfunction(EGD)and complications were assessed in ***:A total of 51 LLDs with mean age of 34.6?9.5 years with baseline mean weight of 80.6±10.8 kg and BMI of 29.1±2.78 kg/m^(2) were started on GM *** a week of following the GM diet,there was an average weight loss of 3.46±2.1 kg,a decrease in fat-fraction by 3.8%±2.7,and an improvement in CT-LAI by 6.7?3.7 *** patients could successfully undergo donor hepatectomy with an average postoperative ICU stay of 2.86±0.8 days and hospital stay of 6.82?0.81 *** donor had steatosis>10% on intraoperative Tru-cut biopsy and their post-operative outcomes were similar to normal liver *** were intra-abdominal collections in 2 donors requiring drainage and one required re-exploration for intestinal *** was EGD in 8 recipients(15.6%)and mortality in 1(1.9%)***:GM diet is safe and effective regimen to reduce steatosis and increase healthy LLD pool without compromising donor or recipient safety.

关键词： Steatosis GM diet weight loss donor optimization LDLT donor hepatectomy donor outcomes

Robotic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: Analysis of surgical outcomes and long-term prognosis in a high-volume center

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 2023年第2期22卷 140-146页

作者： Xiu-Ping Zhang Shuai Xu Zhi-Ming Zhao Qu Liu Guo-Dong Zhao Ming-Gen Hu Xiang-Long Tan Rong Liu Faculty of Hepato-biliary-Pancreatic surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of liver Transplantation and Hepatobiliary surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China

Background: Robotic pancreaticoduodenectomy(RPD) has been reported to be safe and feasible for patients with pancreatic ductal adenocarcinoma(PDAC) of the pancreatic head. This study aimed to analyze the surgical outcomes and risk factors for poor long-term prognosis of these patients. Methods: Data from patients who underwent RPD for PDAC of pancreatic head were retrospectively analyzed. Multivariate Cox regression analysis was used to seek the independent prognostic factors for overall survival(OS), and an online nomogram calculator was developed based on the independent prognostic factors. Results: Of the 273 patients who met the inclusion criteria, the median operative time was 280.0 minutes, the estimated blood loss was 100.0 m L, the median OS was 23.6 months, and the median recurrence-free survival(RFS) was 14.4 months. Multivariate analysis showed that preoperative carbohydrate antigen 19-9(CA19-9) [hazard ratio(HR) = 2.607, 95% confidence interval(CI): 1.560-4.354, P < 0.001], lymph node metastasis(HR = 1.429, 95% CI: 1.005-2.034, P = 0.047), tumor moderately(HR = 3.190, 95% CI: 1.813-5.614, P < 0.001) or poorly differentiated(HR = 5.114, 95% CI: 2.839-9.212, P < 0.001), and Clavien-Dindo grade ≥ Ⅲ(HR = 1.657, 95% CI: 1.079-2.546, P = 0.021) were independent prognostic factors for OS. The concordance index(C-index) of the nomogram constructed based on the above four independent prognostic factors was 0.685(95% CI: 0.640-0.729), which was significantly higher than that of the AJCC staging(8th edition): 0.541(95% CI: 0.493-0.589)( P < 0.001). Conclusions: This large-scale study indicated that RPD was feasible for PDAC of pancreatic head. Preoperative CA19-9, lymph node metastasis, tumor poorly differentiated, and Clavien-Dindo grade ≥ Ⅲ were independent prognostic factors for OS. The online nomogram calculator could predict the OS of these patients in a simple and convenient manner.

关键词： Robotic pancreaticoduodenectomy Nomogram Long-term prognosis Pancreatic ductal adenocarcinoma

Derivation and validation of a preoperative prognostic model for resectable pancreatic ductal adenocarcinoma

维普期刊数据库

同方期刊数据库评论

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 160-168页

作者： Shuai Xu Xiu-Ping Zhang Guo-Dong Zhao Wen-Bo Zou Zhi-Ming Zhao Qu Liu Ming-Gen Hu Rong Liu Faculty of Hepato-biliary-Pancreatic surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of liver Transplantation and Hepatobiliary surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China

Background: The prognosis of patients with pancreatic ductal adenocarcinoma(PDAC) remains poor even after radical pancreaticoduodenectomy(PD). The study aimed to develop and validate a novel preoperative prognostic model to accurately predict the long-term survival of patients with ***: Patients with PDAC of pancreatic head from Chinese PLA General Hospital were included. The preoperative PDAC model with contour plots was developed using a non-linear model in the training cohort and then tested in the validation ***: Of 421 patients who met the inclusion criteria, 280 were in the training cohort and 141 in the validation cohort. Contour plots for preoperative PDAC model were established to visually predict the survival probabilities of these patients, based on preoperative carbohydrate antigen 19-9, preoperative fibrinogen to albumin ratio and pain symptoms. This model stratified patients into low-and high-risk groups with distinctly different long-term survival in the training cohort [median overall survival(OS)32.1 vs. 17.5 months;median recurrence-free survival(RFS) 19.3 vs. 10.0 months, both P < 0.001] and the validation cohort(median OS 28.3 vs. 19.0 months;median RFS 17.5 vs. 11.2 months, both P < 0.001).Time-dependent receiver operating characteristic and decision curve analyses revealed that the model provided higher diagnostic accuracy and superior net benefit compared to other staging ***: This study constructed and validated a novel preoperative prognostic model that can accurately and conveniently predict the long-term survival of patients with resectable PDAC of pancreatic head. Besides, the model can screen high-risk patients with poor prognosis, which may provide references for personal treatment strategies in the future.

关键词： Pancreatic ductal adenocarcinoma Pancreaticoduodenectomy Contour plot Overall survival Recurrence-free survival

Hepatitis B virus recurrence after liver transplantation: An old tale or a clear and present danger?

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2020年第18期26卷 2166-2176页

作者： Ilaria Lenci Martina Milana Giuseppe Grassi Tommaso M Manzia Carlo Gazia Giuseppe Tisone Roberta Angelico Leonardo Baiocchi Hepatology and liver Transplant Unit University of Tor VergataRome 00133Italy Hepato-Pancreato-biliary and Transplant Department of SurgeryUniversity of Rome Tor VergataRome 00133Italy

Hepatitis B virus(HBV) recurrence after liver transplantation(LT) has been described more than 50 years ago. Similarly, to other clinical conditions, in which impairment of host immune defense favors viral replication, early reports described in details recurrence and reactivation of HBV in liver transplant recipients. The evidence of a possible, severe, clinical evolution of HBV reappearance in a significant percentage of these patients, allowed to consider,for some years, HBV positivity a contraindication for LT. Moving from the old to the new millennium this picture has changed dramatically. Several studies contributed to establish efficient prophylactic protocols for HBV recurrence and with the advent of more potent anti-viral drugs an increased control of infection was achieved in transplanted patients as well as in the general immunecompetent HBV population. Success obtained in the last decade led some authors to the conclusion that HBV is now to consider just as a "mere nuisance".However, with regard to HBV and LT, outstanding issues are still on the table:(1)A standard HBV prophylaxis protocol after transplant has not yet been clearly defined;(2) The evidence of HBV resistant strains to the most potent antiviral agents is claiming for a new generation of drugs;and(3) The possibility of prophylaxis withdrawal in some patients has been demonstrated, but reliable methods for their selection are still lacking. The evolution of LT for HBV is examined in detail in this review together with the description of the strategies adopted to prevent HBV recurrence and their pros and cons.

关键词： liver transplant Hepatitis B virus Viral recurrence Prophylaxis Minimization Antiviral drug

Clinical practice guidelines for hepatocellular carcinoma:the first evidence based guidelines from Japan

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2006年第5期12卷 828-829页

作者： Masatoshi Makuuchi Norihiro Kokudo Department of surgery Hepato-Biliary-Pancreatic Surgery DivisionUniversity of TokyoTokyoJapan

Hepatocellular carcinoma （HCC） is one of the leading causes of cancer death in Japan, ranked 3^rd in males and 5^th in females. Thanks to recent progress, there are several definitive treatment modalities available for HCC, including surgery （liver resection and transplantation）, ablation therapy, and transarterial chemoembolization （TACE）. It is fortunate for both patients and doctors to have multiple treatment options, however, there have been very few evidence-based guidelines for decision-making. Sup- ported by the Japanese Ministry of Health, Labour and Welfare, we have compiled the ＂Clinical practice guidelines for hepatocellular carcinoma＂. This set of guidelines covers 6 fields for HCC, including prevention, diagnosis and surveillance, surgery, chemotherapy, TACE, and ablation therapy. We have surveyed 7192 publications on HCC extracted mainly from MEDLINE （1966-2002）, and selected 334 articles to form 58 pairs of research questions and recommendations. For convenience in practical use, we have also created algorithms for the surveillance and treatment of HCC.

关键词： Hepatocellular carcinoma surgery

Hepatic blood inflow occlusion with/without hemihepatic artery control versus the Pringle maneuver in resection of hepatocellular carcinoma： a retrospective comparative analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Medical Journal 2010年第11期123卷 1413-1416页

作者： YI Bin QIU Ying-he LIU Chen LUO Xiang-ji JIANG Xiao-qing TAN Wei-feng WU Meng-chao Department of biliary I Eastern Hepatobiliary Surgery HospitalShanghai 200438 China

Background The Pringle maneuver, which has been the standard for hepatic resection surgery for a long time, has the major flaw of ischemic damage in the liver. The aim of this research was to evaluate hepatic blood inflow occlusion with/without hemihepatic artery control vs. the Pringle maneuver in hepatocellular carcinoma （HCC） resection. Methods Two hundred and eighty-one cases of resection of HCC with hepatic blood inflow occlusion （with/without hemihepatic artery control） and the Pringle maneuver from January 2006 to December 2008 in our hospital were analyzed and compared retrospectively; among them 107 were in group I （Pringle maneuver）, 98 in group II （hepatic blood inflow occlusion）, and 76 in group III （hepatic blood inflow occlusion without hemihepatic artery control）. The operation time, intraoperative blood loss, postoperative liver function and complications were used as the endpoints for evaluation. Results The operative duration and intraoperative blood loss of three groups showed no significant difference; alanine aminotransferase, total bilirubin and incidence of postoperative complications were significantly lower in groups II and Ill postoperation than those in group I. Conclusion Hepatic blood inflow occlusion without hemihepatic artery control is safe, convenient and feasible for resection of HCC, especially for cases involving underlying diseases such as cirrhosis.

关键词： hepatic resection hepatic blood inflow occlusion hemihepatic artery control hepatic blood flow occlusion Pringle maneuver

Routine use of a transanastomotic stent is unnecessary for hepatojejunostomy in liver transplantation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Medical Journal 2012年第14期125卷 2411-2416页

作者： WANG Gen-shu YANG Yang JIANG Nan FU Bin-sheng LI Hua LI Shi-hui JIN Hai YANG Jian-xu ZHANG Jian CHEN Gui-hua liver Transplantation Center Department of Hepatic surgery

Background The use of transanastomotic stents for Roux-en-Y hepatojejunostomy （RYHJ） in liver transplantation （LT） remains controversial. The aim of this retrospective study was to assess the role of transanastomotic stent for RYHJ in LT. Methods RYHJ for biliary reconstruction in LT was performed in 52 patients. Twenty-five patients had bile duct reconstruction by RYHJ with transanastomotic stents （S group）, while 27 patients underwent the same procedure without transanastomotic stents （non-S group）. The two groups were compared in terms of post-LT biliary complications and survival. Results The incidences of bile leakage, anastomotic stricture, non-anastomotic stricture, biliary sludge/lithiasis and biliary infection were 12% （3/25）, 9.5% （2/21）, 23.5% （4/17）, 11.8% （2/17）, and 24% （6/25）, respectively in the S group, and 0, 0, 20.0% （5/25）, 10.0% （2/20）, and 16.7% （4/24）, respectively in the non-S group. One and three year survival rates were 48.0% （12/25） and 34.0% （8/23）, respectively, in the S group and 57.7% （15/26） and 38.9% （7/18）, respectively, in the non-S group. There was no significant difference between the two groups in terms of the incidence of various biliary complications and survival （P 〉0.05）. Conclusion The routine use of transanastomotic stents is not necessary for RYHJ for biliary reconstruction in LT.

关键词： hepatojejunostomy liver transplantation, stent

Needle track seeding:A real hazard after percutaneous radiofrequency ablation for colorectal liver metastasis

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2009年第13期15卷 1653-1655页

作者： Shirley Yuk-Wah Liu Kit-Fai Lee Paul Bo-San Lai Division of Hepato-biliary and Pancreatic surgery Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong Kong

Neoplastic needle track seeding following percutaneous radiofrequency ablation(RFA)of secondary liver tumors is exceedingly *** on cutaneous tumor seeding after percutaneous RFA for colorectal liver metastasis are even rarer in the *** we report a case of a 46-year-old female who developed an ulcerating skin lesion along the needle track of a previous percutaneous RFA site around 6 mo after the *** previous RFA was performed by the LeVeen needle for a secondary liver tumor from a primary rectal *** diagnosis of secondary skin metastasis was confirmed by fine needle aspiration *** lesion was successfully treated with wide local *** believe that tumor seeding after percutaneous RFA in our patient was possibly related to its unfavorable subcapsular location and the use of an expansion-type ***,prophylactic ablation of the needle track should be performed whenever ***,alternative routes of tumor ablation such as laparoscopic or open RFA should be considered.

关键词： Radiofrequency catheter ablation Needles Neoplasm seeding liver neoplasms Skin neoplasms Neoplasm metastasis

Imaging lexicon for acute pancreatitis:2012 Atlanta Classification revisited

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2016年第1期4卷 16-23,I0001页

作者： Binit Sureka Kalpana Bansal Yashwant Patidar Ankur Arora Department of Radiology/Interventional Radiology Institute of Liver and Biliary SciencesNew DelhiIndia

The original 1992 Atlanta Classification Systemfor acute pancreatitis was revised in 2012 by the Atlanta Working Group,assisted by various national and international societies,through web-based *** revised classification identifies two phases of acute pancreatitis:early and *** pancreatitis can be either oedematous interstitial pancreatitis or necrotizing *** of the disease is categorized into three levels:mild,moderately severe and severe,depending upon organ failure and local/systemic *** to the type of pancreatitis,collections are further divided into acute peripancreatic fluid collection,pseudocyst,acute necrotic collection,and walled-off *** into the revised terminology is essential for accurate communication of imaging *** this review article,we will summarize the updated nomenclature and illustrate corresponding imaging findings using examples.

关键词： acute pancreatitis imaging acute peripancreatic fluid collection pseudocyst walled-off necrosis