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A rare case of periampullary carcinoma with ectopic ending of Vater's ampulla

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World Journal of Gastroenterology 2009年第37期15卷 4729-4731页

作者： Shu-Guang Jin Zhe-Yu Chen Lu-Nan Yan Yong Zeng Wei Huang Nan Xu Department of hepato-bilio-pancreatic Surgery West China Hospital of Sichuan University Chengdu 610041 Sichuan Province China

A 71-year-old woman was referred to our department complaining of painless progressive jaundice for the last 3 too. Magnetic resonance imaging and magnetic resonance cholangiopancreatography （MRCP） showed the ectopic hepatopancreatic ampulla draining into the fourth part of the duodenum adjacent to the duodenojejunal flexure; the irregular morphology of the duodenojejunal flexure likely due to a soft tissue mass. Laparotomy confirmed the presence of the abnormal ampulla of Vater located at the fourth part of the duodenum and a soft tissue tumor about 6 cm × 5 cm×5 cm with a peduncle adjoining the ampulla. Resection of the tumor, including some peripheral tissue, and a Roux-Y loop anastomosis choledochojejunostomy were performed. Pathological examination indicated an intestinal villous adenoma accompanied by severe dysplasia and focal canceration. Periampullary carcinoma with ectopic ending of the Vater＇s ampulla into the fourth part of the duodenum is rather rare. The embryonic genetic background of this anomaly has not yet been fully explained. It is worth mentioning that MRCP is useful for demonstrating anomalies and anatomic variants of the biliary tract system and pancreatic duct.

关键词： Ectopia, Ampulla of Vater, Periampullary carcinoma Magnetic resonance cholangiopancreatography Treatment

Platelet-to-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer: A systematic review and meta-analysis

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World Journal of Gastroenterology 2018年第15期24卷 1658-1665页

作者： Quirino Lai Fabio Melandro Zoe Larghi Laureiro Francesco Giovanardi Stefano Ginanni Corradini Flaminia Ferri Redan Hassan Massimo Rossi Gianluca Mennini hepato-bilio-pancreatic and Liver Transplant Unit Department of Surgery Sapienza University of Rome division of Gastroenterology Department of Clinical Medicine Sapienza University of Rome

AIM To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio(PLR) as a risk factor for post-transplant hepatocellular cancer(HCC) recurrence. METHODS A systematic literature search was performed using PubM ed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria:(1) studies comparing pre-transplant low vs high PLR values;(2) studies reporting post-transplant recurrence rates; and(3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation. RESULTS A total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases(80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation(OR = 3.33; 95%CI: 1.78-6.25; P hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.

关键词： Recurrence inflammation hepatocellular cancer liver transplantation platelet-to-lymphocyte ratio

Donor-to-recipient gender match in liver transplantation: A systematic review and meta-analysis

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World Journal of Gastroenterology 2018年第20期24卷 2203-2210页

作者： Quirino Lai Francesco Giovanardi Fabio Melandro Zoe Larghi Laureiro Manuela Merli Barbara Lattanzi Redan Hassan Massimo Rossi Gianluca Mennini hepato-bilio-pancreatic and Liver Transplant Unit Department of Surgery Sapienza University of Rome division of Gastroenterology Department of Clinical Medicine Sapienza University of Rome

AIM To perform a systematic review and meta-analysis on donor-to-recipient gender mismatch as a risk factor for post-transplant graft loss. METHODS A systematic literature search was performed using PubM ed, Cochrane Library database and EMBASE. The primary outcome was graft loss after liver transplantation. Odds ratios and 95% confidence intervals were calculated to compare the pooled data between groups with different donor-to-recipient gender matches. Three analyses were done considering(1) gender mismatches(F-M and M-F) vs matches(M-M and F-F);(2) Femaleto-Male mismatch vs other matches; and(3) Male-toFemale mismatch vs other *** A total of 7 articles were analysed. Gender mismatch(M-F and F-M) was associated with a significant increase of graft loss respect to match(M-M and F-F)(OR: 1.30; 95%CI: 1.13-1.50; P < 0.001). When F-M mismatch was specifically investigated, it confirmed its detrimental role in terms of graft survival(OR: 1.83; 95%CI: 1.20-2.80; P = 0.005). M-F mismatch failed to present a significant role(OR: 1.09; 95%CI: 0.73-1.62; P = 0.68).CONCLUSION Gender mismatch is a risk factor for poor graft survival after liver transplantation. Female-to-male mismatch represents the worst combination. More studies are needed with the intent to better clarify the reasons for these results.

关键词： Graft survival Female-to-male mismatch Liver transplantation Donor-to-recipient match Gender

Primary hepatic myelolipoma: A case report and review of the literature

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World Journal of Clinical Cases 2020年第19期8卷 4615-4623页

作者： Ke-Yu Li Ai-Lin Wei Ang Li Department of hepato-bilio-pancreatic Surgery West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Primary hepatic myelolipoma is a rare hepatic mesenchymal tumor mixed by adipose tissue and bone marrow,and there is a lack of general guidelines related to its epidemiology and clinical *** SUMMARY A 26-year-old woman was admitted to our department complaining of a newly found tumor on her left lobe of the *** tumor was painless and not associated with any systemic or localized compressive *** tests disclosed a slight increase of gamma-glutamyl transpeptidase(70.0 U/L)and total bilirubin(19.2 pmol/L).Ultrasonography showed a mass about 5.0 cm x 5.0 cm in size that was located in the left lobe of the liver and displayed hyperechoic and well-encapsulated *** resection was applied,and the following histopathological examination observed a variable proportion of myeloid tissues scattering throughout mature fibrotic adipose tissues,in which myeloid,erythroid,and megakaryocytic cells can be found in magnified *** follow-up did not show any changes 6 mo after *** This case highlights an extremely rare hepatic mesenchymal tumor,the primary hepatic myelolipoma,and discloses the common characteristics behind this disease and gives clinical recommendations.

关键词： Hepatic myelolipoma Liver neoplasms Myelolipoma Tumor Liver Extraadrenal myelolipoma Case report

Artificial intelligence in the diagnosis and management of colorectal cancer liver metastases

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World Journal of Gastroenterology 2022年第1期28卷 108-122页

作者： Gianluca Rompianesi Francesca Pegoraro Carlo DL Ceresa Roberto Montalti Roberto Ivan Troisi division of hepato-bilio-pancreatic Minimally Invasive and Robotic SurgeryDepartment of Clinical Medicine and SurgeryFederico II University HospitalNaples 80125Italy Department of hepato-Pancreato-Biliary Surgery Oxford University Hospitals NHS Foundation TrustOxford OX39ESUnited Kingdom division of hepato-bilio-pancreatic Minimally Invasive and Robotic SurgeryDepartment of Public HealthFederico II University HospitalNaples 80125Italy

Colorectal cancer(CRC)is the third most common malignancy worldwide,with approximately 50%of patients developing colorectal cancer liver metastasis(CRLM)during the follow-up *** of CRLM is best achieved via a multidisciplinary approach and the diagnostic and therapeutic decision-making process is *** order to optimize patients’survival and quality of life,there are several unsolved challenges which must be *** primarily include a timely diagnosis and the identification of reliable prognostic ***,to allow optimal treatment options,a precision-medicine,personalized approach is *** widespread digitalization of healthcare generates a vast amount of data and together with accessible high-performance computing,artificial intelligence(AI)technologies can be *** increasing diagnostic accuracy,reducing timings and costs,the application of AI could help mitigate the current shortcomings in CRLM *** this review we explore the available evidence of the possible role of AI in all phases of the CRLM natural *** analysis and convolutional neural networks(CNN)which combine computed tomography(CT)images with clinical data have been developed to predict CRLM development in CRC *** models have also proven themselves to perform similarly or better than expert radiologists in detecting CRLM on CT and magnetic resonance scans or identifying them from the noninvasive analysis of patients’exhaled *** application of AI and machine learning(ML)in diagnosing CRLM has also been extended to histopathological examination in order to rapidly and accurately identify CRLM tissue and its different histopathological growth *** and CNN have shown good accuracy in predicting response to chemotherapy,early local tumor progression after ablation treatment,and patient survival after surgical treatment or *** the initial enthusiasm and the accumulating evidence,AI technologies’role i

关键词： Colorectal cancer Liver metastases Artificial intelligence Machine learning Deep learning Neural networks Radiomics

Radioembolization in the setting of liver transplantation: great expectations or hard times?

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hepatobiliary Surgery and Nutrition 2018年第1期7卷 58-60页

作者： Quirino Lai Gianluca Mennini hepato-bilio-pancreatic and Liver Transplant Unit Department of SurgerySapienza University of RomeRomeItaly

Trans-arterial radio-embolization(TARE)with yttrium-90 represents one of the most efficacious approaches for the treatment of selected patients with advanced hepatocellular cancer(HCC)(1).

关键词： embolization arterial liver

Review of preoperative transarterial chemoembolization for resectable hepatocellular carcinoma

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World Journal of hepatology 2015年第1期7卷 40-43页

作者： Zhi-Hui Gao Dou-Sheng Bai Guo-Qing Jiang Sheng-Jie Jin hepato-bilio-pancreatic Surgery Department Subei People’s HospitalYangzhou University

hepatocellular carcinoma(HCC) is one of the few cancers whose incidence has been continually increasing over recent *** of HCC offers the only hope for ***,recurrences are common in patients who have undergone *** our opinion,the effectiveness with which transarterial chemoembolization(TACE) as a neoadjuvant therapy for resectable HCC prevents recurrence and prolongs survival has not been conclusively *** published meta-analyses have consistently failed to demonstrate that preoperative TACE improves the prognosis of resectable *** believe that these published articles have several limitations and have our own views about the results of *** is very important that the scientific community shed more light on the pathogenesis of HCC and relate this to choice of *** review mainly concerns our understanding of preoperative TACE for resectable HCC and briefly addresses desirable directions for future studies.

关键词： hepatocellular carcinoma Surgical resection Transarterial chemoembolization Preoperative Review

Comment on:“Impact of portable normothermic blood-based machine perfusion on outcomes of liver transplant:the OCS Liver PROTECT randomized clinical trial”

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hepatobiliary Surgery and Nutrition 2022年第2期11卷 267-269页

作者： Arthur Marichez Jean-Philippe Adam Department of hepato-bilio-pancreatic Surgery and Liver Transplantation Haut Lévêque HospitalCHU de BordeauxFrance

We read with great interest the paper by Markmann et ***“Impact of portable normothermic blood-based machine perfusion on outcomes of liver transplant:The OCS Liver PROTECT randomized clinical trial”(1).In this multicenter randomized clinical trial,the authors compared posttransplant outcomes for recipients who received donation after brainstem death(DBD)or donation after circulatory death(DCD)livers preserved using ischemic cold storage(ICS)or a portable normothermic machine perfusion(NMP)[Organ Care System(OCS)Liver].The primary endpoint was the incidence of early allograft dysfunction(EAD)as defined by Olthoff et ***(2).The trial was methodologically designed to test both non-inferiority on the primary endpoint,and superiority if non-inferiority was *** study was conducted from 2016 to 2019 at 20 US liver transplant programs.

关键词： Impact portable Liver

The role of associating liver partition and portal vein ligation for staged hepatectomy in the management of patients with colorectal liver metastasis

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hepatobiliary Surgery and Nutrition 2020年第6期9卷 694-704页

作者： Juan Glinka Victoria Ardiles Juan Pekolj Eduardo de Santibañes Martin de Santibañes Department of General Surgery Hepato-Bilio-Pancreatic&Liver Transplantation Unit Hospital Italiano de Buenos AiresBuenosAiresArgentina

Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)approach emerged as a promising surgical strategy for rapid and large hypertrophy of the future liver remnant(FLR)when a major liver resection is *** liver metastasis(CRLM)is their main ***,the promising results published so far,are very difficult to interpret since they usually focus on the technique and not on the underlying ***,they are usually made up of complex populations,which received different chemotherapy schemes,with the ALPPS technical variations implemented over time and without consistent long-term follow-up results as ***,its role in CRLM should be analyzed as carefully as possible to indicate and select the best candidates who will benefit the most from this *** conducted a computerized search using PubMed and Google Scholar for reports published so far,using mesh headings and keywords related to the ALPPS and CRLM.

关键词： Liver resection associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) colorectal cancer metastasis liver regeneration