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hepatobiliary & Pancreatic Diseases International 2024年第6期23卷 653-657页

作者： Sung-Min Kim Deok-Bog Moon Young-In Yoon Sung-Gyu Lee division of hepatobiliary surgery and Liver Transplantation Department of SurgeryUniversity of Ulsan College of MedicineAsan Medical CenterSeoulKorea

To the Editor:Hemangioma is a benign liver tumor that rarely requires treatment if the patient is asymptomatic[1].However,great cavernous hemangioma(GCH)can lead to symptoms due to its mass effect and Kasabach-Merritt syndrome(KMS)[2].GCH treatment options vary;therefore,tailoring treatment to individual patients according to their condition,such as symptoms,tumor location,and liver function,is ***,GCH is associated with hemangiomatosis,and its boundaries with normal tissue are unclear[3],leading to a lack of consensus on the initial therapeutic approach,with literature primarily comprising case reports or series[4].This study presented two cases of GCH and coexisting hemangiomatosis;the patients underwent liver resection of the main mass to relieve symptoms but ultimately required liver transplantation(LT).We aimed to describe the role of LT in these patients.

关键词： hemangioma cases donor

Vascular endothelial growth factor attenuates hepatic sinusoidal capillarization in thioacetamide-induced cirrhotic rats

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World Journal of Gastroenterology 2008年第15期14卷 2349-2357页

作者： Hao Xu Bao-Min Shi Xiao-Fei Lu Feng Liang Xing Jin Tai-Huang Wu Jian Xu Department of hepatobiliary and pancreas surgery Shandong Provincial Hospital Clinical College of Shandong University Jinan 25002 l Shandong Province China Department of Vascular surgery Shandong Provincial Hospital Clinical College of Shandong University Jinan 250021 Shandong Province China

AIM: To investigate the effect of vascular endothelial growth factor (VEGF) transfection on hepatic sinusoidal capillarization. METHODS: Enhanced green fluorescent protein (EGFP)/ VEGF transfection was confirmed by immunofluorescence microscopy and immunohistoche-mistry both in primary hepatocytes and in normal liver. Cirrhotic rats were generated by thioacetamide (TAA) administration and then divided into a treatment group, which received injections of 400 μg of plasmid DNA encoding an EGFP- VEGF fusion protein, and a blank group, which received an equal amount of normal saline through the portal vein. The portal vein pressure was measured in the normal and cirrhotic state, in treated and blank groups. The average number of fenestrae per hepatic sinusoid was determined using transmission electron microscopy (TEM), while the relative abundance of VEGF transcripts was examined by Gene array. RESULTS: Green fluorescent protein was observed in the cytoplasms of liver cells under immunofluorescence microscopy 24 h after transfection with EGFP/VEGF plasmid in vitro. Staining with polyclonal antibodies against VEGF illustrated that hepatocytes expressedimmunodetectable VEGF both in vitro and in vitro. There were significant differences in the number of fenestrae and portal vein pressures between normal and cirrhotic rats (7.40 ± 1.71 vs 2.30 ± 1.16 and 9.32 ± 0.85 cmH2O vs 17.92 ± 0.90 cmH2O, P < 0.01), between cirrhotic and treated rats (2.30 ± 1.16 cmH2O vs 4.60 ± 1.65 and 17.92 ± 0.90 cmH2O vs 15.52 ± 0.93 cmH2O, P < 0.05) and between the treatment group and the blank group (4.60 ± 1.65 cmH2O vs 2.10 ± 1.10 cmH2O and 15.52 ± 0.93 cmH2O vs 17.26 ± 1.80 cmH2O, P < 0.05). Gene- array analysis revealed that the relative abundance of transcripts of VEGF family members decreased in the cirrhotic state and increased after transfection. CONCLUSION: Injection of a plasmid encoding VEGF through the portal vein is an effective method to induce the formation of fenestrae and decre

关键词： Liver cirrhosis Hepatic sinusoid capillari-zation Fenestrae Vascular endothelial growth factor Transmission electrical microscopy Ultrastructure Genearray

A score model for predicting post-liver transplantation survival in HBV cirrhosis-related hepatocellular carcinoma recipients: a single center 5-year experience

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hepatobiliary & Pancreatic Diseases International 2015年第1期14卷 43-49页

作者： Li-Ying Wang Shu-Sen Zheng Xiao Xu Wei-Lin Wang Jian Wu Min Zhang Yan Shen Sheng Yan Hai-Yang Xie Xin-Hua Chen Tian-An Jiang Fen Chen division of hepatobiliary and Pancreatic surgery Department of Surgery First Affiliated Hospital Zhejiang University School of Medicine Key Laboratory of Combined Multi-Organ Transplantation Ministry of Health

BACKGROUND： The prognostic prediction of liver transplantation（LT） guides the donor organ allocation. However, there is currently no satisfactory model to predict the recipients’ outcome, especially for the patients with HBV cirrhosis-related hepatocellular carcinoma（HCC）. The present study was to develop a quantitative assessment model for predicting the post-LT survival in HBV-related HCC ***： Two hundred and thirty-eight LT recipients at the Liver Transplant Center, First Affiliated Hospital, Zhejiang University School of Medicine between 2008 and 2013 were included in this study. Their post-LT prognosis was recorded and multiple risk factors were analyzed using univariate and multivariate analyses in Cox ***： The score model was as follows： 0.114×（Child-Pugh score）-0.002×（positive HBV DNA detection time）＋0.647×（number of tumor nodules）＋0.055×（max diameter of tumor nodules）＋0.231×ln AFP＋0.437×（tumor differentiation grade）.The receiver operating characteristic curve analysis showed that the area under the curve of the scoring model for predicting the post-LT survival was 0.887. The cut-off value was 1.27, which was associated with a sensitivity of 72.5% and a specificity of 90.7%, ***： The quantitative score model for predicting post-LT survival proved to be sensitive and specific.

关键词： HBV cirrhosis hepatocellular carcinoma liver transplantation Hangzhou criteria post-LT survival

Anatomical resection of hepatocellular carcinoma: A critical review of the procedure and its benefits on survival

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World Journal of Gastroenterology 2017年第7期23卷 1139-1146页

作者： Koo Jeong Kang Keun Soo Ahn division of hepatobiliary and Pancreatic surgery Department of SurgerySchool of MedicineKeimyung University Dong-san Medical CenterDaegu 41931South Korea

Hepatocellular carcinoma(HCC) is the sixth most common type of cancer and the third most frequent cause of cancer-related death. Advances in preoperative assessment of HCC(e.g., imaging studies and liver function tests), surgical techniques, and postoperative care have improved the surgical outcomes and survival of patients who undergo hepatic resection for HCC. However, in the last 20 years, the long-term survival after hepatectomy has remained unsatisfactory owing to the high rates of local recurrence and multicentric occurrence. Anatomical liver resection(AR) was introduced in the 1980 s. Although several studies have revealed tangible benefits of AR for HCC, these benefits are still debated. Because most HCCs occur in patients with liver cirrhosis and poor hepatic function, there are many factors that affect survival, including the surgical method. Nevertheless, many studies have documented the perioperative and long-term benefits of AR in various conditions. In this article, we review the results of several recently published, well-designed comparative studies of AR, to investigate whether AR provides real benefits on survival outcomes. We also discuss the potential pitfalls associated with this approach.

关键词： Hepatocellular carcinoma Cirrhosis Curative Anatomical resection Prognosis

The benefit of curative liver resection with a selective bile duct preserving approach for hepatocellular carcinoma with macroscopic bile duct tumor thrombus

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hepatobiliary surgery and Nutrition 2020年第6期9卷 729-738页

作者： Anon Chotirosniramit Akkaphod Liwattanakun Sunhawit Junrungsee Wasana Ko-iam Trichak Sandhu Worakitti Lapisatepun division of hepatobiliary and Pancreatic surgery Department of SurgeryFaculty of MedicineChiang Mai University HospitalChiang MaiThailand

Background:Hepatocellular carcinoma(HCC)presenting with macroscopic bile duct tumor thrombus(BDTT)is an uncommon *** role of a curative hepatic resection and associated long-term outcomes remain *** addition the necessity for bile duct resection is still *** aim of this study was to evaluate outcomes of hepatectomy with a selective bile duct preservation approach for HCC with BDTT in comparison to outcomes without ***:A total of 22 HCC with BDTT patients who had undergone curative hepatic resection with a selective bile duct preservation approach at our institute were retrospectively *** were compared to group of 145 HCC without BDTT *** impact of curative surgical resection and BDTT on clinical outcomes and survival after surgical resection were ***:All HCC with BDTT cases underwent major hepatectomy vs.32.4%in the comparative *** duct preservation rate was 56.5%.The 1-,3-and 5-year survival rates of HCC with BDTT patients in comparison to the HCC without BDTT group were 81.8%,52.8%and 52.8%vs.73.6%,55.6%and 40.7%(P=0.804)*** resection margin,tumor size≥5 cm and AFP≥200 IU/mL were significant risk factors regarding overall ***,it is unclear whether presence of a bile duct tumor thrombus has an adverse impact on either recurrence free survival or overall ***:Bile duct obstruction from tumor thrombus did not necessarily indicate an advanced form of *** size and AFP had greater impact on long-term outcomes than bile duct tumor *** liver resection with a selective bile duct preserving approach in HCC with BDTT can achieve favorable outcomes comparable to those of HCC without BDTT in selected patients.

关键词： Hepatocellular carcinoma(HCC) bile duct tumor thrombus(BDTT) bile duct preserve outcomes

Minimal access liver surgery: from the escalation, to the boundaries, searching for the rules

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hepatobiliary surgery and Nutrition 2019年第6期8卷 637-639页

作者： Guido Torzilli division of hepatobiliary&General surgery Department of SurgeryHumanitas Research HospitalHumanitas UniversityMilanoItaly

Minimal access liver surgery(MALS),is now routinely performed worldwide,and procedures like limited resections of antero-inferior segments and left lateral sectionectomy could be retained as standard once performed laparoscopically(1).It is a common believe that MALS procedures mean shorter and better postoperative outcome,and essentially more safety compared to the open ***,MALS procedures facing with complex disease presentations are increasingly proposed(2).In this escalation of MALS in the panorama of the surgical offer available for patients with liver tumors open liver surgery(OLS)seems somehow passed *** this setting,the paper of Tong et *** to set clinically based criteria for allowing to foresee the risk of conversion and morbidity once a MALS is planned(3).At least the attempt is worth to be awarded while the results should be validated by means of further studies able to test the scoring system the authors *** sure there is the merit to investigate the burden of MALS,which implies the recognition of a limit and subsequently the need for its precise definition.A definition which,as anything in medicine,could not be considered definitive,since it will probably evolve with expertise and technology as it has been the case in the last 10-15 ***,pointing out the existence of a limit superimposes caution to any effort to get over the burden unless the attempt is based on a solid *** sure,in this sense,the authors have provided an instrument for the surgical community which conveys limits to which any surgeon has to face with.

关键词： routine instrument searching

Achieving laparoscopic anatomic resection for hepatocellular carcinoma by fluorescence guided positive staining of hepatic cone unit

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hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 406-411页

作者： Jun-Fang Deng Chuan-Hui Peng Yu Zhang Xiao-Feng Xu Rong-Liang Tong Zheng-Long Zhai Di-Yu Chen Cheng Zhang Li-Ming Wu Jian Wu division of hepatobiliary Pancreatic surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Laparoscopic anatomical liver resection has been increasingly reported worldwide,but how to demarcate the resection planes is technically challenging[1].Positive staining technique with intraoperative indocyanine green(ICG)-fluorescence imaging has been introduced as an effective tool for real-time intraoperative guidance[2].Liver anatomy is ***,liver is composed of 9 segments,each is composed of two to three subsegments,and each subsegment contains several hepatic cone units.A hepatic cone unit is dominated by a tertiary or quaternary hepatic pedicles[3].

关键词： hepatic resection anatomy

Robotic pancreatic surgery: a slowly developing field

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hepatobiliary surgery and Nutrition 2020年第5期9卷 673-675页

作者： Patrick N.Salibi John B.Martinie division of hepatobiliary and Pancreatic surgery Department of SurgeryAtrium Health Carolinas Medical CenterCharlotteNCUSA

Robotic surgery has undergone rapid development over the last several decades and minimally invasive surgery has become the standard of care for many surgical *** adoption within the world of hepatobiliary and pancreas surgery has been tempered by the complexity of the *** reports showcased the feasibility of distal pancreatectomy and pancreaticoduodenectomy in a minimally invasive fashion and where followed by case series demonstrating its safety and efficacy(1,2).This has since been confirmed with large matched cohorts confirming at a minimum oncologic equivalence between minimally invasive pancreatic resections as compared to open procedures(3).Given the complexity of pancreatic surgery and the inherent limitations of laparoscopic surgery the robotic surgical platform has seen an exponential rise in attention with its role in minimally invasive pancreatic *** this interest there have been two consensus guidelines published on minimally invasive pancreatic surgery demonstrating its growth within the field(4,5).

关键词： surgery slowly matched

Technical aspects of biliary reconstruction in adult living donor liver transplantation

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hepatobiliary & Pancreatic Diseases International 2011年第2期10卷 136-142页

作者： Xiao-Ning Feng, Chao-Feng Ding, Mei-Yuan Xing, Min-Xia Cai and Shu-Sen Zhengdivision of hepatobiliary and Pancreatic surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China division of hepatobiliary and Pancreatic surgery First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China

BACKGROUND: The last decade has witnessed great progress in living donor liver transplantation worldwide. However, biliary complications are more common in partial liver transplantation than in whole liver transplantation. This is due to an impaired blood supply of the hilar bile duct during organ procurement and recipient surgery, commonly encountered anatomical variations, a relatively small graft duct, and complicated surgical techniques used in biliary reconstruction. DATA SOURCES: MEDLINE and PubMed were searched for articles on 'living donor liver transplantation', 'biliary complication', 'anatomical variation', 'biliary reconstruction', 'stenting' and related topics. RESULT: In this review, biliary complications were analyzed with respect to anatomical variation, surgical techniques in biliary reconstruction, and protection of the arterial plexus of the hilar bile duct. CONCLUSION: Transecting the donor bile duct at the right place to secure a larger bile duct stump, anastomosing techniques, and stenting methods as well as preserving the blood supply to the bile duct are all important in reducing biliary complications.

关键词： living donor liver transplantation biliary complications biliary reconstruction biliary drainage biliary anatomy

Feasibility of ABO-incompatible adult living donor liver transplantation for acute-on-chronic liver failure

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hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 662-664页

作者： Seok-Hwan Kim Gi-Won Song Shin Hwang Chul-Soo Ahn Deok-Bog Moon Tae-Yong Ha Sung-Gyu Lee division of hepatobiliary surgery and Liver Transplantation Department of Surgery Asan Medical Center University of Ulsan College of Medicine Seoul 05505 Korea

To the Editor:In Korea,the annual number of deceased donors for or gan transplantation per million people is still less ***,approximately 40%of patients with acute liver failure or acute-on-chronic liver failure undergo living donor liver transplantation（LDLT）.;Although the use of ABO-incompatible（ABOi）living donors is an attrac tive option,ABOi LDLT has very restricted applications

关键词： ABO Feasibility of ABO-incompatible adult living donor liver transplantation for acute-on-chronic liver failure RIT