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Laparoscopic liver resection utilizing the ventral avascular area of the inferior vena cava:A retrospective cohort study

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World Journal of Gastroenterology 2025年第1期31卷 42-57页

作者： Kun Huang Zhu Chen Heng Xiao Hai-Yang Hu Xing-Yu Chen Cheng-You Du Xiang Lan department of Hepatobiliary surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400000China department of General surgery Mianyang Hospital of Traditional Chinese MedicineMianyang 621000Sichuan ProvinceChina

BACKGROUND Laparoscopic liver resection(LLR)can be challenging due to the difficulty of establishing a retrohepatic tunnel under *** the third hepatic hilum before parenchymal transection often leads to significant liver mobilization,tumor compression,and bleeding from the short hepatic veins(SHVs).This study introduces a novel technique utilizing the ventral avascular area of the inferior vena cava(IVC),allowing SHVs to be addressed after parenchymal transection,thereby reducing surgical complexity and improving outcomes in in situ *** To introduce and evaluate a novel LLR technique using the ventral avascular area of the IVC and compare its short-term outcomes with conventional *** The clinical cohort data of patients with pathologically confirmed hepatocellular carcinoma or intrahepatic cholangiocarcinoma who underwent conventional LLR and novel LLR between July 2021 and July 2023 at the First Affiliated Hospital of Chongqing Medical University were retrospectively *** novel LLR,we initially separated the caudate lobe from the IVC using dissecting forceps along the ventral avascular area of the ***,we transected the parenchyma of the left and right caudate lobes from the caudal side to the cephalic side using the avascular area as a ***,we addressed the SHVs and finally dissected the root of the right hepatic vein or left hepatic *** short-term postoperative outcomes and oncological results of the two approaches were evaluated and *** A total of 256 patients were included,with 150(58.59%)undergoing conventional LLR and 106(41.41%)undergoing novel *** novel technique resulted in significantly larger tumor resections(6.47±2.96 cm vs 4.01±2.33 cm,P<0.001),shorter operative times(199.57±60.37 minutes vs 262.33±83.90 minutes,P<0.001),less intraoperative blood loss(206.92±37.09 mL vs 363.34±131.27 mL,P<0.001),and greater resection volume(345.11±31.40 mL vs 264.38±31.98 mL,P<0.001)comp

关键词： Laparoscopic liver resection Inferior vena cava Retrohepatic tunnel Short hepatic veins Complex liver tumors Intraoperative bleeding control

Brachioradialis tendon transfer and palmaris longus tendon graft for thumb avulsion:A case report and review of literature

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World Journal of Clinical Cases 2025年第4期13卷 48-55页

作者： Pierre Curings Sonia Ramos-Pascual Kinga Michalewska Nicolas Gibert Lionel Erhard Mo Saffarini AlexisNogier department of Hand surgery Clinique TrenelSainte-Colombe 69560France Medical Research ReSurg SANyon 1260VaudSwitzerland department of Hand surgery Hand and Upper Limb Surgical InstituteVilleurbanne 69100France department of Orthopaedics Clinique TrenelSainte-Colombe 69560France

BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous *** treatments include direct tendon suture or tendon transfer,most commonly from the ring *** optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon *** SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a *** patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and *** patient was treated with two stage thumb *** first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon *** second intervention consisted of PL tendon graft and BR tendon ***-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 *** Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.

关键词： Brachioradialis tendon transfer Flexor pollicis longus Palmaris longus tendon graft Replantation Thumb amputation Thumb avulsion Case report

Characteristics of patients with columnar-lined Barrett's esophagus and risk factors for progression to esophageal adenocarcinoma

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World Journal of Gastroenterology 2005年第43期11卷 6807-6814页

作者： Kamal E Bani-Hani Bayan K Bani-Hani Iain G Martin department of surgery Academic surgical unit and Center for Digestive Diseases

AIM： To determine the risk factors for the development of esophageal adenocarcinoma in these patients with columnar-lined esophagus （CLE）. METHODS： Data collected retrospectively on 597 consecutive patients diagnosed at endoscopy and histology to have CLE at Leeds General Infirmary between 1984 and 1995 were analyzed. Factors evaluated included age, sex, length of columnar segment, smoking, and drinking habits, history of non-steroidal ingestion, presence of endoscopic esophagitis, ulceration or benign strictures and presence of Helicobacter pylori in esophageal biopsies. Univariate and multivariate analyses were performed to identify risk factors for the development of adenocarcinoma. RESULTS： Forty-four patients presented or developed esophageal adenocarcinoma during follow-up. Independent risk factors for the development of adenocarcinoma in palJents with CLE were males （OR 5.12, 95%CI 2.04-12.84, P = 0.0005）, and benign esophageal stricture （OR 4.37, 95%CI 2.02-9.45, P = 0.0002）. Male subjects and patients who developed benign esophageal stricture constituted 86% （n = 38） of all patients who presented or developed esophageal adenocarcinoma. The presence of esophagitis was associated with a significant reduction in the development of esophageal carcinoma （OR 0.28, 95%CI 0.13-0.57, P = 0.0006）. No other clinical characteristics differentiate between the non-malignant and malignant group. CONCLUSION： In patients with CLE, endoscopic surveillance for the early detection of adenocarcinoma may be restricted to male subjects, as well as patients who develop benign esophageal strictures.

关键词： Barrett's esophagus Adenocarcinoma Risk factors Esophageal adenocarcinoma Esophagealstricture

Updates on abdominal desmoid tumors

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World Journal of Gastroenterology 2007年第45期13卷 5985-5988页

作者： Bernardino Rampone Corrado Pedrazzani Daniele Marrelli Enrico Pinto Franco Roviello department of General surgery and surgical Oncology Unit of Surgical Oncology University of Siena Italy

Desmoid tumor is a monoclonal, f ibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia inf iltrates locally, recurs frequently after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations diff icult. This distinct pathological entity is reviewed with a specif ic focus on aetiology and management.

关键词： Desmoid Abdomen Fibromatosis Familialadenomatous polyposis Gardner's syndrome

Comparative study of living donor kidney transplants:Right vs left

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World Journal of Transplantation 2025年第1期15卷 115-123页

作者： Taqi Khan Nadeem Ahmad Qaisar Iqbal Muneeb Hassan Lajward Asnath Naveed Khan Sajid Shakeel Kidney Transplant unit Rehman Medical InstitutePeshawar 25100Khyber PakhtunkhwaPakistan department of surgery Princess Noura Binti AbdulRehman UniversityRiyadh 84428Saudi Arabia

BACKGROUND Transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft loss or graft ***,circumstances may arise where selecting the RK over the left kidney(LK)is ***,it is crucial to thoroughly examine the implications of such a choice on the overall transplant *** To compare transplant outcomes between recipients of RK and LK while examining the factors that influence these *** We retrospectively analyzed data from adult patients who received LD kidney transplants involving meticulous patient selection and surgical techniques at our center from January 2020 to December *** included all kidney donors who were over 18,fit to donate,and had undergone diethylenetriamine pentaacetic acid split function and/or computed tomography based *** variables examined comprised donor and recipient demographics,and outcome measures included technical graft loss(TGL),delayed or slow graft function(SGF),and post-transplant serum creatinine(SC)*** used a logistic regression model to assess the likelihood of adverse outcomes considering the donor kidney *** Of the 250 transplants performed during the period,56(22%)were *** recipient demographics and transplant factors were comparable for the right and LKs,except that the donor warm and cold ischemia time were shorter for *** and SGF each occurred in 2%(n=1)of RKs and 0.5%(n=1)of LKs,the difference being *** complications,however,were not related to the venous *** RK(2%)developed delayed graft function after 48 hours,which was attributable to postoperative hypoxia rather than the surgical *** post-transplant SC trend and mean SC at the last follow-up were similar across both kidney *** The donor kidney side has little impact on post-transplant

关键词： Living donor Right kidney Right renal vein Venous anastomosis Technical graft loss Early graft function

Tricks and tips in pancreatoduodenectomy

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World Journal of Gastrointestinal Oncology 2014年第9期6卷 344-350页

作者： Anna Pallisera Rafael Morales Jose Manuel Ramia department of surgery Hospital Son Llatzer hpb unit Department of SurgeryHospital Universitario de Guadalajara

Pancreaticoduodenectomy(PD) is the standard surgical treatment for tumors of the pancreatic head,proximal bile duct,duodenum and ampulla,and represents the only hope of cure in cases of *** its initial description in 1935 by Whipple et al,this complex surgical technique has evolved and undergone several *** review three key issues in PD:(1) the initial approach to the superior mesenteric artery,known as the artery-first approach;(2) arterial complications caused by anatomic variants of the hepatic artery or celiac artery stenosis;and(3) the extent of lymphadenectomy.

关键词： Pancreas Pancreaticoduodenectomy Artery-first surgery Lymphadenectomy Celiac axis Hepatic artery

Right hepatectomy with a cholangiojejunostomy and hepaticojejunostomy for unilobar Caroli’s syndrome

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Hepatobiliary & Pancreatic Diseases International 2023年第5期22卷 547-550页

作者： Duminda Subasinghe Sivasuriya Sivaganesh Division of hpb surgery Department of SurgeryFaculty of MedicineUniversity of ColomboColombo00800Sri Lanka The University surgical unit The National Hospital of Sri LankaColombo00800Sri Lanka

Choledochal cysts are benign cystic dilatations of the extra-and intrahepatic bile ducts[1,2].If untreated,their sequelae include recurrent cholangitis,secondary biliary cirrhosis,acute pancreatitis,and cholangiocarcinoma[3,4].Todani et al.[5]classified choledochal cysts into 5 subtypes,of which type V is Caroli’s *** disease is either localized,where unilobar biliary dilatation,commonly in the left,is present,or diffuse,where the entire liver is involved.

关键词： Caroli acute

Ciinical value and cost-effectiveness of minimally invasive distal pancreatectomy

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Hepatobiliary surgery and Nutrition 2020年第2期9卷 205-207页

作者： Andrea Belli Francesco Izzo Giulio Belli department of Abdominal Oncology HPB Surgical Oncology UnitNational Cancer InstituteFondazione G.Pascale-IRCCSNaplesItaly department of General and hpb surgery Loreto Nuovo HospitalNaplesItaly

Minimally invasive pancreatic resection(MIPR)has gained popularity in the last decade and it is currently widely applied with selected indications in highly specialized centres *** pancreatectomy(DP),which lacks of a technical demanding and complex reconstruction phase,is the most suitable pancreatic resection for a minimal invasive approach and is therefore the most performed *** non-randomized studies and meta-analyses suggested that a minimally invasive distal pancreatectomy(MIDP)could improve the short-term postoperative outcomes by reducing the intraoperative blood loss and the postoperative morbidity when compared to open distal pancreatectomy(ODP)(1).MIDP seems also to promote an earlier recovery and a reduction in the length of postoperative stays when compared to ODP without affecting the oncologic ***,the diffusion of MIDP is increasing and a minimally invasive approach is generally recognized as a suitable approach to benign,borderline malignant lesions and to *** value of MIDP for the surgical treatment of pancreatic ductal adenocarcinoma(PDAC)is still under evaluation despite its feasibility and safety in this setting have been demonstrated and similar long-term oncological outcomes were reported by several single and multicentre series(2).The recent published DIPLOMA study,a European retrospective propensity score-matched cohort study on minimally invasive versus open DP for PDAC,raised some concerns in terms of oncological adequacy of MIDP(3).

关键词： centre value distal

Octogenarian liver grafts:Is their use for transplant currently justified?

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World Journal of Gastroenterology 2017年第17期23卷 3099-3110页

作者： Carlos Jiménez-Romero Felix Cambra Oscar Caso Alejandro Manrique Jorge Calvo Alejandro Marcacuzco Paula Rioja David Lora Iago Justo hpb surgery and Abdominal Organ Transplantation unit University Hospital“Doce de Octubre” department of surgery Facultad de Medicina

AIMTo analyse the impact of octogenarian donors in liver *** present a retrospective single-center study, performed between November 1996 and March 2015, that comprises a sample of 153 liver transplants. Recipients were divided into two groups according to liver donor age: recipients of donors ≤ 65 years (group A; n = 102), and recipients of donors ≥ 80 years (group B; n = 51). A comparative analysis between the groups was performed. Quantitative variables were expressed as mean values and SD, and qualitative variables as percentages. Differences in properties between qualitative variables were assessed by χ2 test. Comparison of quantitative variables was made by t-test. Graft and patient survivals were estimated using the Kaplan-Meier ***, 3 and 5-year overall patient survival was 87.3%, 84% and 75.2%, respectively, in recipients of younger grafts vs 88.2%, 84.1% and 66.4%, respectively, in recipients of octogenarian grafts (P = 0.748). One, 3 and 5-year overall graft survival was 84.3%, 83.1% and 74.2%, respectively, in recipients of younger grafts vs 84.3%, 79.4% and 64.2%, respectively, in recipients of octogenarian grafts (P = 0.524). After excluding the patients with hepatitis C virus cirrhosis (16 in group A and 10 in group B), the 1, 3 and 5-year patient (P = 0.657) and graft (P = 0.419) survivals were practically the same in both groups. Multivariate Cox regression analysis demonstrated that overall patient survival was adversely affected by cerebrovascular donor death, hepatocarcinoma, and recipient preoperative bilirubin, and overall graft survival was adversely influenced by cerebrovascular donor death, and recipient preoperative *** standard criteria for utilization of octogenarian liver grafts are: normal gross appearance and consistency, normal or almost normal liver tests, hemodynamic stability with use of unit s

关键词： Older liver Donor age Marginal liver Liver transplant Aging liver