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Repair of the portal vein using a hepatic ligamentum teres patch for laparoscopic pancreatoduodenectomy: A case report

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World Journal of Clinical Cases 2019年第18期7卷 2879-2887页

作者： Qiang Wei Qiang-Pu Chen Qing-Hai Guan Wen-Tao Zhu Department of hepatobiliary Surgery and Clinical Nutrition center Binzhou Medical University Hospital

BACKGROUND Laparoscopic pancreatoduodenectomy (LPD) has been developed gradually with the advances in surgical laparoscopic techniques. It is technically challenging to perform LPD with portal vein resection and reconstruction. CASE SUMMARY A 71-year-old female patient was diagnosed with distal cholangiocarcinoma. After preoperative examination and rigorous preoperative preparation, the patient underwent LPD using 3D laparoscopy on July 17, 2018. During the surgery, we found that the tumor invaded the right wall of the portal vein;thus, pancreaticoduodenectomy combined with partial portal vein wall resection was performed. The defect of the portal vein wall was approximately 2.5 cm × 1.0 cm. The hepatic ligamentum teres was excised by laparoscopy and then recanalized in vitro. Following recanalization, the hepatic ligamentum teres was cut longitudinally and then trimmed into vascular patches that were then used to reconstruct the defect of the portal vein through 3D laparoscopy. The operative time was 560 min, and intraoperative blood loss was 100 mL. The duration of the blood occlusion time was 63 min. No blood transfusion was required. The patient underwent enhanced recovery after surgery procedures after the operation. The patient was discharged on postoperative day 11. Follow-up for 6 months after discharge showed no stenosis of the portal vein and good patency of blood flow. CONCLUSION It is safe and feasible to use the hepatic ligamentum teres patch to repair portal vein in LPD. However, the long-term patency of this technique for venous reconstruction requires further investigation.

关键词： Hepatic ligamentum teres patch Laparoscopic pancreatoduodenectomy Portal vein repair Case report

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Clinical analysis of surgical treatment of portal hypertension

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World Journal of Gastroenterology 2005年第29期11卷 4552-4559页

作者： Xin-Bao Xu Jing-Xiu Cai Xi-Sheng Leng Jia-Hong Dong Ji-Ye Zhu Zhen-Ping He Fu-Shun Wang Ji-Run Peng Ben-Li Han Ru-Yu Du Department of hepatobiliary Surgery People's Hospital Peking University Beijing 100044 China Department of hepatobiliary Surgery Airforce General Hospital Beijing 100036 China center of hepatobiliary Surgery Southwest Hospital The Third Military Medical University Chongqing 400038 China

AIM： To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS： The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization （PAD）, 167 with portasystemic shunt （PSS）, 62 with selective shunt （SS）, 11 with combined portasystemic shunt and portaazygous devascularization （PSS＋PAD）, 9 with liver transplantation （LT）, 3 with union operation for hepatic carcinoma and portal hypertension （HCC＋PH）. RESULTS： In the 167 patients treated with PSS, free portal pressure （FPP） was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation （P〈0.01）. After the operation, FPP in the former patients markedly decreased compared to the latter ones （P〈0.01）. The incidence rate of hemorrhage in patients treated with PAD, PSS, 55, PSS＋PAD, and HCC＋PH was 21.09% （54/256）, 13.77 （23/167）, 11.29 （7/62）, 36.36% （4/11）, and 100% （3/3）, respectively. The incidence rate of hepatic encephalopathy was 3.91% （10/256）, 9.58% （16/167）, 4.84% （3/62）, 9.09% （1/11）, and 100% （3/3）, respectively while the operative mortality was 5.49% （15/256）, 4.22% （7/167）, 4.84% （3/62）, 9.09% （1/11）, and 66.67% （2/3） respectively. The operative mortality of liver transplantation was 22.22% （2/9）. CONCLUSION： Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.

关键词： Portal hypertension Surgical operation Shunt

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Identification of Expression Pattern and Clinical Significance of the Small Cajal Body-specific RNA SCARNA16 in Hepatocellular Carcinoma

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Journal of Clinical and Translational Hepatology 2022年第1期10卷 104-111页

作者： Sitong Zhang Yuan Ding Zhongquan Sun Yao Ge Yanjie Li Xin Han Qianhui Xu Liuzhi Zhou Yining Chen Hao Xu Yang Bai Chang Xu Hao Ding Sheng Yan Weilin Wang Department of hepatobiliary and Pancreatic Surgery The Second Affiliated HospitalZhejiang University School of Medi-cineKey Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang ProvinceRe-search Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang ProvinceClinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang UniversityClinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang ProvinceZhejiang University Cancer CenterHangzhouZhejiangChina Key Laboratory of Precision Diagnosis and Treatment for hepatobiliary and Pancreatic Tumor of Zhejiang Province Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang ProvinceClinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang UniversityClinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang ProvinceZhejiang University Cancer CenterHangzhouZhejiangChina

Background and Aims:For high morbidity and mortality,hepatocellular carcinoma(HCC)becomes a major health issue ***,numerous non-coding RNAs(ncRNAs)are known to regulate the occurrence and patho-genesis of *** ncRNAs have also been developed as tumor biomarkers and therapeutic ***,the potential function of the small Cajal body-specific RNA(scaRNA)SCARNA16,a newly identified ncRNA,remains to be explored in ***:In both HCC cell lines and specimens from 120 enrolled patients,the expression val-ues of SCARNA16 were *** divided patients into SCARNA16 high and low expression subgroups,and then analyzed the difference of various clinical characteristics and prognosis data between ***:Compared to paired controls,SCARNA16 was significantly down-regulated in HCC cell lines and clinical specimens(p<0.01).Besides,HCC patients with lower SCARNA16 expression commonly presented with larger and more tumor lesions,more ves-sel carcinoma emboli,more capsular invasion and higher TNM stages(p<0.05).Moreover,SCARNA16 expression was negatively correlated with postoperative prognosis of HCC patients in 5-year follow-up,including tumor-free survival(TFS)(median time of low *** subgroups:14 vs.48 months,p=0.006)and overall survival(OS)(median time of low *** subgroups:39 vs.52 months,p=0.001).Besides,SCARNA16 acted as an independent prognostic bio-marker in TFS(hazard ratio[HR]:0.578,95%CI:0.345-0.969,p=0.038)and OS(HR:0.366,95%CI:0.178-0.752,p=0.006).Conclusions:Low expression patterns of SCAR-NA16 remarkably associated with severe clinical status and poor survival of patients,suggesting that SCARNA16 pos-sesses potency as a novel biomarker for HCC.

关键词： Hepatocellular carcinoma Non-coding RNA SCARNA16 Clinical assessment Biomarker

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Living donor liver transplantation for an adult patient with situs inversus totalis

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World Journal of Gastroenterology 2010年第18期16卷 2311-2313页

作者： Bong-Wan Kim Byong-Ku Bae Weiguang Xu Hee-Jung Wang Myung-Wook Kim center for Liver Transplantation and hepatobiliary Surgery Ajou University Hospital Ajou University School of Medicine

This recipient with situs inversus totalis(SIT) was a 60-year-old female who had hepatitis B-related endstage liver *** donor evaluation showed that the right posterior section satisfied graft volume and was space-fitting in the recipient hepatic fossa when it was rotated 180 *** operation and postoperative course progressed *** weeks after living donor liver transplantation(LDLT),the graft function was disturbed by compression of bottom-placed right hepatic *** was treated with a vascular stent and subsequently the graft function was *** present case shows that LDLT for patients with SIT using a right posterior section graft is feasible.

关键词： Living donor liver transplantation Situs inversus totalis Right posterior section graft

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Omega-3 polyunsaturated fatty acids promote liver regeneration after 90% hepatectomy in rats

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World Journal of Gastroenterology 2012年第25期18卷 3288-3295页

作者： Yu-Dong Qiu Sheng Wang Yue Yang Xiao-Peng Yan De-partment of hepatobiliary Surgery Affiliated Drum Tower Hos-pitalMedical College of Nanjing UniversityJiangsu Province'sKey Medical Center for Hepatobiliary DiseaseNanjing 210008Jiangsu ProvinceChina

AIM:To evaluate the effectiveness of omega-3 polyunsaturated fatty acid(ω-3 PUFA) administration on liver regeneration after 90% partial hepatectomy(PH) in ***:ω-3 PUFAs were intravenously injected in the ω-3 PUFA group before PH ***,sparing only the caudate lobe,was performed in both the control and the ω-3 PUFA *** rates,liver weight/body weight ratios,liver weights,HE staining,transmission electron microscope imaging,nuclearassociated antigen Ki-67,enzyme-linked immunosorbent assay and signal transduction were evaluated to analyze liver ***:All rats in the control group died within 30 h after *** rates in the ω-3 PUFA group were 20/20 at 30 h and 4/20 1 wk after *** weight/body weight ratios and liver weights increased significantly in the ω-3 PUFA *** structure of sinusoidal endothelial cells and space of Disse was greatly restored in the ω-3 PUFA group compared to the control group after *** the ω-3 PUFA group,interleukin(IL)-4 and IL-10 levels were significantly increased whereas IL-6 and tumor necrosis factor-levels were dramatically *** addition,activation of protein kinase B(Akt) and of signal transducer and activator of transcription 3 signaling pathway were identified at an earlier time after PH in the ω-3 PUFA ***:Omega-3 polyunsaturated fatty acids may prevent acute liver failure and promote liver regeneration after 90% hepatectomy in rats.

关键词： Omega-3 polyunsaturated fatty acids Sur-vival rate Inflammatory cytokines Signaling pathways

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Conversion therapy in liver transplantation for hepatocellular carcinoma:What's new in the era of molecular and immune therapy?

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hepatobiliary & Pancreatic Diseases International 2023年第1期22卷 7-13页

作者： Chao Jiang Xiao-Dong Sun Wei Qiu Yu-Guo Chen Da-Wei Sun Guo-Yue Lv General Surgery center Department of Hepatobiliary and Pancreatic Surgerythe First Hospital of Jilin UniversityChangchun 130021China

Background:Hepatocellular carcinoma(HCC)is the sixth most common cancer globally,with limited therapies and unsatisfactory prognosis once in the advanced *** promising advances in locoregional and systematic treatments,fast development of targeted drugs,the success of immunotherapy,as well as the emergence of the therapeutic alliance,conversion therapy has recently become more well developed and an effective therapeutic *** article aimed to review recent developments in conversion therapy in liver transplantation(LT)for *** sources:We searched for relevant publications on Pub Med before September 2022,using the terms“HCC”,“liver transplantation”,“downstaging”,“bridging treatment”and“conversion therapy.”Results:Conversion therapy was frequently represented as a combination of multiple treatment modalities to downstage HCC and make patients eligible for *** combining various local and systematic treatments in conversion therapy is still controversial,growing evidence has suggested that multimodal combined treatment strategies downstage HCC in a shorter time,which ultimately increases the opportunities for ***,the recent breakthrough of immunotherapy and targeted therapy for HCC also benefit patients with advanced-stage ***:In the era of targeted therapy and immunotherapy,applying the thinking of transplant oncology to benefit HCC patients receiving LT is a new topic that has shed light on advanced-stage *** the expansion of conversion therapy concepts,further investigation and research is required to realize the full potential of conversion treatment strategies,including accurately selecting candidates,determining the timing of surgery,improving the conversion rate,and guaranteeing the safety and long-term efficacy of treatment.

关键词： Liver transplantation Hepatocellular carcinoma Conversion therapy Targeted therapy Immunotherapy Combination therapy

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Giant hepatobiliary cystadenoma in a male with obvious convex papillate

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World Journal of Gastroenterology 2009年第15期15卷 1906-1909页

作者： Zhao-Wei Qu Qiang He Ren Lang Fei Pan Zhong-Kui Jin Qin-Song Sheng Dong Zhang Xiao-Sheng Zhang Da-Zhi Chen Department of hepatobiliary and Pancreatospleenic Surgery Beijing Chaoyang Hospital Affiliated to CapitalMedical University Beijing 100020 China

hepatobiliary cystadenoma that is most often found in is an uncommon lesion middle-aged women and difficult to diagnose preoperatively. Here, we report a case of giant hepatobiliary cystadenoma in a male patient with obvious convex papillate. On the basis of imaging examinations, the patient was diagnosed as hepatobiliary cystadenoma prior to operation. Left hepatectomy was performed and the patient was symptom-free during a 6-too follow-up period, suggesting that imaging examination is the major diagnostic method of hepatobiliary cystadenoma, and operation is its best treatment modality.

关键词： hepatobiliary cystadenoma Liverneoplasm Biliary ductal tumour Diagnosis Treatment

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Traditional surgical planning of liver surgery is modified by 3D interactive quantitative surgical planning approach： a single-center experience with 305 patients

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hepatobiliary & Pancreatic Diseases International 2017年第3期16卷 271-278页

作者： Xue-Dong Wang Hong-Guang Wang Jun Shi Wei-Dong Duan Ying Luo Wen-Bin Ji Ning Zhang Jia-Hong Dong Department of hepatobiliary Surgery Beijing Tsinghua Changgung Hospital Medical Center Tsinghua University Beijing 102218 China Hospital and Institute of hepatobiliary Surgery Chinese PLA General Hospital Beijing 100853 China

BACKGROUND： Decision making and surgical planning are to achieve the precise balance of maximal removal of target lesion, maximal sparing of functional liver remnant volume, and minimal surgical invasiveness and therefore, crucial in liver surgery. The aim of this prospective study was to validate the accuracy and predictability of 3D interactive quantitative surgical planning approach （IQSP）, and to evaluate the impact of IQSP on traditional surgical plans based on 2D images. METHODS： A total of 305 consecutive patients undergoing hepatectomy were included in this study. Surgical plans were created by traditional 2D approach using picture archiving and communication system （PACS） and 3D approach using IQSP respectively by two groups of physicians who did not know the surgical plans of the other group. The two surgical plans were submitted to the chief surgeon for selection before operation. The specimens were weighed. The two surgical plans were compared and analyzed retrospectively based on the operation results. RESULTS： The two surgical plans were successfully developed in all 305 patients and all the 3D IQSP surgical plans were selected as the final decision. Total 278 patients successfully underwent surgery, including 147 uncomplex hepatectomy and 131 complex hepatectomy. Twenty-seven patients were withdrawn from hepatectomy. In the uncomplex group, the two surgical plans were the same in all 147 patients and no statistically significant difference was found among 2D calcu- lated resection volume （2D-RV）, 3D IQSP calculated resection volume （IQSP-RV） and the specimen volume. In the complex group, the two surgical plans were different in 49 patients （49/131, 37.4%）. According to the significance of differences, the 49 different patients were classified into three grades. No statistically significant difference was found between IQSP-RV and specimen volume. The coincidence rate of territory analy- sis of IQSP with operation was 92.1% （93/101） for 101 patients of

关键词： precision quantitative surgical planning reconstruction hepatectomy

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Retrospective observation of therapeutic effects of adult auxiliary partial living donor liver transplantation on postpartum acute liver failure: A case report

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World Journal of Gastroenterology 2015年第9期21卷 2840-2847页

作者： Chuan-Yun Li Wei Lai Shi-Chun Lu Department of hepatobiliary Surgery and Liver Transplantation center Beijing You-An HospitalCapital Medical University Department of hepatobiliary Surgery the First People’s Hospital of Chengdu Institute and Hospital of hepatobiliary Surgery Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLAChinese PLA Medical SchoolChinese PLA General Hospital

We present a female patient with preterm labor, severe viral hepatitis B of acute phase, hepatic encephalopathy stage Ⅲ and *** delivery, the illness was exacerbated and the patient presented with clinical signs of vital organ dysfunctions such as acute respiratory distress syndrome, cerebral edema and hypoxemia that needed mechanical *** liver transplantation was recommended after multidisciplinary panel *** donor, her mother, consented to donate her right *** partial orthotopic living donor liver transplantion(APOLDLT) was *** operation, the patient was on triple medication of tacrolimus plus mofetil mycophenolate and prednisone for *** combination of antihepatitis B virus(HBV) immunoglobulin and entecavir was initiated for anti-HBV *** the patient and the donor recovered well without any *** patient was followed up *** liver function, clinical signs and symptoms improved *** now, the recipient has been living for more than 78 mo free of any *** APOLDLT is a life-saving modality for rescuing patients with high-risk acute liver failure following HBV infection without available donor and hence is recommended under standardized antiviral therapy coverage as stated above.

关键词： Auxiliary partial orthotopic living donor liver tr

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Inhibition of pancreatic stellate cell activity by adipose-derived stem cells

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hepatobiliary & Pancreatic Diseases International 2015年第2期14卷 215-221页

作者： Fu-Xiang Yu Long-Feng Su Chun-Lei Dai Yang Wang Yin-Yan Teng Jun-Hui Fu Qi-Yu Zhang Yin-He Tang Department of hepatobiliary and Pancreatic Surgery FirstAffiliatedHospital WenzhouMedicalCollege Department of hepatobiliary and Pancreatic Surgery FirstAffiliatedHospitalWenzhouMedicalCollege

BACKGROUND：Pancreatic stellate cells（PSCs）play a critical role in the development of pancreatic *** this study we used a novel method to isolate and culture rat PSCs and then investigated the inhibitory effects of adipose-derived stem cells（ADSCs）on activation and proliferation of ***：Pancreatic tissue was obtained from SpragueDawley rats for PSCs *** cell cultures were adopted for co-culture of ADSCs and PSCs. PSCs prolifera- tion and apoptosis were determined using CCK-8 and flow cytometry, respectively, a-SMA expressions were analyzed using Western blotting. The levels of cytokines [nerve growth factor （NGF）, interleukin-10 （IL-10） and transforming growth factor-ill （TGF-[31）] in conditioned medium were detected by ELISA. Gene expression （MMP-2, MMP-9 and TIMP-1） was analyzed using qRT-PCR. RESULTS： This method produced 17.6_＋6.5 ~ 103 ceils per gram of the body weight with a purity of 90%-95% and a viability of 92%-97%. Co-culture of PSCs with ADSCs significantly inhib- ited PSCs proliferation and induced PSCs apoptosis. Moreover, a-SMA expression was significantly reduced in PSCs＋ADSCs compared with that in PSC-only cultures, while expression of fibrinolytic proteins （e.g., MMP-2 and MMP-9） was upregulated and anti-fibrinolytic protein （TIMP-1） was downregulated. In addition, NGF expression was up-regulated, but IL-10 and TGF-β1 expressions were down-regulated in the coculture conditioned medium compared with those in the PSC- only culture medium. CONCLUSIONS： This study provided an easy and reliable technique to isolate PSCs. The data demonstrated the inhibitory effects of ADSCs on the activation and proliferation of PSCs in vitro.

关键词： pancreatic stellate cells isolation mesenchymal stem cells pancreatic fibrosis fibrinolytic protein

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