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Diagnosis and outcomes of collateral arterial formation after irreversible early hepatic artery thrombosis in pediatric liver recipients

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Hepatobiliary & Pancreatic Diseases International 2017年第1期16卷 39-44页

作者： Li-Hong Gu Feng-Hua Li Qiang Xia Hua Fang Shi-Jun Zhang Long-Zhi Han Department of ultrasound Renji Hospital School of Medicine Shanghai Jiaotong University Shanghai 200127 China Department of liver Surgery Renji Hospital School of Medicine Shanghai Jiaotong University Shanghai 200127 China

BACKGROUND： Early hepatic artery thrombosis （eHAT） has been recognized as an important cause of graft loss and mortality. However, the incidence, etiology and outcome are not dear, especially for children. The present study was to investigate the formation of collateral artery flow after irreversible eHAT and its impact on patient＇s prognosis. METHODS： We analyzed eHAT after liver transplantation in children from October 2006 to April 2015 in our center, illustrated the formation of collateral hepatic artery flow after irreversible eHAT and explored the diagnosis, complications, treatment and prognosis. The basic and follow-up ultrasonographic images were also compared. RESULTS： Of the 330 pediatric liver recipients, 22 （6.67%） de- veloped eHAT within 1 month. Revascularization attempts in- duding surgical thrombectomy, interventional radiology and conservational treatment （thrombolysis） were successful in 5 patients. Among the 17 patients who had irreversible eHAT, follow-up ultrasonography revealed that collateral artery flow was developed as early as 2 weeks after eHAT. liver abscess and bile duct complication occurred secondary to eHAT in variable time. CONCLUSIONS： Collateral arterial formation is a compensatory adaptation to eHAT to supply blood to liver grafts. However, the severe bile duct damage secondary to eHAT is irreversible and retransplantation is unavoidable.

关键词： ultrasonography liver transplantation children hepatic artery thrombosis collateral arterial formation

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Percutaneous electrochemotherapy in the treatment of portal vein tumor thrombosis at hepatic hilum in patients with hepatocellular carcinoma in cirrhosis: A feasibility study

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World Journal of Gastroenterology 2017年第5期23卷 906-918页

作者： Luciano Tarantino Giuseppina Busto Aurelio Nasto Raffaele Fristachi Luigi Cacace Maria Talamo Catello Accardo Sara Bortone Paolo Gallo Paolo Tarantino Riccardo Aurelio Nasto Matteo Nicola Dario Di Minno Pasquale Ambrosino Department of Surgery Interventional Hepatology UnitAndrea Tortora Hospital Department of Oncology Andrea Tortora Hospital Department of Surgery Unit of General Surgery and OncologyAndrea Tortora Hospital Department of Pathology Andrea Tortora Hospital Department of Radiology Andrea Tortora Hospital Department of Advanced Biomedical Sciences Division of CardiologyFederico II University unit of Cell and Molecular Biology in Cardiovascular Diseases Centro Cardiologico MonzinoIRCCS Department of Clinical Medicine and Surgery Federico II University

AIMTo treated with electrochemotherapy (ECT) a prospective case series of patients with liver cirrhosis and Vp3-Vp4- portal vein tumor thrombus (PVTT) from hepatocellular carcinoma (HCC), in order to evaluate the feasibility, safety and efficacy of this new non thermal ablative technique in those *** patients (5 males and 1 female), aged 61-85 years (mean age, 70 years), four in Child-Pugh A and two in Child-Pugh B class, entered our study series. All patients were studied with three-phase computed tomography (CT), contrast enhanced ultrasound (CEUS) and ultrasound-guided percutaneous biopsy of the thrombus before ECT. All patients underwent ECT treatment (Cliniporator Vitae®, IGEA SpA, Carpi, Modena, Italy) of Vp3-Vp4 PVTT in a single session. At the end of the procedure a post-treatment biopsy of the thrombus was performed. Scheduled follow-up in all patients entailed: CEUS within 24 h after treatment; triphasic contrast-enhanced CT and CEUS at 3 mo after treatment and every six months ***-treatment CEUS showed complete absence of enhancement of the treated thrombus in all cases. Post-treatment biopsy showed apoptosis and necrosis of tumor cells in all cases. The follow-up ranged from 9 to 20 mo (median, 14 mo). In 2 patients, the follow-up CT and CEUS demonstrated complete patency of the treated portal vein. Other 3 patients showed a persistent avascular non-tumoral shrinked thrombus at CEUS and CT during follow-up. No local recurrence was observed at follow-up CT and CEUS in 5/6 patients. One patient was lost to follow-up because of death from gastrointestinal hemorrage 5 wk after *** patients with cirrhosis, ECT seems effective and safe for curative treatment of Vp3-Vp4 PVTT from HCC.

关键词： Hepatocellular carcinoma Portal vein tumor thrombosis Electrochemotherapy

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Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1647-1659页

作者： Ju-Hang Chu Lu-Yao Huang Ya-Ru Wang Jun Li Shi-Long Han Hao Xi Wen-Xue Gao Ying-Yu Cui Ming-Ping Qian Department of General Surgery Shanghai Tenth People's HospitalSchool of MedicineTongji UniversityShanghai 200072China Department of interventional and Vascular Surgery Shanghai Tenth People's HospitalSchool of MedicineTongji UniversityShanghai 200072China Department of Pathology Shanghai Tenth People's HospitalSchool of MedicineTongji UniversityShanghai 200072China Clinical Research Management Office Shanghai Tenth People’s HospitalShanghai 200072China Department of Cell Biology Institute of Medical GeneticsState Key Laboratory of CardiologyTongji University School of MedicineShanghai 200331China

BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of death due to its complexity,heterogeneity,rapid metastasis and easy recurrence after surgical *** demonstrated that combination therapy with transcatheter arterial chemoembolization(TACE),hepatic arterial infusion chemotherapy(HAIC),Epclusa,Lenvatinib and Sintilimab is useful for patients with advanced *** SUMMARY A 69-year-old man who was infected with hepatitis C virus(HCV)30 years previously was admitted to the hospital with abdominal *** computed tomography(CT)revealed a low-density mass in the right lobe of the liver,with a volume of 12.9 cm×9.4 cm×15 cm,and the mass exhibited a“fast-in/fast-out”pattern,with extensive filling defect areas in the right branch of the portal vein and an alpha-fetoprotein level as high as 657 ng/***,he was judged to have advanced *** treatment,the patient received three months of Epclusa,three TACE treatments,two HAIC treatments,three courses of sintilimab,and twenty-one months of *** the third month of treatment,the patient developed severe side effects and had to stop immunotherapy,and the Lenvatinib dose had to be *** pathological diagnosis indicated a complete *** patient recovered well after the operation,and no tumor recurrence was *** Multidisciplinary conversion therapy for advanced enormous HCC caused by HCV infection has a significant *** drug adjustments should be made during any treatment according to the patient's tolerance to treatment.

关键词： Hepatocellular therapy Conversion hepatectomy interventional therapy Epclusa Lenvatinib Sintilimab Case report

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Comprehensive genomic analysis of early and late-onset hepatocellular carcinoma

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Genes & Diseases 2024年第4期11卷 77-81页

作者： Jialin Yang Chao Chen Song Wang Yaru Zhang Jiaohui Pang Yajun Wang Qiuxiang Ou Hao Jiang Juying Liu Department of Radiation Oncology Sichuan Cancer Hospital&InstituteSichuan Cancer CenterSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengduSichuan 610041China Jinling Hospital Department of OncologyNanjing Medical UniversityNanjingJiangsu 210002China Geneseeq Research Institute Nanjing Geneseeq Technology Inc.NanjingJiangsu 210000China Department of Oncology Haian Hospital of Traditional Chinese MedicineHaianJiangsu 226600China interventional Therapy Department Jiangsu Cancer Hospital&Jiangsu Institute of Cancer Research&The Affiliated Cancer Hospital of Nanjing Medical UniversityNanjingJiangsu 210009China

Hepatocellular carcinoma(HCC)is the major histologic type of primary liver cancer,accounting for approximately 75%of liver cancer cases.'Despite many advancements in its treatment,the prognosis and drug response of HCC patients are ***,there is an unmet clinical need to explore genomic aberrations underlying early-and lateonset HcC,which might facilitate drug discovery and provide personalized biomarker-driven treatment options for these patients.

关键词： patients prognosis cancer

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Hemorrhagic cardiac tamponade after percutaneous laser ablation of a liver metastasis in segment II

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Hepatoma Research 2016年第1期2卷 193-196页

作者： Paola Tombesi Francesca Di Vece Silvia Rinaldi Matteo Bertini Sergio Sartori Section of interventional ultrasound Department of Internal MedicineSt.Anna Hospital44100 FerraraItaly Anesthesiology unit St.Anna Hospital44100 FerraraItaly Cardiology unit St.Anna Hospital44100 FerraraItaly

Despite percutaneous laser thermal ablation(LTA)of liver tumors being regarded as a safe technique,major complications can *** report the first case of hemorrhagic cardiac tamponade after LTA of a colorectal metastasis in segment II of the *** heat diffusion causing indirect thermal injury to the pericardium with resultant hemorrhagic reaction was hypothesized as the most likely cause of tamponade.A pericardial drain was emergently placed,200 mL of bright red blood were drained,and the patient showed rapid hemodynamic *** lesions located in segment II of the liver and strictly close to the pericardium,a careful risk/benefit analysis should be made by the multidisciplinary team to identify the best treatment option,taking into account both effectiveness and complications of each available technique.

关键词： Laser thermal ablation liver tumors complications cardiac tamponade

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Laser ablation of liver tumors:An ancillary technique,or an alternative to radiofrequency and microwave?

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World Journal of Radiology 2017年第3期9卷 91-96页

作者： Sergio Sartori Francesca Di Vece Francesca Ermili Paola Tombesi Section of interventional ultrasound St Anna Hospital44100 FerraraItaly

Radiofrequency ablation(RFA) is currently the most popular and used ablation modality for the treatment ofnon surgical patients with primary and secondary liver tumors, but in the last years microwave ablation(MWA) is being technically improved and widely rediscovered for clinical use. Laser thermal ablation(LTA) is by far less investigated and used than RFA and MWA, but the available data on its effectiveness and safety are quite good and comparable to those of RFA and MWA. All the three hyperthermia-based ablative techniques, when performed by skilled operators, can successfully treat all liver tumors eligible for thermal ablation, and to date in most centers of interventional oncology or interventional radiology the choice of the technique usually depends on the physician's preference and experience, or technical availability. However, RFA, MWA, and LTA have peculiar advantages and limitations that can make each of them more suitable than the other ones to treat patients and tumors with different characteristics. When all the three thermal ablation techniques are available, the choice among RFA, MWA, and LTA should be guided by their advantages and disadvantages, number, size, and location of the liver nodules, and cost-saving considerations, in order to give patients the best treatment option.

关键词： Radiofrequency ablation liver neoplasm Laser ablation Microwave ablation Hepatocellular carcinoma liver metastases

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Nationwide trends and predictors of inpatient mortality in 83884 transjugular intrahepatic portosystemic shunt

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World Journal of Gastroenterology 2016年第25期22卷 5780-5789页

作者： Edward Wolfgang Lee Andrew Kuei Sammy Saab Ronald W Busuttil Francisco Durazo Steven-Huy Han Mohamed M El-Kabany Justin P Mc Williams Stephen T Kee Department of Radiology Division of Interventional Radiology Ronald Reagan Medical Center at UCLA David Geffen School of Medicine at UCLA Department of Medicine Division of Hepatology Pfleger Liver Institute University of California at Los Angeles Dumont-UCLA Transplant Center Pfleger Liver Institute Division of Liver and Pancreas Transplantation Department of Surgery David Geffen School of Medicine at University of California Los Angeles

AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt (TIPS) in 15 ***: Using the National Inpatient Sample which is a part of Health Cost and Utilization Project, we identified a discharge-weighted national estimate of 83884 TIPS procedures performed in the united States from 1998 to 2012 using international classification of diseases-9 procedural code 39.1. The demographic, hospital and co-morbility data were analyzed using a multivariant analysis. Using multi-nominal logistic regression analysis, we determined predictive factors related to increases in-hospital mortality. Comorbidity measures are in accordance to the Comorbidity Software designed by the Agency for Healthcare Research and ***: Overall, 12.3% of patients died during hospitalization with downward trend in-hospital mortality with the mean length of stay of 10.8 ± 13.1 d. Notable, African American patients (OR = 1.809 vs Caucasian patients, P < 0.001), transferred patients (OR = 1.347 vs non-transferred, P < 0.001), emergency admissions (OR = 3.032 vs elective cases, P < 0.001), patients in the Northeast region (OR = 1.449 vs West, P < 0.001) had significantly higher odds of in-hospital mortality. Number of diagnoses and number of procedures showed positive correlations with in-hospital death (OR = 1.249 per one increase in number of procedures). Patients diagnosed with acute respiratory failure (OR = 8.246), acute kidney failure (OR = 4.359), hepatic encephalopathy (OR = 2.217) and esophageal variceal bleeding (OR = 2.187) were at considerably higher odds of in-hospital death compared with ascites (OR = 0.136, P < 0.001). Comorbidity measures with the highest odds of in-hospital death were fluid and electrolyte disorders (OR = 2.823), coagulopathy (OR = 2.016), and lymphoma (OR = 1.842).CONCLUSION: The overall mortality of the TIPS procedure is stea

关键词： Transjugular intrahepatic portosystemic shunt Mortality Inpatient united States National Inpatient Sample database Health Cost and Utilization Project

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Branching patterns of the left portal vein and consequent implications in liver surgery:The left anterior sector

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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 399-402页

作者： Mattia Garancini Mauro Alessandro Scotti Luca Gianotti Antonio Rovere Fabio Uggeri Marco Braga Fabrizio Romano unit of Hepatobiliary Pancreatic Surgery Department of General Surgery 1ASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 3320900 MonzaMBItaly unit of interventional Radiology Department of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 3320900 MonzaMBItaly

To the Editor: There are still some open issues about the systematization of the knowledge of the branching of the left portal vein(LPV) and the division in anatomo-functional units within the left liver. The first controversial topic concerns the division of S4 in subsegments. The Brisbane 20 0 0 system of Nomenclature of Hepatic Anatomy and Resections(B20 0 0) [1] does not mention such subdivision, but in literature this is still a matter of discussion.

关键词： branching portal discussion

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Dual neovascular targets of vascular endothelial growth factor receptors and platelet-derived growth factor receptor ameliorate thioacetamide induced liver fibrosis in rats

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Portal Hypertension & Cirrhosis 2024年第1期3卷 1-13页

作者： Bin Xiong Yaowei Bai Jiacheng Liu Tongqiang Li Yingliang Wang Chen Zhou Department of interventional Radiology The First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina Department of Radiology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina Hubei Province Key Laboratory of Molecular Imaging WuhanHubeiChina

Aims:Neovascularization plays a crucial role in liver fibrosis(LF),and blocking vascular endothelial growth factor receptors(VEGFR)has been shown to improve *** aim of our study was to investigate the role of dual neovascularization targets,VEGFR,and platelet-derived growth factor receptor(PDGFR),in ameliorating ***:In vitro,we observed the effects of apatinib(APA)(a VEGFR inhibitor)and donafenib(DON)(a VEGFR and PDGFR inhibitor)on the activation,proliferation,and apoptosis of hepatic stellate cells(HSCs)from rats and *** vivo,we established a thioacetamide(TAA)-induced liver fibrosis rat model to explore the antifibrosis effect of APA and *** used the method of random table to randomly divide the rats into 4 *** detected the expression of angiogenesis-related proteins using Western blot and ***:APA and DON inhibited the proliferation and activation of HSCs,promoted apoptosis of HSCs,and arrested the S phase of the cell cycle in *** also found that DON had a stronger inhibitory effect on *** vivo,APA and DON ameliorated liver fibrosis,reduced collagen deposition andα-SMA expression in rats,and DON had a stronger improvement *** and DON downregulated the expression of VEGFR2 while inhibiting the phosphorylation of Akt and ERK1/*** can act through both VEGF and PDGF pathways,whereas APA can only act through the VEGF ***:Antiangiogenesis is a promising approach for the treatment of *** with a single-target drug(APA),the dual-target drug(DON)can achieve better therapeutic effects.

关键词： antiangiogenesis apatinib donafenib fibrosis

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liver resection vs radiofrequency ablation in single hepatocellular carcinoma of posterosuperior segments in elderly patients

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World Journal of Gastrointestinal Surgery 2021年第12期13卷 1696-1707页

作者： Antonella Delvecchio Riccardo Inchingolo Rita Laforgia Francesca Ratti Maximiliano Gelli Massimiliano Ferdinando Anelli Alexis Laurent Giulio Vitali Paolo Magistri Giacomo Assirati Emanuele Felli Taiga Wakabayashi Patrick Pessaux Tullio Piardi Fabrizio di Benedetto Nicola de'Angelis Javier Briceño Antonio Rampoldi RenèAdam Daniel Cherqui Luca Antonio Aldrighetti Riccardo Memeo unit of General Surgery "A.Perrino"HospitalCeglie Messapica 70124BariItaly interventional Radiology unit "F.Miulli"General Regional HospitalAcquaviva delle Fonti 75100Italy unit of Laparoscopic Surgery University of BariBary 70124Italy unit of Hepato-Pancreatic-Biliary Surgery University Vita Salute San RaffaeleMilan 20132Italy Department of Surgical Oncology Gustave Roussy Cancer Campus Grand ParisVillejuif 94800France of General Surgery Reina Sofia University HospitalCordoba 14004Spain Department of Digestive and Hepatobiliary Surgery Henry Mondor University HospitalCreteil 94000France Division of Transplantation Geneva University HospitalGeneva 44041Switzerland Hepato-Pancreato-Biliary Surgery and liver Transplantation unit University of Modena and Reggio EmiliaModena 42121Italy Department of Digestive Surgery Strasbourg University HospitalStrasbourg 67000France Department of Digestive and Hepatobiliary Surgery Robert DebrèUniversity HospitalReims 51100France unit of Minimally Invasive and Robotic Digestive Surgery "F.Miulli"General Regional HospitalAcquaviva delle Fonti 70124Italy interventional Radiology unit Niguarda HospitalMilan 20162Italy Department of Hepatobiliary Surgery Paul Brousse University HospitalVillejuif 94800France Department of Hepatobiliary Surgery University Vita Salute San RaffaeleMilan 20132Italy unit of Hepato-Pancreatic-Biliary Surgery "F.Miulli"General Regional HospitalAcquaviva delle Fonti 70124Italy

BACKGROUND liver resection and radiofrequency ablation are considered curative options for hepatocellular *** choice between these techniques is still controversial especially in cases of hepatocellular carcinoma affecting posterosuperior segments in elderly *** To compare post-operative outcomes between liver resection and radiofrequency ablation in elderly with single hepatocellular carcinoma located in posterosuperior *** A retrospective multicentric study was performed enrolling 77 patients age≥70-years-old with single hepatocellular carcinoma(≤30 mm),located in posterosuperior segments(4a,7,8).Patients were divided into liver resection and radiofrequency ablation groups and preoperative,peri-operative and long-term outcomes were retrospectively analyzed and compared using a 1:1 propensity score *** After propensity score matching,twenty-six patients were included in each *** time and overall postoperative complications were higher in the resection group compared to the ablation group(165 min vs 20 min,P<0.01;54%vs 19%P=0.02 respectively).A median hospital stay was significantly longer in the resection group than in the ablation group(7.5 d vs 3 d,P<0.01).Ninety-day mortality was comparable between the two *** were no significant differences between resection and ablation group in terms of overall survival and disease free survival at 1,3,and 5 *** Radiofrequency ablation in posterosuperior segments in elderly is safe and feasible and ensures a short hospital stay,better quality of life and does not modify the overall and disease-free survival.

关键词： Elderly Hepatocellular carcinoma Posterosuperior segments liver resection Radiofrequency ablation Multicentric study

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