HPB surgery : a world journal of hepatic, pancreatic and biliary surgery最新文献_第5页

A single centre experience of first "one hundred laparoscopic liver resections". 第一次“一百次腹腔镜肝脏切除术”的单一中心经验。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2014-01-01 Epub Date: 2014-02-11 DOI: 10.1155/2014/930953

S Rehman, S K P John, J J French, D M Manas, S A White

{"title":"A single centre experience of first \"one hundred laparoscopic liver resections\".","authors":"S Rehman, S K P John, J J French, D M Manas, S A White","doi":"10.1155/2014/930953","DOIUrl":"https://doi.org/10.1155/2014/930953","url":null,"abstract":"Background. Laparoscopic liver resection (LLR) has emerged as an alternative procedure to open liver resection in selected patients. The purpose of this study was to describe our initial experience of 100 patients undergoing LLR. Methods. We analysed a prospectively maintained hepatobiliary database of 100 patients who underwent LLR between August 2007 and August 2012. Clinicopathological data were reviewed to evaluate surgical outcomes following LLR. Results. The median age was 64 and median BMI 27. Patients had a liver resection for either malignant lesions (n = 74) or benign lesions (n = 26). Commonly performed procedures were segmentectomy/metastectomy (n = 55), left lateral sectionectomy (LLS) (n = 26), or major hepatectomy (n = 19). Complete LLR was performed in 84 patients, 9 were converted to open and 7 hand-assisted. The most common indications were CRLM (n = 62), followed by hepatic adenoma (n = 9) or hepatocellular carcinoma (n = 7). The median operating time was 240 minutes and median blood loss was 250 mL. Major postoperative complications occurred in 9 patients. The median length of stay (LOS) was 5 days. One patient died within 30 days of liver resection. Conclusions. LLR is a safe and oncologically feasible procedure with comparable short-term perioperative outcomes to the open approach. However, further studies are necessary to determine long-term oncological outcomes. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2014 ","pages":"930953"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/930953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32211276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Risk Factors Associated with Reoperation for Bleeding following Liver Transplantation. 肝移植术后再手术出血的相关危险因素。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2014-01-01 Epub Date: 2014-11-20 DOI: 10.1155/2014/816246

Maxwell A Thompson, David T Redden, Lindsey Glueckert, A Blair Smith, Jack H Crawford, Keith A Jones, Devin E Eckhoff, Stephen H Gray, Jared A White, Joseph Bloomer, Derek A DuBay

{"title":"Risk Factors Associated with Reoperation for Bleeding following Liver Transplantation.","authors":"Maxwell A Thompson, David T Redden, Lindsey Glueckert, A Blair Smith, Jack H Crawford, Keith A Jones, Devin E Eckhoff, Stephen H Gray, Jared A White, Joseph Bloomer, Derek A DuBay","doi":"10.1155/2014/816246","DOIUrl":"https://doi.org/10.1155/2014/816246","url":null,"abstract":"Introduction. This study's objective was to identify risk factors associated with reoperation for bleeding following liver transplantation (LTx). Methods. A retrospective study was performed at a single institution between 2001 and 2012. Operative reports were used to identify patients who underwent reoperation for bleeding within 2 weeks following LTx (operations for nonbleeding etiologies were excluded). Results. Reoperation for bleeding was observed in 101/928 (10.8%) of LTx patients. The following characteristics were associated with reoperation on multivariable analysis: recipient MELD score (OR 1.06/MELD unit, 95% CI 1.03, 1.09), number of platelets transfused (OR 0.73/platelet unit, 95% CI 0.58, 0.91), and aminocaproic acid utilization (OR 0.46, 95% CI 0.27, 0.80). LTx patients who underwent reoperation for bleeding had a longer ICU stay (5 days ± 7 versus 2 days ± 3, P < 0.001) and hospitalization (18 days ± 9 versus 10 days ± 18, P < 0.001). The risk of death increased in patients who underwent reoperation for bleeding (HR 1.89, 95% CI 1.26, 2.85). Conclusion. Reoperation for bleeding following LTx was associated with increased resource utilization and recipient mortality. A lower threshold for intraoperative platelet transfusion and antifibrinolytics, especially in patients with high lab-MELD score, may decrease the incidence of reoperation for bleeding following LTx. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2014 ","pages":"816246"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/816246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32906107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 27

Debakey forceps crushing technique for hepatic parenchymal transection in liver surgery: a review of 100 cases and ergonomic advantages. Debakey钳粉碎技术在肝脏手术中肝实质横断:100例临床分析及人机工程学优势。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2014-01-01 Epub Date: 2014-06-09 DOI: 10.1155/2014/861829

Sundeep Jain, Bharat Sharma, Mitesh Kaushik, Lokendra Jain

{"title":"Debakey forceps crushing technique for hepatic parenchymal transection in liver surgery: a review of 100 cases and ergonomic advantages.","authors":"Sundeep Jain, Bharat Sharma, Mitesh Kaushik, Lokendra Jain","doi":"10.1155/2014/861829","DOIUrl":"https://doi.org/10.1155/2014/861829","url":null,"abstract":"Introduction and Objective. Bleeding is an important complication in liver transections. To determine the safety and efficacy of Debakey forceps for liver parenchymal transection and its ergonomic advantages over clamp crushing method we analysed our data. Methods. We used Debakey crushing technique in 100 liver resections and analysed data for transection time, transfusion rate, morbidity, mortality, hospital stay, influence of different types of liver conditions, and ergonomi features of Debakey forceps. Results. Mean age, transection time and hospital stay of 100 patients were 52.38 ± 17.44 years, 63.36 ± 33.4 minutes, and 10.27 ± 5.7 days. Transection time, and hospital stay in patients with cirrhotic liver (130.4 ± 44.4 mins, 14.6 ± 5.5 days) and cholestatic liver (75.8 ± 19.7 mins, 16.5 ± 5.1 days) were significantly greater than in patients with normal liver (48.1 ± 20.1 mins, 6.7 ± 1.8 days) (P < 0.01). Transection time improved significantly with experience (first fifty versus second fifty cases-70.2 ± 31.1 mins versus 56.5 ± 34.5 mins, P < 0.04). Qualitative evaluation revealed that Debakey forceps had ergonomic advantages over Kelly clamp. Conclusions. Debakey forceps crushing technique is safe and effective for liver parenchymal transection in all kinds of liver. Transection time improves with surgeon's experience. It has ergonomic advantages over Kelly clamp and is a better choice for liver transection. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2014 ","pages":"861829"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/861829","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32492551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Use of Pharmacologic Agents for Modulation of Ischaemia-Reperfusion Injury after Hepatectomy: A Questionnaire Study of the LiverMetSurvey International Registry of Hepatic Surgery Units. 使用药物调节肝切除术后缺血再灌注损伤:肝脏调查国际肝脏外科单位登记的问卷研究。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2014-01-01 Epub Date: 2014-11-12 DOI: 10.1155/2014/437159

Santhalingam Jegatheeswaran, Saurabh Jamdar, Thomas Satyadas, Aali J Sheen, Rene Adam, Ajith K Siriwardena

{"title":"Use of Pharmacologic Agents for Modulation of Ischaemia-Reperfusion Injury after Hepatectomy: A Questionnaire Study of the LiverMetSurvey International Registry of Hepatic Surgery Units.","authors":"Santhalingam Jegatheeswaran, Saurabh Jamdar, Thomas Satyadas, Aali J Sheen, Rene Adam, Ajith K Siriwardena","doi":"10.1155/2014/437159","DOIUrl":"https://doi.org/10.1155/2014/437159","url":null,"abstract":"Objectives. This study is a questionnaire survey on the use of pharmacological agents to modify liver ischaemia-reperfusion (IR) injury in patients undergoing hepatectomy for colorectal liver metastases with the target population being those units participating in the LiverMetSurvey international registry. Methods. Members of LiverMetSurvey were sent an online questionnaire using SurveyMonkey comprising ten questions on the use of pharmacological agents to modulate hepatic IR injury in the perioperative period after hepatectomy. The questionnaire was sent to 446 clinicians registered with the LiverMetSurvey. There were 83 (19%) respondents. Results. Fifty-two (77% of 68 respondents to this question) never used pharmacological agents to modify liver IR injury during hepatectomy. Thirteen (19%) used pharmacological agents selectively. Three (4%) used these routinely. N-Acetylcysteine was the most widely used pharmacological agent with equal distribution of use around intraoperative and postoperative periods. Conclusions. This is believed to be the first survey on the use of pharmacological agents to modify liver IR injury. The target population is clinicians involved in liver resection. The results show that pharmacological modulation is used by only a minority of respondents to this questionnaire and that when this treatment is selected, N-acetylcysteine is the most frequently used. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2014 ","pages":"437159"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/437159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32882154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Pancreatic resections in renal failure patients: is it worth the risk? 肾衰患者行胰腺切除术:值得冒险吗?

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2014-01-01 Epub Date: 2014-02-09 DOI: 10.1155/2014/938251

K S Norman, S R Domingo, L L Wong

{"title":"Pancreatic resections in renal failure patients: is it worth the risk?","authors":"K S Norman, S R Domingo, L L Wong","doi":"10.1155/2014/938251","DOIUrl":"https://doi.org/10.1155/2014/938251","url":null,"abstract":"Background. Chronic kidney disease affects 20 million US patients, with nearly 600,000 on dialysis. Long-term survival is limited and the risk of complex pancreatic surgery in this group is questionable. Previous studies are limited to case reports and small case series and a large database may help determine the true risk of pancreatic surgery in this population. Methods. The American College of Surgeons National Surgical Quality Improvement Program database was queried (2005-2011) for patients who underwent pancreatic resection. Renal failure was defined as the clinical condition associated with rapid, steadily increasing azotemia (rise in BUN) and increasing creatinine above 3 mg/dL. Operative trends and short-term outcomes were reviewed for those with and without renal failure (RF). Results. In 18,533 patients, 28 had RF. There was no difference in wound infections, neurologic or cardiovascular complications. Compared to non-RF patients, those with RF had more unplanned intubation (OR 4.89, 95% CI 1.85-12.89), bleeding requiring transfusion (OR 3.12, 95% CI 1.37-14.21), septic shock (OR 8.86, 95% CI 3.75-20.91), higher 30-day mortality (21.4% versus 2.3%, P < 0.001) and longer hospital stay (23 versus 12 days, P < 0.001). Conclusions. RF patients have much higher morbidity and mortality after pancreatic resections and surgeons should consider this before proceeding. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2014 ","pages":"938251"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/938251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32211277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Iatrogenic biliary injuries: multidisciplinary management in a major tertiary referral center. 医源性胆道损伤:主要三级转诊中心的多学科管理。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2014-01-01 Epub Date: 2014-11-10 DOI: 10.1155/2014/575136

Ibrahim Abdelkader Salama, Hany Abdelmeged Shoreem, Sherif Mohamed Saleh, Osama Hegazy, Mohamed Housseni, Mohamed Abbasy, Gamal Badra, Tarek Ibrahim

{"title":"Iatrogenic biliary injuries: multidisciplinary management in a major tertiary referral center.","authors":"Ibrahim Abdelkader Salama, Hany Abdelmeged Shoreem, Sherif Mohamed Saleh, Osama Hegazy, Mohamed Housseni, Mohamed Abbasy, Gamal Badra, Tarek Ibrahim","doi":"10.1155/2014/575136","DOIUrl":"https://doi.org/10.1155/2014/575136","url":null,"abstract":"Background. Iatrogenic biliary injuries are considered as the most serious complications during cholecystectomy. Better outcomes of such injuries have been shown in cases managed in a specialized center. Objective. To evaluate biliary injuries management in major referral hepatobiliary center. Patients & Methods. Four hundred seventy-two consecutive patients with postcholecystectomy biliary injuries were managed with multidisciplinary team (hepatobiliary surgeon, gastroenterologist, and radiologist) at major Hepatobiliary Center in Egypt over 10-year period using endoscopy in 232 patients, percutaneous techniques in 42 patients, and surgery in 198 patients. Results. Endoscopy was very successful initial treatment of 232 patients (49%) with mild/moderate biliary leakage (68%) and biliary stricture (47%) with increased success by addition of percutaneous (Rendezvous technique) in 18 patients (3.8%). However, surgery was needed in 198 patients (42%) for major duct transection, ligation, major leakage, and massive stricture. Surgery was urgent in 62 patients and elective in 136 patients. Hepaticojejunostomy was done in most of cases with transanastomotic stents. There was one mortality after surgery due to biliary sepsis and postoperative stricture in 3 cases (1.5%) treated with percutaneous dilation and stenting. Conclusion. Management of biliary injuries was much better with multidisciplinary care team with initial minimal invasive technique to major surgery in major complex injury encouraging early referral to highly specialized hepatobiliary center. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2014 ","pages":"575136"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/575136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32847060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

Prognostic factors for long-term survival in patients with ampullary carcinoma: the results of a 15-year observation period after pancreaticoduodenectomy. 壶腹癌患者长期生存的预后因素:胰十二指肠切除术后15年的观察结果。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2014-01-01 Epub Date: 2014-03-02 DOI: 10.1155/2014/970234

Fritz Klein, Dietmar Jacob, Marcus Bahra, Uwe Pelzer, Gero Puhl, Alexander Krannich, Andreas Andreou, Safak Gül, Olaf Guckelberger

{"title":"Prognostic factors for long-term survival in patients with ampullary carcinoma: the results of a 15-year observation period after pancreaticoduodenectomy.","authors":"Fritz Klein, Dietmar Jacob, Marcus Bahra, Uwe Pelzer, Gero Puhl, Alexander Krannich, Andreas Andreou, Safak Gül, Olaf Guckelberger","doi":"10.1155/2014/970234","DOIUrl":"https://doi.org/10.1155/2014/970234","url":null,"abstract":"Introduction. Although ampullary carcinoma has the best prognosis among all periampullary carcinomas, its long-term survival remains low. Prognostic factors are only available for a period of 10 years after pancreaticoduodenectomy. The aim of this retrospective study was to identify factors that influence the long-term patient survival over a 15-year observation period. Methods. From 1992 to 2007, 143 patients with ampullary carcinoma underwent pancreatic resection. 86 patients underwent pylorus-preserving pancreaticoduodenectomy (60%) and 57 patients underwent standard Kausch-Whipple pancreaticoduodenectomy (40%). Results. The overall 1-, 5-, 10-, and 15-year survival rates were 79%, 40%, 24%, and 10%, respectively. Within a mean observation period of 30 (0-205) months, 100 (69%) patients died. Survival analysis showed that positive lymph node involvement (P = 0.001), lymphatic vessel invasion (P = 0.0001), intraoperative administration of packed red blood cells (P = 0.03), an elevated CA 19-9 (P = 0.03), jaundice (P = 0.04), and an impaired patient condition (P = 0.01) are strong negative predictors for a reduced patient survival. Conclusions. Patients with ampullary carcinoma have distinctly better long-term survival than patients with pancreatic adenocarcinoma. Long-term survival depends strongly on lymphatic nodal and vessel involvement. Moreover, a preoperative elevated CA 19-9 proved to be a significant prognostic factor. Adjuvant therapy may be essential in patients with this risk constellation. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2014 ","pages":"970234"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/970234","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32256661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 65

Metabolomic Analysis of Liver Tissue from the VX2 Rabbit Model of Secondary Liver Tumors. VX2兔继发性肝肿瘤模型肝脏组织代谢组学分析。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2014-01-01 Epub Date: 2014-03-02 DOI: 10.1155/2014/310372

R Ibarra, J-E Dazard, Y Sandlers, F Rehman, R Abbas, R Kombu, G-F Zhang, H Brunengraber, J Sanabria

{"title":"Metabolomic Analysis of Liver Tissue from the VX2 Rabbit Model of Secondary Liver Tumors.","authors":"R Ibarra, J-E Dazard, Y Sandlers, F Rehman, R Abbas, R Kombu, G-F Zhang, H Brunengraber, J Sanabria","doi":"10.1155/2014/310372","DOIUrl":"https://doi.org/10.1155/2014/310372","url":null,"abstract":"Purpose. The incidence of liver neoplasms is rising in USA. The purpose of this study was to determine metabolic profiles of liver tissue during early cancer development. Methods. We used the rabbit VX2 model of liver tumors (LT) and a control group consisting of sham animals implanted with Gelfoam into their livers (LG). After two weeks from implantation, liver tissue from lobes with and without tumor was obtained from experimental animals (LT+/LT-) as well as liver tissue from controls (LG+/LG-). Peaks obtained by Gas Chromatography-Mass Spectrometry were subjected to identification. 56 metabolites were identified and their profiles compared between groups using principal component analysis (PCA) and a mixed-effect two-way ANOVA model. Results. Animals recovered from surgery uneventfully. Analyses identified a metabolite profile that significantly differs in experimental conditions after controlling the False Discovery Rate (FDR). 16 metabolites concentrations differed significantly when comparing samples from (LT+/LT-) to samples from (LG+/LG-) livers. A significant difference was also shown in 20 metabolites when comparing samples from (LT+) liver lobes to samples from (LT-) liver lobes. Conclusion. Normal liver tissue harboring malignancy had a distinct metabolic signature. The role of metabolic profiles on liver biopsies for the detection of early liver cancer remains to be determined. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2014 ","pages":"310372"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/310372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32256660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Erratum to "The Effects of L-Arginine on Liver Damage in Experimental Acute Cholestasis an Immunohistochemical Study" “l -精氨酸对实验性急性胆汁淤积症肝损害的影响及免疫组织化学研究”的勘误

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2013-02-04 DOI: 10.1155/2013/492846

Yucel Ozsoy, T. Coşkun, Yavuz Kaya, K. Ozbilgin, A. Var, B. Ozyurt

引用次数: 0

Partial Preservation of Segment IV Confers No Benefit When Performing Extended Right Hepatectomy for Colorectal Liver Metastases. 部分保留IV节段对结直肠癌肝转移患者行扩大右肝切除术无益处。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2013-01-01 Epub Date: 2013-12-11 DOI: 10.1155/2013/458641

M G Wiggans, S Fisher, H Adwan, S Aroori, M J Bowles, D A Stell

{"title":"Partial Preservation of Segment IV Confers No Benefit When Performing Extended Right Hepatectomy for Colorectal Liver Metastases.","authors":"M G Wiggans, S Fisher, H Adwan, S Aroori, M J Bowles, D A Stell","doi":"10.1155/2013/458641","DOIUrl":"https://doi.org/10.1155/2013/458641","url":null,"abstract":"Introduction. Reducing the volume of resected liver parenchyma may lead to lower morbidity and mortality. The aim of this study was to determine whether partial preservation of segment IV leads to improved outcomes when undertaking extended right hepatectomy for colorectal liver metastases (CRLM). Materials and Methods. A retrospective analysis of patients undergoing right-sided hepatectomy for CRLM was performed. Rates of 90-day mortality and organ dysfunction were compared in 117 patients undergoing right hepatectomy (n = 85), partially extended right hepatectomy with preservation of part of segment IV (n = 20), and fully extended right hepatectomy (n = 12). Results. The 90-day mortality rate of those undergoing right hepatectomy (3/85) was similar to that of those undergoing extended right hepatectomy (0/12) (P = 1.000) but lower than that of those undergoing partially extended right hepatectomy (4/20) (P = 0.024). The rates of hepatic and renal dysfunction were similar between patients undergoing right hepatectomy, partially extended or extended hepatectomy. Discussion. Preservation of part of segment IV confers little clinical benefit when performing extended right hepatectomy for CRLM. ","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2013 ","pages":"458641"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/458641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32002325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1