HPB surgery : a world journal of hepatic, pancreatic and biliary surgery最新文献_第8页

Biliary leak in post-liver-transplant patients: is there any place for metal stent? 肝移植后胆道渗漏:金属支架是否适用?

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-05-01 DOI: 10.1155/2012/684172

Fernanda P Martins, Melissa Phillips, Monica R Gaidhane, Timothy Schmitt, Michel Kahaleh

{"title":"Biliary leak in post-liver-transplant patients: is there any place for metal stent?","authors":"Fernanda P Martins, Melissa Phillips, Monica R Gaidhane, Timothy Schmitt, Michel Kahaleh","doi":"10.1155/2012/684172","DOIUrl":"https://doi.org/10.1155/2012/684172","url":null,"abstract":"Objectives. Endoscopic management of bile leak after orthotopic liver transplant (OLT) is widely accepted. Preliminary studies demonstrated encouraging results for covered self-expandable metal stents (CSEMS) in complex bile leaks. Methods. Thirty-one patients with post-OLT bile leaks underwent endoscopic temporary placement of CSEMS (3 partially CSEMS , 18 fully CSEMS with fins and 10 fully CSEMS with flare ends) between December 2003 and December 2010. Long-term clinical success and safety were evaluated. Results. Median stent indwelling and follow-up were 89 and 1,353 days for PCSEMS, 102 and 849 for FCSEMS with fins and 98 and 203 for FCSEMS with flare ends. Clinical success was achieved in 100%, 77.8%, and 70%, respectively. Postplacement complications: cholangitis (1) and proximal migration (1), both in the FCSEMS with fins. Postremoval complications were biliary strictures requiring drainage: PCSEMS (1), FCSEMS with fins (6) and with flare ends (1). There was no significant differences in the FCSEMS groups regarding clinical success, age, gender, leak location, previous treatment, stent indwelling, and complications. Conclusion. Temporary placement of CSEMS is effective to treat post-OLT biliary leaks. However, a high number of post removal biliary strictures occurred especially in the FCSEMS with fins. CSEMS cannot be recommended in this patient population.","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2012 ","pages":"684172"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/684172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30638184","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: 13

Laparoscopy in Liver Transplantation: The Future has Arrived. 腹腔镜在肝移植中的应用:未来已经到来。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-08-07 DOI: 10.1155/2012/148387

Quirino Lai, Rafael S Pinheiro, Giovanni B Levi Sandri, Gabriele Spoletini, Fabio Melandro, Nicola Guglielmo, Marco Di Laudo, Fabrizio M Frattaroli, Pasquale B Berloco, Massimo Rossi

{"title":"Laparoscopy in Liver Transplantation: The Future has Arrived.","authors":"Quirino Lai, Rafael S Pinheiro, Giovanni B Levi Sandri, Gabriele Spoletini, Fabio Melandro, Nicola Guglielmo, Marco Di Laudo, Fabrizio M Frattaroli, Pasquale B Berloco, Massimo Rossi","doi":"10.1155/2012/148387","DOIUrl":"https://doi.org/10.1155/2012/148387","url":null,"abstract":"In the last two decades, laparoscopy has revolutionized the field of surgery. Many procedures previously performed with an open access are now routinely carried out with the laparoscopic approach. Several advantages are associated with laparoscopic surgery compared to open procedures: reduced pain due to smaller incisions and hemorrhaging, shorter hospital length of stay, and a lower incidence of wound infections. Liver transplantation (LT) brought a radical change in life expectancy of patients with hepatic end-stage disease. Today, LT represents the standard of care for more than fifty hepatic pathologies, with excellent results in terms of survival. Surely, with laparoscopy and LT being one of the most continuously evolving challenges in medicine, their recent combination has represented an astonishing scientific progress. The intent of the present paper is to underline the current role of diagnostic and therapeutic laparoscopy in patients waiting for LT, in the living donor LT and in LT recipients.","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2012 ","pages":"148387"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/148387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30855957","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

Bleeding in Hepatic Surgery: Sorting through Methods to Prevent It. 肝外科出血:预防方法的分类。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-11-18 DOI: 10.1155/2012/169351

Fabrizio Romano, Mattia Garancini, Fabio Uggeri, Luca Degrate, Luca Nespoli, Luca Gianotti, Angelo Nespoli, Franco Uggeri

引用次数: 38

Vest-over-Pant Method for Closure of Residual Cavity of Liver Hydatid Cyst. 背心套裤法封堵肝包虫囊残腔。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-04-08 DOI: 10.1155/2012/628176

Saba Behdad, Akbar Behdad, Samin Behdad, Mehrdad Hosseinpour

{"title":"Vest-over-Pant Method for Closure of Residual Cavity of Liver Hydatid Cyst.","authors":"Saba Behdad, Akbar Behdad, Samin Behdad, Mehrdad Hosseinpour","doi":"10.1155/2012/628176","DOIUrl":"https://doi.org/10.1155/2012/628176","url":null,"abstract":"Objective. Although several therapeutic strategies have proven to be effective for hydatid cyst of liver, but surgery is still the most common therapy despite its morbidity and mortality. Furthermore, a variety of technique has been recommended for managing the residual cavity after cystectomy. We report here a new technical method for the reconstruction of hydatid cyst residual cavity with using overlapping flaps of liver edges (Vest over Pant). Methods. In this technique after removing the cyst, the edges of one side of cyst cavity were sutured to the base of the cavity using three to four mattress sutures), and edges of other side of liver was overlapped on the dorsal part of previous layer using four to five mattress sutures. Therefore residual cavity dead space was obliterated with two surfaces of cavity. Results. Fifty males were treated by our method. The average cyst volume was 423 ± 110 mL. There was no intraabdominal sepsis, bile leakage, or hepatic necrosis. In follow-up ultrasound study, residual cavities were disappeared one month after operation. Conclusion. Overlapping flaps of liver edges (Vest over Pant) provides easy, safe closure of cyst with preservation of the liver anatomy.","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2012 ","pages":"628176"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/628176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30585871","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

Contemporary strategies in the management of hepatocellular carcinoma. 当代肝癌治疗策略的探讨。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-11-04 DOI: 10.1155/2012/154056

Shirin Elizabeth Khorsandi, Nigel Heaton

引用次数: 5

Evaluation of the white test for the intraoperative detection of bile leakage. 术中白色试验检测胆漏的评价。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-04-03 DOI: 10.1155/2012/425435

Kawin Leelawat, Kittipong Chaiyabutr, Somboon Subwongcharoen, Sa-Ad Treepongkaruna

{"title":"Evaluation of the white test for the intraoperative detection of bile leakage.","authors":"Kawin Leelawat, Kittipong Chaiyabutr, Somboon Subwongcharoen, Sa-Ad Treepongkaruna","doi":"10.1155/2012/425435","DOIUrl":"https://doi.org/10.1155/2012/425435","url":null,"abstract":"We assess whether the White test is better than the conventional bile leakage test for the intraoperative detection of bile leakage in hepatectomized patients. This study included 30 patients who received elective liver resection. Both the conventional bile leakage test (injecting an isotonic sodium chloride solution through the cystic duct) and the White test (injecting a fat emulsion solution through the cystic duct) were carried out in the same patients. The detection of bile leakage was compared between the conventional method and the White test. A bile leak was demonstrated in 8 patients (26.7%) by the conventional method and in 19 patients (63.3%) by the White test. In addition, the White test detected a significantly higher number of bile leakage sites compared with the conventional method (Wilcoxon signed-rank test; P < 0.001). The White test is better than the conventional test for the intraoperative detection of bile leakage. Based on our study, we recommend that surgeons investigating bile leakage sites during liver resections should use the White test instead of the conventional bile leakage test.","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":" ","pages":"425435"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/425435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40195746","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

Icam-1 upregulation in ethanol-induced Fatty murine livers promotes injury and sinusoidal leukocyte adherence after transplantation. 在乙醇诱导的脂肪小鼠肝脏中，Icam-1上调可促进移植后的损伤和窦状白细胞粘附。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-06-18 DOI: 10.1155/2012/480893

Tom P Theruvath, Venkat K Ramshesh, Zhi Zhong, Robert T Currin, Thomas Karrasch, John J Lemasters

{"title":"Icam-1 upregulation in ethanol-induced Fatty murine livers promotes injury and sinusoidal leukocyte adherence after transplantation.","authors":"Tom P Theruvath, Venkat K Ramshesh, Zhi Zhong, Robert T Currin, Thomas Karrasch, John J Lemasters","doi":"10.1155/2012/480893","DOIUrl":"https://doi.org/10.1155/2012/480893","url":null,"abstract":"Background. Transplantation of ethanol-induced steatotic livers causes increased graft injury. We hypothesized that upregulation of hepatic ICAM-1 after ethanol produces increased leukocyte adherence, resulting in increased generation of reactive oxygen species (ROS) and injury after liver transplantation (LT). Methods. C57BL/6 wildtype (WT) and ICAM-1 knockout (KO) mice were gavaged with ethanol (6 g/kg) or water. LT was then performed into WT recipients. Necrosis and apoptosis, 4-hydroxynonenal (4-HNE) immunostaining, and sinusoidal leukocyte movement by intravital microscopy were assessed. Results. Ethanol gavage of WT mice increased hepatic triglycerides 10-fold compared to water treatment (P < 0.05). ICAM-1 also increased, but ALT was normal. At 8 h after LT of WT grafts, ALT increased 2-fold more with ethanol than water treatment (P < 0.05). Compared to ethanol-treated WT grafts, ALT from ethanol-treated KO grafts was 78% less (P < 0.05). Apoptosis also decreased by 75% (P < 0.05), and 4-HNE staining after LT was also decreased in ethanol-treated KO grafts compared to WT. Intravital microscopy demonstrated a 2-fold decrease in leukocyte adhesion in KO grafts compared to WT grafts. Conclusions. Increased ICAM-1 expression in ethanol-treated fatty livers predisposes to leukocyte adherence after LT, which leads to a disturbed microcirculation, oxidative stress and graft injury.","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2012 ","pages":"480893"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/480893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30749536","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: 6

Small-for-Size Liver Transplantation Increases Pulmonary Injury in Rats: Prevention by NIM811. 小尺寸肝移植增加大鼠肺损伤:NIM811的预防作用

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-05-22 DOI: 10.1155/2012/270372

Qinlong Liu, Hasibur Rehman, Russell A Harley, John J Lemasters, Zhi Zhong

{"title":"Small-for-Size Liver Transplantation Increases Pulmonary Injury in Rats: Prevention by NIM811.","authors":"Qinlong Liu, Hasibur Rehman, Russell A Harley, John J Lemasters, Zhi Zhong","doi":"10.1155/2012/270372","DOIUrl":"https://doi.org/10.1155/2012/270372","url":null,"abstract":"Pulmonary complications after liver transplantation (LT) often cause mortality. This study investigated whether small-for-size LT increases acute pulmonary injury and whether NIM811 which improves small-for-size liver graft survival attenuates LT-associated lung injury. Rat livers were reduced to 50% of original size, stored in UW-solution with and without NIM811 (5 μM) for 6 h, and implanted into recipients of the same or about twice the donor weight, resulting in half-size (HSG) and quarter-size grafts (QSG), respectively. Liver injury increased and regeneration was suppressed after QSG transplantation as expected. NIM811 blunted these alterations >75%. Pulmonary histological alterations were minimal at 5-18 h after LT. At 38 h, neutrophils and monocytes/macrophage infiltration, alveolar space exudation, alveolar septal thickening, oxidative/nitrosative protein adduct formation, and alveolar epithelial cell/capillary endothelial apoptosis became overt in the lungs of QSG recipients, but these alterations were mild in full-size and HSG recipients. Liver pretreatment with NIM811 markedly decreased pulmonary injury in QSG recipients. Hepatic TNFα and IL-1β mRNAs and pulmonary ICAM-1 expression were markedly higher after QSG transplantation, which were all decreased by NIM811. Together, dysfunctional small-for-size grafts produce toxic cytokines, leading to lung inflammation and injury. NIM811 decreased toxic cytokine formation, thus attenuating pulmonary injury after small-for-size LT.","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2012 ","pages":"270372"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/270372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30673272","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: 9

C-Jun N-Terminal Kinase 2 Promotes Liver Injury via the Mitochondrial Permeability Transition after Hemorrhage and Resuscitation. C-Jun n -末端激酶2通过出血和复苏后线粒体通透性转变促进肝损伤。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-06-27 DOI: 10.1155/2012/641982

Christoph Czerny, Tom P Theruvath, Eduardo N Maldonado, Mark Lehnert, Ingo Marzi, Zhi Zhong, John J Lemasters

{"title":"C-Jun N-Terminal Kinase 2 Promotes Liver Injury via the Mitochondrial Permeability Transition after Hemorrhage and Resuscitation.","authors":"Christoph Czerny, Tom P Theruvath, Eduardo N Maldonado, Mark Lehnert, Ingo Marzi, Zhi Zhong, John J Lemasters","doi":"10.1155/2012/641982","DOIUrl":"https://doi.org/10.1155/2012/641982","url":null,"abstract":"Hemorrhagic shock leads to hepatic hypoperfusion and activation of mitogen-activated stress kinases (MAPK) like c-Jun N-terminal kinase (JNK) 1 and 2. Our aim was to determine whether mitochondrial dysfunction leading to hepatic necrosis and apoptosis after hemorrhage/resuscitation (H/R) was dependent on JNK2. Under pentobarbital anesthesia, wildtype (WT) and JNK2 deficient (KO) mice were hemorrhaged to 30 mm Hg for 3 h and then resuscitated with shed blood plus half the volume of lactated Ringer's solution. Serum alanine aminotransferase (ALT), necrosis, apoptosis and oxidative stress were assessed 6 h after resuscitation. Mitochondrial polarization was assessed by intravital microscopy. After H/R, ALT in WT-mice increased from 130 U/L to 4800 U/L. In KO-mice, ALT after H/R was blunted to 1800 U/l (P < 0.05). Necrosis, caspase-3 activity and ROS were all substantially decreased in KO compared to WT mice after H/R. After sham operation, intravital microscopy revealed punctate mitochondrial staining by rhodamine 123 (Rh123), indicating normal mitochondrial polarization. At 4 h after H/R, Rh123 staining became dim and diffuse in 58% of hepatocytes, indicating depolarization and onset of the mitochondrial permeability transition (MPT). By contrast, KO mice displayed less depolarization after H/R (23%, P < 0.05). In conclusion, JNK2 contributes to MPT-mediated liver injury after H/R.","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2012 ","pages":"641982"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/641982","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30759376","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

Ischemic preconditioning of rat livers from non-heart-beating donors decreases parenchymal cell killing and increases graft survival after transplantation. 非心脏供体的大鼠肝脏缺血预处理减少了实质细胞的杀伤，增加了移植后的移植物存活率。

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery Pub Date : 2012-01-01 Epub Date: 2012-07-19 DOI: 10.1155/2012/236406

Robert T Currin, Xing-Xi Peng, John J Lemasters

{"title":"Ischemic preconditioning of rat livers from non-heart-beating donors decreases parenchymal cell killing and increases graft survival after transplantation.","authors":"Robert T Currin, Xing-Xi Peng, John J Lemasters","doi":"10.1155/2012/236406","DOIUrl":"https://doi.org/10.1155/2012/236406","url":null,"abstract":"A critical shortage of donors exists for liver transplantation, which non-heart-beating cadaver donors could help ease. This study evaluated ischemic preconditioning to improve graft viability after non-heart-beating liver donation in rats. Ischemic preconditioning was performed by clamping the portal vein and hepatic artery for 10 min followed by unclamping for 5 min. Subsequently, the aorta was cross-clamped for up to 120 min. After 2 h of storage, livers were either transplanted or perfused with warm buffer containing trypan blue. Aortic clamping for 60 and 120 min prior to liver harvest markedly decreased 30-day graft survival from 100% without aortic clamping to 50% and 0%, respectively, which ischemic preconditioning restored to 100 and 50%. After 60 min of aortic clamping, loss of viability of parenchymal and nonparenchymal cells was 22.6 and 5.6%, respectively, which preconditioning decreased to 3.0 and 1.5%. Cold storage after aortic clamping further increased parenchymal and non-parenchymal cell killing to 40.4 and 10.1%, respectively, which ischemic preconditioning decreased to 12.4 and 1.8%. In conclusion, ischemic preconditioning markedly decreased cell killing after subsequent sustained warm ischemia. Most importantly, ischemic preconditioning restored 100% graft survival of livers harvested from non-heart-beating donors after 60 min of aortic clamping.","PeriodicalId":77165,"journal":{"name":"HPB surgery : a world journal of hepatic, pancreatic and biliary surgery","volume":"2012 ","pages":"236406"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/236406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30830250","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