Search results for "hepatectomy"
showing 10 items of 95 documents
“Anatomical” versus “Territorial” Belonging of the Middle Hepatic Vein: Virtual Imaging and Clinical Repercussions
2011
Background Venous drainage patterns are of vital importance in live donor liver transplantation. The purpose of this study was to delineate “anatomical-topographical” and “territorial-physiologic” patterns of the middle hepatic vein (MHV) in a 3-D liver model as determined by the Pringle line and its drainage volume of the right and left hemilivers. Methods One hundred thirty-seven consecutive live donor candidates were evaluated by 3-D CT reconstructions and virtual hepatectomies. Based on right (R) and left (L), anatomical (A) and territorial (T) belonging patterns of the MHV, each individual was assigned to one of four possible types: type I:AR–TR; type II:AL–TL; type III:AR–TL; type IV:…
Prediction of complexity and complications of laparoscopic liver surgery: The comparison of the Halls‐score to the IWATE‐score in 100 consecutive lap…
2020
BACKGROUND The development of laparoscopic liver surgery is slower than in other disciplines. Two different scoring systems have been proposed to estimate difficulty of laparoscopic liver resections (LLR) preoperatively. The aim of this analysis was to compare these two scores in an independent patient cohort regarding the predictability of morbidity. METHODS All LLRs performed between 01/2011 until 01/2019 were identified from our prospective institutional database. Patient characteristics as well as intra- and postoperative data were analyzed. Postoperative complications were graded according to Dindo-Clavien classification. Difficulty of LLR was classified using IWATE- and Halls-score. R…
Treatment of Metachronous and Simultaneous Liver Metastases of Pancreatic Cancer
2009
<i>Aim:</i> Patients were analyzed who underwent treatment of liver metastases from pancreatic cancer. <i>Methods:</i> Selection criteria were the possibility of R0 resection of the primary and/or the liver metastases, no other sites of metastases, and the presentation of liver metastases. A comparison of treatment by surgery versus chemotherapy regarding overall survival and disease-free interval was performed. <i>Results:</i> Between 1996 and 2008, a total number of 23 patients were retrospectively identified from a prospective database of 193 cases of pancreatic cancer. In 14 cases, liver metastases were found simultaneously, and in 9 cases metachronou…
Resection with cryotherapy of colorectal hepatic metastases has the same survival as hepatic resection alone.
2001
Abstract Background Hepatic resection is well established as a potentially curative treatment for hepatic colorectal cancer metastases. However, only a small proportion of patients with liver metastases are suitable for resection because they either have extrahepatic disease, or the extent and/or the distribution of their hepatic disease would make excision impossible. We have previously described the use of cryotherapy for inadequate resection margins and lesions in the remaining lobe of the liver. Combining such cryodestructive techniques with resection offers the possibility of increasing the proportion of patients to whom potentially curative treatment can be offered. The aim of this st…
An endoscopic approach to the management of surgical bile duct injuries: nine years’ experience
2003
Abstract Background. The evaluation of the endoscopic treatment of surgical bile duct injuries, especially in the management of post-operative strictures, remains controversial. Aim. The aim of this study was to evaluate the feasibility of using endoscopic management from a study of the clinical reports of two of the main endoscopy units in Sicily. Patients and methods. A total of 137 consecutive patients were selected. There were 85 simple biliary fistulas: 64 from the cystic duct stump; 19 from the gall bladder bed; and two from intra-hepatic bile ducts. There were 52 biliary lesions: 15 complete transections; 12 incomplete lesions of the common bile duct with six associated strictures; f…
Totally laparoscopic liver resections for primary and metastatic cancer in the elderly: safety, feasibility and short-term outcomes.
2012
Standard oncologic liver resections performed on elderly patients (≥70 years old) have been shown to be safe and effective. The aim of this study was to analyze operative and oncologic short-term outcomes of totally laparoscopic liver resections (TLLR) performed on elderly patients for malignancies. We performed a retrospective statistical analysis of prospectively recorded data of TLLR performed from October 2008 to February 2012 by a single hepato-pancreato-biliary (HPB) surgeon. Patients were divided into two groups according to age (<70 vs. ≥70 years old) and perioperative outcomes were compared. A total of 60 TLLR for malignancies were identified of which 25 patients (42 %) were aged ≥…
Extent of portal vein tumour thrombosis in patients with hepatocellular carcinoma: The more, the worse?
2018
BACKGROUND & AIMS Portal vein tumour thrombosis (PVTT) has a significant impact on the prognosis of patients with hepatocellular carcinoma (HCC). The degree of PVTT varies from sub-/segmental invasion to complete occlusion of the main trunk. Aim of this study was to evaluate whether the degree of PVTT correlates with prognosis. METHODS A total of 1317 patients with HCC treated at our tertiary referral centre between January 2005 and December 2016 were included. PVTT was diagnosed by contrast-enhanced computed tomography or magnetic resonance imaging. The extent of PVTT was documented according to the Liver Cancer Study Group of Japan classification: Vp0 = no PVTT, Vp1 = segmental portal vei…
Mini-Invasive Approach Contributes to Expand the Indication for Liver Resection for Hepatocellular Carcinoma Without Increasing the Incidence of Post…
2016
Liver resection (LR) for hepatocellular carcinoma (HCC) is the best alternative option for increasing the survival of many patients with intermediate or advanced stages of the Barcelona Clinic Liver Cancer staging classification. Mini-invasive approach may play a positive role in treating a tumor rising almost exclusively in a diseased liver.A prospectively collected database was retrospectively reviewed for 167 consecutive patients who underwent LR between 1999 and 2015.A total of 38 LRs were performed from 1999 to 2009 (Period I), and 129 between 2010 and 2015 (Period II). Laparoscopic procedures increased from 5.3% to 38.1%. Not undergoing laparoscopic LR increased length of stay, and Cl…
Survival and recurrence after liver transplantation versus liver resection for hepatocellular carcinoma: a retrospective analysis.
1998
Objective This study compares the results of liver transplantation (LTx) and liver resection (LR) for hepatocellular carcinoma (HCC) to test the widespread hypothesis that LTx is the preferable approach for small HCCs. Summary Background Data With respect to scarcity of donor organs and poor results, LTxs for large HCCs are obsolete. Small HCC transplantations have been reported to result in an excellent survival rate. However, the data of comparative studies are controversial. Methods Patients who were treated curatively by LTx (n = 50) or LR (n = 52) for HCC were included in this retrospective study. Survival and freedom from recurrence were analyzed. Patients were stratified according to…
Intraoperative assessment of liver organ condition by the procurement surgeon.
2007
Abstract Generally the transplanting surgeon accepts or declines the offer of a marginal organ in view of all available information. Hence, in some cases it is the procurement surgeon who decides about the suitability for potential further liver transplantation. Methods From January 1, 2003 to September 30, 2005, a total of 402 organ procurement operations were performed in our region. Results Due to infrastructural problems in nine cases intraoperative evaluation of liver biopsies was not achievable in time, and the decision to reject the organs was based on the procurement surgeon’s clinical assessment. The main reason for liver rejection was alleged extreme steatosis, (6 of 9) or liver c…