BACKGROUND： The primary focus of the study was to ana- lyze the risk factors for bile leakage after hepatectomy for be- nign or malignant tumors. METHODS： A total of 411 patients who had undergone hepa- tectomy betw...BACKGROUND： The primary focus of the study was to ana- lyze the risk factors for bile leakage after hepatectomy for be- nign or malignant tumors. METHODS： A total of 411 patients who had undergone hepa- tectomy between December 2006 and December 2011 were ret- rospectively analyzed. The severity of bile leakage was graded according to the ISGLS classification. Twenty-eight pre- and postoperative parameters were analyzed. RESULTS： The overall bile leakage incidence was 10.2% （42/411）. The severity of the leakage was classified according to the IS- GLS classification. Bile leakage was detected early in case of abdominal drainage （11.4% vs 1.9%, P=0.034）. It prolonged the time of hospitalization （16 vs 9 days, P=0.001）. In all patients, wedge resection was associated with a higher incidence of bile leakage in contrast to anatomical resections （25.6% vs 4.1%, P〈0.0001） regardless of the underlying liver disease. Furthermore, total vascular exclusion increased risk of bile leakage （P=0.008）. CONCLUSIONS： Bile leakage as a major issue after hepatic resection is related to the postoperative morbidity and the hospitalization time. It is associated with non-anatomical re- section and a total vascular exclusion.展开更多
Liver transplantation(LT)for irresectable colorectal cancer liver metastases(i-CRLM)has been considered up to now an absolute contraindication due to unfavorable outcomes,scarcity of grafts and ethical considerations....Liver transplantation(LT)for irresectable colorectal cancer liver metastases(i-CRLM)has been considered up to now an absolute contraindication due to unfavorable outcomes,scarcity of grafts and ethical considerations.Recently,promising results of the Norwegian SECA trial raise the question of the utility of LT for i-CRLM with a 5-year survival rate of 60%(1).However,some concerns should be considered as to oncological selection criteria(when to perform the transplantation?)and the source of liver grafts:deceased donor at cost of recipient listed for standard indication or living donor in a population with a higher risk of recurrence.展开更多
Introduction Resection of large hepatic malignancies involving inferior vein cava(IVC)have long considered overly challenging and discouraged.However,improvements in surgical techniques,developments of supporting devi...Introduction Resection of large hepatic malignancies involving inferior vein cava(IVC)have long considered overly challenging and discouraged.However,improvements in surgical techniques,developments of supporting devices as well as the growing expertise in both anesthesiology and surgery have led to question this attitude.展开更多
文摘BACKGROUND： The primary focus of the study was to ana- lyze the risk factors for bile leakage after hepatectomy for be- nign or malignant tumors. METHODS： A total of 411 patients who had undergone hepa- tectomy between December 2006 and December 2011 were ret- rospectively analyzed. The severity of bile leakage was graded according to the ISGLS classification. Twenty-eight pre- and postoperative parameters were analyzed. RESULTS： The overall bile leakage incidence was 10.2% （42/411）. The severity of the leakage was classified according to the IS- GLS classification. Bile leakage was detected early in case of abdominal drainage （11.4% vs 1.9%, P=0.034）. It prolonged the time of hospitalization （16 vs 9 days, P=0.001）. In all patients, wedge resection was associated with a higher incidence of bile leakage in contrast to anatomical resections （25.6% vs 4.1%, P〈0.0001） regardless of the underlying liver disease. Furthermore, total vascular exclusion increased risk of bile leakage （P=0.008）. CONCLUSIONS： Bile leakage as a major issue after hepatic resection is related to the postoperative morbidity and the hospitalization time. It is associated with non-anatomical re- section and a total vascular exclusion.
文摘Liver transplantation(LT)for irresectable colorectal cancer liver metastases(i-CRLM)has been considered up to now an absolute contraindication due to unfavorable outcomes,scarcity of grafts and ethical considerations.Recently,promising results of the Norwegian SECA trial raise the question of the utility of LT for i-CRLM with a 5-year survival rate of 60%(1).However,some concerns should be considered as to oncological selection criteria(when to perform the transplantation?)and the source of liver grafts:deceased donor at cost of recipient listed for standard indication or living donor in a population with a higher risk of recurrence.
文摘Introduction Resection of large hepatic malignancies involving inferior vein cava(IVC)have long considered overly challenging and discouraged.However,improvements in surgical techniques,developments of supporting devices as well as the growing expertise in both anesthesiology and surgery have led to question this attitude.
