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Validation and performance of three scoring systems for predicting primary non-function and early allograft failure after liver transplantation 被引量:1
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作者 Yu Nie Jin-Bo Huang +5 位作者 Shu-Jiao He Hua-Di Chen Jun-Jun Jia Jing-Jing Li Xiao-Shun He Qiang Zhao 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第5期463-471,共9页
Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipien... Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies. 展开更多
关键词 Primary non-function Early allograft failure Risk predicting model Liver transplantation
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Intraoperative cholangio-ultrasonography(IOCUS)during hepatectomy with resection of the biliary confluence:An effective alternative to intraoperative cholangiography
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作者 Daniele Del Fabbro Fabio Procopio +5 位作者 Jacopo Galvanin Guido Costa Simone Famularo Angela Palmisano Matteo Donadon Guido Torzilli 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第4期417-420,共4页
Intraoperative ultrasonography(IOUS)in hepatobiliary surgery is well known as an essential tool for radical and safe hepatectomies,allowing to perform parenchymal sparing surgery and,as consequence,to expand the surgi... Intraoperative ultrasonography(IOUS)in hepatobiliary surgery is well known as an essential tool for radical and safe hepatectomies,allowing to perform parenchymal sparing surgery and,as consequence,to expand the surgical indications for patients otherwise considered unresectable.Nevertheless,since many years,despite its effectiveness in the study of vascular anatomy of the liver,the gold standard for the assessment of biliary anatomy during surgery is intraoperative cholangiography(IOC),which is used for the validation of preoperative imaging as well as for guiding reconstruction in case of bile duct injury or resection. 展开更多
关键词 anatomy BILIARY ULTRASONOGRAPHY
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Achieving laparoscopic anatomic resection for hepatocellular carcinoma by fluorescence guided positive staining of hepatic cone unit
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作者 Jun-Fang Deng Chuan-Hui Peng +7 位作者 Yu Zhang Xiao-Feng Xu Rong-Liang Tong Zheng-Long Zhai Di-Yu Chen Cheng Zhang Li-Ming Wu Jian Wu 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第4期406-411,共6页
Laparoscopic anatomical liver resection has been increasingly reported worldwide,but how to demarcate the resection planes is technically challenging[1].Positive staining technique with intraoperative indocyanine gree... Laparoscopic anatomical liver resection has been increasingly reported worldwide,but how to demarcate the resection planes is technically challenging[1].Positive staining technique with intraoperative indocyanine green(ICG)-fluorescence imaging has been introduced as an effective tool for real-time intraoperative guidance[2].Liver anatomy is complex.Generally,liver is composed of 9 segments,each is composed of two to three subsegments,and each subsegment contains several hepatic cone units.A hepatic cone unit is dominated by a tertiary or quaternary hepatic pedicles[3]. 展开更多
关键词 HEPATIC RESECTION ANATOMY
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A robust genomic-based prognostic model for the assessment ofcancer stemness and survival for patients with hepatocellularcarcinoma
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作者 Cheng-Li Du Shen-Yu Wei +1 位作者 Yun-Hao Chen Kang-Jie Chen 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第1期97-102,共6页
To the Editor:Hepatocellular carcinoma(HCC)is an aggressive malignancy with poor long-term prognosis[1].Liver cancer stem cell(CSC)can drive the metastasis,drug resistance,and recurrence of HCC[2].The regulatory mecha... To the Editor:Hepatocellular carcinoma(HCC)is an aggressive malignancy with poor long-term prognosis[1].Liver cancer stem cell(CSC)can drive the metastasis,drug resistance,and recurrence of HCC[2].The regulatory mechanisms about liver cancer stemness have been investigated,which encouraged the identification and characterization of novel prognostic and therapeutic strategies for HCC[3]. 展开更多
关键词 cancer PROGNOSIS LIVER
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Middle hepatic vein variation provides a safe path for anterior transection of hepatocellular carcinoma in caudate lobe
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作者 Bing-Yi Lin Qi-Jun Zhang +1 位作者 Zhe Yang Shu-Sen Zheng 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第4期438-440,共3页
To the Editor:Hepatocellular carcinoma(HCC)is one of the main causes of cancer related death worldwide,and new cases are expected to continue to increase in future[1].Surgical resection is still the best way to remove... To the Editor:Hepatocellular carcinoma(HCC)is one of the main causes of cancer related death worldwide,and new cases are expected to continue to increase in future[1].Surgical resection is still the best way to remove the tumor and improve patient’s prognosis.However,resection of caudate lobe often presents a technical challenge,even to accomplished hepatic surgeons.Caudate lobe is located anterior to the inferior vena cava(IVC)and posterior to the bifurcation of the portal vein(PV),generally consists of three regions:the paracaval portion,the left Spiegel lobe and the process portion[2].The anatomy of the paracaval portion includes the liver parenchyma ventral to the hepatic IVC and the area between the Spiegel lobe and the right lobe adjacent to the middle hepatic vein(MHV)ventrally,which was classified by Couinaud as segment IX[3].Here,we presented a case of HCC with successful downstaging therapy,as well as variation of MHV,which provides a safe path for anterior transection of segment IX. 展开更多
关键词 HEPATIC ANATOMY MIDDLE
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Navigated liver surgery:State of the art and future perspectives 被引量:9
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作者 Paschalis Gavriilidis Bjørn Edwin +5 位作者 Egidijus Pelanis Ernest Hidalgo Nicola de’Angelis Riccardo Memeo Luca Aldrighetti Robert P Sutcliffe 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2022年第3期226-233,共8页
Background:In recent years,the development of digital imaging technology has had a significant influence in liver surgery.The ability to obtain a 3-dimensional(3D)visualization of the liver anatomy has provided surger... Background:In recent years,the development of digital imaging technology has had a significant influence in liver surgery.The ability to obtain a 3-dimensional(3D)visualization of the liver anatomy has provided surgery with virtual reality of simulation 3D computer models,3D printing models and more recently holograms and augmented reality(when virtual reality knowledge is superimposed onto reality).In addition,the utilization of real-time fluorescent imaging techniques based on indocyanine green(ICG)uptake allows clinicians to precisely delineate the liver anatomy and/or tumors within the parenchyma,applying the knowledge obtained preoperatively through digital imaging.The combination of both has transformed the abstract thinking until now based on 2D imaging into a 3D preoperative conception(virtual reality),enhanced with real-time visualization of the fluorescent liver structures,effectively facilitating intraoperative navigated liver surgery(augmented reality).Data sources:A literature search was performed from inception until January 2021 in MEDLINE(Pub Med),Embase,Cochrane library and database for systematic reviews(CDSR),Google Scholar,and National Institute for Health and Clinical Excellence(NICE)databases.Results:Fifty-one pertinent articles were retrieved and included.The different types of digital imaging technologies and the real-time navigated liver surgery were estimated and compared.Conclusions:ICG fluorescent imaging techniques can contribute essentially to the real-time definition of liver segments;as a result,precise hepatic resection can be guided by the presence of fluorescence.Furthermore,3D models can help essentially to further advancing of precision in hepatic surgery by permitting estimation of liver volume and functional liver remnant,delineation of resection lines along the liver segments and evaluation of tumor margins.In liver transplantation and especially in living donor liver transplantation(LDLT),3D printed models of the donor’s liver and models of the recipient’s hilar anatomy can contribute further to improving the results.In particular,pediatric LDLT abdominal cavity models can help to manage the largest challenge of this procedure,namely large-for-size syndrome. 展开更多
关键词 Navigated Hepatic surgery 3D Computer assistance Image guidance Image guided surgery Indocyanine green 3D print Visual simulation Virtual reality Augmented reality Real-time navigated liver surgery
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Morbidity analysis of left hepatic trisectionectomy for hepatobiliary disease and live donor
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作者 Young-In Yoon Sung-Gyu Lee +4 位作者 Deok-Bog Moon Shin Hwang Ki-Hun Kim Hui-Ju Kim Ki-Hoon Choi 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2022年第4期362-369,共8页
Background:Despite remarkable advances in surgical techniques and perioperative management,left hepatic trisectionectomy(LHT)remains a challenging procedure with a somewhat high postoperative morbidity rate compared w... Background:Despite remarkable advances in surgical techniques and perioperative management,left hepatic trisectionectomy(LHT)remains a challenging procedure with a somewhat high postoperative morbidity rate compared with less-extensive resections.This study aimed to analyze the short-and long-term outcomes of LHT and identify factors associated with the postoperative morbidity of this technically demanding surgical procedure.Methods:The medical records of 53 patients who underwent LHT between June 2005 and October 2019 at a single institution were retrospectively reviewed.The independent prognostic factor of postoperative morbidity was analyzed using the logistic regression model.Results:Hepatocellular carcinoma was the most common indication for surgery(n=21),followed by hilar cholangiocarcinoma(n=14),intrahepatic cholangiocarcinoma(n=10),and other pathologies(including colorectal liver metastasis,hepatolithiasis,gallbladder cancer,living donor,hemangioma,and multilocular biliary cyst;n=8).The rates of postoperative morbidities of Clavien-Dindo grade 3 or higher and 90-day mortality were 39.6% and 1.9%,respectively.The 1-,3-,and 5-year overall survival rates were 81.1%,61.4%,and 44.6%,respectively.Multivariate analysis revealed that preoperative jaundice[hazard ratio(HR)=6.15,95%confidence interval(CI):1.57-24.17,P=0.009]and operative time>420 min(HR=4.66,95%CI:1.27–17.17,P=0.021)were independent predictors of postoperative morbidity.Conclusions:The in-hospital mortality of LHT surgery can be minimalized by a reliable preoperative evaluation of liver function and selection of the dominant anatomic features of right posterior sector,active and appropriate preoperative management for obstructive cholangitis and compensatory hypertrophy of the future remnant posterior sector,and the experience of the surgeon. 展开更多
关键词 Left hepatic trisectionectomy Major hepatectomy Liver neoplasms Survival rate MORBIDITY
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Older liver grafts from donation after circulatory death are associated with impaired survival and higher incidence of biliary non-anastomotic structure 被引量:1
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作者 Tian Shen Shan-Hua Zheng +6 位作者 Jun Chen Zhi-Sheng Zhou Meng-Fan Yang Xiang-Yan Liu Jun-Li Chen Shu-Sen Zheng Xiao Xu 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2023年第6期577-583,共7页
Background:Grafts from older donors after circulatory death were associated with inferior outcome in liver transplants in the past.But it has seemed to remain controversial in the last decade,as a result of modified c... Background:Grafts from older donors after circulatory death were associated with inferior outcome in liver transplants in the past.But it has seemed to remain controversial in the last decade,as a result of modified clinical protocols,selected recipients,and advanced technology of organ perfusion and preservation.The present study aimed to examine the impact of older donor age on complications and survival of liver transplant using grafts from donation after circulatory death(DCD).Methods:A total of 944 patients who received DCD liver transplantation from 2015 to 2020 were included and divided into two groups:using graft from older donor(aged≥65 years,n=87)and younger donor(age<65 years,n=857).Propensity score matching(PSM)was applied to eliminate selection bias.Results:A progressively increased proportion of liver transplants with grafts from older donors was observed from 1.68%to 15.44%during the study period.The well-balanced older donor(n=79)and younger donor(n=79)were 1:1 matched.There were significantly more episodes of biliary nonanastomotic stricture(NAS)in the older donor group than the younger donor group[15/79(19.0%)vs.6/79(7.6%);P=0.017].The difference did not reach statistical significance regarding early allograft dysfunction(EAD)and primary non-function(PNF).Older livers had a trend toward inferior 1-,2-,3-year graft and overall survival compared with younger livers,but these differences were not statistically significant(63.1%,57.6%,57.6%vs.76.9%,70.2%,67.7%,P=0.112;64.4%,58.6%,58.6%vs.76.9%,72.2%,72.2%,P=0.064).The only risk factor for poor survival was ABO incompatible transplant(P=0.008)in the older donor group.In the subgroup of ABO incompatible cases,it demonstrated a significant difference in the rate of NAS between the older donor group and the younger donor group[6/8(75.0%)vs.3/14(21.4%);P=0.014].Conclusions:Transplants with grafts from older donors(aged≥65 years)after circulatory death are more frequently associated with inferior outcome compared to those from younger donors.Older grafts from DCD are more likely to develop NAS,especially in ABO incompatible cases. 展开更多
关键词 Older donor Liver transplantation SURVIVAL Biliary stricture Donation after circulatory death
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Clinical analysis of Wernicke encephalopathy after liver transplantation
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作者 Li-Min Ding Li-Shan Deng +3 位作者 Jun-Jie Qian Gang Liu Lin Zhou Shu-Sen Zheng 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2023年第4期352-357,共6页
Background:Wernicke encephalopathy(WE)is an acute neurological disease resulting from vitamin B1 deficiency,and there are only very few case reports of WE after liver transplantation.The present study aimed to investi... Background:Wernicke encephalopathy(WE)is an acute neurological disease resulting from vitamin B1 deficiency,and there are only very few case reports of WE after liver transplantation.The present study aimed to investigate the clinical characteristics,etiology,magnetic resonance imaging(MRI)features,treatment and prognosis of patients with WE after liver transplantation.Methods:Twenty-three patients with WE after liver transplantation from the First Affiliated Hospital,Zhejiang University School of Medicine and Jiangxi Provincial People’s Hospital between January 2011 and December 2021 were retrospectively analyzed.Results:Among the 23 patients diagnosed with WE after liver transplantation,6(26%)had a classic triad of impaired consciousness,oculomotor palsy and ataxia,and 17(74%)had two features.The misdiagno-sis rate was 65%.After treatment with high-dose vitamin B1,19(83%)patients showed improvement,whereas 4(17%)showed no improvement,including 3 with residual short-term memory impairments and 1 with residual spatial and temporal disorientation and ataxia.Conclusions:The misdiagnosis rate is high in the early stage of WE,and the prognosis is closely asso-ciated with whether WE is diagnosed early and treated timely.High-dose glucose or glucocorticoids can trigger WE and cannot be administered before vitamin B1 treatment.Vitamin B1 is suggested to be used as a prophylactic treatment for patients with WE after liver transplantation. 展开更多
关键词 Liver transplantation Wernicke encephalopathy Vitamin B1 Clinical presentations Imaging features DIAGNOSIS TREATMENT PROGNOSIS
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Overexpression of P-glycoprotein in hepatocellular carcinoma and its clinical implication 被引量:13
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作者 Kong XB Yang ZK +2 位作者 Liang LJ Huang JF Lin HL 《World Journal of Gastroenterology》 SCIE CAS CSCD 2000年第1期134-135,共2页
INTRODUCTIONMost advanced hepatocellular garcinoma (HCC) isinsensitive to most anticancer drugs which might berelated to the high frequency of expression of themultidrug resistance-1(MDR1) gene and itsproduct,P-glycop... INTRODUCTIONMost advanced hepatocellular garcinoma (HCC) isinsensitive to most anticancer drugs which might berelated to the high frequency of expression of themultidrug resistance-1(MDR1) gene and itsproduct,P-glycoprotein (p-gp).p-gp expressionmay also be concerned with tumor progression anddifferentiation.In the present study。 展开更多
关键词 Subject headings liver NEOPLASMS carcinoma HEPATOCELLULAR P-GLYCOPROTEIN MULTIDRUG resistance-1 gene IMMUNOHISTOCHEMISTRY
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Prognosis of hepatocellular carcinoma with bile duct tumor thrombus after R0 resection:a matched study 被引量:11
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作者 Ding-Ding Wang Li-Qun Wu Zu-Sen Wang 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2016年第6期626-632,共7页
BACKGROUND: Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare. The present study aimed to determine post-surgical prognoses in HCC patients with BDTT, as outcomes are currently unclear. ... BACKGROUND: Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare. The present study aimed to determine post-surgical prognoses in HCC patients with BDTT, as outcomes are currently unclear. METHODS: We compared the prognoses of 110 HCC patients without BDTT (group A) to 22 cases with BDTT (group B). The two groups were matched in age, gender, tumor etiology, size, number, portal vascular invasion, and TNM stage. Additionally, 28 HCC patients with BDTT were analyzed to identify prognostic risk factors. RESULTS: The 1-, 3-, and 5-year overall survival rates were 90.9%, 66.9%, and 55.9% for group A and 81.8%, 50.0%, and 37.5% for group B, respectively. The median survival time in groups A and B was 68.8 and 31.4 months, respectively (P=0.043). The patients for group B showed higher levels of serum total bilirubin, alanine aminotransferase and gammaglutamyl transferase, a larger hepatectomy range, and a higher rate of anatomical resection. In subgroup analyses of patients with BDTT who underwent R0 resection, TNM stage Ⅲ-Ⅳ was an independent risk factor for overall survival; these patients had worse prognoses than those with TNM stage Ⅰ-Ⅱ after R0 resection (hazard ratio=6.056, P=0.014). Besides, univariate and multivariate analyses revealed that non-R0 resection and TNM stage Ⅲ-Ⅳ were independent risk factors for both disease-free survival and overall survival of 28 HCC patients with BDTT. The median overall survival time of patients with BDTT who underwent R0 resection was longer than that of patients who did not undergo R0 resection (31.0 vs 4.0 months, P=0.007).CONCLUSIONS: R0 resection prolonged survival time in HCC patients with BDTT, although prognosis remains poor. For such patients, R0 resection is an important treatment that determines long-term survival. 展开更多
关键词 hepatocellular carcinoma bile duct tumor thrombus PROGNOSIS RECURRENCE R0 resection
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Follicular dendritic cell sarcoma of the liver:unusual presentation of a rare tumor and literature review 被引量:13
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作者 Paulo N Martins Sanjay Reddy +1 位作者 Ann-Britt Martins Marcelo Facciuto 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2011年第4期443-445,共3页
BACKGROUND:Hepatic follicular dendritic cell (FDC) sarcoma is an extremely rare neoplasm.Most commonly,FDC sarcoma presents as a solitary mass in lymph nodes,however,several extra-nodal locations have been identified.... BACKGROUND:Hepatic follicular dendritic cell (FDC) sarcoma is an extremely rare neoplasm.Most commonly,FDC sarcoma presents as a solitary mass in lymph nodes,however,several extra-nodal locations have been identified.METHODS:We report a case of a 53-year-old female who presented with symptoms of abdominal pain,fever,anemia,and jaundice.After an extensive review of the literature,we have found only 12 cases of hepatic FDC sarcoma.RESULTS:The tumor was 11.5 cm in diameter and composed of spindle and epithelioid cells with ovoid nuclei and associated with mixed inflammatory infiltrate.Immunohistochemical stains were positive for CD35 and CD21.The patient underwent a left hepatic lobectomy.CONCLUSIONS:Liver follicular dendritic cell sarcoma is a very rare tumor.Most cases present with abdominal pain and weight loss,and most of them can be managed by hepatic resection with excellent short-term outcomes. 展开更多
关键词 follicular dendritic cell tumor liver neoplasms SARCOMA JAUNDICE
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Laparoscopic resection of an adrenal pseudocyst mimicking a retroperitoneal mucinous cystic neoplasm 被引量:6
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作者 Bum-Soo Kim Sun-Hyung Joo +1 位作者 Sung-Il Choi Jeong-Yoon Song 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第23期2923-2926,共4页
Adrenal pseudocysts are rare cystic masses that arise within the adrenal gland and are usually non-functional and asymptomatic. Adrenal pseudocysts consist of a fibrous wall without a cellular lining. We report a pati... Adrenal pseudocysts are rare cystic masses that arise within the adrenal gland and are usually non-functional and asymptomatic. Adrenal pseudocysts consist of a fibrous wall without a cellular lining. We report a patient with a 9 cm, left-sided suprarenal cystic mass who presented with abdominal discomfort of 2 years' duration. A 38-year-old woman was referred to our service for evaluation of abdominal discomfort and gastrointestinal symptoms. Routine laboratory tests were within normal limits. An abdominal computed tomography scan showed a 9 cm × 8 cm × 8 cm well-defined cystic lesion displacing the left kidney. Magnetic resonance imaging showed a cystic lesion with low signal intensity on the Tl-weighted image and high signal intensity on the T2-weighted image. A laparoscopic left adrenalectomy was performed to diagnose the lesion. The final pathology showed an adrenal pseudocyst without a cellular lining. The patient had no postoperative complications and she was discharged four days after surgery. 展开更多
关键词 Adrenal gland PSEUDOCYST LAPAROSCOPY ADRENALECTOMY
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Recurrence and survival following microwave, radiofrequency ablation, and hepatic resection of colorectal liver metastases: A systematic review and network meta-analysis 被引量:7
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作者 Paschalis Gavriilidis Keith J Roberts +2 位作者 Nicola de’Angelis Luca Aldrighetti Robert P Sutcliffe 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2021年第4期307-314,共8页
Background: Gold standard for colorectal liver metastases(CRLM) remains hepatic resection(HR). However, patients with severe comorbidities, unresectable or deep-situated resectable CRLM are candidates for ablation. Th... Background: Gold standard for colorectal liver metastases(CRLM) remains hepatic resection(HR). However, patients with severe comorbidities, unresectable or deep-situated resectable CRLM are candidates for ablation. The aim of the study was to compare recurrence rate and survival benefit of the microwave ablation(MWA), radiofrequency ablation(RFA) and HR by conducting the first network meta-analysis. Data sources: Systematic search of the literature was conducted in the electronic databases. Both updated traditional and network meta-analyses were conducted and the results were compared between them. Results: HR cohort demonstrated significantly less local recurrence rate and better 3-and 5-year diseasefree(DFS) and overall survival(OS) compared to MWA and RFA cohorts. HR cohort included significantly younger patients and with significantly lower preoperative carcinoembryonic antigen(CEA) by 10.28 ng/m L compared to RFA cohort. Subgroup analysis of local recurrence and OS of solitary and ≤3 cm CRLMs did not demonstrate any discrepancies when compared with the whole sample. Conclusions: For resectable CRLM the treatment of choice still remains HR. MWA and RFA can be used as a single or adjunct treatment in patients with unresectable CRLM and/or prohibitive comorbidities. 展开更多
关键词 Microwave ablation Radiofrequency ablation Hepatic resection Liver resection
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Impact of treatment modalities on patients with recurrent hepatocellular carcinoma after liver transplantation:Preliminary experience 被引量:11
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作者 Zhe Yang Shuo Wang +5 位作者 Xin-Yao Tian Qin-Fen Xie Li Zhuang Qi-Yong Li Cheng-Ze Chen Shu-Sen Zheng 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2020年第4期365-370,共6页
Background:Post-liver transplantation(LT)hepatocellular carcinoma(HCC)recurrence still occurs in approximately 20%of patients and drastically affects their survival.This study aimed to evaluate the efficacy of various... Background:Post-liver transplantation(LT)hepatocellular carcinoma(HCC)recurrence still occurs in approximately 20%of patients and drastically affects their survival.This study aimed to evaluate the efficacy of various treatments for recurrent HCC after LT in a Chinese population.Methods:A total of 64 HCC patients with tumor recurrence after LT were enrolled in this study.Univariate and multivariate analyses were performed to identify factors affecting post-recurrence survival.Results:Of the 64 patients with recurrent HCC after LT,those who received radical resection followed by nonsurgical therapy had a median overall survival(OS)of 20.9 months after HCC recurrence,significantly superior to patients who received only nonsurgical therapy(9.4 months)or best supportive care(2.4 months).The one-and two-year OS following recurrence was favorable for patients receiving radical resection followed by nonsurgical therapy(93.8%,52.6%),poor for patients receiving only nonsurgical therapy(30.8%,10.8%),and dismal for patients receiving best supportive care(0%,0%;overall P<0.001).Median OS in sorafenib-tolerant patients treated with lenvatinib was 19.5 months,far surpassing the patients that discontinued sorafenib or were treated with regorafenib after sorafenib failure(12 months,P<0.001).Compared with tacrolimus-based immunosuppressive therapy,OS was significantly increased with sirolimus-based therapy at one and two years after HCC recurrence(P=0.035).Multivariate analysis showed radical resection combined with nonsurgical therapy for recurrent HCC and sorafenib-lenvatinib sequential therapy were independent favorable factors for post-recurrence survival.Conclusions:Aggressive surgical intervention in well-selected patients significantly improves OS after recurrence.A multidisciplinary treatment approach is required to slow down disease progression for patients with unresectable recurrent HCC. 展开更多
关键词 Hepatocellular carcinoma Liver transplantation Treatment modality Tumor recurrence PROGNOSIS
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Assessment of clinical outcomes of advanced hilar cholangiocarcinoma 被引量:3
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作者 Kang-Jie Chen Fu-Chun Yang +2 位作者 Yun-Sheng Qin Jing Jin Shu-Sen Zheng 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2018年第2期155-162,共8页
Background: Low resectability and poor survival outcome are common for hilar cholangiocarcinoma(HCCA), especially in advanced stages. The present study was to assess the clinical outcome of advanced HCCA, focusing on ... Background: Low resectability and poor survival outcome are common for hilar cholangiocarcinoma(HCCA), especially in advanced stages. The present study was to assess the clinical outcome of advanced HCCA, focusing on therapeutic modalities, survival analysis and prognostic assessment.Methods: Clinical data of 176 advanced HCCA patients who had been treated in our hospital between January 2013 and December 2015 were analyzed retrospectively. Prognostic effects of clinicopathological factors were explored by univariate and multivariate analysis. Survival predictors were evaluated by the receiver operating characteristic(ROC) curve.Results: The 3-year overall survival rate was 13% for patients with advanced HCCA. Preoperative total bilirubin(P = 0.009), hepatic artery invasion(P = 0.014) and treatment modalities(P = 0.020) were independent prognostic factors on overall survival. A model combining these independent prognostic factors(area under ROC curve: 0.748; 95% CI: 0.678–0.811; sensitivity: 82.3%, specificity: 53.5%) was highly predictive of tumor death. After R0 resection, the 3-year overall survival was up to 38%. Preoperative total bilirubin was still an independent negative factor, but not for hepatic artery invasion.Conclusions: Surgery is still the best treatment for advanced HCCA. Preoperative biliary drainage should be performed in highly-jaundiced patients to improve survival. Prediction of survival is improved significantly by a model that incorporates preoperative total bilirubin, hepatic artery invasion and treatment modalities. 展开更多
关键词 Hilar cholangiocarcinoma Hepatic artery resection Preoperative biliary drainage Prognostic factors
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Radiofrequency ablation-assisted liver resection a step toward bloodless liver resection 被引量:3
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作者 Athanasios Petrou Kyriakos Neofytou +4 位作者 Constantinos Mihas Jessamy Bagenal Michael Kontos John Griniatsos Evangelos Felekouras 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2015年第1期69-74,共6页
BACKGROUND: Liver resection is currently the most efficient curative approach for a wide variety of liver tumors. The application of modern techniques and new surgical devices has improved operative outcomes. Radiofr... BACKGROUND: Liver resection is currently the most efficient curative approach for a wide variety of liver tumors. The application of modern techniques and new surgical devices has improved operative outcomes. Radiofrequency ablation is used more often for liver parenchymal transection. This study aimed to assess the efficacy and safety of radiofrequency ablation-assisted liver resection.METHODS: A retrospective study of 145 consecutive patients who underwent radiofrequency ablation-assisted liver resection was performed. Intraoperative blood loss, need for transfusion or intraoperative Pringle maneuver, the duration of liver parenchymal transection, perioperative complications, and postoperative morbidity and mortality were all evaluated.RESULTS: Fifty minor and ninety-five major liver resections were performed. The mean intraoperative blood loss was 251 m L, with a transfusion rate of 11.7%. The Pringle maneuver was necessary in 12 patients(8.3%). The mean duration for parenchymal transection was 51.75 minutes. There were 47 patients(32.4%) with postoperative complications. There is no mortality within 30 days after surgery. CONCLUSIONS: Radiofrequency ablation-assisted liver resection permits both major and minor liver resections with minimal blood loss and without occlusion of hepatic inflow. Furthermore it decreases the need for blood transfusion and reduces morbidity and mortality. 展开更多
关键词 BLEEDING COMPLICATIONS HEPATECTOMY radiofrequency ablation Pringle maneuver
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Feasibility of ABO-incompatible adult living donor liver transplantation for acute-on-chronic liver failure 被引量:3
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作者 Seok-Hwan Kim Gi-Won Song +4 位作者 Shin Hwang Chul-Soo Ahn Deok-Bog Moon Tae-Yong Ha Sung-Gyu Lee 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2017年第6期662-664,共3页
To the Editor:In Korea,the annual number of deceased donors for or gan transplantation per million people is still less than10.Thus,approximately 40%of patients with acute liver failure or acute-on-chronic liver failu... To the Editor:In Korea,the annual number of deceased donors for or gan transplantation per million people is still less than10.Thus,approximately 40%of patients with acute liver failure or acute-on-chronic liver failure undergo living donor liver transplantation(LDLT).;Although the use of ABO-incompatible(ABOi)living donors is an attrac tive option,ABOi LDLT has very restricted applications 展开更多
关键词 ABO Feasibility of ABO-incompatible adult living donor liver transplantation for acute-on-chronic liver failure RIT
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International Organ Protection Symposium: The fusion of engineering and medicine 被引量:7
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作者 Jun-Jun Jia Jian-Hui Li +5 位作者 Liming Xin Hao-Yu Li Mitesh Badiwala Yu Sun Xiao Xu Shu-Sen Zheng 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2019年第6期601-602,共2页
The International Organ Protection Symposium was held in Toronto,Canada on May 15–16,2019.This symposium focused on the fusion of engineering and medicine,bringing together experts in organ transplantation,organ repa... The International Organ Protection Symposium was held in Toronto,Canada on May 15–16,2019.This symposium focused on the fusion of engineering and medicine,bringing together experts in organ transplantation,organ repair,artificial organs,precision medicine,automation,micro and nanotechnologies.This letter highlights some of the innovative and impactful presentations in this symposium.Dr.Mitesh Badiwala,Director of Heart Transplantation Program at University Health Network,gave a speech of“Cardiac transplant advances in donation after circulatory death”.Dr.Badiwala introduced the history of heart transplantation and the donor organ shortage crisis.He pointed out that ex-situ heart perfusion allows the resuscitation of donation after circulatory death and expand organ pool.He reviewed the contemporary heart transplant research after circulatory death and shared his experience.At the end of his speech he showed the current challenges and future directions in heart donation after circulatory death. 展开更多
关键词 CANADA bringing DIRECTOR
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Implementing an innovated liver ex-situ machine perfusion technology:The 2018 Joint International Congress of ILTS,ELITA and LICAGE 被引量:2
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作者 Jun-Jun Jia Jian-Hui Li +2 位作者 Hai-Yang Xie Lin Zhoua Shu-Sen Zheng 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2018年第4期283-285,共3页
The 2018 Joint International Congress of ILTS,ELITA and LICAGE were held in Lisbon,Portugal on May 23–26,2018.The exciting and innovative program brought together 1144 experts in liver transplantation(LT)such as surg... The 2018 Joint International Congress of ILTS,ELITA and LICAGE were held in Lisbon,Portugal on May 23–26,2018.The exciting and innovative program brought together 1144 experts in liver transplantation(LT)such as surgeons,physicians or basic scientists from 61 countries.The presentations included 110 invited speakers,181 oral presentations,and 545 posters.This editorial highlights some of the most innovative and impactful presentations in 展开更多
关键词 NMP WIT DCD Implementing an innovated liver ex-situ machine perfusion technology:The 2018 Joint International Congress of ILTS ELITA and LICAGE
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