Liver resection as the definitive treatment for unilateral non-oriental primary intrahepatic lithiasis

2006 ◽  
Vol 191 (4) ◽  
pp. 460-464 ◽  
Author(s):  
Paulo Herman ◽  
Marcos V. Perini ◽  
Marcel Autran C. Machado ◽  
Telesforo Bacchella ◽  
Vincenzo Pugliese ◽  
...  
Keyword(s):  
Liver Resection ◽  
Definitive Treatment ◽  
Intrahepatic Lithiasis

The utility of PET scanning in colorectal cancer liver metastases being considered for surgery.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14519-e14519
Author(s):  
Jeffri R. M. Ismail ◽  
Ciara Marie Kelly ◽  
Marian Hanrick ◽  
Cara Regan Downey ◽  
Lauragh McCarthy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Local Recurrence ◽  
Lymph Nodes ◽  
Liver Metastases ◽  
Preoperative Staging ◽  
Definitive Treatment ◽  
Preoperative Imaging ◽  
Colorectal Cancer Liver Metastases ◽  
Pet Scanning

e14519 Background: Liver resection remains the only potentially curative option for a subset of patients with colorectal cancer liver metastases (CRCLM). Preoperative imaging used to determine resectability includes computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET). The objective of this study was to determine the utility of PET scanning for potentially resectable CRCLM. Methods: We retrospectively reviewed a prospectively maintained database for all patients considered for resection of CRCLM from July 2010 to July 2012 in two specialist colorectal/hepatobiliary cancer centres. We extracted and analyzed data with respect to preoperative staging imaging and definitive treatment performed on completion of staging. Results: We identified 100 patients who underwent preoperative staging investigations for potentially resectable CRCLM. The imaging techniques performed included: CT (n=99, 99%), MRI liver (n=75, 75%), PET (n= 96, 96%). In 22 (22/96, 23%) patients PET scanning added to the preoperative staging information, identifying local recurrence (n=3, 3.1%), confirming liver metastases following an inconclusive CT/MRI (n=2, 2.1%), outruling liver metastases (n=1, 1%) and identifying extrahepatic sites (EHS) suspicious for disease (n=16, 16.7%). The EHS included either lung (n=6), bone (n=2), peritoneum (n=1) or lymph nodes (n=7). There were 2 false positive results. One patient with FDG-avid mediastinal lymph nodes had no cancer on endobronchial biopsy. One patient with FDG avidity at the primary anastomosis had no evidence of disease at colonoscopy. PET definitively changed the therapeutic strategy in 16 patients (16/96, 16.6%): precluding liver resection in 10 patients (10/96, 10.4%), leading to resection of extrahepatic disease in 4 patients (4/96, 4.1%), resection of local recurrence in 1 patient (1/96, 1%) and resection of hepatic metastases in one patient (1/96, 1%). Conclusions: In this small retrospective cohort the addition of metabolic imaging altered management in 16.6% of patients with potentially resectable CRCLM. There is a need for randomized evidence to support the routine use of PET in addition to cross-sectional imaging in this setting.

The utility of PET scanning in colorectal cancer liver metastases being considered for surgery.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 561-561
Author(s):  
Ciara Marie Kelly ◽  
Lauragh McCarthy ◽  
Aine O'Reilly ◽  
Peter McEneaney ◽  
Michael William Bennett ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Lymph Nodes ◽  
Liver Metastases ◽  
Preoperative Staging ◽  
Hepatic Metastases ◽  
Metabolic Imaging ◽  
Definitive Treatment ◽  
Preoperative Imaging ◽  
Pet Scanning

561 Background: Liver resection remains the only potentially curative option for a subset of patients with metastatic colorectal cancer (CRC) to liver. Preoperative imaging used to determine resectability includes contrast enhanced computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET). The objective of this study was to determine the utility of PET scanning for potentially resectable metastatic CRC to liver. Methods: We retrospectively reviewed a prospectively maintained database for all patients considered for liver resection of metastatic CRC from July 2010 to July 2012 in a specialist colorectal/hepatobiliary cancer centre. We extracted and analysed data with respect to preoperative staging imaging and definitive treatment performed on completion of staging. Results: We identified 50 patients who underwent preoperative staging investigations for potentially resectable metastatic CRC to liver. The imaging techniques performed included: CT (n=50, 100%), MRI liver (n=45, 90%), PET (n= 47, 94%). In 9 (9/47, 19%) patients PET scanning added to the preoperative cross sectional staging information, identifying local recurrence (n=1, 2%), confirming liver metastases following an inconclusive CT/MRI (n=1, 2%), and identifying extrahepatic sites suspicious for disease (n=7, 15%). The extrahepatic sites included either lung (n=4) or bone (n=1) or lymph nodes (n=2). One patient with FDG-avid mediastinal lymph nodes had no cancer on endobronchial biopsy. PET scanning definitively changed the therapeutic strategy in 6 patients (6/47, 12.8%): precluding liver resection in 2 patients (2/47, 4.3%), leading to resection of extrahepatic disease in 3 patients (3/47, 6.4%) and resection of hepatic metastases in one patient (1/47, 2.1%). Conclusions: In this small retrospective cohort the addition of metabolic imaging changed the management in 12.8% of patients with potentially resectable liver confined metastatic CRC. We plan to include data from other cancer centres in Ireland to confirm our findings.

Liver resection and outcome of hepatocellular carcinoma (HCC) in a transplant center.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 350-350
Author(s):  
Afsaneh Barzi ◽  
Shu Cao ◽  
Yuri Genyk ◽  
Jeffrey Kahn ◽  
Melissa A Wallman ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Resection ◽  
Surgical Resection ◽  
Treatment Options ◽  
Definitive Treatment ◽  
Vascular Involvement ◽  
Survival Outcomes ◽  
P Value ◽  
Incidence And Mortality ◽  
Transplant Candidates

350 Background: HCC has rising incidence and mortality in the US. Liver transplantation and surgery are the definitive treatment options. The median time to liver transplant in California is longer than many other regions. Given the expertise of our surgeons in liver resection we investigated the outcome of HCC at our institution. Methods: We extracted Norris Cancer registry data for patients (pt) with diagnosis of HCC from 2000 to 2010 who received their initial treatment at our facility. Overall survival (OS) is the primary end point of this study. We classified pt into transplant candidates (TC) vs. non-transplant candidates (NTC) based on the combination of T stage and vascular involvement. Results: We identified a total of 497 pts with HCC (Table). 98 pts had incomplete staging and 20 had metastatic disease and excluded from the analysis. We classified 221 pts as TC and 158 pts as NTC. The median OS for the TC was 2.9 years (yr) (95% CI 2.1-3.9) and in the NTC was 1.4 yr (95% CI 1.1 – 1.6). Amongst TC, 44 received transplant, 33 had surgical resection, and 144 had loco-regional treatment. Transplant recipients had an OS of 9.7 yr versus 4.3 yr (95% CI 1.9-9.1) in surgical patients, those with no definitive treatment had a OS of 1.8 yr (95%CI 1.6 -2.3). Among TC Hispanics had the best OS 4.3 yr (95% CI 1.9 – 9.7), followed by Asians 4.0 (95% CI 2.4-5.8), and Whites 2.0 (95% CI 1.4 -2.7) (p-value 0.0125). Among NTC Hispanics had the best OS 1.8 yr (95% CI 1.3 – 2.6), Asians 1.5 (95% CI 1.0 -2.1), and Whites 1.0 (95% CI 0.7 -1.4) (p-value 0.079). Conclusions: Liver transplantation continues to offer the best survival outcomes; however, in a region with long wait times, surgical resection offers a reasonable alternative with favorable survival outcomes. The trend of superior survival amongst Hispanics is noteworthy and subject of further investigation at our center. [Table: see text]

Major Liver Resection as Definitive Treatment in Post-cholecystectomy Common Bile Duct Injuries

2015 ◽  
Vol 39 (5) ◽  
pp. 1216-1223 ◽  
Author(s):  
Juan Pekolj ◽  
Alejandro Yanzón ◽  
Agustin Dietrich ◽  
Gabriela del Valle ◽  
Victoria Ardiles ◽  
...  
Keyword(s):  
Liver Resection ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Definitive Treatment ◽  
Major Liver Resection ◽  
Bile Duct Injuries

scholarly journals Two cases of Klebsiella pneumoniae liver abscess necessitating liver resection for effective treatment

2015 ◽  
Vol 97 (3) ◽  
pp. e37-e38
Author(s):  
B Maybury ◽  
A Powell-Chandler ◽  
N Kumar
Keyword(s):  
Liver Resection ◽  
Klebsiella Pneumoniae ◽  
Effective Treatment ◽  
Liver Abscess ◽  
Definitive Treatment ◽  
Aggressive Treatment ◽  
Geographic Spread ◽  
Liver Infection

We report two British cases of liver abscess, due to Klebsiella pneumoniae and associated with synchronous infection elsewhere, which required liver resection for definitive treatment. They illustrate the geographic spread of aggressive K pneumoniae liver infection and demonstrate the importance of early aggressive treatment.

Usefulness of Doppler ultrasound in a case of liver resection for intrahepatic lithiasis with hepatic vein abnormalities

Choonpa Igaku ◽  
2017 ◽  
Vol 44 (4) ◽  
pp. 389-394
Author(s):  
Hidehiko WAKI ◽  
Makiko UEDA ◽  
Kohsuke ITO ◽  
Takayoshi NAKAJIMA ◽  
Shinichi IKUTA ◽  
...  
Keyword(s):  
Liver Resection ◽  
Doppler Ultrasound ◽  
Hepatic Vein ◽  
Intrahepatic Lithiasis

scholarly journals LIVER RESECTION FOR NON-ORIENTAL HEPATOLITHIASIS

2019 ◽  
Vol 32 (4) ◽  
Author(s):  
Orlando Jorge Martins TORRES ◽  
Marcelo Moura LINHARES ◽  
Eduardo José B RAMOS ◽  
Paulo Cezar G AMARAL ◽  
Marcos BELOTTO ◽  
...  
Keyword(s):  
Liver Resection ◽  
Biliary Stricture ◽  
Clinical Symptoms ◽  
Type I ◽  
Function Test ◽  
Intrahepatic Lithiasis ◽  
History Of ◽  
Local Dilatation ◽  
Lateral Sectionectomy ◽  
The Ideal

ABSTRACT Background: Primary intrahepatic lithiasis is defined when the stones are formed in the liver and associated with local dilatation and biliary stricture. Liver resection is the ideal procedure. Aim: To evaluate the results of liver resection in the treatment of non-oriental intrahepatic lithiasis. Methods: Fifty-one patients with symptomatic benign non-oriental hepatolithiasis underwent surgical resection in six institutions in Brazil. Demography data, clinical symptoms, classification, diagnosis, management and postoperative course were analyzed. Results: Of the 51 patients, 28 were male (54.9%), with a mean age of 49.3 years. History of cholangitis was observed in 15 (29.4%). The types of intrahepatic lithiasis were type I in 39 (76.5%) and type IIb in 12 (23.5%), with additional type Ea in six (11.8%). Liver function test were normal in 42 patients (82.4%). Segmental atrophy was observed in 12 (23.5%). Treatments included left lateral sectionectomy in 24 (47.1%), left hepatectomy in 14 (27.5%) and right hepatectomy in eight (15.7%), with associated hepaticojejunostomy in four (7.8%). Laparoscopic liver resection was performed in eight (15.7%). Postoperative complications were observed in 20 (39.2%) with no mortality. Conclusion: Liver resection in patients with hepatolithiasis is the ideal procedure as it removes stones, stricture, atrophic parenchyma, and minimizes the risk of cholangiocarcinoma.

Surgical approaches for definitive treatment of hepatic alveolar echinococcosis: results of a survey in 178 patients

Parasitology ◽  
2019 ◽  
Vol 146 (11) ◽  
pp. 1414-1420 ◽  
Author(s):  
Chuang Yang ◽  
Jingyu He ◽  
Xianwei Yang ◽  
Wentao Wang
Keyword(s):  
Liver Resection ◽  
Hepatic Resection ◽  
Alveolar Echinococcosis ◽  
Larval Growth ◽  
Postoperative Mortality ◽  
Definitive Treatment ◽  
Surgical Approaches ◽  
Hepatic Alveolar Echinococcosis ◽  
Group A ◽  
Group D

AbstractHepatic alveolar echinococcosis (HAE) is a potentially fatal disease caused by the larval growth of Echinococcus multilocularis. We analysed the clinical data of 178 consecutive HAE patients treated with definitive radical surgery at our institution. According to the surgical approach: group A patients underwent direct radical hepatic resection; group B patients first underwent percutaneous puncture external drainage, followed by radical hepatic resection 2 months later; group C patients underwent a two-step hepatic resection; and group D patients underwent liver transplantation. The baseline characteristics, mortality, postoperative complications and recurrence rates were evaluated. Symptoms were present in 79.8% (142/178) patients. Bi-lobar lesion was found in 34 (19.1%, 34/178) patients, 47.2% (84/178) of whom had ⩾2 lesions each. There were no intraoperative deaths. The postoperative mortality was 2.29% in group A, 8.62% in group D and 0% in groups B and C. The main cause of death was a serious postoperative complication (Clavien–Dindo grades III–V). Patients were followed-up systematically for a median of 35.8 months (8–72) without recurrence. Active HAE should be treated by radical liver resection, and the complicated alveolar echinococcosis of the liver has been managed whenever possible using principles of radical liver resection by experienced hepatic surgeons.

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