scholarly journals Portal vein arterialization as a salvage procedure in hepatopancreatobiliary surgery: a systematic review

2021 ◽  
Vol 64 (2) ◽  
Author(s):  
Ali Majlesara ◽  
Omid Ghamarnejad ◽  
Elias Khajeh ◽  
Mohammad Golriz ◽  
Negin Gharabaghi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Animal Studies ◽  
Survival Rates ◽  
Celiac Trunk ◽  
Salvage Procedure ◽  
Portal Vein Arterialization ◽  
Hepatopancreatobiliary Surgery ◽  
Meta Analyses

Background: Portal vein arterialization (PVA) is a possible option when hepatic artery reconstruction is impossible during liver resection. The aim of this study was to review the literature on the clinical application of PVA in hepatopancreatobiliary (HPB) surgery. Methods: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched the PubMed, Embase and Web of Science databases until December 2019. Experimental (animal) studies, review articles and letters were excluded. Results: Twenty studies involving 57 patients were included. Cholangiocarcinoma was the most common indication for surgery (40 patients [74%]). An end-to-side anastomosis between a celiac trunk branch and the portal vein was the main PVA technique (35 patients [59%]). Portal hypertension was the most common longterm complication (12 patients [21%] after a mean of 4.1 mo). The median followup period was 12 (range 1–87) months. The 1-, 3- and 5-year survival rates were 64%, 27% and 20%, respectively. Conclusion: Portal vein arterialization can be considered as a rescue option to improve the outcome in patients with acute liver de-arterialization when arterial reconstruction is not possible. To prevent portal hypertension and liver injuries due to thrombosis or overarterialization, vessel calibre adjustment and timely closure of the anastomosis should be considered. Further prospective experimental and clinical studies are needed to investigate the potential of this procedure in patients whose liver is suddenly de-arterialized during HPB procedures.

scholarly journals Multidisciplinary treatment of left hepatic artery pseudoaneurysm after hepatobiliary resection for gallbladder cancer: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Ryusei Yamamoto ◽  
Teiichi Sugiura ◽  
Yukiyasu Okamura ◽  
Takaaki Ito ◽  
Yusuke Yamamoto ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Liver Failure ◽  
Hepatic Artery ◽  
Remnant Liver ◽  
Left Hepatic Artery ◽  
Artery Pseudoaneurysm ◽  
Hepatobiliary Resection ◽  
Portal Vein Arterialization ◽  
Arterial Inflow

Abstract Background When a postoperative hepatic artery pseudoaneurysm develops after massive hepatectomy, both an intervention for the pseudoaneurysm and patency of hepatic artery should be considered because occlusion of the residual hepatic artery results in critical liver failure. However, the treatment strategy for a pseudoaneurysm of the hepatic artery after hepatobiliary resection is not well established. Case presentation A 65-year-old woman underwent right hepatectomy, extrahepatic duct resection, and portal vein resection, for gallbladder cancer. Although the patient had an uneventful postoperative course, computed tomography on postoperative day 6 showed a 6-mm pseudoaneurysm of the hepatic artery. Angiography revealed the pseudoaneurysm located on the bifurcation of the left hepatic artery to the segment 2 artery plus the segment 3 artery and 4 artery. Stent placement in the left hepatic artery was not feasible because the artery was too narrow, and coiling of the pseudoaneurysm was associated with a risk of occluding the left hepatic artery and inducing critical liver failure. Therefore, portal vein arterialization constructed by anastomosing the ileocecal artery and vein was performed prior to embolization of the pseudoaneurysm to maintain the oxygen level of the remnant liver, even if the left hepatic artery was accidentally occluded. The pseudoaneurysm was selectively embolized without occlusion of the left hepatic artery, and the postoperative laboratory data were within normal limits. Although uncontrollable ascites due to portal hypertension occurred, embolization of the ileocolic shunt rapidly resolved it. The patient was discharged on postoperative day 45. Conclusion Portal vein arterialization prior to embolization of the aneurysm may be a feasible therapeutic strategy for a pseudoaneurysm that develops after hepatectomy for hepatobiliary malignancy to guarantee arterial inflow to the remnant liver. Early embolization of arterioportal shunting after confirmation of arterial inflow to the liver should be performed to prevent morbidity induced by portal hypertension.

scholarly journals The stand of portal vein arterialization in hepatobiliary surgery: a systematic review

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S463
Author(s):  
A. Majlesara ◽  
M. Golriz ◽  
O. Ghamarnejad ◽  
E. Khajeh ◽  
A. Mehrabi
Keyword(s):  
Systematic Review ◽  
Portal Vein ◽  
Hepatobiliary Surgery ◽  
Portal Vein Arterialization

Zirconia Biocompatibility in Animal Studies - A Systematic Review

2017 ◽  
Vol 376 ◽  
pp. 12-28 ◽  
Author(s):  
Sanda Mihaela Popescu ◽  
Horia Octavian Manolea ◽  
Oana Andreea Diaconu ◽  
Veronica Mercuţ ◽  
Monica Scrieciu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dental Implants ◽  
Animal Studies ◽  
Case Reports ◽  
Powder Injection ◽  
Mesh Terms ◽  
Meta Analyses ◽  
Abstract Screening

Zirconia is a metal used in dental implantology. Its biocompatibility was studied in vitro and in vivo, results of the studies being analyzed in reviews and meta analyses. The aim of this systematic review was to evaluate biocompatibility of zirconia in animal studies in vivo expressed as results of histomorphometric tests. Databases were searched from 1980 until February 2016, with different combination of the following MeSH terms: zirconium, biocompatibility, dental implants, in vivo, animal studies. Letters to the editors, case reports, commentaries, review articles and articles published in other languages then English were excluded. The search of PubMed, ScienceDirect and Google Scholar databases yielded 690 titles. After abstract screening and duplicate discarding 50 articles were identified and finally, 40 were included in the review. Most of the studies compared zirconia with titanium, a well established material for dental implants. In majority of the studies zirconia showed a similar osseointegration with titanium. Surface implant treatments, like sandblasted and etched zirconia (ZrO2-SLA), alumina toughed zirconia (ATZ), and powder injection molding (PIM) were used to improve osseointegration of zirconia with good results. In the light of histomorphometric test, zirconia, no matter physical and structural forms tested, is a biocompatible material.

FA03.02: IS SURGERY STILL NECESSARY IN RESECTABLE OESOPHAGEAL CANCER? META-ANALYSES OF DEFINITIVE CHEMORADIOTHERAPY VERSUS TRIMODALITY THERAPY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 6-6
Author(s):  
Daan Voeten ◽  
Chantal Den Bakker ◽  
Donald Van Der Peet
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Survival Rates ◽  
Oesophageal Carcinoma ◽  
Risk Of Bias ◽  
Survival Advantage ◽  
Definitive Chemoradiotherapy ◽  
Trimodality Therapy ◽  
Meta Analyses ◽  
Overall Survival Rates

Abstract Background Standard therapy for resectable oesophageal carcinoma is trimodality therapy (TMT) consisting of neoadjuvant chemoradiotherapy and oesophagectomy. Evidence of survival advantage of TMT over organ preserving definitive chemoradiotherapy (dCRT) is inconclusive. The aim of this study is to compare survival between TMT and dCRT. Methods A systematic review and meta-analyses were conducted. Randomised controlled trials and observational studies on primary resectable, curatively treated, oesophageal carcinoma patients above 18 years were included. Three online databases were searched for studies comparing TMT with dCRT. Primary outcomes were two-, three- and five-year overall survival rates. Risk of bias was assessed using the Cochrane risk of bias tools for RCTs and cohort studies. Results Thirty-two studies described in 35 articles were included in this systematic review, thirty-three were included in the meta-analyses. Two-, three- and five-year overall survival was significantly lower in dCRT compared to TMT, with relative risks (RR) of 0.69 (95%CI, 0.57–0.83), 0.76 (95%CI, 0.63–0.92), and 0.57 (95%CI, 0.47–0.71) respectively. However, when only analysing studies with equal patient groups at baseline no differences for two-, three- and five-year overall survival were found with RRs of 0.83 (95%CI, 0.62–1.10), 0.81 (95%CI 0.57–1.14), 0.63 (95%CI, 0.36–1.12). The forest plot for three-year overall survival is presented in figure 1. Figure 1. 3 year overall survival rates Conclusion Despite limitations of the available evidence these meta-analyses suggest there is no survival advantage for TMT over dCRT, assuming comparable groups at baseline. Selection of surgical candidates in oesophageal carcinoma should be part of personalised and tailored care. Disclosure All authors have declared no conflicts of interest.

Portal Vein Arterialization as a Salvage Procedure During Left Hepatic Trisectionectomy for Hilar Cholangiocarcinoma

2008 ◽  
Vol 207 (5) ◽  
pp. e1-e6 ◽  
Author(s):  
Alastair L. Young ◽  
K. Rajendra Prasad ◽  
Robert Adair ◽  
Mohammed Abu Hilal ◽  
J. Ashley Guthrie ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hilar Cholangiocarcinoma ◽  
Salvage Procedure ◽  
Portal Vein Arterialization ◽  
Left Hepatic Trisectionectomy

scholarly journals Immunogenicity and safety of adenovirus-based vector vaccines for COVID-19: a systematic review and meta-analysis

2021 ◽  
Vol 30 (4) ◽  
pp. 264-78
Author(s):  
Ayers Gilberth Ivano Kalaij ◽  
Valerie Josephine Dirjayanto ◽  
Syarif Maulana Yusuf ◽  
Erni Juwita Nelwan
Keyword(s):  
Systematic Review ◽  
Animal Studies ◽  
Vaccine Development ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Effective Vaccine ◽  
Forest Plot ◽  
Vector Vaccine ◽  
Effect Model ◽  
Meta Analyses

BACKGROUND Despite various research on vaccine development, severe acute respiratory syndrome coronavirus 2 infection continues to spread. Thus, developing a more effective vaccine for production and clinical efficacy is still in high demand. This review aimed to assess the immunogenicity and safety of adenovirus-based vector vaccine (Ad-vaccines) including Ad5-vectored, ChAdOx1 nCoV-19, rAd26-S or rAd5-S, and Ad26.COV2.S as the promising solutions for COVID-19. METHODS We conducted a systematic review and meta analysis of clinical trials based on the preferred reporting items for systematic reviews and meta-analyses guidelines through PubMed, Scopus, Cochrane, and EBSCOhost until August 17, 2021. We implemented inclusion and exclusion criteria and assessed the studies using OHAT risk of bias rating tool for human and animal studies. Pooled estimates of odds ratio (OR) were analyzed using fixed-effect model. RESULTS This systematic review yielded 12 clinical studies with a total of 75,105 subjects. Although the studies were heterogeneous, this meta-analysis showed that Ad-vaccine significantly increased protection and immune response against COVID-19 with a pooled efficacy of 84.68% compared to placebo (p<0.00001). Forest plot also indicated that Ad-vaccine conferred protection against moderate to severe COVID-19 with a pooled OR of 0.26 (p<0.00001). Ad-vaccine had also shown a good safety profile with local site pain and fever as the most common side effects. CONCLUSIONS Ad-vaccine had shown a good immunogenicity for COVID-19 with a good pooled efficacy and was proven safe for COVID-19 patients.

No difference in mortality among ALPPS, two-staged hepatectomy, and portal vein embolization/ligation: A systematic review by updated traditional and network meta-analyses

2020 ◽  
Vol 19 (5) ◽  
pp. 411-419
Author(s):  
Paschalis Gavriilidis ◽  
Robert P Sutcliffe ◽  
Keith J Roberts ◽  
Madhava Pai ◽  
Duncan Spalding ◽  
...  
Keyword(s):  
Systematic Review ◽  
Portal Vein ◽  
Portal Vein Embolization ◽  
Meta Analyses ◽  
Staged Hepatectomy

scholarly journals Portal vein arterialization: a salvage procedure for a totally de-arterialized liver. The Paul Brousse Hospital experience

HPB ◽  
2014 ◽  
Vol 16 (8) ◽  
pp. 723-738 ◽  
Author(s):  
Prashant Bhangui ◽  
Chady Salloum ◽  
Chetana Lim ◽  
Paola Andreani ◽  
Arie Ariche ◽  
...  
Keyword(s):  
Portal Vein ◽  
Salvage Procedure ◽  
Portal Vein Arterialization ◽  
Hospital Experience

scholarly journals Effect of tetracyclines on pulpal and periodontal healing after tooth replantation: a systematic review of human and animal studies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mingmei Meng ◽  
Yandi Chen ◽  
Huidi Ren ◽  
Qiong Zhang ◽  
Song Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Normal Saline ◽  
Animal Studies ◽  
Human Study ◽  
Permanent Teeth ◽  
Tooth Replantation ◽  
Clinically Significant ◽  
Meta Analyses ◽  
Periodontal Healing ◽  
Systemic Application

Abstract Background Pulpal and periodontal healing are two main concerns of delayed replantation of avulsed teeth. The objective of this review was to evaluate the effectiveness of topical and systemic application of tetracyclines on pulpal and periodontal healing after tooth replantation. Methods A comprehensive electronic search was conducted in six databases. This systematic review was carried out according to Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results After exclusion of 246 irrelevant papers, 14 animal studies and one human study were included in this review. The human study showed that avulsed permanent teeth treated with doxycycline did not show a better clinical outcome for pulp and periodontal healing compared with treatment with normal saline. As for animal studies, significant more pulpal healing was observed in immature teeth treated with topical doxycycline in two researches, while another one study showed that there is no difference between teeth treated with normal saline and teeth treated with doxycycline. Systemic doxycycline exerted no significant effect on pulpal revascularization illustrated by one research. Only one out of four articles illustrated the positive effect of systemic tetracyclines on periodontal healing. One paper reported that intracanal application of demeclocycline promoted favorable periodontal healing. Two articles showed topical doxycycline contributed to favorable periodontal healing, while five studies showed no significant effect of topical tetracyclines on periodontal healing. Conclusions As a result of data heterogeneity and limitations of the studies, the effect of topical or systemic application of tetracyclines on pulpal and periodontal healing is inconclusive. More studies are required to get more clinically significant conclusions.

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