scholarly journals Hepatic Alveolar Echinococcosis: the Possibilities of Ultrasonographyin the Planning of Surgical Operation

2017 ◽  
pp. 32-48
Author(s):  
O. I. Ashivkina
Keyword(s):  
Liver Resection ◽  
Alveolar Echinococcosis ◽  
New Technologies ◽  
Statistical Significance ◽  
Vena Cava ◽  
Hepatic Veins ◽  
Surgical Operation ◽  
Curative Therapy ◽  
Specificity And Sensitivity ◽  
Ct And Mri

Alveolar echinococcosis (AE) is a rare anthropozoonotic parasitic disease, which can affects the liver, lungs and other organs. R0-radical liver resection is the sole curative therapy for the patients with AE. Size of the parasitic foci, distant dissemination, and involvement of main liver vessels – all this information allows the surgeon to make the right decision about practicability and volume of operation. Formerly, ultrasonography (US) was not method of choice for the qualitative pre-operative diagnostic of AE. Nevertheless nowadays development of new technologies allows US to be an equal to CT and MRI.The aim:to estimate the possibilities of US in the planning of surgery in patients with AE.Materials and methods.The data of 64 patients who were undergone complete liver resection or reduction surgery in A.V. Vishnevsky Surgery Institute in period from January 2008 to December 2016 we respectively analyzed. Specificity and sensitivity of US, CT and MRI were analyzed and ROC-curves were constructed. Statistical significance was calculated using Chi-square.Results.The efficiency of US was significantly comparable to CT and MRI when we analyzed the involved of porta hepatis, vena cava, hepatic veins. Assessment of involvement of liver arteries and vena porta was not statistical significant.Conclusion.Accumulated experience of A.V. Vishnevsky Surgery Institute shows the possibility of qualitative preoperationUS evaluation of AE-lesion, which has to include assessment of distant dissemination and involvement of the liver main vessels. In a big surgical hospitals, which has an experience of AE treatment, pre-operative US can become the method of choice in planning of surgical operation. 

scholarly journals A new treatment strategy for end-stage hepatic alveolar echinococcosis: IVC resection without reconstruction

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Qiancheng Du ◽  
Yanyan Wang ◽  
Mengzhao Zhang ◽  
Yichong Chen ◽  
Xuepeng Mei ◽  
...  
Keyword(s):  
Liver Resection ◽  
Alveolar Echinococcosis ◽  
Vena Cava ◽  
Gastrointestinal Haemorrhage ◽  
Lower Limbs ◽  
Combined Resection ◽  
Hepatic Alveolar Echinococcosis ◽  
Resection Of The Liver ◽  
Ivc Resection ◽  
End Stage

Abstract Patients with hepatic alveolar echinococcosis (HAE) infringing on the inferior vena cava (IVC) have a poor prognosis when radical resection cannot be performed because curative resection is limited by IVC reconstruction. There is little information concerning combined resection of the liver and the IVC. This study explored a novel treatment method for HAE infringing on the IVC and evaluated the safety and feasibility of combined resection of the liver and the IVC. A total of 13 patients were treated with liver resection combined with IVC resection for end-stage HAE between January 2016 and July 2018 at the Affiliated Hospital of Qinghai University. The demographic, clinical, and follow-up data were collected and analysed. The 13 patients underwent resection of the IVC without reconstruction. Of these, 3 exhibited oedema of both lower limbs and the scrotum (23.1%), 2 exhibited pneumothorax (15.4%), 1 exhibited bile leakage (7.7%), 1 exhibited bacteraemia (7.7%), and 1 developed abdominal haemorrhage that was stopped with conservative treatment (7.7%). There was 1 case of operation-related mortality because of upper gastrointestinal haemorrhage (7.7%), and no patients developed recurrence or had residual lesions. Liver resection combined with IVC resection is effective and feasible for patients with HAE infringing on the IVC.

scholarly journals Ex Vivo Liver Resection and Autotransplantation as Surgical Option for Zone II–III Leiomyosarcoma of IVC: A Case Report and Literature Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Tuerhongjiang Tuxun ◽  
Tao Li ◽  
Shadike Apaer ◽  
Yi-Biao He ◽  
Lei Bai ◽  
...  
Keyword(s):  
Liver Resection ◽  
Hepatic Vein ◽  
Ex Vivo ◽  
Three Dimensional ◽  
Vena Cava ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Hepatic Recurrence ◽  
Chiari Syndrome ◽  
Zone Ii

We report the first documented case of leiomyosarcoma at zone II-III of inferior vena cava with thrombi in three hepatic veins undergoing ex vivo liver resection and autotransplantation (ELRA) and hepatic veins thrombectomy. A 33-year-old female patient presented with abdominal distention and lower extremities edema. Abdominal wall varicosis and shifting dullness were positive on physical examination. Her liver function was classified as Child-Pugh B and a solid tumor at retro-hepatic vena cava extending to right atrium with thrombi in three hepatic veins were confirmed. The diagnosis of leiomyosarcoma with Budd-Chiari syndrome was highly suspected with preoperative ultrasound, echocardiogram, CT scan, and three-dimensional reconstruction. A zone II-III leiomyosarcoma of IVC origin was confirmed at surgery and ex vivo liver resection and autotransplantation, and hepatic vein thrombectomy with atrial reconstruction were performed under cardiopulmonary bypass (CPB). Operative time, anhepatic time, and CPB time were 12 h, 128 min, and 84 min, respectively. The patients experienced post-operative liver dysfunction and was cured with conservative therapy. Hepatic recurrence two years after surgery was managed with radiofrequency. The patient was alive with liver metastasis three years after surgery. Despite being regarded as an extremely aggressive procedure, ELRA could be considered in the treatment of advanced leiomyosarcoma with Budd-Chiari syndrome and hepatic vein thrombi.

Laparoscopic liver resection for centrally located tumors close to the hilum, major hepatic veins, or inferior vena cava

Surgery ◽  
2013 ◽  
Vol 153 (4) ◽  
pp. 502-509 ◽  
Author(s):  
Yoo-Seok Yoon ◽  
Ho-Seong Han ◽  
Jai Young Cho ◽  
Ji Hoon Kim ◽  
Yujin Kwon
Keyword(s):  
Liver Resection ◽  
Inferior Vena Cava ◽  
Laparoscopic Liver Resection ◽  
Inferior Vena ◽  
Vena Cava ◽  
Hepatic Veins

scholarly journals Case Report: Successful DaVinci-Assisted Major Liver Resection for Alveolar Echinococcosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Mohammad Golriz ◽  
Viktoria Flossmann ◽  
Ali Ramouz ◽  
Ali Majlesara ◽  
Yakup Kulu ◽  
...  
Keyword(s):  
Liver Resection ◽  
Alveolar Echinococcosis ◽  
Fluid Collection ◽  
Bile Leakage ◽  
Radical Resection ◽  
Major Liver Resection ◽  
Curative Therapy ◽  
The Right ◽  
Surgical System ◽  
Radical Surgical Resection

We report a case of successful robot-assisted major liver resection in a patient with liver alveolar echinococcosis (AE). A 62-year-old male patient was incidentally diagnosed with a large infiltrative lesion in the right liver lobe suspicious for AE. A radical surgical resection as a right-sided hemihepatectomy was indicated. The operation was carried out via a robotic-assisted procedure using the DaVinci Xi Surgical System. The tumor measured 12.4 × 8.8 cm and was successfully resected through a suprapubic incision of 13 cm. The patient was free of pain after the second post-operative day. A fluid collection near the resection plate was easily drained without bile leakage. The patient had no surgical complications. Radical resection is inevitable for adequate curative therapy of AE and provides clear margins. Robotic surgery is a relatively new and safe option for curative resection of AE lesions, with remarkable advantages for patients and surgeons.

Development, Popularization and Application of An Online OvAge Calculator: Qualitative Study Based on the WeChat Mini Program (Preprint)

2020 ◽  
Author(s):  
Wenwen Xu ◽  
Hui Wang ◽  
Zheng Zhu ◽  
Quan Wang ◽  
Jing Jin ◽  
...  
Keyword(s):  
Predictive Model ◽  
Ovarian Reserve ◽  
Chinese Women ◽  
Polycystic Ovary ◽  
Statistical Significance ◽  
Clinical Samples ◽  
Clinical Markers ◽  
Clinical Trial Registry ◽  
Specificity And Sensitivity ◽  
Short Period

BACKGROUND At present, there are many clinical markers and models to assess ovarian reserve, but none of them are ideal. The number of clinical samples is a key factor limiting the specificity and sensitivity of the markers and models, and traditional methods of subject recruitment are time and vigor. In addition, the model of ovarian reserve assessment for Chinese women need to be further explored. OBJECTIVE To explore the possibility of self-reporting for subjects through the WeChat mini program, and provide more data support for further optimization of the OvAge model, and to develop a predictive model of ovarian reserve that is specific to Chinese women. METHODS In this paper, with reference to the existing OvAge model, we developed an online OvAge calculator based on the WeChat mini program for data collection, and then applied the generalized linear model theory to obtain a predictive model of ovarian reserve which is in line with the characteristics of Chinese women. RESULTS Compared to traditional recruiting methods, the online OvAge calculator is able to collect a large number of samples in a short period of time, which is efficient and convenient. Optimized model of estimated OvAge =exp (3.5254-0.001*PRL-0.0231*AMH). This model showed a high statistical significance for each marker included in the equation. We applied the final equation on diminished ovarian reserve and polycystic ovary syndrome datasets and obtained a mean of predicted ovarian age significantly different from the mean of chronological age in both groups. CONCLUSIONS The OvAge calculator based on the WeChat mini program is a novel online subject self-reporting system that can collect many samples in a short period of time, continuously optimize the model and update the mini program version, which is economical, time-saving and efficient., and is worthy of promotion. In addition, the optimized OvAge model is suitable for Chinese women and provides a reference for clinical assessment of ovarian reserve. CLINICALTRIAL The study was approved by Chinese Clinical Trial Registry (registration No. ChiCTR2000037522) and Medical ethics committee of Jiangsu Province Hospital of Chinese Medicine (approved No. 2019NL-152-02).

scholarly journals Vascular Involvements in Cholangiocarcinoma: Tips and Tricks

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3735
Author(s):  
Roberta Angelico ◽  
Bruno Sensi ◽  
Alessandro Parente ◽  
Leandro Siragusa ◽  
Carlo Gazia ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Vena Cava ◽  
High Volume ◽  
Vascular Reconstruction ◽  
Ex Situ ◽  
Vascular Involvement ◽  
Hepatic Veins ◽  
Hepatic Artery Resection ◽  
Artery Resection

Cholangiocarcinoma (CCA) is an aggressive malignancy of the biliary tract. To date, surgical treatment remains the only hope for definitive cure of CCA patients. Involvement of major vascular structures was traditionally considered a contraindication for resection. Nowadays, selected cases of CCA with vascular involvement can be successfully approached. Intrahepatic CCA often involves the major hepatic veins or the inferior vena cava and might necessitate complete vascular exclusion, in situ hypothermic perfusion, ex situ surgery and reconstruction with autologous, heterologous or synthetic grafts. Hilar CCA more frequently involves the portal vein and hepatic artery. Resection and reconstruction of the portal vein is now considered a relatively safe and beneficial technique, and it is accepted as a standard option either with direct anastomosis or jump grafts. However, hepatic artery resection remains controversial; despite accumulating positive reports, the procedure remains technically challenging with increased rates of morbidity. When arterial reconstruction is not possible, arterio-portal shunting may offer salvage, while sometimes an efficient collateral system could bypass the need for arterial reconstructions. Keys to achieve success are represented by accurate selection of patients in high-volume referral centres, adequate technical skills and eclectic knowledge of the various possibilities for vascular reconstruction.

Recanalization and Reconstruction of a Chronically Occluded Inferior Vena Cava Through an Existing Transjugular Intrahepatic Portosystemic Shunt in the Setting of Budd-Chiari Syndrome

2021 ◽  
pp. 153857442110020
Author(s):  
Reza Talaie ◽  
Hamed Jalaeian ◽  
Nassir Rostambeigi ◽  
Anthony Spano ◽  
Jafar Golzarian
Keyword(s):  
Inferior Vena Cava ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Inferior Vena ◽  
Vena Cava ◽  
Portosystemic Shunt ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Chiari Syndrome ◽  
Intrahepatic Portosystemic Shunt ◽  
The Right

Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails.1-3 Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation.

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