central hepatectomy
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Author(s):  
Huu Thien Ho

TÓM TẮT Bệnh nhi 6 tháng tuổi được chẩn đoán u nguyên bào gan, ban đầu được xem là không thể cắt bỏ được vì khối u có kích thước lớn và lan tỏa. Bệnh nhân được điều trị 4 đợt hóa chất cisplatin với thời gian cách nhau 2 tuần. Kết quả chụp cắt lớp vi tính sau 4 đợt hóa trị cho thấy khối u đã thu nhỏ lại và có thể cắt bỏ. Khối u đã được cắt bỏ bằng phương pháp phẫu thuật cắt gan trung tâm. Bệnh nhân đã có thể ăn uống trở lại vào ngày thứ tư và xuất viện vào ngày thứ bảy sau mổ. Bác sĩ chuyên khoa nhi ung bướu đã theo dõi bệnh nhân bằng siêu âm gan, alpha - fetoprotein và tiếp tục điềutrị thêm 2 chu kỳ cisplatin. ABSTRACT CENTRAL HEPATECTOMY IN A 6 - MONTH - OLD CHILD WITH HEPATOBLASTOMA FOLLOWING CHEMOTHERAPY A hepatoblastoma in a 6 - month - old child was initially considered unresectable because of diffuse liver involvement. The patient received 4 courses of cisplatin with an interval time of 2 weeks. A computed tomography scan after 4 courses of chemotherapy showed shrinking of the tumor, which made it resectable, and the tumor was removed by central hepatectomy. The patient was able to eat a regular diet on the fourth day and was sent discharge on the seventh day, after the operation. The pediatric oncologist followed the patient with liver ultrasonography and alpha - fetoprotein and administered 2 more cycles of cisplatin. Keywords: Central Hepatectomy, Hepatoblastoma, children.


2021 ◽  
Vol 268 ◽  
pp. 570-575
Author(s):  
Stephanie Y Chen ◽  
Abigail K Zamora ◽  
Danny Lascano ◽  
Shengmei Zhou ◽  
Eugene S Kim ◽  
...  

2021 ◽  
pp. 000313482110474
Author(s):  
Iswanto Sucandy ◽  
Furrukh Jabbar ◽  
Cameron Syblis ◽  
Kaitlyn Crespo ◽  
Sharona Ross ◽  
...  

Gallbladder cancer (GBC) is an uncommon but very aggressive malignancy with poor prognosis. Concerns for oncological inferiority related to the technical difficulties in performing laparoscopic portal lymphadenectomy discourage many surgeons to undertake this operation minimally invasively. With wide application of robotic technology to solve limitations of conventional laparoscopy, we describe our initial outcomes of robotic central hepatectomy and portal lymphadenectomy for gallbladder carcinoma in 15 consecutive patients. Data were presented as median (mean ± SD). Patients were 70 (73 ± 10.9) years old with BMI of 26 (26 ± 3.6) kg/m2. Tumor size was 3(4 ± 1.9) cm. Operative duration was 222 (237 ± 85.7) minutes and estimated blood loss was 200 (222 ± 135.4) mL. There were no intraoperative complications and complete resection (R0) was obtained in nearly all patients. Postoperative complications were seen in two patients (bile leak (n = 1) and respiratory failure (n = 1)). Length of stay was 3 (4 ± 4.0) days without 30-day mortality. Robotic approach is safe and effective for the treatment of GBC.


2021 ◽  
Vol 8 ◽  
Author(s):  
Ling Tan ◽  
Fei Liu ◽  
Zi-lin Liu ◽  
Jiang-wei Xiao

Background and Aim: The risk factors for bile leakage after hepatectomy without biliary reconstruction are controversial. This study investigated the risk factors for bile leakage after hepatectomy without biliary reconstruction.Methods: We searched databases (Embase (Ovid), Medline (Ovid), PubMed, Cochrane Library, and Web of Science) for articles published between January 1, 2000, and May 1, 2021, to evaluate the risk factors for bile leakage after hepatectomy without biliary reconstruction.Results: A total of 16 articles were included in this study, and the overall results showed that sex (OR: 1.21, 95% CI: 1.04–1.42), diabetes (OR: 1.21, 95% CI: 1.05–1.38), left trisectionectomy (OR: 3.53, 95% CI: 2.32–5.36), central hepatectomy (OR: 3.28, 95% CI: 2.63–4.08), extended hemihepatectomy (OR: 2.56, 95% CI: 1.55–4.22), segment I hepatectomy (OR: 2.56, 95% CI: 1.50–4.40), intraoperative blood transfusion (OR:2.40 95%CI:1.79–3.22), anatomical hepatectomy (OR: 1.70, 95% CI: 1.19–2.44) and intraoperative bleeding ≥1,000 ml (OR: 2.46, 95% CI: 2.12–2.85) were risk factors for biliary leakage. Age >75 years, cirrhosis, underlying liver disease, left hepatectomy, right hepatectomy, benign disease, Child–Pugh class A/B, and pre-operative albumin <3.5 g/dL were not risk factors for bile leakage after hepatectomy without biliary reconstruction.Conclusion: Comprehensive research in the literature revealed that sex, diabetes, left trisectionectomy, central hepatectomy, extended hemihepatectomy, segment I hepatectomy, intraoperative blood transfusion, anatomical hepatectomy and intraoperative bleeding ≥1,000 ml were risk factors for biliary leakage.


Author(s):  
Edoardo Maria Muttillo ◽  
Eric Felli ◽  
Lorenzo Cinelli ◽  
Fabio Giannone ◽  
Emanuele Felli

2021 ◽  
pp. 874-880
Author(s):  
Huu Thien Ho ◽  
Trung Hieu Mai ◽  
Thanh Xuan Nguyen ◽  
Kim Hoa thi Nguyen ◽  
Nhu Hien Pham ◽  
...  

A hepatoblastoma in a 6-month-old child was initially considered unresectable because of diffuse liver involvement. The patient received 4 courses of cisplatin with an interval time of 2 weeks. A computed tomography scan after 4 courses of chemotherapy showed shrinking of the tumor, which made it resectable, and the tumor was removed by central hepatectomy. The patient was able to eat a regular diet on the fourth day and was sent home on the seventh day, after the operation. The pediatric oncologist followed the patient with liver ultrasonography and alpha-fetoprotein and administered 2 more cycles of cisplatin.


Author(s):  
D. G. Akhaladze ◽  
G. S. Rabaev ◽  
N. G. Uskova ◽  
N. N. Merkulov ◽  
S. R. Talypov ◽  
...  

Aim. To analyze the safety and advantages of central resection in comparison with extended hepatectomies.   Methods. From June 2017 to May 2020 29 central and extended liver resections for children were performed. Central hepatic resections were carried out in 8, extended hepatectomies – in 21 patients. Preoperative investigations, intraoperative and postoperative data in both groups were analyzed.Results. The main indication for surgery was hepatoblastoma. Future liver remnant volume was significantly higher in central resections group (р = 0.003). No difference in median operative time (р = 0.94), intraoperative blood loss (р = 0.078) and blood transfusion rate (р = 0.057) were found between groups. There were no postoperative complications difference. Also no difference in hospital stay length (р = 0.3) were found.Conclusion. In comparison with extended procedures, central liver resection has similar complication rate. Central hepatectomy is a safe procedure in children with liver tumors, which allows to preserve more healthy parenchyma.


2021 ◽  
Vol 91 (4) ◽  
Author(s):  
Ken Min Chin ◽  
Yun‐Le Linn ◽  
Chin Kai Cheong ◽  
Ye‐Xin Koh ◽  
Jin‐Yao Teo ◽  
...  

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