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Intestinal transplantation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
For liver-containing grafts (liver–small bowel or multivisceral), the liver is mobilized from diaphragmatic tissue. Both cava resection (with subsequent replacement) and preservation (for piggyback organ implantation) can be used at the surgeon's discretion. Hepatic hilar dissection and hepatectomy are similar to the corresponding steps in isolated liver transplantation (See Chapter 88). It is important to note that, for multivisceral transplantation, especially in the presence of confluent portomesenteric venous thrombosis where the operation is often performed, it is preferable to treat the entire abdominal viscera as a single organ to be excised en bloc, rather than to attempt a very bloody and dangerous hilar dissection.
Metastatic Colorectal Cancer
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Ganesh Nagarajan, Kaushal Kundalia
The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique is gaining popularity in some units for otherwise unresectable liver metastasis with low residual liver volume. However, its role in the routine management of patients who would otherwise need a second-stage hepatectomy has not yet been defined.
Fetal Growth Factors*
Published in Emilio Herrera, Robert H. Knopp, Perinatal Biochemistry, 2020
Philip A. Gruppuso, Thomas R. Curran, Roderick I. Bahner
Much of our current knowledge of the regulation of liver growth can be traced to in vivo studies on liver regeneration following partial hepatectomy in the rat. Partial hepatectomy leads to an initial alteration in hepatocytes from a quiescent to an actively replicating phenotype, resulting in restoration of liver mass.5,6 This is followed by differentiation and restoration of normal architecture and function. The events following partial hepatectomy have been used to identify growth factors and proto-oncogenes involved in regulation of liver growth, such as the transforming growth factors, TGF-α7 and TGF-β.8 Possible parallels between liver regeneration and fetal hepatic growth have influenced our recent studies (e.g., those on the ontogeny of TGF receptors).9
PA-MSHA Regulates PD-L1 Expression in Hepatoma Cells
Published in Immunological Investigations, 2023
Hangzhi Wei, Yudong Mao, Huihan Zhang, Fahong Wu, Youcheng Zhang
The cohort comprised 30 newly hospitalized patients with HCC (22 males and 8 females, ranging from the ages of 32 to 67, mean age = 54.33) at Lanzhou University Second Hospital. Samples were obtained between September 2020 and October 2021 (Table 1). All patients underwent hepatectomy, and the postoperative specimens were pathologically affirmed to be HCC. Follow-up calls with patients took place 12–24 months after hepatectomy, and there were no complications or mortalities reported. Two human HCC cell lines (Hep3B and Huh7) and one gastric cancer cell line (MGC-803) were obtained from the Cell Bank of Type Culture Collection of the Chinese Academy of Sciences (Shanghai, China). The HCC cell lines were cultured in DMEM, whereas MGC-803 was cultured in modified RPMI medium containing 12% fetal bovine serum (FBS). Finally, the cells were incubated in humidified air (5% CO2) at 37°C.
Open Radiofrequency Ablation Combined with Splenectomy and Pericardial Devascularization vs. Liver Transplantation for Hepatocellular Carcinoma Patients with Portal Hypertension and Hypersplenism: A Case-Matched Comparative Study
Published in Journal of Investigative Surgery, 2023
Xishu Wang, Ximin Sun, Yongrong Lei, Jun Pei, Kuansheng Ma, Kai Feng, Wan Yee Lau, Feng Xia
The key to success in using open radiofrequency ablation to treat HCC is accurate location of liver cancer nodules and accurate determination of the extent of radiofrequency ablation [30]. If the extent of radiofrequency ablation is too small, residual active tumor cells can be left behind. However, if the extent of radiofrequency ablation is too large, the treatment can lead to severe postoperative liver dysfunction, massive ascites, or even perioperative death. In this study, for a single tumor ≤ 3 cm, the extent of radiofrequency ablation was 2 cm from the edges of the tumor. For 2 to 3 tumors with each tumor of less than 3 cm, the extent of radiofrequency ablation aimed at 1 cm. Open radiofrequency ablation was used in this study instead of hepatectomy because all patients enrolled in this study had tumors of less than 3 cm. Based on the BCLC staging guidelines, radiofrequency ablation for these patients could achieve radical cure [32]. Moreover, as some of these lesions were located centrally, hepatectomy could result in acute liver failure, massive gastrointestinal bleeding, and death. Previous reports have shown that there is a significant probability of portal vein thrombosis developing after splenectomy and pericardial devascularization [33]. This study showed that 11 patients in the study group developed this complication, which was treated with anticoagulation and conservative treatment. No patients developed serious complications of portal thrombosis.
Alpha-Fetoprotein in Predicting Survival of Patients with Ruptured Hepatocellular Carcinoma after Resection
Published in Journal of Investigative Surgery, 2022
Wong Hoi She, Miu Yee Chan, Ka Wing Ma, Simon H. Y. Tsang, Wing Chiu Dai, Albert C. Y. Chan, Chung Mau Lo, Tan To Cheung
Diagnosis of rHCC has been detailed in a previous paper [11]. In patients who had no acute abdominal pain, the diagnosis was made during hepatectomy. Pre-hepatectomy management of spontaneous HCC rupture has been described in previous papers [12]. Patients who were stable at presentation were managed conservatively with tranexamic acid if no contraindications were identified. They were monitored closely by clinical and biochemical means in the minimum setting of a high dependency unit. Before 2005, patients who were fit and whose liver function had recovered were offered an early operation. Since 2005, all patients received a further computed tomographic scan (usually two to four weeks after the initial episode) to reevaluate their tumor status before operation. After initial stabilization and recovery, hepatectomy was considered and planned. Relationship between tumor’s anatomical location (regardless of tumor size) and major hepatic vasculatures would determine resectability. A 1-cm resection margin was aimed for, preferably by anatomical resection. Criteria for major resection (removal of 3 or more continuous Couinaud segments [13] have been listed in an earlier article and resection techniques have been detailed in various papers [14].