Perioperative and long-term outcome of en-bloc arterial resection in pancreatic surgery.

Background: Pancreatic tumors are frequently diagnosed in a locally advanced stage with poor prognosis if untreated. This study assesses the safety and oncological outcomes of pancreatic surgery with arterial en-bloc resection.

Methods: We retrospectively reviewed a prospectively maintained database of patients who underwent a pancreatic resection with arterial resection between 2011 and 2020.

Effect of Aprotinin on Liver Injury after Transplantation of Extended Criteria Donor Grafts in Humans: A Retrospective Propensity Score Matched Cohort Analysis.

The number of patients awaiting liver transplantation still widely exceeds the number of donated organs available. Patients receiving extended criteria donor (ECD) organs are especially prone to an aggravated ischemia reperfusion syndrome during liver transplantation leading to massive hemodynamic stress and possible impairment in organ function. Previous studies have demonstrated aprotinin to ameliorate reperfusion injury and early graft survival.

Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans.

Background: The goal of cardiac evaluation of patients awaiting orthotopic liver transplantation (OLT) is to identify the patients at risk for cardiovascular events (CVEs) in the peri- and postoperative periods by opportunistic evaluation of coronary artery calcium (CAC) in non-gated abdominal computed tomographs (CT).

Methods: We hypothesized that in patients with OLT, a combination of Lee's revised cardiac index (RCRI) and CAC scoring would improve diagnostic accuracy and prognostic impact compared to non-invasive cardiac testing. Therefore, we retrospectively evaluated 169 patients and compared prediction of CVEs by both methods.

Global Longitudinal Strain at Rest as an Independent Predictor of Mortality in Liver Transplant Candidates: A Retrospective Clinical Study.

Speckle tracking echocardiography enables the detection of subclinical left ventricular dysfunction at rest in many heart diseases and potentially in severe liver diseases. It could also possibly serve as a predictor for survival. In this study, 117 patients evaluated for liver transplantation in a single center between May 2010 and April 2016 with normal left ventricular ejection fraction were included according to clinical characteristics of their liver disease: (1) compensated ( = 29), (2) clinically significant portal hypertension ( = 49), and (3) decompensated ( = 39).

Loco-regional hepatocellular carcinoma treatment services as a bridge to liver transplantation.

Background: Liver transplantation remains the main curative treatment option for hepatocellular carcinoma (HCC) patients. In the Eurotransplant area Milan criteria are used to assign priority extra points (exceptional MELD, exMELD) for patients on the waiting list. To prevent patients from tumor progression, loco-regional (neoadjuvant) treatment (LRT) is used.

Incisional Hernia Repair of Medium- and Large-Sized Defects: Laparoscopic IPOM Versus Open SUBLAY Technique.

Small incisional hernias can be repaired laparoscopically with low morbidity and reasonable recurrence rates. The aim of this study was to compare laparoscopic with open technique in medium- and large-sized defects regarding postoperative complications and recurrence rates. Between 2012 and 2016, 102 patients with medium- or large-sized defects according to EHS classification underwent incisional hernia repair.

Influence of Telomere Length in Hepatocytes on Liver Regeneration after Partial Hepatectomy in Rats.

Background: The aim of this study was to investigate telomere length in hepatocytes as a biomarker for liver regeneration after partial hepatectomy (PH) in rats.

Materials And Methods: Sixty male Wistar rats underwent a 70% PH. One-month-old rats were assigned to group Y (n = 30) and 4-month-old rats were assigned to group O (n = 30).

Visual quality assessment of the liver graft by the transplanting surgeon predicts postreperfusion syndrome after liver transplantation: a retrospective cohort study.

Background: The discrepancy between demand and supply for liver transplants (LT) has led to an increased transplantation of organs from extended criteria donors (ECD).

Methods: In this single center retrospective analysis of 122 cadaveric LT recipients, we investigated predictors of postreperfusion syndrome (PRS) including transplant liver quality categorized by both histological assessment of steatosis and subjective visual assessment by the transplanting surgeon using multivariable regression analysis. Furthermore, we describe the relevance of PRS during the intraoperative and postoperative course of LT recipients.

Grade of donor liver microvesicular steatosis does not affect the postoperative outcome after liver transplantation.

Background: The potential effect of graft steatosis on the postoperative liver function is discussed controversially. The present study aimed to evaluate the effect of the donor liver microvesicular steatosis on the postoperative outcome after liver transplantation.

Methods: Ninety-four patients undergoing liver transplantation at the University Hospital Aachen were included in this study.

Impact of obesity on postoperative complications after laparoscopic and open incisional hernia repair - A prospective cohort study.

Background: Obese patients are often required to lose weight prior to incisional hernia repair as obesity is thought to increase postoperative complications and recurrence rates. The aim of this study was to determine the impact of BMI on the outcome after laparoscopic and open incisional hernia repair.

Materials And Methods: In a cohort study from May 2012 to August 2016, 178 patients underwent incisional hernia repair: 90 patients open SUBLAY and 88 patients laparoscopic intraperitoneal onlay mesh (IPOM).

Expression of VEGFR-2 during Liver Regeneration after Partial Hepatectomy in a Bioluminescence Mouse Model.

Background: Liver regeneration requires the formation of new blood vessels. Endothelial cell proliferation is stimulated by vascular endothelial growth factor (VEGF) and its receptor tyrosine kinase VEGFR-2. The aim of this study was to investigate VEGFR-2 expression in vivo during liver regeneration after partial hepatectomy (PHx).

Comparative study of the effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats.

Background: Post-hepatectomy liver failure as a result of insufficient liver remnant is a feared complication in liver surgery. Efforts have been made to find new strategies to support liver regeneration. The aim of this study was to investigate the effects of terlipressin versus splenectomy on postoperative liver function and liver regeneration in rats undergoing 70% partial hepatectomy.

Risk factors for morbidity after appendectomy.

Introduction: The aim of the present study was to evaluate the risk factors for postoperative complications after an appendectomy with special regard to both the time period from hospital admission to operation and night time surgery.

Patients And Methods: Patients who underwent an appendectomy due to acute appendicitis and were admitted to the University Hospital Aachen between January 2003 and January 2014 were included in this retrospective analysis. Regarding the occurrence of postoperative complications, patients were divided into the following two groups: the group with complications (group 1) and the group without complications (group 2).

Argon Delays Initiation of Liver Regeneration after Partial Hepatectomy in Rats.

Background: The liver can heal up to restitutio ad integrum following damage resulting from various causes. Different studies have demonstrated the protective effect of argon on various cells and organs. To the best of our knowledge, the organ-protective effects of the noble gas argon on the liver have not yet been investigated, although argon appears to influence signal paths that are well-known mediators of liver regeneration.

Liver Transplantation and Donor Body Mass Index >30: Use or Refuse?

Background: Organ shortage is a major problem in liver transplantation. The use of extended criteria donors has become the most important strategy for increasing the donor pool. However, the role of donor body mass index has not yet been thoroughly investigated.

Liver resection in the elderly: A retrospective cohort study of 460 patients - Feasible and safe.

Introduction: The aim of this study was to determine the influence of age on the early postoperative outcome after liver surgery.

Material And Methods: Between January 2005 and July 2012 460 hepatic resections were performed in patients aged 60 years or younger and 70 years or older at the University Hospital Aachen and University Hospital Maastricht. The postoperative outcome of hepatic resection was evaluated by the time of intensive care unit (ICU) stay, length of hospital stay, appearance of postoperative complications and in-hospital mortality.

Assessment of a course of realistic surgical training during medical education as a tool for pre-residential surgical training.

Background: In recent years the focus on practical skills in the German curriculum of medical school has increased greatly. In this study we evaluate the value of a practical surgery course for medical students as a tool for surgical education, as a way of enhancing interest in surgical fields, and as a method of influencing medical students to subsequently choose a surgical career.

Methods: The "Feel like a surgeon"-course is an optional practical surgery course in which topographical anatomy and realistic surgical training using fresh human cadavers are combined for medical students of the RWTH Aachen University.

Biliary complications in liver transplantation: Impact of anastomotic technique and ischemic time on short- and long-term outcome.

Aim: To elucidate the impact of various donor recipient and transplant factors on the development of biliary complications after liver transplantation.

Methods: We retrospectively reviewed 200 patients of our newly established liver transplantation (LT) program, who received full size liver graft. Biliary reconstruction was performed by side-to-side (SS), end-to-end (EE) anastomosis or hepeaticojejunostomy (HJ).

Liver Transplantation for Patients with Cholestatic Liver Diseases.

Background: Cholestatic liver diseases (CD) account for 11% of all liver transplantations (LT) in the Eurotransplant region. Despite the excellent long-term outcome that is considerably superior to all other indications for LT, transplant surgeons and physicians face nowadays - in the era of MELD (Model of End-Stage Liver Disease)-based allocation, organ shortage, and extended allocation policies - more and more challenges in this patient cohort, especially since there is no curative medical treatment for these entities.

Methods: Based on a literature review and personal experience in liver transplantation for CD, we show the status quo of indication, allocation, and outcome as well as potential strategies to overcome long waiting times and organ shortage.