Proximal Roux-en-y Gastrojejunal Anastomosis with Pyloric Ring Resection Improves Gastric Emptying After Pancreaticoduodenectomy.

Background: Delayed gastric emptying (DGE) is a common complication of pancreaticoduodenectomy. We determined the efficiency of a new reconstruction technique, designed to preserve motilin-secreting cells and maximize the utility of their receptors, in reducing the incidence of DGE after pancreaticoduodenectomy.

Methods: From April 2005 to September 2014, 217 consecutive patients underwent pancreaticoduodenectomy at our institution.

Topically applied 2-octyl cyanoacrylate (Dermabond) for prevention of postoperative pancreatic fistula after pancreaticoduodenectomy.

Objective: We examined whether 2-octyl cyanoacrylate (Dermabond) topically applied to the pancreaticojejunostomy (PJ) anastomotic site after pancreaticoduodenectomy (PD) reduces the rate of postoperative pancreatic fistula (POPF).

Methods: Patients who underwent PD with duct-to-mucosa PJ were evaluated (n = 124). Outcome was compared between patients who received Dermabond (n = 75) after PD and historic patients who did not (n = 49).

Use of decellularized porcine liver for engineering humanized liver organ.

Background: New bioartificial liver devices are needed to supplement the limited supply of organ donors available for patients with end-stage liver disease. Here, we report the results of a pilot study aimed at developing a humanized porcine liver by transplanting second trimester human fetal hepatocytes (Hfh) co-cultured with fetal stellate cells (Hfsc) into the decellularized matrix of a porcine liver.

Material And Methods: Ischemic livers were removed from 19 Yorkshire swine.

Clinical value of plasma hepatocyte growth factor measurement for the diagnosis of periampullary cancer and prognosis after pancreaticoduodenectomy.

Background: Previous studies suggest that serum hepatocyte growth factor (HGF) level may be a useful diagnostic and prognostic biomarker for various tumors. We investigated the utility of plasma HGF level measurements in diagnosing periampullary cancer (PAC).

Methods: Of the patients enrolled in this pilot study (n = 118), 57 had PAC, 21 had benign pancreatic tumor (BPT), 20 had chronic pancreatitis (CP), and 20 were healthy controls.

Morphological features of advanced hepatocellular carcinoma as a predictor of downstaging and liver transplantation: an intention-to-treat analysis.

In selected patients, locoregional therapy (LRT) has been successful in downstaging advanced hepatocellular carcinoma (HCC) so that the conventional criteria for liver transplantation (LT) can be met. However, the factors that predict successful treatment are largely unidentified. To determine these factors, we analyzed our experience with multimodal LRT in downstaging advanced HCC before LT in a retrospective cohort study.

Major liver resection for hepatocellular carcinoma in the morbidly obese: a proposed strategy to improve outcome.

Background: Morbid obesity strongly predicts morbidity and mortality in surgical patients. However, obesity's impact on outcome after major liver resection is unknown.

Case Presentation: We describe the management of a large hepatocellular carcinoma in a morbidly obese patient (body mass index >50 kg/m2).

Complex liver resection for a large intrahepatic cholangiocarcinoma in a Jehovah's witness: a strategy to avoid transfusion.

Although morbidity and mortality after liver resection have improved over the last two decades, complex liver resections still require perioperative blood transfusions. In this report, we describe the use of a combined left trisegmentectomy and caudate lobectomy, along with resection of the inferior vena cava, to treat a large intrahepatic cholangiocarcinoma in a Jehovah's Witness. To our knowledge, this is the first report of major liver resection for a large malignant tumor in this patient population.

Extended right trisegmentectomy using in situ hypothermic perfusion with modified HTK solution for a large intrahepatic cholangiocarcinoma.

The technique of right hepatic trisegmentectomy has been standardized for large tumors that involve the right lobe and extend into the medial segment of the left lobe. However, these tumors are deemed unresectable if they encroach across the falciform ligament into the left lateral segment. We report the technique of extended right trisegmentectomy in a patient with a large intrahepatic cholangiocarcinoma that involved the right lobe of the liver and extended into the medial and lateral segments of the left lobe.