Cornerstones elements of surgical technique to achieve a good efficacy and safety profile in robotic anatomical resections of postero-superior segments have not yet reached an adequate level of standardization. In this technical note, surgical details to perform anatomical resections of postero-superior segments of the liver (Sg7 and Sg8) based on the identification of vascular landmarks and assisted by use of negative staining with indocyanine green (ICG) fluorescence will be described. In Sg7 segmentectomy, dorsal approach to portobiliary pedicle is suggested, followed by root to periphery approach to right hepatic vein along the negative staining demarcation line by indocyanine green.
View Article and Find Full Text PDFBackground: Minimally invasive liver resections (MILRs) in cirrhosis are at risk of conversion since cirrhosis and complexity, which can be estimated by scoring systems, are both independent factors for. We aimed to investigate the consequence of conversion of MILR for hepatocellular carcinoma in advanced cirrhosis.
Methods: After retrospective review, MILRs for HCC were divided into preserved liver function (Cohort-A) and advanced cirrhosis cohorts (Cohort-B).
Liver bleeding secondary to haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is uncommon, but a life-threatening peripartum condition that needs a prompt multidisciplinary approach. In this study, we presented a case of 28-year-old pregnant woman, who was presented to the obstetrics department with signs of preeclampsia and foetal growth restriction. An emergency caesarean section was performed, and the patient developed a HELLP syndrome complicated by spontaneous liver rupture.
View Article and Find Full Text PDFAssociation of thoracic and abdominal injuries in patients with major trauma is common. Under emergency conditions, it is often difficult to promptly perform a certain diagnosis and identify treatment priorities of life-threatening lesions. We present the case of a young man with combined thoracic and abdominal injuries after a motorcycle accident.
View Article and Find Full Text PDFIn January 2020, Novel Coronavirus Disease 2019 (COVID-19) resulted in a global pandemic, creating uncertainty toward the management of liver transplantation (LT) programs. Lombardy has been the most affected region in Italy: the current mortality rate of COVID-19 patients is 18.3% (10 022 deaths; April 10th) with hospitals in Lombardy having to expand the total number of ICU beds from 724 to 1381 to accommodate infected patients.
View Article and Find Full Text PDFHerpes Simplex Virus (HSV) hepatitis in liver transplant patients is a rarely reported infective complication of HSV with severe consequences, often leading to fulminant hepatitis if left untreated. The clinical signs are often atypical, leading to under-reporting in the literature and potential delays in treatment. Our case report describes such atypical mucocutaneous lesions in a liver transplant recipient.
View Article and Find Full Text PDFBackground: Bowel and/or mesentery injuries represent the third most common injury among patients with blunt abdominal trauma. Delayed diagnosis increases morbidity and mortality. The aim of our study was to evaluate the role of clinical signs along with CT findings as predictors of early surgical repair.
View Article and Find Full Text PDFThe anatomy of hepatic arteries is one of the most variable. Accurate awareness of all the possible anatomic variations is crucial in the upper GI surgery and especially in liver and pancreas transplantation. The most frequent anatomical variants are: a replaced or accessory right hepatic artery (RHA) from the superior mesenteric artery (6.
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