Combined pancreatojejunal and hepatojejunal anastomotic stent placement in total laparoscopic pancreaticoduodenectomy.

Introduction: Laparoscopic pancreaticoduodenectomy (LPD) is a technically demanding procedure that is considered safe and feasible if performed in a high-volume institution, where surgeons and medical staff is appropriately trained. For this advanced abdominal procedure only few studies described a reproducible stepwise technique and a standard approach is still lacking.

Methods: The attached video reports all steps of our standardized LPD with pancreatojejunal and hepatojejunal anastomotic stent placement performed with a double approach.

Indocyanine green fluorescence angiography during liver and pancreas transplantation: a tool to integrate perfusion statement's evaluation.

Background: Indocyanine green (ICG) fluorescence imaging is a promising tool for intraoperative decision-making during surgical procedures, in particular to assess organs perfusion.

Methods: We used the ICG fluorescence during liver transplantations in six cirrhotic patients to help assessing the graft biliary duct perfusion in order to identify the appropriate level to perform the anastomosis. We also used ICG fluorescence also in five patients receiving kidney-pancreas transplantation to evaluate the perfusion levels of the duodenal stump of the pancreas graft.

Early Hepatic Artery Thrombosis After Liver Transplantation: What is the Impact of the Arterial Reconstruction Type?

Objective: Hepatic artery thrombosis (HAT) is the most severe vascular complication occurring after liver transplantation, with an incidence ranging from 2 to 9% in adults. Although the ideal arterial reconstruction is often described as a short and non-redundant anastomosis fashioned between the recipient and donor hepatic arteries, there is no strong evidence about this ideal reconstruction in the literature. The aim of this study was to assess the impact of the type of arterial reconstruction on early HAT after primary liver transplantation.

Navigation liver surgery for complex hydatid cyst with biliary tree communication.

Introduction: Today, liver surgery navigation is utilized only in high-specialized centers for patients affected by malignant diseases. However, navigated surgery may also be of great interest for benign diseases such as hydatidosis in particular if the hydatid cyst is communicating with the biliary tree. With navigation we know exactly in each moment during the surgery the relationship of the cyst with the vascular/biliary structures around it.

Four hundred and twenty-three consecutive adults piggy-back liver transplantations with the three suprahepatic veins: was the portal systemic shunt required?

Background And Aims: The aim of this study is to analyze a single-center experience in orthotopic liver transplantation with the piggy-back technique (PB) realized with a cuff of three veins without temporary portacaval shunt. Outcome parameters were graft and patient survival and the surgical complications.

Methods: The records of 423 liver transplantation in 396 adult recipients were reviewed.