[Anastomotic techniques in minimally invasive hepatobiliopancreatic surgery].

The established anastomotic techniques conventionally used in open surgery are increasingly being implemented in a minimally invasive approach and further developed. The aim of all innovations is to carry out a safe anastomosis with a feasible minimally invasive technique; however, there is currently no broad consensus about the role of laparoscopic and robotic surgery in performing pancreatic anastomotic techniques. Pancreatic fistulas determine the morbidity following a minimally invasive resection.

Body composition, mitochondrial oxygen metabolism and metabolome of patients with obesity before and after bariatric surgery (COMMITMENT): protocol for a monocentric prospective cohort study.

Introduction: Obesity, defined as a body mass index ≥30 kg/m, is one of the most prevalent health conditions worldwide. It is part of the metabolic syndrome, which encompasses arterial hypertension, dyslipoproteinaemia and diabetes. Obesity is viewed as a systemic disease with pathophysiological mechanisms on the molecular level.

Robotic hepatic surgery in malignancy: review of the current literature.

The use of minimally invasive liver surgery, such as laparoscopic and robotic surgery, is increasing worldwide. Robot-assisted laparoscopy is a new surgical technique that improves surgical handling. The advantage of this technique is improved dexterity, which leads to increased surgical precision and no tremor or fatigue.

[Influence of Attachment Style on the Outcome of Bariatric Surgery - A Pilot Study].

Bariatric surgery can lower body weight and comorbidities. Different factors might influence the outcome of this treatment. This pilot study examines whether patients' attachment style can influence surgical outcome.

Application of Digital Image Analysis to Determine Pancreatic Islet Mass and Purity in Clinical Islet Isolation and Transplantation.

Pancreatic islet mass, represented by islet equivalent (IEQ), is the most important parameter in decision making for clinical islet transplantation. To obtain IEQ, the sample of islets is routinely counted under a microscope and discarded thereafter. Islet purity, another parameter in islet processing, is routinely assessed by estimation only.

Bariatric surgery to treat obesity.

Obesity has become a global health problem that contributes to numerous life-threatening and disabling diseases, such as type 2 diabetes mellitus and coronary artery disease. The long-term results of traditional weight loss therapies, including diet, exercise, and medications, are relatively poor. Bariatric surgery is the most effective treatment of morbidly obese patients to allow substantial, sustained weight loss and to improve or resolve obesity-associated comorbidities, thereby reducing mortality.

Protein polymer hydrogels: effects of endotoxin on biocompatibility.

Protein polymer-based hydrogels have shown potential for tissue engineering applications, but require biocompatibility testing for in vivo use. Enzymatically crosslinked protein polymer-based hydrogels were tested in vitro and in vivo to evaluate their biocompatibility. Endotoxins present in the hydrogel were removed by Trition X-114 phase separation.

Protein polymer MRI contrast agents: Longitudinal analysis of biomaterials in vivo.

Despite recent advances in tissue engineering to regenerate biological function by combining cells with material supports, development is hindered by inadequate techniques for characterizing biomaterials in vivo. Magnetic resonance imaging is a tomographic technique with high temporal and spatial resolution and represents an excellent imaging modality for longitudinal noninvasive assessment of biomaterials in vivo. To distinguish biomaterials from surrounding tissues for magnetic resonance imaging, protein polymer contrast agents were developed and incorporated into hydrogels.

Biological performance of mussel-inspired adhesive in extrahepatic islet transplantation.

There is significant need for effective medical adhesives that function reliably on wet tissue surfaces with minimal inflammatory insult. To address these performance characteristics, we have generated a synthetic adhesive biomaterial inspired by the protein glues of marine mussels. In-vivo performance was interrogated in a murine model of extrahepatic syngeneic islet transplantation, as an alternative to standard portal administration.

The epididymal fat pad as a transplant site for minimal islet mass.

The epididymal fat pad was evaluated as a site of islet transplantation in a syngeneic murine model of diabetes by comparing the transplant outcomes to that of islets transplanted intraportal. Mouse islets engrafted on the intra-abdominal epididymal fat pad ameliorated streptozotocin-induced hyperglycemia with similar efficacy as grafts implanted intraportally. Mice that received as few as 50 islets, either intraportal or in the epididymal fat pad, displayed similar glucose tolerance curves.

Glucose and lipid metabolism after liver transplantation in inbred rats: consequences of hepatic denervation.

The liver plays a central role in glucose and lipid homeostasis. Because liver transplantation severs the hepatic nerves which influence this function, we hypothesized that insulin resistance and hyperlipidemia develop after liver transplantation, thus increasing the atherosclerotic risk. Therefore, we studied inbred rats 8 months after orthotopic liver transplantation (Tx, n = 39) or laparotomy (sham, n = 37) by either oral glucose tolerance test (Tx, n = 13; sham, n = 8), meal tolerance test (Tx, n = 9; sham, n = 13), or euglycemic hyperinsulinemic clamp with tritiated glucose infusion (Tx, n = 17; sham, n = 16).

Effects of portal vein arterialization on regeneration and morphology in liver transplantation: investigations using the rat model.

Background: Portal vein arterialization (PVA) has been proposed as a technical variant in liver transplantation in the case of non-recanalizable thrombosis. The present study investigates the effects of the arterialized portal vein on the function, morphology, and regenerative behavior of the liver.

Methods: Different PVA techniques, including orthotopic liver transplantation, were used in a rat model.

Impact of changing immunosuppressive monotherapy from Cyclosporin A to Tacrolimus in long-term, stable liver transplant recipients.

A number of studies have reported a lower atherogenic lipid profile in liver transplant recipients under tacrolimus (FK506) than in those under cyclosporine A (CyA) immunosuppression. This has mainly been attributed to the steroid-saving effect of FK506. However, the effects of converting CyA to FK506 monotherapy on lipid metabolism have not been specifically investigated.

Outcome of patients with pre-existing portal vein thrombosis undergoing arterialization of the portal vein during liver transplantation.

Arterialization of the portal vein is being propagated as a technical possibility in liver transplant recipients with pre-existing portal vein thrombosis. In our own small series, portal vein arterialization (PVA) was carried out in four patients undergoing orthotopic liver transplantation. In three of these cases, the portal vein was anastomosed to the aorta via an interposed iliac artery, and in one case, directly to the hepatic artery.