Impact of the VIO system in hepatic resection for patients with hepatocellular carcinoma.

Purposes: This study aimed to evaluate a novel surgical device combination [VIO system containing a bipolar clamp (BiClamp) and the monopolar soft-coagulation (SOFT COAG)] in hepatic resection for patients with hepatocellular carcinoma (HCC).

Methods: This study performed 124 hepatic resections for HCC and divided them into 2 groups: 60 patients (Conventional group) underwent liver parenchymal transection using Cavitron Ultrasonic Surgical Aspirator (CUSA) system and saline-coupled bipolar electrocautery for hemostasis; the BiClamp was used with the CUSA system for liver parenchymal transection and SOFT COAG was used with saline-coupled bipolar electrocautery for hemostasis in 64 patients (VIO group).

Results: The median blood loss in the VIO group was 345 mL, which was less than that in the Conventional group (median 548 mL, P = 0.

Long-term surviving patient with inferior vena cava tumor thrombus and extrahepatic metastasis after spontaneous ruptured hepatocellular carcinoma.

We present a case of long-term survival in a patient with inferior vena cava tumor thrombus (IVCTT) and extrahepatic metastasis after resection for spontaneous ruptured hepatocellular carcinoma (HCC). The patient was a 73-year-old Japanese man previously diagnosed with chronic hepatitis B. He was referred to our emergency room and diagnosed with spontaneous ruptured HCC.

Long-term results of hepatic resection combined with intraoperative local ablation therapy for patients with multinodular hepatocellular carcinomas.

Background: Recently, local ablation therapy has been widely used for treatment of small hepatocellular carcinoma (HCC). The present study assessed the outcome of hepatic resection combined with intraoperative local ablation therapy in patients with multinodular HCCs.

Methods: Forty-one patients with initial and multinodular HCCs underwent hepatic resection combined with intraoperative local ablation therapy.

Comparison of enteral nutrition with combined enteral and parenteral nutrition in post-pancreaticoduodenectomy patients: a pilot study.

Background: Many clinical studies have demonstrated that early postoperative enteral nutrition (EN) improved the postroperative course. Post-pancreaticoduodenectomy (PD), patients tend to suffer from postoperative nausea, abdominal distention, and diarrhoea, causing difficulty in the introduction of EN. In this pilot study, we investigated the appropriate nutritional mode post-pancreatic surgery.

Primary breast lymphoma in the right breast during treatment for left breast cancer.

Background: Primary breast lymphoma is a rare condition, and distinguishing it from breast cancer is important because their treatments differ radically. Moreover, a recent report showed that mastectomy offered no benefit in the treatment of primary breast lymphoma.

Case Presentation: A 59-year-old woman was treated with adjuvant chemotherapy and local radiation after surgery for left breast cancer.

Mucin-hypersecreting bile duct neoplasm characterized by clinicopathological resemblance to intraductal papillary mucinous neoplasm (IPMN) of the pancreas.

Background: Although intraductal papillary mucinous neoplasm (IPMN) of the pancreas is acceptable as a distinct disease entity, the concept of mucin-secreting biliary tumors has not been fully established.

Case Presentation: We describe herein a case of mucin secreting biliary neoplasm. Imaging revealed a cystic lesion 2 cm in diameter at the left lateral segment of the liver.

Risk factors for and management of delayed intraperitoneal hemorrhage after pancreatic and biliary surgery.

Background: Delayed intraperitoneal hemorrhage (DIH) is still an important cause of postoperative mortality in pancreatic and biliary surgery.

Methods: Sixty-nine patients who underwent pancreatic and biliary surgery with skeletonization for lymphadenectomy of the hepatoduodenal ligament between April 2002 and March 2005 were included in this study. Statistical analyses of the risk factors for DIH were performed using both univariate and multivariate modalities.

Gemcitabine combined with 5-fluorouracil and cisplatin (GFP) in patients with advanced biliary tree cancers: a pilot study.

Background: Advanced biliary tree cancers have poor prognosis and chemotherapy has been shown to have little impact. To date, no standard chemotherapy regimens have been established. A pilot study to evaluate gemcitabine/5-Fluorouracil(5-FU)/cisplatin(CDDP) (GFP) chemotherapy in patients with advanced biliary tree cancers was performed.

Hepatic resection without mortality at a community hospital.

The mortality of elective hepatic resections is now below 5%, and the improved result has been attributed partly to performance of such operations at high-volume specialized units. We retrospectively studied 60 consecutive elective hepatic resections performed during a 2-year period between April 1998 and March 2000 at a Red Cross community hospital. There was no hospital mortality and morbidity occurred in 20 patients (33.