Publications by authors named "Kit-Fai Lee"
Background: Intraductal papillary mucinous tumour (IPMN) of pancreas is increasingly recognized to have malignant potential. Fukuoka guidelines are commonly used to select patients with IPMN for resection due to high chance of malignancy, which includes high-grade dysplasia (HGD) or invasive carcinoma (IC).
Methods: A retrospective study on consecutive patients who have undergone pancreatectomy with IPMN as the final pathology was performed.
Article Synopsis
- - The study investigates the effectiveness of laparoscopic liver resection (LLR) vs. open liver resection for patients with hepatocellular carcinoma (HCC) classified as high difficulty, focusing on both short-term and long-term clinical outcomes.
- - Results show that the laparoscopic approach leads to fewer severe complications (3% vs. 10.8%) and shorter hospital stays (6 days vs. 8 days), while the long-term survival rates remain similar for both methods.
- - Overall, LLR demonstrates better short-term outcomes without compromising long-term survival, making it a viable option for selected HCC patients.
Background: Hepatectomy is an established treatment for colorectal liver metastasis (CLM) or neuroendocrine liver metastasis. However, its role in non-colorectal non-neuroendocrine liver metastasis (NCNNLM) is controversial. This study aims to compare long-term survival outcomes after hepatectomy between NCNNLM and CLM in a population-based cohort.
View Article and Find Full Text PDFA case series of emergency pancreaticoduodenectomies: What were their indications and outcomes?
Ann Hepatobiliary Pancreat Surg
November 2023
Emergency pancreaticoduodenectomy (EPD) is a rarely performed operation. It is important to know the indications and outcomes of EPD to have a better understanding of its application in clinical practice. A review of eight consecutive cases of EPD was done.
View Article and Find Full Text PDFArticle Synopsis
- This study aimed to compare outcomes of robotic limited liver resections (RLLR) and laparoscopic limited liver resections (LLLR) for tumors in the posterosuperior liver segments, noting that previous research had not thoroughly examined the differences in performance and safety between the two approaches.
- An analysis of data from 3510 patients showed that RLLR had significant advantages over LLLR, including a lower rate of open conversions, reduced blood loss, and shorter operative times, even in patients with cirrhosis.
- Despite the improved perioperative outcomes for RLLR, postoperative metrics like readmission, morbidity, and mortality rates were similar between both surgical techniques.
Background: Baveno VII criteria for predicting varices needing treatment (VNT) have not been tested in hepatocellular carcinoma (HCC) population. We evaluated Baveno VII consensus for VNT in HCC patients of different stages according to Barcelona Clinic Liver Cancer (BCLC) stages undergoing curative hepatectomy.
Methods: This was a prospective cohort study of patients with HCC.
Article Synopsis
- The study aimed to compare outcomes of robotic major hepatectomy (R-MH) versus laparoscopic major hepatectomy (L-MH), exploring whether R-MH offers any advantages.
- An analysis of 4822 patient cases across 59 centers revealed that R-MH resulted in significantly less blood loss, fewer applications of the Pringle maneuver, and lower rates of conversion to open surgery.
- Moreover, R-MH showed reduced postoperative morbidity and shorter hospital stays for patients with cirrhosis compared to L-MH, indicating its potential benefits.
Purpose: To compare the peri-operative and long-term survival outcomes of minimally invasive liver resection (MILR) (robotic or laparoscopic) with open liver resection (OLR) in patients with hepatocellular carcinoma (HCC).
Methods: Data of patients who underwent liver resection for HCC were reviewed from a prospectively collected database. Outcomes of MILR were compared with those of OLR.
Background: Hepatocellular carcinoma is the sixth most common malignancy in the world. Major hepatectomy (resection of greater than or equal to three liver segments) is needed if a tumour is large or close to major blood vessels. Despite low mortality, open major hepatectomy is associated with high rates of tumour recurrence that limits survival.
View Article and Find Full Text PDFBackground: Left lateral sectionectomy (LLS) is one of the most commonly performed minimally invasive liver resections. While laparoscopic (L)-LLS is a well-established technique, over traditional open resection, it remains controversial if robotic (R)-LLS provides any advantages of L-LLS.
Methods: A post hoc analysis of 997 patients from 21 international centres undergoing L-LLS or R-LLS from 2006 to 2020 was conducted.
Article Synopsis
- The study explored the impact of involved resection margins (R0 vs. R1) during pancreaticoduodenectomy for periampullary and pancreatic head carcinoma on long-term outcomes.
- Results showed that R1 resection occurred in 12% of periampullary and 20% of pancreatic head cancers, with R1 associated with more lymph node metastasis but not affecting overall survival (OS) or disease-free survival (DFS).
- The findings concluded that involved resection margins did not lead to higher recurrence rates and were not significant predictors of poor OS or DFS.
Importance: Laparoscopic and robotic techniques have both been well adopted as safe options in selected patients undergoing hepatectomy. However, it is unknown whether either approach is superior, especially for major hepatectomy such as right hepatectomy or extended right hepatectomy (RH/ERH).
Objective: To compare the outcomes of robotic vs laparoscopic RH/ERH.
Article Synopsis
- A study was conducted to assess the relationship between pancreatic duct size and the risk of postoperative pancreatic fistula (POPF) in patients undergoing duct-to-mucosa pancreaticojejunostomy (DTMPJ) after pancreaticoduodenectomy.
- Out of 288 patients studied from 2003 to 2019, 56.3% experienced POPF, with the highest incidence occurring in those with duct diameters ≤ 1 mm, showing a significant risk increase compared to larger ducts.
- The findings suggest that DTMPJ is safe for patients with pancreatic ducts larger than 1 mm, indicating that smaller duct size is a predictor for higher POPF rates, especially in patients with a soft pancreas.
Comparison of Survival Outcomes in Transarterial Ethanol Ablation and Liver Resection for Solitary Hepatocellular Carcinoma ≤ 5 cm in Patients Stratified by Liver Function.
Cardiovasc Intervent Radiol
March 2022
Article Synopsis
- The study aimed to compare survival outcomes for solitary hepatocellular carcinoma (HCC) patients under 5 cm treated with transarterial ethanol ablation (TEA) versus liver resection (LR), using the ALBI grading system for liver function.
- After analyzing 225 treatment-naïve patients over a follow-up period of at least 7 years, results showed significantly longer overall and recurrence-free survival in the LR group compared to the TEA group.
- However, for patients with ALBI grades 2 or 3, survival rates were similar between TEA and LR, indicating that ALBI grade can help in deciding the appropriate treatment for these patients.
Novel use of the falciform ligament for reconstruction of the inferior vena cava and its tributary.
J Vasc Surg Cases Innov Tech
September 2021
Tumor invasion into the inferior vena cava (IVC) and hepatic vein (HV) is challenging in cancer surgery with curative intent. Appropriate techniques for venous reconstruction are essential. We have described in detail a novel technique of fashioning an interposition tube graft using the falciform ligament to reconstruct the IVC and HV.
View Article and Find Full Text PDFBackground: Robotic distal pancreatectomy has been accepted to be safe and effective for pancreatic tail lesion. Whether spleen preservation by preserving the splenic vessels with robot assistance is feasible and beneficial remains controversial. Here we would like to compare the operative outcomes of robotic distal pancreatectomy and splenectomy (DPS) with robotic spleen preserving distal pancreatectomy by means of splenic vessel preservation (SVP).
View Article and Find Full Text PDFBackground And Aim: Hepatocellular carcinoma is one of the commonest cancer in the world. Despite curative resection, recurrence remains the largest challenge. Many risk factors were identified for predicting recurrence, including liver fibrosis and cirrhosis.
View Article and Find Full Text PDFA narrative review of gallbladder adenomyomatosis: what we need to know.
Ann Transl Med
December 2020
Gallbladder adenomyomatosis (GA) is increasingly encountered in clinical practice due to increasing use of imagings especially ultrasound (US). Clinicians need to know what is the implication of this condition and its proper management. GA is a degenerative and proliferative disease characterized by excessive epithelial proliferation associated with hypertrophy of muscularis propria.
View Article and Find Full Text PDFIntroduction: Although hepatectomy is a curative treatment modality for hepatocellular carcinoma (HCC), the associated 10-year long-term actual survival are rarely reported. This study aims to develop and validate a predictive nomogram for 10-year actual survivors with HCC.
Materials And Methods: From 2004 to 2009, 753 patients with curative hepatectomy for HCC (development set, n = 325; validation set, n = 428) were included.
Analysis for actual mid-term (≥5 years) and long-term (≥10 years) survivors with hepatocellular carcinoma (HCC) following curative hepatectomy are rarely reported in the literature.This retrospective study aims to study the mid- and long-term survival outcome and associated prognostic factors following curative hepatectomy for HCC in a tertiary referral center.The clinical data of 325 patients who underwent curative hepatectomy for HCC were reviewed.
View Article and Find Full Text PDFBackground: Liver resection is an established treatment of choice for colorectal liver metastasis (CLM). However, the role of hepatectomy for non-colorectal liver metastasis (NCLM) is less clear.
Patients And Method: From 2004 to 2017, 264 patients received curative hepatectomy for NCLM (n = 28) and CLM (n = 236).
Background: Minimally invasive approach has been increasingly applied in liver resection. However, laparoscopic major hepatectomy is technically demanding and is practiced only in expert centers around the world. Conversely, use of robot may help to overcome the difficulty and facilitate major hepatectomy.
View Article and Find Full Text PDFA 56-year-old man presented with an 11-cm hepatocellular carcinoma (HCC) at segment 7 of liver. To induce left liver hypertrophy, a sequential transarterial chemoembolization (TACE) and portal vein embolization before right hepatectomy were adopted. However, the tumor further increased in size despite TACE and invaded through the diaphragm to the right lung base.
View Article and Find Full Text PDFIntroduction: Upper gastrointestinal bleeding (UGIB) in patients suffering from hepatocellular carcinoma (HCC) is usually due to oesophageal or gastric varices secondary to portal hypertension. Very rarely, HCC can directly invade into the stomach or duodenum resulting in UGIB.
Presentation Of Case: A 62-year-old man presented to the emergency department for haematemesis and tarry stool.