Luschka Duct Leak: An Unexpected Cause of Choleperitoneum After Liver Transplant.

The anatomic variabilities in ducts of Luschka put patients at risk during hepatobiliary surgery. Clinically relevant bile leakage is the cause of 0.4% to 1.

Increase and Redistribution of Sex Hormone Receptors in Premenopausal Women Are Associated with Varicose Vein Remodelling.

In chronic venous insufficiency of the lower limbs, data show that the clinical manifestation is varicose veins (VVs), and VV epidemiology suggests that sex hormones directly influence disease development through intracellular receptors. This study aimed to determine the presence and localization of oestrogen receptors (ERs), progesterone receptors (PRs), and androgen receptors (ARs) in both healthy and VV wall cells and their relationship with gender. In this study, samples from patients without a history of venous disease (CV) ( = 18) and with VV ( = 40) were used.

Current allocation policy is favorable for patients with hepatocellular carcinoma waiting for liver transplantation.

Background: Patients with hepatocellular carcinoma (HCC) are a growing population of the transplantation waiting list (WL) for orthotopic liver transplantation (OLT). There is no consensus to prioritize these patients while on the WL.

Aims: To assess whether patients with HCC were more prioritized than non-HCC patients based on their WL survival as primary outcome.

Safety and anti-HCV effect of prolonged intravenous silibinin in HCV genotype 1 subjects in the immediate liver transplant period.

Background & Aims: Reinfection of the graft is the rule in patients with HCV cirrhosis undergoing liver transplantation, and HCV-RNA reaches pre-transplantation levels within the first month. Short-term intravenous silibinin monotherapy is safe and shows a potent in vivo anti-HCV effect. We aimed at evaluating the safety and antiviral effect of prolonged intravenous silibinin, started immediately before liver transplantation.

Portal vein arterialization in liver transplantation: an option to restore arterial flow: a case report.

We report a 66-year-old woman who underwent emergency orthotopic liver transplantation due to acute liver failure. The donor's liver graft displayed extensive arteriosclerosis, involving the celiac trunk and hepatic artery. Arterial revascularization of the graft could not be achieved, requiring an arterioportal shunt between the gastroduodenal artery and the portal vein of the recipient.

Repeated liver resection for recurrence of colorectal cancer metastases.

Background: Resection of liver metastases is accepted as treatment for diverse tumours, implying a survival improvement. Metastases often recur after first hepatectomy and, very few would be potentially resectable.

Materials And Methods: A retrospective study of 18 patients undergoing repeated hepatectomies (two or more liver resections in the same patient) due to metastases of colorectal cancer between 1988 and 2006 was performed.

[Hepatic hydatidosis. Radical vs. conservative surgery: 22 years of experience].

Objectives: the incidence of hepatic hydatidosis has remarkably decreased in the last years due to the preventive measures adopted to stop the transmission of the parasite. However, surgery carries on being the treatment of choice, although the surgical procedure is still a matter of controversy. The aim of the study was to evaluate the results obtained with the treatment of this condition after two decades according to surgical procedure type.

Ultrashort bowel syndrome: surgical management and long-term results of an exceptional case.

Management of the short bowel syndrome is a multidisciplinary and very complex problem. The authors report the successful long-term results of an original combination of autologous gastrointestinal reconstruction in a boy who at the age of 16 years lost all but 5 cm of the small bowel. This case demonstrates that lengthening and antipropulsive interposition of a long segment of the colon can be another alternative to early transplantation in exceptional cases.

Massive low gastrointestinal bleeding due to a Dieulafoy rectal lesion.

Massive low gastrointestinal bleedings are often difficult diagnostically and in terms of management. Sometimes, it is not possible to identify the bleeding point after performing diverse diagnostic tests and the patient undergoes a blind subtotal colectomy. With rectal bleeding, this form of surgery is completely useless, as it will not solve the cause of the haemorrhage.

Benign rectovaginal fistulas: management and results of a personal series.

Background: Treatment of benign rectovaginal fistula has a high failure rate and entails difficult decisions. The purpose of this retrospective study was to clarify the concepts which may improve its management.

Methods: Between 1983 and 2004, 46 consecutive women of median age 41 years were treated by the same surgeon.

Value of third metastasectomy of colorectal adenocarcinoma.

62 year-old woman with a tumour in sigmoid colon invading left ovary and metastases in both hepatic lobes. Posterior pelvic exanteration and metastasectomy of left hepatic lesions were performed in the first surgery, right hepatectomy in the second one and metastasectomy of 2 new metastases in the third one. A new metastases in remanent portal pediculum was considered non-operable.

Midline abdominal wall closure: a new prophylactic mesh concept.

Background: Despite intense research efforts, incisional hernias continue to be a problem in patients who undergo laparotomy. This study was designed to reinforce the midline laparotomy closure by including a new prosthetic design between the edges of the surgical wound.

Study Design: A midline incision was made in New Zealand white rabbits and closed by inserting a polypropylene strip, T-shaped in cross-section, between the incisional borders.

Angiogenic capacity of human omental stem cells.

Objectives: The goals of the present study are to obtain, expand and characterize a stem cell population from human omentum and to evaluate its in vivo angiogenic capacities.

Methods: Human omental CD34+ cells were obtained from samples of human omentum by density gradient centrifugation in Ficoll. Proliferative pattern, marker expression (by flow cytometry) and angiogenic growth factor synthesis by omental cell cultures were determined.

Total anorectal reconstruction: a novel technique.

The aim of this report is to describe a novel technical approach to total anorectal reconstruction after a Miles operation for rectal cancer. Recreation of an internal neosphincter with colonic muscle, the implant of an artificial bowel sphincter (ABS), and the association of a coloplasty constitute a complete substitution of the lost structures and functions. Although the patient developed a late complication which required removal of the ABS, the functional result of the technique can be considered as excellent, to be demonstrated by the incontinence score and quality of life with and without the colostomy.

Survival and complication rates in liver transplant patients showing primary dysfunction versus normofunction.

Aims: To determine rates of vascular and biliary duct complications, acute rejection, and graft and patient survival according to function status following liver transplantation.

Methods: We classified 248 consecutive liver transplants performed at the Hospital Ramón y Cajal, Madrid, over a 79-month period according to initial function as primary function (NP) versus dysfunction (PD). The latter group was subdivided into grafts showing primary failure (PF) or inadequate function (IPF).

Donor age as a risk factor for patient survival in the liver transplant.

Objectives: Our aims were to establish whether there is a relationship between donor age and patient and graft survival among liver transplant recipients and to determine the age at which this relationship emerges.

Patients And Methods: We reviewed 254 consecutive liver transplants performed at the Hospital Ramón y Cajal, Madrid in 206 patients over a 79-month period. Survival rates were determined using Kaplan-Meier curves analyzed by the log-rank method.

Impact of donor, recipient, and graft features on the development of primary dysfunction in liver transplants.

Objectives: To establish the utility of eight anatomic/pathologic suboptimal and 9 others graft features, versus in 20 donor versus 14 recipient characteristics to predict primary transplant dysfunction.

Patients And Methods: We reviewed 248 consecutive liver transplants performed at the Hospital Ramón y Cajal, Madrid, in 206 patients over a 79-month period. At least one biopsy specimen was obtained from 169 grafts (68.

Influence of ischemia and surgery times on development of primary dysfunction liver transplant in patients.

Objective: (1) To determine the incidences of primary failure and primary dysfunction of liver transplants performed at our center. (2) To evaluate the effects of mean cold and warm ischemia times as well as the length of five stages of surgery on the development of primary dysfunction.

Patients And Methods: We reviewed 248 liver transplants consecutively performed in 206 patients at the Hospital Ramón y Cajal, Madrid over 79 months.

The use of ischaemic vessels as prostheses or tissue engineering scaffolds after cryopreservation.

Objective: to evaluate the condition of organ donor arteries subjected to prolonged cold-ischaemia followed by cryopreservation, for their possible use as vascular grafts.

Materials And Methods: fresh specimens of human iliac artery from organ donors were used as controls. These arteries were divided into two portions, one of which was cryopreserved in an automated freezer.