Factors influencing failure of progression to completion hepatectomy following liver venous deprivation procedures (PVE or DVE): a longitudinal observational study.

Background: Two-staged hepatectomy (TSH) with portal (PVE) or dual vein embolization (DVE) gained acceptance in liver surgery. The current study assesses the incidence and causes of failure to progress to completion hepatectomy following PVE/DVE and its influence on overall survival (OS).

Methods: This is a longitudinal observational study of patients who underwent PVE or DVE between April 2010-December 2023.

Management of distal cholangiocarcinoma with arterial involvement: Systematic review and case series on the role of neoadjuvant therapy.

Background: The use of neoadjuvant therapy (NAT) in distal cholangiocarcinoma (dCCA) with regional arterial or extensive venous involvement, is not widely accepted and evidence is sparse.

Aim: To synthesise evidence on NAT for dCCA and present the experience of a high-volume tertiary-centre managing dCCA with arterial involvement.

Methods: A systematic review was performed according to PRISMA guidance to identify all studies reporting outcomes of patients with dCCA who received NAT.

Staging Computed Tomography Parameters Predict the Need for Vein Resection during Pancreaticoduodenectomy in Resectable Pancreatic Ductal Adenocarcinoma.

Background: Surgery-first approach is the current standard of care for resectable pancreatic ductal adenocarcinoma (PDAC), and a proportion of these cases will require venous resection. This study aimed to identify parameters on staging computed tomography (CT) that predict the need for venous resection during pancreaticoduodenectomy (PD) for resectable PDAC.

Methods: We conducted a retrospective analysis of prospectively collected data on patients who underwent PD for resectable staged PDAC (as per NCCN criteria) between 2011 and 2020.

Triple Tube Drainage for the Treatment of Complex Duodenal Injury: A Case Report and Literature Update.

Duodenal trauma resulting in perforation is rare and management can be challenging due to injuries in other organs and vascular structures. Primary repair is the preferred option and is technically feasible even in cases with large defects. In more complex injuries with pancreaticobiliary tract involvement, damage control techniques and staged procedures may be required.

Primary Jejunal Enterolith Causing Small Bowel Obstruction Without Any Underlying Bowel Abnormality.

Enterolith formation is a rare condition precipitated by decreased bowel motility. It may cause obstruction or other complications and the diagnosis usually is confirmed after surgery and analysis of the stones or fragments. It is often seen in association with intestinal abnormalities such as diverticula and inflammation or in biliary tract fistulas where stones migrate to the duodenum and small bowel.

Granular cell tumor of distal bile duct treated with Whipple's procedure.

Granular cell tumors (GCTs) are rare benign neoplasms that are most often located in the soft tissues of the extremities and chest wall. Malignant GCTs have also been reported. GCTs of the biliary tract are extremely rare, uncommon non-epithelial benign neoplasms that cause focal thickening of bile duct wall without mucosal invasion.

Primary Large Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of the Gallbladder.

Primary lymphoma of the gallbladder (GB) is a rare condition, and very few cases have been reported so far. Diagnosis is usually made after surgery of suspicious GB mass, which is often difficult to differentiate from GB carcinoma. The GB wall does not contain lymphoid tissue, and tumors arise at the submucosal layer.

Minimizing the risk of small-for-size syndrome after liver surgery.

Background: Primary and secondary liver tumors are not always amenable to resection due to location and size. Inadequate future liver remnant (FLR) may prevent patients from having a curative resection or may result in increased postoperative morbidity and mortality from complications related to small-for-size syndrome (SFSS).

Data Sources: This comprehensive review analyzed the principles, mechanism and risk factors associated with SFSS and presented current available options in the evaluation of FLR when planning liver surgery.

Robotic approach to treat Median Arcuate Ligament syndrome: a case report.

The Median Arcuate Ligament (MAL) syndrome is the symptomatic compression of the celiac trunk by the MAL and other ganglionic periaortic tissue. Despite its rarity, this condition is significant from a clinical, diagnostic and management standpoint and it is usually a diagnosis of exclusion. A 61-year-old female with history of intermittent postprandial epigastric pain was diagnosed with MAL syndrome during CT scan imaging (no other causes of pain were identified).

Irreversible electroporation for the treatment of pancreatic neuroendocrine tumors.

Backgrounds/aims: Resection or enucleation is currently the treatment of choice for small pancreatic neuroendocrine tumors (NETs). Irreversible electroporation is a novel ablative method that is used for locally advanced pancreatic adenocarcinoma, but little data exists for its use for pancreatic NETs. We report an early experience of IRE for early pancreatic NETs.

Liver resection for the treatment of a congenital intrahepatic portosystemic venous shunt.

Intrahepatic portosystemic shunts (IPSS) are rare congenital anomalies arising from disordered portal vein embryogenesis. It has been described in both children and adults and may be asymptomatic or be associated with a variety of neurophysiological and pulmonary complications. When recognized, early intervention to occlude the shunt will reverse the associated complications.

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) procedure for hepatocellular carcinoma with chronic liver disease: a case report and review of literature.

The incidence of complications after liver resection is closely related to functional future liver remnant (FLR). The standard approach to augment FLR is surgical or radiological occlusion of the artery or portal vein on the tumor side. Associated liver partition and portal vein ligation for staged hepatectomy (ALLPS) has been introduced as an alternative method to augment FLR.

AE37 peptide vaccination in prostate cancer: a 4-year immunological assessment updates on a phase I trial.

In our recent phase I trial, we demonstrated that the AE37 vaccine is safe and induces HER-2/neu-specific immunity in a heterogeneous population of HER-2/neu (+) prostate cancer patients. Herein, we tested whether one AE37 boost can induce long-lasting immunological memory in these patients. Twenty-three patients from the phase I study received one AE37 boost 6-month post-primary vaccinations.

Gamma-irradiation induces HER-2/neu overexpression in breast cancer cell lines and sensitivity to treatment with trastuzumab.

Purpose: Overexpression of human epidermal growth factor receptor-2 (HER-2/neu) in breast cancer patients is a prerequisite for treatment with trastuzumab. In the present study, we demonstrate by fluorescence in situ hybridization (FISH) analysis that HER-2/neu gene amplification and chromosome 17 (CEP17) polysomy can be induced by irradiation in human breast cancer cell lines with low basal level of HER-2/neu.

Materials And Methods: The irradiation-induced HER-2/neu gene amplification and CEP17 polysomy enhanced HER-2/neu at the protein level in both human MDA-MB-231 and MDA-MB-435 breast cancer cell lines which was determined by immunohistochemistry and fluorescence analysis and was correlated with mRNA levels.

Endogenous growth hormone and insulin after interposition of a reversed jejunal segment in short bowel syndrome. An experimental study on pigs.

Background: Interposition of a reversed jejunal loop in short bowel sydrome has previously been investigated in human along with animal models and seemed able to facilitate intestinal adaptation. However, it is unclear if growth hormone and insulin, well known for their implication in short bowel pathophysiology, intervene on this effect.

Findings: Porcine models were randomly allocated to two cohorts: (1) short bowel (SB) group (n = 8) and (2) short bowel reverse jejunal segment (SB-RS) group (n = 8).

Massive Subcutaneus Emphysema following Endoscopic Retrograde Cholangiopancreatography with Sphincterotomy.

Although endoscopic retrograde cholangiopancreatography (ERCP) is an effective procedure for the diagnosis and treatment of the pancreatic and extrahepatic biliary tract diseases, it is still related with several complications. A female patient who underwent an ERCP with sphincterotomy developed massive subcutaneous emphysema along with pneumomediastinum and pneumoperitoneum. Although mild respiratory distress occurred, based on the absence of intaabdominal leakage of gastrografin, the patient was managed conservatively.

Interposition of a reversed jejunal segment enhances intestinal adaptation in short bowel syndrome: an experimental study on pigs.

Background: Interposition of a reversed intestinal segment as a factor facilitating intestinal adaptation has been experimentally investigated. Controversy exists about its efficacy in terms of body weight improvement, direction of luminal changes, and underlying mechanisms. This study aims to provide a comprehensive approach.

Mannose addition by yeast Pichia Pastoris on recombinant HER-2 protein inhibits recognition by the monoclonal antibody herceptin.

We report here the generation of a full-length, highly glycosylated HER-2 oncoprotein using yeast strain, Pichia Pastoris. Upon treatment of secreted HER-2 with alpha-mannosidase, reactivity with the monoclonal antibody Herceptin is significantly increased. This phenomenon is due to glycosylation via mannose of the full-length HER-2 protein that extends over the antigenic epitope, which is recognized by Herceptin.

Merkel cell carcinoma of the upper extremity: case report and an update.

Background: Merkel cell carcinoma is a rare but aggressive cutaneous primary small cell carcinoma. It is commonly seen in elderly affecting the head, neck, and extremities. Macroscopically may be difficult to distinguish MCC from other small cells neoplasms especially oat cell carcinoma of the lung.