Publications by authors named "Nermin Halkic"

Introduction Partial hepatectomy (PH) remains associated with complication rates around 30-50%. Delayed return of gastrointestinal function (DRGF) has been reported in 10-20%. This study aimed to assess DRGF predictors after PH.

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Article Synopsis
  • This study investigates the effects of selective internal radiation therapy (SIRT) on liver volume changes in hepatocellular carcinoma (HCC) patients using an anatomical volumetric approach, staying focused on those with varying treatment selectivity.
  • It analyzed data from 88 HCC patients, measuring liver, tumor, and spleen volumes through MRI at baseline and multiple time points post-SIRT, revealing significant increases in untreated liver volume (uLV) primarily during the first six months.
  • Findings indicated that liver function, as measured by the Child-Pugh score, correlated with the extent of uLV increase, with younger age and specific Y activity doses also influencing these changes over time.
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Background And Objectives: Assessment of liver function is paramount before hepatectomy. This study aimed to assess future liver remnant function (FLR-F) using hepatobiliary scintigraphy (HBS) and to compare it to FLR volume (FLR-V) in the prediction of posthepatectomy liver failure (PHLF). The impact of volume and function gains were also assessed in patients undergoing portal vein embolization (PVE) or liver venous deprivation (LVD).

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Alveolar echinococcosis is an endemic parasitosis in Switzerland. This pathology mainly infects the liver and develops similarly as a malignant tumor with its ability to spread into the hepatic parenchyma and its capacity of developing distant lesions via hematogenous dissemination. Treatment is based on complete surgical resection coupled with albendazole treatment.

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Acute cholecystitis is an inflammation of the gallbladder most often related to gallstones. The diagnostic and severity criteria are well described by the Tokyo criteria. Early laparoscopic cholecystectomy remains the treatment of choice.

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Article Synopsis
  • Median arcuate ligament syndrome (MALS) occurs when the median arcuate ligament compresses the celiac trunk, leading to symptoms ranging from post-meal pain to dangerous bleeding from a gastroduodenal artery aneurysm (GAA).
  • In a study of 13 patients, two groups were analyzed: those who had emergency surgery for GAA rupture and those who had elective surgery for Dunbar syndrome, focusing on postoperative complications and recovery times.
  • Findings showed that the elective group had fewer complications, shorter hospital stays, and a safe approach combining laparoscopic ligament release with stenting, suggesting this treatment should be considered for symptomatic MALS patients.
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COVID-19 pandemic has disrupted healthcare systems worldwide, causing the postponement or cancellation of millions of elective surgeries. It is essential for hepatopancreatobiliary (HPB) surgeons to well understand the perioperative risk and management of HPB surgery during the COVID-19 pandemic, including the impact of preoperative COVID-19 infection and timing of surgery, the impact of COVID-19 infection on postoperative mortality, the postoperative pulmonary complications in patients with perioperative COVID-19 infection, and the postoperative complications without pulmonary involvement. Perioperative COVID-19 infection increases the risk of postoperative mortality and pulmonary complications in patients undergoing abdominal surgery.

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Background: According to the Barcelona Clinic Liver Cancer (BCLC) staging system, liver resection (LR) is recommended for early-stage (BCLC-A) hepatocellular carcinoma (HCC) but not for intermediate-stage (BCLC-B). This study aimed to assess the outcomes of LR in these patients using a subclassification tumour burden score (TBS).

Methods: All consecutive patients that underwent LR for BCLC-A and BCLC-B HCC between 01/2010 and 12/2020 in 4 tertiary referral centers were included.

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Objectives: Alveolar echinococcosis (AE) recurrence is one of the major stakes in patients undergoing surgery, the main curative treatment. Preliminary data demonstrated an effect of programmed death-ligand1 (PD-L1) inhibitors on AE proliferation in animals. The current study aimed to analyze the prognostic value of PD-L1 expression in tissue samples of patients with AE undergoing surgery.

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Background: Perioperative decrease of albumin (ΔAlb) appeared as a promising predictor of complications after digestive surgery, but its role after liver surgery remains unclear. This study aimed to analyze whether and how ΔAlb can be used to predict complications after liver surgery.

Methods: A bicentric retrospective analysis of patients undergoing liver surgery (2010-2016) was performed, following TRIPOD guidelines.

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Background: Malnutrition has been shown to be a risk factor for postoperative complications after pancreatoduodenectomy (PD). In addition, patients needing a PD, such as patients with pancreatic cancer or chronic pancreatitis, often are malnourished. The best route of postoperative nutrition after PD remains unknown.

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Enhanced recovery after surgery (ERAS) pathway for pancreas has demonstrated its value in clinical practice. However, there is a lack of specific evidence about its application in elderly patients. The aim of the present study was to assess the impact of age on compliance and postoperative outcomes.

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This retrospective observational study aimed to evaluate whether preoperative sarcopenia, assessed by CT imaging, was associated with postoperative clinical outcomes and overall survival in patients that underwent liver resections. Patients operated on between January 2014 and February 2020 were included. The skeletal muscle index (SMI) was measured at the level of the third lumbar vertebra on preoperative CT scans.

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Hepatic and/or portal vein embolization are performed before hepatectomy for patients with insufficient future liver remnant and usually achieved with a trans-hepatic approach. The aim of the present study is to describe a modified trans-venous liver venous deprivation technique (mLVD), avoiding the potential risks and limitations of a percutaneous approach to hepatic vein embolization, and to assess the safety, efficacy, and surgical outcome after mLVD. Retrospective single-center institutional review board-approved study.

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Introduction And Importance: Synchronous malignancies of gallbladder and biliary tree are together rare entity whose pathogenesis is yet unknown. We report the case of a triple synchronous cancer of 3 distinct location: gallbladder, common bile duct (CBD) and papilla of Vater.

Case Presentation: An 84-years-old woman, was admitted to our Hospital with clinics features of obstructive jaundice.

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Background: Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are well-known benign liver lesions. Surgical treatment is usually chosen for symptomatic patients, lesions more than 5 cm, and uncertainty of diagnosis.

Case Summary: We described the case of a large liver composite tumor in an asymptomatic 34-year-old female under oral contraceptive for 17-years.

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Some hepato-biliary cancers require major liver resections. Post hepatectomy liver failure is a complication that occurs when the remnant liver cannot maintain its synthetic and excretory functions. To overcome this issue, portal vein embolization has been developed to induce future remnant liver hypertrophy preoperatively.

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Background: The current study aimed to assess the performance of the 3-level complexity classification that stratified liver resection procedures into 3 complexity grades (grade I, low; grade II, intermediate; and grade III, high complexity) and to evaluate whether the Enhanced Recovery after Surgery (ERAS) protocol improves postoperative outcomes for each complexity grade.

Study Design: Consecutive patients undergoing open liver resection and laparoscopic liver resection at Lausanne University Hospital during 2010 to 2020 were assessed.

Results: A total of 437 patients were included.

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