Bleeding hepatocellular adenoma: historical series and outcomes.

Introduction: hepatocellular adenoma - AHC - is a rare benign neoplasm of the liver more prevalent in women at reproductive age and its main complication is hemorrhage. In the literature, case series addressing this complication are limited.

Methods: between 2010 and 2022, 12 cases of bleeding AHC were attended in a high-complexity university hospital in southern Brazil, whose medical records were retrospectively evaluated.

RESULTS OF IMMUNOHISTOCHEMISTRY IN THE DIFFERENTIAL DIAGNOSIS OF EARLY HEPATOCELLULAR CARCINOMA AND NODULES WITH HIGH-GRADE DYSPLASIA IN PATIENTS WITH CIRRHOSIS.

Background: Hepatocellular carcinoma (HCC) is the most frequent primary cancer of the liver and cirrhosis is considered a pre-malignant disease. In this context, the evolutionary sequence from low grade dysplastic nodule and high grade dysplastic nodule (HGDN) to early HCC and advanced HCC has been studied. The differential diagnosis between HGDN and early HCC is still a challenge, especially in needle biopsies.

BYPASS VS. SLEEVE AND ITS EFFECTS IN NON-ALCOHOLIC FATTY LIVER DISEASE: WHAT IS THE BEST TECHNIQUE?

Background: Strongly associated with obesity, non-alcoholic fatty liver disease is considered the hepatic manifestation of the metabolic syndrome. It presents as simple steatosis and steatohepatitis, which can progress to cirrhosis and its complications. Among the therapeutic alternatives is bariatric surgery.

Comparison of the severity of non-alcoholic fatty liver disease in diabetic and non-diabetic obese patients.

Introduction: nonalcoholic fatty liver disease presents a broad spectrum of histopathological alterations, from steatosis to liver cirrhosis. Patients with diabetes mellitus (DM) present increased incidence and severity of NAFLD.

Objective: determine the prevalence and severity of NAFLD in diabetic and non-diabetic obese patients undergoing bariatric surgery.

Altered expression of COX-2 and TNF-α in patients with hepatocellular carcinoma.

Background And Aim: hepatocellular carcinoma is a type of cancer related with inflammation, as 90% of cases develop in a chronic inflammation condition. Excess inflammation can affect tissue homeostasis. Cytokines and inflammatory mediators are immunological components that can influence the functioning of cells and tissues.

ENHANCED RECOVERY (ERAS) AFTER LIVER SURGERY:COMPARATIVE STUDY IN A BRAZILIAN TERCIARY CENTER.

Background: After the publication of the first recommendations of ERAS Society regarding colonic surgery, the proposal of surgical stress reduction, maintenance of physiological functions and optimized recovery was expanded to other surgical specialties, with minimal variations.

Aim: To analyze the implementation of ERAS protocols for liver surgery in a tertiary center.

Methods: Fifty patients that underwent elective hepatic surgery were retrospectively evaluated, using medical records data, from June 2014 to August 2016.

IMPLEMENTATION OF ENHANCED RECOVERY AFTER COLORECTAL SURGERY (ERAS) PROTOCOL: INITIAL RESULTS OF THE FIRST BRAZILIAN EXPERIENCE.

Background: Guidelines for enhanced recovery after surgery have their bases in colonic surgery, through the first protocols published in 2012. Since then, this practice has spread throughout the world, mainly due to improvements in surgical outcomes associated with resource savings.

Aim: To analyze the first prospective results after the implementation of the guidelines.

EARLY DRAIN FLUID AMYLASE IS USEFUL TO PREDICT PANCREATIC FISTULA AFTER PANCREATODUODENECTOMY: LESSONS LEARNED FROM A SOUTHERN BRAZILIAN CENTER.

Background: Pancreatic fistula represents the most feared complication after pancreatoduodenectomies, being the major responsible for the high morbidity and mortality after this operation. Its incidence remains around 10% to 30%. In recent years, several authors have studied the value of amylase in abdominal drains fluid, measured at an early stage after the surgical procedure, as a useful tool to identify patients at risk of developing pancreatic fistula.

A case of oncogenic osteomalacia owing to inguinal tumor.

The oncogenic hypophosphatemic osteomalacia is a very incapacitating disease and the mortality rate, mainly due to metabolic disorder, depends on the early diagnosis, since the surgery is curative. The major difficulty is to consider this kind of disease in patients with complex clinical presentation. Moreover, medical centers have to provide a good diagnostic infrastructure because these tumors, in most cases, are small and do not have an obvious site.

Apocrine sweat gland adenocarcinoma: A rare case report and review.

Introduction: Primary apocrine sweat gland carcinoma (PASGC) is an extremely rare neoplasia whose management and treatment are still evolving. The only curative therapy is wide local excision. Many patients have metastasis at the time of the diagnosis, mainly because this neoplasm has been misdiagnosed as some benign skin lesions.

Oncogenic hypophosphatemic osteomalacia: From the first signal of disease to the first signal of healthy.

Introduction: The physical incapacitation of the oncogenic hypophosphatemic osteomalacia (OHO) can be catastrophic and can lead to deformities, metabolic and organic instability and death. The only positive outcome is through early diagnosis by the clinical suspicion. At this moment, medical center infrastructure is also a keypoint.

Use of Left Gastric Vein as an Alternative for Portal Flow Reconstruction in Liver Transplantation.

Portal vein thrombosis is observed in up to 10% of liver transplant candidates, hindering execution of the procedure. A dilated gastric vein is an alternative to portal vein reconstruction and decompression of splanchnic bed. We present two cases of patients with portal cavernoma and dilated left gastric vein draining splanchnic bed who underwent liver transplantation.

AMBULATORY LAPAROSCOPIC CHOLECYSTECTOMY IS SAFE AND COST-EFFECTIVE: a Brazilian single center experience.

Background: - Laparoscopic cholecystectomy is the treatment of choice for gallstone disease, and has been perfomed as an outpatient surgery in many Institutions over the last few years.

Objective: - This is a retrospective study of a single center in Brazil, that aims to analyze the outcomes of 200 cases of ambulatory laparoscopic cholecystectomy performed by the same Hepato-Pancreato-Biliary team, evaluating the safety and cost-effectiveness of the method.

Methods: - Two hundred consecutive patients who underwent elective laparoscopic cholecystectomy were retrospectively analyzed; some of them underwent additional procedures, as liver biopsies and abdominal hernias repair.

ASSOCIATION BETWEEN MURINE DOUBLE MINUTE 2 - T309G polymorphism and recurrence of hepatocellular carcinoma after surgical treatment.

Background: Discovery and incorporation of biomarker panels to cancer studies enabled the understanding of genetic variation and its interference in carcinogenesis at molecular level. The potential association between single nucleotide polymorphism (SNP) 309 and increased development of tumors, such as hepatocellular carcinoma, has been subject to several studies. This is the first study on this association conducted in Brazil.

Low mortality rate in 97 consecutive pancreaticoduodenectomies: the experience of a group.

Context: Pancreaticoduodenectomy is the procedure of choice for resectable cancer of the periampullary region. These tumors account for 4% of deaths from cancer, being referred to as one of the lowest survival rates at 5 years. Surgery remains a complex procedure with substantial morbidity and mortality.

Evaluation of the C3435T polymorphism in the MDR1 gene in patients with hepatocellular carcinoma.

Introduction: Considering the high prevalence of liver tumors and the impact on patient survival, a greater understanding of the biological behavior of those tumors if of great importance. The multidrug resistance gene (MDR1) may present as single nucleotide polymorphism (SNP) which can affect the expression and activity of P-glycoprotein (Pgp), and high expression of Pgp has been associated with a worse prognosis in affected patients.

Objective: To correlate the C3435T polymorphism in the MDR1 gene with the immunohistochemical expression of Pgp.

A rare case of multiple skin metastases from squamous cell carcinoma of the esophagus.

Background: Esophageal cancer is an aggressive disease that generally has a poor prognosis. Patients affected by the disease usually present with signs and symptoms related to local growth of the tumor, gastrointestinal bleeding and nutritional impairment. Skin metastases are rare events, associated with advanced stage and poor survival.

[Evaluation of hepatic resection for hepatocellular carcinoma on cirrhotic livers].

Background: The hepatocellular carcinoma is a disorder that affects patients suffering from cirrhosis. Liver resection, orthotopic liver transplantation and percutaneous ablation are some forms of therapy currently used to provide a cure for this disease.

Aim: To assess the results achieved through liver resection for the treatment of the hepatocellular carcinoma in patients with cirrhosis being under treatment in a general hospital.

[Laparoscopic cholecystectomy in patients with liver cirrhosis].

Background: Initially considered a contraindication to the surgical laparoscopy, cirrhosis have been an occasional discovery during this procedure. Until now many series reported in the literature suggest that the majority of the surgeons still consider cirrhosis as contraindication to the laparoscopic cholecystectomy.

Aim: To evaluate our experience in laparoscopic treatment of the cholelithiasis in cirrhotic patient.