The long-term impact of post-cholecystectomy major bile duct injury on liver stiffness.

Introduction: Iatrogenic bile duct injuries (BDI) are a devastating complication. Long-term impact of corrective hepaticojejunostomy (HJ) for such injuries on post -surgery liver stiffness is lacking. Hence the aim of this study was to explore the extent of hepatic fibrosis in a cohort of patients with Strasberg E bile duct injuries who underwent HJ after a minimum follow-up of six months.

Characteristics and survival of advanced untreated hepatocellular carcinoma of non-viral etiology.

Introduction And Objectives: Hepatocellular carcinoma (HCC) is an aggressive tumor and presents late. The underlying etiology of HCC is changing rapidly. HCC in Sri Lanka is unique due to its predominant non-viral etiology (nvHCC) but lacks survival data.

Challenges faced in establishing a pediatric liver transplant program in a lower-middle-income country with free healthcare service.

Background: Liver transplant is the cure for children with liver failure. Sri Lanka is a lower-middle-income country with a predominant free, state health system. Pediatric liver transplant program in Sri Lanka is still in the budding state where the initial experience of the program is yet to be documented.

The hidden threat of uncontrollable bleeding from the gallbladder bed during laparoscopic cholecystectomy.

Introduction And Importance: Laparoscopic cholecystectomy is the treatment for symptomatic gallstone disease. However, a potential complication during this procedure is intraoperative bleeding resulting from vascular injuries, affecting around 0.9-1.

Computed tomography-based evaluation of segmental variation of liver density and its implications.

Background: Non-alcoholic fatty liver disease (NAFLD) has become a major health concern. Focal fat deposition frequently seems to involve segment IV b. This indicates a consistent pattern of fat deposition in the liver.

Local infiltration versus laparoscopic-guided transverse abdominis plane block in laparoscopic cholecystectomy: double-blinded randomized control trial.

Background: Transverse abdominal plane block (TAP) is a new technique of regional block described to reduce postoperative pain in laparoscopic cholecystectomy (LC). Recent reports describe an easy technique to deliver local anesthetic agent under laparoscopic guidance.

Methods: This randomized control trial was designed to compare the effectiveness of additional laparoscopic-guided TAP block against the standard full thickness port site infiltration.

Association of Serum Ferritin with Diabetes and Alcohol in Patients with Non-Viral Liver Disease-Related Hepatocellular Carcinoma.

Introduction: Non-alcoholic fatty liver disease is a leading cause for hepatocellular carcinoma (HCC) in Sri Lanka. Diabetes mellitus, alcohol abuse, and liver inflammation are known to increase the risk of HCC. The present study evaluates serum ferritin levels in a cohort of patients with non-viral HCC (nvHCC).

Diffuse-Type Hepatoma: A Grave Prognostic Marker.

Background: Data on diffuse-type hepatocellular carcinoma (HCC) are rare. HCC in Sri Lanka is rising, and the majority is related to nonalcoholic fatty liver disease. This study was planned to compare nodular- and diffuse-type HCC in this cohort.

Quality of life and impact of bile reflux after retro colic retro gastric gastrojejunostomy in Whipple surgery.

Background: Delayed gastric emptying and bile reflux are common concerns in long-term survivors after Whipple surgery. The study was designed to assess modified retro colic retro gastric gastrojejunostomy in reducing macro and microscopic bile reflux and impact on dyspepsia related quality of life in long-term survivors.

Methods: Out of 43 patients operated, 23 long-term survivors were included.

Recurrence of graft steatosis after liver transplantation for cryptogenic cirrhosis in recently commenced liver transplant program.

Non-alcoholic fatty liver disease (NAFLD) seems to recur in at least one third of patients transplanted for non-alcoholic steatohepatitis (NASH)-related cirrhosis. While, NASH recurrence does not seem to affect overall graft and patient survival up to 10 years, cardiovascular and infection-related morbidity and mortality seem to be increased in these patients. This report looks at the graft histology in patients who were transplanted for NASH-related cirrhosis after short-term follow up.

Clinical characteristics and outcome of hepatocellular carcinoma in alcohol related and cryptogenic cirrhosis: a prospective study.

Background: Non-alcoholic fatty liver disease (NAFLD) is becoming a leading cause of chronic liver disease. Hepatocellular carcinoma (HCC) is one of its complications. Although the pathophysiology is unclear, it is reasonable to expect that cryptogenic cirrhosis related HCC (cryptogenic HCC) behaves differently to other types of HCC.

Factors affecting post-embolization fever and liver failure after trans-arterial chemo-embolization in a cohort without background infective hepatitis- a prospective analysis.

Background: Transarterial-chemo-embolization (TACE) is used for palliation of unresectable hepatocellular carcinoma (HCC). We studied the tolerability of TACE in a cohort of patients with NASH and alcoholic cirrhosis related HCC.

Methods: Of 290 patients with HCC (July 2011 - December 2014), 84 underwent TACE.

Effects of donor steatosis on liver biochemistry and significance of body mass index in predicting steatosis.

Background: Hepatic steatosis is a major concern in living donor liver transplantation. Factors affecting hepatic functional status after a donor right hepatectomy (with the middle hepatic vein included in the graft) with a focus on changes owing to steatosis were retrospectively studied.

Methods: Donors (n = 325) were categorized into three groups: G0 (no steatosis, n = 178), G1 (< = 10% steatosis, n = 128) and G2 (>10% steatosis, n = 19).

Role of portal vein embolization in hepatocellular carcinoma management and its effect on recurrence: a case-control study.

Background: Liver regeneration that occurs after portal vein embolization (PVE) may have adverse effects on the microscopic tumor foci in the residual liver mass in patients with hepatocellular carcinoma (HCC).

Methods: Fifty-four HCC patients with inadequate functional residual liver volume were offered PVE during a seven-year period. Among them, 34 (63%) patients underwent curative resection.

Effects of the liver volume and donor steatosis on errors in the estimated standard liver volume.

An accurate assessment of donor and recipient liver volumes is essential in living donor liver transplantation. Many liver donors are affected by mild to moderate steatosis, and steatotic livers are known to have larger volumes. This study analyzes errors in liver volume estimation by commonly used formulas and the effects of donor steatosis on these errors.

Synchronous liver metastasis in colorectal cancer in Sri Lanka.

Objective: To assess the incidence of synchronous colorectal liver metastasis in patients referred to a tertiary referral center in Sri Lanka and to evaluate the differences in the clinicopathological features of patients with and without synchronous metastasis.

Methods: Records of 438 patients were retrospectively analyzed. Patients were classified into metastatic group (n = 34, 8%) and non metastastatic group (n = 404, 92%).

Laparoscopy as a diagnostic and therapeutic option in evaluating chronic unexplained right iliac fossa pain.

Background: Management of chronic right iliac fossa (CRIF) pain is poorly documented in literature. No guidelines are available on the best therapeutic approach.

Method: Patients presenting from October 2007 to August 2009 with pain persisting or recurring in right lower abdomen over a period of 6 weeks or more were assessed.