Video-assisted transthoracic liver resection in patients with marginal liver function: a retrospective cohort study.

Purpose: Laparoscopic hepatectomy has been widely performed by hepatobiliary surgeons for malignancy of liver and gained wide acceptance for various liver tumors, thanks to advances in surgical techniques and devices. But, there are some challenges for right side tumor in patients of cirrhotic liver. Especially, tumor located in right upper area is difficult for wedge resection in patients with marginal liver function, because trans-abdominal approach requires normal parenchymal dissection.

Laparoscopic Liver Resection Enhanced by an Intervention-Guided Fluorescence Imaging Technique Using Sodium Fluorescein.

Background And Objectives: In laparoscopic liver resections, tumor localization is a critical aspect of ensuring clear resection margins and preserving the hepatic parenchyma. In this study, we designed a fluorescence imaging technique using a new fluorophore for tumor localization.

Materials And Methods: Immediately before laparoscopic or transthoracic liver resection, microcatheter was inserted through the hepatic artery and used to engrave the segment containing the tumor in the intervention room.

Comparison of point and 2-dimensional shear wave elastography for the evaluation of liver fibrosis.

Purpose: This study aimed to assess the technical performance of ElastQ Imaging compared with ElastPQ and to investigate the correlation between liver stiffness (LS) values obtained using these two techniques.

Methods: This retrospective study included 249 patients who underwent LS measurements using both ElastPQ and ElastQ Imaging equipped on the same machine. The applicability, repeatability (coefficient of variation [CV]), acquisition time, and LS values were compared using the chi-square or Wilcoxon signed-rank tests.

Recovery from ischemic monomelic neuropathy after delayed ligation of dialysis access.

Ischemic monomelic neuropathy is characterized by acute painful muscle weakness shortly after access creation and neuronal axon loss without adjacent tissue necrosis, thus, differentiating ischemic monomelic neuropathy from the steal syndrome. Immediate ligation of vascular access is emphasized in current guidelines. We present two cases of recovery from ischemic monomelic neuropathy despite delayed ligation for over 20 days after ischemic monomelic neuropathy development.

Role of peribrachial fat as a key determinant of brachial artery dilatation for successful arteriovenous fistula maturation in hemodialysis patients.

The functional quality of the inflow artery is one of the most important determinants of arteriovenous fistula (AVF) success. We evaluated the association of early optimal brachial arterial dilatation with a successful AVF maturation and assessed the role of peribrachial adipose tissue in determining brachial arterial distensibility. All patients underwent a preoperative vascular mapping with Doppler ultrasound (US), and only patients who had suitable vessels for AVF creation were enrolled (n = 162).

Laparoscopic Whipple's Operation for Locally Advanced Gastric Cancer Invading the Pancreas and Duodenum: a Case Report.

Few surgeons have adopted pancreaticoduodenectomy (PD) for the treatment of advanced gastric cancer (AGC) invading the pancreas or duodenum because it remains controversial whether its prognostic benefits outweigh the high morbidity rates in such advanced cases. However, recent technical advances have revived diverse surgical procedures in minimally invasive approaches. Inspired by this trend, laparoscopic PD procedures have been performed for AGC in our institute since 2014.

Retrograde installation of percutaneous transhepatic negative-pressure biliary drainage stabilizes pancreaticojejunostomy after pancreaticoduodenectomy: a retrospective cohort study.

Background: Leakage from the pancreatoenteric anastomosis has been one of the major complications of pancreaticoduodenectomy (PD). The aim of this study was to investigate the feasibility of retrograde installation of percutaneous transhepatic negative-pressure biliary drainage (RPTNBD), as part of which the drainage tube is intraoperatively inserted into the bile duct and afferent loop by surgical guidance to reduce pancreaticoenteric leakage after PD.

Methods: We retrospectively reviewed the medical records of the patients who underwent pylorus-preserving PD or Whipple's operation for a malignant disease between June 2012 and August 2016.

Erratum: Therapeutic induction of hepatic atrophy for isolated injury of the right anterior sectoral duct following laparoscopic cholecystectomy.

[This corrects the article on p. 189 in vol. 15, PMID: 26421038.

A new glove port for single incision procedure.

Single-incision laparoscopic surgery has gained increasing attention due to its potential to improve the benefits of laparoscopic surgery. However, inconvenience remains for inexperienced surgeons during surgery when instruments conflict with each other, and a glove port is used hesitantly for such diagnosis related groups (DRG) because of its high cost. Authors made a new glove port by an odd surgical gloves and one wound protectors.

Protective effect of ischemic postconditioning against hepatic ischemic reperfusion injury in rat liver.

Purpose: The efficiency of ischemic postconditioning (IPC) was evaluated in a rat model of ischemic liver. Concentration of survivin of liver tissue correlated with the degree of antiapoptosis, so survivin was estimated to evaluate the efficiency of IPC on ischemic reperfusion (IR) injury.

Methods: Twenty-four healthy rats were divided to three groups (SHAM, IR, and IPC).

Synergistic effect of sorafenib and vitamin K on suppression of hepatocellular carcinoma cell migration and metastasis.

Vitamin K plays a role in controlling cell growth. Anti-angiogenic effects of sorafenib lead to impairment of vitamin K uptake and induction of des-γ-carboxyprothrombin release by hepatocellular carcinoma (HCC) cells. We examined sorafenib and vitamin K individually and in combination regarding their ability to suppress migration and metastatic potential of HCC cells.

Single-port laparoscopic distal pancreatectomy: initial experience.

Introduction: Laparoscopic distal pancreatectomy has become the standard treatment of choice for pancreatic tail cystic and solid tumors when technically feasible. Technological advances have led to the development of single-port laparoscopic surgery, a safe alternative procedure. We present our experiences with single-port laparoscopic distal pancreatectomy.

Oncological and surgical results of laparoscopic versus open liver resection for HCC less than 5 cm: case-matched analysis.

Background: The purpose of this study is the evaluation of the surgical and oncological results of laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) by comparing laparoscopic and open liver resection (OLR) in the treatment of this disease. Retrospective analysis of laparoscopic and OLR for HCC (<5 cm) performed over a 4-year period was conducted. The LLR was done by a single surgeon.

Robotic versus laparoscopic liver resection: a comparative study from a single center.

Purpose: The significant advantages of robotic surgery have expanded the scope of surgical procedures that can be performed through minimally invasive techniques. The aim of this study was to compare the perioperative outcomes between robotic and laparoscopic liver surgeries at a single center.

Methods: From July 2007 to October 2011, a total of 206 patients underwent laparoscopic or robotic liver surgery at the Asan Medical Center, Seoul, Korea.

Liver transplantation for acute-on-chronic liver failure from erythropoietic protoporphyria.

Erythropoietic protoporphyria (EPP) is an inherited disorder of the heme metabolic pathway that is characterized by accumulation of protoporphyrin in the blood, erythrocytes, and tissues, and cutaneous manifestations of photosensitivity, all resulting from abnormalities in ferrochelatase (FECH) activity due to mutations in the FECH gene. Protoporphyrin is excreted by the liver, and excess protoporphyrin leads to cholelithiasis with obstructive episodes and chronic liver disease, finally progressing to liver cirrhosis. Patients with end-stage EPP-associated liver disease require liver transplantation.

Laparoscopic liver resection for hepatocellular carcinoma: a three-year study of 57 Patients.

Background/aims: Laparoscopic liver resection has become an increasingly popular operation but is still in relatively limited use. Here we evaluate the intermediate-term results of laparoscopic liver resection.

Methodology: Fifty-seven patients with HCC underwent laparoscopic liver resection at the Asan Medical Center.

Usability of ringed polytetrafluoroethylene grafts for middle hepatic vein reconstruction during living donor liver transplantation.

Large vein allografts are suitable for middle hepatic vein (MHV) reconstruction, but their supply is often limited. Although polytetrafluoroethylene (PTFE) grafts are unlimitedly available, their long-term patency is relatively poor. We intended to enhance the clinical usability of PTFE grafts for MHV reconstruction during living donor liver transplantation (LDLT).

Hemodynamics-compliant reconstruction of the right hepatic vein for adult living donor liver transplantation with a right liver graft.

Secure reconstruction of the right hepatic vein (RHV) is essential for the successful implantation of a right liver graft during living donor liver transplantation (LDLT). To develop reliable surgical techniques for RHV reconstruction, we performed 3 concurrent studies: a simulation study using a fluid dynamics experimental model and a computational simulation model; an observational study analyzing the hemodynamic changes during radiological interventions for RHV stenosis; and a prospective clinical study establishing hemodynamics-compliant surgical techniques. The simplified fluid dynamics experimental model revealed that actually measured outflow volumes were very similar to theoretical values derived from a fluid dynamics formula.

Resection of pulmonary metastases from hepatocellular carcinoma following liver transplantation.

Background: This study was intended to assess the effect of resection of pulmonary metastasis (PM) of hepatocellular carcinoma (HCC) after liver transplantation (LT). No effective treatment modality exists for PM-HCC, and little is known about the posttransplant outcomes of pulmonary metastasectomy (PMT).

Methods: Of 587 adult LT recipients diagnosed with HCC, 43 had PM-HCC.

Reconstruction of inferior right hepatic veins in living donor liver transplantation using right liver grafts.

Because revascularization of the inferior right hepatic vein (IRHV) is a major component of right liver graft (RLG) reconstruction, we assessed the surgical techniques and clinical outcomes of IRHV reconstruction so that we could formulate practical guidelines for standardized procedures. From July 2004 to February 2010, we performed separate IRHV reconstructions in 487 of 1142 adult RLG recipients (42.7%).

Effectiveness of external drainage of the bile duct in pancreaticoduodenectomy: a single surgeon's experience.

Backgrounds/aims: The rates of surgery-related complications during and after pancreaticoduodenectomy (PD) remain very high, reaching up to 41%. They were primarily caused by leakage of pancreatic juice. We evaluated the effectiveness of external drainage of the bile duct using a pigtail drain to prevent pancreatic leakage in patients undergoing PD.