Percutaneous balloon dilatation and long-term drainage as treatment of anastomotic and nonanastomotic benign biliary strictures.

Purpose: This study was designed to determine the effectiveness of percutaneous balloon dilation and long-term drainage of postoperative benign biliary strictures.

Methods: Medical records of patients with postoperative benign biliary strictures, in whom percutaneous transhepatic biliary drainage (PTBD) and balloon dilation was performed between January 1999 and December 2011, were retrospectively reviewed. PTBD and balloon dilation (4-10 mm) were followed by placement of internal-external biliary drainage catheters (8.

Insufficient safety measures reported in operation notes of complicated laparoscopic cholecystectomies.

Background: In 2007, a Dutch guideline for laparoscopic cholecystectomy (LC) was composed that advocates the critical view of safety (CVS) to prevent bile duct injury (BDI). Conversion to open cholecystectomy is recommended in complicated cholecystectomy, but young surgeons are hardly trained in this procedure. The aim of this study was to analyze the accuracy of dictated operation notes, the use of CVS before and after guideline implementation, and the severity of injury after conversion.

[Coats of arms of the Amsterdam Surgeons' Guild in the dome of the Anatomy Theatre].

In 1731, Cornelis Troost (1696-1750) painted three wardens of the surgeons' guild in Amsterdam. We know their names from the family coats of arms shown on the wall behind them. The same coats of arms and names are painted in the dome of the Anatomy Theatre in the 'Waag', the former weighing house at the Nieuwmarkt in Amsterdam, which also housed the board room of the surgeons' guild.

Effect of hepatic artery embolization on liver hypertrophy response in a rabbit liver VX2 tumor model.

Background: Portal vein embolization not only induces hypertrophy of the non-embolized liver, but also enhances tumor growth. The latter could be prevented by embolizing the hepatic arteries supplying the tumor-bearing liver segments. This study aimed to determine the effects of transcatheter arterial embolization (TAE) on tumor volume and liver regeneration in a rabbit VX2 tumor model.

The mechanisms and physiological relevance of glycocalyx degradation in hepatic ischemia/reperfusion injury.

Significance: Hepatic ischemia/reperfusion (I/R) injury is an inevitable side effect of major liver surgery that can culminate in liver failure. The bulk of I/R-induced liver injury results from an overproduction of reactive oxygen and nitrogen species (ROS/RNS), which inflict both parenchymal and microcirculatory damage. A structure that is particularly prone to oxidative attack and modification is the glycocalyx (GCX), a meshwork of proteoglycans and glycosaminoglycans (GAGs) that covers the lumenal endothelial surface and safeguards microvascular homeostasis.

Reactive oxygen and nitrogen species in steatotic hepatocytes: a molecular perspective on the pathophysiology of ischemia-reperfusion injury in the fatty liver.

Significance: Hepatic ischemia-reperfusion (IR) injury results from the temporary deprivation of hepatic blood supply and is a common side effect of major liver surgery (i.e., transplantation or resection).

Patterns of recurrence after resection of gallbladder cancer without routine extrahepatic bile duct resection.

Objective: Routine extrahepatic bile duct (EBD) resection in non-jaundiced patients with gallbladder cancer (GBC) is controversial. The aim of this study was to retrospectively analyse patterns of recurrence in patients who underwent resection of GBC without routine EBD resection.

Methods: This analysis referred to 58 patients who had undergone explorative laparotomy for GBC during 2000-2012 at a single, tertiary referral centre.

Endovascular laser–tissue interactions and biological responses in relation to endovenous laser therapy.

Endovenous laser treatment (ELT) has evolved into a frequently employed modality for the treatment of leg varicose veins. Due to the very high complete response rates, minimal complications and side effects, and the possibility to monitor therapeutic outcome noninvasively by duplex ultrasound, a considerable amount of reports have been published on clinical and translational studies, whereas disproportionally few studies have been performed to elucidate the molecular and cellular basis for post-ELT vessel obliteration. Consequently, this review addresses the putative molecular and cellular mechanisms responsible for varicose vein obliteration following laser irradiation in the context of endovenous laser–tissue interactions.

Diagnostic accuracy of (18) F-methylcholine positron emission tomography/computed tomography for intra- and extrahepatic hepatocellular carcinoma.

Unlabelled: Diagnosis of hepatocellular carcinoma (HCC) primarily involves imaging. The aim of this study was to assess the accuracy of (18) F-fluorocholine ((18) F-FCH) positron emission tomography (PET) for detection of HCC and evaluation of extent of disease. Patients with HCC >1 cm were included between 2009 and July 2011, and follow-up closed in February 2013.

Antecolic versus retrocolic route of the gastroenteric anastomosis after pancreatoduodenectomy: a randomized controlled trial.

Objective: To investigate the relationship between the route of gastroenteric (GE) reconstruction after pancreatoduodenectomy (PD) and the postoperative incidence of delayed gastric emptying (DGE).

Background: DGE is one of the most common complications after PD. Recent studies suggest that an antecolic route of the GE reconstruction leads to a lower incidence of DGE, compared to a retrocolic route.

Prognostic biomarkers in patients with resected cholangiocarcinoma: a systematic review and meta-analysis.

Purpose: Biomarkers for patients with resected cholangiocarcinoma (CC) can improve staging and may ultimately result in personalized medicine. Studies evaluating these biomarkers often have shown inconsistent results. We performed a systematic review and meta-analysis to investigate the prognostic value of all immunohistochemistry-based markers that have been evaluated in patients with resected CC.

Delay in surgical treatment of patients with hilar cholangiocarcinoma: does time impact outcomes?

Background: Substantial time elapses before patients with hilar cholangiocarcinoma (HCC) receive surgical treatment because of time-consuming preoperative staging and other interventions, including biliary drainage and portal vein embolization. Prolonged times potentially lead to unresectability and the formation of metastases, yet these issues have not been investigated previously in HCC. This study aimed to evaluate the time between onset of symptoms and the provision of ultimate treatment in patients with HCC and the impact of the length of time on outcomes.

Association of preoperative symptoms of gastric outlet obstruction with delayed gastric emptying after pancreatoduodenectomy.

Background: Delayed gastric emptying (DGE) is among the most common complications after pancreatoduodenectomy (PD) and might demand postoperative nutritional support. The aim of this study was to investigate the association between preoperative symptoms of gastric outlet obstruction and DGE after PD in an attempt to identify patients in whom placement of a feeding tube at time of operation might be beneficial.

Methods: We analyzed a consecutive series of 401 patients undergoing PD from a prospective database.

[Treatment of colorectal liver metastasis at a regional hospital versus a university medical centre].

Objective: To evaluate the results of this type of liver surgery performed at a specialised regional hospital in comparison with the operation performed at a university medical centre (UMC).

Design: Prospective study at 2 hospitals.

Methods: All patients with colorectal liver metastasis who had undergone a partial liver resection and/or radiofrequency ablation (RFA) at Amphia Hospital or at the Academic Medical Centre - University of Amsterdam (AMC) from January 2005-June 2011 were included.

Prognostic impact of preoperative imaging parameters on resectability of hilar cholangiocarcinoma.

Objectives. To evaluate, in hilar cholangiocarcinoma (HCCA), the prognostic impact of specific preoperative radiologic parameters on resectability, metastases, and yield of laparoscopy, and to evaluate the currently used staging systems. Methods.

'The anatomy lesson of Dr. Frederik Ruysch' of 1683, a milestone in knowledge about obstetrics.

'The anatomy lesson of Dr. Frederik Ruysch' (1683) belongs to the famous collection of group portraits of the Amsterdam Guild of Surgeons. In this painting, Ruysch is portrayed with a dissected corpse of a newborn, which was still attached to its placenta.

Von Meyenburg complexes mimicking metastatic disease at laparotomy for focal nodular hyperplasia.

A 44-year-old woman presented with symptoms of fatigue and increasing abdominal discomfort. MRI with the hepatobiliary contrast Gd-EOB-DTPA (Primovist) was performed showing a 6 cm lesion in segment 2/3 of the liver typical for focal nodular hyperplasia (FNH). Because of severe complaints attributed to the lesion, the patient was scheduled for resection.

Endothelial cell preservation at hypothermic to normothermic conditions using clinical and experimental organ preservation solutions.

Introduction: Endothelial barrier function is pivotal for the outcome of organ transplantation. Since hypothermic preservation (gold standard) is associated with cold-induced endothelial damage, endothelial barrier function may benefit from organ preservation at warmer temperatures. We therefore assessed endothelial barrier integrity and viability as function of preservation temperature and perfusion solution, and hypothesized that endothelial cell preservation at subnormothermic conditions using metabolism-supporting solutions constitute optimal preservation conditions.

Increased hepatic functionality of the human hepatoma cell line HepaRG cultured in the AMC bioreactor.

The clinical application of a bioartificial liver (BAL) depends on the availability of a human cell source with high hepatic functionality, such as the human hepatoma cell line HepaRG. This cell line has demonstrated high hepatic functionality, but the effect of BAL culture on its functionality in time is not known. Therefore, we studied the characteristics of the HepaRG-AMC-BAL over time, and compared the functionality of the HepaRG-AMC-BAL with monolayer cultures of HepaRG cells, normalized for protein (bioactive mass) and DNA (cell number).

Efficacy of liver graft washout as a function of the perfusate, pressure, and temperature.

Donor graft washout can be impaired by colloids in organ preservation solutions that increase the viscosity and agglutinative propensity of red blood cells (RBCs) and potentially decrease organ function. The colloid-induced agglutinative effects on RBCs and RBC retention after liver washout with Ringer's lactate (RL), histidine tryptophan ketoglutarate solution, University of Wisconsin solution, and Polysol were determined as a function of the washout pressure (15 or 100 mm Hg) and temperature (4 or 37°C) in a rat liver washout model with (99m) Tc-pertechnetate-labeled RBCs. Colloids (polyethylene glycol in Polysol and hydroxyethyl starch in University of Wisconsin) induced RBC agglutination, regardless of the solution's composition.

Rembrandt's anatomy lesson of Dr. Deijman of 1656 dissected.

More than 350 years ago, Rembrandt painted Anatomy Lesson of Dr. Deijman. This group portrait, featuring important members of the Amsterdam Guild of Surgeons, belongs to the series of paintings of the guild.