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Graft inflow modulation in recipients with portal hypertension.
Updates Surg
December 2024
Department of Clinical Medicine and Surgery, Division of Minimally Invasive and Robotic HPB Surgery, Transplantation Service, Federico II University Hospital, Via Sergio Pansini 5, 80131, Naples, Italy.
The extended application of living donor liver transplantation (LDLT) has revealed the problem of graft size mismatching, potentially leading to the "small-for-size syndrome" (SFSS). SFSS is a rare dysfunction that may affect a partial liver graft, characterized by coagulopathy, cholestasis, ascites, and encephalopathy. A key role in the physiopathology of SFSS is played by portal hypertension (PHT) to which a small allograft is submitted after reperfusion, resulting in sinusoidal congestion and hemorrhage.
View Article and Find Full Text PDFLaparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension.
J Vis Exp
November 2024
Department of Hepatobiliary Surgery, The First Affiliated Hospital, Jinan University;
Article Synopsis
- Hypersplenism and esophageal variceal hemorrhage are serious complications of decompensated cirrhosis caused by portal hypertension.
- Although various non-surgical treatments have emerged, surgical options like splenectomy combined with pericardial devascularization (SPD) remain crucial in China for treating these conditions.
- The article emphasizes the effectiveness of laparoscopic splenectomy combined with pericardial devascularization (LSPD) as a minimally invasive surgical technique, highlighting the importance of surgeon skill for successful outcomes.
Application of Microwave Ablation in Laparoscopic Partial Splenectomy.
J Vis Exp
November 2024
Department of Hepatobiliary Surgery, The First Affiliated Hospital, Jinan University;
Splenic hemangioma is the most common pathological classification of splenic tumors, and its surgical indication and treatment have been controversial. Before, open splenectomy was usually used to treat splenic hemangioma. Following the rapid development of laparoscopic techniques, people's requirements for minimally invasive treatment have gradually increased, and laparoscopic splenectomy has gradually become the main treatment method.
View Article and Find Full Text PDF[Immune thrombocytopenia: current diagnostics and therapy : The new 2023 expert report in brief].
Inn Med (Heidelb)
December 2024
Medizinische Klinik, Innere Medizin II, Hämatologie, Onkologie, klinische Immunologie und Rheumatologie, Universitätsklinikum Tübingen, Universität Tübingen, Otfried-Müller-Straße 10, 72076, Tübingen, Deutschland.
Immune thrombocytopenia (ITP) is an acquired thrombocytopenia caused by an autoimmune reaction against platelets in the blood and against megakaryocytes in the bone marrow. The indication for treatment is based on the bleeding symptoms and patient-specific factors. This article presents the current 2023 expert report that also forms the basis for the updated version of the Onkopedia guideline, which is expected in the course of 2024.
View Article and Find Full Text PDFSplenic Artery Ligation Versus Splenectomy for Portal Inflow Modulation in Adult Living Donor Liver Transplant: Effects on Early Graft Function, A Prospective Study.
Exp Clin Transplant
October 2024
From the HPB Surgery and Liver Transplantation Unit, El-Rajhy Liver Hospital, Assiut University, Assiut, Egypt.
Objectives: Portal inflow modulation is currently an essential step in living donor liver transplantation, particularly among patients with portal hypertension who receive small grafts. This study compared splenic artery ligation with splenectomy as a method for portal inflow modulation.
Materials And Methods: We compared 31 consecutive prospective adult patients who had splenic artery ligation during living donorlivertransplant with either right or left lobe donation performed from July 2021 to March 2024 with 22 consecutive retrospective patients who had splenectomy performed immediately before July 2021.
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