After listing the indications for liver resection, the operative technique used is discussed with a special reference to an original modification implemented in practice. The case material is made of 52 liver resections and 6 lobectomies with a favourable outcome. In one lobectomy with subtotal proximal resection jejunogastroplasty is performed, supplemented by isolated antireflux anisoperistaltically interposed invagination esophagojejunostomy, duplicated by suturing its two portions. Application of catheter, inserted into the recanalized umbilical vein, is described under the heading of locoregional chemotherapy. In carcinomas involving the confluence of hepatic ducts a variant of Rodney Smith's operation is used while in hepatocholedochus resection plastic repair is done over Kerr drainage. In portal hypertension, after discussing the various methods existing, attention is called to the indirect shunts: splenectomy with omentoreno- and omentoparietopexy, Charsky and fenestration of Glisson's capsule using electric knife and argon with omentohepato- and hepatoparietopexy, as well as implantation of the recanalized v. umbilicalis into m. rectus abdominis dexter. In 15 cases operated on by parenchyma stimulating procedures, survivorship ranging from 3 to 26 years is achieved. For the purpose of prophylaxis against cholangiohepatitis and cirrhosis the following operations are performed: 68 papillotomies and plastic repairs over balloon catheter, passed through the choledochus and papilla, using an electric knife, 12 choledochoduodenostomies type "frog mouth", and 11 deperitonizations-desympathizations with a successful cure being attained.
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Cureus
December 2024
Department of Surgery, Tokyo Saiseikai Central Hospital, Tokyo, JPN.
Ectopic varices can result from portal vein stenosis following pancreaticoduodenectomy with concomitant portal vein resection reconstruction, and they can cause gastrointestinal bleeding. Although they can sometimes be fatal, various treatments have been reported. This report describes a case in which a percutaneous transhepatic approach was used to simultaneously perform variceal embolization and portal vein stenting in which a favorable outcome was achieved.
View Article and Find Full Text PDFTher Adv Rare Dis
January 2025
Department of Pediatrics, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening systemic hyperinflammatory syndrome, rarely associated with bone marrow failure (BMF). Telomere biology disorders (TBD) are caused by inherited defects in telomerase processes and can have heterogeneous presentations including idiopathic pulmonary fibrosis, cirrhosis, and BMF. We report a case of a 10-year-old male from Lima, Peru, who presented with HLH as the initial manifestation of a TBD.
View Article and Find Full Text PDFNat Med
January 2025
Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Up to 50-70% of patients with liver cirrhosis develop hepatic encephalopathy (HE), which is closely related to gut microbiota dysbiosis, with an unclear mechanism. Here, by constructing gut-brain modules to assess bacterial neurotoxins from metagenomic datasets, we found that phenylalanine decarboxylase (PDC) genes, mainly from Ruminococcus gnavus, increased approximately tenfold in patients with cirrhosis and higher in patients with HE. Cirrhotic, not healthy, mice colonized with R.
View Article and Find Full Text PDFJ Formos Med Assoc
January 2025
Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan; Therapeutic and Research Center of Liver Cirrhosis and Portal Hypertension, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Background: Cirrhotic patients with refractory ascites exhibit severe portal hypertension and hemodynamic disturbances. The risks associated modest-volume paracentesis (<5 L) for refractory ascites remains unclear. We aimed to explore the impact of modest-volume paracentesis in refractory ascites.
View Article and Find Full Text PDFLiver Int
February 2025
Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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