Introduction: Liver resections over 50% of hepatic volume can be achieved with a low morbi-mortality, although occasionally they are followed by severe complications. Postoperative evolution and complications after this type of hepatic resections with intermittent occlusion of the portal triad have been studied.
Patients And Methods: 13 right hepatectomies, 5 enlarged right hepatectomies and 2 enlarged left hepatectomies were performed consecutively, with intraoperative ultrasound evaluation and intermittent portal triad occlusion.
Results: Maximum time of continuous hepatic hilum occlusion was 15 minutes, with a mean isquemia time of 25 +/- 8.6 minutes. Peak of disturbance of hepatic function was at 24 hours and recovered totally at 7th postoperative day. Nine of the 20 patients (45%) did not need intraoperative transfusion and the average of transfusion was 1.8 +/- 1.9 blood units. Four biliary leaks (20%), with no severe hepatic disfunction were observed during postoperative period, and there was no hospital mortality.
Conclusions: Intermittent portal triad occlusion during hepatic resections in more than 50% of liver volume is a safe surgical maneuver.
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Am J Case Rep
December 2024
Department of Medical Education, University of Toledo, Toledo, OH, USA.
BACKGROUND The configuration of the hepatic arteries is known to vary substantially between individuals. Here, we report a rare retroperitoneal configuration of an accessory hepatic artery existing alongside a left and right hepatic artery branching from the proper hepatic artery. During routine dissection, we discovered an anomalous configuration of the hepatic arteries that does not fit the commonly used categorizations for abnormal hepatic vasculature.
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December 2024
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Understanding cell fate regulation in the liver is necessary to advance cell therapies for hepatic disease. Liver progenitor cells (LPC) contribute to tissue regeneration after severe hepatic injury yet signals instructing progenitor cell dynamics and fate are largely unknown. The Tissue Inhibitor of Metalloproteinases, TIMP1 and TIMP3 control the sheddases ADAM10 and ADAM17, key for NOTCH activation.
View Article and Find Full Text PDFEur J Neurol
January 2025
Department of Internal Medicine, Hospital Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris, Université Paris Cité, Paris, France.
Background: Susac syndrome (SuS) is a rare immune-mediated microangiopathy with potential disabling evolution. We aimed to analyze brain microstructural damage through diffusion tensor imaging (DTI) in SuS and determine its association with poor outcomes.
Method: CarESS study is a prospective multicenter national cohort study of patients with SuS.
Sci Rep
December 2024
Faculty of Health and Social Sciences, Universidad de Las Américas, Santiago, 8370040, Chile.
Ultrasound Q
December 2024
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT.
Sonographic detection of mobile echogenic foci within the main portal vein and its branches or within the liver parenchyma extending along the portal triads to the periphery of the liver is an alarming finding that has been associated with portal venous gas in the setting of bowel ischemia. Ultrasound-enhancing agents (UEAs) have been widely utilized in abdominal ultrasound for evaluation of organ neoplasms and vascular patency as well as in echocardiography for the evaluation of cardiac function. The appearance of UEAs on abdominal ultrasound can resemble gas like that seen in the portal venous system and liver in patients with bowel ischemia; therefore, UEA residuals should always be a part of the differential diagnosis of echogenic foci when seen on abdominal ultrasounds with preceding recent UEA administration.
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