The Safe Minimally Ischemic Liver Remnant for Small-for-Size Syndrome in Porcine Hepatectomy

2013 ◽  
Vol 45 (6) ◽  
pp. 2419-2424 ◽  
Author(s):  
J. Leng ◽  
H. Xing ◽  
J. Tan ◽  
K. Chen ◽  
J. Dong
Keyword(s):  
Liver Remnant ◽  
Small For Size

scholarly journals Small-for-flow liver failure after extended hepatectomy: hot questions and an update

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Simone Famularo ◽  
Luca Gianotti ◽  
Oliviero Riggio
Keyword(s):  
Liver Failure ◽  
Portal Pressure ◽  
Management Strategies ◽  
Liver Parenchyma ◽  
Point Of View ◽  
Liver Size ◽  
Liver Remnant ◽  
Mortality And Morbidity ◽  
Small For Size

Small-for-size liver syndrome and posthepatectomy liver failure remain a major challenge for surgeons. Recently, updates in literature points to describe this two syndrome as two face of the same coin. These syndromes are characterized by hyperbilirubinemia, coagulopathy, hyper-GGT, high portal pressure and flow in liver remnant, occurring within the first postoperative week. It can lead to post-operative sepsis and bleeding, increasing mortality and morbidity. Despite the large experience in the field of transplantation, few studies are focused on small-for-size syndrome after major hepatectomy. For years, scientists were focused on the size of liver remnant, supposing a small liver remnant, in relation with the primary liver size, was the cause of the syndrome. The strategies used to prevent it after transplantation, have however shown a predominant role of high portal pressure and flow, leading to an alteration in functional regeneration of liver parenchyma, as the prevalent mechanism. According to these evidences, we suggest adopting another nomenclature for the two syndromes: small-for-flow-liver failure. In this article, we analyze and summarize different experiences, proposing our inward algorithm, including the role of portal flow and pressure measurements. This review seeks to be an operative instrument for surgeons and hepatologists in an effort to find a common point of view regarding small for flow liver failure and its management strategies.

scholarly journals Proteomic characterization of biological features in the small for size future rat liver remnant

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S483-S484
Author(s):  
M. Meier ◽  
K. Jarlhelt Andersen ◽  
A. Riegels Knudsen ◽  
M. Ludvigsen ◽  
B. Honoré ◽  
...  
Keyword(s):  
Rat Liver ◽  
Liver Remnant ◽  
Biological Features ◽  
Small For Size

scholarly journals Granulocyte Colony-stimulating Factor Supports Liver Regeneration in a Small-for-size Liver Remnant Mouse Model

2007 ◽  
Vol 11 (3) ◽  
pp. 280-285 ◽  
Author(s):  
Daniel Inderbitzin ◽  
Guido Beldi ◽  
Daniel Sidler ◽  
Peter Studer ◽  
Adrian Keogh ◽  
...  
Keyword(s):  
Mouse Model ◽  
Liver Regeneration ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Liver Remnant ◽  
Small For Size ◽  
Stimulating Factor

799 The effect of erythropoietin on survival in a novel small for size liver remnant mouse model

Hepatology ◽  
2003 ◽  
Vol 38 ◽  
pp. 546-547
Author(s):  
G BELDI ◽  
D INDERBITZIN ◽  
A KEOGH ◽  
S BISCHKNADEN ◽  
B GLOOR ◽  
...  
Keyword(s):  
Mouse Model ◽  
Liver Remnant ◽  
Small For Size

scholarly journals Bisegmentectomy 7–8 for Small-for-Size Remanant Liver for Cirrhotic Patients Under Right Hemi-hepatectomy With Hepatocellular Carcinoma: A Case-Matched Comparative Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xishu Wang ◽  
Yongrong Lei ◽  
Hongbo Huan ◽  
Shu Chen ◽  
Kuansheng Ma ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Morbidity Rate ◽  
Control Group ◽  
Study Group ◽  
Liver Remnant ◽  
Long Term Treatment ◽  
Small For Size

Aim: To compare the short- and long-term treatment outcomes of bisegmentectomy 7–8 vs. right hepatectomy for patients with hepatocellular carcinoma and cirrhosis.Methods: Thirty six cirrhotic HCC patients with infiltration of right hepatic vein in segments 7–8 underwent bisegmentectomy 7–8 for small-for-size remanant liver under right hemi-hepatectomy. Its outcome was compared with a case-matched control group of cirrhotic HCC patients who underwent right hemi-hepatectomy during the study period.Results: The study group consisted of 36 patients and the control group 36 patients selected from 1,526 patients matched with age, tumor size, tumor location, and Pugh-Child staging. There were no significant differences between the two groups in operative parameters and in perioperative main complications which included hemorrhage, bile leakage, ascites, pleural effusion, and liver failure. The overall morbidity rate and morbidity rate classified according to Clavien's classification were similar. There was no in-hospital mortality or 90 day post-operative mortality. The mean follow-up was 30 and 32 months for the study group and control group, respectively. The disease free survival rate (DFS) for the study group was just significantly better than the control group. The median DFS was 24 months for the study group and 8 months for the control group (P = 0.049). Meanwhile, the median cumulative overall survival was 35 months for the study group and 27 months for the control group (P = 0.494).Conclusion: Bisegmentectomy 7–8 was safe and feasible for selected cirrhosis patients, and did not increase the perioperative risk and inferior long-term overall survival outcomes. It extended the indications for liver resection in patients with borderline volumes of future liver remnant for HCC cirrhotic liver.

scholarly journals Effects of Portal Preconditioning In Low-Volume Liver Remnants: Study In Rats

2021 ◽  
Author(s):  
Alexandre de Abreu Ribeiro ◽  
Christina Maeda Takiya ◽  
Vera Nunes Pannain ◽  
Mauricio Andrade Perez ◽  
Joaquim Ribeiro Filho
Keyword(s):  
Liver Biopsy ◽  
Statistical Significance ◽  
Laboratory Analysis ◽  
Refractory Ascites ◽  
Control Group ◽  
Sample Collection ◽  
Liver Remnant ◽  
Significant Difference ◽  
Small For Size ◽  
The Impact

Abstract The increase of liver surgical indications, the expansion of the margins in hepatic resections and the lack of organ donors led to the use of more split livers from cadaver and living donors and smaller liver remnants in post-operatory patients. The use of increasingly smaller grafts associated with hepatic resections broadened the spectrum for observation of small-for size syndrome, caused by significant inflammation and early hepatic fibrosis. The small-for-size syndrome is manifested clinically by prolonged cholestasis, refractory ascites and progressive hepatic dysfunction (encephalopathy and coagulopathy). In the search for mechanisms to reduce liver damage, preconditioning is presented as a possibility of protecting the low weight remnant in experimental works. Objective: Study the hepatic tissue measuring the impact of portal preconditioning in small hepatic remnant in Wistar rats Methods: Rats weighing approximately 250g were divided in 4 groups with 7 members each. Group 1, Control group requiring only collection of the material, blood laboratory analysis and liver biopsy for pathology and immunohistochemistry; Group 2, Sham, were operated with simple laparotomy, 48 hours later they were subjected to another surgery with sample collection to do blood laboratory analysis and liver biopsy for pathology and immunohistochemistry. Group 3, hepatectomy with preconditioning. In this group was made the preconditioning procedure before the resection of 70% of the liver, 48 hours later they underwent another surgery for sample collection to do blood laboratory analysis and liver biopsy for pathology and immunohistochemistry. Group 4, hepatectomy without preconditioning. In this group the members were operated with resection of 70% of the liver, 48 hours later were reoperated with sample collection to do blood laboratory analysis and liver biopsy for pathology and immunohistochemistry. We studied and compared the impacts in morphology, laboratory, histology, immunohistochemistry.Results: There was no intraoperative mortality in the model used, there was no statistically significant difference in histological and laboratory parameters between the groups with and without preconditioning, there was an increase in the expression of PCNA with statistical significance in the hepatic remnant of the group submitted to preconditioning. Conclusion: Liver preconditioning can provide an increase in cell proliferation in small volume liver remnant.

103 The effect of hematopoietic growth factors on survival in a novel surgical small for size liver remnant mouse model

2004 ◽  
Vol 40 ◽  
pp. 38-39
Author(s):  
G. Beldi ◽  
A. Keogh ◽  
S. Bisch-Knaden ◽  
E. Ayuni ◽  
P. Studer ◽  
...  
Keyword(s):  
Growth Factors ◽  
Mouse Model ◽  
Hematopoietic Growth Factors ◽  
Liver Remnant ◽  
Small For Size

The Contemporary Role of Resection and Ablation in Colorectal Cancer Liver Metastases

2020 ◽  
Vol 04 (03) ◽  
pp. 291-302
Author(s):  
Mariam F. Eskander ◽  
Christopher T. Aquina ◽  
Aslam Ejaz ◽  
Timothy M. Pawlik
Keyword(s):  
Colorectal Cancer ◽  
Portal Vein ◽  
Surgical Oncology ◽  
Portal Vein Ligation ◽  
Safe Alternative ◽  
Colorectal Cancer Liver Metastases ◽  
Liver Remnant ◽  
New Era ◽  
Ablation Therapy

AbstractAdvances in the field of surgical oncology have turned metastatic colorectal cancer of the liver from a lethal disease to a chronic disease and have ushered in a new era of multimodal therapy for this challenging illness. A better understanding of tumor behavior and more effective systemic therapy have led to the increased use of neoadjuvant therapy. Surgical resection remains the gold standard for treatment but without the size, distribution, and margin restrictions of the past. Lesions are considered resectable if they can safely be removed with tumor-free margins and a sufficient liver remnant. Minimally invasive liver resections are a safe alternative to open surgery and may offer some advantages. Techniques such as portal vein embolization, association of liver partition with portal vein ligation for staged hepatectomy, and radioembolization can be used to grow the liver remnant and allow for resection. If resection is not possible, nonresectional ablation therapy, including radiofrequency and microwave ablation, can be performed alone or in conjunction with resection. This article presents the most up-to-date literature on resection and ablation, with a discussion of current controversies and future directions.

scholarly journals Major Hepatectomy in a Child with Extremely Low Future Liver Remnant Without Posthepatectomy Liver Failure

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S201
Author(s):  
D. Akhaladze ◽  
D. Kachanov ◽  
G. Rabaev ◽  
N. Merkulov ◽  
N. Uskova ◽  
...  
Keyword(s):  
Liver Failure ◽  
Major Hepatectomy ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
Posthepatectomy Liver Failure
Sign in / Sign up

Export Citation Format

Share Document