In search of a pathogenesis for impaired liver regeneration after major hepatectomy with extrahepatic bile duct resection: The plot thickens!

2019 ◽  
Vol 49 (10) ◽  
pp. 1091-1093 ◽  
Author(s):  
Riccardo Pravisani ◽  
Umberto Baccarani ◽  
Susumu Eguchi
Keyword(s):  
Bile Duct ◽  
Liver Regeneration ◽  
Major Hepatectomy ◽  
Extrahepatic Bile Duct ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection ◽  
Impaired Liver

Preoperative Sarcopenia Negatively Impacts Postoperative Outcomes Following Major Hepatectomy with Extrahepatic Bile Duct Resection

2015 ◽  
Vol 39 (6) ◽  
pp. 1494-1500 ◽  
Author(s):  
Hidehiko Otsuji ◽  
Yukihiro Yokoyama ◽  
Tomoki Ebata ◽  
Tsuyoshi Igami ◽  
Gen Sugawara ◽  
...  
Keyword(s):  
Bile Duct ◽  
Major Hepatectomy ◽  
Extrahepatic Bile Duct ◽  
Postoperative Outcomes ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection

scholarly journals Probiotic-related bacteremia after major hepatectomy for biliary cancer: a report of two cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mitsuhiro Shimura ◽  
Masamichi Mizuma ◽  
Kei Nakagawa ◽  
Shuichi Aoki ◽  
Takayuki Miura ◽  
...  
Keyword(s):  
Bile Duct ◽  
Major Hepatectomy ◽  
Extrahepatic Bile Duct ◽  
Perioperative Period ◽  
Blood Cultures ◽  
Biliary Cancer ◽  
Caudate Lobectomy ◽  
Bile Duct Resection ◽  
Case Presentation ◽  
Extrahepatic Bile Duct Resection

Abstract Background Probiotics have been reported to be beneficial for the prevention of postoperative complications and are often used during the perioperative period. Among the probiotic-related adverse events, bacteremia is rare. Here, we report two cases of probiotic-related bacteremia after major hepatectomy for biliary cancer. Case presentation 1 A 74-year-old man was referred to our hospital to be treated for gallbladder cancer. Neoadjuvant chemotherapy, two courses of gemcitabine plus S-1 combination therapy, was administered. Extended right hepatectomy with caudate lobectomy, extrahepatic bile duct resection and biliary reconstruction were performed 3 weeks after chemotherapy. Probiotics, Clostridium butyricum (C. butyricum) MIYAIRI 588, were administered 6 days before surgery and continued after surgery. Sepsis of unknown origin occurred 17 days after surgery and developed into septic shock. C. butyricum was detected in blood cultures at postoperative day 26 and 45. After stopping the probiotic agent, C. butyricum was undetectable in the blood cultures. The patient died due to an uncontrollable sepsis 66 days after surgery. Case presentation 2 A 63-year-old man with diabetes mellitus whose past history included total colectomy, papillectomy, and Frey’s operation at the age of 19, 34 and 48, respectively, was referred to our hospital to be treated for perihilar cholangiocarcinoma. Extended left hepatectomy with caudate lobectomy, extrahepatic bile duct resection and reconstruction of bile duct were performed. Probiotics were administered during the perioperative period. Combined probiotics that included lactomin, amylolytic bacillus and C. butyricum, were given before surgery. C. butyricum MIYAIRI 588 was given after surgery. Sepsis occurred 16 days after surgery and developed to respiratory failure 8 days later. Blood culture at postoperative day 25 revealed Enterococcus faecalis and C. butyricum. After the probiotics were stopped at postoperative day 27, C. butyricum was not detected in the blood culture. The general condition improved with intensive care. The patient was transferred to another hospital for rehabilitation at postoperative day 156. Conclusion It should be noted that the administration of probiotics in severe postoperative complications can lead to probiotic-related bacteremia.

Postoperative Liver Failure Criteria for Predicting Mortality after Major Hepatectomy with Extrahepatic Bile Duct Resection

2018 ◽  
Vol 36 (2) ◽  
pp. 158-165 ◽  
Author(s):  
Takeshi Kawamura ◽  
Takehiro Noji ◽  
Keisuke Okamura ◽  
Kimitaka Tanaka ◽  
Yoshitsugu Nakanishi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Liver Failure ◽  
Total Bilirubin ◽  
Major Hepatectomy ◽  
Extrahepatic Bile Duct ◽  
Study Cohort ◽  
Bile Duct Resection ◽  
Predictive Values ◽  
Extrahepatic Bile Duct Resection ◽  
Related Mortality

Background: Post-hepatectomy liver failure (PHLF) is a serious complication after major hepatectomy with extrahepatic bile duct resection (Hx with EBDR) that may cause severe morbidity and even death. The purpose of this study was to compare several criteria systems as predictors of PHLF-related mortality following Hx with EBDR for perihilar cholangiocarcinoma (PHCC). Methods: The study cohort consisted of 222 patients who underwent Hx with EBDR for PHCC. We compared several criteria systems, including previously established criteria (the International Study Group of Liver Surgery (ISGLS) criterion; and the “50-50” criterion), and our institution’s novel systems “Max T-Bili” defined as total bilirubin (T-Bili) >7.3 mg/dL during post-operative days (POD) 1–7, and the “3-4-50” criterion, defined as total bilirubin >4 mg/dL and prothrombin time <50% on POD #3. Results: Thirteen patients (5.8%) died from PHLF-related causes. The 3-4-50 criterion showed high positive predictive values (39.1%), the 3-4-50, Max T-Bili, and 50-50 criterion showed high accuracies (91.7, 86.9, and 90.5%, respectively) and varying sensitivities (69.2, 69.2, and 38.5% respectively). Conclusions: The 3-4-50, Max T-Bili, and 50-50 criterion were all useful for predicting PHLF-related mortality after Hx with EBDR for PHCC.

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