scholarly journals Bleeding in Hepatic Surgery: Sorting through Methods to Prevent It

HPB Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Fabrizio Romano ◽  
Mattia Garancini ◽  
Fabio Uggeri ◽  
Luca Degrate ◽  
Luca Nespoli ◽  
...  
Keyword(s):  
Blood Loss ◽  
Liver Surgery ◽  
New Technologies ◽  
Hepatic Surgery ◽  
Technical Aspects ◽  
Liver Resections ◽  
Life Threatening ◽  
New Devices

Liver resections are demanding operations which can have life threatening complications although they are performed by experienced liver surgeons. The parameter “Blood Loss” has a central role in liver surgery, and different strategies to minimize it are a key to improve results. Moreover, recently, new technologies are applied in the field of liver surgery, having one goal: safer and easier liver operations. The aim of this paper is to review the different principal solutions to the problem of blood loss in hepatic surgery, focusing on technical aspects of new devices.

scholarly journals The introduction of navigation in liver surgery in Brazil

2014 ◽  
Vol 41 (6) ◽  
pp. 451-454 ◽  
Author(s):  
Mauro Monteiro Correia ◽  
José Paulo de Jesus ◽  
Raul Feitosa ◽  
Dário Augusto Oliveira
Keyword(s):  
National Cancer Institute ◽  
Liver Surgery ◽  
Ministry Of Health ◽  
Technical Aspects ◽  
Liver Resections

The authors thoroughly report the development, the technical aspects and the performance of the first navigated liver resections, by laparotomy and laparoscopy, in Brazil, done at the National Cancer Institute, Ministry of Health, using a surgical navigator.

Laparoscopic ultrasound navigation in liver surgery—technical aspects and feasibility

2004 ◽  
Vol 1268 ◽  
pp. 793-796 ◽  
Author(s):  
M Kleemann ◽  
P Hildebrand ◽  
R Keller ◽  
H.P Bruch ◽  
M Birth
Keyword(s):  
Liver Surgery ◽  
Laparoscopic Ultrasound ◽  
Technical Aspects

scholarly journals The Pathophysiology and Management of Hemorrhagic Shock in the Polytrauma Patient

2021 ◽  
Vol 10 (20) ◽  
pp. 4793
Author(s):  
Alison Fecher ◽  
Anthony Stimpson ◽  
Lisa Ferrigno ◽  
Timothy H. Pohlman
Keyword(s):  
Blood Loss ◽  
Whole Blood ◽  
Damage Control ◽  
Clinical Information ◽  
Fresh Frozen Plasma ◽  
Practical Reasons ◽  
Freeze Dried ◽  
Life Threatening ◽  
Sudden Decrease ◽  
Polytrauma Patient

The recognition and management of life-threatening hemorrhage in the polytrauma patient poses several challenges to prehospital rescue personnel and hospital providers. First, identification of acute blood loss and the magnitude of lost volume after torso injury may not be readily apparent in the field. Because of the expression of highly effective physiological mechanisms that compensate for a sudden decrease in circulatory volume, a polytrauma patient with a significant blood loss may appear normal during examination by first responders. Consequently, for every polytrauma victim with a significant mechanism of injury we assume substantial blood loss has occurred and life-threatening hemorrhage is progressing until we can prove the contrary. Second, a decision to begin damage control resuscitation (DCR), a costly, highly complex, and potentially dangerous intervention must often be reached with little time and without sufficient clinical information about the intended recipient. Whether to begin DCR in the prehospital phase remains controversial. Furthermore, DCR executed imperfectly has the potential to worsen serious derangements including acidosis, coagulopathy, and profound homeostatic imbalances that DCR is designed to correct. Additionally, transfusion of large amounts of homologous blood during DCR potentially disrupts immune and inflammatory systems, which may induce severe systemic autoinflammatory disease in the aftermath of DCR. Third, controversy remains over the composition of components that are transfused during DCR. For practical reasons, unmatched liquid plasma or freeze-dried plasma is transfused now more commonly than ABO-matched fresh frozen plasma. Low-titer type O whole blood may prove safer than red cell components, although maintaining an inventory of whole blood for possible massive transfusion during DCR creates significant challenges for blood banks. Lastly, as the primary principle of management of life-threatening hemorrhage is surgical or angiographic control of bleeding, DCR must not eclipse these definitive interventions.

scholarly journals Successful treatment of false aneurysm of the subclavian artery

2019 ◽  
Vol 178 (2) ◽  
pp. 69-72
Author(s):  
A. N. Ryazanov ◽  
V. V. Soroka ◽  
S. P. Nokhrin ◽  
E. P. Mikhelson ◽  
I. D. Magamedov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Minimally Invasive ◽  
Positive Result ◽  
Subclavian Artery ◽  
Successful Treatment ◽  
New Technologies ◽  
False Aneurysm ◽  
Life Threatening ◽  
Minimally Invasive Methods

The article describes the clinical experience of treatment of life-threatening pathology by minimally invasive methods. There is a long-term stable positive result after the operation. The introduction of new technologies in medicine minimizes the risk of postoperative complications, contributing to a favorable outcome of the disease.

Medical Ethical and Policy Issues Arising from RIA

2008 ◽  
pp. 324-332
Author(s):  
Jimmie L. Joseph ◽  
David P. Cook
Keyword(s):  
Public Policy ◽  
Clinical Trials ◽  
New Technologies ◽  
Medical Profession ◽  
Leading Edge ◽  
Medical Treatments ◽  
Life Saving ◽  
Life Threatening ◽  
Care Technology ◽  
Social Upheaval

New technologies can lead to social upheaval and ethical dilemmas which are unrecognized at the time of their introduction. Medical care technology has advanced rapidly over the course of the past two decades and has frequently been accompanied by unforeseen consequences for individuals, the medical profession and government budgets, with concomitant implications for society and public policy (Magner, 1992; Marti-Ibanez, 1962). Advances in information technology (IT) during the last decade and a half are now impacting the medical profession, and the delivery of medical advances, in ways that will impact public policy debates for the foreseeable future. The World Wide Web (Web) makes information that was once the eminent domain of medical professionals available to average citizens who are increasingly demanding medical treatments from the leading edge of medical technology. For example, CenterWatch (www.centerwatch. com) provides a wealth of information concerning clinical trials and offers a conduit by which patients can become involved in such studies. The availability of such information has also led to patients suffering from life-threatening diseases not part of such clinical trials to request special access to potentially life-saving therapies. As a result, the Web is increasing the complexity of answering public policy questions surrounding what medical technologies to make available to the public, who will be eligible to receive new medical treatments, and at what cost.

scholarly journals Analysis of the International Study Group of Hepatic Surgery definitions of typical complications after liver surgery

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S576-S577
Author(s):  
W. Tesfazgi ◽  
M. Knoth ◽  
E. Birgin ◽  
T. Wilhelm ◽  
S. Post ◽  
...  
Keyword(s):  
Liver Surgery ◽  
International Study ◽  
Study Group ◽  
Hepatic Surgery ◽  
International Study Group

Feasibility of Nonanatomical Liver Resection in Diligently Selected Patients with Hepatoblastoma and Comparison of Outcomes with Anatomic Resection

2020 ◽  
Author(s):  
Sajid S. Qureshi ◽  
Seema A. Kembhavi ◽  
Mufaddal Kazi ◽  
Vasundhara Smriti ◽  
Akshay Baheti ◽  
...  
Keyword(s):  
Blood Loss ◽  
Postoperative Morbidity ◽  
Operative Time ◽  
Treatment Guidelines ◽  
Liver Tumors ◽  
Oncologic Outcomes ◽  
Resection Margins ◽  
Liver Resections ◽  
Significant Difference ◽  
Group Distribution

Abstract Introduction Treatment guidelines for hepatoblastoma discourage nonanatomic liver resections. However, the evidence for this is inadequate and comes from a study performed almost two decades ago which additionally contained inherent limitations. This study aimed to assess the feasibility and oncologic outcomes of nonanatomic resections (NAR) performed in diligently selected patients and compare the results with anatomic resections (AR). Materials and Methods A total of 120 patients who underwent liver resections for hepatoblastoma between January 2008 and July 2019 were reviewed. Feasibility of NAR was based on postchemotherapy relations to vessels, site of the lesion, and possibility of achieving negative resection margins. Results AR was performed in 95 patients and 25 had NAR. The NAR cohort had similar International Childhood Liver Tumors Strategy Group (SIOPEL) risk group distribution. Blood loss and operative times were lower in patients undergoing NAR. No differences were noted between the two groups concerning postoperative morbidity and hospitalization. There were no pathologic positive margins or local recurrences in the NAR patients. Relapse free (RFS) and overall survival (OS) was similar in the two groups (p = 0.54 and 0.96, respectively). Subgroup analysis of only posttreatment extent of tumor (POSTTEXT) I and II patients also showed no difference in RFS or OS for the two groups with a persistent significant difference in operative times and blood loss. Conclusion NAR is feasible with clear margins in carefully selected patients. It is not associated with more complications and outcomes are not inferior to AR. NAR is associated with lesser blood loss and operative time.

scholarly journals Complete laparoscopic pancreaticoduodenectomy: our experience of the first case

2019 ◽  
Vol 22 (1) ◽  
pp. 26-30
Author(s):  
Mukund Raj Joshi ◽  
Sujan Regmee ◽  
Tanka Prasad Bohara ◽  
Rupesh Chakradhar ◽  
Mandesh Shrestha
Keyword(s):  
Blood Loss ◽  
Point Of View ◽  
Resected Specimen ◽  
Laparoscopic Pancreaticoduodenectomy ◽  
Technical Aspects ◽  
Technical Point ◽  
Operative Outcomes ◽  
Post Operative Period ◽  
First Case

Laparoscopic pancreaticoduodenectomy was described in 1994. It is considered the most challenging abdominal surgery. Although the procedure was found to be feasible in initial reports, the benefits were not considered favorable. In recent days, with the increasing experience of surgeons, acceptable outcomes are being observed and have been found to be technically beneficial and oncologically safe in selective cases in experienced hands. We performed the procedure in a 42-year-old gentleman with good operative and post-operative outcomes. The patient’s follow-up for six post-operative months seems satisfactory. The operation took 840 minutes with minimal blood loss. The resected specimen was adequate and satisfactory from an oncological and technical point of view. The patient developed some inherent complications of the procedure in the post-operative period. He recovered well. Details of the case and technical aspects are being discussed.  

scholarly journals Bilothorax: A Bitter Complication of Liver Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-2 ◽  
Author(s):  
L. A. C. Hamers ◽  
K. Bosscha ◽  
M. H. van Leuken ◽  
M. A. M. Moviat ◽  
C. P. C. de Jager
Keyword(s):  
Liver Surgery ◽  
Rare Condition ◽  
Biliary System ◽  
Hepatic Surgery ◽  
Abdominal Drainage

Bilothorax is a rare condition, mostly associated with surgery involving the biliary system or trauma. In this article a case of bilothorax secondary to liver surgery is reported, which recovered by pleural and abdominal drainage. Bilothorax should be considered as a cause of respiratory detoriation in patients with recent biliary or hepatic surgery.

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