Journal of hepato-biliary-pancreatic sciences
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J Hepatobiliary Pancreat Sci · Aug 2014
Tips for anatomical hepatectomy for hepatocellular carcinoma by the Glissonean pedicle approach (with videos).
Couinaud described three fundamental approaches at the hepatic hilus in liver surgery. The Glissonean pedicle approach at the hepatic hilus is one of these procedures and provides anatomical hepatectomy for hepatocellular carcinoma (HCC). The Glissonean pedicle approach was introduced by Couinaud and Takasaki in the early 1980s. ⋯ This procedure allows an approach to the tertiary branches, which feed a smaller anatomical area than Couinaud's segment. We refer to this area as a cone unit of the liver. The procedure is also available in laparoscopic hepatectomy and provides new knowledge of the surgical anatomy, especially for small anatomical liver resection in the cirrhotic liver.
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J Hepatobiliary Pancreat Sci · Aug 2014
Efficacy of occlusion of hepatic artery and risk of carbon dioxide gas embolism during laparoscopic hepatectomy in a pig model.
The important point in safely performing laparoscopic hepatectomy (LH) is to control bleeding. The aims of this study were: (i) to assess the bleeding reduction effect by occlusion of the hepatic artery in LH; and (ii) to evaluate the risk of carbon dioxide (CO2 ) gas embolism (GE) in the case of high pneumoperitoneum (PP). ⋯ The occlusion of the hepatic artery in LH reduces blood loss. The control of bleeding from the hepatic vein is feasible with a high PP, but there is a possibility of GE.
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J Hepatobiliary Pancreat Sci · Jul 2014
Pancreaticogastrostomy following distal pancreatectomy prevents pancreatic fistula-related complications.
The most common postoperative complication after distal pancreatectomy (DP) is still postoperative pancreatic fistula (POPF), which is closely associated with other major complications and remains an unsolved problem. ⋯ Pancreaticogastrostomy as an additional procedure following distal pancreatectomy was associated with a reduced rate of POPF-related complications that resulted in relatively lower medical cost for hospitalization.
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J Hepatobiliary Pancreat Sci · Jun 2014
Analysis of risk factors for recurrence after curative resection of well-differentiated pancreatic neuroendocrine tumors based on the new grading classification.
It is difficult to predict the malignant potential of pancreatic neuroendocrine tumors (PNETs) precisely. This study investigated the validity of a new grading system adopted by the World Health Organization 2010 classification to determine risk factors for recurrence of PNETs. ⋯ This study confirmed the prognostic relevance of the new grading classification and that evaluation of perineural invasion and histological grade should be considered as prognostic predictors in well-differentiated PNETs (NET G1 and G2).
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J Hepatobiliary Pancreat Sci · Feb 2014
Multivariate logistic regression analysis for prediction of clinically relevant pancreatic fistula in the early phase after pancreaticoduodenectomy.
Postoperative pancreatic fistula (PF) remains a major complication after pancreaticoduodenectomy (PD). We aimed to investigate the predictors of clinically relevant PF after PD. ⋯ White blood cell count, CRP and d-amylase on POD4 were predictive factors for clinically relevant PF after PD. These findings indicate that our formula is useful for management of drain after PD.