• The Journal of Korean Medicine
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• v.36 no.1
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• pp.22-32
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• 2015

Objectives: This study researched the effect of Gamisoyo-san intravenous pharmacopuncture on restoration of liver function after partial hepatectomy in SD rat. Methods: Twelve rats were randomly divided into three groups: control group (n=4) underwent partial hepatectomy, saline group (n=4) was injected $1m{\ell}$ saline after partial hepatectomy, Gamisoyo-san group (n=4) was injected with 10mg/kg Gamisoyo-san after partial hepatectomy. Liver function and liver regeneration ratio were measured on the seventh day after partial hepatectomy. Results: The results show that the AST, AST and ALT level in Gamisoyo-san group was significantly lower than those of control group and saline group(P<0.05) Conclusion: In partial hepatectomy model, Gamisoyo-san intravenous pharmacopuncture seems to significantly promote the restoration of liver function.

• Journal of the Korean Society of Food Science and Nutrition
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• v.24 no.3
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• pp.415-419
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• 1995

Ornithine decarboxylase(ODC) catalyzes the first and key step in the polyamine biosynthetic pathway. Ornithine decarboxylase is known to the enzyme that increase substantially its activity in regenerating liver. We found that activity and mRNA level for ODC increase significantly after partial hepatectomy in the rat. After laparotomy, there was significant decrease in activity ; however, mRNA content was unaltered in contrast to previous reports of no change in ornithine decarboxylase and thymidine kinase after sham hepatectomy. This may be mediated by the decrease in food intake after hepatectomy. Therefore it is necessary to examine the effect of food intake after hepatectomy on the ODC activity and mRNA level in the future.

• Biomedical Science Letters
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• v.11 no.1
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• pp.45-49
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• 2005

The change of catechol-O-methyltransferase (COMT) activity during regeneration of rat liver was studied. Cytosolic, mitochondrial and microsomal COMTs activities were estimated in regenerating rat livers over a period of ten days after $70\%$ (median and left lateral lobes) partial hepatectomy. The values of Km and Vmax in the hepatic enzymes were also measured. The activities of cytosolic and microsomal COMTs in regenerating rat liver after partial hepatectomy were found to be significantly increased between the second and the third day. Whereas the mitochondrial COMT activity did not change. The Vmax values of the cytosolic and microsomal COMTs in the regenerating rat liver were significantly increased at the second day after partial hepatectomy, however, the Km values of the above hepatic enzymes did not vary in all the experimental groups. Therefore, the results suggest that the biosynthesis of COMT was increased during the regeneration of rat liver.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1649-1654
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• 2014

Background: Clinically significant portal hypertension (PHT) is considered as a contraindication for hepatectomy according to the guidelines of the European Association for Study of Liver and the American Association for Study of Liver Diseases. However, this issue remains controversial. Here we performed a metaanalysis to evaluate the impact of PHT on the results of hepatectomy for hepatocellular carcinoma (HCC). Methods: Cohort studies evaluating the impact of clinically significant PHT, defined as oesophageal varices and/or splenomegaly associated with thrombocytopenia, on the results of hepatectomy for HCC were identified using a predefined search strategy. Summary risk ratios (RRs) and 95% confidence intervals (95% CIs) for PHT and outcomes after hepatectomy for HCC were calculated. Results: Seven cohort studies which including 574 cases with PHT and 1,354 cases without PHT were considered eligible for inclusion. The meta-analysis showed that, in all patients, pooled RRs of post-operative liver failure, post-operative ascites, peri-operative blood transfusion, operative mortality, 3- and 5-year overall survival associated with PHT were 2.23 (95% CI: 1.48-3.34, P=0.0001), 1.77 (95% CI: 1.19-2.64, P=0.005), 1.23 (95% CI: 1.03-1.49, P=0.03), 2.58 (95% CI: 1.12-5.96, P=0.03), 0.82 (95% CI: 0.75-0.88, P<0.00001) and 0.76 (95% CI: 0.69-0.85, P<0.00001), respectively. In subgroup analysis, similar results were found in Child-Pugh class A patients. Conclusion: This meta-analysis suggests that presence of oesophageal varices and/or splenomegaly associated with thrombocytopenia is associated with higher rates of post-operative complications and poor long-term survival after hepatectomy for HCC.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.1
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• pp.70-75
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• 2023

Backgrounds/Aims: Locally advanced gallbladder cancer (GBC) is associated with survival limited to a few months. Extended resections (ER) are occasionally performed in this group and outcomes remain inconclusive. This study assessed outcomes after ER for locally advanced GBC. Methods: Patients who underwent ER for GBC between 2011 and 2020 were reviewed. ER was defined as a major hepatectomy alone (n = 9), a pancreaticoduodenectomy (PD) with or without minor hepatectomy (n = 3), a major hepatectomy with PD (HPD) (n = 3) or vascular resection and reconstruction (n = 4). We assessed 30-day morbidity, mortality, and 2-year overall survival (OS). Results: Among 19 patients, negative margins were achieved in 14 (73.6%). The 30-day mortality was 1/9 (11.1%) for a major hepatectomy, 0/3 (0%) for a minor HPD, 2/3 (66.7%) for a major HPD, and 1/4 (25.0%) for vascular resection. All short term survivors (< 6 months) (n=8) had preoperative jaundice and 6/8 (75.0%) underwent a major HPD or vascular resection. There were five (26.3%) long term survivors. The median OS in patients with and without preoperative jaundice was 4.1 months (0.7-11.1 months) and 13.7 months (12-30.4 months), respectively (p = 0.009) (2-year OS = 7% vs. 75%; p = 0.008). The median OS in patients who underwent a major hepatectomy alone or a minor HPD was 11.3 months (6.8-17.3 months) versus 1.4 months (0.3-4.1 months) (p = 0.02) in patients who underwent major HPD or vascular resection (2 year OS = 33% vs. not reached) (p = 0.010) respectively. Conclusions: In selected patients with GBC, when ER is limited to a major hepatectomy alone, or a minor HPD, acceptable survival can be achieved.

• Applied Microscopy
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• v.18 no.2
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• pp.205-217
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• 1988

An ultrastructural study of hepatocyte proliferation in the regenerating rat liver has been made by means of the partial hepatectomy. And electron microscopic histochemistry of hepatocyte in the regenerating rat liver is studied through alkaline phosphatase reaction. The results are as follows: 1. When the regeneration of rat liver is induced by the partial hepatectomy, the prominent ultrastructural characteristics of hepatocyte are changes of the distribution of chromatin in nucleus, increase of the number of mitochondria and decrease of the size of them, development of rough endoplasmic reticulum, and transient decrease of glycogen granules in cytoplasm. 2. Alkaline phosphatase reaction products are appeared in the nucleus or rough endoplasmic reticulum of hepatocyte during the initial regeneration of liver as 24, 48 and 72 hour groups after partial hepatectomy. And these positive reaction are mainly increased in cytoplasm and plasma membrane of hepatocytes during 1, 2 and 3 week groups after partial hepatectomy. As 4 weeks passed after partial hepatectomy, these positive reaction is located in the sinusoidal epithelial cells or erythrocytes. With above results, we concluded that alkaline phosphatase was synthesized in the rough endoplasmic reticulum bounded ribosomes of regenerating hepatocyte, was transported to the plasma membrane of them, and then was transported in blood by the way sinusoidel epithelial cells.

• Journal of Veterinary Clinics
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• v.18 no.2
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• pp.170-173
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• 2001

Primary hepatocellular carcinomas are rare in dogs. A 12-year-old 5.4 kg female Poodle was referred to the Veterinary Medical Teaching Hospital with abdominal distension and mild anorexia. In this case, an extensive soft tissue mass was clearly palpable in the upper abdomen and radiography revealed a spherical mass of soft tissue density in the abdomen but its origin was not clear. In following an exploratory laparotomy, a partial hepatectomy was performed. Surgical complications were minimal. The survival time was seven months before dyspnea lead to a sudden and rapid decline.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.483-486
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• 2012

Background: The hepatocellular carcinoma is very common in China. Our aim in this report was to investigate clinical and pathological factors based on the current decade data that could influence prognosis of HCC patients after hepatectomy. Methods: Between 2002 and 2009, all patients undergoing hepatectomy for HCC were followed up and reviewed retrospectively. Prognostic factors were studied by univariate and multivariate analysis, with Kaplan-Meier and Cox multivariate survival analyses. Results: Complete clinicopathologic and follow-up data were available for 114 patients. The estimated cumulative survival rates at 1, 3, and 5 yr were 84.6%, 60.2% and 51.8%, respectively. On univariate analysis, key prognostic factors were AFP level, GGT level, tumor size, number of tumors, portal vein invasion, liver cirrhosis status and TNM stage. In the multivariate analysis, tumor size, GGT level, liver cirrhosis status and portal vein invasion were significantly associated with patients' prognosis. Conclusion: Through follow-up of a relatively large cohort of Chinese patients, tumor size, GGT level, liver cirrhosis status, portal vein invasion were revealed as important factors for long-term survival after hepatectomy. Early diagnosis for tumor and the improvement of liver function before surgery are important ways to improve the prognosis.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5389-5393
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• 2014

Background: A clinical pathway (CP) can standardize and improve perioperative care for a number of interventions. In hepatic surgery, however, pertinent evidence is very limited. This study was conducted to implement a CP for hepatocellular carcinoma (HCC) patients undergoing hepatectomy, and to evaluate its effects on hospital costs, length of hospital stay (LOHS) and early clinical outcomes. Materials and Methods: Medical records for HCC patients undergoing hepatectomy were retrospectively reviewed before implementation of a CP (the non-CP group) from March 2012 to August 2012. This information was compared with the data collected prospectively from patients after implementation of the CP (the CP group) between September 2012 and April 2013. Hospital costs, LOHS and early clinical outcomes were evaluated and compared between groups. Results: There were no significant differences in terms of patient clinical characteristics between the two groups. For clinical outcome measures, no significant differences were found in postoperative complications, mortality and readmission rate. The hospital costs were significantly reduced from 24,844 RMB in the non-CP group to 19,761 RMB in the CP group (p<0.01). In addition, patients of the CP group also had shorter LOHS compared with the non-CP group (8.3 versus 12.3 days, p<0.001). Conclusions: The CP proved to be an effective approach to minimize hospital costs and LOHS with hepatectomy for HCC without compromising patient care.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.1
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• pp.95-101
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• 2023

Rapid adoption of a robotic approach as a minimally invasive surgery tool has enabled surgeons to perform more complex hepatobiliary surgeries than conventional laparoscopic surgery. Although various types of liver resections have been performed robotically, parenchymal transection is challenging as commonly used instruments (Cavitron Ultrasonic Surgical Aspirator [CUSA] and Harmonic) lack articulation. Further, CUSA also requires a patient-side assistant surgeon with hepatobiliary laparoscopic skills. We present a case report of total robotic right hepatectomy for multifocal hepatocellular carcinoma in a 70-year-old male using 'Vessel Sealer' for parenchymal transection. Total operative time was 520 minutes with a blood loss of ~400 mL. There was no technical difficulty or instrument failure encountered during surgery. The patient was discharged on postoperative day five without any significant complications such as bile leak. Thus, Vessel Sealer, a fully articulating instrument intended to seal vessels and tissues up to 7 mm, can be a promising tool for parenchymal transection in a robotic surgery.