• Title/Summary/Keyword: Hepatic vein complications

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The Application of Interventional Radiology in Living-Donor Liver Transplantation

  • Gi-Young Ko;Kyu-Bo Sung;Dong-Il Gwon
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1110-1123
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    • 2021
  • Owing to improvements in surgical techniques and medical care, living-donor liver transplantation has become an established treatment modality in patients with end-stage liver disease. However, various vascular or non-vascular complications may occur during or after transplantation. Herein, we review how interventional radiologic techniques can be used to treat these complications.

Microvascular Anastomosis of Hepatic Artery in Children Undergoing Liver Transplantation (소아 간이식에서 간동맥의 미세혈관 문합술)

  • Jin, Ung Sik;Chang, Hak;Minn, Kyung Won;Yi, Nam Joon;Suh, Kyung Suk
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.454-457
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    • 2006
  • Purpose: The anastomosis of hepatic artery to recipient vessel has a major role in a liver transplantation, so its occlusion is the most important cause of failure of liver transplantations. We made the study to reveal the peculiarities in pediatric liver transplantations compared with adult cases. Methods: From January 1999 to September 2005, we performed 99 cases of pediatric liver transplantation. The mean age at operation was 4.17 years of age. The hepatic vein and portal vein are anastomosed by the general surgeons and then the hepatic artery is anastomosed by the plastic surgeons. The Doppler ultrasonography and computed tomography were used for postoperative checkup for hepatic artery patency. Results: There were no immediate complications, but hepatic arterial occlusion was developed in 3 cases (2.8%). In pediatric patients, the anastomosis of hepatic artery is more difficult than adults because of the rapid respiratory and pulse rate, the small vascular diameter, and the large gap of diameter difference between the recipient and the donor vessels. Conclusion: We could confirm that pediatric liver transplantations are relatively safe but long learning curve was needed.

Imaging of Umbilical Venous Catheter-Related Hepatic Complications in Neonates (신생아의 제대 정맥 카테터와 관련된 간 합병증의 영상 소견)

  • Min Ju Kim;So-Young Yoo;Tae Yeon Jeon;Ji Hye Kim;Yu Jin Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.586-595
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    • 2023
  • An umbilical venous catheter (UVC) is commonly placed for central venous access in preterm or critically ill full-term neonates to provide total parenteral nutrition (TPN) and medication. However, UVCs can result in complications, including infection, portal vein thrombosis, and hepatic tissue injury. The inadvertent administration of hypertonic fluid through a malpositioned UVC can also cause hepatic parenchymal damage with mass-like fluid collection that simulates a tumorous condition during imaging. Ultrasonography and radiographic examinations play an essential role in detecting UVC-related complications. This pictorial essay aims to present the imaging findings of UVC-related hepatic complications in neonates.

Transcaval TIPS in Patients with Failed Revision of Occluded Previous TIPS

  • Chang Kyu Seong;Yong Joo Kim;Tae Beom Shin;Hyo Yong Park;Tae Hun Kim;Duk Sik Kang
    • Korean Journal of Radiology
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    • v.2 no.4
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    • pp.204-209
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    • 2001
  • Objective: To determine the feasibility of transcaval transjugular intrahepatic portosystemic shunt (TIPS) in patients with occluded previous TIPS. Materials and Methods: Between February 1996 and December 2000 we performed five transcaval TIPS procedures in four patients with recurrent gastric cardiac variceal bleeding. All four had occluded TIPS, which was between the hepatic and portal vein. The interval between initial TIPS placement and revisional procedures with transcaval TIPS varied between three and 31 months; one patient underwent transcaval TIPS twice, with a 31-month interval. After revision of the occluded shunt failed, direct cavoportal puncture at the retrohepatic segment of the IVC was attempted. Results: Transcaval TIPS placement was technically successful in all cases. In three, tractography revealed slight leakage of contrast materials into hepatic subcapsular or subdiaphragmatic pericaval space. There was no evidence of propagation of extravasated contrast materials through the retroperitoneal space or spillage into the peritoneal space. After the tract was dilated by a bare stent, no patient experienced trans-stent bleeding and no serious procedure-related complications occurred. After successful shunt creation, variceal bleeding ceased in all patients. Conclusion: Transcaval TIPS placement is an effective and safe alternative treatment in patients with occluded previous TIPS and no hepatic veins suitable for new TIPS.

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Effects of Fractions of Benincasa hispida on Antioxidative Status in Streptozotocin Induced Diabetic Rats (동과(Benincasa hispida) 분획물의 투여가 Streptozotocin 유발 당뇨 흰쥐의 항산화 효과에 미치는 영향)

  • Lim, Sook-Ja
    • Journal of Nutrition and Health
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    • v.40 no.4
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    • pp.295-302
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    • 2007
  • This study was designed to examine the effects of fractions of ethanol extract of Benincasa hispida (wax gourd) on hepatic antioxidative status in streptozotocin (STZ) induced diabetic rats. Sprague-Dawley rats were induced diabetes mellitus by STZ injection (45 mg/kg) into the tail vein and were divided into 5 groups: normal, STZ-control, three experimental diabetic groups. Fractions of ethanol extract of Benincasa hispida were administered orally into the diabetic rats for 14 days. Hepatic glutathione peroxidase (GSH-px) activity (determined with H$_2$O$_2$ as substrate) was increased in the groups supplemented with chloroform (CHCl$_3$) and butanol (BuOH) fractions. Glutathione peroxidase (GR) activity in the liver cytosol of H$_2$O fraction groups was significantly lower than that of STZ-control group. The H$_{2}$O fraction supplemented group has been shown the notably decrease in the hepatic superoxide dismutase (SOD) activity. The hepatic cytosol catalase (CAT) activity was significant decreased by the supplementation with BuOH fraction. It was found from the results that the supplementation of BuOH and H$_2$O fractions of Benincasa hispida extract could be beneficial for the diabetic complications and damages from the lipid peroxidation.

Liver abscess and septic complications associated with advanced gastric cancer (간농양에 의한 패혈성 합병증과 동반된 진행성 위암)

  • Youn, Gun Jung;Choi, Young;Kim, Min Jae;Lee, Jae Sin;Ko, Ui Won;Joo, Yeon Ho
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.38-41
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    • 2015
  • Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.

Surgical management of hilar cholangiocarcinoma: Controversies and recommendations

  • Suvendu Sekhar Jena;Naimish N Mehta;Samiran Nundy
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.227-240
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    • 2023
  • Hilar cholangiocarcinomas are highly aggressive malignancies. They are usually at an advanced stage at initial presentation. Surgical resection with negative margins is the standard of management. It provides the only chance of cure. Liver transplantation has increased the number of 'curative' procedures for cases previously considered to be unresectable. Meticulous and thorough preoperative planning is required to prevent fatal post-operative complications. Extended resection procedures, including hepatic trisectionectomy for Bismuth type IV tumors, hepatopancreaticoduodenectomy for tumors with extensive longitudinal spread, and combined vascular resection with reconstruction for tumors involving hepatic vascular structures, are challenging procedures with surgical indications expanded. Liver transplantation after the standardization of a neoadjuvant protocol described by the Mayo Clinic has increased the number of patients who can undergo operation.

Successful Treatment of a Traumatic Hepatic Arterioportal Fistula: A Case Report (간열상에 발생한 외상성 간동맥문맥 단락의 치료 1예)

  • Mun, Yun Su;Kwon, Oh Sang;Lee, Jang Young;Park, Gyeong Nam;Han, Hyun Young;Lee, Min Koo
    • Journal of Trauma and Injury
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    • v.26 no.1
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    • pp.22-25
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    • 2013
  • Severe blunt abdominal trauma frequently involves the liver. The development of nonsurgical treatment of liver trauma has led to more frequent appearance of unusual complications. A hepatic arterioportal fistula (APF) is a rare complication of liver trauma. We present a case of traumatic APF in a patient with liver trauma. A 31-year-old male visited our emergency department with pain in the right upper abdomen following a traffic accident. Initial physical exam and abdominal computed tomography (CT) revealed liver laceration with hemoperitoneum. An abdominal CT obtained on day 11 revealed early opacification of the right portal vein on the arterial phase. After we had come to suspect an APF of the liver, its presence was confirmed on angiography. It was subsequently managed by using transcatheter coil embolization. In patients with portal hypertension and no evidence or history of cirrhosis, one should consider an APF as a potential etiology if history of liver biopsy or penetrating trauma exists. In a patient with liver trauma, serial abdominal CT is important for early detection and treatment of an APF.

Long-term outcomes after stent insertion in patients with early and late hepatic vein outflow obstruction after living donor liver transplantation

  • Kim, Kyeong Sik;Lee, Ji Soo;Choi, Gyu Sung;Kwon, Choon Hyuck David;Cho, Jae-Won;Lee, Suk-Koo;Park, Kwang Bo;Cho, Sung Ki;Shin, Sung Wook;Kim, Jong Man
    • Annals of Surgical Treatment and Research
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    • v.95 no.6
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    • pp.333-339
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    • 2018
  • Purpose: The purpose of this study was to describe the long-term effects of stenting in patients with hepatic venous outflow obstruction (HVOO), who underwent living donor liver transplantation (LDLT). Methods: Between January 2000 and December 2009, 622 adult patients underwent LDLT at our hospital, and of these patients, 21 (3.3%) were diagnosed with HVOO; among these patients, 17 underwent stenting. The patients were divided into early or late groups according to the time of their HVOO diagnoses (cutoff: 60 days after liver transplantation). Results: The median follow-up period was 54.2 months (range, 0.5-192.4 months). Stent insertion was successful in 8 of 10 patients in the early group and 6 of 7 in the late group. The 5-year primary patency rates were 46% and 20%, respectively. In both groups, patients with recurrent HVOO at the beginning showed kinking confirmed by venography. Patients who carried their stents for more than 3 years maintained long-term patency. There was no significant difference in spleen size between groups; however, when the groups were compared according to whether they maintained patency, spleens tended to be smaller in the patency-maintained group. Conclusion: Unlike stenosis, if kinking is confirmed on venography, stenting is not feasible in the long term for patients with LDLT.

Fine needle aspiration biopsy for the diagnosis of fatty liver in cattle (Fine needle aspiration biopsy에 의한 소의 지방간진단(脂肪肝診斷))

  • Hwang, Bum-tae;Han, Hong-ryul
    • Korean Journal of Veterinary Research
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    • v.31 no.1
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    • pp.109-121
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    • 1991
  • This study was carried out to investigate the morbidity of fatty liver in cattle at the abattoir and on the farm, and to cytodiagnose fatty liver in cattle by fine needle aspiration biopsy. Incidence rates of fatty liver in cattle, detected macroscopically or based on hepatic lipid content by buoyancy, were 0.30% in Korean native cows, 4.70% in dairy cows, and 0.15% in dairy bull. Fatty liver was enlarged, swollen with round edges, light weight, and pale to yellow-orange color, but its color was not always correlated to the severity of fatty liver. The findings of fat infiltration of the hepatic lobule were large droplets around central vein, fine droplets in the periphery, and fat infiltration in the perivascular region execpt for most of normal liver and severe fatty liver. The sensitivty, specificity, and accuracy of cytological finding compared with hepatic lipid content by buoyancy were 94.4%, 95.2%, and 94.9% in normal cases, 64.3%, 100%, and 87.2% in mild cases, 100%, 83.3%, and 87.2% in moderate cases, and 100%, 100%, and 100% in sesvere cases, respectively. Cytological findings were well correlated with histological findings. Complications of fine needle aspiration biopsy were not recognized clinically. Consequently, the cytodiagnosis by fine needle aspiration biopsy is simple, rapid, safe, and economical method compared with histological techniques in the diagnosis of fatty liver in cattle.

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