• 제목/요약/키워드: Hepatobiliary

검색결과 312건 처리시간 0.025초

Total robotic right hepatectomy for multifocal hepatocellular carcinoma using vessel sealer

  • Peeyush Varshney;Vaibhav Kumar Varshney
    • 한국간담췌외과학회지
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    • 제27권1호
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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.

Port-site metastasis after laparoscopic radical pancreatosplenectomy in left-sided pancreatic cancer

  • Su Hyeong Park;Zhanay Zhassanov;Chang Moo Kang
    • 한국간담췌외과학회지
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    • 제28권1호
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    • pp.104-108
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    • 2024
  • Despite debates regarding the safety of well-selected left-sided pancreatic cancer, minimally invasive distal pancreatosplenectomy is considered safer and more effective than open distal pancreatosplenectomy in well-selected patients. Previous studies have shown that minimally invasive surgery yields comparable oncologic outcomes to open surgery. While patients who undergo minimally invasive distal pancreatosplenectomy also experience recurrences and metastases after surgery, port-site metastasis is particularly rare. In this report, we report an extremely rare case of port-site metastasis following minimally invasive distal pancreatosplenectomy for left-sided pancreatic cancer.

Up-regulation of NICE-3 as a Novel EDC Gene Could Contribute to Human Hepatocellular Carcinoma

  • Wei, Yuan-Jiang;Hu, Qin-Qin;Gu, Cheng-Yu;Wang, Yu-Ping;Han, Ze-Guang;Cai, Bing
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4363-4368
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    • 2012
  • The epidermal differentiation complex (EDC) contains a large number of gene products which are crucial for the maturation of the human epidermis and can contribute to skin diseases, even carcinogenesis. It is generally accepted that activation of oncogenes and/or inactivation of tumor suppressor genes play pivotal roles in the process of carcinogenesis. Here, NICE-3, a novel EDC gene, was found to be up-regulated in human hepatocellular carcinoma (HCC) by quantitative real-time RT-PCR. Furthermore, overexpression of exogenous NICE-3 by recombinant plasmids could significantly promote cell proliferation, colony formation and soft agar colony formation in Focus and WRL-68 HCC cell lines. Reversely, NICE-3 silencing by RNA interference could markedly inhibit these malignant phenotypes in YY-8103 and MHCC-97H cells. Moreover, cell cycle analysis of MHCC-97H transfected with siRNA by flow cytometry showed that NICE-3 knockdown may inhibit cell growth via arrest in G0/G1 phase and hindering entry of cells into S phase. All data of our findings indicate that NICE-3 may contribute to human hepatocellular carcinoma by promoting cell proliferation.

Risk of Treatment-related Mortality with Sorafenib in Patients with Cancer

  • Zhang, Xin-Ji;Zhang, Tian-Yi;Yu, Fei-Fei;Wei, Xin;Li, Ye-Sheng;Xu, Feng;Wei, Li-Xin;He, Jia
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6681-6686
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    • 2013
  • Background: Fatal adverse events (FAEs) have been reported with sorafenib, a vascular endothelial growth factor receptor kinase inhibitor (VEGFR TKI). We here performed an up-to-date and detailed meta-analysis to determine the overall risk of FAEs associated with sorafenib. Methods: Databases, including PubMed, Embase and Web of Science, and abstracts presented at the American Society of Clinical Oncology annual meetings were searched to identify relevant studies. Eligible studies included randomized controlled trials evaluating sorafenib effects in patients with all malignancies. Summary incidence rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated for FAEs. In addition, subgroup analyses were performed according to tumor type and therapy regimen. Results: 13 trials recruiting 5,546 patients were included in our analysis. The overall incidence of FAEs with sorafenib was 1.99% (95%CI, 0.98-4.02%). Patients treated with sorafenib had a significantly increased risk of FAEs compared with patients treated with control medication, with an RR of 1.77 (95%CI 1.25-2.52, P=0.001). Risk varied with tumour type, but appeared independent of therapy regimen. A significantly increased risk of FAEs was observed in patients with lung cancer (RR 2.26; 95% CI 1.03-4.99; P= 0.043) and renal cancer (RR 1.84; 95% CI 1.15-2.94; P= 0.011). The most common causes of FAEs were hemorrhage (8.6%) and thrombus or embolism (4.9%). Conclusions: It is important for health care practitioners to be aware of the risks of FAEs associated with sorafenib, especially in patients with renal and lung cancer.

Effects of Secondary Left-sided Portal Hypertension on the Radical Operation Rate and Prognosis in Patients with Pancreatic Cancer

  • Zhang, Shuo;Wen, Dong-Qing;Kong, Ya-Lin;Li, Ya-Li;Zhang, Hong-Yi
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권5호
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    • pp.2239-2244
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    • 2014
  • Objective: To investigate the effects of secondary left-sided portal hypertension (LSPH) on the radical operation rate of patients with pancreatic cancer and systemically evaluate the prognosis of patients with LSPH secondary to pancreatic cancer after radical surgery. Materials and Methods: The data of patients with pancreatic cancer who underwent laparotomy over a 15-year period in Department of Hepatobiliary Surgery of Chinese PLA Air Force General Hospital from Jan. 1, 1997, to Jun. 30, 2012 was retrospectively reviewed. Results: A total of 362 patients with pancreatic cancer after laparotomy were selected, including 73 with LSPH and 289 without LSPH. Thirty-five patients with LSPH (47.9%) and 147 without non-LSPH (50.9%) respectively underwent radical operations. No significant difference was found between these two groups regarding the total resection rate and stratified radical resection rate according to different pathological types and cancer locations. The mean and median survival time of patients after radical operation in LSPH group were $13.9{\pm}1.3$ months and 14.8 months, respectively, while those in non-LSPH group were $22.6{\pm}1.4$ months and 18.4 months, respectively(P<0.05). Conclusions: Radical operations for pancreatic cancer and secondary LSPH are safe and effective. Because high-grade malignancy and poor prognosis are closely associated, the decision for radical surgery should be made more meticulously for the patients with pancreatic cancer.

DEP Domain Containing 1 is a Novel Diagnostic Marker and Prognostic Predictor for Hepatocellular Carcinoma

  • Yuan, Sheng-Guang;Liao, Wei-Jia;Yang, Jian-Jun;Huang, Guo-Jin;Huang, Zhao-Quan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10917-10922
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    • 2015
  • Background: This study was conducted to determine DEPDC1 expression in hepatocelluar carcinomas (HCCs) and to reveal its potential role in diagnosis and prognosis of affected patients. Materials and Methods: DEPDC1 expression at the mRNA level was detected by quantitative real-time PCR (qRT-PCR) in 205 cases of HCC and paired adjacent normal liver tissues, and by semi-quantitative RT-PCR in 20 cases. Survival curves were obtained by using Kaplan-Meier method and Log-rank test. Independent predictors associated with regard to disease free survival (DFS) and overall survival (OS) were identified using the Cox proportional hazard model. Results: High DEPDC1 mRNA levels were detected in 144 out of 205 cases (70.24%) of HCC, significantly associated with clinicopathological parameters, including tumor size (${\geq}4cm$), alpha-fetoprotein (${\geq}100ng/ml$), B-C of BCLC stage and recurrence. Kaplan-Meier survival analysis revealed that HCC patients with high DEPDC1 expression had poor OS and DFS. Multivariate analysis demonstrated that high DEPDC1 expression was an independent predictor for OS (HR=1.651; 95% 95%CI, 1.041-2.617; p=0.033) and DFS (HR=1.583; 95%CI, 1.01-2.483; p=0.045). Conclusions: Our results indicate DEPDC1 might be a novel diagnostic marker and an independent prognostic predictor for HCC patients.