The British journal of surgery
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Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a two-stage strategy that may increase hepatic tumour resectability and reduce postoperative liver failure rate by inducing rapid hypertrophy of the future liver remnant (FLR). Pathophysiological mechanisms after the first stage of ALPPS are poorly understood. ⋯ Molecular and functional imaging are promising non-invasive methods to investigate the pathophysiological mechanisms of ALPPS with potential for clinical application.
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Heterogeneity of outcomes is a problem for assessing intervention effectiveness when considering treatments for uncomplicated symptomatic gallstone disease. The value to all stakeholders of outcomes that have been measured and reported to date is also unclear. The aim of this study was to develop a core outcome set for symptomatic uncomplicated gallstone disease. ⋯ A core outcome set for symptomatic uncomplicated gallstone disease has been developed with patients and healthcare professionals. Eleven outcomes across four key domains have been identified. These represent the minimum set of outcomes that should be reported in trials evaluating interventions for gallstone disease.
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This study estimated the cost-effectiveness of liver transplantation in patients with colorectal liver metastases confined to the liver with progressive disease, compared with alternative treatment options: TAS-102, regorafenib, or best supportive care. Using a mathematical simulation model, people’s life expectancy and healthcare costs over 25 years were estimated. Transplanted patients lived for 4.28 years, more than 3 years longer than those who received alternative treatment options. Despite this, the high cost of liver transplantation meant that this treatment was cost-effective only at high willingness-to-pay thresholds.