HPB : the official journal of the International Hepato Pancreato Biliary Association
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Comparative Study
Is there any difference between right hepatectomy and left lateral sectionectomy for living donors? as much you cut, as much you hurt?
The worldwide rising demand for cadaveric donors in liver transplantation is an important incentive for the development of alternative transplantation options, such as living donors. A precise evaluation of surgical complications is, therefore, considered to be an important issue in this setting. ⋯ Hepatectomy for living donor liver transplantation (LDLT) was a safe procedure, regardless of the type of liver resection undertaken. We found no difference in morbidity between RH and LLS, which suggests that complications may occur despite the amount of liver retrieved.
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Multicenter Study
Surgical management of acute pancreatitis in Italy: lessons from a prospective multicentre study.
This study aimed to evaluate the surgical treatment of acute pancreatitis in Italy and to assess compliance with international guidelines. ⋯ The results indicate poor compliance with published guidelines. In severe pancreatitis, early surgical intervention is frequently performed and enteral feeding is seldom used. Only a small number of patients with mild biliary pancreatitis undergo definitive treatment (i.e. cholecystectomy) within 4 weeks of the onset of pancreatitis.
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Gd-EOB-DTPA (gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid) is a gadolinium-based hepatocyte-specific contrast agent for magnetic resonance imaging (MRI). The aim of this study was to determine whether the hepatic uptake and excretion of Gd-EOB-DTPA differ between patients with primary biliary cirrhosis (PBC) and healthy controls, and whether differences could be quantified. ⋯ Dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) has a potential role as an imaging-based liver function test. The high spatial resolution of MRI enables hepatic function to be assessed on segmental and sub-segmental levels.
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Comparative Study
Peri-operative blood transfusion and operative time are quality indicators for pancreatoduodenectomy.
Minimization of blood loss during pancreatoduodenectomy requires careful surgical technique and specific preventative measures. Therefore, red blood cell (RBC) transfusions and operative time are potential surgical quality indicators. The aim of the present study was to compare peri-operative RBC transfusion and operative time with 30-day morbidity/mortality after pancreatoduodenectomy. ⋯ Peri-operative RBC transfusion after pancreatoduodenectomy is linearly associated with 30-day morbidity. Longer operative time also correlates with increased morbidity and mortality. Therefore, blood transfusions and prolonged operative time should be considered quality indicators for pancreatoduodenectomy.
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Ischaemic preconditioning (IPC) of the right liver graft in the donor has not been studied in adult-to-adult living related liver transplantation (LRLT). ⋯ Graft IPC in the living related donor is not associated with any benefit for the recipient or the donor and its clinical value remains uncertain.