Library

feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    ISSN: 1432-0509
    Keywords: Liver, neoplasm ; Hepatocellular carcinoma, CT, MR, US
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The capabilities of computed tomography (CT), ultrasonography (US), and magnetic resonance (MR) imaging were studied in order to determine the role of each of these noninvasive examinations for estimating the T-factor of hepatocellular carcinomas (HCCs). Fifty-one patients with surgically proven HCCs received CT (50 patients), US (46 patients), and MR (44 patients). The images of CT, US, and MR were prospectively evaluated for main tumor size, intrahepatic metastases, and vascular invasion, which compose the T-factor of HCC, and compared to pathological results. The sizes of the main tumor were estimated correctly by all examinations. For estimating intrahepatic metastases, US (74%) and MR (73%) were superior to CT (65%). For estimating portal invasion, CT (79%) was superior to US (70%) and MR (66%), because CT could demonstrate the segmental staining caused by portal invasion. The estimates of hepatic venous invasion were difficult during any of the examinations. We conclude that presurgical evaluations of the T-factor require the use of US and CT or MR and CT.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 1436-2813
    Keywords: major hepatectomy ; multiple regression analysis ; portal pressure ; aging ; liver cirrhosis ; chronic hepatitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The regenerative capacity of the liver was assessed using a volumetric method on computed tomography in 21 adults: 16 underwent a standard right hepatic lobectomy for hepatocellular carcinoma, there were hepatic metastases in 3 others, and 2 suffered from other diseases. The patients' ages ranged from 33 to 68 years with a mean age of 57.0 years. The regeneration rate was expressed as the rate of the volume increase of the remnant left lobe compared with the preoperative volume of the left lobe. A univariate regression analysis showed that the portal pressure had a highly inverse correlation with the regeneration rate of the liver (r = −0.4753,P = 0.0397), while a multiple regression analysis demonstrated the correlation between the portal pressure, age, and the regeneration rate (multipler = 0.5640). The regeneration rate of the normal liver (97.6 ± 53.5%) was significantly higher than that of the chronic hepatitic (43.0 ± 40.7%), and also tended to be higher than that of the cirrhotic liver (51.5 ± 13.2%). However, there were no differences between chronic hepatitic and cirrhotic livers. The portal pressure before hepatectomy of the normal liver (149 ± 19 mmH2O) was significantly lower than those of chronic hepatitic (188 ± 38 mmH2O) and cirrhotic (245 ±78 mmH2O) livers. We thus conclude that the regenerative capacity of the liver following a right hepatic lobectomy could be estimated on the basis of both portal pressure and age. The regenerative capacity was also influenced by underlying liver diseases.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Vingt-deux patients cirrhotiques ayant un carcinome hépatocellulaire associé à des varices esophagiennes ont eu une résection hépatique aggressive associée à une dévascularisation et/ou à une sclérothérapie endoscopique périopératoire (groupe A). Les résultats ont été comparés à ceux de 37 patients cirrhotiques sans varices oesophagiennes qui ont eu une résection hépatique pour un carcinome 〈 2 cm pendant la même période (groupe B). Ont été étudiés les données cliniques, paracliniques préopératoires, l'aspect anatomopathologique, la survie globale et la survie sans maladie. La durée de l'opération, la quantité de sang perdu et le poids du foie réséqué ne différaient pas, alors que la taille de la tumeur dans le groupe A (2.7±1.6 cm, moyenne±ET) était significativement plus importante que dans le groupe B (1.5±0.3 cm). La fonction hépatique préopératoire était plus perturbée dans le groupe A par rapport au groupe B exception faite pour le temps de prothrombine. En dépit de ces inconvénients, les taux de survie sans maladie à 1, 3 et 5 ans des groupes A étaient respectivement de 72% et 94%, 48% et 54%, et 38% et 45% par rapport au groupe B, repsectivement. Les taux de survie globale étaient respectivement de 91% et 97%, 79% et 79% et 54% et 67%, sans différence significative, dans les groups A et B. Aucun malade dans le groupe A n'a saigné après traitement. Sur ces données, la résection hépatique aggressive associée à une dévasculatisation simultanée ou une sclérothérapie endoscopique périopératoire est le traitement de choix pour un carcinome hépatocellulaire associé à des varices oesophagiennes.
    Abstract: Resumen Veintidós pacientes con carcinoma hepatocelular (CHC) y várices esofágicas concomitantes fueron sometidos a resección hepática acompañada de devascularización y/o escleroterapia endoscópica perioperatoria (grupo A). Con el propósito de evaluar esta modalidad de tratamiento, se estudiaron también 37 pacientes cirróticos sin varices esofágicas que fueron sometidos a resección hepática por CHC pequeño, de 2 cm o menos, en la misma época (grupo B), comparando datos preoperatorios, hallazgos anatomopatológicos, tasas de evolución libre de enfermedad y tasas de sobrevida. El tiempo operatorio, la magnitud de la pérdida de sangre y el peso del hígado resecado no mostraron diferencias entre los dos grupos; sin embargo, el tamaño del tumor en el grupo A (2.7±1.6 cm) fue significativamente mayor que en el grupo B (1.5±0.3 cm). La alteración de la función hepática en el grupo A apareció más pronunciada que en el grupo B, excepto por el tiempo de protrombina. A pesar de estas ventajas, las tasas de evolución a uno, tres y cinco años en los dos grupos fueron 91% vs 97%, 79% vs 79% y 54% vs 67% (grupo A vs grupo B) respectivamente, cifras que no representan diferencia significativa. Además, no se encontró sangrado varicoso en el grupo A después del tratamiento. Con base en taies hallazgos, se plantea que el tratamiento de elección en los pacientes con CHC y várices esofágicas concomitantes es la resección agresiva combinada con devascularización simultánea y/o escleroterapia endoscópica perioperatoria.
    Notes: Abstract Twenty-two cirrhotic patients with hepatocellular carcinoma (HCC) and concomitant esophageal varices underwent aggressive hepatic resection accompanied by simultaneous devascularization, perioperative endoscopic injection sclerotherapy, or both (group A). To evaluate this treatment, 37 cirrhotic patients without esophageal varices who underwent hepatic resection for small HCC (2 cm or less) during the same period (group B) were studied to compare clinical data, preoperative laboratory data, pathologic findings, disease-free rates, and survival rates. The operative time, blood loss, and resected liver weight did not differ between the two groups; however, the tumor size of group A (2.7±1.6 cm, mean±SD) was significantly larger than that of group B (1.5±0.3 cm). The preoperative liver function of group A was also more severe than that of group B except for prothrombin time. Despite these disadvantages, the 1-, 3-, and 5-year disease-free rates of the two groups were 72% versus 94%, 48% versus 54%, and 38% versus 45%, respectively, and the 1-, 3-, and 5-year survival rates were 91% versus 97%, 79% versus 79%, and 54% versus 67% (group A versus group B), respectively, which showed no significant differences. Furthermore, there was no variceal bleeding in group A after treatment. Based on the above findings, for treatment of HCC and concomitant esophageal varices, aggressive hepatic resection accompanied by simultaneous devascularization, perioperative endoscopic injection sclerotherapy, or both is the preferred form of treatment.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les auteurs ont étudié les suites opératoires de 50 malades qui avaient subi une résection hépatique en comparant les taux de rétention de l'indocyanine green (ICG) mesurés lors du 3ème jour post-opératoire par rapport à ceux appréciés immédiatement après l'opération. Ce rapport étant l'expression de l'index ICG du parenchyme restant. Le groupe A de 22 malades avec un index restant de moins de 1.0, (qui signifie le taux de rétention de ICG à 15 mm lors du 3ème jour post-opératoire) a montré une amélioration par comparaison aux faits qui ont succédé immédiatement à l'intervention. Un groupe B de 28 malades chez qui l'index au 3ème jour était supérieur à 1.0, indiquant par conséquent une élévation du taux de clarance de l'ICG après résection hépatique, a été individualisé. De sérieuses complications comprenant infection abdominale et hyperbilirubinémie se sont manifestées en post-opératoire respectivement chez 2 (9.1%) du groupe A et 16 (57.1%) du groupe B (p〈0.001). Un malade (4.5%) du groupe A décéda cependant que 9 malades (32.1%) du groupe B moururent pendant l'hospitalisation (p〈0.02). Il ne fut pas constaté de différence significative en ce qui concerne la fonction hépatique préopératoire et les paramètres cliniques. Ces observations suggèrent que l'amélioration du taux de la clairance de l'ICG au 3ème jour post-opératoire par comparaison au taux déterminé immédiatement après l'intervention permet de préjuger des suites post-opératoire après résection hépatique.
    Abstract: Resumen Hemos valorado la evolución postoperatoria de 50 pacientes sometidos a resección hepática, utilizando la relación entre las tasas de retención del verde de indocianina (VIC) medidas en el tercer día postoperatorio y los valores estimados inmediatamente después de la operación. Esta relación fue expresada en forma del indice VIC de remanente hepático. El grupo A incluyó 22 pacientes con un indice de menos de 1.0, lo cual significa que la tasa de retención VIC a los 15 minutos en el tercer día postoperatorio mostró mejoría en comparación con los hallazgos inmediatamente al término de la operación. En el grupo B hubo 28 pacientes cuyos indices en el tercer día postoperatorio fue superior a 1.0, lo cual indica exacerbación de la tasa de depuración de VIC después de la resección hepática. Se presentaron complicaciones postoperatorias graves, incluso sepsis intraabdominal e hiperbilirrubinemia en 2 (9.1%) en el grupo A y 16 (57.1%) en el grupo B (p〈0.001). Murió un paciente (4.5%) en el grupo A contra 9 pacientes (32.1%) que murieron en el grupo B en el curso de la hospitalización (p〈 0.02). No se observaron diferencias significativas en cuanto a las pruebas preoperatorias de función hepática o los parámetros clínicos. Estas observaciones sugieren que la mejoría en la tasa de depuración de VIC en el tercer día postoperatorio, comparada con aquella inmediatamente al término de la operación, es un paramétro de utilidad en la predicción del curso postoperatorio de pacientes hepatectomizados.
    Notes: Abstract We evaluated the postoperative course of 50 patients who underwent hepatic resection, using the ratio of indocyanine green (ICG) retention rates measured on the third postoperative day to values estimated immediately after the operation. This ratio was expressed as the remnant liver ICG index. Group A included 22 patients with a remnamt liver ICG index of less than 1.0, which meant that the ICG retention rate at 15 minutes on the third postoperative day showed improvement, compared to events immediately after the operation. In group B, there were 28 patients whose index on the third postoperative day was over 1.0, thereby indicating exacerbation of the ICG clearance rate after hepatic resection. Serious complications including intraabdominal sepsis and hyperbilirubinemia occurred postoperatively in 2 (9.1%) in group A and 16 (57.1%) in group B (p〈0.001). One patient (4.5%) in group A died, while 9 patients (32.1%) in group B died during hospitalization (p〈 0.02). There were no significant differences with regard to preoperative liver function and clinical parameters. These observations suggest that improvement in the ICG clearance rate on the third postoperative day, compared to that immediately after the operation, is useful to predict the postoperative course of hepatectomized patients.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le traitement du cancer du foie associé à des varices oesophagiennes fut pratiqué chez 8 cirrhotiques qui présentaient une hypertension portale. Chez 5 malades, admis pour le traitement chirurgical de varices oesophagiennes, un cancer limité du foie fut décelé au moment de l'exploration opératoire. Chez 3 malades le diagnostic d'hépatome avait été porté avant l'intervention. L'exérèse de la tumeur du foie suivie d'une anastomose porto-cave fut pratiquée avec succès chez 6 malades. Le traitement simultané des varices oesophagiennes et du cancer du foie est possible quand la tumeur hépatique est découverte à un stade précoce. Le procédé le plus fiable pour aboutir à un diagnostic exact est représenté par l'artériographie hépatique. Notre propre expérience nous incite donc à recommander l'étude artériographique chez les cirrhotiques, particulièrement quand on envisage de traiter chirurgicalement les varices oesophagiennes.
    Notes: Abstract Surgical treatment of liver cancer associated with esophageal varices was carried out in 8 cirrhotic patients with evidence of portal hypertension. In 5 patients admitted for elective surgery of esophageal varices, minute hepatomas were detected during the course of preoperative investigation. The remaining 3 patients were referred to our department when esophageal varices plus hepatoma had become evident. Extirpative treatment of the liver tumor followed by selective shunt operations were successfully carried out in 6 patients, and interrupted procedures were used in 2 patients. Treatment of both esophageal varices and liver cancer appears to be effective when the tumor in the liver is detected in an early stage. The most reliable diagnostic tool at the present time seems to be hepatic arteriography. Our experience strongly suggests that arteriographic studies should be seriously considered in cirrhotic patients, particularly when surgery for varices is being contemplated.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    ISSN: 1436-2813
    Keywords: hepatectomy ; fibrinolysis ; tissue-type plasminogen activator ; plasminogen activator inhibitor-1
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The factors related to the initiation of fibrinolysis, especially with regard to the tissue-type plasminogen activator (tPA) and the plasminogen activator inhibitor-1 (PAI-1), were investigated in 15 patients who underwent hepatic resection, and the findings were compared between those with normal livers and those with diseased livers. It was found that tPA increased before hepatic division, whereas PAI-1 increased after hepatic division and reached a peak immediately following the operation. Plasminogen decreased during hepatectomy, reaching its lowest point on postoperative day 1, and increasing later. Decreased levels of both plasminogen and the α2-plasmin inhibitor were considered to be partly due to plasmin formation in the blood. Patients with a diseased liver tended to have higher intraoperative values of euglobulin lysis activity and higher postoperative values of plasminogen activator, but significantly lower postoperative values of α2-plasmin inhibitor than those with a normal liver. The results of this study suggest that activation of the fibrinolytic system occurs both during hepatectomy and in the early postoperative period, and that patients with a diseased liver are prone to develop hyperfibrinolysis during hepatectomy. Moreover, the increased levels of both tPA and PAI-1 can serve as one of the most sensitive markers for the vital reaction against surgical stress.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
    ISSN: 1436-2813
    Keywords: Key Words Hepatic sclerosing hemangioma ; Metastatic liver tumor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present herein the case of a sclerosing hemangioma of the liver which was extremely difficult to differentiate from liver metastasis of rectal cancer, in a 67-year-old woman. All the radiological findings were compatible with liver metastasis; however, marginal pooling of the tumor revealed by computed tomographic angiography and magnetic resonance imaging scans was inconsistent with a diagnosis of liver metastasis. At laparotomy, the tumor was macroscopically unusual in that it was yellowish elastic-hard with a very clear margin, and thus, it did not have the appearance of a metastatic tumor. Mile's operation and a partial hepatectomy were performed, followed by an uneventful postoperative course and no signs of recurrence. The carcinoembryonic antigen (CEA) level in the peripheral blood was not elevated at any time. The postoperative pathological diagnosis was a rare hepatic tumor, namely, a "sclerosing hemangioma," based on the findings of cellular fibrous stroma containing vascular channels with flattened endothelial cells. Preoperatively differentiating between sclerosing hemangioma and a metastatic liver tumor from colorectal cancer may be very difficult; however, this case demonstrated some interesting characteristics, namely, the serum CEA level was not elevated, marginal pooling of the tumor was found in the enhanced radiological findings, and the tumor was macroscopically unusual. Therefore, the possibility of sclerosing hemangioma should be borne in mind when considering the differential diagnosis of patients suspected of having colorectal liver metastasis. A preoperative biopsy should be carried out and when a laparotomy is performed under the misdiagnosis of colorectal liver metastasis, it is advisable that either an intraoperative needle biopsy or a frozen histological analysis be undertaken to avoid unnecessary extended hepatic resection of this rare benign hepatic tumor.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 8
    ISSN: 1573-689X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A simple outpatient follow-up system was developed with a laptop personal computer to assist management of patients with hepatocellular carcinoma after hepatic resections. Since it is based on a non-relational database program and the graphical user interface of Macintosh operating system, those who are not a specialist of the computer operation can use it. It is helpful to promptly recognize current status and problems of the patients, to diagnose recurrences of the disease and to prevent lost from follow-up cases. A portability of the computer also facilitates utilization of these data everywhere, such as in clinical conferences and laboratories.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Surgery today 13 (1983), S. 32-36 
    ISSN: 1436-2813
    Keywords: small liver cancer ; early detection ; diagnostic sensitivity ; operative management
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report eight cirrhotic patients with liver cancer of less than 2 cm in diameter, and who were successfully treated by surgery. The sensitivities of diagnostic procedures for small lesions showed that alpha-fetoprotein (AFP) was 75 per cent, radionuclide scanning 25 per cent, CT 33 per cent, ultrasonography 40 per cent and angiography 88 per cent. Serial measurement of AFP appears to be the most helpful for detection of hepatocellular carcinoma at the early stage, particularly in cirrhotic patients. Although hepatic imagings are of limited value for small hepatic tumors, those tools are often useful as a back-up for the routine tests but not for initial procedures. It should also be kept in mind that hepatic arteriography performed in the high risk group often leads to detection of small cancers. In cirrhotic patients with small hepatocellular carcinoma, surgical resection should be done, providing the clinical status and hepatocellular reserve are adequate.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 10
    ISSN: 1436-2813
    Keywords: nonresectable hepatic tumor ; vascular accessgraft ; intraarterial chemotherapy ; liver cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...