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  • Liver, neoplasm  (1)
  • bile leakage  (1)
  • diagnostic sensitivity  (1)
  • 1
    Digitale Medien
    Digitale Medien
    Occurrence of intraperitoneal septic complications after hepatic resections between 1985 and 1990 (1995)
    Springer
    Surgery today 25 (1995), S. 49-54 
    Details
    ISSN: 1436-2813
    Schlagwort(e): intraperitoneal sepsis ; hepatic resection ; bile leakage ; blood transfusion ; gut-origin sepsis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In this study, the risk factors related to intraperitoneal septic complications occurring after hepatectomy (IPSCH) as well as the effect of various perioperative variables on the outcome of IPSCH between 1985 and 1990 were analyzed. Twenty-one of 211 patients (10.0%) developed IPSCH. The findings in the patients with IPSCH were compared with those in 190 patients without IPSCH. The significant variables associated with the development of IPSCH included a high incidence of accompanying chronic renal failure (14.3% vs 2.1%), a larger blood loss during surgery (2,130 vs 1,340 ml) as well as a greater amount of intraoperative blood replacement (1,130 vs 570 ml), and a greater weight of the resected liver (367 vs 233g). IPSCH occurred in 10 of 12 patients who had postoperative bile leakage. Eighteen patients (85.7%) with IPSCH were discharged from the hospital after non-operative management; however, the hospital death rate (14.3% vs 1.1%) was significantly higher in patients with IPSCH. This review suggests that the incidence of IPSCH has not decreased recently. Thus, to prevent IPSCH, at least following bile leakage, it is necessary to perform a careful division of the liver parenchyma followed by a bile leakage test, and when this complication occurs unexpectedly in patients who have a good functional reserve of the remnant liver, IPSCH can be effectively drained percutaneously under ultrasound guidance.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00309385
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  • 2
    Digitale Medien
    Digitale Medien
    Small liver cancer (1983)
    Springer
    Surgery today 13 (1983), S. 32-36 
    Details
    ISSN: 1436-2813
    Schlagwort(e): small liver cancer ; early detection ; diagnostic sensitivity ; operative management
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: 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.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02469687
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  • 3
    Digitale Medien
    Digitale Medien
    Hepatocellular carcinoma: Prospective assessments of the T-factor with CT, US, and MR imaging (1993)
    Springer
    Abdominal imaging 18 (1993), S. 247-252 
    Details
    ISSN: 1432-0509
    Schlagwort(e): Liver, neoplasm ; Hepatocellular carcinoma, CT, MR, US
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: 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.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00198115
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