1,721,128 research outputs found
Is right hepatectomy for liver living donation really comparable to right hepatectomy for benign liver lesions?
No full textIntroduction: Right hepatectomy (RH) for adult to adult living liver donation
(LD) remains risky despite major progress in the last 10 years. In order to
elucidate factors explaining this lower tolerance of a standardized procedure
we prospectively studied the outcome of patients (pts) who underwent a RH
for benign lesions (BL) in comparison with RH for LD.
Materials and methods: From 2001 we studied prospectively the pre- and
post-operative data, including volumetric variations of 26 RH for BL. This
group was matched with 26 LD which underwent a RH in the same period.
The two groups (BL vs LD) were similar for age (43±11 vs 46±11 years),
sex and BMI (25±4 vs 23±3). All pts have the same pre- and post-operative
assessment (preoperative CT scan with volumetric measurements and study
of coagulation profi le, biological tests every day until POD 7, including an
abdominal CT scan on POD 7).
Results: The comparison of the two groups (BL vs LD) showed that operation
duration was longer in LD group (320±76 vs 382±65 min) (p=0.004). The
blood loss was similar (623±260 vs 590±350 mL). Postoperative biochemical
data showed that total serum bilirubin was signifi cantly higher in LD group
in POD 2, 3, 5 and 8. Morbidity classifi ed with the Clavien’s system was
similar in both groups 38% vs 42% p=ns. The mortality was nil. After
subtraction of the tumor’s volume (mean 421±530 cc) in the BL group the
total liver volume was similar in both groups (1438±226 vs 1460 ± 318 cc)
but the left remnant liver volume was higher in the BL group (650±216 vs
455±152 cc) (p<0.001) representing 35±7% in BL group vs 31±7% in LD
group (p=0.03). The ratio remnant weight/body weight was higher in BL pts
(1±0.32 vs 0.7±0.23) (p<0.001). At POD 7 the left remnant liver was similar
in the two groups (947 vs 862 cc) demonstrating a regeneration rate of 57%
in BL group as compared to 84% in LD group (p=0.009).
Conclusions: This study demonstrates that RH for LD is not comparable to
the same procedure in pts with BL. The left liver which is smaller in LD group
acquires the same volume at day 7 refl ecting a higher process of regeneration.
These results showing that in LD an important deprivation of liver volume
restored by a signifi cant and sudden regeneration in the fi rst postoperative
week may be the background promoting fatal complications
Is right hepatectomy for liver living donation really comparable to right hepatectomy for benign liver lesions?
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Budd-Chiari syndrome: spectrum of imaging findings.
No full textOBJECTIVE: The objective of our study was to illustrate the imaging findings of Budd-Chiari syndrome, including CT, MRI, sonographic, and angiographic findings. CONCLUSION: The key imaging findings in Budd-Chiari syndrome are occlusion of the hepatic veins, inferior vena cava, or both; caudate lobe enlargement; inhomogeneous liver enhancement; and the presence of intrahepatic collateral vessels and hypervascular nodules. Awareness of these findings is important for early diagnosis and appropriate treatment
Le calcificazioni pancreatiche sono specifiche nella diagnosi di pancreatite cronica? Studio con TC multidetettore.
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Focal nodular hyperplasia: typical and atypical MR imaging findings with emphasis on the use of contrast media
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