【Abstract】Objective To explore the different characteristics of tumor recurrence after liver transplantation (LT) and hepatectomy (HC) in patients with hepatocellular carcinoma (HCC). Methods The literatures about tumor recurrence of HCC after LT and HC were reviewed and their characteristics were compared. Results There are distinctions of recurrence rates, time, common sites between the recurred tumors after LT and HC, and their correlation factors and mechanisms of recurrence are also different. Conclusion Preventive measures should be strengthened and treatments should be more targeted according to the different characteristics of tumor recurrence after LT and HC to improve postoperative life quality and increase the survival rate.
【Abstract】 ObjectiveTo review the advances in techniques of hepatic blood occlusion in hepatectomy. Methods The related literatures were reviewed and analysed. ResultsThere were many techniques of hepatic blood occlusion. The most frequently used and studied techniques were hemihepatic vascular occlusion and intermittent hepatic inflow occlusion. Hepatic vascular exclusion was employed when hepatic veins and/or vena cava would be damaged. Total vascular exclusion and other techniques were rarely used. Conclusion To reduce blood loss in hepatectomy and make patient safe, based on the situation of the patient, the technique should be ingeniously selected.
【Abstract】ObjectiveTo study the advances in use of imaging in the evaluation of living donor liver. Methods The literatures in recent years on the use of imaging in evaluation of living donor liver were reviewed. ResultsPreoperative computed tomography (CT) and magnetic resonance imaging (MRI) in the donor allowed accurate determination of liver volume and rough determination of macrovesicular hepatic steatosis of the liver. CT angiography could assess the anatomy of hepatic artery, portal vein and hepatic veins. Intraoperative cholangiography allowed detection of the anatomy of the biliary tree. ConclusionImaging techniques are widely used in the evaluation of liver volume, vasculature and biliary system in the living donor liver.
【Abstract】ObjectiveTo summarize the study on the feasibility of celiac axis ligation. Methods Literatures about celiac axis ligation were reviewed retrospectively. ResultsCeliac axis branches included common hepatic artery， splenic artery， left gastric artery which had many variation and collateral flow between celiac and mesenteric vessels by gastroduodenal artery and pancreaticoduodenal artery. Celiac axis could be possibly ligated without obvious complications in patients who had celiac axis injuries, celiac artery aneurysms, upper gastrointestinal haemorrhage, excision of carcinoma around the celiac axis and portal hypertension. However, gallbladder necrosis or perforation, focal infarction of the liver even higher mortality had also been reported. ConclusionCeliac axis ligation should not be performed routinely, but it is surgically possible and may be a life saving approach in certain circumstances.
【Abstract】ObjectiveTo investigate the indications, maternal and fetal/neonatal risks and treatments of pregnancy after liver transplantation. Methods The related published literatures were summarized and reviewed.ResultsMost females can recover a regular menstrual cycle. Hypertension, preeclampsia, bacterial and viral infection resulted from immuno-suppression therapy and increasing rate of caesarian section are the major risks for the mother. Abortion and preterm delivery, premature rupture of fetal membrane, hypoadrenalism, abnormality, immune deficiency, hepatitis virus B and cytomegalovirus and bacterial infection are the major risks for the fetus/neonate.ConclusionSatisfactory results can be obtained in most pregnancies after liver transplantation. Evaluation before gestation and surveillance during gestation by the related departments are mandatory. A guideline based on large cases is necessary for pregnancy after liver transplantation.
ObjectiveTo understand the progress and problems of liver transplantation standard for hepatocellular carcinoma. MethodsThe related articles regarding transplant criteria of hepatocellular carcinoma were reviewed and analyzed. ResultsSince Milan criteria were proposed by Mazzaferro in 1996, a number of criteria were porposed by many transplant centers. These criteria expanded Milan criteria. Compared with Milan criteria, these criteria expanded tumor size and (or) tumor number, or combined with some biological variables, or combined with some immunological variables. However, there are still some issues should be clarified. ConclusionDespite there are many transplant criteria of hepatocellular carcinoma, but a number of issues should be further investigated.