109 results match your criteria Perioperative Management of the Patient With Liver Disease


[Practice of laparoscopic hepatectomy in primary care facilities in China: surgical planning, surgical techniques and postoperative management].

Authors:
M Pan C Zhang

Nan Fang Yi Ke Da Xue Xue Bao 2022 Jan;42(1):156-162

Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.

With the development and application of laparoscopic hepatectomy in major medical centers, domestic and foreign guidelines have summarized the indications, surgical techniques and operational procedures of the surgery. But in primary care facilities, where the surgical equipment are available, laparoscopic hepatectomy is performed only in a small number of cases and the progress of its application remains slow. The reasons possibly lie in the failure of a full understanding of the surgery, the lack of anatomical knowledge of laparoscopic hepatectomy, the lack of close multidisciplinary cooperation in the perioperative period and insufficient training of laparoscopic technology. Read More

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January 2022

Elevation in creatine kinase isoenzyme-MM associated with hepatocellular carcinoma: a case report and review of literature.

Clin J Gastroenterol 2022 Apr 23;15(2):460-466. Epub 2022 Feb 23.

Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.

We report the case of a 79-year-old woman with hepatocellular carcinoma (HCC) who presented with creatine kinase (CK)-MM elevation. On admission, her serum CK-MM level exceeded 4000 IU/L (normal, 44-206 IU/L), and computed tomography revealed two HCCs in hepatic segment VIII (23 mm, 86 mm). The patient denied experiencing muscular symptoms such as weakness or pain. Read More

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Pituitary adenoma apoplexy in pregnancy: Case report and literature review.

Exp Ther Med 2022 Mar 14;23(3):218. Epub 2022 Jan 14.

Department of Obstetrics and Gynecology, National Institute of Mother and Child Care, 400012 Bucharest, Romania.

Gestational pituitary apoplexy is an extremely rare condition. It is characterised by an unexpected headache, vomiting, nausea, and visual disturbances. Pituitary apoplexy in pregnancy and postpartum is a challenging diagnosis with symptoms overlapping multiple conditions. Read More

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Anesthesia and perioperative management for giant adrenal Ewing's sarcoma with inferior vena cava and right atrium tumor thrombus: A case report.

World J Clin Cases 2022 Jan;10(2):643-655

Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.

Background: Ewing's sarcoma of the adrenal gland with inferior vena cava (IVC) and right atrium thrombus is extremely rare. Here, we report a case of giant adrenal Ewing's sarcoma with IVC and right atrium tumor thrombus and summarize the anesthesia and perioperative management.

Case Summary: A young female was admitted to the Department of Urology with intermittent pain under the right costal arch for four months. Read More

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January 2022

Case Report of a Patient Treated With Acenocumarol Awaiting Orthotopic Liver Transplant: Perioperative Coagulation Management and Risk for Hepatic Artery Thrombosis.

Transplant Proc 2022 Jan-Feb;54(1):62-64. Epub 2021 Dec 9.

Hepatobiliary Anesthesiology Department, Virgen del Rocío University Hospital, Seville, Spain.

Background: End-stage liver disease is associated with a concomitant reduction of pro- and anticoagulant factors that typically leads to rebalanced hemostasis. This rebalanced hemostasis can be easily disturbed, encountering both hemostasis-related bleeding episodes and thrombotic events.

Methods: This article reports a case of a 52-year-old man diagnosed with portal vein thrombosis and treated with Acenocumarol. Read More

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February 2022

Risk Factors and Overcoming Strategies of Surgical Site Infection After Hepatectomy for Colorectal Liver Metastases.

Anticancer Res 2021 Nov;41(11):5651-5656

Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.

Background/aim: The aim of this study was to investigate the risk factors of surgical site infection (SSI) in patients who underwent liver resection for colorectal liver metastases (CRLM).

Patients And Methods: A total of 151 patients who underwent liver resection for CRLM were included in this study. We investigated the relationship between the patient characteristics and perioperative factors and the incidence of SSI. Read More

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November 2021

Preoperative Assessment and Management of Cardiovascular Risk in Patients Undergoing Non-Cardiac Surgery: Implementing a Systematic Stepwise Approach during the COVID-19 Pandemic Era.

J Cardiovasc Dev Dis 2021 Oct 3;8(10). Epub 2021 Oct 3.

Orthopedic Unit, Antonio Cardarelli Hospital, 80131 Naples, Italy.

Major adverse cardiac events, defined as death or myocardial infarction, are common causes of perioperative mortality and major morbidity in patients undergoing non-cardiac surgery. Reduction of perioperative cardiovascular risk in relation to non-cardiac surgery requires a stepwise patient evaluation that integrates clinical risk factors, functional status and the estimated stress of the planned surgical procedure. Major guidelines on preoperative cardiovascular risk assessment recommend to establish, firstly, the risk of surgery per se (low, moderate, high) and the related timing (elective vs. Read More

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October 2021

Bivalirudin for the prevention of hepatic artery thrombosis in pediatric liver transplantation.

Pediatr Transplant 2021 Nov 13;25(7):e14068. Epub 2021 Jul 13.

Division of Transplant Surgery, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Background: Early hepatic artery thrombosis (HAT) after liver transplantation is a serious complication that frequently results in graft loss and the need for retransplantation. Although studies have reported on various operative and endovascular treatment approaches, pharmacologic strategies for the prevention or management of HAT are not well defined. Patients with blood clotting disorders, those with a contraindication to heparin, and those who have previously developed HAT represent unique challenges in management. Read More

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November 2021

Metabolic Complications in Liver Transplantation Recipients: How We Can Optimize Long-Term Survival.

Liver Transpl 2021 10 31;27(10):1468-1478. Epub 2021 Jul 31.

Multi Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.

Liver transplantation (LT) recipients have experienced a significant improvement in short-term survival during the past 3 decades attributed to advancements in surgical techniques, perioperative management, and effective immunosuppressive regimens. However, long-term survival is affected by a high incidence of metabolic disorders and their consequences, including cardiovascular disease (CVD) and malignancies. Pretransplant metabolic impairments especially in those with nonalcoholic steatohepatitis cirrhosis are aggravated by the addition of posttransplant weight gain, physical inactivity, and reversal from catabolic to anabolic state. Read More

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October 2021

Management of factor XI deficiency in oncological liver and colorectal surgery by therapeutic plasma exchange: A case report.

Transfus Apher Sci 2021 Oct 31;60(5):103176. Epub 2021 May 31.

Transfusion Medicine Deparment, Hospital Italiano de Buenos Aires, Argentina.

Introduction: Factor XI (FXI) deficiency is a rare congenital hemostatic disorder associated with increased bleeding tendency in trauma, surgery or when other hemostatic defects are present. Perioperative hemostatic management of a patient with a severe FXI deficiency undergoing major oncological liver and colorectal surgery with therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) is reported.

Case Description: A 54-year-old male with severe FXI deficiency was scheduled for resection of synchronous rectal cancer and multiple liver metastases. Read More

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October 2021

Anesthesia for the Patient with Severe Liver Failure.

Adv Anesth 2020 12;38:251-267

Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, 3 Eaton North, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. Electronic address:

The incidence of liver failure continues to increase, and it is associated with increased perioperative morbidity and mortality. Liver failure is associated with multiorgan dysfunction, including central nervous, cardiac, respiratory, gastrointestinal, renal, and hematological systems. Preoperative identification, optimization, and tailored anesthetic management are essential for optimum outcomes in patients with liver disease undergoing surgery. Read More

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December 2020

Pericardiectomy for Constrictive Pericarditis: Analysis of Outcomes.

J Cardiothorac Vasc Anesth 2021 12 11;35(12):3797-3805. Epub 2021 Feb 11.

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN. Electronic address:

Constrictive pericarditis is caused by pericardial inflammation and fibrosis, leading to diastolic heart failure. The diagnosis requires a high index of suspicion because it often can mimic restrictive myocardial disease and cardiac tamponade and can be associated with severe tricuspid regurgitation and chronic liver disease. Patients who remain undiagnosed can experience a 90% mortality rate, and for those who undergo pericardiectomy, the survival rate varies significantly, depending on the underlying etiology and preoperative functional class of the patient. Read More

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December 2021

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition).

Autophagy 2021 Jan 8;17(1):1-382. Epub 2021 Feb 8.

University of Crete, School of Medicine, Laboratory of Clinical Microbiology and Microbial Pathogenesis, Voutes, Heraklion, Crete, Greece; Foundation for Research and Technology, Institute of Molecular Biology and Biotechnology (IMBB), Heraklion, Crete, Greece.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Read More

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January 2021

A focal extramedullary hematopoiesis of the spleen in a patient with essential thrombocythemia presenting with a complicated postoperative course: a case report.

Surg Case Rep 2021 Jan 26;7(1):33. Epub 2021 Jan 26.

Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.

Background: Extramedullary hematopoiesis is a compensatory response occurring secondary to inadequate bone marrow function and is occasionally observed in essential thrombocythemia (ET). This disease usually presents as multifocal masses in the paravertebral or intra-abdominal region; however, formation of a focal mass in the liver or spleen is rare. In addition, ET is characterized by increased platelet count and shows a tendency toward thrombosis and, occasionally, bleeding. Read More

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January 2021

Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report.

Surg Case Rep 2021 Jan 5;7(1). Epub 2021 Jan 5.

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Background: Erythropoietic protoporphyria (EPP) is a rare disorder of heme synthesis. Patients with EPP mainly show symptoms of photosensitivity, but approximately 20% of EPPs are associated with the liver-related complications. We report a case of breast cancer in a 48-year-old female patient with EPP in whom meticulous perioperative management was required in order to avoid complications resulting from this disease. Read More

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January 2021

Robot-Assisted Total Pancreatectomy With Autologous Islet Cell Transplantation: Perioperative Nursing Considerations.

AORN J 2020 10;112(4):353-365

Chronic pancreatitis (CP) is an inflammatory disease of the pancreas that causes pain and gastrointestinal problems in patients. Robot-assisted total pancreatectomy with autologous islet cell transplantation (TPAIT) is a surgical procedure for treating patients with CP that has been unresponsive to other treatments. After performing a total pancreatectomy, the surgical team isolates islet cells and then infuses them into the patient's liver. Read More

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October 2020

Evaluation of surgical risk in patients with liver cirrhosis.

Vnitr Lek 2020 ;66(4):253-257

The prevalence of liver cirrhosis in population is increasing, as well as its prevalence among patients admitted to hospital for elective surgery. These patients are at risk of high postoperative morbidity and mortality. Perioperative risk assessment of patients with liver cirrhosis is a complex procedure. Read More

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November 2020

Preoperative Evaluation and Anesthetic Management of Patients With Liver Cirrhosis Undergoing Cardiac Surgery.

J Cardiothorac Vasc Anesth 2022 05 14;36(5):1429-1448. Epub 2020 Aug 14.

Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA.

Preoperative evaluation and anesthetic management of patients with liver cirrhosis undergoing cardiac surgery remain a clinical challenge because of its high risk for perioperative complications. This narrative review article summarizes the pathophysiology and anesthetic implication of liver cirrhosis on each organ system. It will help physicians to evaluate surgical candidates, to optimize intraoperative management, and to anticipate complications in liver cirrhosis patients undergoing cardiac surgery. Read More

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Anesthetic considerations for combined heart--liver transplantation in patients with Fontan-associated liver disease.

Curr Opin Organ Transplant 2020 10;25(5):501-505

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Purpose Of Review: The success of the Fontan procedure has led to increased survival of patients born with certain congenital heart disease to the point that new sequlae, as a result of Fontan circulation, are being discovered. Included among these is Fontan-associated liver disease (FALD). The purpose of this review is to present available literature on the perioperative management of the combined heart--liver transplantation (CHLT) in patients with FALD. Read More

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October 2020

Bariatric Surgery in the Setting of Liver Cirrhosis with Portal Hypertension: the Confection and Particularities of Roux-en-Y Gastric Bypass in a High-Risk Patient.

Obes Surg 2020 Oct 27;30(10):4165-4166. Epub 2020 Jul 27.

Université Côte d'Azur, Nice, France.

Introduction: Morbid obesity is associated with the occurrence of non-alcoholic fatty liver disease, which may progress to cirrhosis. Although weight loss is the treatment of choice, surgical management can be challenging at the stage of cirrhosis. The aim of this video report is to present the confection and the features of a Roux-en-Y gastric bypass (RYGB) in the setting of liver cirrhosis. Read More

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October 2020

Good syndrome with cytomegalovirus hepatitis: successful resection of Thymoma: a case report.

J Cardiothorac Surg 2020 Jun 15;15(1):141. Epub 2020 Jun 15.

Division of Chest Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.

Background: Good syndrome is a rare condition, manifesting as immunodeficiency due to hypogammaglobulinemia associated with thymoma. Herein, we present a patient with Good syndrome whose thymoma was resected after treatment of cytomegalovirus hepatitis.

Case Presentation: The patient was a 45-year-old woman presenting with fever, cough, and nasal discharge, and was diagnosed with thymoma and hypogammaglobulinemia. Read More

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[A Case of Superior Mesenteric Vein Thrombosis during Administration of Bevacizumab for Rectal Cancer].

Gan To Kagaku Ryoho 2019 Dec;46(13):2491-2493

Dept. of Surgery, Japan Community Healthcare Organization(JCHO)Osaka Hospital.

A colonoscopy to investigate fecal incontinence revealed a type 3 tumor in the rectum of a 67-year-old man. Histological findings demonstrated rectal adenocarcinoma. CT revealed multiple metastases in the liver, and the patient was diagnosed as having rectal cancer(Rb, Ant, type 3, T3, N3, M1a[H2], cStage Ⅳa). Read More

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December 2019

Endovascular Treatment of Acute Posttransplant Portal Vein Thrombosis Due to Portal Steal From Mesocaval And Coronary Portosystemic Shunts.

Exp Clin Transplant 2020 10 7;18(5):653-656. Epub 2020 Feb 7.

>From the Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy.

The management of portosystemic shunts in liver transplant recipients relies on appropriate perioperative study. There are several strategies for shunt handling, ranging from preoperative interventional procedures to intraoperative surgical interruption or embolization. Appropriate management often results in a successful outcome, although wrong decisions could lead to serious consequences. Read More

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October 2020

Perioperative anesthetic management for cesarean delivery of severe Wilson's disease with liver failure: a case report.

JA Clin Rep 2019 Nov 13;5(1):75. Epub 2019 Nov 13.

Department of Anesthesiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.

Background: Wilson's disease is a rare autosomal recessive disorder affecting copper metabolism, which presents liver and brain dysfunction caused by abnormal copper accumulation. We report a patient who showed exacerbation of liver failure during pregnancy.

Case Presentation: A 24-year-old woman with Wilson's disease was scheduled for emergency cesarean delivery at 30 weeks of gestation. Read More

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November 2019

Anesthesia for the Patient with Severe Liver Failure.

Anesthesiol Clin 2020 Mar 3;38(1):35-50. Epub 2020 Jan 3.

Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, 3 Eaton North, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. Electronic address:

The incidence of liver failure continues to increase, and it is associated with increased perioperative morbidity and mortality. Liver failure is associated with multiorgan dysfunction, including central nervous, cardiac, respiratory, gastrointestinal, renal, and hematological systems. Preoperative identification, optimization, and tailored anesthetic management are essential for optimum outcomes in patients with liver disease undergoing surgery. Read More

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Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association.

Circulation 2019 Jul 1:CIR0000000000000696. Epub 2019 Jul 1.

It has been 50 years since Francis Fontan pioneered the operation that today bears his name. Initially designed for patients with tricuspid atresia, this procedure is now offered for a vast array of congenital cardiac lesions when a circulation with 2 ventricles cannot be achieved. As a result of technical advances and improvements in patient selection and perioperative management, survival has steadily increased, and it is estimated that patients operated on today may hope for a 30-year survival of >80%. Read More

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Dentistry and oral and maxillofacial surgery in the patient with liver disease: key messages for clinical practice.

Minerva Stomatol 2019 Aug 27;68(4):192-199. Epub 2019 May 27.

Unit of Gastroenterology, Molinette - San Giovanni Antica Sede Hospital, Turin, Italy -

The recent changes in terms of both epidemiology of chronic liver disease (CLD) and long-term survival of patients with CLD have had a great impact in the field of dentistry and oral and maxillofacial surgery. In this context, compared with the previous decades, today it is more probable to cure patients with CLD also at advanced stage (cirrhosis), that could remain asymptomatic for long, before the appearance of signs of decompensation. Hence, it is crucial to identify the patient with CLD and to define the stage of the latter. Read More

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Mixed neuroendocrine-non-neuroendocrine carcinoma of gallbladder: case report.

World J Surg Oncol 2019 Mar 22;17(1):55. Epub 2019 Mar 22.

Faculty of Medicine in Pilsen, Charles University, 301 00, Pilsen, Czech Republic.

Background: Mixed neuroendocrine-non-neuroendocrine tumors (MINEN) of the gallbladder are extremely rare; indeed, the English expert literature reports a mere handful of case reports and case series on this topic. According to the WHO classification of 2010, MINEN are considered to be tumors consisting of two major components, neuroendocrine and non-neuroendocrine, each of which hosts at least 30% of the total cellular population. To date, the etiology and pathogenesis of MINEN have not been precisely determined and the non-specific symptoms generally result in late diagnosis (mainly in the terminal stages of the condition) and contribute to the generally poor prognosis. Read More

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[Preconditioning of the liver].

Chirurg 2019 Jul;90(7):542-547

Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie Tübingen, Hoppe-Seylerstraße 3, 72076, Tübingen, Deutschland.

Posthepatectomy liver failure (PHLF) still represents a severe complication after major liver resection associated with a high mortality. In addition to an insufficient residual liver volume various factors play an important role in the pathophysiology of PHLF. These include the quality of the parenchyma, liver function, perfusion, i. Read More

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Persistent acidosis after reperfusion-A prognostic indicator of increased 30-day and in-hospital postoperative mortality in liver transplant recipients.

Clin Transplant 2019 03 24;33(3):e13473. Epub 2019 Jan 24.

Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

During liver transplantation, the patient is at risk of developing progressive lactic acidosis. Following reperfusion, correction of acidosis may occur. In some patients, acidosis will worsen, a phenomenon referred to as persistent acidosis after reperfusion (PAAR). Read More

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