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Hepatobiliary surgery and nutrition
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Background: Malnutrition is recognised as a preoperative risk factor for patients undergoing hepatic resection. It is important to identify malnourished patients and take preventive therapeutic action before surgery. However, there is no evidence regarding which existing nutritional assessment score (NAS) is best suited to predict outcomes of liver surgery. Methods: All patients scheduled for elective liver resection at the surgical department of the University Hospital of Heidelberg and the Mun...
An increasing number of patients with colorectal cancer (CRC) are presenting with synchronous disease to the liver. The optimal surgical approach for this complex patient group is controversial, but ultimately depends on individual patient characteristics and institutional practices. Surgical strategies include the traditional staged approach, a combined colorectal and liver resection, or a liver-first reverse approach. In this review, the authors will provide an overview of each strategy, inclu...
The robotic surgical system has been applied in various types of pancreatic surgery. However, controversial concerns exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. This study aimed to evaluate the current status of robotic pancreatic surgery and put forth experts’ consensus and recommendations to promote its development. Based on the WHO Handbook for Guideline Development, a Consensus Steering Group and a Consensus Dev...
Hepatocellular carcinoma (HCC) is the most common liver-related complication seen in patients with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) (1). NASH is strongly associated with type 2 diabetes mellitus (T2DM) but it has also been apparent for a number of years that T2DM is associated with an increased risk of HCC independent of the presence of NASH (2).
Fluorescence-guided surgery (FGS) is a potentially powerful tool for hepatobiliary (HPB) surgery. There are a number of FDA approved fluorophores used in surgery such as methylene blue (MB), 5-aminolevulinic acid (5-ALA), and indocyanine green (ICG). ICG is currently the most commonly used fluorophore for fluorescence-guided HPB surgery due to its biliary excretion mechanisms, improved tissue depth penetration and wide availability of devices equipped to image 800 nm. ICG has been used to visual...
There remain no consensus guidelines on the optimum surgical strategy for the management of synchronous colorectal liver metastases in spite of a number of published reviews and meta-analyses (1,2). In their paper, Howard et al. describe the ‘real world’ referral patterns and resection pathways of Canadian surgeons for this challenging patient cohort (3). This is a timely and interesting area for study. Data was generated from an online survey sent out to all surgeons in Canada. Responses were r...
#1Yasushi HasegawaH-Index: 11
#2Hiroyuki NittaH-Index: 24
Last.Akira SasakiH-Index: 30
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Robotic hepatectomy remains controversial to date, despite continuous advances in the technology and more surgeons gaining experience with the method. Melstrom et al . (1) recently published an interesting article in Hepatobiliary Surgery and Nutrition, titled “ Selecting incision-dominant cases for robotic liver resection: towards outpatient hepatectomy with rapid recovery .” The authors evaluated 97 cases of robotically-assisted liver resection (RLR) arguing that it is difficult to reach the s...
Chronic hepatitis C virus (HCV) infection is a public health issue which effects people throughout the world, with more than 71 million people effected, and 400,000 deaths annually (1). HCV, which is when active carriage of HCV RNA is in the blood, is the leading cause of cirrhosis, liver failure, and hepatocellular carcinoma (HCC) (2).
Robotic approach is already a new technological system in surgery and its potential advantages such as ergonomics, reduced tremor, 3D view and improved instruments movements have been well described (1,2). Concerning the current literature, the studies addressing the robotic benefits on left pancreatectomies are few. However, it has been showed that robotic distal pancreatectomy is both feasible and safe as well as the laparoscopic and the standard open approach. Although, there is a lack of hig...
A 54-year-old man presented with a 2-month history of painless swelling of the right abdomen that had persistent right epigastric pain radiating toward the dorsal shoulder, with no jaundice.
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