Preoperative portal vein embolization for Gaint Hepatic alveolar echinococcosis

Hepatic echinococcosis, characterized by tumor-like infiltrative growth, is fatal if appropriate treatment is not undertaken on time. Surgical resection is still the most effective treatment for early stage patients. However, due to asymptomatic progression, many patients miss the opportunity to have the lesion removed. In this paper, we report a new method to treat a patient with giant hepatic echinococcosis. Based on preoperative portal vein embolization of the right portal venous branches, a radical right trisectionectomy of hepatic segment with complete removal of the giant lesion was performed successfully without any postoperative complications. To our knowledge, currently there is no report on the use of preoperative portal vein embolization to treat Hepatic echinococcosis

Synchronous intraoperative radiofrequency ablation for multiple liver metastasis and resection of giant solid pseudopapillary tumors of the pancreas / 中华医学杂志(英文版)

The solid pseudopapillary tumors of the pancreas (SPTP) are rare tumors, which are commonly found in adolescent women. Radical surgical resection of the primary tumor or metastases is the standard treatment for SPTP and could achieve long-term survival. We reported a case of a 20-year-old female with multiple liver metastases of SPTP, and performed surgical resection for primary tumor 14 cm in diameter and 2 major liver metastases (both 5 cm in diameter), radiofrequency ablation (RFA) for small lesions and one major liver metastase 6 cm in diameter successfully. No evidence of recurrence in situ or in the liver was found by computed tomography (CT) scan 3 months after the operation. RFA is a safe and effective treatment for unresectable multiple liver metastases of SPTP.

Left hemihepatectomy and caudate resection after transarterial embolization for multiple giant liver hemangioma

Hemangiomas are the most common benign tumors of the liver and need to be treated in cases where they are accompanied with symptoms, have a risk of rupture, or are hardly distinguishable from malignancy. The authors adopted Transarterial embolization preoperatively to alleviate progressive symptom and avoid rupture of tumor, using staged resection method instead of liver transplantation, and proceed for left hemihepatectomy and caudate resection with lesion of segmente! left to next surgical procedure. The resected tumor of left lobe was 20.2cmx7.3cm in size and 1680 g in weight; and the caudate hemangioma was 17.7cmx8.5cm in size and 1520 g in weight. By this approach the gianthemangioma was safely resected without any threatening complication, which should be considered a useful method of multiple giant hemangioma management

Hemi-portocaval shunt: a simple salvage maneuver for small-for-size graft during living donor liver transplantation: a case report / 中华医学杂志(英文版)

Since the fast expansion of living donor liver transplantation (LDLT) over last few decades, small-for-size syndrome (SFSS) has emerged as a tough problem. Herein the first case of LDLT combined hemi-portocaval shunt in the mainland of China was reported. Portal venous over perfusion was well modulated and the recipient recovered uneventfully. LDLT combined hemi-portocaval shunt was a feasible procedure for preventing SFSS in LDLT.

Surgical Management for Giant liver Hemangiomas Greater Than 20 cm in Size

BACKGROUND/AIMS: The aim of this study was to investigate the primary management experience for giant liver hemangiomas greater than 20 cm in size. METHODS: Records of patients referred for evaluation of radiologically and/or histopathologically proven giant liver hemangiomas between January 2007 and March 2010 were retrospectively analyzed. The reasons for referral, results of imaging studies, preoperative and surgical treatments, and outcome were reviewed. RESULTS: A retrospective analysis was performed for 14 patients diagnosed with a giant hemangioma on the basis of an imaging study and/or a histopathological examination. All cases were diagnosed as giant liver hemangioma with at least one lesion greater than 20 cm in size. Abdominal discomfort was the main presenting complaint for the referral in 9 patients (64.2%). Abdominal ultrasound established the diagnosis in 12 patients (85.7%). Twelve patients underwent liver resection, 2 of whom underwent staged resection. Enucleation was performed in 2 patients. Selective transcatheter arterial embolization was implemented in 9 patients. Postoperative morbidity occurred in 3 patients (21.4%). No complications related to the hemangiomas occurred during follow up. CONCLUSIONS: Liver resection is indicated for giant liver hemangiomas with abdominal discomfort, especially for lesions greater than 20 cm in size. Staged operations are performed for patients with multiple lesions. Preoperative selective transcatheter arterial embolization alleviates progressive abdominal pain.