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Resumen Antecedentes Las anomalías de la morfología hepática son raras, y se dividen en 2 categorías: las que resultan del desarrollo excesivo de tejido hepático, como el lóbulo de Riedel y otros lóbulos accesorios, y las de desarrollo deficiente del hígado, que incluyen agenesia, hipoplasia y aplasia de los lóbulos hepáticos. Presentación del caso Paciente del sexo masculino de 57 años de edad, sometido a plastia inguinal laparoscópica programada, donde se dio el hallazgo de hipoplasia hepática. Conclusión La hipoplasia hepática es poco frecuente, no presenta síntomas, ni repercusiones clínicas a largo plazo, suele ser un hallazgo incidental durante un estudio de imagen o durante un procedimiento quirúrgico abdominal.
Abstract Background: Abnormalities of liver morphology are rare, divided into two categories: those resulting from overgrowth of liver tissue, such as the Riedel lobe and other accessory lobes, and those with poor liver development include agenesis, hypoplasia and aplasia of the hepatic lobes. Presentation of the case 57-year-old man, subjected to laparoscopic programmed inguinal surgery, finding liver hypoplasia. Conclusions Hepatic hypoplasia is rare, has no symptoms or long-term clinical repercussions, is usually an incidental finding during an imaging study or during an abdominal surgical procedure.
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Background: Liver abscess is a major health problem in tropical and subtropical regions. Aim: The present study aimed to evaluate the clinical profile, management of amoebic liver abscess patients. Materials and methods: A cross-sectional study was conducted in Department of Surgery MNR Medical College Hospital, Sangareddy over a period of 2 years from June 2014 to July 2016. A total of 100 patients with liver abscess were included in this study. Clinical examination, detail case history, ultrasonography reports, case management and outcome were recorded during study. Results: Among 100 patients, 88 were males and 12 were females. Majority of cases were belongs to the age group of 30 -40 years (45%). Most common clinical features of amoebic liver abscess was fever (89%), abdominal pain (78%) and diarrhoea (37%). The major signs were hepatomegaly (87%), right lobe abscess (68%), left lobe abscess (36%) and pleural effusion (18%). Mortality rate was 3% out of 100 patients.
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Objective To investigate clinical effectiveness and feasibility of adult liver transplantation using the left lobe.Methods We analyzed the clinical data of 9 recipients who underwent adult liver transplantation using left lobe from March 2007 to April 2011,including 5 cases receiving split liver transplantation and rest 4 cases receiving living donor liver transplantation.Mean graft weight was 444.6 g (325-570 g) and mean graft-recipient weight ratio was 0.886％ (0.65％-1.18％ ).The middle hepatic vein was reserved in 7 cases.Six cases underwent Laden back surgical and 3 cases underwent classical surgical procedures.During the operation,PVP of 4 cases exceeded 20 mm Hg (2.67 kPa),3 cases were subjected to splenic artery ligation and 1 case to splenectomy.All recipients after operation were treated with triple drug maimenance therapy of Tacrolimus,Mycophenolate Mofetil and corticosteroids.We followed-up the recipients long-term,and the incidence of vascular complications and biliary complications,patient and graft survival,restoration of liver function were observed.Results No serious complications occurred in 4 living donors subject to left lobotomy and the liver function had a good recovery.The median follow-up period of these 9 recipients was 15.7 months ( 1 month to 51 months).Overall 1-year patient and graft survival rate was 77.8％ (7/9).Two cases died after operation.In the remaining 7 cases,1 case had initial poor graft function,and cases had initial good graft function.The main complications after operation included biliary anastomotic strictures in 1 case,small-for-size syndrome in 1 case,portal vein thrombosis in 1 case,initial poor graft function in 1 case and abdominal infection in 2 cases.Conclusion With strict for selecting and good matching donor-recipient,adult liver transplantation using left lobe is safe and feasible.
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PURPOSE: Procuring the left liver lobe plus the caudate lobe was originally done in an effort to increase the graft mass itself. However, there has been some controversy about the procedure's effectiveness. We investigated the effect of concomitant caudate lobe transplantation and fates of the implanted caudate lobe. METHODS: From January 2002 to December 2003, 290 cases of living donor liver transplantation (LDLT) were performed at our institution. Among them, there was 31 case of adult-to-adult LDLT using a left lobe plus the caudate lobe. The volumes of left lobe and caudate lobe were measured separately by using computed tomogram (CT) volumetry. The operation time for the concomitant caudate lobe procurement took an average of an additional 30 minutes over the routine left lobe procurement because of the dissection of the retrohepatic vena cava. There was no separate caudate duct in the 31 consecutive grafts in this series. RESULTS: The graft weight of the left lobe plus the caudate lobe was 455+/-55 gm, yielding a mean graft-recipient weight ratio of 0.79+/-0.11. Volumetry of the preoperative donor CT scan revealed that the volume of the caudate lobe was 24+/-6 ml, which was equivalent to 5% of the left lobe volume. We prepared the largest single caudate vein with a caval patch and then reconstructed it in 24 recipients. The regeneration rate of the caudate lobe after transplantation was 116% after 1 week and 121% after 1 month. On the other hand, the regeneration rate of the left lobe was 193% after 1 week and 227% after 1 month. The regeneration rate for the left lobe was greater than that for the caudate lobe. 29 of the 31 recipients survived. CONCLUSION: We think that increasing the graft mass by 5% justifies to performing the concomitant caudate lobe procurement at the expense of 30-minute's effort.