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1.
Chinese Journal of Pathophysiology ; (12): 2113-2122, 2023.
Article Dans Chinois | WPRIM | ID: wpr-1023819

Résumé

AIM:To explore the modulation of 2-arachidonoylglycerol(2-AG)on A-type potassium channels injured by kainic acid(KA)and its molecular mechanism.METHODS:Primary cultured caudate nucleus(CN)neurons were treated with KA to establish a neuroexcitatory toxicity model.Whole-cell patch clamp recording was performed to ob-serve the changes of electrical activity of A-type potassium channels induced by KA-induced excitatory toxicity and 2-AG-mediated neuroprotective effect.RESULTS:In cultured CN neurons,patch clamp experiments confirmed that KA signifi-cantly decreased the A-type potassium channel current(IA)density and changed the electrical function of CN neurons:the slope(k)of inactivation curve and the recovery time constant(τ)after inactivation of A-type potassium channels in CN neurons were significantly increased.The experiments showed that the increase in 2-AG level,whether using 2-AG direct-ly or application of monoacylglycerol lipase inhibitor URB602 to decrease 2-AG metabolism and increase 2-AG level indi-rectly,inhibited the KA-induced reduction of IA density and the changes of electrical activity of A-type potassium channels through cannabinoid receptor 1(CB1R):2-AG effectively antagonized the KA-induced increases in τ value and k value for inactivation of A-type potassium channels,which accelerated the recovery process after inactivation of the channels.CONCLUSION:The changes of the electrical characteristics of A-type potassium channels may be one of the mecha-nisms of KA-induced excitotoxic injury of CN neurons.The 2-AG plays a neuroprotective role in KA-induced neuroexcit-atory toxic model by regulating the function of A-type potassium channels through CB1R.

2.
Chinese Journal of Digestive Surgery ; (12): 23-27, 2023.
Article Dans Chinois | WPRIM | ID: wpr-1022459

Résumé

Objective:To investigate the clinical efficacy of laparoscopic hepatic caudate lobectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients with hepatic caudate lobe tumor who were admitted to the General Hospital of PLA Northern Theater Command from July 2018 to June 2021 were collected. There were 2 males and 3 females, aged 49(range, 26-55)years. All 5 patients underwent laparoscopic hepatic caudate lobectomy. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using telephone interview or outpatient examination to detect tumor recurrence. The follow-up was up to March 2023. Measurement data with skewed distribution were represented as M(range) and count data were described as absolute numbers. Results:(1) Intraoperative situations. All 5 patients underwent laparoscopic hepatic caudate lobectomy with the left approach, including 3 cases receiving laparoscopic partial resection of hepatic caudate lobe, 1 case receiving laparoscopic partial resection of hepatic caudate lobe+left lateral lobectomy and 1 case receiving laparoscopic partial resection of hepatic caudate lobe+cholecystectomy. Intraoperative hilar occlusion was performed in 3 patients. The operation time and volume of intraoperative blood loss of 5 patients was 240(range, 180-370)minutes and150(range, 100-200)mL, respectively. (2) Postoperative situations. On the first day after surgery, the levels of albumin, alanine aminotransferase, and aspartate aminotransferase in 5 patients was 32.9(range, 29.2-40.3)g/L, 104.09(range, 57.11-1 018.67)U/L, and 67.13(range, 58.00-852.66)U/L, respectively. Three of 5 patients showed no significant changes in prothrombin time (PT) on the first day after surgery, while two patients did not undergo PT test. On the third day after surgery, the visual analogue score of 5 patients was mild pain. Among the 5 patients, 1 case had anal exhaust on the postoperative 1st day, and 4 cases had anal exhaust on the postoperative 2nd day. The time to drainage tube removal for 5 patients was 6(range, 4-10)days. There was no postoperative complication such as bleeding, infection, bile leakage or liver failure in 5 patients. Results of postoperative histopathological examination showed that 2 cases with adenoma, 2 cases with cavernous hemangioma and 1 case with smooth myolipoma. The duration of postoperative hospital stay of 5 patients was 6(range, 5-11)days. (3) Follow-up. All 5 patients were followed up for 22 (range, 19-51)months, and there was no tumor recurrence.Conclusion:It is safe and feasible to selectively carry out laparoscopic hepatic caudate lobectomy by strictly gras-ping the indications.

3.
Chinese Journal of Digestive Surgery ; (12): 160-166, 2023.
Article Dans Chinois | WPRIM | ID: wpr-990623

Résumé

The hepatic caudate lobe is located in the deep back area of the liver. Due to the unique anatomical position of hepatic caudate lobe, surgical treatment for tumor of hepatic caudate lobe is particularly difficult. Non-surgical treatment, such as ablation, transarterial embolization, etc, is also challenging for tumor of hepatic caudate lobe, and the therapeutic effect is inferior to that of surgery. Therefore, surgical resection is the only treatment for tumor of hepatic caudate lobe. The authors discuss the research history of hepatic caudate lobe, the problems of laparoscopic technique in hepatic caudate lobe resection, etc, in order to provide a theoretical basis for improving the concept of accuracy of laparoscopic caudate lobectomy.

4.
Chinese Journal of Behavioral Medicine and Brain Science ; (12): 127-132, 2023.
Article Dans Chinois | WPRIM | ID: wpr-992066

Résumé

Objective:To investigate the neurobiochemical metabolites of caudate nucleus and thalamus in patients with obsessive-compulsive disorder and their relationship with obsessive-compulsive symptoms.Methods:From April 2019 to January 2022 in Beijing Anding Hospital, totally 25 untreated patients with obsessive-compulsive disorder were recruited, and 20 healthy controls matched with gender, age and educational background were recruited for the study.The maps of neurobiochemical metabolites of patients and normal controls were collected by hydrogen proton magnetic resonance spectroscopy.With bilateral caudate nucleus and thalamus as brain regions of interest.The relative concentrations of N-acetylaspartic acid (NAA), glutamic acid (Glu) and γ-aminobutyric acid (GABA) were fitted by LCModel software.At the same time, the clinical symptoms of patients were evaluated with Yale-Brown obsessive-compulsive scale (Y-BOCS) and Hamilton anxiety scale (HAMA). SPSS 20.0 software was used for statistical analysis.Independent double sample t-test was used to compare the differences of different nerve biochemical metabolite concentrations between patients with obsessive-compulsive disorders and healthy controls.Pearson correlation analysis was used to explore the correlation between biochemical metabolite concentrations and clinical symptoms. Results:The Glu concentration in the left thalamus of patients with obsessive-compulsive disorder (3.97±0.41) was higher than that of the control group (3.66±0.55)( t=-2.11, P<0.05), while the NAA concentration was (4.87±0.47)lower than that of the control group (5.15±0.44)( t=2.05, P<0.05). The GABA concentrations in the right caudate nucleus (0.50±0.18) and thalamus (0.80±0.19) were lower than those in the control group ((0.63±0.23), (0.96±0.24))( t=2.08, 2.36, both P<0.05). Pearson correlation analysis showed that the Glu concentration in the left caudate nucleus of patients with obsessive-compulsive disorder was positively correlated with the total score of Y-BOCS( r=0.46, P<0.05). Spearman correlation analysis showed that Glu concentration in the right caudate nucleus was positively correlated with the total score of HAMA in patients with obsessive-compulsive disorder ( r=0.46, P<0.05). Conclusion:NAA, Glu and GABA metabolism in caudate nucleus and thalamus are abnormal in patients with obsessive-compulsive disorder, and Glu concentration is positively correlated with the severity of obsessive-compulsive and anxiety symptoms.

5.
Chinese Acupuncture & Moxibustion ; (12): 767-773, 2021.
Article Dans Chinois | WPRIM | ID: wpr-887480

Résumé

OBJECTIVE@#To observe the efficacy of @*METHODS@#A total of 58 participants were included. Of them, 29 patients with insomnia were included into an observation group, and 29 healthy participants were included into a control group. The patients in the observation group were treated with @*RESULTS@#The total effective rate was 89.7% (26/29) in the observation group. In the observation group, the scores of PSQI, ISI and DISS, the A, B speed of NCT were all decreased after treatment (@*CONCLUSION@#The


Sujets)
Humains , Thérapie par acupuncture , Encéphale/imagerie diagnostique , Émotions , Imagerie par résonance magnétique , Troubles de l'endormissement et du maintien du sommeil/thérapie
6.
J Cancer Res Ther ; 2020 May; 16(2): 258-262
Article | IMSEAR | ID: sea-213809

Résumé

Aims: The goal of this study was to analyze the puncture routes of imaging-guided thermal ablation for tumors of the hepatic caudate lobe. Materials and Methods: The imaging-guided thermal ablation puncture routes of 12 cases of hepatic caudate lobe tumors were collected in our hospital from January 2013 to February 2019. The puncture routes were retrospectively analyzed, and the experience of thermal ablation therapy for hepatic caudate lobe tumors was summarized. Results: Among the 12 cases of hepatic caudate lobe tumors, puncture routes were divided into the anterior (through the left lobe of the liver) approach (six cases), the right hepatic approach (five cases), and the transthoracic approach (one case). Different ablation electrodes were selected according to the puncture route and method of guiding. No serious postoperative complications were noted. Conclusion: The hepatic caudate lobe is surrounded by the inferior vena cava, hepatic vein, and hepatic hilum, leading to great difficulties and risks in performing minimally invasive treatment of hepatic caudate lobe malignancies. Therefore, selecting an appropriate puncture route is an important factor in the success of the treatment

7.
Article | IMSEAR | ID: sea-209129

Résumé

Juvenile-onset Huntington’s disease (JHD) is a rare autosomal dominant neurodegenerative disorder of the central nervoussystem characterized by the presence of abnormal involuntary movements, rigidity, and ataxic gait. We are presenting a rarecase of a 9-year-old male who was referred to the Radiology Department of Gandhi Medical College and Hamidia Hospital formagnetic resonance imaging (MRI) brain with complaints of progressive impairment of gait, bradykinesia, and marked posturalinstability for the past 2 years. The patient also had a history of episodes of seizures for 4 years. MRI findings revealed: Atrophyof bilateral caudate nuclei and putamina of basal ganglia.

8.
Chinese Journal of Postgraduates of Medicine ; (36): 795-800, 2019.
Article Dans Chinois | WPRIM | ID: wpr-753350

Résumé

Objective To investigate the safety, efficacy and the key points of ultrasound-guided percutaneous radiofrequency ablation (RFA) in treatment of caudate lobe liver tumor. Methods The clinical data of 30 patients with caudate lobe liver tumor (57 lesions, 33 caudate lobe lesions) in the Affiliated Tumor Hospital of Zhengzhou University from January 2017 to December 2018 were retrospectively analyzed. All the patients were treated with ultrasound- guided percutaneous radiofrequency ablation. The puncture approach and single-needle or double-needle radiofrequency ablation were chosen according to the lesion location. The efficacy after treatment was evaluated according to the imaging examination. The deadline of follow-up was January 31, 2019, and the median follow-up time was 10 (1 to 20) months. After ablation, CT/MR was performed to evaluate whether the lesions were completely ablated. The effect of treatment and short-term complication were recorded. Results Thirty patients were successfully treated with ultrasound-guided percutaneous radiofrequency ablation. Among the 33 caudate lobe lesions, complete ablation rate at one time was 81.8% (27/33); local tumor progression rate after treatment was 12.1% (4/33), and the median time was 2.5 months. The new lesion rate was 26.7% (8/30), and the median time was 3.0 months. Two patients had significant abdominal pain, 1 patient had fever, 1 patient had hypoxemia during the ablation, and total incidence of complication was 13.3% (4/30). There was no bile leakage, gastrointestinal tract injury, uncontrollable bleeding and other serious complications and related deaths. Conclusions For the caudate lobe liver tumor, ultrasound-guided percutaneous radiofrequency ablation is safe and effective. It is necessary to select the appropriate puncture approach, avoid the intrahepatic duct reasonably and master the key points of ablation.

9.
Annals of Surgical Treatment and Research ; : 124-129, 2019.
Article Dans Anglais | WPRIM | ID: wpr-762697

Résumé

PURPOSE: Complete removal of the caudate lobe, which is sometimes necessary, is accomplished via isolated caudate lobectomy or hepatectomy that includes the caudate lobe. It is impossible, however, to confirm the right and ventral margins of the caudate lobe by preoperative imaging. This study was undertaken to determine whether we could identify the right and ventral margins of the caudate lobe preoperatively using Synapse 3D visualization software. METHODS: Ninety-four preoperative 3-dimensional (3D) computed tomographic images (1-mm slices) of the liver from candidate donors were examined. The images of the caudate lobe were subjected to a counter-staining method according to Synapse 3D to delineate their dimensions. We first examined whether the right margin of the caudate lobe exceeded the plane formed by the root of the right hepatic vein (RHV) and the right side of the inferior vena cava (IVC). Second, we determined whether the ventral margin of the caudate lobe exceeded the plane formed by the root of the middle hepatic vein (MHV) and the root of the RHV. RESULTS: For the right margin, 17 cases (18%) exceeded the RHV-IVC plane by a mean of 10.2 mm (range, 2.4–27.2 mm). For the ventral margin, 28 cases (30%) exceeded the MHV-RHV plane by a mean of 17.4 mm (range, 1.2–49.1 mm). CONCLUSION: Evaluating the anatomy of caudate lobe using Synapse 3D preoperatively could be helpful for more precise anatomical resection of the caudate lobe.


Sujets)
Humains , Hépatectomie , Veines hépatiques , Imagerie tridimensionnelle , Foie , Méthodes , Synapses , Donneurs de tissus , Veine cave inférieure
10.
Chinese Journal of Postgraduates of Medicine ; (36): 795-800, 2019.
Article Dans Chinois | WPRIM | ID: wpr-798114

Résumé

Objective@#To investigate the safety, efficacy and the key points of ultrasound-guided percutaneous radiofrequency ablation (RFA) in treatment of caudate lobe liver tumor.@*Methods@#The clinical data of 30 patients with caudate lobe liver tumor (57 lesions, 33 caudate lobe lesions) in the Affiliated Tumor Hospital of Zhengzhou University from January 2017 to December 2018 were retrospectively analyzed. All the patients were treated with ultrasound-guided percutaneous radiofrequency ablation. The puncture approach and single-needle or double-needle radiofrequency ablation were chosen according to the lesion location. The efficacy after treatment was evaluated according to the imaging examination. The deadline of follow-up was January 31, 2019, and the median follow-up time was 10 (1 to 20) months. After ablation, CT/MR was performed to evaluate whether the lesions were completely ablated. The effect of treatment and short-term complication were recorded.@*Results@#Thirty patients were successfully treated with ultrasound-guided percutaneous radiofrequency ablation. Among the 33 caudate lobe lesions, complete ablation rate at one time was 81.8% (27/33); local tumor progression rate after treatment was 12.1% (4/33), and the median time was 2.5 months. The new lesion rate was 26.7% (8/30), and the median time was 3.0 months. Two patients had significant abdominal pain, 1 patient had fever, 1 patient had hypoxemia during the ablation, and total incidence of complication was 13.3% (4/30). There was no bile leakage, gastrointestinal tract injury, uncontrollable bleeding and other serious complications and related deaths.@*Conclusions@#For the caudate lobe liver tumor, ultrasound-guided percutaneous radiofrequency ablation is safe and effective. It is necessary to select the appropriate puncture approach, avoid the intrahepatic duct reasonably and master the key points of ablation.

11.
Chinese Journal of Digestive Surgery ; (12): 1181-1186, 2018.
Article Dans Chinois | WPRIM | ID: wpr-733531

Résumé

Objective To explore the treatment experience and efficacy of precise surgery for hepatic caudate lobe involved lesions.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 127 patients with hepatic caudate lobe involved lesions who were admitted to Hunan Provincial People's Hospital between January 2012 and December 2016 were collected,including 71 of malignant tumors,52 of benign lesions and 4 of other diseases.Anatomical hepatectomy was performed in patients via left approach,right approach,anterior approach,left combined with right approach,left and right combined with anterior approach,left and right combined with para-liver hanging tape approach,anterior combined with left approach,retrograde approach according to their conditions.Observation indicators:(1) intraoperative and postoperative recovery situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was done to detect postoperative survival of patients up to February 2018.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).Kaplain-Meier method was used to calculate survival rate.Results (1) Intraoperative and postoperative recovery situations:all the 127 patients underwent successful operation without perioperative death,including 111 of open surgery and 16 of laparoscopic surgery.Of 127 patients,single total caudate lobectomy and partial caudate lobectomy were performed in 2 and 13 patients,single hepatic segmentectomy combined with total caudate lobectomy,double hepatic segmentectomy combined with total caudate lobectomy,hepatic trisegmentectomy combined with total caudate lobectomy,left hemitectomy combined with total caudate lobectomy,left hepatic trilobectomy combined with total caudate lobectomy,right hemitectomy combined with total caudate lobectomy,right hepatic trilobectomy combined with total caudate lobectomy were performed in 6,4,5,1,1,30,3 patients respectively,single hepatic segmentectomy combined with partial caudate lobectomy,double hepatic segmentectomy combined with partial caudate lobectomy,left hemitectomy combined with partial caudate lobectomy,left hepatic trilobectomy combined with partial caudate lobectomy,right hemitectomy combined with partial caudate lobectomy,right hepatic trilobectomy combined with partial caudate lobectomy were performed in 3,3,41,2,5,8 patients respectively,including 78 via left approach,29 via right approach,2 via anterior approach,7 via left combined with right approach,2 via left and right combined with anterior approach,6 via left and right combined with para-liver hanging tape approach,1 via anterior combined with left approach,2 via retrograde approach.The operation time,time of first hepatic hilum occlusion,volume of intraoperative blood loss and duration of postoperative hospital stay were 285 minutes (range,188-670 minutes),47 minutes(range,30-150 minutes),294 mL(range,20-2 500 mL) and 10 days (range,6-27 days) respectively.Thirty-four patients had postoperative complications,including 21 with abdominal ascites,20 with pleural effusion,6 with incisional infection,5 with hemorrhage,4 with bile leakage,2 with pulmonary infection (1 patient combined with multiple complications).One patient underwent reoperation after ineffective conservative treatment for hemorrhage within postoperative 24 hours and other 33 were cured by conservative treatment.(2) Follow-up and survival situations:of 127 patients,124 including 68 of malignant tumors and 56 of non-malignant tumors were followed up for 2-71 months with a median time of 33 months.During the follow-up,1-,3-,5-year overall survival rates were 83.1%,63.4%,22.5% in 68 patients with malignant tumors,89.3%,71.4%,57.1% in 28 patients with hilar cholangiocarcinoma and 76.9%,46.2%,23.1% in 26 with hepatocellular carcinoma.All the 56 patients with non-malignant tumors survived well.Conclusions Anatomical hepatectomy using precise surgery is safe and feasible.Preoperative precise evaluation and surgical procedure design,intraoperative vascular control and surgical plane mastering are keys to success.

12.
Clinical Psychopharmacology and Neuroscience ; : 449-460, 2018.
Article Dans Anglais | WPRIM | ID: wpr-718216

Résumé

OBJECTIVE: Prior functional magnetic resonance imaging (fMRI) work has revealed that children/adolescents with disruptive behavior disorders (DBDs) show dysfunctional reward/non-reward processing of non-social reinforcements in the context of instrumental learning tasks. Neural responsiveness to social reinforcements during instrumental learning, despite the importance of this for socialization, has not yet been previously investigated. METHODS: Twenty-nine healthy children/adolescents and 19 children/adolescents with DBDs performed the fMRI social/non-social reinforcement learning task. Participants responded to random fractal image stimuli and received social and non-social rewards/non-rewards according to their accuracy. RESULTS: Children/adolescents with DBDs showed significantly reduced responses within the caudate and posterior cingulate cortex (PCC) to non-social (financial) rewards and social non-rewards (the distress of others). Connectivity analyses revealed that children/adolescents with DBDs have decreased positive functional connectivity between the ventral striatum (VST) and the ventromedial prefrontal cortex (vmPFC) seeds and the lateral frontal cortex in response to reward relative to non-reward, irrespective of its sociality. In addition, they showed decreased positive connectivity between the vmPFC seed and the amygdala in response to non-reward relative to reward. CONCLUSION: These data indicate compromised reinforcement processing of both non-social rewards and social non-rewards in children/adolescents with DBDs within core regions for instrumental learning and reinforcement-based decision-making (caudate and PCC). In addition, children/adolescents with DBDs show dysfunctional interactions between the VST, vmPFC, and lateral frontal cortex in response to rewarded instrumental actions potentially reflecting disruptions in attention to rewarded stimuli.


Sujets)
Amygdale (système limbique) , Troubles déficitaires de l'attention et du comportement perturbateur , Conditionnement opérant , Fractales , Lobe frontal , Gyrus du cingulum , Apprentissage , Imagerie par résonance magnétique , Cortex préfrontal , Comportement déviant , Renforcement social , Récompense , Socialisation , Striatum ventral
13.
Chinese Journal of Hepatobiliary Surgery ; (12): 654-658, 2018.
Article Dans Chinois | WPRIM | ID: wpr-708483

Résumé

Objective To study the feasibility,efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) in the caudate lobe.Methods From November 2006 to June 2017,31 patients with 31 HCCs located in the caudate lobe were treated with percutaneous RFA at the First Affiliated Hospital of Sun Yat-sen University.The treatment efficacy,complications,and the local tumor progression (LTP),disease-free survival (DFS) and overall survival (OS) rates were analyzed.Results Residual tumors were detected in 5 patients after the first treatment.Complete necrosis was achieved in all the patients after the second treatment.The mean number of ablation sessions was 1.16±0.37.At a follow-up period which ranged from 3 to 65 months,19 patients had died,10 patients were still alive,and 2 patients were lost to follow-up.The 1-,2-,3-,and 5-years OS rates were 78.4%,48.5%,12.1% and 12.1%,respectively.On follow-up,9 caudate lobe HCC lesions were detected to have LTP.The 1-,2-,and 3-years LTP rates were 21.5%,41.6% and 41.6%,respectively;while the 1-,2-,and 3-years DFS rates were 22.3%,11.2% and 11.2%,respectively.Ablationrelated complications were detected in 4 patients.Conclusions Ultrasound-guided percutaneous RFA was safe and effective for patients with HCC in the caudate lobe.These patients should be followed-up closely to detect LTP.

14.
Chinese Journal of Interventional Imaging and Therapy ; (12): 391-395, 2017.
Article Dans Chinois | WPRIM | ID: wpr-616608

Résumé

Objective To evaluate the efficacy and safety of transcatheter hepatic arterial chemoembolization (TACE) combined with CT guided radiofrequency ablation (RFA) for primary liver cancer in the caudate lobe.Methods Sixteen patients with primary liver cancer in the caudate lobe were treated with combination therapy of TACE and RFA.Complet ablation rate,overall and recurrence-free survival,and complications were evaluated.Results A total of 15 cases achieved complet ablation,complet ablation rate was 93.75% (15/16).Recurrence-free survival time was 19.35 months,overall survival time was 44.62 months.Overall survival rates were 88.23%,66.65% and 33.18% at 1,3,5 years after therapy,respectively.Conclusion TACE combined with RFA is a safe and useful therapeutic option for treatment of primary liver cancer in the caudate lobe.

15.
Chinese Journal of Hepatobiliary Surgery ; (12): 304-306, 2017.
Article Dans Chinois | WPRIM | ID: wpr-618704

Résumé

Objective To study the feasibility and safety of laparoscopic hepatic caudate lobe resec tion.Methods The clinical data of seven patients who underwent laparoscopic hepatic caudate lobe resection in our hospital were retrospective analyzed.There were 3 male and 4 female patients.The mean age was 45.3 years.The primary diseases included hepatic haemangioma (n =2),metastatic liver cancer (n =2),hepatocellular carcinoma (n =1),recurrent hepatocellular carcinoma (n =1) and hepatic adenoma (n =1).The total blood loss,operation time,hospital stay after surgery and complication were analyzed.Results The surgery was successful in all these 7 patients and no patients required any conversion to open surgery.Five patients underwent partial caudate lobe resection,and the remaining 2 underwent combined left hemi hepatectomy with partial caudate lobe resection.The operation time ranged from 200 to 250 minutes with a mean of 235 minutes.The intraoperative blood loss ranged from 40 to 600 ml with a mean of 188 ml.There was no postoperative bleeding and bile leakage.The resections were all R0 resections.Conclusions Laparoscopic hepatic caudate lobe resection was safe and feasible in appropriate patients.Familiarity with anatomy of the liver caudate lobe and skilled laparoscopic techniques are important to carry out this surgery.

16.
The Journal of Practical Medicine ; (24): 1094-1097, 2017.
Article Dans Chinois | WPRIM | ID: wpr-619071

Résumé

Objective To investigate the value of microwave ablation in the treatment of hepatocellular carcinoma in the caudate lobe.Methods We retrospectively analyzed the data of patients with hepatocellular carcinoma in the caudate lobe treated primarily by microwave ablation from January 2011 to May 2016 in our department,and explore the safety,efficacy of microwave ablation (MWA).Results The 11 patients had been treated with microwave ablation procedure in 13 lesions,through caudate lobe epigastric puncture in 9 cases and intercostal puncture in 2 cases.A total of 2 cases did not reach the technical success due to one case treated by radiation therapy,and the other treated by repeated MWA.However,the repeated MWA of that patient failed to reach the technical success.And the effective rate of treatment was 81.8% (9/11).Following up to October 2016,the average follow-up time was (31.5±15.4) months.There were 1 patient with extrahepatic metastasis and 4 cases of patients with intrahepatic distant recurrence,among which 3 cases underwent MWA treatment again and 1 case underwent radiotherapy.Conclusion Microwave ablation is a safe and effective therapy option for the Caudate Lobe tumor.

17.
Chinese Journal of Interventional Imaging and Therapy ; (12): 513-516, 2017.
Article Dans Chinois | WPRIM | ID: wpr-611976

Résumé

Recently,with the recognition of blood supply and anatomy of the liver caudate lobe,the intervention therapies of hepatocellular carcinoma in caudate lobe were enriched.However,because of the complex anatomy,the treatment of hepatocellular carcinoma in caudate lobe is still controversial.The interventional methods for hepatocellular carcinoma in caudate lobe were mainly included transcatheter arterial chemoembolization (TACE),percutaneous ethanol injection (PEI),transcatheter arterial embolization (TAE),radioembolization,radiofrequency ablation (RFA) and endoscopic ultrasound-guided ethanol injection.The present statues and progresses of interventional therapy of hepatocellular carcinoma in caudate lobe were reviewed in this article.

18.
Journal of Practical Radiology ; (12): 542-544,549, 2017.
Article Dans Chinois | WPRIM | ID: wpr-606688

Résumé

Objective To study the clinical significance of the caudate lobe vein in patients with Budd-Chiari syndrome (BCS) by contrast-enhanced magnetic resonance imaging(MRI).Methods Contrast-enhanced MRI data of 46 patients with BCS, 30 patients with cirrhosis due to hepatitis B virus (HBV) and 49 healthy people in our institution were analyzed retrospectively.The presence and diameter of the caudate lobe vein among the three groups were measured.Among the BCS group, in which the caudate lobe vein could be seen, andpatients were divided into two groups according to disease duration and patency of inferior vena cava (IVC), respectively.And comparative study of diameter between two groups was performed.Results ①The caudate lobe vein was noted in 76.1% of patients with BCS, in 30.0% of patients with cirrhosis due to HBV,and in 36.7% of healthy subjects.The diameter of caudate lobe vein in BCS group was larger than that in both cirrhosis group and healthy group(P0.05).②Among BCS group,the caudate vein was shown in 35 patients, with mean diameter of(4.21±1.66)mm.For 35 BCS,the diameter of caudate lobe vein in chronic group was larger than that in acute group(P<0.05).The diameter of caudate lobe vein in IVC obstruction group was larger than that in IVC open group(P<0.05).Conclusion The demonstration of the caudate lobe vein on contrast-enhanced MRI is of great significance in the diagnosis and treatment of BCS.

19.
Article Dans Anglais | IMSEAR | ID: sea-175601

Résumé

Background: To study the morphology of the caudate lobe of liver. The caudate lobe is visible on the posterior surface, bounded on the left by the fissure for the ligamentum venosum, below by the porta hepatis and on the right by the groove for the inferior vena cava. Above, it continues into the superior surface on the right of the upper end of the fissure for the ligamentum venosum. Below and to the right, it is connected to the right lobe by a narrow caudate process, which is immediately behind the porta hepatis and above the epiploic foramen. Below and to the left, the caudate lobe has a small rounded papillary process. Taking into consideration clinical importance of this lobe in metastasis, cirrhosis and hepatic resections a morphological study was carried out on caudate lobe. Methods: This study was undertaken on 36 cadaveric livers available in the Department of Anatomy of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly to study the morphometery of caudate lobe of liver using vernier caliper. Results: Various shapes of the caudate lobe were observed, rectangular being the commonest. Conclusion: Knowledge of variations of caudate lobe may be important to anatomists and morphologists for new variant, embryologists for new developmental defect, clinicians for diseases, surgeons for planning surgery involving liver, and imagery specialists for avoiding misinterpretation of CT and MRI.

20.
Chinese Journal of Hepatobiliary Surgery ; (12): 661-664, 2016.
Article Dans Chinois | WPRIM | ID: wpr-502359

Résumé

Objective To systematically review the risks and effectiveness of combined caudate lobectomy in Klatskin tumor.Methods A systematic literature search was conducted on PubMed,Embase,Cochrane Library,Scopus,CNKI databases and Chinese Bio Medical Literature (CBM).A systematic review and meta-analysis of the current literatures were conducted based on the PRISMA guideline.Odds ratios were calculated using the Mantel-Haenszel method.The primary outcome variables included safety,effectiveness of combined caudate lobectomy and its impact on long-term survival.Results Nine out of 312 articles were included.Results showed caudate lobectomy did not increase the incidence of postoperative complications (OR = 1.15;95 % CI 0.74-1.81;P > 0.05),but improved R0 resection rate (OR = 4.81;95 % CI 2.72 ~ 8.53;P < 0.01) and long-term survival in these patients (OR = 0.20;95% CI 0.11 ~ 0.39;P <0.01).Conclusion Combined caudate lobe resection is a safe and effective treatment for Klatskin tumor.

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