DOES MALE GENDER INCREASE THE RISK OF LAPAROSCOPIC CHOLECYSTECTOMY?

BACKGROUND: Laparoscopic cholecystectomy is the preferable treatment for chronic or acute cholecystitis. Some factors may increase the rate of laparoscopic conversion to open cholecystectomy and perioperative complications. The role of gender as a risk factor for laparoscopic cholecystectomy is controversial. AIM: To evaluate the role of the gender on the operative findings and outcome of laparoscopic cholecystectomy. METHOD: All patients who underwent laparoscopic cholecystectomy for chronic or acute cholecystitis were included. Demographic, clinical, laboratory, imaging exams, intraoperative and postoperative data were obtained and analyzed. The data was obtained retrospectively from electronic medical records and study protocols. RESULTS: Of a total 1,645 patients who were subjected to laparoscopic cholecystectomy, 540 (32.8%) were men and 1,105 (67.2%) were women. Mean age was similar in both genders (p=0.817). Operative time has longer in the male (72.48±28.50) than in the female group (65.46±24.83, p<0.001). The rate of acute cholecystitis was higher in the male (14.3%) than in the female group (5.1%, p<0.001). There was no difference between the genders in regard to the rate of conversion (p=1.0), intraoperative complication (p=1.0), postoperative complication (p=0.571), and operative mortality (p=1.0). CONCLUSION: Male gender is not an independent risk factor for laparoscopic conversion and perioperative complications.

Does male gender increase the risk of laparoscopic cholecystectomy? / O gênero masculino aumenta o risco de colecistectomia laparoscópica?

ABSTRACT Background: Laparoscopic cholecystectomy is the preferable treatment for chronic or acute cholecystitis. Some factors may increase the rate of laparoscopic conversion to open cholecystectomy and perioperative complications. The role of gender as a risk factor for laparoscopic cholecystectomy is controversial. Aim: To evaluate the role of the gender on the operative findings and outcome of laparoscopic cholecystectomy. Method: All patients who underwent laparoscopic cholecystectomy for chronic or acute cholecystitis were included. Demographic, clinical, laboratory, imaging exams, intraoperative and postoperative data were obtained and analyzed. The data was obtained retrospectively from electronic medical records and study protocols. Results: Of a total 1,645 patients who were subjected to laparoscopic cholecystectomy, 540 (32.8%) were men and 1,105 (67.2%) were women. Mean age was similar in both genders (p=0.817). Operative time has longer in the male (72.48±28.50) than in the female group (65.46±24.83, p<0.001). The rate of acute cholecystitis was higher in the male (14.3%) than in the female group (5.1%, p<0.001). There was no difference between the genders in regard to the rate of conversion (p=1.0), intraoperative complication (p=1.0), postoperative complication (p=0.571), and operative mortality (p=1.0). Conclusion: Male gender is not an independent risk factor for laparoscopic conversion and perioperative complications.

RESUMO Racional: A colecistectomia laparoscópica é o tratamento de escolha para colecistite crônica ou aguda. Alguns fatores podem aumentar a taxa de conversão para colecistectomia laparotômica e de complicações perioperatórias. O papel do gênero, como um fator de risco para colecistectomia laparoscópica, é controverso. Objetivo: Avaliar o papel do gênero nos achados operatórios e no desfecho da colecistectomia laparoscópica. Métodos: Todos os pacientes que foram submetidos à colecistectomia laparoscópica por colecistite crônica ou aguda foram incluídos. Dados demográficos, clínicos, laboratoriais, de imagem, intraoperatórios e pós-operatórios foram obtidos e analisados. Os dados foram obtidos retrospectivamente a partir de prontuários eletrônicos e protocolos de estudo. Resultados: De um total de 1.645 pacientes que foram submetidos à colecistectomia laparoscópica, 540 (32,8%) eram homens e 1.105 (67,2%) mulheres. A idade média foi semelhante em ambos os gêneros (p=0,817). O tempo operatório foi maior nos homens (72,48±28,50) do que nas mulheres (65,46±24,83) (p<0,001). A taxa de colecistite aguda foi maior no grupo masculino (14,3%) do que no feminino (5,1%, p<0,001). Não houve diferença entre os gêneros quanto à taxa de conversão (p=1,0), complicação intraoperatória (p=1,0), complicação pós-operatória (p=0,571) e mortalidade operatória (p=1,0). Conclusão: O gênero masculino não é fator de risco independente para a conversão laparoscópica e complicações perioperatórias.

Prevalence of non-alcoholic fatty liver disease in women with polycystic ovary syndrome and its correlation with metabolic syndrome.

BACKGROUND: The polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women at childbearing age. Metabolic syndrome is present from 28% to 46% of patients with PCOS. Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic expression of metabolic syndrome. There are few published studies that correlate PCOS and NAFLD. OBJECTIVE: To determine the prevalence of NAFLD and metabolic syndrome in patients with PCOS, and to verify if there is a correlation between NAFLD and metabolic syndrome in this population. METHODS: Study developed at Gynecology Department of Clinical Hospital of Federal University of Parana (UFPR). The sessions were conducted from April 2008 to January 2009. One hundred and thirty-one patients joined the analysis; 101 were diagnosed with PCOS and 30 formed the control group. We subdivided the PCOS patients into two subgroups: PCOS+NAFLD and PCOS. All the patients were submitted to hepatic sonography. For hepatoestheatosis screening, hepatic ecotexture was compared do spleen's. For diagnosis of metabolic syndrome, we adopted the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) criteria, as well as the criteria proposed by International Diabetes Federation. Statistical analysis were performed with t of student and U of Mann-Whitney test for means and chi square for proportions. RESULTS: At PCOS group, NAFLD was present in 23.8% of the population. At control group, it represented 3.3%, with statistical significance (P=0.01). Metabolic syndrome, by NCEP/ATP III criteria, was diagnosed in 32.7% of the women with PCOS and in 26.6% of the women at control group (no statistical difference, P=0.5). At PCOS+DHGNA subgroup, age, weight, BMI, abdominal circumference and glucose tolerance test results were higher when compared to PCOS group (P<0.01). Metabolic syndrome by NCEP/ATPIII criteria was present in 75% and by International Diabetes Federation criteria in 95.8% of women with PCOS+NAFLD with P<0.01. Insulin levels at SOP+DHGNA were higher than at PCOS group with P<0.01. CONCLUSION: Almost 25% of the patients with PCOS were diagnosed for NAFLD. Metabolic syndrome was present between 32.7% and 44.6% of patients with PCOS. At subgroup PCOS+NAFLD, metabolic syndrome is highly prevalent. These patients are more obese, with higher BMI and higher glucose levels.

Prevalence of nnn-alcoholic fatty liver diseasein women with polycystic ovary syndrome and its correlation with metabolic syndrome / Prevalência de doença hepática gordurosa não alcoólica em pacientes com síndrome dos ovários policísticos e sua correlação com síndrome metabólica

Background The polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women at childbearing age. Metabolic syndrome is present from 28% to 46% of patients with PCOS. Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic expression of metabolic syndrome. There are few published studies that correlate PCOS and NAFLD. Objective To determine the prevalence of NAFLD and metabolic syndrome in patients with PCOS, and to verify if there is a correlation between NAFLD and metabolic syndrome in this population. Methods Study developed at Gynecology Department of Clinical Hospital of Federal University of Parana (UFPR). The sessions were conducted from April 2008 to January 2009. One hundred and thirty-one patients joined the analysis; 101 were diagnosed with PCOS and 30 formed the control group. We subdivided the PCOS patients into two subgroups: PCOS+NAFLD and PCOS. All the patients were submitted to hepatic sonography. For hepatoestheatosis screening, hepatic ecotexture was compared do spleen’s. For diagnosis of metabolic syndrome, we adopted the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) criteria, as well as the criteria proposed by International Diabetes Federation. Statistical analysis were performed with t of student and U of Mann-Whitney test for means and chi square for proportions. Results At PCOS group, NAFLD was present in 23.8% of the population. At control group, it represented 3.3%, with statistical significance (P=0.01). Metabolic syndrome, by NCEP/ATP III criteria, was diagnosed in 32.7% of the women with PCOS and in 26.6% of the women at control group (no statistical difference, P=0.5). At PCOS+DHGNA subgroup, age, weight, BMI, abdominal circumference and glucose tolerance test results were higher when compared to PCOS group (P<0.01). Metabolic syndrome by NCEP/ATPIII criteria was present in 75% and by International Diabetes Federation criteria ...

Contexto A síndrome dos ovários policísticos (SOP) é um dos distúrbios endócrinos mais comuns nas mulheres na idade fértil. A síndrome metabólica está presente em 28% a 46% das pacientes com SOP. A doença hepática gordurosa não alcoólica (DHGNA) é considerada a expressão hepática da síndrome metabólica. Existem poucos estudos publicados da associação SOP e DHGNA. Objetivos Determinar a prevalência de DHGNA e síndrome metabólica em portadoras de SOP, verificar se existe correlação entre a ocorrência de DHGNA e síndrome metabólica nessa população. Métodos Estudo realizado no Ambulatório de Ginecologia do Hospital de Clínicas da Universidade Federal do Paraná. O período de estudo foi de abril 2008 a janeiro de 2009. Participaram da análise 131 pacientes, sendo 101 com SOP e 30 controles. Subdividimos as pacientes com SOP em dois subgrupos: SOP+DHGNA e SOP. Todas foram submetidas a exame ultrassonográfico do fígado. Para rastreamento da esteatose hepática, a ecotextura do parênquima hepático foi comparada com a do baço. Para do diagnóstico da síndrome metabólica foram adotados os critérios propostos pelo National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) e do International Diabetes Federation. A análise estatística foi feita com teste t de student e U de Mann-Whitney para medias e qui-quadrado para proporções. Resultados No grupo com SOP, a DHGNA esteve presente em 23,8% da população. No grupo controle, isso ocorreu em 3,3%, com diferença estatística (P=0,01). A síndrome metabólica pelos critérios NCEP/ATP III, esteve presente em 32,7% no grupo SOP e 26,6% no grupo controle (sem diferença estatística P=0,5). No subgrupo SOP+DHGNA, a idade, o peso, IMC, circunferência abdominal e teste de tolerância à glicose foram maiores quando comparados ao grupo SOP (P<0,01). A síndrome metabólica pelo critério NCEP/ATPIII esteve presente em 75% e pelo International Diabetes Federation em 95,8% no grupo SOP+DHGNA com P<0,01. ...

Hypothalamic-pituitary-gonadal function in men with liver cirrhosis before and after liver transplantation / Função do eixo hipotálamo-hipófise-gonadal em homens cirróticos antes e após o transplante hepático

Objective: To evaluate the influence of end-stage liver disease and orthotopic liver transplantation in the pituitary function and hormone metabolism before and after liver transplantation. Methods: In a prospective study, serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and prolactin (PRL) of 30 male patients with cirrhosis were determined two to four hours before and six months after liver transplantation. The results were compared according to the Model for End-stage Liver Disease (MELD). Results: male patients with liver cirrhosis have hypogonadism. FSH was normal, but inappropriately low due to androgen failure; E2 and PRL, on their turn, were high. After liver transplantation, FSH and LH levels increased (p < 0.05), whereas E2 and PRL normalized (p < 0.05). The MELD score did not influence changes in FSH, PRL and LH, however, the more severe the cirrhosis was, the more significant was the normalization of E2 (p = 0.01). Conclusion: Patients with cirrhosis and male hypogonadism have inappropriately normal levels of FSH and LH, associated with an increase in E2 and LRP. After liver transplantation, FSH and LH increased, while E2 and PRL returned to normal. Changes in E2 levels were most pronounced in patients with MELD > 18. The severity of cirrhosis had no influence on FSH, PRL and LH. .

Objetivo: avaliar a influência da doença hepática terminal e do transplante hepático ortotópico na função hipofisária e no metabolismo hormonal através da aferição dos níveis séricos dos hormônios folículo estimulante (FSH), hormônio luteinizante (HL), estradiol (E2) e prolactina (PRL) antes e após o transplante hepático. Métodos: em um estudo prospectivo, níveis séricos dos hormônios folículo estimulante (FSH), hormônio luteinizante (HL), estradiol (E2) e prolactina (PRL) de 30 paciente masculinos com cirrose foram determinados duas a quatro horas antes e seis meses após o transplante hepático. Os resultados foram comparados de acordo com o Model for End-stage Liver Disease (MELD). Resultados: acientes masculinos com cirrose hepática apresentam hipogonadismo. O FSH encontravam-se normais, porém inapropriadamente baixos devido à falência androgênica; já o E2 e o PRL estavam elevados. Após o transplante hepático, os níveis de FHS e HL aumentaram (p < 0,05), enquanto o E2 e o PRL normalizaram (p < 0,05). O MELD não influenciou as alterações no FSH, HL ou PRL, todavia, quanto mais grave a cirrose, mais significante foi a normalização do E2 (p=0,01). Conclusão: pacientes masculinos com cirrose e hipogonadismo apresentam níveis inapropriadamente normais de FSH e HL, associados com elevação do E2 e PRL. Após o transplante hepático, FSH e HL aumentaram, enquanto E2 e PRL retornaram aos valores normais. As alterações nos níveis de E2 foram mais pronunciadas em pacientes com MELD > 18. A gravidade da cirrose não teve influência no FSH, HL e PRL. .

Hypothalamic-pituitary-gonadal function in men with liver cirrhosis before and after liver transplantation.

OBJECTIVE: To evaluate the influence of end-stage liver disease and orthotopic liver transplantation in the pituitary function and hormone metabolism before and after liver transplantation. METHODS: In a prospective study, serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and prolactin (PRL) of 30 male patients with cirrhosis were determined two to four hours before and six months after liver transplantation. The results were compared according to the Model for End-stage Liver Disease (MELD). RESULTS: male patients with liver cirrhosis have hypogonadism. FSH was normal, but inappropriately low due to androgen failure; E2 and PRL, on their turn, were high. After liver transplantation, FSH and LH levels increased (p < 0.05), whereas E2 and PRL normalized (p < 0.05). The MELD score did not influence changes in FSH, PRL and LH, however, the more severe the cirrhosis was, the more significant was the normalization of E2 (p = 0.01). CONCLUSION: Patients with cirrhosis and male hypogonadism have inappropriately normal levels of FSH and LH, associated with an increase in E2 and LRP. After liver transplantation, FSH and LH increased, while E2 and PRL returned to normal. Changes in E2 levels were most pronounced in patients with MELD > 18. The severity of cirrhosis had no influence on FSH, PRL and LH.

Insulin-like growth factor I correlates with MELD and returns to normal level after liver transplantation.

BACKGROUND: Insulin-like growth factor I (IGF-I) is produced almost entirely by the liver and is the main promoter of anabolic growth hormone (GH) effects on protein, carbohydrate, and lipid metabolism. IGF-I is significantly decreased in patients with liver cirrhosis. Our objective was to determine the relationship between circulating IGF-I and MELD (Model for End-stage Liver Disease) in cirrhotics subjected to orthotopic liver transplantation (OLT). We also assessed the changes of IGF-I and its major binding protein (IGF-binding protein-3 or IGFBP-3) after OLT. MATERIAL AND METHODS: In a prospective study, serum levels of IGF-I and IGFBP-3 of 25 male adult patients with end-stage liver disease were measured 2 to 4 hours before and 6 months after orthotopic liver transplantation. Seven age-matched healthy male volunteers with normal liver enzymes, albumin, and prothrombin time served as controls. MELD was determined on the day of OLT. For this analysis, extra points were not added for patients with hepatocarcinoma. RESULTS: The cirrhotic group had significantly lower IGF-I (46.7±21.6 ng/mL) and IGFBP-3 (1.0±0.9 ng/mL) levels in the pre-transplant period compared with the controls (208.6±76.5 ng/mL and 4.62±0.93 ng/mL, respectively) (p<0.05). There was a negative correlation between IGF-I or IGFBP-3 and MELD (p<0.001) (ß=-1.750; standard error =2.5054 and ß=-0.038; standard error <0.0001, respectively). IGF-I e IGFBP-3 increased to normal levels after OLT (207.7±82.8 and 4.14±1.1 ng/mL, respectively) (p<0.001). CONCLUSIONS: Low levels of IGF-I and IGFBP-3 observed in patients with advanced liver cirrhosis are corrected after OLT. IGF-I and IGFBP-3 correlate negatively with MELD.

Donor complications including the report of one death in right-lobe living-donor liver transplantation.

BACKGROUND/AIMS: Our objective is to assess donor complications in all right hepatic lobe living-donor liver transplantation (LDLT) at our center. METHODS: Of a total of 352 liver transplantations performed, 60 were right-lobe LDLT. Most donors (88.3%) were related to the recipients. RESULTS: Mean hospital stay was 5.4+/-0.6 days. No complications occurred due to preoperative evaluation. Most donors received one or two units of autologous blood transfusion. Only 5 (8.3%) needed nonautologous blood transfusion. Most complications were minor and treated conservatively. Bile leaks from the cut surface of the liver occurred in 5 donors (8.3%). Two patients had potentially fatal complications: perforated duodenal ulcer and portal vein thrombosis (PVT). The donor with perforated ulcer developed septicemia and multiple organ failure. He was discharged from the hospital with hemiparesis due to cerebral ischemia. The patient with PVT remained asymptomatic and the portal vein was recanalized by the 3rd postoperative month. One donor died in the immediate postoperative period of cardiac arrest due to cardiac arrhythmia. CONCLUSION: Right hepatectomy for LDLT may be associated with significant morbidity, including death and it should be performed only by surgeons with great experience.

[Study of biliary anatomy in living related liver transplantation]. / Anatomia das vias biliares em doadores e receptores de transplante hepático inter vivos.

BACKGROUND: Anatomic variations of the biliary tree are frequent and increase complications after liver transplantation. AIM: To describe the anatomy of the bile ducts of donors and recipients of living related liver transplantation. METHODS: From March 1998 to September 2002, the study was retrospective (23 transplantations). From October 2002 to August 2003, the study was prospective (17 transplantations). We studied the hepatic anatomy of 80 consecutive patients (40 donors and 40 recipients) of the living-related liver transplantation program of the "Hospital de Clínicas da Universidade Federal do Paraná" and the "Hospital Nossa Senhora das Graças", Curitiba, PR, Brazil; 51 were male (27 recipients 24 donors) and 29 female (13 recipients and 16 donors). The median age among the donors was 32.6 years and among the recipients was 36.3 years. Thirty-two recipients were adults and 8 recipients were under 15 years old. The bile duct anatomy was studied by magnetic resonance cholangiography in 33 patients, and anomalies were seen in 3 of them (9.1%). RESULTS: The most prevalent variation of bile ducts was the fusion of the right posterior duct with the left duct (6.06%; n=2). In the 40 harvesting operations, the right bile duct was single in 25 patients (87.5%), among the 32 right-lobe donors, double in 2 (6.25%) and triple in 2 (6.25%). All of the eight left livers procured had single bile ducts. Among the 40 recipients, the common bile duct was bifurcated in 2 of them (5%). CONCLUSION: The prevalence of biliary anomalies is high in patients subjected to living liver transplantation and some anomalies are not diagnosed with preoperative imaging exams.

Anatomia das vias biliares em doadores e receptores de transplante hepático inter vivos / Study of biliary anatomy in living related liver transplantation / Study of biliary anatomy in living related liver transplantation

RACIONAL: Variações anatômicas das vias biliares são freqüentes e aumentam as complicações dos transplantes hepáticos. OBJETIVO: Avaliar a anatomia das vias biliares nos doadores e receptores do transplante hepático inter vivos realizados no Hospital de Clínicas da Universidade Federal do Paraná e do Hospital Nossa Senhora das Graças de Curitiba, Curitiba, PR. CASUíSTICA E MÉTODOS: A avaliação foi retrospectiva de março de 1998 até setembro de 2002 (23 transplantes), quando os dados passaram a ser captados de forma prospectiva (17 transplantes), até agosto de 2003. Foram obtidos dados de 80 pacientes consecutivos (40 doadores e 40 receptores), submetidos a transplante hepático inter vivos, sendo 32 transplantes com receptor adulto e 8 transplantes pediátricos (receptor com idade inferior a 15 anos). Entre os 80 pacientes incluídos no estudo, 51 eram do sexo masculino (27 receptores e 24 doadores) e 29 do feminino (13 receptores e 16 doadores). A idade média dos doadores foi de 32,6 anos e a dos receptores de 36,3 anos. RESULTADOS: Nas cirurgias de captação do lobo hepático direito, a via biliar direita foi única em 25 entre 29 casos (86,2 por cento), dupla em dois (6,9 por cento) e tripla em dois (6,9 por cento). Nos oito casos em que o setor lateral esquerdo ou o lobo hepático esquerdo foram captados, a via biliar foi única. Entre os 33 pacientes submetidos a colangiografia por ressonância magnética, variações foram verificadas em três pacientes (9,1 por cento), sendo a mais comum o ducto biliar posterior direito tributário do ducto hepático esquerdo (6,06 por cento; n = 2). CONCLUSÃO: A prevalência de anomalias biliares nos transplantes inter vivos de fígado é elevada e algumas não são diagnosticadas com os exames de imagem pré-operatórios.

BACKGROUND: Anatomic variations of the biliary tree are frequent and increase complications after liver transplantation. AIM: To describe the anatomy of the bile ducts of donors and recipients of living related liver transplantation. METHODS: From March 1998 to September 2002, the study was retrospective (23 transplantations). From October 2002 to August 2003, the study was prospective (17 transplantations). We studied the hepatic anatomy of 80 consecutive patients (40 donors and 40 recipients) of the living-related liver transplantation program of the "Hospital de Clínicas da Universidade Federal do Paraná" and the "Hospital Nossa Senhora das Graças", Curitiba, PR, Brazil; 51 were male (27 recipients 24 donors) and 29 female (13 recipients and 16 donors). The median age among the donors was 32.6 years and among the recipients was 36.3 years. Thirty-two recipients were adults and 8 recipients were under 15 years old. The bile duct anatomy was studied by magnetic resonance cholangiography in 33 patients, and anomalies were seen in 3 of them (9.1 percent). RESULTS: The most prevalent variation of bile ducts was the fusion of the right posterior duct with the left duct (6.06 percent; n=2). In the 40 harvesting operations, the right bile duct was single in 25 patients (87.5 percent), among the 32 right-lobe donors, double in 2 (6.25 percent) and triple in 2 (6.25 percent). All of the eight left livers procured had single bile ducts. Among the 40 recipients, the common bile duct was bifurcated in 2 of them (5 percent). CONCLUSION: The prevalence of biliary anomalies is high in patients subjected to living liver transplantation and some anomalies are not diagnosed with preoperative imaging exams.

Anatomia da artéria hepática em doadores e receptores de transplante hepático intervivos / Hepatic artery anatomy in living related liver transplantation

OBJETIVO: O objetivo do presente estudo é avaliar a anatomia da artéria hepática nos doadores e receptores do transplante hepático intervivos realizados no Hospital de Clínicas da Universidade Federal do Paraná e do Hospital Nossa Senhora das Graças de Curitiba. MÉTODO: A avaliação foi retrospectiva de março de 1998 até setembro de 2002 (23 transplantes), quando os dados passaram a ser captados de forma prospectiva (17 transplantes), até agosto de 2003. Foram obtidos dados de 80 pacientes consecutivos (40 doadores e 40 receptores), submetidos a transplante hepático intervivos, sendo 32 transplantes com receptor adulto e 8 transplantes pediátricos (receptor com idade inferior a 15 anos). Entre os 80 pacientes incluídos no estudo, 51 eram do sexo masculino (27 receptores e 24 doadores) e 29 eram do sexo feminino (13 receptores e 16 doadores). A idade média dos doadores foi de 32,6 anos e a dos receptores de 36,3 anos. RESULTADOS: No estudo da anatomia da artéria hepática, realizaram-se arteriografias em 43 pacientes, e variações anatômicas foram encontradas em 18 casos (41,86 por cento), sendo a mais comum a artéria hepática direita ramo da artéria mesentérica superior (12,5 por cento; n=5); no estudo da anatomia arterial realizado nas cirurgias, foram verificadas variações em 16 casos (20 por cento) entre os 80 casos estudados, sendo a mais comum a artéria hepática direita como ramo da artéria mesentérica superior (7,5 por cento; n=6). CONCLUSÃO: Conclui-se que a prevalência de variações na anatomia da artéria hepática é elevada.

Anatomia das veias hepáticas em doadores e receptores de transplante hepático intervivos / Hepatic veins anatomy of donors and recipients of living related liver transplantation

Anomalias das veias hepáticas são comuns e podem aumentar as complicações do transplante hepático intervivos. Objetivo - avaliar a anatomia das veias hepáticas nos doadores e receptores do transplante hepático intervivos realizados no Hospital de Clínicas da Universida Federal do Paraná e do Hospital Nossa Senhora das Graças de Curitiba / Anomalies of the hepatic veins are common and may increase complications after living related liver transplantation. Aim - to describe the anatomy of the hepatic artery of donors and recipients of living related liver transplantation...