Kooperativer Bibliotheksverbund

Berlin Brandenburg

and
and

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    In: Transplantation Journal, 2012, Vol.94(11), pp.1138-1144
    Description: BACKGROUND: Preoperative imaging and donor selection are cardinal components of adult-to-adult live donor liver transplantation (ALDLT). The purpose of this study was to evaluate our three-dimensional (3D) computed tomography image-derived computer-assisted surgical planning (3D CASP) in ALDLT. METHODS: Eighty-three consecutive ALDLTs (71 right and 12 left) were planned with 3D CASP. Graft, remnant, and total liver volume compliance were calculated and compared with actual intraoperative values. Computed risk analysis encompassing territorial liver mapping, functional (safely drained) volumes, and outflow congestion volumes in grafts and remnants allowed for the individualized management of the middle hepatic vein (MHV). RESULTS: Graft volume compliance was 13.5%±4.4%. Three small-for-size (SFS) grafts with lethal SFS syndrome (SFSS) had nonsignificant volume compliance with maximal graft volume-body weight ratios of less than 0.83. Seven SFS grafts with reversible or absent SFSS showed maximal graft volume-body weight ratios of 0.9 to 1.16. Significant differences were identified for (a) virtual graft and remnant congestion volumes of risky versus nonrisky MHV types (49%±6% and 34%±7% vs. 29%±8% and 33%±12%, P〈0.001 and P〈0.02, respectively) and (b) virtual mean functional versus surgical volumes of grafts (527±119 vs. 963±176 mL, P〈0.0001) and remnants (419±182 vs. 640±213 mL, P〈0.001). CONCLUSIONS: CASP allowed for (a) prevention of SFSS in extremely small grafts by predicting donor liver plasticity and (b) individualized MHV management for both donors and recipients based on functional graft/remnant volume analysis.
    Keywords: Donors ; Computed Tomography ; Hepatic Vein ; Mapping ; Imaging ; Plasticity (Functional) ; Computed Tomography ; Donors ; Mapping ; Plasticity (Functional) ; Hepatic Vein ; Imaging ; Transplantation;
    ISSN: 0041-1337
    E-ISSN: 15346080
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    In: Transplantation, 2010, Vol.89(12), pp.1518-1525
    Description: BACKGROUND.: The knowledge of “venous dominance” is essential to prevent serious venous congestion in live donor liver transplantation and extended liver resections. AIMS.: The purpose of our study was to delineate our proposed anatomic-functional classification of hepatic venous drainage. METHODS.: One hundred forty consecutive live liver donor candidates underwent three-dimensional computed tomography reconstructions and three-dimensional virtual hepatectomies. Five different venous dominance types were defined on drainage volumes or territories. “Risky” configurations were identified and classified. RESULTS.: The right hepatic vein (RHV) was dominant for the entire liver and right hemiliver (RHH) in most (83.5%) cases irrespective of the presence of inferior (accessory) hepatic veins (IHVs). The middle hepatic vein (MHV) was dominant for the total liver (TL) in 15.5% of cases and for the RHH in 27% of cases. The left hepatic vein was almost always (92%) dominant for the left hemiliver. When associated with a large IHV drainage volume, a RHV/IHV complex dominant for the TL led to a RHH dominant MHV (mean 59.5%RHH) if the IHV was not reconstructed. CONCLUSIONS.: Our proposed anatomic-functional classification provides a valuable insight into hepatic vein dominance patterns. RHH venous drainage patterns at “high risk” for venous congestion include (1) a dominant MHV for the TL and (2) a dominant RHV/IHV complex with a large IHV drainage volume.
    Keywords: Hepatic Veins -- Pathology ; Image Processing, Computer-Assisted -- Methods ; Liver -- Blood Supply ; Liver Transplantation -- Methods ; Tomography, X-Ray Computed -- Methods;
    ISSN: 0041-1337
    E-ISSN: 15346080
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    In: Transplantation, 2009, Vol.87(11), pp.1672-1680
    Description: BACKGROUND.: The purpose of this study was to compare outcomes after duct-to-duct anastomoses with or without biliary T-tube in orthotopic liver transplantation. METHODS.: We pooled the outcomes of 1027 patients undergoing choledocho-choledochostomy with or without T-tube in 9 of 46 screened trials by means of fixed or random effects models. RESULTS.: The “without T-tube” and “with T-tube” groups had equivalent outcomes for: anastomotic bile leaks or fistulas, choledocho-jejunostomy revisions, dilatation and stenting, hepatic artery thromboses, retransplantation, and mortality due to biliary complications. The “without T-tube” group had better outcomes when considering “fewer episodes of cholangitis,” “fewer episodes of peritonitis,” and showed a favorable trend for “overall biliary complications.” Although the “with T-tube” group showed superior result for “anastomotic and nonanastomotic strictures,” the incidence of interventions was not diminished. CONCLUSIONS.: Our systematic review and meta analysis favor the abandonment of T-tubes in orthotopic liver transplantation.
    Keywords: Hepatic Artery ; Mortality ; Cholangitis ; Peritonitis ; Bile ; Reviews ; Stenosis ; Clinical Trials ; Models ; Liver Transplantation ; Transplantation;
    ISSN: 0041-1337
    E-ISSN: 15346080
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. Further information can be found on the KOBV privacy pages