2.Role of Liver Biopsy in the Assessment of Hepatic Fibrosis: Its Utility and Limitations.
The Korean Journal of Hepatology 2007;13(2):138-145
Hepatic fibrosis and cirrhosis are the consequences of many types of chronic liver disease. The precise quantification of fibrosis is important to predict the prognosis and monitor the response of treatment modality. The liver biopsy has a role to estimate the stage of fibrosis. However, its sensitivity is below 80%. Its use is limited by sampling errors, inter- and intraobserver variability and possible morbidity and mortality. There is increasing attention to developing clinical algorithms and new noninvasive alternative techniques to predict the stage of fibrosis. However none of these can replace the utility of liver biopsy in the intermediate stage of hepatic fibrosis. Therefore, the liver biopsy is still the "gold standard" to assess the precise stage of hepatic fibrosis.
Biopsy
;
Chronic Disease
;
Disease Progression
;
Fibrosis
;
Humans
;
Liver/*pathology
;
Liver Cirrhosis/*pathology/surgery
;
Severity of Illness Index
3.Current status of laparoscopic liver resection for hepatocellular carcinoma.
Hanisah GURO ; Jai Young CHO ; Ho Seong HAN ; Yoo Seok YOON ; YoungRok CHOI ; Mohan PERIYASAMY
Clinical and Molecular Hepatology 2016;22(2):212-218
Laparoscopic liver resection (LLR) is becoming widely accepted for the treatment of hepatocellular carcinoma (HCC). Laparoscopic left lateral sectionectomy and minor laparoscopic liver resection are now considered standard approaches, especially for tumors located in the anterolateral segments of the liver. Laparoscopic left lateral sectionectomy in adult donors is also gaining acceptance for child liver transplantation in many centers. Major LLRs, including left hepatectomy and right hepatectomy, have been recently attempted. Laparoscopic donor hepatectomy is becoming more popular owing to increasing demand from young living donors who appreciate its minimal invasiveness and excellent cosmetic outcomes. Several centers have performed total laparoscopic donor right hepatectomy in adult-to-adult living donor liver transplantation. Many meta-analyses have shown that LLR is better than open liver resection in terms of short-term outcomes, principally cosmetic outcomes. Although no randomized control trials have compared LLR with open liver resection, the long-term oncologic outcomes were similar for both procedures in recent case-matched studies.
Carcinoma, Hepatocellular/complications/pathology/*surgery
;
Humans
;
Laparoscopy
;
Liver Cirrhosis/complications
;
Liver Neoplasms/pathology/*surgery
;
Neoplasm Recurrence, Local
;
Prognosis
4.Current status of laparoscopic liver resection for hepatocellular carcinoma.
Hanisah GURO ; Jai Young CHO ; Ho Seong HAN ; Yoo Seok YOON ; YoungRok CHOI ; Mohan PERIYASAMY
Clinical and Molecular Hepatology 2016;22(2):212-218
Laparoscopic liver resection (LLR) is becoming widely accepted for the treatment of hepatocellular carcinoma (HCC). Laparoscopic left lateral sectionectomy and minor laparoscopic liver resection are now considered standard approaches, especially for tumors located in the anterolateral segments of the liver. Laparoscopic left lateral sectionectomy in adult donors is also gaining acceptance for child liver transplantation in many centers. Major LLRs, including left hepatectomy and right hepatectomy, have been recently attempted. Laparoscopic donor hepatectomy is becoming more popular owing to increasing demand from young living donors who appreciate its minimal invasiveness and excellent cosmetic outcomes. Several centers have performed total laparoscopic donor right hepatectomy in adult-to-adult living donor liver transplantation. Many meta-analyses have shown that LLR is better than open liver resection in terms of short-term outcomes, principally cosmetic outcomes. Although no randomized control trials have compared LLR with open liver resection, the long-term oncologic outcomes were similar for both procedures in recent case-matched studies.
Carcinoma, Hepatocellular/complications/pathology/*surgery
;
Humans
;
Laparoscopy
;
Liver Cirrhosis/complications
;
Liver Neoplasms/pathology/*surgery
;
Neoplasm Recurrence, Local
;
Prognosis
5.Littoral Cell Angioma (LCA) Associated with Liver Cirrhosis.
Hi Gu KIM ; In Suh PARK ; Jung Il LEE ; Seok JEONG ; Jin Woo LEE ; Kye Suk KWON ; Don Haeng LEE ; Pum Soo KIM ; Hyung Gil KIM ; Yong Woon SHIN ; Young Soo KIM ; In Sun AHN ; Keon Young LEE
Yonsei Medical Journal 2005;46(1):184-188
A littoral cell angioma (LCA) is a rare benign vascular tumor of the spleen. A 60-year-old man, with multiple nodules in imaging study and liver cirrhosis graded as Child-Pugh classification class A, was transferred for splenomegaly. A thrombocytopenia was found on hematological evaluation. Because there was no evidence of hematological and visceral malignancy, a splenectomy was performed for a definitive diagnosis. The histological and immunohistochemical features of the splenic specimens were consistent with a LCA. After the splenectomy, the thrombocytopenia recovered to the normal platelet count. There has been no previous report of a LCA combined with liver cirrhosis. Herein, the first case of a LCA in Korea, diagnosed and treated by a splenectomy, is reported.
Hemangioma/*complications/pathology/surgery
;
Humans
;
Liver Cirrhosis/*complications/pathology
;
Male
;
Middle Aged
;
Splenectomy
;
Splenic Neoplasms/*complications/pathology/surgery
6.Focal nodular hyperplasia-like nodule in liver cirrhosis.
Haeryoung KIM ; Young Nyun PARK
The Korean Journal of Hepatology 2008;14(2):226-230
No abstract available.
Diagnosis, Differential
;
Focal Nodular Hyperplasia/etiology/*pathology/surgery
;
Hepatectomy
;
Humans
;
Liver Cirrhosis/complications/*diagnosis/pathology
;
Male
;
Middle Aged
7.Analysis of prognostic factors in patients with hepatocellular carcinoma (≤5 cm) underwent hepatectomy.
Weiqi RONG ; Weibo YU ; Jianxiong WU ; Fan WU ; Liming WANG ; Fei TIAN ; Songlin AN ; Li FENG
Chinese Journal of Surgery 2016;54(2):89-93
OBJECTIVETo explore the clinical and pathological factors influencing the prognosis of patients with hepatocellular carcinoma (HCC)(≤5 cm) after hepatectomy.
METHODSTwo hundreds and nineteen cases with HCC(≤5 cm) undergoing hepatectomy in Cancer Hospital, Chinese Academy of Medical Sciences between December 2003 and July 2013 were collected. The alpha fetoprotein (AFP) level, tumor number, tumor size (diameter), liver cirrhosis, vascular invasion, capsular invasion, differentiation, surgical methods, resection margin, the way of treatments, the situation of recurrence and time to recurrence were analyzed. Log-rank test and the stepwise Cox proportional-hazards models were used to compare the prognosis, respectively.
RESULTSThe 1-, 3-, 5- and 10- year overall survival rates were 95.9%, 85.3%, 67.8% and 53.3% respectively in all patients.Single factor analysis indicated that vascular invasion, capsular invasion, tumor size, hepatic vascular occult, liver cirrhosis, tumor differentiation, AFP, the way of treatments, the situation of recurrence and time to recurrence can affect the prognosis significantly (all P<0.05). The multifactor analysis showed that AFP, tumor differentiation, liver cirrhosis, capsular invasion, tumor size and the situation of recurrence and time to recurrence were independent prognostic factors (all P<0.05).
CONCLUSIONThe prognosis of patients with HCC(≤5 cm) underwent hepatectomy are affected by multi-factors, such as AFP, tumor differentiation, liver cirrhosis, capsular invasion, tumor size and the situation of recurrence and time to recurrence.
Carcinoma, Hepatocellular ; diagnosis ; surgery ; Hepatectomy ; Humans ; Liver Cirrhosis ; diagnosis ; pathology ; Liver Neoplasms ; diagnosis ; surgery ; Neoplasm Recurrence, Local ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; alpha-Fetoproteins ; analysis
8.Role and significance of extrahepatic control of hepatic vein and inferior vena cava in difficult hepatectomies for patients with liver tumors.
Shu-you PENG ; Ying-bin LIU ; Bin XU ; Xiu-jun CAI ; Yi-ping MU ; Yu-lian WU ; Li-ping CAO ; He-qing FANG ; Jian-wei WANG ; Hai-jun LI ; Jiang-tao LI ; Xin-bao WANG ; Gui-long DENG
Chinese Journal of Surgery 2004;42(5):260-264
OBJECTIVETo explore the role of extrahepatic control on blood flow of hepatic vein and inferior vena cava in hepatectomy, and observe its effect on minimizing hemorrhage.
METHODSFrom 2001 to April 2003, 33 patients who had liver tumors involving segment IV, VII, VIII or half liver underwent major hepatectomies that required exposure of the inferior vena cava and main trunks of hepatic veins, during which the major hepatic veins and inferior vena cava were isolated and taped to control blood flow when necessary.
RESULTSIn 33 attempts, 32 were successful and all tumors were resected successfully. The placement of occlusion tape was unsuccessful in 1 case. 7 cases did not need blood transfusion during operation. The amount of blood transfusion for other cases were form 0 to 1 600 ml. there was no operative mortality.
CONCLUSIONSAppropriate control of main truck of hepatic vein and inferior vena cava is effective in reducing blood loss during hepatectomies. It is also very helpful for performing difficult hepatectomies.
Adult ; Aged ; Carcinoma, Hepatocellular ; surgery ; Female ; Hepatectomy ; adverse effects ; methods ; Hepatic Duct, Common ; surgery ; Hepatic Veins ; surgery ; Humans ; Liver ; blood supply ; pathology ; Liver Cirrhosis ; etiology ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Vena Cava, Inferior ; surgery
9.Congenital hepatic fibrosis: report of a case.
Chinese Journal of Pathology 2010;39(7):485-486
10.CT Detection of Hepatocellular Carcinoma in Advanced Liver Cirrhosis: Correlation of Helical CT and Explanted Liver.
Jae Hoon LIM ; Min Ju KIM ; Liu Wei CHIANG ; Hyo Keun LIM ; Cheol Keun PARK ; Seung Woon PAIK ; Kwang Cheol KOH ; Jae Won JOH
The Korean Journal of Hepatology 2002;8(2):201-208
OBJECTIVE: The objective of this study was evaluate the diagnostic efficacy of three-phase helical dynamic CT in the detection of hepatocellular carcinomas in patients with advanced liver cirrhosis. MATERIALS AND METFODS: Three-phase helical dynamic CT in 77 patients with advanced liver cirrhosis was evaluated prospectively before orthotopic liver transplantation. The histopathologically confirmed hepatocellular carcinomas in the explanted livers were compared with pretransplantation CT results by one-to-one correlation. RESULTS: Histopathologic examination of the explanted livers revealed 72 hepatocellular carcinomas in 41 patients. The size of the hepatocellular carcinomas was 0.5-14.0 cm (mean, 1.6 cm). The use of helical dynamic CT enabled the detection of 38 of 72 hepatocellular carcinomas (sensitivity, 53%). Fifteen of 35 (43%) hepatocellular carcinomas smaller than 2 cm and 23 of 37 (62%), hepatocellular carcinomas ranging from 2.0 cm to 14.0 cm were detected. Patient sensitivity and specificity in the detection of hepatocellular carcinoma were 81% (33/41) and 94% (34/36), respectively. CONCLUSIONS: Three-phase helical dynamic CT is insensitive for detection of hepatocellular carcinomas in patients with advanced liver cirrhosis, especially for hepatocellular carcinomas smaller than 2 cm.
Adolescent
;
Adult
;
Biopsy
;
Carcinoma, Hepatocellular/complications/pathology/*radiography/surgery
;
Female
;
Human
;
Liver/*pathology
;
Liver Cirrhosis/*complications
;
Liver Neoplasms/complications/pathology/*radiography/surgery
;
Male
;
Middle Aged
;
Prospective Studies
;
Sensitivity and Specificity
;
*Tomography, Spiral Computed