No abstract available.
Bile Duct Neoplasms/complications/*diagnosis/pathology ; *Bile Ducts, Intrahepatic/pathology ; Cholangiocarcinoma/complications/*diagnosis/pathology ; Female ; Humans ; Lithiasis/*etiology/pathology/surgery ; Liver Diseases/*etiology/pathology/surgery ; Middle Aged

OBJECTIVETo assess the value of magnetic resonance imaging (MRI) in mid- and long-term complication monitoring after liver transplantation.

METHODSTwenty-one recipients receiving orthotropic liver transplantation between Feb 2003 and May 2005 were enrolled in this study. FLASH T(1)-weighted, T(2)-weighted fast spin echo, T(2)-weighted fat suppression, dynamic gadolinium-enhanced, MR cholangiopancreatography (MRCP) and three-dimensional dynamic gadolinium-enhanced FISP MRA images were obtained.

RESULTSOf the 21 patients, bile duct complications were detected in all cases and liver arterial and venous complications in 8 cases. Liver cancer relapse occurred in 5 cases and allograft failure in 4.

CONCLUSIONMR imaging allows effective monitoring of mid- and long-term complications of liver transplantation, which provides valuable clues for their clinical treatment.

Adult ; Arterial Occlusive Diseases ; diagnosis ; etiology ; Bile Duct Diseases ; diagnosis ; etiology ; Female ; Hepatic Artery ; diagnostic imaging ; pathology ; Humans ; Liver Cirrhosis ; surgery ; Liver Neoplasms ; surgery ; Liver Transplantation ; adverse effects ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Radiography ; Reproducibility of Results ; Sensitivity and Specificity

Idiopathic cecal ulcer is a rare disease entity of unknown cause diagnosed by ruling out other known causes of cecal ulceration. The most common complication of an idiopathic cecal ulcer is bleeding; perforation, peritonitis, abscess, and stricture formation have been noted. The authors treated a 53-year-old woman who presented with fever and intermittent right upper quadrant abdominal pain. Multiple pyogenic liver abscess and a solitary cecal ulcer were diagnosed by radiologic, endoscopic, and pathologic examination, followed by laparoscopic cecectomy. After extensive study, we concluded that this patient's liver abscesses were a complication of the idiopathic cecal ulcer. Herein, we report a case of multiple pyogenic liver abscess caused by microperforation of idiopathic cecal ulcer.
Cecal Diseases/complications/*diagnosis/surgery ; Colonoscopy ; Female ; Humans ; Laparoscopy ; Liver/pathology ; Liver Abscess, Pyogenic/*diagnosis/etiology ; Middle Aged ; Tomography, X-Ray Computed ; Ulcer/complications/*diagnosis/surgery

Spontaneous intrahepatic bleeding is a rare condition. In the absence of trauma, intrahepatic hematoma may be due to underlying liver disease. We report a case of hepatocellular carcinoma in the patient who had huge intrahepatic hematoma without definite intrahepatic tumor at the time of initial presentation. A 54-year-old man was admitted to our hospital with a sudden onset of upper abdominal pain. Initial abdominal CT scan showed huge hematoma measuring more than 13 cm in diameter in the right lobe of the liver. However, there was no enhancing lesion in the liver. Laboratory data showed high alanine aminotransferase, alpha-fetoprotein and positive HBsAg. The MRI and angiography could not also depict any mass in the liver. The patient was treated with percutaneous drainage on the intrahepatic hematoma. The cytology from drainaged blood revealed no malignant cell. After hematoma decreased, follow-up CT scan depicted an enhancing tumor in the liver. He underwent right hepatic lobectomy and histopathological examination showed hepatocellular carcinoma.
Carcinoma, Hepatocellular/*diagnosis/pathology/surgery ; Hematoma/*diagnosis/etiology ; Humans ; Liver Diseases/*diagnosis/etiology ; Liver Neoplasms/*diagnosis/pathology/surgery ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo evaluate therapeutical effect of combined hepatic resection and fenestration on patients with severe adult polycystic liver disease (APLD).

METHODSPreoperative clinical symptoms, postoperative complications and prognoses from 33 patients with severe adult polycystic liver disease (APLD) treated with combined hepatic resection and fenestration were recorded. According to the number and location of cysts before surgery and the remnant liver parenchyma after operation, all patients were classified into two types: class A and B. And patients in each type were further classified into three grades: Grade I, II and III. The frequency of postoperative complications of two types patients was compared.

RESULTSThe mean follow-up time was 57 months. There were three patients with recurrence of symptoms at 81, 68 and 43 mouths after operation. Two patients died of renal failure due to polycystic kidney disease at 137 and 85 mouths after operation. And one patient with postoperative hepatic inadequacy received an orthotopic liver transplantation. The total number of patients with postoperative complications was 26 cases, including one patient with bleeding, two patients with bile leakage, fourteen patients with mild ascites, twelve patients with severe ascites and eighteen patients with pleural effusion, and the overall incidence was 78.8%. There were 22 patients with imaging data, including 6 patients within A type and sixteen patients within B type. The frequencies of postoperative complications were 4 and 31, respectively, and the difference was statistically significant (Chi-square test = 4.99, P less than 0.05).

CONCLUSIONCombined hepatic resection and fenestration is a safe and acceptable procedure for the treatment of severe APLD.

Adult ; Aged ; Ascites ; epidemiology ; etiology ; Cysts ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Humans ; Liver ; diagnostic imaging ; pathology ; surgery ; Liver Diseases ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Pleural Effusion ; epidemiology ; etiology ; Postoperative Complications ; epidemiology ; prevention & control ; Prognosis ; Recurrence ; Retrospective Studies ; Severity of Illness Index ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo evaluate the therapeutic effect of subcutaneous tunnel hepaticoplasty on the treatment of hepatolithiasis.

METHODSThe early complications and clinical effects of 99 hepatolithiasis cases who underwent subcutaneous tunnel hepaticoplasty from January 1993 to August 2006 were analyzed retrospectively. The stones of 28 (28.3%) patients were in the left lobe, 24.2% (24/99) in the right, and 47.5% (47/99) in bilateral lobe. Sixty-six patients (66.7%) had both stones and biliary strictures. During the procedure, a portion of the liver habouring stone was resected if necessary. The hepatic duct and strictures were opened, the stones were removed, and the porta hepatis was repaired by one end of a segment of jejunum. The other end of the jejunum was set subcutaneously. The gall bladders of 27 patients (27.3%) were used as subcutaneous tunnel instead.

RESULTSNinety-five out of ninety-nine cases were followed up with an average of 4.2 years (1 month to 13.5 years). The rates of residual stone, recurrent stone and cholangitis were 23.2% (23/99), 20.0% (19/95) and 14.7% (14/95) respectively. Postoperatively, 34 cases who had residual or recurrent stones were underwent lithotomy by choledochoscope through the subcutaneous blind loop and the achievement ratio was 91.2% (31/34).

CONCLUSIONSSubcutaneous tunnel hepatocholangioplasty decreases the relapsing cholangitis effectively, and makes an easy way to take out residual or recurrent stones.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bile Ducts, Intrahepatic ; pathology ; surgery ; Biliary Tract Surgical Procedures ; methods ; Cholelithiasis ; pathology ; surgery ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Humans ; Liver Diseases ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; Recurrence ; Retrospective Studies ; Treatment Outcome

BACKGROUND/AIMS: Chronic liver disease leads to liver fibrosis, and although the liver does have a certain regenerative capacity, this disease is associated with dysfunction of the liver vessels. C-reactive protein (CRP) is produced in the liver and circulated from there for metabolism. CRP was recently shown to inhibit angiogenesis by inducing endothelial cell dysfunction. The objective of this study was to determine the effect of CRP levels on angiogenesis in a rat model of liver dysfunction induced by bile duct ligation (BDL). METHODS: The diameter of the hepatic vein was analyzed in rat liver tissues using hematoxylin and eosin (H&E) staining. The expression levels of angiogenic factors, albumin, and CRP were analyzed by real-time PCR and Western blotting. A tube formation assay was performed to confirm the effect of CRP on angiogenesis in human umbilical vein endothelial cells (HUVECs) treated with lithocholic acid (LCA) and siRNA-CRP. RESULTS: The diameter of the hepatic portal vein increased significantly with the progression of cirrhosis. The expression levels of angiogenic factors were increased in the cirrhotic liver. In contrast, the expression levels of albumin and CRP were significantly lower in the liver tissue obtained from the BDL rat model than in the normal liver. The CRP level was correlated with the expression of albumin in hepatocytes treated with LCA and siRNA-CRP. Tube formation was significantly decreased in HUVECs when they were treated with LCA or a combination of LCA and siRNA-CRP. CONCLUSION: CRP seems to be involved in the abnormal formation of vessels in hepatic disease, and so it could be a useful diagnostic marker for hepatic disease.
Angiogenic Proteins/genetics/metabolism ; Animals ; Bile Ducts/surgery ; C-Reactive Protein/*analysis/genetics/metabolism ; Cells, Cultured ; Disease Models, Animal ; Hepatic Veins/abnormalities ; Hepatocytes/cytology/metabolism ; Human Umbilical Vein Endothelial Cells ; Humans ; Lithocholic Acid/pharmacology ; Liver/metabolism/pathology ; Liver Cirrhosis/etiology ; Liver Diseases/metabolism/*pathology ; Male ; Microscopy, Fluorescence ; Mitochondria/drug effects/metabolism ; RNA Interference ; RNA, Small Interfering/metabolism ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Serum Albumin/genetics/metabolism