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Management of a ruptured liver hydatid cyst in the bile ducts: A report of a case
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Electronic Poster Abstracts
Conclusions: To improve the treatment results, radical surgical intervention and liver transplantation are required. RFA in the course of management of HCC patients is an alternative to the existing surgical techniques. Sorafenib included into the therapy of incurable HCC patients permits to improve quality of life.
EP01C-117 MANAGEMENT OF A RUPTURED LIVER HYDATID CYST IN THE BILE DUCTS: A REPORT OF A CASE S. Zatir Militery Hospital Oran, Algeria It’s a 35-year old patient admitted for surgical management of a huge hydatid cyst of the liver segment 4 segment 5 segment 15 centimeter long axis that has realized the diagnosis aeete grace and an abdominal CT hydatid serology who returned positive in preoperative. We operates our patient subcutaneously costal right, the exploration finds large hydatid cyst of the segment 4 and 5 contiguous intimately with gallbladder with dilatation of the bile duct resection. We carry a puncture salient dome of the cyst, cholecystectomiede principle cholangiography per operatoir transcystic objective which the material presence of hydatid da bile duct. On PROCESS a choledochotomy extraction of hydatid material washing and external biliary drainage kind kehr.
EP01D e Electronic Poster: 1D e Liver Technical Surgery
EP01D-001 MEDICAL IMAGE THREEDIMENSIONAL VISUALIZATION SYSTEM IN THE OPERATION PLANNING OF CENTRALLY LOCATED HEPATOCELLULAR CARCINOMA C. -H. Fang Department of Hepatobiliary Surgery, ZhuJiang Hospital of Southern Medical University, China Introduction: This retrospective study was to compare the outcomes of operations based on medical Image ThreeDimensional Visualization System (MI-3DVS) operation planning with non- MI-3DVS operations in the treatment of centrally located HCC. Methods: From April 2008 to March 2014, 116 patients with centrally located HCC received surgical treatment in our department. 60 patients received resection with operation planning based on MI-3DVS (group A); the remaining 56 received treatment with the aid of traditional imaging (group B). MI-3DVS surgical planning, including the classification system for centrally located HCC, was elaborated in the study. Results: Compared with group B, group A was linked to shorter operation time (294.5 61.9 minutes vs 324.3 83.1 minutes; p＝0.028) and lower rate of hepatic inflow occlusion (51.7% vs 71.4%; p＝0.029). The groups were similar in their rates of complications, except that group B was more liable to have Clavien
Grade III to V complications (3.3% vs 14.3%; p＝0.048). Besides, a significant difference in ascites was found across the 2 cohorts (2 in group A and 8 in group B; p＝ 0.048), the 2 groups also differed significantly in total bilirubin (23.2 16.1 g/L vs 31.1 24.1 g/L; p＝0.032) and albumin (29.3 5.2 g/L vs 27.8 7.9 g/L; p＝ 0.033). Conclusion: The operation planning based on MI-3DVS is a more effective and reasonable method to treat centrally located HCC. And the classification system may facilitate the MI-3DVS operation planning.
EP01D-003 PURE LAPAROSCOPIC LIVER RESECTIONS IN THE POSTEROSUPERIOR SEGMENTS IN SEMIPRONE POSITION. SINGLE CENTER EXPERIENCE AND ANALYSIS OF LEARNING CURVE M. D’Hondt1, E. Yoshihara1, D. Devriendt1, F. Van Rooy1, F. Vansteenkiste1 and I. Parmentier2 1 Digestive and Hepatobiliary/Pancreatic Surgery, and 2 Oncology, Groeninge Hospital, Belgium Background: Performing pure laparoscopic liver resections in the posterosuperior segments (LRPSS) remains challenging. We analyzed our experience with laparoscopic resections of tumors in the posterosuperior segments in the semiprone position. Methods: Retrospective review of prospectively collected database on operative and postoperative characteristics and surgical outcomes of all patients in whom LRPSS was performed by one surgeon between September 2011 and September 2015. Results: Forty nine patients underwent LRPSS. Median age was 64 years (range 23e82). In total 58 resections were performed in the posterosuperior segments. Seven patients underwent additional resections in other segments. Indication for surgery was mainly colorectal liver metastases (n = 31;63.3%). There were 4 postoperative complications (Clavien Dindo I or II (1 bile leak)). Ninety day mortality was 0. There were 2 (4.1%) conversions. Median operative time was 140min (50e260). Median intraoperative blood loss was 150 mL (0e1500). A Pringle maneuver was never used. Median hospital stay was 7days (3e14). R0 resection rate was 100%. There was no difference in operative times when comparing the first 25 cases with the last 24 cases (130 minutes (IQR 100e140) e first 25 cases;150 minutes (IQR 125e185) e last 24 cases (t = 1.75; p = 0.086)). There was no difference in blood loss when comparing the first 25 cases with the last 24 cases (150 mL (IQR 100e350) e first 25 cases;165 mL (IQR 75e300) e last 24 cases (r = 0.20; p = 0.84)). Conclusions: LRPSS in semiprone are safe and feasible. Placing the patient in semiprone improves visualization, mobilization, enables this laparoscopic technique to provide safe and effective parenchyma preserving liver resections for lesions in these difficult segments and avoids a steep learning curve.
HPB 2016, 18 (S1), e1ee384
Electronic Poster Abstracts
Conclusions: To improve the treatment results, radical surgical intervention and liver transplantation are required. RFA in the course of management of HCC patients is an alternative to the existing surgical techniques. Sorafenib included into the therapy of incurable HCC patients permits to improve quality of life.
EP01C-117 MANAGEMENT OF A RUPTURED LIVER HYDATID CYST IN THE BILE DUCTS: A REPORT OF A CASE S. Zatir Militery Hospital Oran, Algeria It’s a 35-year old patient admitted for surgical management of a huge hydatid cyst of the liver segment 4 segment 5 segment 15 centimeter long axis that has realized the diagnosis aeete grace and an abdominal CT hydatid serology who returned positive in preoperative. We operates our patient subcutaneously costal right, the exploration finds large hydatid cyst of the segment 4 and 5 contiguous intimately with gallbladder with dilatation of the bile duct resection. We carry a puncture salient dome of the cyst, cholecystectomiede principle cholangiography per operatoir transcystic objective which the material presence of hydatid da bile duct. On PROCESS a choledochotomy extraction of hydatid material washing and external biliary drainage kind kehr.
EP01D e Electronic Poster: 1D e Liver Technical Surgery
EP01D-001 MEDICAL IMAGE THREEDIMENSIONAL VISUALIZATION SYSTEM IN THE OPERATION PLANNING OF CENTRALLY LOCATED HEPATOCELLULAR CARCINOMA C. -H. Fang Department of Hepatobiliary Surgery, ZhuJiang Hospital of Southern Medical University, China Introduction: This retrospective study was to compare the outcomes of operations based on medical Image ThreeDimensional Visualization System (MI-3DVS) operation planning with non- MI-3DVS operations in the treatment of centrally located HCC. Methods: From April 2008 to March 2014, 116 patients with centrally located HCC received surgical treatment in our department. 60 patients received resection with operation planning based on MI-3DVS (group A); the remaining 56 received treatment with the aid of traditional imaging (group B). MI-3DVS surgical planning, including the classification system for centrally located HCC, was elaborated in the study. Results: Compared with group B, group A was linked to shorter operation time (294.5 61.9 minutes vs 324.3 83.1 minutes; p＝0.028) and lower rate of hepatic inflow occlusion (51.7% vs 71.4%; p＝0.029). The groups were similar in their rates of complications, except that group B was more liable to have Clavien
Grade III to V complications (3.3% vs 14.3%; p＝0.048). Besides, a significant difference in ascites was found across the 2 cohorts (2 in group A and 8 in group B; p＝ 0.048), the 2 groups also differed significantly in total bilirubin (23.2 16.1 g/L vs 31.1 24.1 g/L; p＝0.032) and albumin (29.3 5.2 g/L vs 27.8 7.9 g/L; p＝ 0.033). Conclusion: The operation planning based on MI-3DVS is a more effective and reasonable method to treat centrally located HCC. And the classification system may facilitate the MI-3DVS operation planning.
EP01D-003 PURE LAPAROSCOPIC LIVER RESECTIONS IN THE POSTEROSUPERIOR SEGMENTS IN SEMIPRONE POSITION. SINGLE CENTER EXPERIENCE AND ANALYSIS OF LEARNING CURVE M. D’Hondt1, E. Yoshihara1, D. Devriendt1, F. Van Rooy1, F. Vansteenkiste1 and I. Parmentier2 1 Digestive and Hepatobiliary/Pancreatic Surgery, and 2 Oncology, Groeninge Hospital, Belgium Background: Performing pure laparoscopic liver resections in the posterosuperior segments (LRPSS) remains challenging. We analyzed our experience with laparoscopic resections of tumors in the posterosuperior segments in the semiprone position. Methods: Retrospective review of prospectively collected database on operative and postoperative characteristics and surgical outcomes of all patients in whom LRPSS was performed by one surgeon between September 2011 and September 2015. Results: Forty nine patients underwent LRPSS. Median age was 64 years (range 23e82). In total 58 resections were performed in the posterosuperior segments. Seven patients underwent additional resections in other segments. Indication for surgery was mainly colorectal liver metastases (n = 31;63.3%). There were 4 postoperative complications (Clavien Dindo I or II (1 bile leak)). Ninety day mortality was 0. There were 2 (4.1%) conversions. Median operative time was 140min (50e260). Median intraoperative blood loss was 150 mL (0e1500). A Pringle maneuver was never used. Median hospital stay was 7days (3e14). R0 resection rate was 100%. There was no difference in operative times when comparing the first 25 cases with the last 24 cases (130 minutes (IQR 100e140) e first 25 cases;150 minutes (IQR 125e185) e last 24 cases (t = 1.75; p = 0.086)). There was no difference in blood loss when comparing the first 25 cases with the last 24 cases (150 mL (IQR 100e350) e first 25 cases;165 mL (IQR 75e300) e last 24 cases (r = 0.20; p = 0.84)). Conclusions: LRPSS in semiprone are safe and feasible. Placing the patient in semiprone improves visualization, mobilization, enables this laparoscopic technique to provide safe and effective parenchyma preserving liver resections for lesions in these difficult segments and avoids a steep learning curve.
HPB 2016, 18 (S1), e1ee384