Abstract:
PURPOSE:Although left-sided hepatectomy, such as a left hepatectomy or left trisectionectomy with resection of the caudate lobe and extrahepatic bile duct, is used to treat hilar cholangiocarcinoma predominantly involving the left side of the hepatic hilum, it is associated with several difficult technical points. The important points during left-sided hepatectomy are described here. TECHNIQUES:There are anatomical variations of the sectional artery and bile duct. It is essential to understand the individual intrahepatic and hilar anatomy preoperatively. Surgical procedures consist of lymph node clearance, dissection of the distal bile duct, skeletonization resection of the hepatoduodenal ligament, mobilization of the liver and liver resection, dissection of the intrahepatic bile ducts, and biliary reconstruction. During lymph node dissection and skeletonization resection of the hepatoduodenal ligament, the nerve plexus around the hepatic artery is dissected, and its adventitia is exposed with great care to avoid injuring the hepatic artery. Mobilization of the caudate lobe is performed only from the left side. There is no clear landmark between the caudate lobe and the right posterior section during liver resection. In the final step of liver resection, it progresses toward the right edge of the inferior vena cava. When dividing intrahepatic bile ducts, extreme care should be used to avoid injury to the corresponding hepatic arteries, especially the anomalous supraportal posterior sectional artery. CONCLUSIONS:Left-sided hepatectomy for hilar cholangiocarcinoma should be considered a more complicated and technically demanding procedure than right-sided hepatectomy. Surgeons need to pay close attention to anatomical variations in order to perform a left-sided hepatectomy safely and successfully.
journal_name
J Hepatobiliary Pancreat Scijournal_title
Journal of hepato-biliary-pancreatic sciencesauthors
Uesaka Kdoi
10.1007/s00534-011-0474-6subject
Has Abstractpub_date
2012-05-01 00:00:00pages
195-202issue
3eissn
1868-6974issn
1868-6982journal_volume
19pub_type
杂志文章,评审abstract:BACKGROUND:Whether systemically transplanted human adipose-derived stem cells (ADSCs) homed to the injured liver in nude mice under stress with subsequent hepatectomy (Hx) and ischemia-reperfusion (I/R) was investigated in the present study. The types of cells in the liver that were involved in the homing of ADSCs were...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.147
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Pancreatoduodenectomy (PD) carries a high morbidity. Over time, pancreatic surgeons have altered their perioperative management in efforts to reduce morbidity rates, thereby creating major technical and management variations. We aim to evaluate the practice patterns of hepato-pancreato-biliary (HPB) surgeons...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章,多中心研究
doi:10.1002/jhbp.443
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. METHODS:In this 3rd version, clinical questions (CQs...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.870
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Hypoxia is an important condition to promote angiogenesis that is essential to tumor progression, including pancreatic ductal adenocarcinoma (PDAC). We evaluated whether the immunohistochemistry for hypoxia inducible factor-1α (HIF-1α) was correlated with hepatic metastases in PDAC. METHODS:We examined the ...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.6
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:This study reviews the outcomes of retransplantation using living-donor right-liver grafts. METHODS:A retrospective study of liver retransplants performed between 1996 and 2013 was conducted. The retransplants were divided into the DD group (with deceased donors) and the LD group (with living donors). Survi...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.100
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:A total of 26 pancreas transplants from brain dead donors, including 21 simultaneous pancreas and kidney (SPK) transplantation procedures, have been performed at Fujita Health University Hospital since the new pancreas transplant program was initiated in August 2012. The objective of this study is to investi...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.339
更新日期:2016-05-01 00:00:00
abstract:INTRODUCTION:Laparoscopic cholecystectomy (LC) is considered difficult in patients with an impacted gallstone (IG). We examined the efficacy of releasing an IG after percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis (AC) and the usefulness of the Difficulty Score (DS) proposed in the Tokyo ...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.857
更新日期:2020-10-31 00:00:00
abstract::Surgical intervention and, more recently, endoscopic intervention have been performed for the treatment of malignant gastric outlet obstruction. Recently, endoscopic ultrasonography (EUS)-guided gastrojejunostomy using special devices has been established. In line with this, we have developed a novel EUS-guided double...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章,评审
doi:10.1002/jhbp.148
更新日期:2015-01-01 00:00:00
abstract::Surgical resection, considered the optimal treatment of biliary papillomatosis, often remains incomplete due to high risk of recurrence in view of positive margins or recurrence on the remnant bile duct because of its multifocality. Resection of the whole biliary tree by liver transplantation and duodenopancreatectomy...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1007/s00534-009-0151-1
更新日期:2010-05-01 00:00:00
abstract::For the resection of advanced liver tumors in which the tumor thrombus extends into the intrathoracic inferior vena cava (IVC) above the diaphragm, surgeons need very skillful techniques and much experience. However, after detachment of the line of fusion of the pericardium to the diaphragm (LFPD), the intrathoracic I...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1007/s00534-009-0260-x
更新日期:2010-03-01 00:00:00
abstract::Intrahepatic cholangiocarcinomas (ICCs) are made up of heterogenous carcinomas arising from different anatomical sites of the liver. Two types of candidate stem/progenitor cells of the biliary tree are postulated to exist at the peribiliary glands for large bile ducts and at the canals of Hering for small ducts and he...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章,评审
doi:10.1002/jhbp.154
更新日期:2015-02-01 00:00:00
abstract::Highlight Although recent advances in robotic surgery have enabled more precise movements of the needle driver, a sophisticated laparoscopic suturing technique is still desired. Honda and colleagues describe the basic knowledge of and a small but useful trick for atraumatic needle driving in laparoscopic suturing, bas...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.814
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Intrahepatic cholangiocarcinoma (IHC) is a rare liver malignancy with a rising incidence worldwide. Since no standard treatment has been established so far, the aim of this study was to assess the safety and efficacy of repeated liver resection and/or radiofrequency ablation (RFA) in selected cases with recu...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1007/s00534-009-0256-6
更新日期:2010-07-01 00:00:00
abstract::Considering that the Japanese (JPN) guidelines for the management of acute pancreatitis were published in Takada et al. (J HepatoBiliary Pancreat Surg 13:2-6, 2006), doubts will be cast as to the reason for publishing a revised edition of the Guidelines for the management of acute pancreatitis: the JPN guidelines 2010...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 评论,杂志文章
doi:10.1007/s00534-009-0216-1
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The rate of preoperative biliary drainage for pancreaticoduodenectomy has been increasing despite most recent evidence that favors avoiding it. Only a few studies have focused on late surgical complications - biliary stricture after pancreaticoduodenectomy and have produced only inconclusive results. We eval...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.559
更新日期:2018-06-01 00:00:00
abstract:PURPOSE:We report two cases in which portal blood flow via the peribiliary vascular plexus (PBP) was clearly demonstrated using contrast-enhanced intra-operative ultrasonography (CE-IOUS). METHODS:Two patients who underwent hemihepatectomies were investigated using CE-IOUS. Before injection of the contrast medium, bot...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1007/s00534-011-0380-y
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Drip infusion cholangiography with computed tomography (DIC-CT) is a major preoperative modality used for patients undergoing laparoscopic cholecystectomy (LC). METHODS:This study included 218 patients for whom preoperative DIC-CT images were obtained prior to undergoing LC. The association between gallblad...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.718
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The study aim was to determine the short- and long-term results of lateral pancreaticojejunostomy for chronic pancreatitis at a single center in Japan. METHODS:The records of 64 consecutive patients were retrospectively reviewed. All patients underwent surgery at Hiroshima University Hospital between Decemb...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.48
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Previous reports have suggested that patients with intraductal papillary mucinous neoplasm (IPMN) have a favorable prognosis after surgical resection. Thus, a variety of types of partial pancreatic resections have been advocated for treating these low-grade malignant tumors. However, the surgical outcome of ...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章,多中心研究
doi:10.1007/s00534-009-0173-8
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Pancreaticobiliary malignant diseases are primarily treated by surgical resection. However, the surgical indications for elderly patients, especially for pancreaticoduodenectomy (PD), must be carefully considered due to patient compliance. Whether PD can contribute to better prognoses in elderly patients rem...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.840
更新日期:2020-10-15 00:00:00
abstract:BACKGROUND:Intrahepatic cholangiocarcinoma had been considered a contraindication for liver transplantation because of poorer outcomes. However, incidental intrahepatic cholangiocarcinoma in the explanted liver has been reported because of the difficulty of obtaining an accurate diagnosis in cirrhotic livers on preoper...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.896
更新日期:2021-01-19 00:00:00
abstract::Although the diagnostic and severity grading criteria on the 2013 Tokyo Guidelines (TG13) are used worldwide as the primary standard for management of acute cholangitis (AC), they need to be validated through implementation and assessment in actual clinical practice. Here, we conduct a systematic review of the literat...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 信件,评审
doi:10.1002/jhbp.512
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:In spite of the great risk involved, the donor bile duct division procedure has not been thoroughly addressed in the literature. The purpose of this study is to show the appropriate approach to bile duct division in living donor hepatectomy. METHODS:Of 87 living donor liver surgeries, we performed b...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1007/s00534-010-0322-0
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:The Blumgart system has been used for local tumor assessment in perihilar cholangiocarcinoma to predict resectability and survival, and T3 tumors are considered unresectable disease. The aim was to validate the predictive performance of this system using a Japanese cohort. METHODS:Medical records of consecu...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.694
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:For the establishment of personalized therapy, we investigated biomarkers that can contribute to the selection of adjuvant therapy for pancreatic ductal adenocarcinoma (PDAC). METHODS:Between 2005 and 2014, of 141 consecutive patients with PDAC who underwent R0 or R1 resection, 61 patients given gemcitabine...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.366
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:An aberrant right posterior sectoral hepatic duct (PHD) draining into extrahepatic bile duct, gallbladder or cystic duct directly is a common and critical anomaly during cholecystectomy. This study aimed to investigate the frequency of aberrant PHD and describe why PHD is critical. METHODS:In 753 consecutiv...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.252
更新日期:2015-07-01 00:00:00
abstract::Revealing the mechanism of adult organ maintenance and regeneration after injury is fundamental to our understanding of the pathogenesis of diseases. Considering the results of pulse and chase experiments using inducible insulin-Cre or Elastase-Cre, and more recently HNF1b-Cre, adult pancreatic cells (beta, acinar, an...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章,评审
doi:10.1007/s00534-010-0307-z
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Indocyanine green (ICG) is a synthetic dye that is widely used to evaluate liver function in critically ill patients, before liver resection or after liver transplantation. Controversy still exists about the impact exerted on the ICG ratio after 15 min (ICG R15) by differences in liver perfusion rates, hyper...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1007/s00534-009-0160-0
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:The National Clinical Database (NCD) in Japan is a nationwide registry that collects the data of more than 1,200,000 surgical cases annually from over 3,500 hospitals. Based on the NCD data, this study compared the perioperative outcomes of major laparoscopic liver resection (LLR) with those of major open li...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1002/jhbp.405
更新日期:2016-11-01 00:00:00
abstract::Segmentectomy is anatomical resection of segments based on the classification of Couinaud. This procedure is performed mainly for hepatocellular carcinoma. Invasion of portal vein and intrahepatic metastases often occur with hepatocellular carcinoma. Thus, it is desirable to perform anatomical resection of the cancer-...
journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 杂志文章
doi:10.1007/s00534-011-0448-8
更新日期:2012-01-01 00:00:00