British Journal of Surgery

Dralle, H

doi: 10.1046/j.1365-2168.2002.02160.xpmid: 12190669

References 1 Miyauchi A , Matsuzuka F, Hirai K, Yokozawa T, Kobayashi K, Kuma S et al. Unilateral surgery supported by germline RET oncogene mutation analysis in patients with sporadic medullary thyroid carcinoma . World J Surg 2000 ; 24 : 1367 – 72 . Google Scholar Crossref Search ADS PubMed WorldCat 2 Dralle H , Damm I, Scheumann GFW, Kotzerke J, Kupsch E, Geerlings H et al. Compartment-oriented microdissection of regional lymph nodes in medullary thyroid carcinoma . Surg Today 1994 ; 24 : 112 – 21 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Dralle H , Scheumann GFW, Proye C, Bacourt F, Frilling A, Limbert F et al. The value of lymph node dissection in hereditary medullary thyroid carcinoma—a retrospective European multicenter study . J Intern Med 1995 ; 238 : 357 – 61 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Dralle H , Gimm O, Simon D, Frank-Raue K, Görtz G, Niederle B et al. Prophylactic thyroidectomy in 75 children and adolescents with hereditary medullary thyroid carcinoma: German and Austrian experience . World J Surg 1998 ; 22 : 744 – 51 . Google Scholar Crossref Search ADS PubMed WorldCat 5 Gimm O , Rath FW, Dralle H. Pattern of lymph node metastases in papillary thyroid carcinoma . Br J Surg 1998 ; 85 : 252 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 6 Machens A , Hinze R, Thomusch O, Dralle H. The pattern of nodal metastases in primary and reoperative thyroid cancer . World J Surg 2002 ; 26 : 22 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 7 Tisell LE , Hansson G, Jansson S, Salander H. Reoperation in the treatment of asymptomatic metastasizing medullary thyroid carcinoma . Surgery 1986 ; 99 : 60 – 6 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 8 van Heerden J , Grant CS, Gharib H, Hay ID, Istrup DM. Long-term course of patients with persistent hyper calcitoninemia after apparent curative primary surgery for medullary thyroid carcinoma . Ann Surg 1990 ; 212 : 395 – 401 . Google Scholar Crossref Search ADS PubMed WorldCat 9 Moley JF , DeBenedetti MK. Pattern of nodal metastases in palpable medullary thyroid carcinoma: recommendations for extent of node dissection . Ann Surg 1999 ; 229 : 880 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Machens A , Gimm O, Ukkat J, Hinze R, Schneyer U, Dralle H. Improved prediction of calcitonin normalization in medullary thyroid carcinoma patients by quantitative lymph node analysis . Cancer 2000 ; 88 : 1909 – 15 . Google Scholar Crossref Search ADS PubMed WorldCat 11 Wells SA Jr, Chi DD, Toshima K, Dehner LP, Coffin CM, Dowton SB et al. Predictive DNA testing and prophylactic thyroidectomy in patients at risk for multiple endocrine neoplasia type 2A . Ann Surg 1994 ; 220 : 237 – 50 . Google Scholar Crossref Search ADS PubMed WorldCat Article PDF first page preview Close This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd

Hardwick, R H; Williams, G T

doi: 10.1046/j.1365-2168.2002.02175.xpmid: 12190670

References 1 Ormsby AH , Goldblum JR, Rice TW, Richter JE, Gramlich TL. The utility of cytokeratin subsets in distinguishing Barrett's-related oesophageal adenocarcinoma from gastric adenocarcinoma . Histopathology 2001 ; 38 : 307 – 11 . Google Scholar Crossref Search ADS PubMed WorldCat 2 Rudiger Siewert J , Feith M, Werner M, Stein HJ. Adeno carcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in 1002 consecutive patients . Ann Surg 2000 ; 232 : 353 – 61 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Kelly S , Harris KM, Berry E, Hutton J, Roderick P, Cullingworth J et al. A systematic review of the staging performance of endoscopic ultrasound in gastro-oesophageal carcinoma . Gut 2001 ; 49 : 534 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Sobin L , Wittekind C. TNM Classification of Malignant Tumours . 5th ed. New York : Wiley–Liss , 1997 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 5 Dolan K , Sutton R, Walker SJ, Morris AI, Campbell F, Williams EM. New classification of oesophageal and gastric carcinomas derived from changing patterns in epidemiology . Br J Cancer 1999 ; 80 : 834 – 42 . Google Scholar Crossref Search ADS PubMed WorldCat 6 Wijnhoven BP , Siersema PD, Hop WC, van Dekken H, Tilanus HW. Adenocarcinomas of the distal oesophagus and gastric cardia are one clinical entity. Rotterdam Oesophageal Tumour Study Group . Br J Surg 1999 ; 86 : 529 – 35 . Google Scholar Crossref Search ADS PubMed WorldCat 7 Steup WH , De Leyn P, Deneffe G, Van Raemdonck D, Coosemans W, Lerut T. Tumors of the esophagogastric junction. Long-term survival in relation to the pattern of lymph node metastasis and a critical analysis of the accuracy or inaccuracy of pTNM classification . J Thorac Cardiovasc Surg 1996 ; 111 : 85 – 95 . Google Scholar Crossref Search ADS PubMed WorldCat 8 Dresner SM , Lamb PJ, Bennett MK, Hayes N, Griffin SM. The pattern of metastatic lymph node dissemination from adenocarcinoma of the esophagogastric junction . Surgery 2001 ; 129 : 103 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 9 Dickson GH , Singh KK, Escofet X, Kelley K. Validation of a modified GTNM classification in peri-junctional oesophago-gastric carcinoma and its use as a prognostic indicator . Eur J Surg Oncol 2001 ; 27 : 641 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Korst RJ , Rusch VW, Venkatraman E, Bains MS, Burt ME, Downey RJ et al. Proposed revision of the staging classification for esophageal cancer . J Thorac Cardiovasc Surg 1998 ; 115 : 660 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat Article PDF first page preview Close This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd

Deshpande, R R; Heaton, N D; Rela, M

doi: 10.1046/j.1365-2168.2002.02153.xpmid: 12190671

Abstract Background The emergence of split and living donor liver transplantation has necessitated re-evaluation of liver anatomy in greater depth and from a different perspective than before. Early attempts at split liver transplantation were met with significant numbers of vascular and biliary complications. Technical innovations in this field have evolved largely by recognizing anatomical anomalies and variations at operation, and devising novel ways of dealing with them. This has led to increasing acceptance of these procedures and decreased morbidity and mortality rates, similar to those observed with whole liver transplantation. Methods and results The following review is based on clinical experience of more than 180 split and living related liver transplantations in adults and children, performed over a 7-year period from 1994 to 2001. Conclusion A comprehensive understanding and application of surgical anatomy of the liver is essential to improve and maintain the excellent results of segmental liver transplantation. References 1 Todo S , Furukawa H, Jin MB, Shimamura T. Living donor liver transplantation in adults: outcome in Japan . Liver Transpl 2000 ; 6 ( Suppl 2 ): S66 – S72 . Google Scholar Crossref Search ADS PubMed WorldCat 2 Rogiers X , Malago M, Gawad K, Jauch KW, Olausson M, Knoefel WT et al. In situ splitting of cadaveric livers. The ultimate expansion of a limited donor pool . Ann Surg 1996 ; 224 : 331 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Renz JF , Roberts JP. Long-term complications of living donor liver transplantation . Liver Transpl 2000 ; 6 ( Suppl 2 ): S73 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Sugawara Y , Makuuchi M. Technical advances in living-related liver transplantation . J Hepatobiliary Pancreat Surg 1999 ; 6 : 245 – 53 . Google Scholar Crossref Search ADS PubMed WorldCat 5 Marcos A . Right-lobe living donor liver transplantation . Liver Transpl 2000 ; 6 ( Suppl 2 ): S59 – 63 . Google Scholar Crossref Search ADS PubMed WorldCat 6 Nakamura S , Tsuzuki T. Surgical anatomy of the hepatic veins and the inferior vena cava . Surg Gynecol Obstet 1981 ; 152 : 43 – 50 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 7 Delattre J , Avisse C, Flament JB. Anatomic basis of hepatic surgery . Surg Clin North Am 2000 ; 80 : 345 – 62 . Google Scholar Crossref Search ADS PubMed WorldCat 8 Ger R . Surgical anatomy of the liver . Surg Clin North Am 1989 ; 69 : 179 – 92 . Google Scholar Crossref Search ADS PubMed WorldCat 9 Dodson TF . Surgical anatomy of hepatic transplantation . Surg Clin North Am 1993 ; 73 : 645 – 59 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Rela M , Vougas V, Muiesan P, Vilca-Melendez H, Smyrniotis V, Gibbs P et al. Split liver transplantation: King's College Hospital experience . Ann Surg 1998 ; 227 : 282 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 11 Srinivasan P , Vilca-Melendez H, Muiesan P, Prachalias A, Heaton ND, Rela M. Liver transplantation with mono segments . Surgery 1999 ; 126 : 10 – 12 . Google Scholar Crossref Search ADS PubMed WorldCat 12 Emond JC , Heffron TG, Whittington PF, Broelsch CE. Reconstruction of the hepatic vein in reduced size hepatic transplantation . Surg Gynecol Obstet 1993 ; 176 : 11 – 17 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 13 Kasai H , Makuuchi M, Kawasaki S, Ishizome S, Kitahara S, Matsunami H et al. Intraoperative color Doppler ultra sonography for partial-liver transplantation from the living donor in paediatric patients . Transplantation 1992 ; 54 : 173 – 5 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 14 Strasberg SM , Lowell JA, Howard TK. Reducing the shortage of donor livers: what would it take to reliably split livers for transplantation into two adult recipients? Liver Transpl Surg 1999 ; 5 : 437 – 50 . Google Scholar Crossref Search ADS PubMed WorldCat 15 Gundlach M , Broering D, Topp S, Sterneck M, Rogiers X. Split-cava technique: liver splitting for two adult recipients . Liver Transpl 2000 ; 6 : 703 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 16 Reichert PR , Renz JF. Anatomical variations hampering the use of right lobe in living donor liver transplantation . Liver Transpl 2001 ; 7 : C – 85 . Google Scholar OpenURL Placeholder Text WorldCat 17 Cui D , Kiuchi T, Oike F, Kaihara S, Egawa H, Uemoto S et al. Microcirculatory changes of the liver in right lobe living donor liver transplantation: is the anterior segment really congested? Liver Transpl 2001 ; 7 : C – 86 . Google Scholar OpenURL Placeholder Text WorldCat 18 Srinivasan P , Bowles MJ, Muiesan P, Heaton ND, Rela M. Living related liver transplantation in biliary atresia with absent inferior vena cava . Liver Transpl 2001 ; 7 : 376 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 19 Mitchell A , Mirza D, de Ville de Goyet J, Buckels J. Absence of the left portal vein: a difficulty for reduction of liver grafts? Transplantation 2000 ; 69 : 1731 – 2 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 20 Imamura H , Makuuchi M, Sakamoto Y, Sugawara Y, Sano K, Nakayama A et al. Anatomical keys and pitfalls in living donor liver transplantation . J Hepatobiliary Pancreat Surg 2000 ; 7 : 380 – 94 . Google Scholar Crossref Search ADS PubMed WorldCat 21 Thayer WP , Claridge JA, Chang-Kwon OH, Pelletie SJ, Sawyer RG, Pruett TL. Portal vein reconstruction in right lobe living donor liver transplantation . Liver Transpl 2001 ; 7 : C – 85 . Google Scholar OpenURL Placeholder Text WorldCat 22 Michels NA . Newer anatomy of the liver and its variant blood supply and collateral circulation . Am J Surg 1966 ; 112 : 337 – 47 . Google Scholar Crossref Search ADS PubMed WorldCat 23 Stapleton GN , Hickman R, Terblanche J. Blood supply of the right and left hepatic ducts . Br J Surg 1998 ; 85 : 202 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 24 Ikegama T , Kawasaki S, Matsunami H, Hashikura Y, Nakazawa Y, Miyagawa S et al. Should all hepatic arterial branches be reconstructed in living-related liver transplant ation? Surgery 1996 ; 119 : 431 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 25 Broelsch CE , Whitington PF, Emond JC, Heffron TG, Thistlethwaite JR, Stevens L et al. Liver transplantation in children from living related donors. Surgical techniques and results . Ann Surg 1991 ; 214 : 428 – 37 . Google Scholar Crossref Search ADS PubMed WorldCat 26 Rela M , McCall JL, Karani J, Heaton ND. Accessory right hepatic artery arising from the left: implications for split liver transplantation . Transplantation 1998 ; 66 : 792 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 27 Renz JF , Reichert PF, Emond JC. Hepatic arterial anatomy as applied to living-donor and split-liver transplantation . Liver Transpl 2000 ; 6 : 367 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 28 Smadja C , Blumgart LH. The biliary tract and the anatomy of biliary exposure. In: Blumgart LH, ed. Surgery of the Liver and Biliary Tract. Vol. 1 . 2nd ed. Edinburgh : Churchill Livingstone , 1994 : 11 – 24 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 29 Northover JMA , Terblanche J. A new look at the arterial supply of the bile duct in man and its surgical implications . Br J Surg 1979 ; 66 : 379 – 84 . Google Scholar Crossref Search ADS PubMed WorldCat 30 Busuttil RW , Goss JA. Split liver transplantation . Ann Surg 1999 ; 229 : 313 – 21 . Google Scholar Crossref Search ADS PubMed WorldCat 31 Testa G , Malago M, Valentin-Gamazo C, Lindell G, Broelsch CE. Biliary anastomosis in living related liver transplantation using the right liver lobe: techniques and complications . Liver Transpl 2000 ; 6 : 710 – 14 . Google Scholar Crossref Search ADS PubMed WorldCat 32 Renz JF , Reichert PR, Emond JC. Biliary anatomy as applied to pediatric living donor and split-liver transplantation . Liver Transpl 2000 ; 6 : 801 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 33 Lopez-Santamaria M , Martinez L, Hierro L, Gamez M, Murcia J, Camarena C et al. Late biliary complications in pediatric liver transplantation . J Pediatr Surg 1999 ; 34 : 316 – 20 . Google Scholar Crossref Search ADS PubMed WorldCat 34 Schlitt HJ , Meier PN, Nashan B, Oldhafer KJ, Boeker K, Flemming P et al. Reconstructive surgery for ischemic-type lesions at the bile duct bifurcation after liver transplantation . Ann Surg 1999 ; 229 : 137 – 45 . Google Scholar Crossref Search ADS PubMed WorldCat 35 Spada M , Gridelli B, Colledan M, Segalin A, Lucianetti A, Petz W et al. Extensive use of split liver for paediatric liver transplantation: a single-centre experience . Liver Transpl 2000 ; 6 : 415 – 28 . Google Scholar Crossref Search ADS PubMed WorldCat 36 Azoulay D , Castaing D, Adam R, Savier E, Delvart V, Karam V et al. Split-liver transplantation for two adult recipients: feasibility and long-term outcomes . Ann Surg 2001 ; 233 : 565 – 74 . Google Scholar Crossref Search ADS PubMed WorldCat 37 Egawa H , Uemoto S, Inomata Y, Shapiro AM, Asonuma K, Kiuchi T et al. Biliary complications in pediatric living related liver transplantation . Surgery 1998 ; 124 : 901 – 10 . Google Scholar Crossref Search ADS PubMed WorldCat 38 Broelsch C , Malago M, Testa G, Gamazo CV. Living donor liver transplantation in adults: outcome in Europe . Liver Transpl 2000 ; 6 : S64 – 5 . Google Scholar Crossref Search ADS PubMed WorldCat This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd

Court, F G; Wemyss-Holden, S A; Dennison, A R; Maddern, G J

doi: 10.1046/j.1365-2168.2002.02166.xpmid: 12190672

Abstract Background Partial hepatectomy is the strongest stimulator of hepatic regeneration. The process of initiation and the control of the final size of the regenerated liver have been the subject of research for many years. A better understanding of this process and the effect of disease may allow better selection of patients for partial hepatectomy. It may also allow an insight into the possible application of clinical stimulation of regeneration. Methods Data were reviewed from the published literature using the Medline database. Results Most knowledge comes from in vitro studies and the study of resection in the rat model. A variety of cytokines, hormones and growth factors are involved in regeneration but very few have been found capable of stimulating regeneration in vitro. The exact interactions are not known, but there is probably a cascade involving different factors at differing stages of regeneration. Conclusion Further in vivo research should allow greater understanding of liver regeneration, thereby providing a potential therapeutic tool in patients for whom regeneration has failed, or is likely to fail. Such research is also important in respect of liver support devices, which may inhibit liver regeneration by filtration of many of the factors involved. References 1 Takahashi T , Malchesky PS, Nose Y. Artificial liver. State of the art . Dig Dis Sci 1991 ; 36 : 1327 – 40 . Google Scholar Crossref Search ADS PubMed WorldCat 2 Steer CJ . Liver regeneration . FASEB J 1995 ; 9 : 1396 – 400 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Higashiyama H , Yamaguchi T, Mori K, Nakano Y, Yokoyama T, Takeuchi T et al. Graft size assessment by preoperative computed tomography in living related partial liver transplantation . Br J Surg 1993 ; 80 : 489 – 92 . Google Scholar Crossref Search ADS PubMed WorldCat 4 LaBrecque D . Liver regeneration: a picture emerges from the puzzle . Am J Gastroenterol 1994 ; 89 ( Suppl ): S86 – 96 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 5 Fausto N . Hepatic regeneration. In: Zakim D, Boyer TD, eds. Hepatology. A Textbook of Liver Disease. Vol. 1 . 2nd ed. Philadelphia, Pennsylvania : WB Saunders , 1990 : 49 – 65 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 6 Gove CD , Hughes RD. Liver regeneration in relationship to acute liver failure . Gut 1991 ; ( Suppl ): S92 – 6 . Google Scholar OpenURL Placeholder Text WorldCat 7 Nagasue N , Yukaya H, Ogawa Y, Kohno H, Nakamura T. Human liver regeneration after major hepatic resection. A study of normal liver and livers with chronic hepatitis and cirrhosis . Ann Surg 1987 ; 206 : 30 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 8 Canalese J , Gove CD, Gimson AE, Wilkinson SP, Wardle EN, Williams R. Reticuloendothelial system and hepatocytic function in fulminant hepatic failure . Gut 1982 ; 23 : 265 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 9 Francavilla A , Hagiya M, Porter KA, Polimeno L, Ihara I, Starzl TE. Augmenter of liver regeneration: its place in the universe of hepatic growth factors . Hepatology 1994 ; 20 : 747 – 57 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Higgins GM , Anderson RM. Experimental pathology of the liver; I. Restoration of the liver by the white rat following partial surgical removal . Arch Pathol 1931 ; 12 : 186 – 202 . Google Scholar OpenURL Placeholder Text WorldCat 11 Diehl AM , Rai R. Review: regulation of liver regeneration by pro-inflammatory cytokines . J Gastroenterol Hepatol 1996 ; 11 : 466 – 70 . Google Scholar Crossref Search ADS PubMed WorldCat 12 Kuo FC , Darnesll JE Jr Evidence that interaction of hepatocytes with the collecting (hepatic) veins triggers position-specific transcription of the glutamine synthetase and ornithine aminotransferase genes in the mouse liver . Mol Cell Biol 1991 ; 11 : 6050 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 13 Fausto N , Brandt JT, Kesner L. Possible interactions between the urea cycle and synthesis of pyrimidines and polyamines in regenerating liver . Cancer Res 1975 ; 35 : 397 – 404 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 14 Weinbren K , Woodward E. Delayed incorporation of 32P from orthophosphate into deoxyribonucleic acid of rat liver after subtotal hepatectomy . Br J Exp Path 1964 ; 45 : 442 – 9 . Google Scholar OpenURL Placeholder Text WorldCat 15 Bucher NLR , Swaffield MN. Rate of incorporation of labeled thymidine into the deoxyribonucleic acid of regenerating rat liver in relation to the amount of liver excised . Cancer Res 1964 ; 24 : 1611 – 25 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 16 Ozawa K , Yamada T, Ukikusa M, Ngala K, Ida T, Nakase A et al. Mitochondrial phosphorylative activity and DNA synthesis in regenerating liver of diabetic rats . J Surg Res 1981 ; 31 : 38 – 45 . Google Scholar Crossref Search ADS PubMed WorldCat 17 Ozawa K . Hepatic function and liver resection . J Gastroenterol Hepatol 1990 ; 5 : 296 – 309 . Google Scholar Crossref Search ADS PubMed WorldCat 18 Gaub J , Iversen J. Rat liver regeneration after 90% partial hepatectomy . Hepatology 1984 ; 4 : 902 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 19 Starzl TE , Putnam CW, Groth CG, Corman JL, Taubman J. Alopecia, ascites, and incomplete regeneration after 85–90 per cent liver resection . Am J Surg 1975 ; 129 : 587 – 90 . Google Scholar Crossref Search ADS PubMed WorldCat 20 Leevy CB . Abnormalities of liver regeneration: a review . Dig Dis 1998 ; 16 : 88 – 98 . Google Scholar Crossref Search ADS PubMed WorldCat 21 Kitamura T , Watanabe S, Sato N. Liver regeneration, liver cancers and cyclins . J Gastroenterol Hepatol 1998 ; 13 ( Suppl ): S96 – 9 . Google Scholar Crossref Search ADS WorldCat 22 Tahara H , Nakanishi T, Kitamoto M, Nakashio R, Shay JW, Tahara E et al. Telomerase activity in human liver tissues: comparison between chronic liver disease and hepatocellular carcinomas . Cancer Res 1995 ; 55 : 2734 – 6 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 23 Selzner M , Clavien PA. Failure of regeneration of the steatotic rat liver: disruption at two different levels in the regeneration pathway . Hepatology 2000 ; 31 : 35 – 42 . Google Scholar Crossref Search ADS PubMed WorldCat 24 Chen T , Kiernan T, Leevy CM. Ethanol and cell replication in the digestive tract . Clin Gastroenterol 1981 ; 10 : 343 – 54 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 25 Forrest AP . Principles of cancer management. In: Aljafri AM, Kingsnorth A, eds. Fundamentals of Surgical Practice . 1st ed. London : Greenwich Medical Media , 1998 : 179 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 26 Friedman JM , Chung EY, Darnell JE Jr Gene expression during liver regeneration . J Mol Biol 1984 ; 179 : 37 – 53 . Google Scholar Crossref Search ADS PubMed WorldCat 27 Diehl AM , Rai RM. Liver regeneration 3: regulation of signal transduction during liver regeneration . FASEB J 1996 ; 10 : 215 – 27 . Google Scholar Crossref Search ADS PubMed WorldCat 28 Streetz KL , Luedde T, Manns MP, Trautwein C. Interleukin 6 and liver regeneration . Gut 2000 ; 47 : 309 – 12 . Google Scholar Crossref Search ADS PubMed WorldCat 29 Cressman DE , Greenbaum LE, DeAngelis RA, Ciliberto G, Furth EE, Poli V et al. Liver failure and defective hepatocyte regeneration in interleukin-6-deficient mice . Science 1996 ; 274 : 1379 – 83 . Google Scholar Crossref Search ADS PubMed WorldCat 30 Greenbaum LE , Li W, Cressman DE, Peng Y, Ciliberto G, Poli V et al. CCAAT enhancer-binding protein beta is required for normal hepatocyte proliferation in mice after partial hepatectomy . J Clin Invest 1998 ; 102 : 996 – 1007 . Google Scholar Crossref Search ADS PubMed WorldCat 31 Chen RH , Chang MC, Su YH, Tsai YT, Kuo ML. Interleukin-6 inhibits transforming growth factor-beta-induced apoptosis through the phosphatidylinositol 3-kinase/Akt and signal transducers and activators of transcription 3 pathways . J Biol Chem 1999 ; 274 : 23013 – 19 . Google Scholar Crossref Search ADS PubMed WorldCat 32 Bucher NL . Liver regeneration: an overview . J Gastroenterol Hepatol 1991 ; 6 : 615 – 24 . Google Scholar Crossref Search ADS PubMed WorldCat 33 Columbano A , Shinozuka H. Liver regeneration versus direct hyperplasia . FASEB J 1996 ; 10 : 1118 – 28 . Google Scholar Crossref Search ADS PubMed WorldCat 34 Michalopoulos GK . Liver regeneration: molecular mechanisms of growth control . FASEB J 1990 ; 4 : 176 – 87 . Google Scholar Crossref Search ADS PubMed WorldCat 35 Tsubouchi H , Niitani Y, Hirono S, Nakayama H, Gohda E, Arakaki N et al. Levels of the human hepatocyte growth factor in serum of patients with various liver diseases determined by an enzyme-linked immunosorbent assay . Hepatology 1991 ; 13 : 1 – 5 . Google Scholar Crossref Search ADS PubMed WorldCat 36 Schmidt C , Bladt F, Goedecke S, Brinkmann V, Zschiesche W, Sharpe M et al. Scatter factor/hepatocyte growth factor I is essential for liver development . Nature 1995 ; 373 : 699 – 702 . Google Scholar Crossref Search ADS PubMed WorldCat 37 Fausto N . Growth factors in liver development, regeneration and carcinogenesis . Prog Growth Factor Res 1991 ; 3 : 219 – 34 . Google Scholar Crossref Search ADS PubMed WorldCat 38 Shiota G , Rhoads DB, Want TC, Nakamura T, Schmidt EV. Hepatocyte growth factor inhibits growth of hepatocellular carcinoma cells . Proc Natl Acad Sci U S A 1992 ; 89 : 373 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 39 LaBrecque DR . Hepatocyte growth factor − how do I know thee? Let me count the ways . Gastroenterology 1992 ; 103 : 1686 – 91 . Google Scholar Crossref Search ADS PubMed WorldCat 40 Hashimoto M , Kothary PC, Eckhauser FE, Raper SE. Treatment of cirrhotic rats with epidermal growth factor and insulin accelerates liver DNA synthesis after partial hepatectomy . J Gastroenterol Hepatol 1998 ; 13 : 1259 – 65 . Google Scholar Crossref Search ADS PubMed WorldCat 41 Labrecque DR , Wilson M, Fogerty S. Stimulation of HTC hepatoma cell growth in vitro by hepatic stimulator substance (HSS). Interactions with serum, insulin, glucagon, epidermal growth factor and platelet derived growth factor . Exp Cell Res 1984 ; 160 : 419 – 29 . Google Scholar OpenURL Placeholder Text WorldCat 42 LaBrecque DR . In vitro stimulation of cell growth by hepatic stimulator substance . Am J Physiol 1982 ; 242 : G289 – 95 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 43 LaBrecque DR , Bachur NR. Hepatic stimulator substance: physicochemical characteristics and specificity . Am J Physiol 1982 ; 242 : G281 – 8 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 44 Bucher NL , Swaffield MN. Synergistic action of glucagon and insulin in regulation of hepatic regeneration . Adv Enzyme Regul 1975 ; 13 : 281 – 93 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 45 Fisher B , Szuch P, Levine M, Fisher ER. A portal blood factor as the humoral agent in liver regeneration . Science 1971 ; 171 : 575 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 46 Whitfield JF , Durkin JP, Franks DJ, Keline LP, Raptis L, Rixon RH et al. Calcium, cyclic AMP and protein kinase C − partners in mitogenesis . Cancer Metastasis Rev 1987 ; 5 : 205 – 50 . Google Scholar Crossref Search ADS PubMed WorldCat 47 Alison MR , Al-Ani F. The influence of environmental factors upon induced compensatory hyperplasia in the rat liver . Virchows Arch B Cell Pathol Incl Mol Pathol 1985 ; 48 : 167 – 73 . Google Scholar Crossref Search ADS PubMed WorldCat 48 Short J , Armstrong NB, Zemel R, Lieberman I. A role for amino acids in the induction of deoxyribonucleic acid synthesis in liver . Biochem Biophys Res Commun 1973 ; 50 : 430 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 49 McGowan J , Atryzek V, Fausto N. Effects of protein-deprivation on the regeneration of rat liver after partial hepatectomy . Biochem J 1979 ; 180 : 25 – 35 . Google Scholar Crossref Search ADS PubMed WorldCat 50 Francavilla A , Azzarone A, Carrieri G, Scotti-Foglieni C, Zeng QH, Cillo U et al. Effect on the canine Eck fistula liver of intraportal TGF-beta alone or with hepatic growth factors . Hepatology 1992 ; 16 : 1267 – 70 . Google Scholar Crossref Search ADS PubMed WorldCat 51 Russell WE , Coffey RJ Jr, Ouellette AJ, Moses HL. Type beta transforming growth factor reversibly inhibits the early proliferative response to partial hepatectomy in the rat . Proc Natl Acad Sci U S A 1988 ; 85 : 5126 – 30 . Google Scholar Crossref Search ADS PubMed WorldCat 52 Sanderson N , Factor V, Nagy P, Kopp J, Kondaiah P, Wakefield L et al. Hepatic expression of mature transforming growth factor beta 1 in transgenic mice results in multiple tissue lesions . Proc Natl Acad Sci U S A 1995 ; 92 : 2572 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd

Khot, U P; Lang, A Wenk; Murali, K; Parker, M C

doi: 10.1046/j.1365-2168.2002.02148.xpmid: 12190673

Abstract Background Colorectal stents are being used for palliation and as a ‘bridge to surgery’ in obstructing colorectal cancers. Methods A systematic review of the published data on stenting for the treatment of colorectal obstruction was carried out by searching Medline and other online databases for the period from January 1990 to December 2000. A total of 58 publications (case series, single case reports and reviews) was found, of which 29 case series were included in the analysis. Technical and clinical success, complications and reobstruction, both in palliation and as a ‘bridge to surgery’, were assessed. Both descriptive statistics and pooled analyses were carried out. Results Pooled results showed that stent insertion was attempted in 598 instances. Technical success was achieved in 551 (92 per cent) and clinical success in 525 (88 per cent). Palliation was achieved in 302 (90 per cent) of 336 cases, while 223 (85 per cent) of 262 insertions succeeded as a ‘bridge to surgery’ (95 per cent had a one-stage surgical procedure). There were three deaths (1 per cent). Perforation occurred 22 times (4 per cent). Stent migration was reported in 54 (10 per cent) of 551 technically successful cases. The rate of stent reobstruction was 52 (10 per cent) of 525, mainly in the palliative group. Conclusion Evidence suggests that colorectal stents offer good palliation, and are safe and effective as a ‘bridge to surgery’. Stent usage can avoid the need for a stoma, and is associated with low rates of mortality and morbidity. Dilatation of malignant strictures at the time of stent placement appears to be dangerous and should be avoided. References 1 Dohmoto M . New method—endoscopic implantation of rectal stent in palliative treatment of malignant stenosis . Endoscopia Digestiva 1991 ; 3 : 1507 – 12 . Google Scholar OpenURL Placeholder Text WorldCat 2 Deans GT , Krukowski ZH, Irwin ST. Malignant obstruction of the left colon . Br J Surg 1994 ; 81 : 1270 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Riedl S , Wiebelt H, Bergmann U, Hermanek P Jr Post operative Komplikationen und Letalität in der chirurgischen Therapie des Coloncarcinoms . Chirurg 1995 ; 66 : 597 – 606 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 4 Neugent KP , Daniels P, Stewart B, Patankar R, Johnson CD. Quality of life in stoma patients . Dis Colon Rectum 1999 ; 42 : 1569 – 74 . Google Scholar Crossref Search ADS PubMed WorldCat 5 Leitman IM , Sullivan JD, Brams D, DeCosse JJ. Multivariate analysis of morbidity and mortality from the initial surgical management of obstructing carcinoma of the colon . Surg Gynecol Obstet 1992 ; 174 : 513 – 18 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 6 Tejero E , Mainar A, Fernandez L, Tobio R, De Gregorio MA. New procedure for the treatment of colorectal neoplastic obstructions . Dis Colon Rectum 1994 ; 37 : 1158 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 7 Zollikofer CL , Jost R, Schoch E, Decurtins M. Gastro intestinal stenting . Eur Radiol 2000 ; 10 : 329 – 41 . Google Scholar Crossref Search ADS PubMed WorldCat 8 Camunez F , Echenagusia A, Simo G, Turegano F, Vazquez J, Barreiro-Meiro I. Malignant colorectal obstruction treated by means of self-expanding metallic stents: effectiveness before surgery and in palliation . Radiology 2000 ; 216 : 492 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 9 Mainar A , De Gregorio MA, Tejero E, Tobio R, Alsonso E, Pinto I et al. Acute colorectal obstruction: treatment with self-expandable metallic stents before scheduled surgery—results of a multicenter study . Radiology 1999 ; 210 : 65 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Fernandez Lobato R , Pinto I, Paul L, Tejero E, Montes C, Fernandez L et al. Self expanding prostheses as palliative method in treating advanced colorectal cancer . Int Surg 1999 ; 84 : 159 – 62 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 11 Tejero E , Fernandez Lobato R, Mainar A, Montes C, Pinto I, Fernandez L et al. Initial results of a new procedure for treatment of malignant obstruction of the left colon . Dis Colon Rectum 1997 ; 40 : 432 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 12 Cole SJ , Boorman P, Osman H, Sathananthan M, Parker MC. Endoluminal stenting for relief of colonic obstruction is safe and effective . Colorectal Dis 2000 ; 2 : 282 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 13 Baron TH , Dean PA, Yates MR III, Canon C, Koehler RE. Expandable metal stents for the treatment of colonic obstruction: techniques and outcomes . Gastrointest Endosc 1998 ; 47 : 277 – 86 . Google Scholar Crossref Search ADS PubMed WorldCat 14 De Gregorio MA , Mainar A, Tejero E, Tobio R, Alfonso E, Pinto I et al. Acute colorectal obstruction: stent placement for palliative treatment—results of a multicenter study . Radiology 1998 ; 209 : 117 – 20 . Google Scholar Crossref Search ADS PubMed WorldCat 15 Law WL , Chu KW, Ho JWC, Tung HM, Law SYK, Chu KM. Self-expanding metallic stent in the treatment of colonic obstruction caused by advanced malignancies . Dis Colon Rectum 2000 ; 43 : 1522 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 16 Choo IW , Do YS, Suh SW, Chun HK, Choo SW, Park HS et al. Malignant colorectal obstruction: treatment with flexible covered stent . Radiology 1998 ; 206 : 415 – 21 . Google Scholar Crossref Search ADS PubMed WorldCat 17 Diaz LP , Pabon IP, Lobato RF, Lopez CM. Palliative treatment of malignant colorectal strictures with metallic stents . Cardiovasc Intervent Radiol 1999 ; 22 : 29 – 36 . Google Scholar Crossref Search ADS PubMed WorldCat 18 Rocca R , De Angelis C, Coppola F, Barletti C, Pera A, Rizzetto M et al. Enteral wallstent for the emergency treatment of acute colonic obstruction due to malignant strictures . Gastrointest Endosc 2000 ; 51 : 105 . Google Scholar Crossref Search ADS WorldCat 19 Repici A , Reggio D, De Angelis C, Barletti C, Marchesa P, Musso A et al. Covered metal stents for management of inoperable malignant colorectal strictures . Gastrointest Endosc 2000 ; 52 : 735 – 40 . Google Scholar Crossref Search ADS PubMed WorldCat 20 Saida Y , Sumiyama Y, Nagao J, Takase M. Stent endo prosthesis for obstructing colorectal cancers . Dis Colon Rectum 1996 ; 39 : 552 – 5 . Google Scholar Crossref Search ADS PubMed WorldCat 21 Canon CL , Baron TH, Morgan DE, Dean PA, Koehler RE. Treatment of colonic obstruction with expandable metal stents: radiologic features . AJR Am J Roentgenol 1997 ; 168 : 199 – 205 . Google Scholar Crossref Search ADS PubMed WorldCat 22 Spinelli P , Dal Fante M, Mancini A. Rectal metal stents for palliation of colorectal malignant stenosis . Bildgebung 1993 ; 60 ( Suppl 1 ): 48 – 50 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 23 Liberman H , Adams DR, Blatchford GJ, Ternent CA, Christensen MA, Thorson AG. Clinical use of the self-expanding metallic stent in the management of colorectal cancer . Am J Surg 2000 ; 180 : 407 – 12 . Google Scholar Crossref Search ADS PubMed WorldCat 24 Adamsen S , Holm J, Meisner S, Moller P, Naver LPS, West F et al. Endoscopic placement of self-expanding metal stents for treatment of colorectal obstruction with long-term follow-up . Dan Med Bull 2000 ; 47 : 225 – 7 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 25 Rey JF , Romanczyk T, Greff M. Metal stents for palliation of rectal carcinoma: a preliminary report on 12 patients . Endoscopy 1995 ; 27 : 501 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 26 Knoepfle E , Wamser G, Mayer H, Zugel N, Bohndorf K. Emergency decompression of a mechanical colonic ileus before elective surgery: first clinical results of fluroscopic stent placement . Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 1998 ; 168 : 380 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 27 Buchanan GN , Khawaja AR, Okojie EI, Rowe PH, Saunders MP, Stoodley BJ et al. A retrospective analysis of palliative colonic stent placement in an elderly population . Colorectal Dis 2000 ; 2 : 277 – 81 . Google Scholar Crossref Search ADS PubMed WorldCat 28 Tamim WZ , Ghellai A, Counihan C, Swanson RS, Colby JM, Sweeney B. Experience with endoluminal colonic wall stents for the management of large bowel obstruction for benign and malignant disease . Arch Surg 2000 ; 135 : 434 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 29 Tack J , Gevers AM, Rutgeerts P. Self-expanding metallic stents in the palliation of rectosigmoidal carcinoma: a follow-up study . Gastrointest Endosc 1998 ; 48 : 267 – 71 . Google Scholar Crossref Search ADS PubMed WorldCat 30 Wholey MH , Levine EA, Ferral H, Castaneda-Zuniga W. Initial clinical experience with colonic stent placement . Am J Surg 1998 ; 175 : 194 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 31 Fava MP , Contreras OO, Loyola SZ, Lopez FK. Treatment of obstructing colonic carcinoma with expandable metal stents . Rev Med Chil 1999 ; 127 : 1207 – 12 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 32 Desroches E , Faucheron JL, Sengel C, Lachachi F, Risse O, Delannoy P et al. Self-expandable metal stent in the treatment of obstructive cancer of the left colon. Preliminary results and review of the literature . Ann Chir 1999 ; 53 : 1029 – 32 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 33 Miyayama S , Matsui O, Kifune K, Yamashiro M, Yamamoto T, Kitagawa K et al. Malignant colonic obstruction due to extrinsic tumor: palliative treatment with a self-expanding nitinol stent . AJR Am J Roentgenol 2000 ; 175 : 1631 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 34 Wallis F , Campbell KL, Eremin O, Hussey JK. Self-expanding metal stents in the management of colorectal carcinoma—a preliminary report . Clin Radiol 1998 ; 53 : 251 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 35 Arnell T , Stamos MJ, Takahashi P, Ojha S, Sze G, Eysselein V. Colonic stents in colorectal obstruction . Am Surg 1998 ; 64 : 986 – 8 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 36 Castaneda-Zuniga W . Colonic stenting: new alternative in the treatment of acute neoplastic obstruction . Cardiovasc Intervent Radiol 1996 ; 19 ( Suppl 1 ): 1 – 4 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 37 De Gregorio MA , Mainar A, Tobio R, Fernández JA, Quintana J, Alfonso ER et al. Tratamiento de las obstrucciones colorrectales agudas mediante implantación de prótesis metálicas expandibles . Rev Esp Enferm Dig 1996 ; 88 : 667 – 71 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 38 Binkert CA , Ledermann H, Jost R, Saurenmann P, Decurtins M, Zollikofer CL. Acute colonic obstruction: clinical aspects and cost-effectiveness of preoperative and palliative treatment with self-expanding metallic stents—a preliminary report . Radiology 1998 ; 206 : 199 – 204 . Google Scholar Crossref Search ADS PubMed WorldCat 39 Mainar A , Tejero E, Maynar M, Ferral H, Castaneda-Zuniga W. Colorectal obstruction: treatment with metallic stents . Radiology 1996 ; 198 : 761 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 40 Rupp KD , Dohmoto M, Meffert R, Holzgreve A, Hohlbach G. Cancer of the rectum—palliative endoscopic treatment . Eur J Surg Oncol 1995 ; 21 : 644 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 41 Osaka H , Maeda K, Nishiguchi Y, Yashiro M, Swai M, Yamashita Y et al. Expandable metallic stent for the treatment of left-sided colonic obstruction with malignant disease . Gan To Kagaku Ryoho 2000 ; 27 : 1970 – 2 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 42 Soonawalla Z , Thakur K, Boorman P, Macfarlane P, Sathananthan N, Parker M. Use of self-expanding stents in the management of obstruction of the sigmoid colon . AJR Am J Roentgenol 1998 ; 171 : 633 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 43 Turegano-Fuentes F , Echenagusia-Belda A, Simo-Muerza G, Camunez F, Munoz-Jimenez F, Del Valle Hernandez W et al. Transanal self-expanding metal stents as an alternative to palliative colostomy in selected patients with malignant obstruction of the left colon . Br J Surg 1998 ; 85 : 232 – 5 . Google Scholar Crossref Search ADS PubMed WorldCat 44 Boorman P , Soonawalla Z, Sathananthan N, MacFarlane P, Parker MC. Endoluminal stenting of obstructed colorectal tumors . Ann R Coll Surg Engl 1999 ; 81 : 251 – 4 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 45 Osman HS , Rashid HI, Sathananthan N, Parker MC. The cost effectiveness of self-expanding metal stents in the management of malignant left sided large bowel obstruction . Colorectal Dis 2000 ; 2 : 233 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 46 Stamatakis J , Thompson M, Chave H. National Audit of Bowel Obstruction due to Colorectal Cancer, April 1998–March 1999 . London : Association of Coloproctology of Great Britain and Ireland , 2000 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 47 Harris GJC , Senagore AJ, Lavery IC, Fazio VW. The management of neoplastic colorectal obstruction with colonic endolumenal stenting devices . Am J Surg 2001 ; 181 : 499 – 506 . Google Scholar Crossref Search ADS PubMed WorldCat 48 Park JJ , Del Pino A, Orsay PC, Nelson RL, Pearl RK, Cintron JR et al. Stoma complications: the Cook County Hospital experience . Dis Colon Rectum 1999 ; 42 : 1575 – 80 . Google Scholar Crossref Search ADS PubMed WorldCat This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd

Oláh, A; Belágyi, T; Issekutz, Á; Gamal, M E; Bengmark, S

doi: 10.1046/j.1365-2168.2002.02189.xpmid: 12190674

Abstract Background Microbial infection of the pancreatic tissue in patients with severe acute pancreatitis increases the morbidity and mortality rates. Colonization of the lower gastrointestinal tract and oropharynx with Gram-negative, but sometimes also Gram-positive, bacteria precedes contamination of the pancreas. The aim of this study was to determine whether lactic acid bacteria such as Lactobacillus plantarum 299 could prevent colonization of the gut by potential pathogens and thus reduce the endotoxaemia associated with acute pancreatitis. Methods Patients with acute pancreatitis were randomized into two double-blind groups. The treatment group received a freeze-dried preparation containing live L. plantarum 299 in a dose of 109 organisms, together with a substrate of oat fibre, for 1 week by nasojejunal tube. The control group received a similar preparation but the Lactobacillus was inactivated by heat. Results A total of 45 patients completed the study. Twenty-two patients received treatment with live and 23 with heat-killed L. plantarum 299. Infected pancreatic necrosis and abscesses occurred in one of 22 patients in the treatment group, compared with seven of 23 in the control group (P = 0·023). The mean length of stay was 13·7 days in the treatment group versus 21·4 days in the control group (P not significant). Conclusion Supplementary L. plantarum 299 was effective in reducing pancreatic sepsis and the number of surgical interventions. References 1 Isenmann R , Rau B, Beger HG. Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis . Br J Surg 1999 ; 86 : 1020 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 2 Beger HG , Bittner R, Block S, Büchler M. Bacterial contamination of pancreatic necrosis. A prospective clinical study . Gastroenterology 1986 ; 91 : 433 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Büchler MW , Gloor B, Müller CA, Friess H, Seiler CA, Uhl W. Acute necrotizing pancreatitis: treatment strategy according to the status of infection . Ann Surg 2000 ; 232 : 619 – 26 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Kingsnorth A . Role of cytokines and their inhibitors in acute pancreatitis . Gut 1997 ; 40 : 1 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 5 Qamruddin AO , Chadwick PR. Preventing pancreatic infection in acute pancreatitis . J Hosp Infect 2000 ; 44 : 243 – 53 . Google Scholar Crossref Search ADS PubMed WorldCat 6 Golub R , Siddiqi F, Pohl D. Role of antibiotics in acute pancreatitis: a meta-analysis . J Gastrointest Surg 1998 ; 2 : 496 – 503 . Google Scholar Crossref Search ADS PubMed WorldCat 7 Alexander JW , MacMillan BG, Stinnett JD, Ogle CK, Bozian RC, Fischer JE et al. Beneficial effects of aggressive protein feeding in severely burned children . Ann Surg 1980 ; 192 : 505 – 17 . Google Scholar Crossref Search ADS PubMed WorldCat 8 Kudsk KA , Minard G, Croce MA, Brown RO, Lowrey TD, Pritchard FE et al. A randomized trial of isonitrogenous enteral diets after severe trauma. An immune-enhancing diet reduces septic complications . Ann Surg 1996 ; 224 : 531 – 43 . Google Scholar Crossref Search ADS PubMed WorldCat 9 Moore FA , Feliciano DV, Andrassy RJ, McArdle AH, McBooth FV, Morgenstein-Wagner TB et al. Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis . Ann Surg 1992 ; 216 : 172 – 83 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Guillou PJ . Enteral versus parenteral nutrition in acute pancreatitis . Baillieres Best Pract Res Clin Gastroenterol 1999 ; 13 : 345 – 55 . Google Scholar Crossref Search ADS PubMed WorldCat 11 Erstad BL . Enteral nutrition support in acute pancreatitis . Ann Pharmacother 2000 ; 34 : 514 – 21 . Google Scholar Crossref Search ADS PubMed WorldCat 12 Oláh A , Pardavi G, Belágyi T, Nagy A, Issekutz Á, Gamal EM. Early nasojejunal feeding in acute pancreatitis is associated with a lower complication rate . Nutrition 2002 ; 18 : 259 – 62 . Google Scholar Crossref Search ADS PubMed WorldCat 13 Bengmark S . Prospect for a new and rediscovered form of therapy: probiotic and phage. In: Andrew PW, Oystron P, Smith GL, Stewart-Tull DE, eds. Fighting Infection in the 21st Century . London : Blackwells , 2000 : 97 – 132 . Google Scholar Crossref Search ADS Google Preview WorldCat COPAC 14 Bengmark S . Use of pro-, pre- and synbiotics in the ICU—future options. In: Shikora SA, Martindale RG, Schwaitzberg SD, eds. Nutritional Considerations in the Intensive Care Unit—Science, Rationale and Practice . Denver, Colorado : Aspen , 2002 381 – 99 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 15 Bengmark S . Pre-, pro- and synbiotics . Curr Opin Clin Nutr Metab Care 2001 ; 4 : 571 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 16 Rayes N , Hansen S, Boucsein K, Müller AR, Serke S, Brammer M et al. Comparison of parenteral and early enteral nutrition with fibre and lactobacilli after major abdominal surgery—a prospective randomised trial . Nutrition (in press). OpenURL Placeholder Text WorldCat 17 Rayes N , Hansen S, Boucsein K, Seehofer D, Müller AR, Serke S et al. Early enteral supply of fibre and lactobacilli vs selective bowel decontamination—a randomised controlled trial in liver transplant recipients . Transplantation (in press). OpenURL Placeholder Text WorldCat 18 Mangiante G , Colucci G, Canepari P, Bassi C, Nicoli N, Casaril A et al. Lactobacillus plantarum reduces infection of pancreatic necrosis in experimental acute pancreatitis . Dig Surg 2001 ; 18 : 47 – 50 . Google Scholar Crossref Search ADS PubMed WorldCat 19 Blamey SL , Imrie CW, O'Neill J, Gilmour WH, Carter DC. Prognostic factors in acute pancreatitis . Gut 1984 ; 25 : 1340 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 20 McGregor CS , Marshall JC. Enteral feeding in acute pancreatitis: just do it . Curr Opin Crit Care 2001 ; 7 : 89 – 91 . Google Scholar Crossref Search ADS PubMed WorldCat 21 Al-Omran M , Groof A, Wilke D. Enteral versus parenteral nutrition for acute pancreatitis (Cochrane Review) . Cochrane Database Syst Rev 2001 ; 2 : CD002837 . Google Scholar OpenURL Placeholder Text WorldCat 22 Norman J . The role of cytokines in the pathogenesis of acute pancreatitis . Am J Surg 1998 ; 175 : 76 – 83 . Google Scholar Crossref Search ADS PubMed WorldCat 23 de Souza LJ , Sampietre SN, Figueiredo S, Yria Y, Machado MC, Pinotti HW. Bacterial translocation in acute pancreatitis. Experimental study in rats . Rev Hosp Clin Fac Med Sao Paolo 1996 ; 51 : 116 – 20 . Google Scholar OpenURL Placeholder Text WorldCat 24 Wang X , Andersson R, Soltesz V, Leveau P, Ihse I. Gut origin sepsis, macrophage function, and oxygen extraction associated with acute pancreatitis in the rat . World J Surg 1996 ; 20 : 299 – 308 . Google Scholar Crossref Search ADS PubMed WorldCat 25 Leveau P , Wang X, Soltesz V, Ihse I, Andersson R. Alterations in intestinal motility and microflora in experimental acute pancreatitis . Int J Pancreatol 1996 ; 20 : 119 – 25 . Google Scholar PubMed OpenURL Placeholder Text WorldCat This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd

Sailer, M; Fuchs, K-H; Fein, M; Thiede, A

doi: 10.1046/j.1365-2168.2002.02194.xpmid: 12190675

Abstract Background Functional results after rectal resection with straight coloanal anastomosis are poor. While most functional aspects are improved with coloanal J pouch anastomosis, it is still unclear whether this translates into better quality of life. The aim of this trial was to investigate health-related quality of life as a primary endpoint in patients undergoing sphincter-saving rectal resection. Methods Sixty-four patients were randomized to either straight (n = 32) or coloanal J pouch (n = 32) anastomosis. Patients were studied before operation, at the time of stoma reversal and at 3-month intervals for 1 year thereafter. Quality of life was measured using two generic (Gastrointestinal Quality of Life Index and European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30) and one disease-specific (EORTC QLQ-CR38) instruments. Functional results using a standardized score as well as manometric variables were recorded. Results Thirty-nine patients (19 with a pouch and 20 with a straight anastomosis) completed the trial. There was a marked difference between the two groups with regard to quality of life profile. Patients with a pouch reconstruction had a significantly better quality of life, particularly in the early postoperative period. Conclusion Patients undergoing low anterior rectal resection and coloanal J pouch reconstruction may expect not only better functional results but also an improved quality of life in the early months after surgery compared with patients who receive a straight coloanal anastomosis. References 1 Heald RJ , Karanjia ND. Results of radical surgery for rectal cancer . World J Surg 1992 ; 16 : 848 – 57 . Google Scholar Crossref Search ADS PubMed WorldCat 2 Kwok SPY , Lau WY, Leung KL, Liew CT, Li AKC. Prospective analysis of the distal margin of clearance in anterior resection for rectal carcinoma . Br J Surg 1996 ; 83 : 969 – 72 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Enker WE , Merchant N, Cohen AM, Lanouette NM, Swallow C, Guillem J et al. Safety and efficacy of low anterior resection for rectal cancer: 681 consecutive cases from a speciality service . Ann Surg 1999 ; 230 : 544 – 54 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Batignani G , Monaci I, Ficari F, Tonelli F. What affects continence after anterior resection of the rectum? Dis Colon Rectum 1991 ; 34 : 329 – 35 . Google Scholar Crossref Search ADS PubMed WorldCat 5 Varma JS , Smith AN. Anorectal function following colo-anal sleeve anastomosis for chronic radiation injury to the rectum . Br J Surg 1986 ; 73 : 285 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 6 Lazorthes F , Fages P, Chiotasso P, Lemozy J, Bloom E. Resection of the rectum with construction of a colonic reservoir and colo-anal anastomosis for carcinoma of the rectum . Br J Surg 1986 ; 73 : 136 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 7 Parc R , Tiret E, Frileux P, Moszkowski E, Loygue J. Resection and colo-anal anastomosis with colonic reservoir for rectal carcinoma . Br J Surg 1986 ; 73 : 139 – 41 . Google Scholar Crossref Search ADS PubMed WorldCat 8 Hallböök O , Pahlman L, Krog M, Wexner SD, Sjödahl R. Randomised comparison of straight and colonic J pouch anastomosis after low anterior resection . Ann Surg 1996 ; 224 : 58 – 65 . Google Scholar Crossref Search ADS PubMed WorldCat 9 Seow-Choen F , Goh HS. Prospective randomised trial comparing J colonic pouch–anal anastomosis and straight coloanal reconstruction . Br J Surg 1995 ; 82 : 608 – 10 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Ortiz H , De Miguel M, Armendariz P, Rodriguez J, Chocarro C. Coloanal anastomosis: are functional results better with a pouch? Dis Colon Rectum 1995 ; 38 : 375 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 11 Lazorthes F , Chiotasso P, Gamagami RA, Istvan G, Chevreau P. Late clinical outcome in a randomised prospective comparison of colonic J pouch and straight coloanal anastomosis . Br J Surg 1997 ; 84 : 1449 – 51 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 12 Ko CY , Rusin LC, Schoetz DJ Jr, Moreau L, Coller JA, Murray JJ et al. Does better functional result equate with better quality of life? Implications for surgical treatment in familial adenomatous polyposis . Dis Colon Rectum 2000 ; 43 : 829 – 37 . Google Scholar Crossref Search ADS PubMed WorldCat 13 Renner K , Rosen HR, Novi G, Höbling N, Schiessel R. Quality of life after surgery for rectal cancer: do we still need a permanent colostomy? Dis Colon Rectum 1999 ; 42 : 1160 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 14 Shelton AA , Madoff RD. Defining anal incontinence: establishing a uniform continence scale . Semin Colon Rectal Surg 1997 ; 8 : 54 – 60 . Google Scholar OpenURL Placeholder Text WorldCat 15 Hallböök H , Hass U, Wänstrom A, Sjödahl R. Quality of life measurement after rectal excision for cancer. Comparison between straight and colonic J pouch anastomosis . Scand J Gastroenterol 1997 ; 32 : 490 – 3 . Google Scholar Crossref Search ADS PubMed WorldCat 16 O'Boyle CA . Assessment of quality of life in surgery . Br J Surg 1992 ; 79 : 395 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 17 Bulpitt CJ . Quality of life as an outcome measure . Postgrad Med J 1997 ; 73 : 613 – 16 . Google Scholar Crossref Search ADS PubMed WorldCat 18 Moinpour C , Feigl P, Metch B, Hayden KA, Meyskens FL Jr, Crowley J. Quality of life end points in cancer clinical trials: review and recommendations . J Natl Cancer Inst 1989 ; 81 : 485 – 95 . Google Scholar Crossref Search ADS PubMed WorldCat 19 Eypasch E , Williams JI, Wood-Dauphinee S, Ure BM, Schmulling C, Neugebauer E et al. Gastrointestinal Quality of Life Index: development, validation and application of a new instrument . Br J Surg 1995 ; 82 : 216 – 22 . Google Scholar Crossref Search ADS PubMed WorldCat 20 Aaronson NK , Ahmedzai SA, Bergman B, Bullinger M, Cull A, Duez NJ et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology . J Natl Cancer Inst 1993 ; 85 : 365 – 76 . Google Scholar Crossref Search ADS PubMed WorldCat 21 Sprangers MAG , te Velde A, Aaronson NK. The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). European Organization for Research and Treatment of Cancer Study Group on Quality of Life . Eur J Cancer 1999 ; 35 : 238 – 47 . Google Scholar Crossref Search ADS PubMed WorldCat 22 Freys SM , Fuchs KH, Fein M, Heimbucher J, Sailer M, Thiede A. Inter- and intraindividual reproducibility of anorectal manometry . Langenbecks Arch Surg 1998 ; 383 : 325 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 23 Camilleri-Brennan J , Steele RJC. Quality of life after treatment for rectal cancer . Br J Surg 1998 ; 85 : 1036 – 43 . Google Scholar Crossref Search ADS PubMed WorldCat 24 Whynes DK , Neilson AR, Robinson MH, Hardcastle JD. Colorectal cancer screening and quality of life . Qual Life Res 1994 ; 3 : 191 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 25 Whynes DK , Neilson AR. Symptoms before and after surgery for colorectal cancer . Qual Life Res 1997 ; 6 : 61 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 26 Koller M , Lorenz W. Quality of life research in patients with rectal cancer: traditional approaches versus a problem-solving oriented perspective . Langenbecks Arch Surg 1998 ; 383 : 427 – 36 . Google Scholar Crossref Search ADS PubMed WorldCat 27 Lee SJ , Park YS. Serial evaluation of anorectal function following low anterior resection of the rectum . Int J Colorectal Dis 1998 ; 13 : 241 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 28 Cavaliere F , Pemberton JH, Cosimelli M, Fazio VW, Beart RW Jr Coloanal anastomosis for rectal cancer. Long-term results at the Mayo and Cleveland Clinics . Dis Colon Rectum 1995 ; 38 : 807 – 12 . Google Scholar Crossref Search ADS PubMed WorldCat 29 Paty PB , Enker WE, Cohen AM, Minsky BD, Friedlander-Klar H. Long-term functional results of coloanal anastomosis for rectal cancer . Am J Surg 1994 ; 167 : 90 – 5 . Google Scholar Crossref Search ADS PubMed WorldCat 30 Brickman P , Coates D, Janoff-Bulman R. Lottery winners and accident victims: is happiness relative? J Pers Soc Psychol 1978 ; 36 : 917 – 27 . Google Scholar Crossref Search ADS PubMed WorldCat 31 Allal AS , Sprangers MAG, Laurencet F, Reymond MA, Kurtz JM. Assessment of long-term quality of life in patients with anal carcinomas treated by radiotherapy with or without chemotherapy . Br J Cancer 1999 ; 80 : 1588 – 94 . Google Scholar Crossref Search ADS PubMed WorldCat This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd

Al-Ghnaniem, R; Benjamin, I S

doi: 10.1046/j.1365-2168.2002.02182.xpmid: 12190676

Abstract Background Hepaticojejunostomy is the ‘gold standard’ procedure for repairing iatrogenic bile duct injuries. The aim of this study was to examine the long-term outcome following hepaticojejunostomy for iatrogenic bile duct injury and the utility of routine construction of an access loop. Methods Patients with iatrogenic biliary injuries were treated with hepaticojejunostomy and access loop by a single surgeon. Injuries were classified according to the Bismuth level. An ‘excellent’ outcome was achieved if the patient never experienced jaundice or cholangitis in the follow-up period, and the outcome was ‘good’ if the patient developed symptoms but was asymptomatic for more than 12 months. Results Forty-eight patients underwent such operation. There was one operative death. Thirty-three patients were followed for 3 years or more (mean follow-up 80·4 (range 46–118) months). Thirteen of the 33 injuries were Bismuth level II, 13 were Bismuth level III and seven were Bismuth level IV. Outcome was dependent on the Bismuth level (P < 0·001). It was excellent in all 13 patients with Bismuth level II injuries, excellent in seven and good in six of the 13 patients with Bismuth level III injuries, and excellent in one and good in six of the seven patients with Bismuth level IV injuries. Moreover, the need for access loop intervention was dependent on the Bismuth level (P < 0·001). No patient with Bismuth level II injury required intervention, compared with five of 13 with Bismuth level III and six of seven with Bismuth level IV injuries. Conclusion Biliary reconstruction affords satisfactory long-term outcome. The likelihood of needing the access loop for radiological intervention is dependent on the Bismuth level. The authors recommend that an access loop be constructed in all patients with Bismuth level III and IV injuries. References 1 Blumgart LH . Benign biliary strictures. In: Blumgart LH, ed. Surgery of the Liver and Biliary Tract . Edinburgh : Churchill Livingstone , 1988 : 721 – 52 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 2 Chapman WC , Halevy A, Blumgart LH, Benjamin IS. Postcholecystectomy bile duct strictures. Management and outcome in 130 patients . Arch Surg 1995 ; 130 : 597 – 602 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Lillemoe KD , Melton GB, Cameron JL, Pitt HA, Campbell KA, Talamini MA et al. Postoperative bile duct strictures. management and outcome in the 1990s . Ann Surg 2000 ; 232 : 430 – 41 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Lillemoe KD , Martin SA, Cameron JL, Yeo CJ, Talamini MA, Kaushal S et al. Major bile duct injuries during laparoscopic cholecystectomy. Follow-up after combined surgical and radiologic management . Ann Surg 1997 ; 225 : 459 – 68 . Google Scholar Crossref Search ADS PubMed WorldCat 5 Blumgart LH , Kelley CJ, Benjamin IS. Benign bile duct stricture following cholecystectomy: critical factors in management . Br J Surg 1984 ; 71 : 836 – 43 . Google Scholar Crossref Search ADS PubMed WorldCat 6 Frattaroli FM , Reggio D, Guadalaxara A, Illomei G, Pappalardo G. Benign biliary strictures: a review of 21 years of experience . J Am Coll Surg 1996 ; 183 : 506 – 13 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 7 Hutson DG , Russell E, Schiff E, Levi JJ, Jeffers L, Zeppa R. Balloon dilatation of biliary strictures through a choledochojejuno-cutaneous fistula . Ann Surg 1984 ; 199 : 637 – 47 . Google Scholar Crossref Search ADS PubMed WorldCat 8 Hutson DG , Russell E, Yrizarry J, Levi JU, Livingstone AS, Guerra J et al. Percutaneous dilatation of biliary strictures through the afferent limb of a modified Roux-en-Y choledochojejunostomy or hepaticojejunostomy . Am J Surg 1998 ; 175 : 108 – 13 . Google Scholar Crossref Search ADS PubMed WorldCat 9 Schweizer WP , Matthews JB, Baer HU, Nudelmann LI, Triller J, Halter F et al. Combined surgical and interventional radiological approach for complex benign biliary tract obstruction . Br J Surg 1991 ; 78 : 559 – 63 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Bismuth H . Postoperative strictures of the bile duct. In: Blumgart LH, ed. The Biliary Tract . Edinburgh : Churchill livingstone , 1982 : 209 – 18 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 11 Schol FP , Go PM, Gouma DJ. Outcome of 49 repairs of bile duct injuries after laparoscopic cholecystectomy . World J Surg 1995 ; 19 : 753 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 12 Southern Surgeons Club . A prospective analysis of 1518 laparoscopic cholecystectomies . N Engl J Med 1991 ; 324 : 1073 – 8 . Crossref Search ADS PubMed WorldCat 13 Adamsen S , Hansen OH, Funch-Jensen P, Schulze S, Stage JG, Wara P. Bile duct injury during laparoscopic cholecystectomy: a prospective nationwide series . J Am Coll Surg 1997 ; 184 : 571 – 8 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 14 Davidoff AM , Pappas TN, Murray EA, Hilleren DJ, Johnson RD, Baker ME et al. Mechanisms of major biliary injury during laparoscopic cholecystectomy . Ann Surg 1992 ; 215 : 196 – 202 . Google Scholar Crossref Search ADS PubMed WorldCat 15 Deziel DJ , Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic cholecystectomy: a national survey of 4292 hospitals and an analysis of 77 604 cases . Am J Surg 1993 ; 165 : 9 – 14 . Google Scholar Crossref Search ADS PubMed WorldCat 16 Fullarton GM , Bell G. Prospective audit of the introduction of laparoscopic cholecystectomy in the west of Scotland. West of Scotland Laparoscopic Cholecystectomy Audit Group . Gut 1994 ; 35 : 1121 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 17 MacFadyen BV Jr, Vecchio R, Ricardo AE, Mathis CR. Bile duct injury after laparoscopic cholecystectomy. The United States experience . Surg Endosc 1998 ; 12 : 315 – 21 . Google Scholar Crossref Search ADS PubMed WorldCat 18 Richardson MC , Bell G, Fullarton GM. Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. West of Scotland Laparoscopic Cholecystectomy Audit Group . Br J Surg 1996 ; 83 : 1356 – 60 . Google Scholar Crossref Search ADS PubMed WorldCat 19 Shea JA , Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN et al. Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis . Ann Surg 1996 ; 224 : 609 – 20 . Google Scholar Crossref Search ADS PubMed WorldCat 20 Stewart L , Way LW. Bile duct injuries during laparoscopic cholecystectomy. Factors that influence the results of treatment . Arch Surg 1995 ; 130 : 1123 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 21 Andren-Sandberg A , Alinder G, Bengmark S. Accidental lesions of the common bile duct at cholecystectomy. Pre- and peri operative factors of importance . Ann Surg 1985 ; 201 : 328 – 32 . Google Scholar Crossref Search ADS PubMed WorldCat 22 Wright KD , Wellwood JM. Bile duct injury during laparoscopic cholecystectomy without operative cholangiography . Br J Surg 1998 ; 85 : 191 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 23 Carroll BJ , Friedman RL, Liberman MA, Phillips EH. Routine cholangiography reduces sequelae of common bile duct injuries . Surg Endosc 1996 ; 10 : 1194 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 24 Lorimer JW , Fairfull-Smith RJ. Intraoperative cholangiography is not essential to avoid duct injuries during laparoscopic cholecystectomy . Am J Surg 1995 ; 169 : 344 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 25 Soper NJ , Dunnegan DL. Routine versus selective intra-operative cholangiography during laparoscopic cholecystectomy . World J Surg 1992 ; 16 : 1133 – 40 . Google Scholar Crossref Search ADS PubMed WorldCat 26 Fletcher DR , Hobbs MS, Tan P, Valinsky LJ, Hockey RL, Pikora TJ et al. Complications of cholecystectomy: risks of the laparoscopic approach and protective effects of operative cholangiography: a population-based study . Ann Surg 1999 ; 229 : 449 – 57 . Google Scholar Crossref Search ADS PubMed WorldCat 27 Shah SR , Mirza DF, Afonso R, Mayer AD, McMaster P, Buckels JA. Changing referral pattern of biliary injuries sustained during laparoscopic cholecystectomy . Br J Surg 2000 ; 87 : 890 – 1 . Google Scholar Crossref Search ADS PubMed WorldCat 28 Barker EM , Winkler M. Permanent-access hepaticojejunostomy . Br J Surg 1984 ; 71 : 188 – 91 . Google Scholar Crossref Search ADS PubMed WorldCat 29 Gibson RN , Adam A, Czerniak A, Halevy A, Hadjis N, Benjamin IS et al. Benign biliary strictures: a proposed combined surgical and radiological management . Aust N Z J Surg 1987 ; 57 : 361 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 30 Fan ST , Mok F, Zheng SS, Lai EC, Lo CM, Wong J. Appraisal of hepaticocutaneous jejunostomy in the management of hepatolithiasis . Am J Surg 1993 ; 165 : 332 – 5 . Google Scholar Crossref Search ADS PubMed WorldCat 31 Hutson DG , Russell E, Levi JU, Livingstone AS, Yrizarry JM, Guerra J et al. Balloon dilatation through the subcutaneously placed afferent limb of a hepaticojejunostomy in patients with resected Klatskin tumors . Am Surg 1995 ; 61 : 518 – 20 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 32 Martin EC , Laffey KJ, Bixon R. Percutaneous transjejunal approaches to the biliary system . Radiology 1989 ; 172 : 1031 – 4 . Google Scholar Crossref Search ADS PubMed WorldCat 33 McPherson SJ , Gibson RN, Collier NA, Speer TG, Sherson ND. Percutaneous transjejunal biliary intervention: 10-year experience with access via Roux-en-Y loops . Radiology 1998 ; 206 : 665 – 72 . Google Scholar Crossref Search ADS PubMed WorldCat 34 Takada T , Yasuda H, Uchiyama K, Hasegawa H, Shikata J, Kuniyasu Y. The relationship between a subcutaneously placed afferent jejunal loop in a hepaticojejunostomy and postoperative cholangitis . Int Surg 1989 ; 74 : 167 – 70 . Google Scholar PubMed OpenURL Placeholder Text WorldCat This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd

Yeh, C-N; Lee, W-C; Jeng, L-B; Chen, M-F; Yu, M-C

doi: 10.1046/j.1365-2168.2002.02188.xpmid: 12190677

Abstract Background Hepatocellular carcinoma (HCC) is a common disease in Taiwan. Ruptured HCC is an uncommon and potentially fatal complication of the condition. Information on the impact of ruptured HCC on hepatic resection is, however, limited. Methods The clinical features of 60 patients with ruptured HCC who underwent hepatic resection from 1986 to 1998 were reviewed. Clinical features and factors influencing the outcome of 475 patients with non-ruptured HCC were used for comparison. Results Of 535 surgically resected HCCs, 60 (11·2 per cent) were ruptured. Univariate analysis showed that sudden onset of abdominal pain, physical signs of haemodynamic unstability, reduced haemoglobin level and a raised aspartate aminotransferase level were more frequently found in patients with ruptured HCC than in those with non-ruptured tumours. Multivariate stepwise logistic regression analysis revealed sudden-onset abdominal pain to be the only independently significant factor in patients in the ruptured HCC group. The 1-, 3- and 5-year survival rates of patients with non-ruptured HCC were 72·1, 47·3 and 33·9 per cent, and those of patients with ruptured HCC were 54·2, 35·0 and 21·2 per cent respectively. Similar overall survival rates were found in patients with ruptured and non-ruptured HCC, although patients in the non-ruptured HCC group had a significantly better disease-free survival rate (P = 0·023). Conclusion The presence of sudden-onset abdominal pain is the only independent indicator of ruptured HCC. Hepatic resection, when feasible, is the treatment of choice and can result in an overall survival rate comparable to that of patients with non-ruptured HCC. References 1 Department of Health . Annual Report of Cancer Registration, 1998 . China Department of Health, Executive , Yuan, Taiwan , 1998 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 2 Chen MF , Jan YY, Lee TY. Transcatheter hepatic arterial embolization followed by hepatic resection for the spontaneous rupture of hepatocellular carcinoma . Cancer 1986 ; 58 : 332 – 5 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Kasai Y , Tamaki A. Kakita Y. Surgical treatment of primary hepatocellular carcinoma . Geka Shinryo 1977 ; 19 : 46 – 54 . Google Scholar OpenURL Placeholder Text WorldCat 4 Chen MF , Hwang TL, Jeng LB, Jan YY, Wang CS. Surgical treatment for spontaneous rupture of hepatocellular carcinoma . Surg Gynecol Obstet 1988 ; 167 : 99 – 102 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 5 Chen MF , Hwang TL, Jeng LB, Jan YY, Wang CS, Chou FF. Hepatic resection in 120 patients with hepatocellular carcinoma . Arch Surg 1989 ; 124 : 1025 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 6 Chen MF , Hwang TL, Jeng LB, Jan YY, Wang CS. Clinical experience with hepatic resection for ruptured hepatocellular carcinoma . Hepatogastroenterology 1995 ; 42 : 166 – 8 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 7 Healy JE Jr, Schroy PC. Anatomy of the biliary ducts within the human liver. Analysis of the prevailing pattern of branchings and the major variations of the biliary ducts . Arch Surg 1953 ; 66 : 599 – 616 . Google Scholar Crossref Search ADS WorldCat 8 Couinaud C . Le Foie: Etudes Anatomiques et Chirurgicales . Paris : Masson , 1957 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 9 Edmondsen HA , Steiner PE. Primary carcinoma of the liver: a study of 100 cases among 48 900 necropsies . Cancer 1954 ; 7 : 462 – 503 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Lai EC , Wu KM, Choi TK, Fan ST, Wong J. Spontaneous ruptured hepatocellular carcinoma. An appraisal of surgical treatment . Ann Surg 1988 ; 210 : 24 – 8 . Google Scholar Crossref Search ADS WorldCat 11 Dewar GA , Griffin SM, Ku KW, Lau WY, Li AKC. Management of bleeding liver tumours in Hong Kong . Br J Surg 1991 ; 78 : 463 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 12 Yamagata M , Maeda T, Ikeda Y, Shirabe K, Nishizaki T, Koyanagi N. Surgical results of spontaneously ruptured hepatocellular carcinoma . Hepatogastroenterology 1995 ; 42 : 461 – 4 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 13 Vergara V , Muratore A, Bouzari H, Polastri R, Ferrero A, Galatola G et al. Spontaneous rupture of hepatocellular carcinoma: surgical resection and long-term survival . Eur J Surg Oncol 2000 ; 26 : 770 – 2 . Google Scholar Crossref Search ADS PubMed WorldCat 14 Tung Pin Poon R , Fan ST, Wong J. Risk factors, prevention, and management of postoperative recurrence after resection of hepatocellular carcinoma . Ann Surg 2000 ; 232 : 10 – 24 . Google Scholar Crossref Search ADS PubMed WorldCat This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd

Yamaguchi, R; Nagino, M; Oda, K; Kamiya, J; Uesaka, K; Nimura, Y

doi: 10.1046/j.1365-2168.2002.02184.xpmid: 12190678

Abstract Background The clinical significance of perineural invasion of gallbladder carcinoma remains unclear. The aim of this study was to elucidate the incidence and mode of perineural invasion of gallbladder carcinoma and clarify its prognostic significance. Methods A clinicopathological study was conducted on 68 patients who underwent attempted curative resection for gallbladder carcinoma. According to the pathological tumour node metastasis (pTNM) classification of the Union Internacional Contra la Cancrum, there were five (7 per cent), nine (13 per cent), 20 (29 per cent) and 34 (50 per cent) patients with pT1, pT2, pT3 and pT4 disease respectively. Twenty patients (29 per cent) had pM1 disease, including involved para-aortic nodes, liver metastases and localized dissemination. Results The overall incidence of perineural invasion was 71 per cent (48 of 68 patients). Forty-four (96 per cent) of 46 patients with extrahepatic bile duct invasion had perineural invasion. Although several histological factors were associated with perineural invasion, multivariate analysis demonstrated that extrahepatic bile duct invasion was the only significant factor correlated with perineural invasion (odds ratio 99·0, P < 0·001). The perineural invasion index, defined as the ratio of the number of involved nerves to the total number of nerves examined, was significantly higher at the centre than in the proximal and distal parts of the tumour in the 46 patients with extrahepatic bile duct invasion (P < 0·001). The 5-year survival rate for patients with perineural invasion was significantly lower than that for patients with no invasion (7 versus 72 per cent; P < 0·001). Cox proportional hazard analysis identified perineural invasion (relative risk (RR) 5·3, P < 0·001) and lymph node metastasis (RR 2·5, P = 0·008) as significant independent prognostic factors. Conclusion Perineural invasion is common in advanced gallbladder carcinoma and has a significant negative impact on patient survival. References 1 Gagner M , Rossi RL. Radical operation for carcinoma of the gallbladder: present status in North America . World J Surg 1991 ; 15 : 344 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 2 Shirai Y , Yoshida K, Tsukada K, Muto T, Watanabe H. Radical surgery for gallbladder carcinoma. Long-term results . Ann Surg 1992 ; 216 : 565 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Henson DE , Albores-Saavedra J, Corle D. Carcinoma of the gallbladder. Histologic type, stage of disease, grade, and survival rates . Cancer 1992 ; 70 : 1493 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Cubertafond P , Gainant A, Cucchiaro G. Surgical treatment of 724 carcinomas of the gallbladder. Results of the French Surgical Association Survey . Ann Surg 1994 ; 219 : 275 – 80 . Google Scholar Crossref Search ADS PubMed WorldCat 5 Manfredi S , Benhamiche AM, Isambert N, Prost P, Jouve JL, Faivre J. Trends in incidence and management of gallbladder carcinoma: a population-based study in France . Cancer 2000 ; 89 : 757 – 62 . Google Scholar Crossref Search ADS PubMed WorldCat 6 Nimura Y , Hayakawa N, Kamiya J, Maeda S, Kondo S, Yasui A et al. Hepatopancreatoduodenectomy for advanced carcinoma of the biliary tract . Hepatogastroenterology 1991 ; 38 : 170 – 5 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 7 Nakamura S , Nishiyama R, Yokoi Y, Serizawa A, Nishiwaki Y, Konno H et al. Hepatopancreatoduodenectomy for advanced gallbladder carcinoma . Arch Surg 1994 ; 129 : 625 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 8 Bloechle C , Izbicki JR, Passlick B, Gawad K, Passow C, Rogiers X et al. Is radical surgery in locally advanced gallbladder carcinoma justified? Am J Gastroenterol 1995 ; 90 : 2195 – 200 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 9 Bartlett DL , Fong Y, Fortner JG, Brennan MF, Blumgart LH. Long-term results after resection for gallbladder cancer. Implication for staging and management . Ann Surg 1996 ; 224 : 639 – 46 . Google Scholar Crossref Search ADS PubMed WorldCat 10 Tsukada K , Hatakeyama K, Kurosaki I, Uchida K, Shirai Y, Muto T et al. Outcome of radical surgery for carcinoma of the gallbladder according to the TNM stage . Surgery 1996 ; 120 : 816 – 21 . Google Scholar Crossref Search ADS PubMed WorldCat 11 Miyazaki M , Itoh H, Ambiru S, Shimizu A, Togawa A, Gohchi E et al. Radical surgery for advanced gallbladder carcinoma . Br J Surg 1996 ; 83 : 478 – 81 . Google Scholar Crossref Search ADS PubMed WorldCat 12 Todoroki T , Kawamoto T, Takahashi H, Takada Y, Koike N, Ohtsuka M et al. Treatment of gallbladder cancer by radical resection . Br J Surg 1999 ; 86 : 622 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 13 Fong Y , Jarnagin W, Blumgart LH. Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention . Ann Surg 2000 ; 232 : 557 – 69 . Google Scholar Crossref Search ADS PubMed WorldCat 14 Kondo S , Nimura Y, Kamiya J, Nagino M, Kanai M, Uesaka K et al. Five-year survivors after aggressive surgery for stage IV gallbladder carcinoma . J Hepatobiliary Pancreat Surg 2001 ; 8 : 511 – 17 . Google Scholar Crossref Search ADS PubMed WorldCat 15 Kondo S , Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K. Extensive surgery for carcinoma of the gallbladder . Br J Surg 2002 ; 89 : 179 – 84 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 16 Goepfert H , Dichtel WJ, Mediana JE, Lindberg RD, Luna MD. Perineural invasion in squamous cell skin carcinoma of the head and neck . Am J Surg 1984 ; 148 : 542 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 17 Hassan MO , Maksem J. The prostatic perineural space and its relation to tumor spread: an ultrastructural study . Am J Surg Pathol 1980 ; 4 : 143 – 8 . Google Scholar Crossref Search ADS PubMed WorldCat 18 Nagakawa T , Konishi I, Higashino Y, Ueno K, Ohta T, Kayahara M et al. The spread and prognosis of carcinoma in the region of the pancreatic head . Jpn J Surg 1989 ; 19 : 510 – 18 . Google Scholar Crossref Search ADS PubMed WorldCat 19 Bhuiya MR , Nimura Y, Kamiya J, Kondo S, Fukata S, Hayakawa N et al. Clinicopathologic studies on perineural invasion of bile duct carcinoma . Ann Surg 1992 ; 215 : 344 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 20 Bhuiya MR , Nimura Y, Kamiya J, Kondo S, Nagino M, Hayakawa N. Clinicopathologic factors influencing survival of patients with bile duct carcinoma: multivariate statistical analysis . World J Surg 1993 ; 17 : 653 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 21 Chijiiwa K , Yamaguchi K, Tanaka M. Clinicopathologic differences between long-term and short-term postoperative survivors with advanced gallbladder carcinoma . World J Surg 1997 ; 21 : 98 – 102 . Google Scholar Crossref Search ADS PubMed WorldCat 22 Nagakawa T , Mori K, Nakano T, Kadoya M, Kobayashi H, Akiyama T et al. Perineural invasion of carcinoma of the pancreas and biliary tract . Br J Surg 1993 ; 80 : 619 – 21 . Google Scholar Crossref Search ADS PubMed WorldCat 23 International Union Against Cancer (UICC) . TNM Classification of Malignant Tumours . 5th ed. New York , Wiley-Liss , 1997 . Google Scholar Google Preview OpenURL Placeholder Text WorldCat COPAC 24 Kondo S , Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K. Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma . Br J Surg 2000 ; 87 : 418 – 22 . Google Scholar Crossref Search ADS PubMed WorldCat 25 Moore RA . The morphology of small prostatic carcinoma . J Urol 1935 ; 33 : 224 – 34 . Google Scholar Crossref Search ADS WorldCat 26 Warren S , Harris PN, Graves RC. Osseous metastasis of carcinoma of the prostate with special reference to the perineural lymphatics . Arch Pathol 1936 ; 22 : 139 – 60 . Google Scholar OpenURL Placeholder Text WorldCat 27 Larson DL , Rodin AE, Roberts DK, O'Steen WK, Rapperport AS, Lewis SR. Perineural lymphatics; myth or fact . Am J Surg 1966 ; 112 : 488 – 92 . Google Scholar Crossref Search ADS PubMed WorldCat 28 Maxwell P , Hamilton PW, Sloan JM. Three-dimensional reconstruction of perineural invasion in carcinoma of the extrahepatic bile ducts . J Pathol 1996 ; 180 : 142 – 5 . Google Scholar Crossref Search ADS PubMed WorldCat 29 Nakao A , Harada A, Nonami T, Kaneko T, Takagi H. Clinical significance of carcinoma invasion of the extrapancreatic nerve plexus in pancreatic cancer . Pancreas 1996 ; 12 : 357 – 61 . Google Scholar Crossref Search ADS PubMed WorldCat 30 Fahim RB , McDonald JR, Richards JC, Ferris DO. Carcinoma of the gallbladder: a study of its modes of spread . Ann Surg 1962 ; 156 : 114 – 24 . Google Scholar Crossref Search ADS PubMed WorldCat 31 Neibling HA , Dockerty MB, Waugh JM. Carcinoma of the extrahepatic bile ducts . Surg Gynecol Obstet 1949 ; 89 : 429 – 38 . Google Scholar PubMed OpenURL Placeholder Text WorldCat 32 Chomette G , Auriol M, Tranbaloc P, Vaillant JM. Adenoid cystic carcinoma of minor salivary glands. Analysis of 86 cases. Clinico-pathological, histoenzymological and ultrastructural studies . Virchows Arch 1982 ; 395 : 289 – 301 . Google Scholar Crossref Search ADS WorldCat This content is only available as a PDF. © 2002 British Journal of Surgery Society Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2002 British Journal of Surgery Society Ltd