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| 1 | Laparoscopic liver resection under hemihepatic vascular inflow occlusion using the lowering of hilar plate approach显示文摘BACKGROUND: With advances in technology, laparoscopic liver resection is widely accepted. Laparoscopic liver resection under hemihepatic vascular inflow occlusion has advantages over the conventional total hepatic inflow occlusion using the Pringle's maneuver, especially in patients with cirrhosis.METHOD: From November 2011 to August 2012, eight consecutive patients underwent laparoscopic liver resection under hemihepatic vascular inflow occlusion using the lowering of hilar plate approach with biliary bougie assistance.RESULTS: The types of liver resection included right hepatectomy(n1), right posterior sectionectomy(n1), left hepatectomy and common bile duct exploration(n1), segment 4b resection(n1), left lateral sectionectomy(n2), and wedge resection(n2). Four patients underwent right and 4 left hemihepatic vascular inflow occlusion. Four patients had cirrhosis. The mean operation time was 176.3 minutes. The mean time taken to achieve hemihepatic vascular inflow occlusion was 24.3minutes. The mean duration of vascular inflow occlusion was54.5 minutes. The mean intraoperative blood loss was 361 mL.No patient required blood transfusion. Postoperatively, one patient developed bile leak which healed with conservative treatment. No postoperative liver failure and mortality occurred. The mean hospital stay of the patients was 7 days.CONCLUSION: Our technique of hemihepatic vascular inflow vascular occlusion using the lowering of hilar plate approachwas safe, and it improved laparoscopic liver resection by minimizing blood loss during liver parenchymal transection. | Ying-Jun Chen Zuo-Jun Zhen Huan-Wei Chen Eric CH Lai Fei-Wen Deng Qing-Han Li Wan Yee Lau | 2014 | Hepatobiliary & Pancreatic Diseases International2014，13，5： | 23 |
| 2 | Optimal central venous pressure during partial hepatectomy for hepatocellular carcinoma显示文摘BACKGROUND:Low central venous pressure(CVP) affects hemodynamic stability and tissue perfusion.This prospective study aimed to evaluate the optimal CVP during partial hepatectomy for hepatocellular carcinoma(HCC).METHODS:Ninety-seven patients who underwent partial hepatectomy for HCC had their CVP controlled at a level of 0 to 5 mmHg during hepatic parenchymal transection.The systolic blood pressure(SBP) was maintained,if possible,at 90 mmHg or higher.Hepatitis B surface antigen was positive in 90 patients(92.8%) and cirrhosis in 84 patients(86.6%).Pringle maneuver was used routinely in these patients with clamp/unclamp cycles of 15/5 minutes.The average clamp time was 21.4±8.0 minutes.These patients were divided into 5 groups based on the CVP:group A:0-1 mmHg;B:1.1-2 mmHg;C:2.1-3 mmHg;D:3.1-4 mmHg and E:4.1-5 mmHg.The blood loss per transection area during hepatic parenchymal transection and the arterial blood gas before and after liver transection were analyzed.RESULTS:With active fluid load,a constant SBP ≥90 mmHg which was considered as optimal was maintained in 18.6% in group A(95% CI:10.8%-26.3%);39.2% in group B(95% CI:29.5%-48.9%);72.2% in group C(95% CI:63.2%-81.1%);89.7% in group D(95% CI:83.6%-95.7%);and 100% in group E(95% CI:100%-100%).The blood loss per transection area during hepatic parenchymal transection decreased with a decrease in CVP.Compared to groups D and E,blood loss in groups A,B and C was significantly less(analysis of variance test,P<0.05).Compared with the baseline,the blood oxygenation decreased significantly when the CVP was reduced.Base excess and HCO 3-in groups A and B were significantly decreased compared with those in groups C,D and E(P<0.05).CONCLUSION:In consideration of blood loss,SBP,base excess and HCO 3-,a CVP of 2.1-3 mmHg was optimal in patients undergoing partial hepatectomy for HCC. | Cheng-Xin Lin Ya Guo Wan Yee Lau Guang-Ying Zhang Yi-Ting Huang Wen-Zheng He Eric CH Lai | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，5： | 19 |
| 3 | Associating liver partition and portal vein ligation for staged hepatectomy: the current role and development显示文摘BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) has recently been developed to induce rapid liver hypertrophy and reduce posthepatectomy liver failure in patients with insufficient future liver remnant(FLR). ALPPS is still considered to be in an early developmental phase because surgical indications and techniques have not been standardized. This article aimed to review the current role and future developments of ALPPS.DATA SOURCES: Studies were identified by searching MEDLINE and Pub Med for articles from January 2007 to October 2016 using the keywords 'associating liver partition and portal vein ligation for staged hepatectomy' and 'ALPPS'. Additional papers were identified by a manual search of references from key articles.RESULTS: ALPPS induces more hypertrophy of the FLR in less time than portal vein embolization or portal vein ligation.The benefits of ALPPS include rapid hypertrophy 47%-110% of the liver over a median of 6-16.4 days, and 95%-100% completion rate of the second stage of ALPPS. The main criticisms of ALPPS are centered on its high morbidity and mortality rates. Morbidity rates after ALPPS have been reported to be 15.3%-100%, with ≥ the Clavien-Dindo grade III morbidity of 13.6%-44%. Mortality rates have been reported to be 0%-29%.The important questions to ask even if oncologic long-term results are acceptable are: whether the gain in quality and quantity of life can be off balance by the substantial risks of morbidity and mortality, and whether stimulation of rapid liver hypertrophy also accelerates rapid tumor progression and spread. Up till now, the documentations of the ALPPS procedure come mainly from case series, and most of these series include heterogeneous groups of malignancies. The numbers are also too small to separately evaluate survival for different tumor etiologies.CONCLUSIONS: Currently, knowledge on ALPPS is limited, and prospective randomized studies are lacking. From the reported preliminary results, safety of the ALPPS procedure remains questionable. ALPPS should only be used in experienced, high-volume hepatobiliary centers. | Wan Yee Lau Eric CH Lai Stephanie HY Lau | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，1： | 16 |
| 4 | Modifications of ALPPS–from complex to more complex or from complex to less complex operations显示文摘BACKGROUND:Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) has recently been developed to induce rapid liver hypertrophy to reduce the chance of post-hepatectomy liver failure in patients with borderline or insufficient future liver remnant.ALPPS is still in an early developmental stage and its techniques have not been standardized.This study aimed to review the technical modifications of the conventional ALPPS procedure.DATA SOURCES:Studies were identified by searching MEDLINE and Pub Med for articles published from January 2007 to December 2016 using the keywords 'associating liver partition and portal vein ligation for staged hepatectomy' and 'ALPPS'.Additional articles were identified by a manual search of references from key articles.RESULTS:There have been a lot of modifications of the conventional ALPPS.These are classified as:(1) modifications aiming to improve surgical results;(2) modifications aiming to expand surgical indications;(3) salvage ALPPS;(4) ALPPS using the minimally invasive approach.Some of these modifications have made the conventional ALPPS procedure to become even more complex,although there have also been other attempts to make the procedure less complex.The results of most of these modifications have been reported in small case series or case reports.We need better well-designed studies to establish the true roles of these modifications.However,it is interesting to see how this conventional ALPPS procedure has evolved since its introduction.CONCLUSIONS:There is a trend for the use of minimally invasive procedure in the phase 1 or 2 of the conventional ALPPS procedure.Some of these modifications have expanded the use of ALPPS in patients who have been considered to have unresectable liver tumors.The long-term oncological outcomes of these modifications are still unknown. | Wan Yee Lau Eric CH Lai | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，4： | 7 |
| 5 | Mutation analysis of Crouzon syndrome in Taiwanese patients 显示文摘 | Chang CP Wan L Tsai CH et al | 2006 | J Clin Lab Anal2006，20，： | 1 |
| 6 | Establishment of a dsRed- monomer-harboring ICR transgenic mouse model and effects of the transgene on tissue development 显示文摘 | Chou C J Peng SY Wan CH | 2015 | Chin J Physiol2015，58，1： | 1 |
| 7 | Natural (^210Pb, ^7Be) and fallout (^137Cs,^239,240pu,^9OSr) radionuclides as geochemical tracers of sedimentation in Greifensee, Switzerland 显示文摘 | Wan G J Santsehi P H Sturm M Farrenkothen K Lueck A Werth W Schuler Ch | 1987 | Chem Geol1987，63，34： | 1 |
| 8 | Vitamin D receptor gene polymorphisms are associated with risk of Hashimoto's thyroiditis in Chinese patients in Taiwan显示文摘 | Lin WY Wan L Tsai CH | 2006 | J Clin Lab Anal2006，20，3： | 1 |
| 9 | Molecular detection and prevalence of cntcroviruses within enteronmental water in Taiwan 显示文摘 | Hsu BM Chen CH Wan MT | 2008 | J Appl Microbiol2008，104，3： | 1 |
| 10 | The Hypertension Scale of the System of Quality of Life Instruments for Chronic Diseases QLICDHY:Development and Validation Study显示文摘 | Wan CH Jiang RS Tu X | 2012 | Int J Nurs Stud2012，49，4： | 1 |
| 11 | Vitamin D receptor gene polymorphisms are associated with risk of Hashimoto's thyroiditis in Chinese patients in Taiwan显示文摘 | Lin WY Wan L Tsai CH | 2006 | Clin Lab Anal2006，20，3： | 1 |
| 12 | Validation of the Simplified Chinese Version of the EORTC QLQ-LC43 for Patients with Lung Cancer 显示文摘 | Wan CH Zhang CZ Tu XM | 2008 | Cancer investigation2008，26，5： | 1 |
| 13 | Psychometric properties of the Chinese Version of the FACT-L for Measuring Quality of Life Pa- tients with Lung Cancer 显示文摘 | Wan CH Zhang CZ Cai L | 2007 | Lung Cancer2007，56，3： | 1 |
| 14 | Development and Validation of the System of Quality of Life Instruments for Cancer Patients : Lung Cancer (QLICP-LU) 显示文摘 | Wan CH Lu YB Tang W | 2008 | Lung cancer2008，60，1： | 1 |
| 15 | Development and Validation of the General Module of the System of Quality of Life Instruments for Cancer Patients (QLICP-GM)显示文摘 | Wan CH Yang Z Meng Q | 2008 | International Journal of Cancer2008，122，1： | 1 |
| 16 | Genetic diversity of epidemic enterovirus 71 strains recovered from clinical and environmental samples in Taiwan显示文摘 | Hsu BM Chen CH Wan MT | 2007 | VirusRes2007，126，12： | 1 |
| 17 | Mutation analysis of Yaiwanese Wilson disease patients显示文摘 | Wan L Ysai CH Tsai V | 2006 | Biochem Biophys Res Commun2006，345，2： | 1 |
| 18 | Molecular detection and prevalence of enterovirus within environmental water in Taiwan显示文摘 | Chen CH Hsu BM Wan MT | 2008 | J Appl Microbiol2008，104，3： | 1 |
| 19 | Functional genomic analysisidentified epidermal growth factor receptor activation as the mostcommon genetic event in oral squamous cell carcinoma显示文摘 | Sheu JJ Hua CH Wan L | 2009 | CancerRes2009，69，6： | 1 |
| 20 | Mutation analysis of Gaueher disease patients in Taiwan:high prevalence of the RecNcil and L444P muta- tions multiple lessons from a single gene disorder显示文摘 | Wan L Hsu CM Tsai CH | 2006 | Blood Cells Mol Dis2006，36，3： | 1 |
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