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| 1 | High-intensity focused ultrasound ablation:An effective bridging therapy for hepatocellular carcinoma patients显示文摘AIM:To analyze whether high-intensity focused ultrasound(HIFU) ablation is an effective bridging therapy for patients with hepatocellular carcinoma(HCC).METHODS:From January 2007 to December 2010,49 consecutive HCC patients were listed for liver transplantation(UCSF criteria).The median waiting time for transplantation was 9.5 mo.Twenty-nine patients received transarterial chemoembolization(TACE) as a bringing therapy and 16 patients received no treatment before transplantation.Five patients received HIFU ablation as a bridging therapy.Another five patients with the same tumor staging(within the UCSF criteria) who received HIFU ablation but not on the transplant list were included for comparison.Patients were comparable in terms of Child-Pugh and model for end-stage liver disease scores,tumor size and number,and cause of cirrhosis.RESULTS:The HIFU group and TACE group showed no difference in terms of tumor size and tumor number.One patient in the HIFU group and no patient in the TACE group had gross ascites.The median hospital stay was 1 d(range,1-21 d) in the TACE group and two days(range,1-9 d) in the HIFU group(P < 0.000).No HIFU-related complication occurred.In the HIFU group,nine patients(90%) had complete response and one patient(10%) had partial response to the treatment.In the TACE group,only one patient(3%) had response to the treatment while 14 patients(48%) had stable disease and 14 patients(48%) had progressive disease(P = 0.00).Seven patients in the TACE group and no patient in the HIFU group dropped out from the transplant waiting list(P = 0.559).CONCLUSION:HIFU ablation is safe and effective in the treatment of HCC for patients with advanced cirrhosis.It may reduce the drop-out rate of liver transplant candidate. | Tan To Cheung Sheung Tat Fan See Ching Chan Kenneth SH Chok Ferdinand SK Chu Caroline R Jenkins Regina CL Lo James YY Fung Albert CY Chan William W Sharr Simon HY Tsang Wing Chiu Dai Ronnie TP Poon Chung Mau Lo | 2013 | World Journal of Gastroenterology2013，19，20： | 23 |
| 2 | Pancreaticoduodenectomy with vascular reconstruction for adenocarcinoma of the pancreas with borderline resectability显示文摘AIM:To analyze whether pancreaticoduodenectomy with simultaneous resection of tumor-involved vessels is a safe approach with acceptable patient survival.METHODS:Between January 2001 and March 2012,136 patients received pancreaticoduodenectomy for adenocarcinoma at our hospital.Seventy-eight patients diagnosed with pancreatic head carcinoma were included in this study.Among them,46 patients received standard pancreaticoduodenectomy(group 1)and32 patients received pancreaticoduodenectomy with simultaneous resection of the portal vein or the superior mesenteric vein or artery(group 2)followed by reconstruction.The immediate surgical outcomes and survivals were compared between the groups.Fifty-five patients with unresectable adenocarcinoma of the pancreas without liver metastasis who received only bypassoperations(group 3)were selected for additional survival comparison.RESULTS:The median ages of patients were 67 years(range:37-82 years)in group 1,and 63 years(range:35-86 years)in group 2.All group 2 patients had resection of the portal vein or the superior mesenteric vein and three patients had resection of the superior mesenteric artery.The pancreatic fistula formation rate was21.7%(10/46)in group 1 and 15.6%(5/32)in group2(P=0.662).Two hospital deaths(4.3%)occurred in group 1 and one hospital death(3.1%)occurred in group 2(P=0.641).The one-year,three-year and five-year overall survival rates in group 1 were 71.1%,23.6%and 13.5%,respectively.The corresponding rates in group 2 were 70.6%,33.3%and 22.2%(P=0.815).The one-year survival rate in group 3 was13.8%.Pancreaticoduodenectomy with simultaneous vascular resection was safe for pancreatic head adenocarcinoma.CONCLUSION:The short-term and survival outcomes with simultaneous resection were not compromised when compared with that of standard pancreaticoduodenectomy. | Tan To Cheung Ronnie TP Poon Kenneth SH Chok Albert CY Chan Simon HY Tsang Wing Chiu Dai See Ching Chan Sheung Tat Fan Chung Mau Lo | 2014 | World Journal of Gastroenterology2014，20，46： | 8 |
| 3 | Little girl who conquered the 'ALPPS''显示文摘An insufficient future liver remnant(FLR)is associated with post-hepatectomy liver failure.Associating liver partition and portal vein ligation for stage hepatectomy(ALPPS)has been shown to be effective for the induction of rapid FLR hypertrophy so as to improve the resectability in patients with insufficient FLR.We hereby report our experience of this novel approach for a 6-year-old patient with hepatoblastoma.Computed tomography showed a hepatoblastoma measuring12.5 cm×9.9 cm×11.7 cm in the right liver(Couinaud segmentⅣ,ⅤandⅧ).Volumetric assessment of the FLR i.e.,left lateral section was 112.6 mL i.e.,21.2%of the estimated total liver volume.In view of the small-for-size FLR,ALPPS was contemplated.An anterior approach was adopted for the in-situ parenchymal split without mobilisation of the right liver.FLR volumetry on the seventh postoperative day was 160.7 mL,which represented a 46.1%gain in volume,and a FLR/ESLV ratio of 30.2%.A right trisectionectomy was performed on the eighth postoperative day.Postoperative recovery was uneventful.Patient was discharged on day 16 after the first operation.To our knowledge,this was the first report that showed the applicability of ALPPS to a paediatric patient. | Albert Chan Patrick HY Chung Ronnie TP Poon | 2014 | World Journal of Gastroenterology2014，20，29： | 8 |
| 4 | Response to endoscopic therapy for biliary anastomotic strictures in deceased versus living donor liver transplantation显示文摘BACKGROUND:Endoscopic therapy has been successful in the management of biliary complications after both deceased donor liver transplantation(DDLT) and living donor liver transplantation(LDLT).LDLT is thought to be associated with higher rates of biliary complications,but there are few studies comparing the success of endoscopic management of anastomotic strictures between the two groups.This study aims to compare our experience in the endoscopic management of anastomotic strictures in DDLT versus LDLT.METHODS:This is a retrospective database review of all liver transplant patients undergoing endoscopic retrograde cholangiopancreatography(ERCP) after liver transplantation.The frequency of anastomotic stricture and the time to develop and to resolve anastomotic stricture were compared between DDLT and LDLT.The response of anastomotic stricture to endoscopic therapy was also analyzed.RESULTS:A total of 362 patients underwent liver transplantation between 2003 and 2011,with 125 requiring ERCP to manage biliary complications.Thirty-three(9.9%) cases of DDLT and 8(27.6%) of LDLT(P=0.01) were found to have anastomotic stricture.When comparing DDLT and LDLT,there was no difference in the mean time to the development of anastomotic strictures(98±17 vs 172±65 days,P=0.11),likelihood of response to ERCP [22(66.7%) vs 6(75.0%),P=0.69],mean time to the resolution of anastomotic strictures(268±77 vs 125±37 days,P=0.34),and the number of ERCPs required to achieve resolution(3.9±0.4 vs 4.7±0.9,P=0.38).CONCLUSIONS:Endoscopic therapy is effective in the majority of biliary complications relating to liver transplantation.Anastomotic strictures occur more frequently in LDLT compared with DDLT,with equivalent endoscopic treatment response and outcomes for both groups. | Calvin HY Chan Fergal Donnellan Michael F Byrne Alan Coss Mazhar Haque Holly Wiesenger Charles H Scudamore Urs P Steinbrecher Alan A Weiss Eric M Yoshida | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，5： | 7 |
| 5 | Lean techniques for the improvement of patients' flow in emergency department显示文摘BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called 'lean' management. This study aims to(1) evaluate the current patient flow in ED,(2) to identify and eliminate the non-valued added process, and(3) to modify the existing process.METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage(PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T(hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared.RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed(38.24 minutes; SD 66.35) and blood testing result(mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward(EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program(P<0.05).CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction. | HY Chan SM Lo LLY Lee WYL Lo WC Yu YF Wu ST Ho RSD Yeung JTS Chan | 2014 | World Journal of Emergency Medicine2014，5，1： | 6 |
| 6 | Modulation of graft vascular inflow guided by flowmetry and manometry in liver transplantation显示文摘BACKGROUND:Survival of the partial graft after living donor liver transplantation owes much to its tremendous regenerative ability.With excellent venous outflow capacity,a graft within a wide range of graft-to-standard-liver-volume ratios can cope with portal hypertension that is common in liver transplant recipients.However,when the ratio range is exceeded,modulation of graft vascular inflow becomes necessary for graft survival.The interplay between graft-to-standard-liver-volume ratio and portal pressure,in the presence of portosystemic shunt or otherwise,requires individualized modulation of graft portal and arterial inflows.Boosting of portal inflow by shunt ligation can be guided by transonic flowmetry,whereas muting of portal inflow by splenic artery ligation can be monitored by portal electronic manometry.METHOD:We describe four cases to illustrate the above.RESULTS:One patient had hepatic artery thrombosis resulting from splenic artery steal syndrome which was the sequela of small-for-size syndrome.Emergency splenic artery ligation and re-anastomosis of the hepatic artery successfully muted the portal inflow and boosted the hepatic arterial inflow.Another patient with portal vein thrombosis underwent thrombendvenectomy.Portal inflow was boosted with ligation of portosystemic shunt,which is often present in these patients with portal hypertension.The coexistence of splenic aneurysm and splenorenal shunt required ligation of both in the third patient.The fourth patient,with portal pressure and flow monitoring,avoided ligation of a coronary vein which became a main portal inflow after portal thrombendvenectomy.CONCLUSION:Management of graft inflow modulation guided selectively by transonic flowmetry or portal manometry was described. | See Ching Chan Chung Mau Lo Kenneth SH Chok William W Sharr Tan To Cheung Simon HY Tsang Albert CY Chan Sheung Tat Fan | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，6： | 5 |
| 7 | Outcome analysis of management of liver trauma: A 10-year experience at a trauma center显示文摘AIM: To review the outcomes of liver trauma in patients with hepatic injuries only and in patients with associated injuries outside the liver.METHODS: Data of liver trauma patients presented to our center from January 2003 to October 2013 were reviewed. The patients were divided into two groups. Group 1 consisted of patients who had hepatic injuries only. Group 2 consisted of patients who also had associated injuries outside the liver.RESULTS: Seven(30.4%) patients in group 1 and 10(28.6%) patients in group 2 received non-operative management; the rest underwent operation. Blunt trauma occurred in 82.8%(48/58) of the patients and penetrative trauma in 17.2%(10/58). A higher injury severity score(ISS) was observed in group 2(median 45 vs 25, P < 0.0001). More patients in group 1 were hemodynamically stable(65.2% vs 37.1%, P = 0.036). Other parameters were comparable between groups. Group 1 had better 30-d survival(91.3% vs 71.4%, P = 0.045). On multivariate analysis using the logistic regression model, ISS was found to be associated with mortality(P = 0.004, hazard ratio = 1.035, 95%CI:CONCLUSION: Liver trauma patients with multiple injuries are relatively unstable on presentation. Despite a higher ISS in group 2, non-operative management was possible for selected patients. Associated injuries outside the liver usually account for morbidity and mortality. | Wong Hoi She Tan To Cheung Wing Chiu Dai Simon HY Tsang Albert CY Chan Daniel KH Tong Gilberto KK Leung Chung Mau Lo | 2016 | World Journal of Hepatology2016，8，15： | 3 |
| 8 | Survival analysis of breast cancer liver metastasis treated by hepatectomy: A propensity score analysis for Chinese women in Hong Kong显示文摘Background: Survival of patients with breast cancer liver metastasis is very poor. This study aimed to analyze the survival outcome of hepatectomy for this patient population. Methods: From January 1995 to December 2014, 2522 patients with liver cancer received hepatectomy at our hospital. Twenty-one of them, all female, received the operation for breast cancer liver metastasis. Performance was compared with patients with colorectal liver metastasis treated with hepatectomy after propensity score analysis in a ratio of 1:3. Results: Twenty-one patients received hepatectomy for breast cancer. After propensity score matching, 63 patients who had hepatectomy for colorectal cancer were selected for comparison. There was no significant difference in immediate or short-term outcomes between the two groups of patients in terms of operative time, blood loss and surgical morbidities. All patients with breast cancer had R0 resection. No hospital death occurred. After hepatectomy, the 1-, 3- and 5-year overall survival rates were 100.0%, 58.9% and 58.9% respectively in patients with breast cancer. The 1-, 3- and 5-year overall survival rates were 95.0%, 57.2% and 39.7% respectively in patients with colorectal cancer (P = 0.572). On multivariate analysis, triple negative status was the only independent poor prognostic factor in breast cancer liver metastasis (OR = 6.411;95% CI: 1.351–30.435;P = 0.019). Conclusions: Hepatectomy is a safe and effective way of treating breast cancer liver metastasis at experienced centers where multidisciplinary adjuvant treatments are available. It can be considered more frequently as part of the multidisciplinary care for this patient population. | Tan To Cheung Kenneth SH Chok Albert CY Chan Simon HY Tsang Wing Chiu Dai Thomas CC Yau Ava Kwong Chung Mau Lo | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，5： | 3 |
| 9 | The impact of family history of hepatocellular carcinoma on its patients' survival显示文摘BACKGROUND:Family history of hepatocellular carcinoma(HCC) has been identified as a risk factor for the development of the disease.The aim of this study is to evaluate the impact of such a history on HCC patients' survival.METHODS:Data of all HCC patients(n=4532) managed at our center from 1989 to 2008 were prospectively collected.The patients were quizzed on their various characteristics including family HCC history.RESULTS:Totally 475(10.48%) patients had a family history of HCC.They presented the disease at a significantly earlier age(median 53 vs 59 years,P<0.0001) and at an earlier stage(the United Network for Organ Sharing staging system).They had significantly better liver function in terms of ChildPugh classification and serum albumin and bilirubin levels.Significantly more of them presented the disease without symptoms(44.0% vs 29.4%,P<0.0001).They also had significantly better overall survival under these specifications:patients in the whole study cohort,patients who had minor hepatectomy,patients with stage I disease,patients with stage II disease,and patients with stage III disease.CONCLUSIONS:Contrary to what is generally believed,we found in this study cohort that patients with a family history of HCC had better overall survival than those without such a history.We believe this was in part due to earlier diagnosis of the disease and better liver function in this group of patients.However,the effects of genetic factors on the risk of HCC cannot be overlooked and are yet to be identified. | Wing Chiu Dai Sheung Tat Fan Tan To Cheung Kenneth SH Chok Albert CY Chan Simon HY Tsang Ronnie TP Poon Chung Mau Lo | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，2： | 2 |
| 10 | Retrohepatic vena cava deroofing in living donor liver transplantation for caudate hepatocellular carcinoma显示文摘The removal of tumor together with the native liver in living donor liver transplantation for hepatocellular carcinoma is challenged by a very close resection margin if the tumor abuts the inferior vena cava.This is in contrast to typical deceased donor liver transplantation where the entire retrohepatic inferior vena cava is included in total hepatectomy.Here we report a case of deroofing the retrohepatic vena cava in living donor liver transplantation for caudate hepatocellular carcinoma.In order to ensure clear resection margins,the anterior portion of the inferior vena cava was included.The right liver graft was inset into a Dacron vascular graft on the back table and the composite graft was then implanted to the recipient inferior vena cava.Using this technique,we observed the no-touch technique in tumor removal,hence minimizing the chance of positive resection margin as well as the chance of shedding of tumor cells during manipulation in operation. | See Ching Chan William W Sharr Tan To Cheung Albert CY Chan Simon HY Tsang Kenneth SH Chok Kin Chung Leung Chung Mau Lo | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，5： | 2 |
| 11 | Artemisinins:pharmacological actions beyond anti-malarial显示文摘 | Ho WE Peh HY Chan TK | 2014 | Pharmacol Ther2014，142，1： | 1 |
| 12 | Cost evaluation of ad- verse drug reactions in hospitalized patients in Taiwan: A prospective, descriptive, observational study 显示文摘 | Chan ALF Lee HY Ho CH | 2008 | Current Therapeutic Research2008，69，2： | 1 |
| 13 | An epididymis-specific beta-defensin is important for the initiation of sperm maturation显示文摘 | Zhou CX Zhang YL Xiao L Zheng M Leung KM Chan MY Lo PS Tsang LL Wong HY Ho LS | | 0，，05： | 1 |
| 14 | A longitudinal study on quality of life after gynecologic cancer treatment显示文摘 | Chan YM Ngan HY Li BY | 2001 | Gynecol Oncol2001，83，： | 1 |
| 15 | Seasonal influenza activity in Hong Kong and its association with meteorological variations 显示文摘 | Chan PK Mok HY Lee TC | 2009 | J Med Virol2009，81，10： | 1 |
| 16 | Artemisinins: pharmaco- logical actions beyond anti-malarial 显示文摘 | Ho WE Peh HY Chan TK | 2014 | Pharmacol Ther2014，142，1： | 1 |
| 17 | Psychometric Properties of the Chinese Version of the 25-Item National Eye Institute Visual Function Questiormaire显示文摘 | Wang CW Chan CLW Jin HY | 2008 | Optometry Vision Sci2008，85，11： | 1 |
| 18 | Serum HBsAg quantification to predict response to peginterferon therapy of e antigen positive chronic hepatitis B 显示文摘 | Chan HL Wong VW Chim AM Chan HY Wong GL Sung JJ | 2010 | Aliment Pharmacol Ther2010，32，1112： | 1 |
| 19 | Potent Antioxidative and UVB protective effect of water extract of Eclipta prostrata显示文摘 | Chan CF Huang WY Guo HY | 2014 | Sci World J2014，2，75： | 1 |
| 20 | Changes in cervical cancer incidence after three decades of screening US women less than 30 years old显示文摘 | Chan PG Sung HY Sawaya GF | 2006 | Orig Res2006，61，6： | 1 |
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