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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 | American Society of Clini- cal Oncology executive summary of the clinical practice guideline update on the role of bone-modifying agents in metastatic breast cancer显示文摘 | Van Poznak CH Temin S Yee GC | 2011 | J Clin Oncol2011，29，9： | 1 |
| 6 | Zoledronic acid to prevent bone loss in Chinese men receiving androgen deprivation therapy for prostate cancer 显示文摘 | Yee CH Ng CF Wong AY | 2011 | Asia Pac J Clin Oncol2011，7，2： | 1 |
| 7 | American society of clinical oneology executive summary of the clinical practice guideline update on the role of bone-modifying agents in meta- static breast eancer显示文摘 | Van Poznak CH Temin S Yee GC | 2011 | Clin Oneol2011，29，9： | 1 |
| 8 | American Society of Clinical Oncology executive summary of the clinical practice guideline update on the role of bone-modifying agents in metastatic breast cancer显示文摘 | Van Poznak CH Temin S Yee GC | 2011 | J Clin Oncol2011，29，9： | 1 |
| 9 | The effect of urethral calibration on female primary bladder outlet obstruction显示文摘 | Yee CH Ho LY Hung HH | 2012 | Int Urogynecol J2012，23，2： | 1 |
| 10 | Inflammatory myofibroblastic tumor of spermatic cord in undescended testis显示文摘 | YEE CH TO KF HOU SM | 2009 | Urology2009，73，6： | 1 |
| 11 | Inflammatory Myofibro- blastic Tumor of Spermatic Cord in Undescended Testis显示文摘 | Yee CH To KF Hou SM | 2009 | Urology2009，73，6： | 1 |
| 12 | Family medicine education in Singapore:A long-standing collaboration between specialists and family physicians显示文摘 | Teck Yee Wong Gerald CH Koh Eng Hin Lee | 2008 | Annals Academy of Medicine2008，37，： | 1 |
| 13 | American Society of Clinical Oncology executive summary of the clinical practice guide- line update on the role of bone-modifying agents in metastatic breast cancer显示文摘 | Van Poznak CH Temin S Yee GC | 2011 | J Clin Oncol2011，29，9： | 1 |
| 14 | Zoledronic acid to prevent bone loss in Chinese men receiving androgen deprivation therapy for prostate cancer显示文摘 | Yee CH Ng CF Wong AYF | 2011 | Asia-Pacific Journal of Clinical Oncology2011，7，2： | 1 |
| 15 | Robot-assisted radical prostatectomy in Hong Kong:a review of 235 cases显示文摘 | YIP KH YEE CH NG CF | | 0，，3： | 1 |
| 16 | Management of bile duct injury after laparoscopic cholecystectomy:a review 显示文摘 | Wan Yee Lau Eric CH Lai Stephanie HY Lau | 2010 | ANZ J Surg2010，80，1： | 1 |
| 17 | The effect of urethral calibration on female primary bladder outlet obstruction 显示文摘 | Yee CH Ho LY Hung HH | 2012 | Int Urogynecol J2012，23，2： | 1 |
| 18 | American Society of ClinicalOncology executive summary of the clinical practice guideline updateon the role of bone-modifying agents in metastatic breast cancer显示文摘 | Van Poznak CH Temin S Yee GC | 2011 | JClin Oncol2011，29，9： | 1 |
| 19 | Management of bile duet injury after laparoscopic choleeysteetomy: a review 显示文摘 | Wan Yee Lau Eric CH Lai Stephanie HY Lau | 2010 | ANZ J Surg2010，80，1： | 1 |
| 20 | Clinical Outcome of a Prospec- tive Case Series of Patients With Ketamine Cystitis Who Underwent Standardized Treatment Protocol 显示文摘 | Yee CH Lai PT Lee WM | 2015 | Urology2015，86，2： | 1 |
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