Publications by authors named "Wethit Dumronggittigule"
Background: Post-pancreaticoduodenectomy (PD) intestinal failure (IF) is rare and associated with poor outcomes. To our knowledge, the role of intestinal transplantation (ITx) as a rescue treatment for this complication has never been reported.
Case Summary: A 42-year-old female with a benign neurilemmoma of the duodenum underwent PD.
The clinical significance of occult HCC identified on explant pathology in liver transplantation (LT) remains unclear. Among recipients of LT, discordance between pre-LT radiographic assessment of HCC and explant tumor burden is common. Data regarding the association of incidental HCC (no pre-LT radiographic diagnosis) and occult multifocal hepatocellular carcinoma (omHCC, pre-LT radiology underestimates a number of explant tumors) with outcomes are scarce.
View Article and Find Full Text PDFPancreatectomy for pancreatic metastases (PM) yields acceptable survival outcomes in selected renal cell carcinoma (RCC) patients. We describe a technique for robotic subtotal left pancreatectomy with preservation of the common bile duct (CBD) and spleen in a patient with multifocal RCC-PM. The patient, who had RCC and underwent nephrectomy 20 years ago, presented with a pancreatic mass.
View Article and Find Full Text PDFBackground: Chronic kidney disease (CKD) is one of the major complications after liver transplantation (LT), with a significant impact on patient outcomes. This study aims to investigate the incidence and risk factors of CKD in LT recipients at Siriraj Hospital over the past 20 years.
Methods: There were 366 adult patients undergoing LT at Siriraj Hospital between January 2002 and December 2021.
Purpose: To determine hepatocellular carcinoma (HCC) magnetic resonance imaging (MRI) biomarkers that enable the prediction of delisting from tumor progression versus successful transplantation in patients listed for orthotopic liver transplantation (OLT).
Methods: With IRB approval and HIPPA compliance, patients with HCC awaiting OLT who were delisted due to HCC progression from 2006 to 2015 were identified. Patients with adequate MR images for review were subsequently matched with a cohort of patients successfully bridged to OLT in the same time period.
Background: Although the benefits of laparoscopic hepatectomy (LH) for hepatocellular carcinoma (HCC) in most circumstances are evident, the benefits for large HCC are contentious. This study aimed to compare the perioperative outcomes and survival after LH versus open hepatectomy (OH) in large HCC patients.
Methods: An analysis of prospectively maintained database included 215 hepatectomies for large HCC (diameter ≥ 5 cm).
Introduction: Acute kidney injury (AKI) is common after liver transplantation and affects outcome after liver transplantation. Antibody induction is commonly used to reduce dose and/or to delay introduction of calcineurin inhibitor (CNI) but is very expensive. We propose a modified immunosuppressive protocol that delays administration of CNI for 48 to 72 hours without antibody induction.
View Article and Find Full Text PDFBackground: The incidence of hepatocellular carcinoma (HCC) in elderly patients is increasing worldwide. Although open hepatectomy (OH) yields acceptable outcomes, high morbidity rate is concerned. Laparoscopic hepatectomy (LH) has evolved to improve perioperative outcomes.
View Article and Find Full Text PDFBackground: Gallbladder cancer (GBC) is a rare and fatal biliary tract malignancy. Genetic derangements are one of many factors that determine the prognosis of GBC. In this study, the expression of the stratifin (SFN) gene encoding 14-3-3 sigma protein, which is reported to be associated with the metastatic property of cholangiocarcinoma cells, was investigated in GBC.
View Article and Find Full Text PDFBackground: Temporary ileostomy during intestinal transplantation (ITx) is the standard technique for allograft monitoring. A detailed analysis of the ITx ileostomy has never been reported.
Methods: A retrospective review of a single-center ITx database was performed.
Article Synopsis
- The study focuses on enhancing liver transplant (LT) outcomes for patients with hepatocellular carcinoma (HCC) by validating and recalibrating a continuous risk score called HALTHCC, which predicts patient risk pre-transplant.
- Data from 4,089 patients over a 12-year period across various global centers revealed that factors like alpha-fetoprotein levels and tumor burden significantly influence risk stratification.
- After recalibration, HALTHCC demonstrated improved predictive accuracy for both overall survival and recurrence risk in HCC patients, highlighting its effectiveness as a tool for assessing transplant eligibility.
Background: Though intestinal failure (IF) after bariatric surgery (BS) is uncommon, its prevalence is increasing. However, data on the outcomes for these patients are limited.
Objectives: To analyze the outcomes of treatment for patients with IF after BS.
Article Synopsis
- The study highlights the critical issue of early allograft dysfunction (EAD) in liver transplant patients, emphasizing its negative impact on both graft and patient survival, and notes the absence of a standardized classification system.
- A new risk estimation model was created to better predict graft failure post-transplant and was compared against traditional measures, including a binary EAD definition and the Model for Early Allograft Function (MEAF) score.
- Retrospective data from 2008 out of 2021 adult liver transplant recipients were analyzed, revealing a 3-month graft failure or death rate of 11.1%, with factors like aspartate aminotransferase level and bilirubin level being significant predictors of patient outcomes.