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In patients with biliary atresia, portal vein problems may cause challenges for liver transplant. Interposition grafts have been used for vascular anastomoses in transplant recipients with varied success. A cryopreserved iliac artery graft was used for the reconstruction of the portal vein in a 29-month-old infant with biliary atresia. At 17 months after transplant, she developed upper gastrointestinal bleeding that was caused by portal vein occlusion because of vascular calcifications in the graft. Upper gastrointestinal endoscopy showed esophageal varices with fresh bleeding, and the varices were band ligated. At 3 months after the bleeding episode, the patient was asymptomatic and biochemical tests were normal. In summary, liver transplant with cryopreserved iliac artery graft may be complicated by calcifications and portal vein occlusion, and caution is advised in using this graft material for portal vein anastomoses.
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http://dx.doi.org/10.6002/ect.2013.0298 | DOI Listing |
Ann Surg Oncol
September 2025
Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Background: Hepatocellular carcinoma (HCC) frequently invades the portal vein, leading to early recurrence and a poor prognosis. However, the mechanisms underlying this invasion remain unclear. In this study, we aimed to detect portal vein circulating tumor cells (CTCs) using a Glypican-3-positive detection method and evaluate their prognostic significance.
View Article and Find Full Text PDFAnn Surg Oncol
September 2025
Hepato‑Biliary and Pancreatic Surgery Unit, Department of Surgery, Hospital del Mar, Pompeu Fabra University, Barcelona, Spain.
Background: Spleen-preserving distal pancreatectomy by robotic surgery is a safe and feasible surgical technique. Currently, spleen-preserving distal pancreatectomy represents an alternative to the classical distal pancreatectomy with splenectomy, in the case of benign and low-grade malignant diseases of the body or pancreas tail. The reasons for preserving the spleen are based on the reduction of postoperative complications, such as post-splenectomy infections, subphrenic abscess, portal thrombosis, pulmonary hypertension, thrombocytosis, and thromboembolism.
View Article and Find Full Text PDFChirurgie (Heidelb)
September 2025
Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburgerallee 160, 23538, Lübeck, Deutschland.
A profound understanding of pancreatic anatomy and its vascular supply is essential for safely performing complex surgical procedures such as pancreaticoduodenectomy. Historically, anatomical exploration began with Herophilos and Ruphos of Ephesos in ancient times, evolving through major surgical innovations by Wirsung, Kausch and Whipple. The pancreas is located secondarily retroperitoneally and therefore has a close relationship of the pancreatic head to the superior mesenteric artery (SMA) and portal vein (PV) and the celiac trunc.
View Article and Find Full Text PDFBackground: Since 2013, we have performed conversion surgery after hepatic arterial infusion chemotherapy (HAIC) for initially unresectable locally advanced hepatocellular carcinoma (LA-HCC).
Methods: Between 2013 and 2021, we assessed the surgical and oncological outcomes and pathological findings of patients with LA-HCC without extrahepatic spread (EHS) whose tumors converted from unresectable to resectable status with the New-FP regimen HAIC.
Results: We censored 153 patients with LA-HCC (Child-Pugh A, without EHS) indicated for HAIC.
Patent ductus venosus is a congenital portosystemic shunt that may cause progressive portal hypertension, hepatic encephalopathy, and focal nodular hyperplasia of the liver. Embolization of the Arantius' duct is the first choice of treatment in infants and children. However, it carries the risk of coil migration into the systemic circulation in adult patients with larger Arantius ducts.
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