Questions: How may gallstones develop if there is no hemolytic disorder and no malformation or alteration of the gallbladder and cystic ducts? Was there a change in the incidence of stones and the assignment of the patients to different age groups? The literature gives answers to these questions on the basis of only few cases. Therefore, a relatively large prospective database of collected cases during 30 years shall be used to give additional answers. Methods: The data are derived from 111 children with symptomatic gallstones without hemolytic diseases. 109 of them required operative therapy. They were examined preoperatively and postoperatively maximum during 30 years of follow-up as well according to a defined program. This program includes taking the patient’s history, evaluation of clinical, radiological including sonographical examination, exclusion of hemolytic primary diseases, histological investigation of intraoperatively gained specimens of the gallbladder, and the spectroscopic qualitative as well as semiquantitative analysis of stones and bile. Results: (1) The qualitative and quantitative composition of the stones is different in the four age groups. (2) The causes of lithogenesis are different in the four age groups. (3) Children with long-term TPN, after cardiopulmonary bypass operations, after extended small bowel resection, suffering from obesity, and girls using hormonal contraception are at risk of developing gallstones. We recommend to observe these patients by repeated ultrasound controls for gallstone formation during a minimum of 10 years. (4) Malformations and pathological alterations of the gallbladder are rare causes for increased lithogenity. The gallbladder appeared morphologically normal in 61% of patients with symptomatic gallstones. (5) An increased frequency of gallstones during the last 30 years was only observed in the age group under 1 year.

Objective: Establish associations between a 40 month period of work of a public liver center unit and characteristics of liver transplant recipients before and after that period. Methods: Retrospective data was collected from the data base SINTRA/INCUCAI. Comparison between: 1e01/05/ 2009e31/12/2012 (before Hospital El Cruce/HEC) and 2e 01/01/2013e31/08/2016 (after HEC). The outcomes evaluated were: total transplants performed and divided by public/private centers, access to list, 24 h mortality, organ assignment order, waiting list time/WLT, donor per million habitants. Comparisons were performed by Wilcoxon Rank Sum test. Results: the median amount of transplant in Argentina during the last 6 years was 107 in each 4 month-period. In our center, 142 interventions were realized, with a median of 13 per 4 months; this represents 40% of the liver transplants/LT performed in public centers, and 11% across the country. There was statistical difference in the MELD score to access a LT (24 vs 26, p 0,0210), WLT (46 vs 72 days p 0,0012), donors per million (15 vs 13 p 0,0049), patients being transplanted in a public center (19 vs 30 p 0,0011). No difference was observed in the transplants performed across Argentina, at private centers, MELD/Emergency status, organ assignment order and 24 h mortality. Conclusion: MELD score and LTs performed in public centers increased; without impact in the global amount, and

levels of AFP that had loco-regional treatment followed by liver transplant with no tumor recurrence 24 months posttransplant. Methods:Results: This is a case of a 55-year-old male who had endstage liver disease due to Hepatitis C Virus (HCV) infection since 2008, and was treated with ribavirin and interferon. He was diagnosed with HCC lesion 2.6 cm in the maximal diameter in April 2014. AFP was 341 IU/mL that jumped to 2599 IU/mL. He underwent transarterial chemoembolization that showed a dramatic drop of AFP down to 21 IU/mL after six weeks.The patient was listed for liver transplant as HCC was within Milan criteria. He underwent liver transplant in September 2014 when AFP was 9 IU/mL. He had an uneventful liver transplant with uncomplicated post-operative course and was discharged in a good condition on the twelfth post-operative day.Serial follow-up of the patient with dynamic magnetic resonance imaging and serum AFP for 24 months posttransplant showed no recurrence of HCC with normal levels of AFP. Conclusion: Exclusion of patients based on their initial serum Alfa-fetoprotein levels at time of diagnosis of HCC could preclude patients with potentially favorable outcome.

The purpose of this study is to evaluate the current tendency to diagnosis and management in our practice. Methods: Benign tumors to be discussed include: hyperplasia, adenomas, hamartomas, hemangiomas and nonparasitic cysts. Improvements in diagnosis and management can be defined as: better understanding of the natural history of each type of tumor, modern imaging techniques in assuring a precise diagnosis of tumor nature (HCA from a well differentiated HCC) , new minimally invasive laparoscopic surgical approach: diagnostic and resectional procedures, and safer liver resections. Results: Between 1990 and 2016, we diagnosed benign liver tumors in 145 patients in 2 specialized HPB units. 91 of these tumors (55 solid and 36 liquid) were operated and 54 are clinically followed (F.Up). 1) Focal nodular hiperplasia (FNH) symptomatic and > 10 cm: 8 Resections., 7 F.Up in small FNH 2) Hepatocellular adenoma (HCA): 36 Resections. and F.Up of 9 asymptomatic with multiple HCA. (others 5, not included, were Carcinoma,) 3) Solid mesenchymal hamartoma: 2 Resections. 4) Hemangiomas: 4 Resections. and 18 F.Up 5) Benign liquid 5.1) Simple biliary cysts = Type 1: 22 patients: 3 Resections. (lobar cysts) and 19 laparoscopic (resections. of the dome in 10),.2) Policystosis (PLC): 6 Res.: 3 symptomatic type 2 PLC and 1 type 3 PLC and 10 F.up 6) Cystadenomas: 8 Resections. Morbidity was 10% (9/91). No mortality. Conclusions: A close imaging assessment is mandatory due to the natural history of HCA. In some cases, the laparoscopic biopsy with IO frozen in the section study.

DCP 2.8 ng/mL. Fifty percent of the cohort had a complete response to DEB-TACE. Univariate analysis revealed BALAD score was significantly associated with treatment response (p = 0.04). Seventy-two percent of patients with BALAD score 2 had incomplete treatment response. Analysis of individual BALAD components revealed no independent association with treatment or complete response. Bilirubin levels were significantly increased with decreasing BALAD albumin thresholds. The BALAD score was modified by altering the biomarker thresholds. Modified BALAD was significantly associated with treatment (p = 0.02) and complete response (p = 0.04). Twenty-two pecent of patients had disease progression defined as rising AFP (>400 ng/mL), multifocal disease, or metastatsis. Only 5% of patients with modified BALAD score 1 had disease progression. Conclusion: Modification of biomarker components from the BALAD score provides insight into treatment response in HCC patients awaiting transplantation.