BackgroundAfter extended liver resection, a remnant liver that is too small can lead to postresection liver failure. To reduce this risk, preoperative evaluation of the future liver remnant volume (FLRV) is critical. The open-source OsiriX® PAC software system can be downloaded for free and used by nonradiologists to calculate liver volume using a stand-alone Apple computer. The purpose of this study was to assess the accuracy of OsiriX® CT volumetry for predicting liver resection volume and FLVR in patients undergoing partial hepatectomy.MethodsPreoperative contrast-enhanced liver CT scans of patients who underwent partial hepatectomy were analyzed by three observers. Two surgical trainees measured the total liver volume, resection volume, and tumor volume using OsiriX®, and a radiologist measured these volumes using CT scanner-linked Aquarius iNtuition® software. Resection volume was correlated with prospectively determined resection weight, and differences in the measured liver volumes were analyzed. Interobserver variability was assessed using Bland–Altman plots.Results25 patients (M/F ratio: 13/12) with a median age of 61 (range, 34–77) years were included. There were significant correlations between the weight and volume of the resected specimens (Pearson’s correlation coefficient: R2 = 0.95). There were no major differences in total liver volumes, resection volumes, or tumor volumes for observers 1, 2, and 3. Bland–Altman plots showed a small interobserver variability. The mean time to complete liver volumetry for one patient using OsiriX® was 19 ± 3 min.ConclusionsOsiriX® liver volumetry performed by surgeons is an accurate and time-efficient method for predicting resection volume and FLRV.

After colonic butyrate administration, splanchnic butyrate release was prevented in patients undergoing upper abdominal surgery. These observations imply that therapeutic colonic SCFA administration at this dose is safe. The trial was registered at clinicaltrials.gov as NCT02271802.

Developing SOS is associated with a lower tumour response to neo-adjuvant oxaliplatin treatment. Hepatic hypoperfusion due to sinusoidal obstruction syndrome might induce hepatic hypoxia, diminishing the response to chemotherapy.

DESCRIPTIONA 66-year-old man was referred to the general surgeon by his general practitioner for excision of a 'bump' on the anterior side of his left ankle because of pain due to irritation from shoe gear. This 'bump' slowly started since several months after an ankle injury. He denies intravenous access or previous surgery in this region of the ankle. Medical history represents obesity, atrial fibrillation, chronic obstructive pulmonary disease and diabetes mellitus type 2. Physical examination of the left ankle revealed an elevated, weak pulsatile mass approximately 2 cm in diameter. It was located along the anterior side of the left ankle in the anatomical region of the dorsalis pedis artery (DPA). MR angiography and MRI ( figure 1A, B) and duplex ultrasound ( figure 1C) showed a round pulsatile lesion just outside the DPA at the level of the tibiotalar joint confirming the diagnosis of false aneurysm of one of the side branches of the DPA. Arteriogram of the left lower extremity ( figure 1D) confirmed the diagnosis of a pseudoaneurysm arising from the anterior tibial artery as it crossed tibiotalar joint with slight compression of the DPA.As the patient suffered pain from the pseudoaneurysm, it was decided to remove it surgically. The pseudoaneurysm was approached with a lazy S incision (figure 2A). The aneurysm was filled by a small side branch of the DPA, which was ligated (figure 2B). The aneurysm was opened and was filled with clot ( figure 2C). When