Background: Middle hepatic vein (MHV) reconstruction is essential to optimize the outflow of the graft in adult-to-adult right lobe living donor liver transplantation (LDLT). The present study aimed to evaluate the safety and feasibility of using artificial vascular to replace MHV with single institute experiences. Methods: Polyester prostheses were used in reconstructing the MHV when the remnant liver volume was less than 35% of the donor liver volume. Venous branches with diameter greater than 5 mm were preserved and anastomosed to the prosthesis. Subsequently, MHV graft was sutured to the right hepatic vein to make one-orifice hepatic vein. From April 2019 to June 2022, 58 cases of LDLT were included in this study. Results:The average age of recipients was 51.8±10.6 years; model for end-stage liver disease score was 26.4±11.5; and graft-recipient weight ratio was 1.32±2.9. The average of back-table time was 38.6±8.7 minutes. V5 reconstruction was done in double (n=11, 24.1%), single (n=41, 70.7%), and none (n=3, 5.2%). V8 reconstruction was done in triple (n=1, 1.7%), double (n=3, 5.2%), single (n=40, 68.9%), and none (n=14, 24.2%). One-month and 6-month conduit patency rates of the vascular grafts were 94.8% and 63.1%, respectively. Conclusions: One-orifice venoplasty with polyester prostheses for MHV reconstruction was feasible in adult-to-adult right lobe LDLT.

Mục tiêu: Nghiên cứu đặt điểm kỹ thuật thực hiện miệng nối tụy – hỗng tràng kiểu Blumgart cải tiến và khảo sát các biến chứng sau phẫu thuật và thái độ xử trí. Đối tượng và phương pháp: Gồm 87 bệnh nhân đượcthực hiện miệng nối tụy hỗng tràng kiểu Blumgart cải tiến sau phẫu thuật cắt đầu tụy tá tràng tại Bệnh viện Trung ương Huế từ 01/2012 đến 12/2022. Kết quả: Tuổi trung bình 59,5 ± 11,0 (18 - 83) và nam/nữ khoảng 2,1. Đau tức bụng hạ sườn phải hoặc quanh rốn là 66.7%, tắc mật 65,5%, ngứa 58,6% và sút cân 56,3% bệnh nhân. Ống tụy giãn (> 3 mm) là 60,9% và không giãn (≤ 3 mm) là 39,1% bệnh nhân, nhu mô tụy xơ hóa là 31,0% so với nhu mô tụy không xơ hóa là 69,0%. Dẫn lưu ống tụy chủ động ra da là 54,7%, không dẫn lưu ống tụy là 27,6% và dẫn lưu bên trong là 5,7% bệnh nhân. Truyền máu trong phẫu thuật 35,8%, số lượng trung bình 571,9 ± 251,0 (350 – 1350 ml) và thời gian phẫu thuật trung bình 280,8 ± 28,9 (220 – 335 phút). Biến chứng chung sau phẫu thuật là 26,4% bệnh nhân. Trong đó, rò tụy 2,3%, chảy máu 5,7%, viêm tụy cấp thoáng qua 13,2% , ứ trệ dạ dày 7,5%, rò miệng nối mật ruột 1,2% và tử vong sau phẫu thuật là 1,2%. Kết luận: Kỹ thuật thực hiện miệng nối tụy hỗng tràng kiểu Blumgart cải tiến dễ làm, an toàn và hiệu quả. Mặc dù biến chứng chung sau phẫu thuật vẫn còn cao nhưng các biến chứng rò tụy, chảy máu thấp và được kiểm soát khá tốt.

Background: The comparing the pancreaticojejunostomy with the pancreaticogastrostomy after pancreaticoduodenectomy operation in terms morbidity, pancreatic fistula and mortality. Patients and Methods: including retrospective 136 patients with diseases of the pancreas underwent pancreaticoduodenectomy operating at the Hue centre Hospital from January 2000 to anuary 2015. Results: morbidity rate of the pancreaticojejunostomy versus the pancreaticogastrostomy was (16%) and (15%). Numbers of patients of multiple compliations of the pancreaticojejunostomy group versus the pancreaticogastrostomy was 13 and 10. The pancreatic fistula and mortality rate of the pancreaticojejunostomy were (6.4%) and (1,3%), whereas those of the pancreaticogastrostomy were (5,0%) and (3,4%) respectively. Conclusions: there was no significant difference between the to groups with regard to pancreatic fistula, morbidity and mortality rate. key word: pancreaticoduodenectomy, pancreaticojejunostomy, pancreaticogastrostomy.

Purpose: This study was evaluated report pathology and results of laparoscopic splenectomy of the spleen disease. Methods: All 61 pateints of laparoscopic splenectomy in Hue central hospital (2010 – 2015) are assembled, analyse the pathology, surgical techniques, complications and results. Results: Laparoscopic splenectomy was indicated of major benign spleen disease. Mean age 36 ± 9.2 (range 16 – 71). The spleen was classification I – III stage. Successfull laparoscopic splenectomy (95,2%), two pateints were going on laparostomy. Low rate of complication is presented. Duration of stay in hospital was 5 to 7 days. Conclusion: Laparoscopic splenectomy was safe and effective. Key words: Laparoscopic splenectomy

Aim: To evaluated the feasibility and initial outcomes application of laparoscopic rectocolectomy with specimen retrieval through natural orifices specimen extraction (N.O.S.E). Material and Method: Prospective, retrospective study in 20 patients were diagnosted sigmoid and rectal cancer and underwent laparoscopic anterior resection, low anterior resection with specimen retrieval through natural orifices specimen extraction (N.O.S.E) at Hue Central Hospital from 2011 to 2013. Results: All cases were successfully performed by laparoscopy. There was no complications during and after operation. Patients felt less pain, had early bowel movement and early discharge from hospital. Conclusions:Our initial experiences showed that laparoscopic surgery with specimen retrieval through natural orifices is feasible. It has full advantages of laparoscopic colectomy otherwise, it prevents an abdominal incision for specimen retrieval. Patient has less pain and short hospitalization. There will be a need for a larger cases study with longer follow-up time to further evaluate the outcome of this method, espencially in oncology. Keywords: colorectal laparoscopic surgery, specimen retrieval transanal.