Simulation of portal/hepatic vein associated remnant liver ischemia/congestion by three-dimensional visualization technology based on preoperative CT scan

Li, Xiaolong; Xu, Bin; Zhu, Xiao‐Dong; Huang, Cheng; Shi, Guo‐Ming; Shen, Ying‐Hao; Wu, Dong; Tang, Min; Tang, Zhao‐You; Zhou, Jian; Fan, Jia; Sun, Hui‐Chuan

doi:10.21037/atm-20-7920

Cited by 13 publications

(6 citation statements)

References 25 publications

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“…To‐and‐fro movement of hyperechoic foci within the intrahepatic portal vein indicates that perfusion pressure within the portal venous system is not preserved, which may result in severe intestinal damage 36,37 . In patients needing intensive care, severe systemic congestion resulted in variation of portal venous waveform 38,39 .…”

Section: Discussionmentioning

confidence: 99%

“…To-and-fro movement of hyperechoic foci within the intrahepatic portal vein indicates that perfusion pressure within the portal venous system is not preserved, which may result in severe intestinal damage. 36,37 In patients needing intensive care, severe systemic congestion resulted in variation of portal venous waveform. 38,39 This waveform variation might be associated with the sonographic findings, such as the to-and-fro movement of hyperechoic foci within the intrahepatic portal vein.…”

Section: Discussionmentioning

confidence: 99%

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Association between the dynamic movement of hyperechoic foci and patients'/sonographic outcomes among pediatric patients with portal venous gas following a cardiac event

Hosokawa

Tanami

Sato

et al. 2023

J of Clinical Ultrasound

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Objectives To demonstrate the association between the dynamic movements of hyperechoic foci in portal venous gas (PVG) and patients'/sonographic outcomes after congenital heart disease or cardiac events. Methods Thirty‐one pediatric patients requiring management of congenital heart diseases or cardiac events who had PVG on ultrasound were included in this retrospective study. The patient outcome was prognosis: dead or alive. The sonographic outcome was recovery from PVG, measured as days from PVG detection to when it diminished on ultrasound. The following sonographic findings of hyperechoic foci in PVG were compared between patients: detection within the mesenteric vein, having to‐and‐fro movements within the intrahepatic portal vein, distribution (left segment or both left and right segments) and shape (line or punctate) in the liver, and detection within the portal and hepatic veins. Comparisons were made using Fisher's exact/Mann–Whitney U test. Results Four patients died without having recovered from PVG. A significant difference was observed in terms of the to‐and‐fro movement (with/without to‐and‐fro movement in dead vs. alive patients: 3/1 vs. 1/26, respectively; P = 0.003). Furthermore, a significant difference in sonographic outcomes was observed regarding patients with/without hyperechoic foci within the mesenteric vein (days with vs. without this finding: 2.0 ± 1.24(1–5) vs.1 ± 0(1), respectively; P = 0.011). Conclusions In our small limited cohort, when PVG was visualized on ultrasound, close evaluation of the dynamic movement of hyperechoic foci, especially their to‐and‐fro movement within the intrahepatic portal vein and detection of hyperechoic foci within the mesenteric vein, were useful in predicting patients' outcomes and the time to PVG diminishment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association between the dynamic movement of hyperechoic foci and patients'/sonographic outcomes among pediatric patients with portal venous gas following a cardiac event

Hosokawa

Tanami

Sato

et al. 2023

J of Clinical Ultrasound

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show abstract

“…Complete hemostasis was achieved by ligation or electrocoagulation. The Pringle maneuver or hepatic vein occlusion was used to control bleeding from inflow or outflow vessels if necessary [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

Radiographic and α-fetoprotein response predict pathologic complete response to immunotherapy plus a TKI in hepatocellular carcinoma: a multicenter study

Huang,

Zhu,

Shen

et al. 2023

BMC Cancer

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Background Pathologic complete response (pCR) following preoperative systemic therapy is associated with improved outcomes after subsequent liver transplant/resection in hepatocellular carcinoma (HCC). However, the relationship between radiographic and histopathological response remains unclear. Methods We retrospectively examined patients with initially unresectable HCC who received tyrosine kinase inhibitor (TKI) plus anti–programmed death 1 (PD-1) therapy before undergoing liver resection between March 2019 and September 2021 across 7 hospitals in China. Radiographic response was evaluated using mRECIST. A pCR was defined as no viable tumor cells in resected samples. Results We included 35 eligible patients, of whom 15 (42.9%) achieved pCR after systemic therapy. After a median follow-up of 13.2 months, tumors recurred in 8 non-pCR and 1 pCR patient. Before resection, there were 6 complete responses, 24 partial responses, 4 stable disease cases, and 1 progressive disease case, per mRECIST. Predicting pCR by radiographic response yielded an area under the receiver operating characteristic curve (AUC) of 0.727 (95% CI: 0.558–0.902), with an optimal cutoff value of 80% reduction in the enhanced area in MRI (called major radiographic response), which had a 66.7% sensitivity, 85.0% specificity, and a 77.1% diagnostic accuracy. When radiographic response was combined with α-fetoprotein response, the AUC was 0.926 (95% CI: 0.785–0.999); the optimal cutoff value was 0.446, which had a 91.7% sensitivity, 84.6%, specificity, and an 88.0% diagnostic accuracy. Conclusions In patients with unresectable HCC receiving combined TKI/anti–PD 1 therapy, major radiographic response alone or combined with α-fetoprotein response may predict pCR.

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“…The authors considered that less invasive Hx based on a hybrid concept might be an alternative to right Hx. Li et al 29 preoperatively simulated portal or hepatic vein‐associated remnant liver ischemia or congestion, and it led to postoperative complications.…”

Section: Preoperative Simulationmentioning

confidence: 99%

Essential updates 2020/2021: Current topics of simulation and navigation in hepatectomy

Saito

Shimada

Morine

et al. 2021

Annals of Gastroent Surgery

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Advances in perioperative care and surgical techniques have significantly improved the outcomes of liver resection during the last three decades. Liver surgery has inherent challenges, including difficult anticipation of complex and variable intrahepatic anatomy and the need for cognitive analysis by the surgeon to integrate preoperative imaging information into the operative field. Therefore, simulation and navigation techniques have been developed in this field.In preoperative simulation, three-dimensional (3D) simulation technology was developed in Germany in the early 2000s, 1 and immediately thereafter software based on an original algorithm was developed in Japan. The development of intraoperative navigation techniques may also help surgeons to perform liver resections as planned. Intraoperative navigation began with intraoperative ultrasound (US) in 1980 2 and progressed to virtual hepatectomy (Hx), [3][4][5][6][7] real-time virtual sonography, 8-12 and finally indocyanine green (ICG) fluorescence. [13][14][15][16][17][18][19][20] Thus, intraoperative navigation has gradually evolved during the past 40 y. This biannual review discusses the essential updates to simulation and navigation in Hx that occurred in the 2-y period from 2020 to 2021. | PREOPER ATIVE S IMUL ATIONPreoperative 3D simulation has enabled surgeons to obtain a great deal of information, such as detailed anatomical visualization, the

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Simulation of portal/hepatic vein associated remnant liver ischemia/congestion by three-dimensional visualization technology based on preoperative CT scan

Cited by 13 publications

References 25 publications

Association between the dynamic movement of hyperechoic foci and patients'/sonographic outcomes among pediatric patients with portal venous gas following a cardiac event

Association between the dynamic movement of hyperechoic foci and patients'/sonographic outcomes among pediatric patients with portal venous gas following a cardiac event

Radiographic and α-fetoprotein response predict pathologic complete response to immunotherapy plus a TKI in hepatocellular carcinoma: a multicenter study

Essential updates 2020/2021: Current topics of simulation and navigation in hepatectomy

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