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Poster Abstracts View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector POSTER ABSTRACTS Benign HPB Diseases Malignant HPB Diseases APHPB-0003 APHPB-0004 SELECTIVE DOUBLE PORTAZYGOUS NOVEL FLUORESCENCE-NAVIGATION DISCONNECTION WITH PRESERVING LIVER SURGERY USING ICG-PDE VAGUS FOR VARICEAL HEMORRHAGE SYSTEM: TUMOR DIAGNOSIS AND OF CIRRHOTIC PORTAL ANATOMICAL MARKING HYPERTENSION N. Atsushi, T. Abo and T. Nagayasu Z. Guang and F. Yang Department of Surgical Oncology, Nagasaki University General Surgery, 81st Hospital of P.L.A., Nanjing, Hospital, Nagasaki, Japan China Objectives: To improve of diagnosis for occult tumor Objectives: How to reduce the episodes of postopera- localization and define the accurate anatomical area for tive complications in patients with cirrhotic portal hepatectomy, we applied the novel fluorescent diagnosis hypertension has been discussed extensively among sur- using the indocyanine green dye-photodynamic eye geons around the world. In China, pericardial devascu- (ICG-PDE) system in 125 patients with hepatic tumors. larization with splenectomy (PDS) has been widely Methods: For tumor detection, 0.5 mg/kg-weight of used in patients, but they were suffered from rebleeding ICG was intravenously administrated 2–7 days prior to and gastric stasis ostoperatively.The aim of this study hepatectomy for the conventional liver functional test. is to evaluate the effect of selective double portazygous To define the accurate liver segmentation for anatomi- disconnection with preserving vagus (SDPDPV) for cal hepatectomy, 0.075 mg/10 mL of ICG was adminis- patients with portal hypertension in the authors’ hospi- trated into the targeted portal vein, which was often tal. administrated into the bile duct to detect the biliary fis- Methods: 453 patients with cirrhotic portal hyperten- tula at the transected planes. Fluorescence of ICG was sion who underwent either SDPDPV or PDS for vari- precisely detected by the photodynamic eye infrared- ceal bleeding from Feb 2007 to January 2013 were camera. retrospectively reviewed. The operation-relevant infor- Results: Detectable liver lesions were 135 nodules. Sen- mation, change of lavatory examination data, postoper- sitivity of diagnosis for malignancy was high as 96% ative complications and clinical outcomes were and, however, diagnostic accuracy was lower in the analyzed. benign tumor. The newly detected liver lesions were Results: There were no significant difference between observed in 3 lesions in hepatocellular carcinomas the SDPDPV group and the PDS group of mean oper- (HCC) histologically. In advanced stage HCC with por- ative time and intraoperative blood loss (p > 0.05). The tal vein thrombosis, extension of tumor thrombi was free portal hypertension pressure in the SDPDPV remarkably detected via portal trunk, which was quite group was much lower than PDS group significantly useful to remove tumor thrombi. In case of the ana- after operation (p < 0.05). The test of biochemical pro- tomical hepatectomy, marking of ICG-PDE was more file of hepatocyte functions and Child-Pugh’s score significantly visible in comarison with the conventional were significantly more altered in the SDPDPV group dye injection method (Video). This diagnosctic tool was than in the PDS group postoperatively (p < 0.05). also useful to detect the burden of the caudate lobe. Except encephalopathy, occurrences or development of Tiny biliary fistula was sensitively detected by ICG- postoperative complications including rebleeding, asci- PDE system in 5 cases. tes and gastric stasis showed great difference between Conclusions: The novel fluoresence-navigation surgery the two groups (p < 0.05). The operative mortality rate using ICG-PDE system is a powerful diagnostic tool and the 3-year survival rates were great difference during hepatectomy to improve surgical results and between the two groups too (p < 0.05). curavility of resections in patients with liver malignancies. Conclusions: The SDPDPV not only controls recurrent bleeding from varices with portal hypertension effectively Benign HPB Diseases but also maintains normal dynamics of stomach and APHPB-0006 physiological function of intestine and hepatobiliary. ACUTE CHOLECYSTITIS CAUSED BY HELMINTHIC INFECTION IN THE GALLBLADDER AND THE BILIARY TRACT M. Vejdani Parasitology and Mycology, University of Medical Sciences, Kermanshah, Iran Objectives: Helminthic infections were reported from tropical and subtropical locations in the world. The © 2015 The Authors HPB 2015, 17 (Suppl. S2), 25–266 HPB © 2015 Americas Hepato-Pancreato-Biliary Association 26 Poster Abstracts parasitic helminths develop and migrate to different Conclusion: n conclusion, pancreas transplant provided organs. Unusual cases may involve the gallbladder and an ideal insulin-free solution for DM, especially the biliary tract. The parasites invade the bile ducts or IDDM. Pancreas transplant could be performed with migrate to choledacus and cause inflammation, fibrotic similar successful rate irrespective of the type of lesions, acute and chronic cholecystitis. pancreas transplant at our hospital. Methods: The patient is undergone cholecystectomy. In this research, there were three unusual cases of parasitic Malignant HPB Diseases infestation in the hospitals of Kermanshah, which is APHPB-0008 located in the west of Iran. The worms were isolated from gallbladder and biliary tract.The patient is under- LONG-TERM SURVIVAL AFTER gone cholecystectomy. In this research, there were three PANCREATICODUODENECTOMY FOR unusual cases of parasitic infestation in the hospitals of PANCREATIC AND PERIAMPULLARY Kermanshah, which is located in the west of Iran. The ADENOCARCINOMAS worms were isolated from gallbladder and biliary tract. Y. Shyr and S. E. Wang Results: There was a female A. lumbricoides in the fun- Surgery, Taipei Veterans General Hospital, Taipei, dus of gallbladder of a 77 year-old woman. In addition, Taiwan there were proglottid of T.saginata in the bile duct of a 29 year-old woman, and an adult form of F. hepatica Objectives: This study was to identify predictors for in the bile duct of a 47 year-old woman. Two of the long-term survival and to compare survivals for pe- cases had obstructive jaundice and invasion of helmin- riampullary adenocarcinomas after a pancreaticoduo- thic parasites caused progressive pathologic lesions, so denectomy. that patients were undergone cholecystectomy opera- Methods: Clinicopathological factors were compared < ≥ tion. between short-term ( 5 years) and long-term ( 5 years) Conclusion: Helminthic infections of gallbladder and survival groups. Both actuarial and actual 5-year sur- biliary tracts are rarely in human, but they can be vival, as well as actuarial 10-year survival for those that occurred chronic complications in patients, therefore, survived over 5 years, were determined. in this study is recommended to carry out the ERCP Results: There were 109 (21.8%) long-term survivors. method before cholecystectomy for recognizing and Most (76%) of the long-term survivors were those with extracting worms from gallbladder and biliary tracts. ampullary adenocarcinoma. Long-term survival was highest for ampullary adenocarcinoma (32.8%) and lowest for pancreatic adenocarcinoma (6.5%). Jaun- Transplantation dice, tumor size, and lymph node involvement were APHPB-0007 found to be independent predictors for long-term sur- PANCREAS TRANSPLANT AT TAIPEI vival. Prognosis was significantly worse for pancreatic VETERANS GENERAL HOSPITAL adenocarcinoma, which had an actuarial 5-year survival of only 6.7%. There was no difference in subsequent Y. Shyr and S. E. Wang actuarial 5-year survival (actuarial 10-year survival) Surgery, Taipei Veterans General Hospital, Taipei, between pancreatic adenocarcinoma and other periam- Taiwan pullary adenocarcinomas for patients surviving over Objectives: Type 1 diabetes eventually leads to 5 years after resection. However, there was a difference nephropathy, neuropathy, retinopathy and angiopathy in actuarial and actual 5-year survivals. – after 10 30 years. Currently, pancreas transplant is the Conclusion: Jaundice, tumor size, and lymph node treatment of choice in tight control of blood sugar for involvement are independent predictors for long-term IDDM patients, and further to stabilize, prevent or survival after pancreaticoduodnectomy. The biological even to reverse the diabetic complications. We will factors of pancreatic adenocarcinoma no longer play a present our experience in pancreas transplant which role in determining the prognosis for those who survive was initiated on September 19, 2003. to the 5 year landmark. Methods: From September 2003 to May 2014, there were 97pancreas transplants performed for 91 patients at Taipei Veterans General Hospital, with 35 SPK, 9 APHPB-0009 PAK, 40 PTA and 13 PBK. Most (82.3%) of our pan- PANCREATICODUODENECTOMY FOR creas transplants were for IDDM patients. PANCREATIC AND PERIAMPULLARY Results: The blood sugar usually returned to normal LESIONS IN THE YOUNG level within 5 h (median) after revascularization of the pancreas grafts. The fasting blood sugar maintained Y. Shyr and S. E. Wang within normal range thereafter throughout the whole Surgery, Taipei Veterans General Hospital, Taipei, clinical course in most cases. There were 2 surgical Taiwan mortality. The technical success rate was 94.9%. Objectives: The purpose of this study was to clarify Excluding the 4 cases with technique failure, overall surgical outcomes and to assess the
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