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| 1 | Laparoscopic liver resection:Experience based guidelines显示文摘Laparoscopic liver resection(LLR) has been progressively developed along the past two decades. Despite initial skepticism, improved operative results made laparoscopic approach incorporated to surgical practice and operations increased in frequency and complexity. Evidence supporting LLR comes from case-series, comparative studies and meta-analysis. Despite lack of level 1 evidence, the body of literature is stronger and existing data confirms the safety, feasibility and benefits of laparoscopic approach when compared to open resection. Indications for LLR do not differ from those for open surgery. They include benign and malignant(both primary and metastatic) tumors and living donor liver harvesting. Currently, resection of lesions located on anterolateral segments and left lateral sectionectomy are performed systematically by laparoscopy in hepatobiliary specialized centers. Resection of lesions located on posterosuperior segments(1, 4a, 7, 8) and major liver resections were shown to be feasible but remain technically demanding procedures, which should be reserved to experienced surgeons. Hand-assisted and laparoscopy-assisted procedures appeared to increase the indications of minimally invasive liver surgery and are useful strategies applied to difficult and major resections. LLR proved to be safe for malignant lesions and offers some short-term advantages over open resection. Oncological results including resection margin status and long-term survival were not inferior to open resection. At present, surgical community expects high quality studies to base the already perceived better outcomes achieved by laparoscopy in major centers' practice. Continuous surgical training, as well as new technologies should augment the application of lap-aroscopic liver surgery. Future applicability of new technologies such as robot assistance and image-guided surgery is still under investigation. | fabricio ferreira coelho jaime arthur pirola kruger gilton marques fonseca raphael leonardo cunha araújo vagner birk jeismann marcos vinícius perini renato micelli lupinacci ivan cecconello paulo herman | 2016 | World Journal of Gastrointestinal Surgery2016，8，1： | 22 |
| 2 | Repeat hepatectomy for recurrent colorectal liver metastases:A comparative analysis of short-and long-term results显示文摘Background: Liver recurrence after resection of colorectal liver metastases(CRLM) is frequent. Repeat hepatectomy has been shown to have satisfactory perioperative results. However, the long-term outcomes and the benefts for patients with early recurrence have not been clarifed. The aim of this study was to compare the short-and long-term outcomes of patients undergoing single hepatectomy and repeat hepatectomy for CRLM. Additionally, the oncological outcomes of patients with early( ≤ 6 months) and late recurrence who underwent repeat hepatectomy were compared. Methods: Consecutive adult patients undergoing hepatectomy for CRLM between June 20 0 0 and February 2020 were included and divided into two groups: single hepatectomy and repeat hepatectomy. Results: A total of 709 patients were included: 649 in the single hepatectomy group and 60 in the repeat hepatectomy group. Patients in the repeat hepatectomy group underwent more cycles of preoperative chemotherapy [4(3-6) vs. 3(2-4), P = 0.003]. Patients in the single hepatectomy group more frequently underwent major hepatectomies(34.5% vs. 16.7%, P = 0.004) and had a greater number of lesions resected(2.9 ± 3.6 vs. 1.9 ± 1.8, P = 0.011). There was no increase in operative time, estimated blood loss, length of hospital stay, complications, or mortality in the repeat hepatectomy group. There were no differences in overall survival( P = 0.626) and disease-free survival( P = 0.579) between the two groups. Similarly, for patients underwent repeat hepatectomy, no difference was observed between the early and late recurrence groups in terms of overall survival( P = 0.771) or disease-free survival( P = 0.350). Conclusions: Repeat hepatectomy is feasible and safe, with similar short-and long-term outcomes when compared to single hepatectomy. Surgical treatment of early liver recurrence offers similar oncological outcomes to those obtained for late recurrence. | Paulo Figueiredo Costa Fabricio Ferreira Coelho Vagner Birk Jeismann Jaime Arthur Pirola Kruger Gilton Marques Fonseca Ivan Cecconello Paulo Herman | 2022 | Hepatobiliary & Pancreatic Diseases International2022，21，2： | 2 |
| 3 | Graph Visualization and Navigation in Information Visualization: A Survey 显示文摘 | Ivan Herman | 2000 | informatics2000，，6： | 1 |
| 4 | Graph visualization and navigation in information visualization:a survey显示文摘 | Herman Ivan Melancon Guy Marshall Scott M | 2000 | IEEE Transactions on Visualization and Computer Graphics2000，6，1： | 1 |
| 5 | Liver resection for the treatment of post-cholecystectomy biliary stricture with vascular injury显示文摘AIM:To report experience with liver resection in a select group of patients with postoperative biliary stricture associated with vascular injury.METHODS:From a prospective database of patients treated for benign biliary strictures at our hospital,cases that underwent liver resections were reviewed.All cases were referred after one or more attempts to repair bile duct injuries following cholecystectomy(open or laparoscopic).Liver resection was indicated in patients with Strasberg E3/E4(hilar stricture)bile duct lesions associated with vascular damage(arterial and/or portal),ipsilateral liver atrophy/abscess,recurrent attacks of cholangitis,and failure of previous hepaticojejunostomy.RESULTS:Of 148 patients treated for benign biliary strictures,nine(6.1%)underwent liver resection;eight women and one man with a mean age of 38.6 years.Six patients had previously been submitted to open cholecystectomy and three to laparoscopic surgery.The mean number of surgical procedures before definitive treatment was 2.4.All patients had Strasberg E3/E4injuries,and vascular injury was present in all cases.Eight patients underwent right hepatectomy and one underwent left lateral sectionectomy without mortality.Mean time of follow up was 69.1 mo and after longterm follow up,eight patients are asymptomatic.CONCLUSION:Liver resection is a good therapeutic option for patients with complex postoperative biliary stricture and vascular injury presenting with liver atrophy/abscess in which previous hepaticojejunostomy has failed. | Marcos V Perini Paulo Herman Andre L Montagnini Jose Jukemura Fabricio F Coelho Jaime A Kruger Telesforo Bacchella Ivan Cecconello | 2015 | World Journal of Gastroenterology2015，21，7： | 1 |
| 6 | Early-onset inflammatory bowel disease and common variable immunodeficiency-like disease caused by IL21 deficiency显示文摘 | Elisabeth Salzer Aydan Kansu Heiko Sic Peter Májek Aydan Ikincio?ullari Figen E. Dogu Nina Kathrin Prengemann Elisangela Santos-Valente Winfried F. Pickl Ivan Bilic Sol A. Ban Zarife Kulo?lu Arzu Meltem Demir Arzu Ensari Jacques Colinge Marta Rizzi Herman | 2014 | The Journal of Allergy and Clinical Immunology2014，，： | 1 |
| 7 | Does bilioenteric anastomosis impair results of liver resection in primary intrahepatic lithiasis?显示文摘AIM:To evaluate the long-term results of liver resection for the treatment of primary intrahepatic lithiasis.Prognostic factors,especially the impact of bilioenteric anastomosis on recurrence of symptoms were assessed.METHODS:Forty one patients with intrahepatic stones and parenchyma fibrosis/atrophy and/or biliary stenosis were submitted to liver resection.Resection was associated with a Roux-en-Y hepaticojejunostomy in all patients with bilateral stones and in those with unilateral disease and dilation of the extrahepatic biliary duct(>2 cm).Late results and risk factors for recurrence of symptoms or stones were evaluated.RESULTS:There was no operative mortality.After a mean follow-up of 50.3 mo,good late results were observed in 82.9% of patients;all patients submitted to liver resection alone and 58.8% of those submitted to liver resection and hepaticojejunostomy were free of symptoms(P=0.0006).Patients with unilateral and bilateral disease showed good late results in 94.1% and 28.6%,respectively(P<0.001).CONCLUSION:Recurrence of symptoms in patients with hepaticojejunostomy showed that this may not be the ideal solution.Further studies are needed to establish the best treatment for patients with bilateral stones or unilateral disease and a dilated extrahepatic duct. | Paulo Herman Marcos V Perini Vincenzo Pugliese Julio Cesar Pereira Marcel Autran C Machado William A Saad Luiz AC D'Albuquerque Ivan Cecconello | 2010 | World Journal of Gastroenterology2010，16，27： | 0 |
| 8 | Surgical treatment of fibrolamellar hepatocellular carcinoma:an underestimated malignant tumor?显示文摘BACKGROUND: Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare disease with an indolent behavior. Its prognosis is better than that of patients with hepatocellular carcinoma. The authors present their experience with resection of FLHCC.METHODS: Twenty-one patients with FLHCC were treated at our institution between 1990 and 2012. Of these patients, 14 were subjected to resection of the tumor. Patient demographics,medical history, results of imaging studies and laboratory tests,surgical data, and pathologic findings were evaluated.RESULTS: The median age of the patients at the diagnosis of the tumor was 20 years and 14 patients were female. None of the patients had tumor-associated chronic liver disease or cirrhosis.The mean tumor size was 12.8 cm (range 6-19) and 18 patients had a single liver nodule. Fourteen patients were subjected to hepatectomy and six of them had lymph node metastases resected. Pathologic evaluation revealed that 5 (35.7%) patients had major vascular invasion. Tumor recurrence was seen in 8 patients (66.7%), during a follow-up. The median survival time for patients who were subjected to resection was 36 months. The 5-year overall survival rate and disease free survival rate were 28.0% and 8.5%, respectively. Univariate analysis showed that vascular invasion was the only variable associated with the disease free survival rate.CONCLUSIONS: Despite an aggressive treatment, patients with FLHCC presented unexpected low survival rates. It seems that an underestimated malignant behavior is attributed to this disease, and that the forms of adjuvant treatment should be urgently evaluated. | Paulo Herman Aline Lopes Chagas Marcos Vinicius Perini Fabricio Ferreira Coelho Gilton Marques Fonseca Venancio Avancini Ferreira Alves Flair José Carrilho Ivan Cecconello | 2014 | Hepatobiliary & Pancreatic Diseases International2014，13，6： | 0 |
| 9 | Maternal choledochal cysts in pregnancy:A systematic review of case reports and case series显示文摘BACKGROUND Choledochal cysts(CC)are cystic dilatations of the biliary tract,usually diagnosed during childhood,with an estimated incidence in the general population of 1:100000.Complications related to CC include rupture,biliary obstruction,and cholangitis.Maternal CC in pregnancy are rarely reported,and there are no guidelines on optimal management.AIM To systematically review maternal CC diagnosed during pregnancy or postpartum with regard to the clinical presentation of CC,the mode of treatment and delivery,and maternal outcomes.METHODS A literature search of cases and case series of maternal CC in pregnancy and postpartum was conducted using MEDLINE/PubMed,Web of Science,Google Scholar,and Embase.There were no restrictions on language or publication year.Databases were lastly accessed on September 1,2022.RESULTS Overall,71 publications met the inclusion criteria,reporting 97 cases.Eighty-eight cases were diagnosed during pregnancy and nine in the puerperium.The most common symptoms were abdominal pain(81.2%)and jaundice(60.4%).Interventions for CC complications were required in 52.5%of the cases,and 34%of pregnancies were induced.Urgent cesarean section(CS)was done in 24.7%.The maternal mortality was 7.2%,while fetal mortality was inconsistently reported.Cholangitis,CC>15 cm,and bilirubin levels>80 mmol/L were associated with a higher likelihood of urgent CS and surgical intervention for CC.Bilirubin levels positively correlated with CC size.There was no correlation between age and cyst dimension,gestational age at cyst discovery,and CC size.CONCLUSION Although rare,maternal CC in pregnancy should be included in the evaluation of jaundice with upper abdominal pain.Symptomatology and clinical course are variable,and treatment may range from an expectative approach to emergent surgical CC treatment and urgent CS.While most cases were managed by conservative measures or drainage procedures,CC>15 cm and progressive cholangitis carry the risk of CC rupture and septic complications,which may increase the rates of unfavorable maternal and fetal outcomes.Therefore,such cases require specific surgical and obstetric interventions. | Goran Augustin Ivan Romic Iva Miličić Mislav Mikuš Mislav Herman | 2023 | World Journal of Gastrointestinal Surgery2023，15，8： | 0 |
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