Left Lateral Section Of Liver Research Articles

A case of intrahepatic pancreatic pseudocyst developed as a complication of pancreatitis

Introduction: Pancreatic pseudocyst is located usually in lesser sac and peripancreatic space and is rarely developed in the liver. The intrahepatic pancreatic pseudocyst(IHPP) following acute pancreatitis is extremely rare with very limited number of clinical reports about IHPP. Methods: A 70-year-old woman was referred because of upper abdominal pain of 3 days' duration. An abdominal CT scan revealed 11x10 cm sized cystic mass in the left lateral section of liver. On EUS findings, a huge hypoechoic lesion with internal echogenicity was noted in the lesser sac. EUS-guided gastrocystostomy was performed and analysis of cystic fluid showed a high level of amylase (21,200 U/L). After the endoscopic procedure, severe abdominal pain developed and physical examination showed peritoneal irritation sign. An emergency operation was performed. Results: On operation findings, a huge cystic tumor was located in the left lateral section of liver without direct communication with pancreas. However, mass-like necrotic tissue was filled with in the hepatoduodenal ligament, hepatogastric ligament, and Glisson sheath of the left hepatic lobe. Left lateral sectionectomy was performed. Pathologic examination confirmed the pseudocyst with findings of non-epithelialized granulation tissue of the cystic wall. Conclusion: IHPP should be considered when a huge intrahepatic cystic lesion is found in patients with recent episodes of pancreatitis. The high level of amylase on cystic fluid analysis plays a key role in the diagnosis of IHPP. Drainage procedure or surgical resection can be considered, if necessary, for the treatment of IHPP.

Intrahepatic pancreatic pseudocyst; a rare complication of pancreatitis

Introduction: Pancreatic pseudocyst is located usually in lesser sac and peripancreatic space and is rarely developed in the liver. The intrahepatic pancreatic pseudocyst(IHPP) following acute pancreatitis is extremely rare with very limited number of clinical reports about IHPP. Methods: A 70-year-old woman was referred because of upper abdominal pain of 3 days' duration. An abdominal CT scan revealed 11x10 cm sized cystic mass in the left lateral section of liver. On EUS findings, a huge hypoechoic lesion with internal echogenicity was noted in the lesser sac. EUS-guided gastrocystostomy was performed and analysis of cystic fluid showed a high level of amylase (21,200 U/L). After the endoscopic procedure, severe abdominal pain developed and physical examination showed peritoneal irritation sign. An emergency operation was performed. Results: On operation findings, a huge cystic tumor was located in the left lateral section of liver without direct communication with pancreas. However, mass-like necrotic tissue was filled with in the hepatoduodenal ligament, hepatogastric ligament, and Glisson sheath of the left hepatic lobe. Left lateral sectionectomy was performed. Pathologic examination confirmed the pseudocyst with findings of non-epithelialized granulation tissue of the cystic wall. Conclusion: IHPP should be considered when a huge intrahepatic cystic lesion is found in patients with recent episodes of pancreatitis. The high level of amylase on cystic fluid analysis plays a key role in the diagnosis of IHPP. Drainage procedure or surgical resection can be considered, if necessary, for the treatment of IHPP.

Retrospective Analysis of Using the Modified in Pediatric Recipients of Left Lateral Segment Liver Graft

Purpose Transplantation of the left lateral section of liver from a living related donor is an effective method of treatment of end stage liver diseases in children. At the same time, the biliary reconstruction remains relevant to this day.The frequency of biliary complications reaches 45%according to world literature. Methods from January 2009 to October 2017 420 left lateral section transplantation in children aged from 4 to 12 months, with body mass from 5 up to 16 kg were performed. There were 404 living related donor and 16 split transplantations. Standard Roux-en-Y procedure for biliary end to side reconstruction with interrupted stitches with PDS 5/0 or 6/0 was used before 2013. Since 2013 a new technique of biliary reconstruction using round ligament of graft for peritonization of biliodigestive anastomosis with several interrupted stitches was proposed. A comparative analysis was carried out by retrospective compare is on two groups of patients: group A (2009-2012) n = 168 with classical Roux-en-Y procedure for biliary reconstruction, and group B (2013-2017) n = 252 with a new method of biliary reconstruction. Results Biliary complication rate was 14,7% in group A (biliary fistula 12,5%, biliary leakage 0.5%, stricture 1.7%). Rate of biliary complications was 9% in group B (biliary fistula 7,5%, biliary leakage 0,2%, stricture 1,3%). Conclusion The proposed surgical technique allows to reduce the amount of biliary complications.

Intrahepatic pseudocyst following acute panceatitis: Report of a case

Introduction: Pancreatic pseudocysts are a common complication of acute pancreatitis. Most commonly, pseudocysts are located in the lesser sac and the retroperitoneum. The intrahepatic location of a pseudocyst is a rare event. Herein, we report a case of intrahepatic pseudocyst, located in left hepatic lobe, following acute pancreatitis. Case report: A 70-year-old woman was referred to out hospital with a upper abdominal pain of 3 days' duration. An abdominal CT scan revealed a 11 × 10 cm sized cystic mass in the left lateral section of liver. On EUS findings, a huge hypoechoic lesion was noted with internal echogenicity in the lesser sac. When the cystic lesion was punctured, dark green colored turbid fluid was aspirated. An EUS-guided gastrocystostomy was performed. The cystic fluid analysis showed a high level of amylase in the fluid collection. (21,200 U/L) After the endoscopic procedure, a severe abdominal pain was developed. Physical examination revealed severe tenderness and rebound tenderness. An emergency left hemihepatectomy was performed. On operation findings, a huge cystic tumor was located in the left lateral section of liver. It did not communicated with pancreas or peripancreatic tissue. However, mass-like necrotic tissue was filled with in the hepatoduodenal ligament, hepatogastric ligament, and Glisson sheath of the left hepatic lobe. Pathologic examination confirmed the pseudocyst by proving nonepithelialized granulation tissue of the cystic wall. Conclusion: The presence of intrahepatic cystic lesions in patients with acute pancreatitis should raise the possibility of intrahepatic pseudocysts, even when they are not associated with pancreas or peripancreatic tissue.

Difficulty in Diagnosis of Leiomyosarcoma of Infrahepatic Inferior Vena Cava

Background: Leiomyosarcomas of inferior vena cava (IVC) are rare tumors that mostly are proposed as a primary malignancy of the IVC. The optimal treatment is completely resects the malignant lesion with preservation of venous return. According to the treated experience of one patient in our hospital, we present our opinions as below. Methods and Results: A 61-year-old woman underwent successful surgical treatment for a leiomyosarcoma with the method of infrahepatic inferior vena cava (IVC). A large tumor that was demonstrated in the Spiegel lobe liver with IVC tumor thrombus was imagined by tomography and magnetic resonance. The tumor was found from IVC, which was performed by suprahepatic and infrahepatic IVC occlusion with Satinskys clamp in the operation. The patient underwent a combined operation which is en bloc resection of the IVC tumor and lobotomy of the left lateral section of liver. Pathological examination confirmed that is primary leiomyosarcoma of the IVC. The patient had a normal live for nearly one year and no recurrence. Conclusion: It is difficult to distinguish leiomyosarcoma from a hepatic tumor. About two thirds of these patients were confirmed as the diagnosis of leiomyosarcomas only after laparotomy. The misdiagnosis to be considered as tumor arising from segment I of the liver with IVC tumor thrombus was lead to the tumor to predominant intra-luminal growth. Radical surgical en bloc resection is the mainly treatment for IVC leiomyosarcomas. Using suprahepatic IVC and infrahepatic IVC occlusion with Satinsky clamp, surgical management of an infrahepatic IVC leiomyosarcoma is a simple vascular surgical techniques.