Objective: Evaluating the results of laparoscopic cholecystectomy (LC) using indocyanine green (ICG) fluorescence. Materials and methods: This is a cross-sectional study of patients with LC using real-time fluorescent ICG to treat gallbladder disease from May 2021 to May 2022 in the 108 Military Central Hospital. Results: There were 68 patients who underwent LC using intraoperative ICG fluorescence for bile duct visualization. The mean age of the patients was 55.4±16.2, and the male/female ratio was 1.52. Chronic cholecystitis caused by stones accounted for the majority (51.47%). The authors detected 7.35% of cases with anatomical changes of the extrahepatic biliary tract using ICG fluorescence and clearly identified the anatomy of the common bile duct and the cystic duct at 100 and 92.65%, respectively. The average surgical time was 42.8±14.6 min. There were no postoperative complications or side effects from ICG; the average hospital stay was 2.8±1.5 days. Conclusions: ICG fluorescence cholangiography allows surgeons to easily identify critical anatomical landmarks in the LC. Thereby helping the surgery to be performed safely, avoiding severe complications due to damage to the biliary tract.
20 December 2023 in Annals of Hepato-Biliary-Pancreatic Surgery
Loi Van Le, Quang Van Vu, Thanh Van Le, Hieu Trung Le, Khue Kim Dang, Tuan Ngoc Vu, Anh Hoang Ngoc Nguyen, Thang Manh Tran. Ann Hepatobiliary Pancreat Surg 2024;28:42-7. https://doi.org/10.14701/ahbps.23-085
Surgical resection remains a curative-intent treatment for hepatocellular carcinoma, but procedure-specific evidence for open minor hepatectomy using Takasaki’s Glissonean pedicle control remains limited. We retrospectively reviewed 74 consecutive patients with histologically confirmed hepatocellular carcinoma who underwent elective open minor hepatectomy, defined as resection of fewer than three Couinaud segments, using Takasaki-style Glissonean pedicle control at a Vietnamese hepatopancreatobiliary center between January 2021 and March 2024. Survival was estimated using the Kaplan–Meier method, and prognostic factors were explored using Cox regression. All patients had Child–Pugh class A liver function; 81.1% were hepatitis B surface antigen-positive and 87.8% had Barcelona Clinic Liver Cancer stage A disease. Median tumor diameter, operative time, and blood loss were 42 mm, 150 min, and 200 mL, respectively. R0 resection was achieved in 94.6%. Post-hepatectomy liver failure, major complications, and 90-day mortality occurred in 1.4%, 4.1%, and 1.4%, respectively. At a median follow-up of 39.6 months, 3-year overall and disease-free survival were 74.7% and 59.9%. This approach appears feasible and safe in selected Child–Pugh class A patients, with acceptable mid-term oncological outcomes.
BACKGROUND:Early bacterial infections are a common and clinically significant complication after living donor liver transplantation. However, clinically usable tools for early individualized risk stratification remain limited in routine clinical practice. MATERIAL AND METHODS:This single-center retrospective cohort study included 205 adult patients who underwent LDLT between October 1, 2017, and October 31, 2025. All patients had complete 30-day follow-up for outcome ascertainment. Early bacterial infection was defined as a microbiologically confirmed infection occurring within 30 days after transplantation. Univariable and multivariable logistic regression analyses were performed to identify independent predictors. Model performance was evaluated using receiver operating characteristic (ROC) analysis, bootstrap-based calibration, and decision curve analysis. Static and web-based dynamic nomograms were constructed based on the final model. RESULTS:Early bacterial infections occurred in 45 patients (21.9%). Higher pre-transplant MELD score, post-transplant blood transfusion, bile leakage, and longer intensive care unit (ICU) stay were independently associated with infection risk. The dynamic risk stratification tool demonstrated good discrimination (AUC=0.792, 95% CI 0.716-0.867), good calibration on internal bootstrap validation (MAE and MSE), and favorable net clinical benefit on decision curve analysis. The web-based dynamic nomogram enabled real-time individualized risk estimation using routinely available clinical variables. CONCLUSIONS:We developed and internally validated a dynamic risk stratification tool for early bacterial infections after LDLT, implemented as static and web-based dynamic nomograms. The tool reflects evolving postoperative risk rather than prediction at a fixed time point, with good apparent performance. However, its true performance and generalizability remain uncertain, and external validation is required before clinical application.
17 November 2022 in Korean Journal of Transplantation
Van Linh Ho, Van Thanh Le, Van Quang Vu, Van Loi Le, Trung Hieu Le, Ngoc Tuan Vu, Hoang Ngoc Anh Nguyen. Korean J Transplant 2022;36:338. https://doi.org/10.4285/ATW2022.F-4833