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| 1 | Laparoscopic liver resection under hemihepatic vascular inflow occlusion using the lowering of hilar plate approach显示文摘BACKGROUND: With advances in technology, laparoscopic liver resection is widely accepted. Laparoscopic liver resection under hemihepatic vascular inflow occlusion has advantages over the conventional total hepatic inflow occlusion using the Pringle's maneuver, especially in patients with cirrhosis.METHOD: From November 2011 to August 2012, eight consecutive patients underwent laparoscopic liver resection under hemihepatic vascular inflow occlusion using the lowering of hilar plate approach with biliary bougie assistance.RESULTS: The types of liver resection included right hepatectomy(n1), right posterior sectionectomy(n1), left hepatectomy and common bile duct exploration(n1), segment 4b resection(n1), left lateral sectionectomy(n2), and wedge resection(n2). Four patients underwent right and 4 left hemihepatic vascular inflow occlusion. Four patients had cirrhosis. The mean operation time was 176.3 minutes. The mean time taken to achieve hemihepatic vascular inflow occlusion was 24.3minutes. The mean duration of vascular inflow occlusion was54.5 minutes. The mean intraoperative blood loss was 361 mL.No patient required blood transfusion. Postoperatively, one patient developed bile leak which healed with conservative treatment. No postoperative liver failure and mortality occurred. The mean hospital stay of the patients was 7 days.CONCLUSION: Our technique of hemihepatic vascular inflow vascular occlusion using the lowering of hilar plate approachwas safe, and it improved laparoscopic liver resection by minimizing blood loss during liver parenchymal transection. | Ying-Jun Chen Zuo-Jun Zhen Huan-Wei Chen Eric CH Lai Fei-Wen Deng Qing-Han Li Wan Yee Lau | 2014 | Hepatobiliary & Pancreatic Diseases International2014，13，5： | 23 |
| 2 | Optimal central venous pressure during partial hepatectomy for hepatocellular carcinoma显示文摘BACKGROUND:Low central venous pressure(CVP) affects hemodynamic stability and tissue perfusion.This prospective study aimed to evaluate the optimal CVP during partial hepatectomy for hepatocellular carcinoma(HCC).METHODS:Ninety-seven patients who underwent partial hepatectomy for HCC had their CVP controlled at a level of 0 to 5 mmHg during hepatic parenchymal transection.The systolic blood pressure(SBP) was maintained,if possible,at 90 mmHg or higher.Hepatitis B surface antigen was positive in 90 patients(92.8%) and cirrhosis in 84 patients(86.6%).Pringle maneuver was used routinely in these patients with clamp/unclamp cycles of 15/5 minutes.The average clamp time was 21.4±8.0 minutes.These patients were divided into 5 groups based on the CVP:group A:0-1 mmHg;B:1.1-2 mmHg;C:2.1-3 mmHg;D:3.1-4 mmHg and E:4.1-5 mmHg.The blood loss per transection area during hepatic parenchymal transection and the arterial blood gas before and after liver transection were analyzed.RESULTS:With active fluid load,a constant SBP ≥90 mmHg which was considered as optimal was maintained in 18.6% in group A(95% CI:10.8%-26.3%);39.2% in group B(95% CI:29.5%-48.9%);72.2% in group C(95% CI:63.2%-81.1%);89.7% in group D(95% CI:83.6%-95.7%);and 100% in group E(95% CI:100%-100%).The blood loss per transection area during hepatic parenchymal transection decreased with a decrease in CVP.Compared to groups D and E,blood loss in groups A,B and C was significantly less(analysis of variance test,P<0.05).Compared with the baseline,the blood oxygenation decreased significantly when the CVP was reduced.Base excess and HCO 3-in groups A and B were significantly decreased compared with those in groups C,D and E(P<0.05).CONCLUSION:In consideration of blood loss,SBP,base excess and HCO 3-,a CVP of 2.1-3 mmHg was optimal in patients undergoing partial hepatectomy for HCC. | Cheng-Xin Lin Ya Guo Wan Yee Lau Guang-Ying Zhang Yi-Ting Huang Wen-Zheng He Eric CH Lai | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，5： | 19 |
| 3 | Associating liver partition and portal vein ligation for staged hepatectomy: the current role and development显示文摘BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) has recently been developed to induce rapid liver hypertrophy and reduce posthepatectomy liver failure in patients with insufficient future liver remnant(FLR). ALPPS is still considered to be in an early developmental phase because surgical indications and techniques have not been standardized. This article aimed to review the current role and future developments of ALPPS.DATA SOURCES: Studies were identified by searching MEDLINE and Pub Med for articles from January 2007 to October 2016 using the keywords 'associating liver partition and portal vein ligation for staged hepatectomy' and 'ALPPS'. Additional papers were identified by a manual search of references from key articles.RESULTS: ALPPS induces more hypertrophy of the FLR in less time than portal vein embolization or portal vein ligation.The benefits of ALPPS include rapid hypertrophy 47%-110% of the liver over a median of 6-16.4 days, and 95%-100% completion rate of the second stage of ALPPS. The main criticisms of ALPPS are centered on its high morbidity and mortality rates. Morbidity rates after ALPPS have been reported to be 15.3%-100%, with ≥ the Clavien-Dindo grade III morbidity of 13.6%-44%. Mortality rates have been reported to be 0%-29%.The important questions to ask even if oncologic long-term results are acceptable are: whether the gain in quality and quantity of life can be off balance by the substantial risks of morbidity and mortality, and whether stimulation of rapid liver hypertrophy also accelerates rapid tumor progression and spread. Up till now, the documentations of the ALPPS procedure come mainly from case series, and most of these series include heterogeneous groups of malignancies. The numbers are also too small to separately evaluate survival for different tumor etiologies.CONCLUSIONS: Currently, knowledge on ALPPS is limited, and prospective randomized studies are lacking. From the reported preliminary results, safety of the ALPPS procedure remains questionable. ALPPS should only be used in experienced, high-volume hepatobiliary centers. | Wan Yee Lau Eric CH Lai Stephanie HY Lau | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，1： | 16 |
| 4 | What are the ten new commandments in severe polytrauma management?显示文摘 | CW Kam CH Lai SK Lam FL So CL Lau KH Cheung | 2010 | World Journal of Emergency Medicine2010，1，2： | 9 |
| 5 | Hemodynamics and oxygen transport dynamics during hepatic resection at different central venous pressures in a pig model显示文摘BACKGROUND: Although low central venous pressure (CVP) has been used to minimize blood loss during hepatectomy the impact of variations of CVP on the rate of blood loss and on the perfusion of end-organs has not been evaluated This animal study aimed to evaluate the hemodynamics and oxygen transport changes during hepatic resection at different CVP levels. METHODS: Forty-eight anesthetized Bama miniature pigs were divided into 8 groups with CVP during hepatic resection controlled at 0 to <1, 1 to <2, 2 to <3, 3 to <4, 4 to <5, 5 to <6, 6 to <7, and 7 to <8 cmH 2 O. Intergroup comparisons were made for hemodynamic parameters, oxygen transport dynamics, and the rate of blood loss. RESULTS: The rate of blood loss and the hepatic venous pressure during hepatic resection were almost linearly related to the CVP. A significant drop in the mean arterial pressure cardiac output, and cardiac index occurred between CVP ≥2 and <2 cmH 2 O. Oxygen delivery (DO 2 ), oxygen consumption (VO 2 ) and oxygen extraction ratio (ERO 2 ) remained relatively constant between CVPs of 2 to <8 cmH 2 O. There was a significant drop in DO 2 when the CVP was <2 cmH 2 O. There was also a significant drop in VO 2 and ExO 2 when the CVP was <1 cmH 2 O.CONCLUSION: The optimal CVP for hepatic resection is 2to 3 cmH2O. | Wan-Yee Lau Eric CH Lai | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，5： | 8 |
| 6 | Modifications of ALPPS–from complex to more complex or from complex to less complex operations显示文摘BACKGROUND:Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) has recently been developed to induce rapid liver hypertrophy to reduce the chance of post-hepatectomy liver failure in patients with borderline or insufficient future liver remnant.ALPPS is still in an early developmental stage and its techniques have not been standardized.This study aimed to review the technical modifications of the conventional ALPPS procedure.DATA SOURCES:Studies were identified by searching MEDLINE and Pub Med for articles published from January 2007 to December 2016 using the keywords 'associating liver partition and portal vein ligation for staged hepatectomy' and 'ALPPS'.Additional articles were identified by a manual search of references from key articles.RESULTS:There have been a lot of modifications of the conventional ALPPS.These are classified as:(1) modifications aiming to improve surgical results;(2) modifications aiming to expand surgical indications;(3) salvage ALPPS;(4) ALPPS using the minimally invasive approach.Some of these modifications have made the conventional ALPPS procedure to become even more complex,although there have also been other attempts to make the procedure less complex.The results of most of these modifications have been reported in small case series or case reports.We need better well-designed studies to establish the true roles of these modifications.However,it is interesting to see how this conventional ALPPS procedure has evolved since its introduction.CONCLUSIONS:There is a trend for the use of minimally invasive procedure in the phase 1 or 2 of the conventional ALPPS procedure.Some of these modifications have expanded the use of ALPPS in patients who have been considered to have unresectable liver tumors.The long-term oncological outcomes of these modifications are still unknown. | Wan Yee Lau Eric CH Lai | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，4： | 7 |
| 7 | Endoscopic hemoclip treatment for bleeding peptic ulcer显示文摘AIM To evaluate the efficacy of endoscopichemoclip in the treatment of bleeding pepticulcer.METHODS Totally,40 patients with F1a andFib hemorrhagic activity of peptic ulcers wereenrolled in this uncontrolled prospective studyfor endoscopic hemoclip treatment.We used anewly developed rotatable clip-device for theapplication of hemoclip(MD850)to stopbleeding.Endoscopy was repeated if there wasany sign or suspicion of rebleeding,and re-clipping was performed if necessary andfeasible.RESULTS Initial hemostatic rate by clippingwas 95%,and rebleeding rate was only 8%.Ultimate hemostatic rates were 87%,96%,and93% in the Fla and Flb subgroups,and totalcases,respectively.In patients with shock onadmission,hemoclipping achieved ultimatehemostasis of 71% and 83% in F1a and F1bsubgroups,respectively.Hemostasis reached100% in patients without shock regardless ofhemorrhagic activity being F1a or F1b.Theaverage number of clips used per case was 3.0(range 2-5).Spurting bleeders required moreclips on average than did oozing bleeders(3.4versus 2.8).We observed no obviouscomplications,no tissue injury,or impairmentof ulcer healing related to hemoclipping.CONCLUSION Endoscopic hemoclip placementis an effective and safe method.With theimprovement of the clip and application device,the procedure has become easier and much moreefficient.Endoscopic hemoclipping deservesfurther study in the treatment of bleeding pepticulcers. | Lai YC Yang SS Wu CH Chen TK | 2000 | World Journal of Gastroenterology2000，6，1： | 6 |
| 8 | The Crosstalk of mTOR/S6K1 and Hedgehog Pathways显示文摘 | Yan Wang Qingqing Ding Chia-Jui Yen Weiya Xia Julie G. Izzo Jing-Yu Lang Chia-Wei Li Jennifer L. Hsu Stephanie A. Miller Xuemei Wang Dung-Fang Lee Jung-Mao Hsu Longfei Huo Adam M. LaBaff Dongping Liu Tzu-Hsuan Huang Chien-Chen Lai Fuu-Jen Tsai Wei-Chao Ch | 2012 | Cancer Cell2012，，3： | 2 |
| 9 | 不同血管紧张素转换酶抑制剂与高血压患者整体和病因特异性死亡率的相关性显示文摘血管紧张素转换酶抑制剂(angiotensin converting enzyme inhibitor,ACEI)已广泛用于治疗高血压,比较不同药物降低死亡率有效性的研究却鲜有报道。方法:选取中国台湾地区全民健康保险数据库中从2004年1月1日至2009年12月31日开始用卡托普利、赖诺普利、依那普利、福辛普利、雷米普利、咪达普利或培哚普利治疗的高血压患者。整体和病因特异性死亡率通过中国台湾地区全民死亡登记来证实。从最初用ACEI开始随访患者直至死亡、退出研究或研究终止(2010年12月31日)。 | Chang CH Lin JW Caffrey JL Wu LC Lai MS | 2015 | 中华高血压杂志2015，23，9： | 2 |
| 10 | randomized trial of neoadjuvant cisplatin,vincristine,bleomyin,and radical hysterectomy versus radiation therapy for bulky stage I B and II A cervical cancer 显示文摘 | Chang TC Lai CH Hong JH | 2000 | Chn Oncol2000，18，8： | 1 |
| 11 | Prenatal diagnosis of z_lobar holoprosencephaly by two-dimensional and three-dimensional ultrasound 显示文摘 | Lai TH Chang CH Yu CH | 2000 | Prenatal Diagnosis2000，20，5： | 1 |
| 12 | Clinical implications of human papillomavirus genotype in cervical adeno -adenosquamous carcinoma显示文摘 | Lai CH Chou HH Chang CJ | 2013 | Eur J Cancer2013，49，3： | 1 |
| 13 | Downregulation of angiotensin converting enzyme Ⅱ is associated with pacing-induced sustained atrial fibrillation显示文摘 | Pan CH Lin JL Lai LP | 2007 | FEBS Lett2007，581，： | 1 |
| 14 | Use of specific primers based on the 16S-23S internal transcribed spacer (ITS) region for the screening Bifidobacterium adolescentis in yogurt products and human stool sam- ples显示文摘 | TSAI CC LAI CH YU B | 2008 | Food Mierobiol2008，14，： | 1 |
| 15 | Downregulation of angiotensin conver-ting enzyme II is associated with pacing-induced sustained atrial fi-brillation显示文摘 | Pan CH Li JL Lai LP ef al | 2007 | FEBS Lett2007，581，3： | 1 |
| 16 | IL-6 regulates Mcl-1L expression through the JAK/PI3K/Akt/CREB signaling pathway in hepatocytes: implication of an anti-apoptotie role during liver regeneration显示文摘 | Chou CH Lai SL Chen CN | 2013 | PLoS One2013，8，66： | 1 |
| 17 | Nationwide population-based epidemiologic study of cryptococcal meningtitis in Taiwan 显示文摘 | Chen YY Lai CH | 2011 | Neuroepidemiology2011，36，2： | 1 |
| 18 | Quantitative study of the coexpression of Fos and N-methyl-D aspartate (NMDA) receptor subunits in otolith-related vestibular nuclear neurons of rats 显示文摘 | Chen LW Lai CH Law HY | 2003 | J Comp Neurol2003，460，2： | 1 |
| 19 | Association of antibiotic resistance and higher internalization activity in resistant Helico- bacter pylori isolates显示文摘 | LAI CH KUO CH CHEN PY | 2006 | J Antimicrob Chemother2006，57，3： | 1 |
| 20 | Human papillomavims genotype in cervical cancer, a population-based study 显示文摘 | Lai CH Huang HJ Hsueh S | 2007 | Int J Cancer2007，120，9： | 1 |
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