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| 1 | Management of hepatocellular carcinoma with portal vein tumor thrombosis: Review and update at 2016显示文摘Portal vein tumor thrombosis(PVTT) is a common phenomenon in hepatocellular carcinoma(HCC). Compared to HCC without PVTT, HCC with PVTT is characterized by an aggressive disease course, worse hepatic function, a higher chance of complications related to portal hypertension and poorer tolerance to treatment. Conventionally, HCC with PVTT is grouped together with metastatic HCC during the planning of its management, and most patients are offered palliative treatment with sorafenib or other systemic agents. As a result, most data on the management of HCC with PVTT comes from subgroup analyses or retrospective series. In the past few years, there have been several updates on management of HCC with PVTT. First, it is evident that HCC with PVTT consists of heterogeneous subgroups with different prognoses. Different classifications have been proposed to stage the degree of portal vein invasion/thrombosis, suggesting that different treatment modalities may be individualized to patients with different risks. Second, more studies indicate that more aggressive treatment, including surgical resection or locoregional treatment, may benefit select HCC patients with PVTT. In this review, we aim to discussthe recent conceptual changes and summarize the data on the management of HCC with PVTT. | Stephen L Chan Charing CN Chong Anthony WH Chan Darren MC Poon Kenneth SH Chok | 2016 | World Journal of Gastroenterology2016，22，32： | 44 |
| 2 | High-intensity focused ultrasound ablation:An effective bridging therapy for hepatocellular carcinoma patients显示文摘AIM:To analyze whether high-intensity focused ultrasound(HIFU) ablation is an effective bridging therapy for patients with hepatocellular carcinoma(HCC).METHODS:From January 2007 to December 2010,49 consecutive HCC patients were listed for liver transplantation(UCSF criteria).The median waiting time for transplantation was 9.5 mo.Twenty-nine patients received transarterial chemoembolization(TACE) as a bringing therapy and 16 patients received no treatment before transplantation.Five patients received HIFU ablation as a bridging therapy.Another five patients with the same tumor staging(within the UCSF criteria) who received HIFU ablation but not on the transplant list were included for comparison.Patients were comparable in terms of Child-Pugh and model for end-stage liver disease scores,tumor size and number,and cause of cirrhosis.RESULTS:The HIFU group and TACE group showed no difference in terms of tumor size and tumor number.One patient in the HIFU group and no patient in the TACE group had gross ascites.The median hospital stay was 1 d(range,1-21 d) in the TACE group and two days(range,1-9 d) in the HIFU group(P < 0.000).No HIFU-related complication occurred.In the HIFU group,nine patients(90%) had complete response and one patient(10%) had partial response to the treatment.In the TACE group,only one patient(3%) had response to the treatment while 14 patients(48%) had stable disease and 14 patients(48%) had progressive disease(P = 0.00).Seven patients in the TACE group and no patient in the HIFU group dropped out from the transplant waiting list(P = 0.559).CONCLUSION:HIFU ablation is safe and effective in the treatment of HCC for patients with advanced cirrhosis.It may reduce the drop-out rate of liver transplant candidate. | Tan To Cheung Sheung Tat Fan See Ching Chan Kenneth SH Chok Ferdinand SK Chu Caroline R Jenkins Regina CL Lo James YY Fung Albert CY Chan William W Sharr Simon HY Tsang Wing Chiu Dai Ronnie TP Poon Chung Mau Lo | 2013 | World Journal of Gastroenterology2013，19，20： | 23 |
| 3 | Pancreaticoduodenectomy with vascular reconstruction for adenocarcinoma of the pancreas with borderline resectability显示文摘AIM:To analyze whether pancreaticoduodenectomy with simultaneous resection of tumor-involved vessels is a safe approach with acceptable patient survival.METHODS:Between January 2001 and March 2012,136 patients received pancreaticoduodenectomy for adenocarcinoma at our hospital.Seventy-eight patients diagnosed with pancreatic head carcinoma were included in this study.Among them,46 patients received standard pancreaticoduodenectomy(group 1)and32 patients received pancreaticoduodenectomy with simultaneous resection of the portal vein or the superior mesenteric vein or artery(group 2)followed by reconstruction.The immediate surgical outcomes and survivals were compared between the groups.Fifty-five patients with unresectable adenocarcinoma of the pancreas without liver metastasis who received only bypassoperations(group 3)were selected for additional survival comparison.RESULTS:The median ages of patients were 67 years(range:37-82 years)in group 1,and 63 years(range:35-86 years)in group 2.All group 2 patients had resection of the portal vein or the superior mesenteric vein and three patients had resection of the superior mesenteric artery.The pancreatic fistula formation rate was21.7%(10/46)in group 1 and 15.6%(5/32)in group2(P=0.662).Two hospital deaths(4.3%)occurred in group 1 and one hospital death(3.1%)occurred in group 2(P=0.641).The one-year,three-year and five-year overall survival rates in group 1 were 71.1%,23.6%and 13.5%,respectively.The corresponding rates in group 2 were 70.6%,33.3%and 22.2%(P=0.815).The one-year survival rate in group 3 was13.8%.Pancreaticoduodenectomy with simultaneous vascular resection was safe for pancreatic head adenocarcinoma.CONCLUSION:The short-term and survival outcomes with simultaneous resection were not compromised when compared with that of standard pancreaticoduodenectomy. | Tan To Cheung Ronnie TP Poon Kenneth SH Chok Albert CY Chan Simon HY Tsang Wing Chiu Dai See Ching Chan Sheung Tat Fan Chung Mau Lo | 2014 | World Journal of Gastroenterology2014，20，46： | 8 |
| 4 | Rapid measurement of indocyanine green retention by pulse spectrophotometry: a validation study in 70 patients with Child-Pugh A cirrhosis before hepatectomy for hepatocellular carcinoma显示文摘BACKGROUND: The indocyanine green (ICG) retention test is the most popular liver function test for selecting patients for major hepatectomy. Traditionally, it is done using spectrophotometry with serial blood sampling. The newly- developed pulse spectrophotometry is a faster alternative, but its accuracy on Child-Pugh A cirrhotic patients undergoing hepatectomy for hepatocellular carcinoma has not been well documented. This study aimed to assess the accuracy of the LiMON , one of the pulse spectrophotometry systems, in measuring preoperative ICG retention in these patients and to devise an easy formula for conversion of the results so that they can be compared with classical literature records where ICG retention was measured by the traditional method. METHODS: We measured the liver function of 70 Child-Pugh A cirrhotic patients before hepatectomy for hepatocellular carcinoma from September 2008 to January 2009. ICG retention at 15 minutes measured by traditional spectrophotometry (ICGR15) was compared with ICG retention at 15 minutes measured by the LiMON (ICGR15(L)). RESULTS: The median ICGR15 was 14.7% (5.6%-32%) and the median ICGR15(L) was 10.4% (1.2%-28%). The mean difference between them was -4.3606. There was a strong correlation between ICGR15 and ICGR15(L) (correlation coefficient, 0.844; 95% confidence interval, 0.762-0.899). The following formula was devised: ICGR15=1.16×ICGR15(L)+2.73.CONCLUSIONS: The LiMON provides a fast and repeatable way to measure ICG retention at 15 minutes, but with constant underestimation of the real value. Therefore, when comparing results obtained by traditional spectrophotometry and the LiMON, adjustment of results from the latter is necessary, and this can be done with a simple mathematical calculation using the above formula. | Tan To Cheung See Ching Chan Kenneth SH Chok Albert CY Chan Wan Ching Yu Ronnie TP Poon Chung Mau Lo Sheung Tat Fan | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，3： | 8 |
| 5 | Acute pancreatitis induced by transarterial chemoembolization:a single-center experience of over 1500 cases显示文摘BACKGROUND: Acute pancreatitis is a relatively rare but potentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma.METHODS: A total of 1632 patients with hepatocellular carcinoma who had undergone transarterial chemoembolization from January 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential complications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications.RESULTS: Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these patients was 61 years. Most(79.6%) of the patients suffered from HBV-related hepatocellular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin eluting bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven(0.4%) patients suffered from acute pancreatitis postchemoembolization. Six patients had chemoembolization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxorubicin eluting bead had a higher risk of acute pancreatitis [6/145(4.1%) vs 1/1487(0.1%), P<0.0001]. Two patients had anatomical arte-rial variations. Four patients developed acute pancreatitisrelated complications including necrotizing pancreatitis(n=3) and pseudocyst formation(n=1). All of the 4 patients resolved after the use of antibiotics and other conservative treatment. Three patients had further transarterial chemoembolization without any complication.CONCLUSIONS: Acute pancreatitis after transarterial chemoembolization could result in serious complications, especially after treatment with doxorubicin eluting bead. Continuation of current treatment with transarterial chemoembolization after acute pancreatitis is feasible providing the initial attack is completely resolved. | Wong Hoi She Albert CY Chan Tan To Cheung Kenneth SH Chok See Ching Chan Ronnie TP Poon Chung Mau Lo | 2016 | Hepatobiliary & Pancreatic Diseases International2016，15，1： | 6 |
| 6 | High-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients awaiting liver transplantation显示文摘The scarcity of liver grafts in Asia leads to a significant dropout of patients from liver transplant waiting lists, particularly patients with hepatocellular carcinoma and a low model for end-stage liver disease score. In order to reduce dropping out, different bridging therapies are employed. We report the use of high-intensity focused ultrasound ablation as a bridging therapy for a patient with hepatocellular carcinoma of stage two and an extremely low platelet count (20×10 9 /L). The ablation was successful. Blood tests showed that his liver function was similar before and after the treatment. No adhesion was encountered in the liver transplantation performed six months later. | Tan To Cheung Kenneth SH Chok Regina CL Lo William W Sharr See Ching Chan Ronnie TP Poon Sheung Tat Fan Chung Mau Lo | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，5： | 3 |
| 7 | The impact of family history of hepatocellular carcinoma on its patients' survival显示文摘BACKGROUND:Family history of hepatocellular carcinoma(HCC) has been identified as a risk factor for the development of the disease.The aim of this study is to evaluate the impact of such a history on HCC patients' survival.METHODS:Data of all HCC patients(n=4532) managed at our center from 1989 to 2008 were prospectively collected.The patients were quizzed on their various characteristics including family HCC history.RESULTS:Totally 475(10.48%) patients had a family history of HCC.They presented the disease at a significantly earlier age(median 53 vs 59 years,P<0.0001) and at an earlier stage(the United Network for Organ Sharing staging system).They had significantly better liver function in terms of ChildPugh classification and serum albumin and bilirubin levels.Significantly more of them presented the disease without symptoms(44.0% vs 29.4%,P<0.0001).They also had significantly better overall survival under these specifications:patients in the whole study cohort,patients who had minor hepatectomy,patients with stage I disease,patients with stage II disease,and patients with stage III disease.CONCLUSIONS:Contrary to what is generally believed,we found in this study cohort that patients with a family history of HCC had better overall survival than those without such a history.We believe this was in part due to earlier diagnosis of the disease and better liver function in this group of patients.However,the effects of genetic factors on the risk of HCC cannot be overlooked and are yet to be identified. | Wing Chiu Dai Sheung Tat Fan Tan To Cheung Kenneth SH Chok Albert CY Chan Simon HY Tsang Ronnie TP Poon Chung Mau Lo | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，2： | 2 |
| 8 | Prevention of pancreatic anastomotic leakage after pancreaticoduo denectomy显示文摘 | Poon RT Lo SH | 2002 | Am J Surg2002，183，1： | 1 |
| 9 | Prevention of pancreatic anas- tomotic leakage after pancreaticoduodenectomy 显示文摘 | Poon RT Lo SH Fong D | 2002 | Am J Surg2002，183，1： | 1 |
| 10 | Prevention of pancreatic anastomotie leakage after panereaticoduodeneetomy显示文摘 | Poon RT Lo SH Fong D | 2002 | Am J Surg2002，183，1： | 1 |
| 11 | Prevention of pancreatic anastomotic leakage after pancreaticojejunostomy 显示文摘 | Poon RT Lo SH Fong D | 2002 | Am J Surg2002，183，1： | 1 |
| 12 | Immune control of HIV- 1 after early treatment of acute infection显示文摘 | Rosenberg ES Altfeld M Poon SH | 2000 | Nature2000，407，： | 1 |
| 13 | Update on yttrium- 90- based radio- embolization for treatment of hepatocellular carcinoma显示文摘 | Kan RW Tsang SH Poon RT | 2012 | ANZ J Surg2012，82，： | 1 |
| 14 | Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy显示文摘 | Poon RT Lo SH Fong D | 2002 | Am J Surg2002，183，1： | 1 |
| 15 | Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy 显示文摘 | Poon RTP Lo SH Fong D | 2002 | Am J Surg2002，183，1： | 1 |
| 16 | Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy 显示文摘 | Poon RT Lo SH Fong D | 2002 | Am J Surg2002，183，1： | 1 |
| 17 | Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy显示文摘 | Poon RT Lo SH Fong D | 2002 | Am J Surg2002，183，1： | 1 |
| 18 | Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy显示文摘 | Poon RT Lo SH Fong D | 2002 | Am J Surg2002，183，： | 1 |
| 19 | Immune control of HIV-1 after early treatment of acute infection显示文摘 | Altfeld M Poon SH | 2000 | Nature2000，407，： | 1 |
| 20 | Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy显示文摘 | Poon RT Lo SH Fong D | 2002 | Am J Surg2002，183，1： | 1 |
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