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BACKGROUND: A recent British Association of Endocrine and Thyroid Surgeons consensus document suggested that day-case thyroidectomy is feasible in a small proportion of patients but has to be balanced against risks. Currently, there is no large reported series of same-day discharge in thyroid and parathyroid surgery from the UK. The aim of this study was to assess the outcomes of day-case thyroid and parathyroid surgery. METHODS: We conducted a retrospective study of patients who underwent thyroid or parathyroid surgery between January 2000 and December 2011 at Oxford University Hospitals. The end points analysed were complications in the form of bleeding, hypocalcaemia, wound infection, and seroma. RESULTS: A total of 2,102 patients (495 males and 1,607 females, age range = 13-90 years) underwent surgery for parathyroid (n = 776) or thyroid (n = 1,326) conditions. The operations included minimally invasive parathyroidectomy (MIP) (n = 331), open parathyroidectomy (n = 445), lobectomy (n = 687), isthmusectomy (n = 23), total thyroidectomy (n = 580) and thyroglossal cyst excision (n = 36). Routine arrangements were in place for consideration of same-day discharge for lobectomies, thyroglossal cyst surgery, and MIPs; lobectomies accounted for 63 % of same-day cases, followed by parathyroidectomy (35 %). Over the decade, day-case surgery increased from 4 to 17 % for thyroid surgery and from 20 to 40 % for parathyroid surgery. None of the 435 patients who had same-day discharge was readmitted for bleeding [confidence interval (CI) 0-0.6 %]. There was no 30-day mortality for the whole cohort. Complications in patients who underwent surgery in the whole cohort versus those who were discharged the same day were temporary hypocalcaemia (4 vs. 0.2 %), permanent hypocalcaemia (1 vs. 0.4 %), bleeding (0.4 vs. 0 %), seroma (0.3 vs. 0 %), and wound infection (0.3 vs. 0 %). CONCLUSION: Current protocols for thyroid or parathyroid surgery make same-day discharge feasible and safe in carefully selected patients.
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Procedimientos Quirúrgicos Ambulatorios/tendencias , Enfermedades de las Paratiroides/cirugía , Paratiroidectomía/tendencias , Enfermedades de la Tiroides/cirugía , Tiroidectomía/tendencias , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Procedimientos Quirúrgicos Ambulatorios/efectos adversos , Estudios de Factibilidad , Femenino , Humanos , Hipocalcemia/etiología , Masculino , Persona de Mediana Edad , Paratiroidectomía/efectos adversos , Alta del Paciente , Hemorragia Posoperatoria/etiología , Estudios Retrospectivos , Seroma/etiología , Infección de la Herida Quirúrgica/etiología , Quiste Tirogloso/cirugía , Tiroidectomía/efectos adversos , Reino Unido , Adulto JovenRESUMEN
BACKGROUND: Anaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer and it has an extremely poor prognosis. Rapid airway compromise is the main cause of death in patients with ATC. METHODS: The present study is based on a retrospective review of clinical data of patients with ATC treated over the last decade in a tertiary referral center. RESULTS: Between January 1998 and December 2010, 31 patients (13 males: 18 females) with a mean age of 74 years (range: 54-90 years) had a diagnosis of ATC made on fine-needle aspiration (n = 29) or biopsy (n = 2). Eight patients underwent total thyroidectomy and lymph node dissection, and five patients had attempted surgery but the procedure was abandoned because of inoperability. Airway compromise was clinically apparent in 11 patients. Five patients had tracheal stents inserted, with a median survival of 2 months (range: 1-36 months). In the whole cohort, 29 patients died of the disease, with a mean survival of 7 months (range: 1-36 months). CONCLUSIONS: Survival of patients with undifferentiated thyroid cancer is severely compromised by airway obstruction. Palliation with tracheal stenting can rescue catastrophic airway obstruction but offers minimal survival benefit.
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Stents , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Tráquea , Anciano , Anciano de 80 o más Años , Biopsia con Aguja Fina , Femenino , Humanos , Escisión del Ganglio Linfático , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tasa de Supervivencia , Carcinoma Anaplásico de Tiroides , Neoplasias de la Tiroides/mortalidad , TiroidectomíaRESUMEN
Surgical interventions have proven to be more effective than other measures in the treatment of morbid obesity. The short-term outcomes of the various surgical interventions have been well documented in the literature, with fewer reports on long-term outcomes. The reported long-term outcome of the vertical-banded gastroplasty (VBG) is conflicting. The aim of the present study was to evaluate our long-term experience with VBG. A retrospective review of a prospectively maintained database was conducted. Records of patients who underwent VBG five or more years ago were retrieved. An analysis of the long-term weight changes and reported complications was conducted. The study included 150 patients: 43 males (29%) and 107 females (71%). Their mean age was 30 years old (12-53), and the mean body mass index (BMI) was 47 ± 8.4 kg/m2. Patients were followed up for an average of 8 years (5-11). More than 60 % of patients had good long-term weight loss (EWL > 50%). A significant negative correlation was found between the excess weight loss percent (EWL%) and the pre-operative BMI (p < 0.05). The differences in EWL% between males and females were not significant (p = 0.061). Nevertheless, the change in EWL% over time for both males and females was significant (p = 0.004). Revision surgery was required in seven patients (4.7%). Five patients had conversion of VBG to gastric bypass (3.3%), while two patients (1.3%) had reversal of the procedure. Late complications included mesh erosion in three cases, staple line dehiscence in two patients, and stomal stenosis in six patients. VBG could be a long-term effective intervention for the treatment of morbid obesity. Good selection is the cornerstone for long-term success. Late complication rate is acceptable after VBG. VBG is a specifically useful tool under stringent financial circumstances.
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Gastroplastia , Obesidad Mórbida/cirugía , Selección de Paciente , Complicaciones Posoperatorias/epidemiología , Adolescente , Adulto , Índice de Masa Corporal , Niño , Egipto/epidemiología , Femenino , Estudios de Seguimiento , Gastroplastia/normas , Gastroplastia/estadística & datos numéricos , Gastroplastia/tendencias , Humanos , Masculino , Persona de Mediana Edad , Obesidad Mórbida/epidemiología , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Factores Sexuales , Factores de Tiempo , Resultado del Tratamiento , Pérdida de PesoRESUMEN
BACKGROUND: Central compartment lymph node (CCLN) metastasis in papillary thyroid cancer (PTC) is associated with higher risk of loco-regional recurrence and distant metastasis. This study evaluated the prognostic implication of the number of metastatic CCLN in PTC. METHODS: Prospective data collection on 91 patients with PTC who underwent total thyroidectomy and CCLN dissection with or without lateral neck dissection between January 2005 and December 2010 was made. Number of positive CCLN was correlated with known prognostic factors (age, gender, tumour size, extrathyroidal extension and lateral node metastasis). RESULTS: Patients were divided into three groups according to the number of positive CCLN: group A = 0 (n = 35); B = 1-2 nodes (n = 32) and C = >3 nodes (n = 24). The risk of lateral compartment disease increased in parallel with the number of positive CCLN (31 vs. 50 vs. 75 % in groups A-B-C, respectively; p < 0.004). Gender/age/tumour size/extrathyroidal extension did not correlate with number of positive CCLN. The increasing number of positive CCLN did not influence post-ablation iodine uptake (1.25 vs. 1.14 vs. 2.63 %) and correlated with mean thyroglobulin values at 1-year post-ablation (12.3 vs. 42.3 vs. 91.48 µg/L) CONCLUSIONS: The number of CCLN metastasis is a risk factor for lateral compartment disease with no correlation with other prognostic markers.
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Carcinoma/mortalidad , Carcinoma/secundario , Ganglios Linfáticos/patología , Recurrencia Local de Neoplasia/patología , Neoplasias de la Tiroides/mortalidad , Neoplasias de la Tiroides/secundario , Adulto , Anciano , Carcinoma/cirugía , Carcinoma Papilar , Distribución de Chi-Cuadrado , Bases de Datos Factuales , Supervivencia sin Enfermedad , Femenino , Humanos , Escisión del Ganglio Linfático/métodos , Escisión del Ganglio Linfático/estadística & datos numéricos , Ganglios Linfáticos/cirugía , Masculino , Persona de Mediana Edad , Disección del Cuello/métodos , Invasividad Neoplásica/patología , Recurrencia Local de Neoplasia/mortalidad , Recurrencia Local de Neoplasia/cirugía , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Análisis de Supervivencia , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Tiroidectomía/métodos , Resultado del Tratamiento , Reino UnidoAsunto(s)
Enfermedad Veno-Oclusiva Hepática/prevención & control , Hidroxietilrutósido/análogos & derivados , Hígado/efectos de los fármacos , Hígado/patología , Metaloproteinasas de la Matriz/metabolismo , Compuestos Organoplatinos/efectos adversos , Sustancias Protectoras/farmacología , Animales , MasculinoRESUMEN
UNLABELLED: Abstract Background: The surgical management of morbid obesity is faced by several challenges. Alternative therapeutic strategies could have an important role in the perioperative risk reduction. The BioEnterics(®) intragastric balloon (BIB) (Inamed Health, Santa Barbara, CA) has been described as being effective in weight reduction and is used as a bridge before bariatric surgery. This study examined the efficacy of BIB in obese Egyptian patients and the value of the extended low caloric liquid diet program in weight loss. SUBJECTS AND METHODS: A retrospective review of a prospectively maintained bariatric database was conducted. Weight changes and complications data were analyzed. Indications for BIB placement were discussed. RESULTS: Records of 55 patients (11 males and 44 females) were retrieved. The mean initial body mass index (BMI) was 45.3±11 kg/m(2). The mean of excess body weight percentage was 111.96±53.2%. Nausea was reported in 30 patients (54.5%). Epigastric discomfort was reported in 23 patients (41.8 %), and vomiting was reported in 27 patients (49.1%). Six patients (10.9%) had an early removal of the balloon, whereas 4 (7.2%) had delayed removal (more than 6 months). The mean excess weight loss percentage (EWL%) was 17.2%. There was significant reduction in patients' BMI from 45.3 to 38.3 kg/m(2) (P<.001). There was no significant correlation between the EWL% and the gender, age, or initial BMI. Two patients had second balloon insertions without complications. There was no significant difference in the EWL% between the 1-week liquid diet group and the extended (4-week) low caloric diet group. CONCLUSIONS: The BIB is effective and safe in weight reduction in obese Egyptian patients. The impact of extended liquid dieting period is not significant.
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Dieta Reductora , Balón Gástrico , Obesidad Mórbida/dietoterapia , Obesidad Mórbida/cirugía , Pérdida de Peso , Adolescente , Adulto , Anciano , Niño , Terapia Combinada , Egipto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
Patients with multiple endocrine neoplasia (MEN) type 2A develop medullary thyroid cancer, which is associated with poor prognosis in its metastatic stage. Hyperparathyroidism is a common finding in both MEN 1 and 2. We report a 68-year-old patient diagnosed clinically with MEN 1 based on the presence of hyperparathyroidism and pituitary Cushing's disease with no supporting genetic evidence. The hyperparathyroidism was later found to be part of MEN 2A with underlying metastatic medullary thyroid cancer. We highlight the importance of genetic confirmation before a diagnosis of MEN 1 is made as other more serious pathologies might be overlooked.
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Adenoma/complicaciones , Neoplasias de las Glándulas Suprarrenales/complicaciones , Neoplasia Endocrina Múltiple Tipo 1/diagnóstico , Neoplasia Endocrina Múltiple Tipo 2a/diagnóstico , Neoplasias de las Paratiroides/complicaciones , Feocromocitoma/complicaciones , Adenoma/diagnóstico , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Anciano , Diagnóstico Diferencial , Detección Precoz del Cáncer , Humanos , Masculino , Neoplasias de las Paratiroides/diagnóstico , Feocromocitoma/diagnósticoRESUMEN
INTRODUCTION: Several congenital anomalies of the spleen have been reported. The polysplenia is a rare anomaly in which the normal spleen is replaced with two or more smaller spleens. The wandering spleen is another anomaly resulting from the laxity of the splenic ligaments. The concomitance of both anomalies is very rare. PRESENTATION OF A CASE: A 22-year old female patient presented with intermittent left hypochondrial pain for more than a year. After a thorough examination of the patient, she only had bilateral accessory nipples. Routine laboratory investigations were all normal. An abdominal ultrasound U/S scan was unremarkable except for a ptotic spleen. with a large splenule 5cm×3cm located near the fundus of the stomach. These findings were confirmed by a CT scan. A decision for a surgical intervention was then made, and the laparoscopic approach was chosen which revealed the condition. Laparoscopic removal of the wandering part was executed. The patient discharged on the first post-operative day. DISCUSSION: The decision making in cases of wandering spleen is not always the same. The association of a wandering spleen with polysplenia is an asset to the surgical decision, along with the age of the patient. CONCLUSION: The laparoscopic approach is an important tool in the diagnosis and management of wandering spleen. The diagnosis of polysplenic anomaly could provide a guidance for the surgical strategy in patients with wandering spleen.
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AIM: To investigate a dual labeling technique, which would enable real-time monitoring of transplanted embryonic stem cell (ESC) kinetics, as well as long-term tracking. METHODS: Liver damage was induced in C57/BL6 male mice (n = 40) by acetaminophen (APAP) 300 mg/kg administered intraperitoneally. Green fluorescence protein (GFP) positive C57/BL6 mouse ESCs were stained with the near-infrared fluorescent lipophilic tracer 1,1-dioctadecyl-3,3,3,3-tetramethylindotricarbocyanine iodide (DiR) immediately before transplantation into the spleen. Each of the animals in the cell therapy group (n = 20) received 5 × 10(6) ESCs 4 h following treatment with APAP. The control group (n = 20) received the vehicle only. The distribution and dynamics of the cells were monitored in real-time with the IVIS Lumina-2 at 30 min post transplantation, then at 3, 12, 24, 48 and 72 h, and after one and 2 wk. Immunohistochemical examination of liver tissue was used to identify expression of GFP and albumin. Plasma alanine aminotransferase (ALT) was measured as an indication of liver damage. RESULTS: DiR-stained ESCs were easily tracked with the IVIS using the indocyanine green filter due to its high background passband with minimal background autofluorescence. The transplanted cells were confined inside the spleen at 30 min post-transplantation, gradually moved into the splenic vein, and were detectable in parts of the liver at the 3 h time-point. Within 24 h of transplantation, homing of almost 90% of cells was confirmed in the liver. On day three, however, the DiR signal started to fade out, and ex vivo IVIS imaging of different organs allowed signal detection at time-points when the signal could not be detected by in vivo imaging, and confirmed that the highest photon emission was in the liver (P < 0.0001). At 2 wk, the DiRsignal was no longer detectable in vivo; however, immunohistochemistry analysis of constitutively-expressed GFP was used to provide an insight into the distribution of the cells. GFP +ve cells were detected in tissue sections resembling hepatocytes and were dispersed throughout the hepatic parenchyma, with the presence of a larger number of GFP +ve cells incorporated within the sinusoidal endothelial lining. Very faint albumin expression was detected in the transplanted GFP +ve cells at 72 h; however at 2 wk, few cells that were positive for GFP were also strongly positive for albumin. There was a significant improvement in serum levels of ALT, albumin and bilirubin in both groups at 2 wk when compared with the 72 h time-point. In the cell therapy group, serum ALT was significantly (P = 0.016) lower and albumin (P = 0.009) was significantly higher when compared with the control group at the 2 wk time-point; however there was no difference in mortality between the two groups. CONCLUSION: Dual labeling is an easy to use and cheap method for longitudinal monitoring of distribution, survival and engraftment of transplanted cells, and could be used for cell therapy models.
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Células Madre Embrionarias/metabolismo , Fallo Hepático Agudo/terapia , Coloración y Etiquetado/métodos , Trasplante de Células Madre/métodos , Acetaminofén/toxicidad , Analgésicos no Narcóticos/toxicidad , Animales , Carbocianinas/metabolismo , Células Cultivadas , Modelos Animales de Enfermedad , Células Madre Embrionarias/citología , Colorantes Fluorescentes/metabolismo , Proteínas Fluorescentes Verdes/metabolismo , Humanos , Fallo Hepático Agudo/inducido químicamente , Fallo Hepático Agudo/fisiopatología , Pruebas de Función Hepática , Masculino , Ratones , Ratones Endogámicos C57BLRESUMEN
BACKGROUND: Sinusoidal obstruction syndrome (SOS) occurs in 50-70% of patients after oxaliplatin treatment for hepatic colorectal metastasis. SOS is associated with portal hypertension and is caused by oxidative damage to endothelial cells and matrix metalloproteinase (MMP) induction. We studied the effect of a flavonoid (monoHER) on SOS prevention. METHODS: A monocrotaline (MTC) SOS model was used in rats, with pre-treatment of monoHER. We studied hepatocellular damage and MMP expression. The potential inhibition of oxaliplatin cytotoxicity by monoHER was tested in vitro in colorectal cancer cell lines. RESULTS: MonoHER ameliorated the increase in portal pressure after MCT (72 hr: 7.3 ± 2.7 mmHg vs. 11.4 ± 3.0 mmHg, P = 0.016 MCT + monoHER vs. MCT, P < 0.01). MonoHER prevented hepatocellular damage (ALT: 48 hr 42.2 ± 3.1 IU/L vs. 253.4 ± 171.7 IU/L, P = 0.034; 72 hr: 46.2 ± 4.3 IU/L vs. 311.9 ± 163.6 IU/L, MCT + monoHER vs. MCT, P < 0.01). The liver damage score was lower in the monoHER group (72 hr: 4.8 ± 3.6 vs. 10.3 ± 0.5, MCT-monoHER vs. MCT, P < 0.01) associated with less inflammatory cell infiltration. Livers of MCT treated rats had higher expression of MMP-9 when compared to monoHER pairs at 24 hr (P = 0.016) and 72 hr (P < 0.001). MonoHER had no effect on in vitro proliferation of colorectal cancer cells when used either alone or in combination with oxaliplatin. CONCLUSIONS: MonoHER prevented MCT induced portal hypertension and hepatic injury in rats.
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Enfermedad Veno-Oclusiva Hepática/prevención & control , Hidroxietilrutósido/análogos & derivados , Hígado/efectos de los fármacos , Hígado/patología , Metaloproteinasas de la Matriz/metabolismo , Compuestos Organoplatinos/efectos adversos , Sustancias Protectoras/farmacología , Animales , Antiinflamatorios/farmacología , Antioxidantes/farmacología , Línea Celular Tumoral , Neoplasias Colorrectales/tratamiento farmacológico , Células Endoteliales/efectos de los fármacos , Células Endoteliales/patología , Inducción Enzimática/efectos de los fármacos , Regulación Enzimológica de la Expresión Génica , Enfermedad Veno-Oclusiva Hepática/inducido químicamente , Enfermedad Veno-Oclusiva Hepática/metabolismo , Hidroxietilrutósido/farmacología , Hígado/enzimología , Masculino , Metaloproteinasa 2 de la Matriz/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Metaloproteinasas de la Matriz/biosíntesis , Metaloproteinasas de la Matriz/efectos de los fármacos , Microscopía Electrónica de Rastreo , Microscopía Electrónica de Transmisión , Monocrotalina , Compuestos Organoplatinos/administración & dosificación , Oxaliplatino , Estrés Oxidativo/efectos de los fármacos , Presión Portal/efectos de los fármacos , Ratas , Ratas Sprague-DawleyAsunto(s)
Neoplasias de los Conductos Biliares/patología , Conductos Biliares Intrahepáticos/patología , Cistoadenoma/patología , Ictericia Obstructiva/patología , Adulto , Neoplasias de los Conductos Biliares/complicaciones , Neoplasias de los Conductos Biliares/cirugía , Conductos Biliares Intrahepáticos/cirugía , Cistoadenoma/complicaciones , Cistoadenoma/cirugía , Femenino , Hepatectomía , Humanos , Ictericia Obstructiva/etiología , Ictericia Obstructiva/cirugía , Pronóstico , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Most research reporting the management of advanced thyroid cancer focuses on major aerodigestive system or vessel involvement. In the present study, we investigated patients with locally advanced thyroid cancers who presented with malignant skin infiltration. The term fungating thyroid cancer (fTC) has been used to describe such a condition. METHODS: The study was based on prospective collection of clinical, laboratory, imaging, and pathological data of all patients admitted to the head and neck and endocrine surgery unit, Main University Hospital, Alexandria School of Medicine, during the period April 2005-March 2011. RESULTS: Eleven patients were referred with fTC, eight of whom had undergone subtotal thyroidectomy for an undiagnosed well-differentiated thyroid cancer (DTC) in another institution. The final pathological diagnosis showed (DTC, n = 3), poorly differentiated thyroid cancer (n = 5), anaplastic cancer (n = 2), and medullary thyroid cancer (n = 1). Extensive resections and reconstruction using flaps (pectoralis major, n = 6; deltopectoral, n = 1; sternocleidomastoid, n = 1) were undertaken. Complete tumor clearance (R0) was achieved in one patient and the others had microscopic (R1, n = 6) or macroscopic (R2, n = 1) residual disease. The three patients who did not undergo operation died within one month of presentation. The latest review of the eight patients who did undergo operation ranged from 3 to 6 months, but their survival remains unknown as access for follow-up was limited.
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Piel/patología , Neoplasias de la Tiroides/patología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuello/patología , Necrosis , Invasividad Neoplásica , Estudios Prospectivos , Neoplasias de la Tiroides/cirugía , TiroidectomíaRESUMEN
Cholesterol granuloma is a well-characterized entity comprised of a foreign-body giant cell-reaction that forms in response to the presence of cholesterol crystals. It is usually found in the middle-ear or mastoid process in patients with diseases associated with chronic inflammation such as cholesteatoma and otitis media. They are rarely seen in the mediastinum. Osseous metaplasia is an exceedingly rare feature of cholesterol granulomas only reported twice in the literature. We report a case of a cholesterol granuloma of the anterior mediastinum with osseous metaplasia in a 75 year-old man that was found incidentally during urgent coronary artery bypass graft surgery.
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INTRODUCTION: Retroperitoneal leiomyomata are rare. They are either mistaken preoperatively for malignant retroperitoneal tumors or dealt with as cases of subserous leiomyomata that turn out intraoperatively to be huge retroperitoneal masses of unknown nature. CASE PRESENTATION: We report the case of a 46-year-old nulligravid female patient of Middle Eastern ethnicity who presented to our university hospital with lower abdominal as well as pelvic pain along with a bloated sensation. She also reported noticing an unusual increase in her abdominal girth. These symptoms developed over the previous two months. Preoperative investigation by means of an ultrasound suggested a degenerated subserous huge uterine leiomyoma. An abdominal hysterectomy was planned. Intraoperatively, a normal sized uterus was found, the surface of which was studded with multiple variable sized pedunculated subserous leiomyomata. Another huge retroperitoneal soft to firm mass was found extending from her left pelvic wall to the level of her spleen, with no connections to her uterus. The mass was excised and a histopathological examination revealed a degenerated leiomyoma. CONCLUSION: Some unusually located extra-uterine leiomyomata have been reported; retroperitoneal leiomyoma being among them. The origin of such tumors is still obscure; a parasitic origin as well as Müllerian cell rests or smooth muscle cells in the retroperitoneal vessels wall have been suggested. An 'iatrogenic' origin for such growths is also a possible theory. The origin of uncommonly located leiomyomata is an unexplored issue that merits more investigation.
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Post-operative liver failure following extensive resections for liver tumours is a rare but significant complication. The only effective treatment is liver transplantation (LT); however, there is a debate about its use given the high mortality compared with the outcomes of LT for chronic liver diseases. Cell therapy has emerged as a possible alternative to LT especially as endogenous hepatocyte proliferation is likely inhibited in the setting of prior chemo/radiotherapy. Both hepatocyte and stem cell transplantations have shown promising results in the experimental setting; however, there are few reports on their clinical application. This review identifies the potential stem cell sources in the body, and highlights the triggering factors that lead to their mobilization and integration in liver regeneration following major liver resections.
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Hepatectomía/efectos adversos , Hepatocitos/trasplante , Fallo Hepático/cirugía , Neoplasias Hepáticas/cirugía , Regeneración Hepática , Trasplante de Células Madre , Animales , Diferenciación Celular , Movimiento Celular , Proliferación Celular , Hepatocitos/patología , Humanos , Fallo Hepático/diagnóstico , Fallo Hepático/etiología , Fallo Hepático/patología , Neoplasias Hepáticas/patología , Resultado del TratamientoRESUMEN
The more frequent deployment of cross-sectional imaging for various abdominal conditions has resulted in an increased detection of cystic pancreatic lesions, particularly cystic pancreatic neoplasms. Cystic pancreatic lesions may be neoplastic or non-neoplastic. They may appear radiologically similar and often present a diagnostic dilemma; they need to be diagnosed and differentiated with accuracy in order to offer optimum treatment. Some of the cystic neoplasms are potentially malignant and have a wide spectrum of histological variation from the frankly benign 'adenomas' to invasive adenocarcinomas .When identified, these cystic lesions need a systematic work up and a diagnostic algorithm should be followed to its logical conclusion. This article reviews these cystic lesions of the pancreas, neoplastic and pseudocysts, and aims to update readers with the current trends in their diagnosis and management.