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This article reviews the Adult-to-Adult Living Donor Liver Transplant Cohort Study (A2ALL). The findings show that the number of adult-to-adult living donor liver transplants is consistently increasing. Living donor liver transplantation has an important benefit for patients with acute liver failure, does not compromise donor safety, and has lower rates of acute cellular rejection in biologically related donor and recipient. The conclusions from the A2ALL consortium have been critical in transplant advancement, supporting increased use to help decrease waitlist death and improve long-term survival of transplant recipients.

Background The Silastic ring vertical gastroplasty (SRVG), a modification of Mason's vertical banded gastroplasty (VBG), was the restrictive procedure of choice for many bariatric surgeons. The reoperation rate for failure/complications reported in long-term studies is approximately 50%. Objective We report our experience in laparoscopic conversion of failed SRVG to Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). Setting A single surgeon's experience at a university-affiliated hospital. Methods Between March 2006 and April 2014, 39 patients underwent conversion of SRVG to laparoscopic RYGB (n = 25) or BPD (n = 14). The outcomes were retrieved from a prospectively collected database and analyzed. Results Most (89%) of the conversions were completed laparoscopically. The mean operative time was 195 and 200 min for RYGB and BPD, respectively. There was no mortality. Complications occurred in 11 patients (28%), 5 in RYGB (19%) and 6 in BPD (42%). At the 3-year follow-up, the mean body mass index decreased from 47±8 kg/m 2 to 26±4 kg/m 2 for BPD, and from 43 kg/m 2 to 34 kg/m 2 ( P = .05) for RYGB. Weight (kg) decreased from 110 to 84 and to 92, and from 123 to 81 and 68, at 1 and 3 years for RYGB and BPD, respectively. Conclusions The weight loss for RYGB and BPD was equal at 1 year but tended to be better for BPD at 3 years postoperatively. Laparoscopic conversion of failed VBG to RYGB or BPD was feasible, but it was followed by prohibitively high complication rates in BPD patients. The risk:benefit ratio of these procedures in this series is questionable.

Background An adverse event in laparoscopic bariatric surgery that has not received much scrutiny involves tube/probe stapling or suturing during gastrectomy or gastroenterostomy. Methods A retrospective analysis was performed using a questionnaire sent to all bariatric surgeons (n = 43) in Israel. Results Eight surgeons reported on 17 cases in which intraoperative nasogastric/orogastric tube (n = 8), temperature probe (n = 6), or bougie stapling (n = 3) was identified. Laparoscopic sleeve gastrectomy was performed in 14 patients and laparoscopic gastric bypass in 3 patients. The patient demographics, operative details, and postoperative results are reported. Conclusion Tube/probe complications can occur during laparoscopic bariatric surgery but are seldom reported. However, they can be associated with significant morbidity. The treatment options are dependent on the situation. More importantly, prevention strategies must include constant communication with the anesthesiologist and removal or relocation of a tube before stapling or suturing.

Nous rapportons un cas de resection iatrogene de l’artere mesenterique superieure (AMS) et du tronc cœliaque pendant une nephrectomie et une surrenalectomie gauches. Une femme de 47 ans avait une volumineuse tumeur surrenale et a eu une surrenalectomie gauche laparoscopique convertie en surrenalectomie et une nephrectomie a ciel ouvert en raison d’une tumeur massive. L’AMS et le tronc cœliaque furent par erreur coupes a leur origine en raison des adherences de la tumeur a l’aorte. Les deux arteres furent revascularisees en anastomosant l’artere splenique distale a l’aorte apres splenectomie pour revasculariser le tronc cœliaque et en utilisant un greffon de veine saphene autologue pour revasculariser l’AMS. La malade n’a eu aucune complication postoperatoire. A notre connaissance, c’est la premiere description de l’utilisation de l’artere splenique pour une revascularisation cœliaque.