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2. Left Split Liver

Author

Cillo, Umberto, Boetto, Riccardo, Cillo, Umberto, editor, De Carlis, Luciano, editor, and De Paolis, Paolo, Foreword by

Published
2020
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3. Portal vein thrombosis and liver transplantation: management, matching, and outcomes: a retrospective multicenter cohort study

Author

Di Benedetto, F, Magistri, P, Di Sandro, S, Boetto, R, Tandoi, F, Camagni, S, Lauterio, A, Pagano, D, Nicolini, D, Violi, P, Dondossola, D, Guglielmo, N, Cherchi, V, Lai, Q, Toti, L, Bongini, M, Frassoni, S, Bagnardi, V, Mazzaferro, V, Tisone, G, Rossi, M, Baccarani, U, Ettorre, G, Caccamo, L, Carraro, A, Vivarelli, M, Gruttadauria, S, De Carlis, L, Colledan, M, Romagnoli, R, Cillo, U, Di Benedetto, Fabrizio, Magistri, Paolo, Di Sandro, Stefano, Boetto, Riccardo, Tandoi, Francesco, Camagni, Stefania, Lauterio, Andrea, Pagano, Duilio, Nicolini, Daniele, Violi, Paola, Dondossola, Daniele, Guglielmo, Nicola, Cherchi, Vittorio, Lai, Quirino, Toti, Luca, Bongini, Marco, Frassoni, Samuele, Bagnardi, Vincenzo, Mazzaferro, Vincenzo, Tisone, Giuseppe, Rossi, Massimo, Baccarani, Umberto, Ettorre, Giuseppe Maria, Caccamo, Lucio, Carraro, Amedeo, Vivarelli, Marco, Gruttadauria, Salvatore, De Carlis, Luciano, Colledan, Michele, Romagnoli, Renato, Cillo, Umberto, Di Benedetto, F, Magistri, P, Di Sandro, S, Boetto, R, Tandoi, F, Camagni, S, Lauterio, A, Pagano, D, Nicolini, D, Violi, P, Dondossola, D, Guglielmo, N, Cherchi, V, Lai, Q, Toti, L, Bongini, M, Frassoni, S, Bagnardi, V, Mazzaferro, V, Tisone, G, Rossi, M, Baccarani, U, Ettorre, G, Caccamo, L, Carraro, A, Vivarelli, M, Gruttadauria, S, De Carlis, L, Colledan, M, Romagnoli, R, Cillo, U, Di Benedetto, Fabrizio, Magistri, Paolo, Di Sandro, Stefano, Boetto, Riccardo, Tandoi, Francesco, Camagni, Stefania, Lauterio, Andrea, Pagano, Duilio, Nicolini, Daniele, Violi, Paola, Dondossola, Daniele, Guglielmo, Nicola, Cherchi, Vittorio, Lai, Quirino, Toti, Luca, Bongini, Marco, Frassoni, Samuele, Bagnardi, Vincenzo, Mazzaferro, Vincenzo, Tisone, Giuseppe, Rossi, Massimo, Baccarani, Umberto, Ettorre, Giuseppe Maria, Caccamo, Lucio, Carraro, Amedeo, Vivarelli, Marco, Gruttadauria, Salvatore, De Carlis, Luciano, Colledan, Michele, Romagnoli, Renato, and Cillo, Umberto

Abstract

BACKGROUND AND AIMS: Besides the increased risk of perioperative morbidity, graft failure, and mortality, the majority of PVT are diagnosed at liver transplantation (LT). Improving preoperative management and patient selection may lead to better short-term and long-term outcomes and reduce the risk of a futile LT. The authors aimed to identify predictors of adverse outcomes after LT in patients with nonmalignant portal vein thrombosis (PVT) and improve donor to recipient matching by analyzing the results of the Italian cohort of LT recipients. METHODS: Adult patients who underwent LT in Italy between January 2000 and February 2020 diagnosed with PVT pre-LT or at time of LT were considered eligible for inclusion. Based on a survey encompassing all 26 surgeons participating in the study, a binary composite outcome was defined. Patients were classified as having the composite event if at least one of these conditions occurred: operative time more than 600 min, estimated blood loss greater than 5000 ml, more than 20 ICU days, 90 days mortality, 90 days retransplant. RESULTS: Seven hundred fourteen patients were screened and 698 met the inclusion criteria. The analysis reports the results of 568 patients that fulfilled the criteria to enter the composite outcome analysis.Overall, 156 patients (27.5%) developed the composite outcome. PVT stage 3/4 at transplant and need for any surgical correction of PVT are independent predictors of the composite outcome occurrence. When stratified by PVT grade, overall survival at 1-year ranges from 89.0% with PVT grade 0/1 to 67.4% in patients with PVT grade 3/4 at LT ( P <0.001). Nevertheless, patients with severe PVT can improve their survival when identified risk factors are not present. CONCLUSIONS: Potential LT candidates affected by PVT have a benefit from LT that should be adequately balanced on liver function and type of inflow reconstruction needed to mitigate the incidence of adverse events. Nonetheless, the absence of spe

Published
2024

4. Portal vein thrombosis and liver transplantation: management, matching, and outcomes: a retrospective multicenter cohort study

Author

Di Benedetto, Fabrizio, primary, Magistri, Paolo, additional, Di Sandro, Stefano, additional, Boetto, Riccardo, additional, Tandoi, Francesco, additional, Camagni, Stefania, additional, Lauterio, Andrea, additional, Pagano, Duilio, additional, Nicolini, Daniele, additional, Violi, Paola, additional, Dondossola, Daniele, additional, Guglielmo, Nicola, additional, Cherchi, Vittorio, additional, Lai, Quirino, additional, Toti, Luca, additional, Bongini, Marco, additional, Frassoni, Samuele, additional, Bagnardi, Vincenzo, additional, Mazzaferro, Vincenzo, additional, Tisone, Giuseppe, additional, Rossi, Massimo, additional, Baccarani, Umberto, additional, Ettorre, Giuseppe Maria, additional, Caccamo, Lucio, additional, Carraro, Amedeo, additional, Vivarelli, Marco, additional, Gruttadauria, Salvatore, additional, De Carlis, Luciano, additional, Colledan, Michele, additional, Romagnoli, Renato, additional, and Cillo, Umberto, additional

Published
2024
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6. Posterior Right Disconnected Bile Duct

Author

Cillo, Umberto, Boetto, Riccardo, De Rose, Agostino Maria, Bassi, Domenico, Ardito, Francesco, Giuliante, Felice, Pawlik, Timothy M., editor, Weber, Sharon, editor, and Gamblin, T. Clark, editor

Published
2017
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7. THE USE OF MACHINE PERFUSION IN SURGICAL ONCOLOGY AND SPLIT LIVER TRANSPLANTATION

Author

Gringeri, Enrico, primary, Lanari, Jacopo, additional, D’Amico, Francesco Enrico, additional, Bassi, Domenico, additional, Boetto, Riccardo, additional, Bertacco, Alessandra, additional, Dolcet, Annalisa, additional, Caregari, Silvia, additional, Mescoli, Claudia, additional, Feltracco, Paolo, additional, Burra, Patrizia, additional, and Cillo, Umberto, additional

Published
2023
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8. Textbook Outcome of Laparoscopic Microwave Ablation for Hepatocellular Carcinoma

Author

Lanari, Jacopo, primary, Caregari, Silvia, additional, Billato, Ilaria, additional, Gringeri, Enrico, additional, D’Amico, Francesco, additional, Gemo, Giancarlo, additional, Bassi, Domenico, additional, D’Amico, Francesco Enrico, additional, Boetto, Riccardo, additional, Bertacco, Alessandra, additional, Marchini, Andrea, additional, Lazzari, Sara, additional, Brolese, Marco, additional, Ballo, Mattia, additional, Vitale, Alessandro, additional, and Cillo, Umberto, additional

Published
2023
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12. Impact of Positive Radial Margin on Recurrence and Survival in Perihilar Cholangiocarcinoma

Author

D’Amico, Francesco Enrico, primary, Mescoli, Claudia, additional, Caregari, Silvia, additional, Pasquale, Alessio, additional, Billato, Ilaria, additional, Alessandris, Remo, additional, Lanari, Jacopo, additional, Bassi, Domenico, additional, Boetto, Riccardo, additional, D’Amico, Francesco, additional, Vitale, Alessandro, additional, Lonardi, Sara, additional, Gringeri, Enrico, additional, and Cillo, Umberto, additional

Published
2022
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20. Impact of Positive Radial Margin on Recurrence and Survival in Perihilar Cholangiocarcinoma.

Author

D'Amico, Francesco Enrico, Mescoli, Claudia, Caregari, Silvia, Pasquale, Alessio, Billato, Ilaria, Alessandris, Remo, Lanari, Jacopo, Bassi, Domenico, Boetto, Riccardo, D'Amico, Francesco, Vitale, Alessandro, Lonardi, Sara, Gringeri, Enrico, and Cillo, Umberto

Subjects
STATISTICS, MULTIVARIATE analysis, BILE duct adenocarcinoma, CANCER relapse, DISEASE incidence, RETROSPECTIVE studies, CANCER patients, DESCRIPTIVE statistics, PROGRESSION-free survival
Abstract

Simple Summary: The only potentially curative treatment of perihilar cholangiocarcinoma (PHC) is complete (R0) resection. This is difficult to achieve and great effort should be made to optimise surgical margins assessment and to thoroughly define their prognostic value. When considering resections for PHC, not only bile duct margins (ductal margins, DM), but also the liver transection plane and the dissection plane in the hepatoduodenal ligament (radial margins, RM) should be examined. Studies concerning PHC resections with comprehensive analyses of the recurrence and survival related to margins status most frequently consider only ductal margins. The importance of also assessing radial margins' prognostic value was recently introduced and deserves to be further studied. To our knowledge, there is currently no evidence of prognostic value of isolated positive RM. Therefore, the aim of this study was to evaluate the incidence and to investigate the effects on the recurrence and survival of positive isolated RM in resected PHC. In resected perihilar cholangiocarcinoma (PHC), positive ductal margin (DM) is associated with poor survival. There is currently little knowledge about the impact of positive radial margin (RM) when DM is negative. The aim of this study was to evaluate the incidence and the role of positive RM. Patients who underwent surgery between 2005 and 2017 where retrospectively reviewed and stratified according to margin positivity: an isolated RM-positive group and DM ± RM group. Of the 75 patients identified; 34 (45.3%) had R1 resection and 17 had positive RM alone. Survival was poorer in patients with R1 resection compared to R0 (p = 0.019). After stratification according to margin positivity; R0 patients showed better survival than DM ± RM-positive patients (p = 0.004; MST 43.9 vs. 23.6 months), but comparable to RM-positive patients (p = 0.361; MST 43.9 vs. 39.5 months). Recurrence was higher in DM ± RM group compared to R0 (p = 0.0017; median disease-free survival (DFS) 15 vs. 30 months); but comparable between RM and R0 group (p = 0.39; DFS 20 vs. 30 months). In univariate and multivariate analysis, DM positivity resulted as a negative prognostic factor both for survival and recurrence. In conclusion, positive RM resections appear to have different recurrence patterns and survival rates than positive DM resections. [ABSTRACT FROM AUTHOR]

Published
2022
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24. Pulmonary Resection for Metastasis of Hepatocellular Carcinoma Recurring After Liver Transplant: An Italian Multicenter Experience

Author

Invenizzi, Federica, primary, Iavarone, Massimo, additional, Donato, Maria Francesca, additional, Mazzucco, Alessandra, additional, Torre, Massimo, additional, Conforti, Serena, additional, Rimessi, Arianna, additional, Zavaglia, Claudio, additional, Schiavon, Marco, additional, Comacchio, Giovanni, additional, Rea, Federico, additional, Boetto, Riccardo, additional, Cillo, Umberto, additional, Dondossola, Daniele, additional, De Carlis, Luciano, additional, Lampertico, Pietro, additional, Nosotti, Mario, additional, and Mendogni, Paolo, additional

Published
2020
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27. Extreme hepatectomies and non-resectability technical breakthrough for liver neoplasia, focusing on colorectal metastases: experimental pilot study on safety, efficacy, and regeneration patterns with new insight on ALLPS-LT hybrid techniques

Author

Boetto, Riccardo

Subjects
Settore MED/18 - Chirurgia Generale, ALPPS, two-stage hepatectomy, liver resection, resectability, oncology, two-stage hepatectomy, liver resection, oncology, ALPPS, MED/18 Chirurgia generale, resectability
Abstract

BACKGROUND New strategies to broaden resectability criteria in hepatobiliary surgery has led to the development of two-stage hepatectomy techniques, multi-step procedures with the aim of promoting effective regeneration of the future liver residue (FLR). The first multicentre international case study was published in 2012 for a new surgical technique defined ALPPS (Associating Liver partition and Portal vein ligation for Staged hepatectomy), which implies in Step1 (laparotomy) ligation of the right portal branch (PVL) with subtotal parenchymal transection (in situ splitting), in order to stimulate rapid FLR hypertrophy for a staged hepatectomy. At the UOC of Hepatobiliary Surgery and Liver Transplantation Unit of Padova University a new surgical technique was introduced that reverses the “classic ALPPS paradigm” based on a Step1 with laparoscopic PVL or portal vein embolization (sequential radiological PVE) and microwave (MWA) thermal ablation on the future transection plane. This method has been identified with the term LAPS (Laparoscopic microwave Ablation and Portal vein occlusion for Staged hepatectomy). MATERIALS AND METHODS Ten patients (M: F = 6: 4, mean age 62.5 years - gamma 29-81) were evaluated, underwent LAPS intervention for primitive or secondary malignant liver disease, upfront unresectable for insufficient preoperative FLR. The intraoperative data, the bio-morphological profile were collected during the first week respectively after both surgical procedures, complications, overall survival and analysis of oncological and postoperative outcomes (median follow-up 17 months, range 4-36). RESULTS Significant increase in FLR from 372.3 cc (range 179-407) to 664 cc (range 491-923) - p = 0.002 – and of the FLR/BW ratio was obtained (0.53% - 0.94%; p = 0.002), with a FLR hypertrophy of 71.5% (range 42.8-132%) and a median daily volume increase of 29.3 cc die (range 16.4 -43.3). All patients considered gained Step2, with effective FLR increase on average in 9.5 days (range 7-11 days). Median duration of Step1 (145 min; range 75-325 min) was significantly lower (p = 0.0005) than Step2 (402.5 min; range 185-630); blood loss was negative (range 0-70 cc) during Step1 so no patient needs transfusion, and 800 cc (range 600-3600) in Step2 (p = 0.0001). The need for postoperative monitoring in intensive care unit was averaged after Step1 and Step2 respectively unnecessary and 2.5 days (range 1-6 days) (p = 0.0057). Total hospitalization was 14 days (range 10-46) with particular feature that 7/10 patients (70%) had interstage home discharge period. The study of postoperative complications using the Dindo-Clavien classification revealed 20 events in 8 patients (80% of patients had at least one complication); analyzing for single Step 4/10 patients (40%) had complications after Step1 while 7/10 (70) patients had complications after Step2; after Step1 and Step2, respectively, 20% and 40% of grade ≥IIIa complications (with a single event IIIb, no grade IV events and no biliary complications). No perioperative mortality event was registered (90-days mortality 0%). Overall Survival (12-months) was 77.8% with a median of 28.2 months. Pathological analysis revealed 8/10 patients (80%) with an oncologically radical resection (R0). CONCLUSIONS LAPS technique was effective in achieving resectability in patients upfront unresectable for FLR insufficiency, although with a remarkable rate of complications, but with comparable data literature ALPPS data. Compared with standard ALPPS data there was sno perioperative mortality rate and 70% of patients had a short interstage discharge. In the broad panorama of two-stage hepatectomy techniques development, LAPS seems to be able to describe one of the new paradigms, enabling by means of minimally-invasive techniques to achieve significant oncological results in selected preoperative unresectable patients.

Published
2017

29. THE USE OF OCTOGENARIAN DONORS FOR LIVER TRANSPLANT

Author

Zanus, Giacomo, Bertacco, Alessandra, Bona, Enrico Dalla, D'Amico, Francesco, Vitale, Alessandro, Gringeri, Enrico, Bassi, Domenico, Boetto, Riccardo, Polacco, Marina, DI GIUNTA, Michela, Feltracco, Paolo, Rugge, Massimo, Burra, Patrizia, Angeli, Paolo, and Cillo, Umberto

Published
2017

37. Totally Laparoscopic Caudate Lobe Resection

Author

Gringeri, Enrico, primary, Boetto, Riccardo, additional, Bassi, Domenico, additional, D’Amico, Francesco E., additional, Polacco, Marina, additional, Romano, Maurizio, additional, Barbieri, Stefania, additional, Feltracco, Paolo, additional, Spampinato, Marcello, additional, Zanus, Giacomo, additional, and Cillo, Umberto, additional

Published
2014
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39. A novel approach to severe acute pancreatitis in sequential liver-kidney transplantation: the first report on the application of VAC therapy

Author

Zanus, Giacomo, primary, Boetto, Riccardo, additional, D’Amico, Francesco, additional, Gringeri, Enrico, additional, Vitale, Alessandro, additional, Carraro, Amedeo, additional, Bassi, Domenico, additional, Scopelliti, Michele, additional, Bonsignore, Pasquale, additional, Burra, Patrizia, additional, Angeli, Paolo, additional, Feltracco, Paolo, additional, and Cillo, Umberto, additional

Published
2010
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42. Clinical Presentation and Diagnosis of Intestinal Adenocarcinoma in Crohn's Disease

Author

Ruffolo, Cesare, Scarpa, Marco, Polese, Lino, D Amico, Francesco E., Boetto, Riccardo, Pozza, Anna, Renata D'Incà, Checchin, Davide, Sturniolo, Giacomo C., Bassi, Nicolo, and Angriman, Imerio

Subjects
esophagitis, DIVISION, Helicobacter pylori, gastritis, Crohn's disease, ulcerative colitis, esophagitis, gastritis, duodenitis, Helicobacter pylori, ENDOSCOPIC BIOPSIES, SYDNEY SYSTEM, HUMAN FECES, GASTRITIS, DUODENUM, DIVISION, TRACT, ULCER, SYDNEY SYSTEM, ULCER, duodenitis, DUODENUM, Crohn's disease, ENDOSCOPIC BIOPSIES, HUMAN FECES, ulcerative colitis, TRACT

43. B1a lymphocytes in the rectal mucosa of ulcerative colitis patients.

Author

Polese L, Boetto R, De Franchis G, Angriman I, Porzionato A, Norberto L, Sturniolo GC, Macchi V, De Caro R, and Merigliano S

Subjects
Adult, Aged, Aged, 80 and over, Antigens, CD immunology, Biopsy, Colitis, Ulcerative pathology, Colitis, Ulcerative physiopathology, Female, Flow Cytometry, Humans, Intestinal Mucosa pathology, Intestinal Mucosa surgery, Lymphocyte Subsets immunology, Male, Middle Aged, Rectum pathology, Rectum surgery, Young Adult, B-Lymphocytes immunology, Colitis, Ulcerative immunology, Intestinal Mucosa immunology, Rectum immunology
Abstract

Aim: To assess B1a cell expression in the rectal mucosa of ulcerative colitis (UC) patients in comparison with healthy controls., Methods: Rectal mucosa biopsies were collected from 15 UC patients and 17 healthy controls. CD5(+) B cells were analysed by three colour flow cytometry from rectal mucosal samples after mechanical disaggregation by Medimachine(®). Immunohistochemical analysis of B and T lymphocytes was also performed. Correlations between, on the one hand, rectal B1a cell concentrations and, on the other, erythrocyte sedimentation rate and C-reactive protein levels and clinical, endoscopic and histological disease activity indices were evaluated., Results: Rectal B-lymphocyte (CD19(+)/CD45(+)) rate and concentration were higher in UC patients compared with those in healthy controls (47.85% ± 3.12% vs 26.10% ± 3.40%, P = 0.001 and 501 ± 91 cells/mm(2) vs 117 ± 18 cells/mm(2), P < 0.001); Rectal B1a cell density (CD5(+)CD19(+)) was higher in UC patients than in healthy controls (85 ± 15 cells/mm(2) vs 31 ± 6.7 cells/mm(2), P = 0.009). Rectal B1a cell (CD5/CD19(+)) rate correlated inversely with endoscopic classification (Rs = -0.637, P < 0.05)., Conclusion: B1a lymphocytes seem to be involved in the pathogenesis of UC, however, the role they play in its early phases and in disease activity, have yet to be defined.

Published
2012
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