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33. Bile duct anastomosis does not promote bacterial contamination of autologous blood salvaged during living donor liver transplantation

Author

Kim, Doyeon, primary, Han, Sangbin, additional, Kim, You Sang, additional, Choi, Gyu‐Sung, additional, Kim, Jong Man, additional, Lee, Kyo Won, additional, Ko, Jae‐Hoon, additional, Yoo, In Young, additional, Ko, Justin Sangwook, additional, Gwak, Mi Sook, additional, Joh, Jae‐Won, additional, and Kim, Gaab Soo, additional

Published
2022
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40. Liver transplantation in an adult patient with hepatocellular carcinoma following liver cirrhosis as a complication of the Fontan procedure -A case report

Author

Cho, Min-kyung, Kwon, Ji-Hye, Gwak, Mi Sook, Joh, Jae-Won, Hwang, JiYun, and Kim, Gaab Soo

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Cirrhosis, Hepatocellular carcinoma, medicine.medical_treatment, Case Report, Liver transplantation, Fontan procedure, 03 medical and health sciences, Liver disease, 0302 clinical medicine, medicine, 030212 general & internal medicine, business.industry, Central venous pressure, General Medicine, Transplantation Anesthesia, medicine.disease, Pulmonary edema, Surgery, surgical procedures, operative, Liver cirrhosis, 030211 gastroenterology & hepatology, Pulmonary atresia, business
Abstract

Background: Fontan-associated liver disease (FALD) is a hepatic disorder caused by hemodynamic changes and systemic venous congestion following the Fontan procedure. FALD includes liver cirrhosis and hepatocellular carcinoma (HCC), both of which may require liver transplantation (LT). However, the Fontan circulation, characterized by elevated central venous pressure and reduced cardiac output, is a challenging issue for surgeons and anesthesiologists.Case: We report a living-donor LT for the treatment of HCC. The patient was a 24-year-old male who underwent the Fontan procedure for pulmonary atresia and right ventricle hypoplasia. We focused on maintaining enough blood volume for cardiac output without causing pulmonary edema, as the patient is not well adapted to changes in volume. Owing to a multidisciplinary approach, the surgery was successfully performed without fatal adverse events.Conclusions: To our knowledge, this is the first case of isolated LT in a recipient who became an adult after having undergone the Fontan procedure.

Published
2020

41. Decreased analgesic requirement in recipient of liver transplantation from monozygotic twin - A case report

Author

Oh, Ah Ran, Ko, Justin Sangwook, and Kim, Gaab-Soo

Subjects
Analgesics, medicine.medical_specialty, Liver transplantation, Monozygotic twin, business.industry, Postoperative pain, medicine.medical_treatment, Analgesic, Case Report, General Medicine, Transplantation Anesthesia, Surgery, medicine, business, Living donor liver transplantation, Abdominal surgery
Abstract

Background There have been many reports about decreased analgesic requirements in liver transplant recipients compared with patients undergoing other abdominal surgery. Case Herein we describe a case in which a 42-year-old man underwent living donor liver transplantation from his monozygotic twin. Because innate pain thresholds may be similar in monozygotic twins, we could effectively investigate postoperative pain in the donor and the recipient. Concordant with previous reports, the recipient used less analgesic than the donor in the present study. Conclusions Physicians caring for patients who have received liver transplantation should consider their comparatively low requirement for analgesic, to prevent delayed recovery due to excessive use of analgesic.

Published
2020

42. Bilateral continuous erector spinae plane block using a programmed intermittent bolus regimen versus intrathecal morphine for postoperative analgesia in living donor laparoscopic hepatectomy: A randomized controlled trial

Author

Kang, RyungA, primary, Chin, Ki Jinn, additional, Kim, Gaab Soo, additional, Gwak, Mi Sook, additional, Kim, Jong Man, additional, Choi, Gyu-Seong, additional, Choi, Soo Joo, additional, Lee, Seung Won, additional, and Ko, Justin Sangwook, additional

Published
2021
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48. Comparison of intragastric pressure between endotracheal tube and supraglottic airway devices in laparoscopic hepatectomy

Author

Ahn, Jin Hee, Jeong, Jiseon, Kang, Se Hee, Yeon, Ji Eun, Cho, Eun A., Choi, Gyu Sung, Kim, Jong Man, and Kim, Gaab Soo

Subjects
Male, Esophageal pH Monitoring, Operative Time, supraglottic device, hepatectomy, laryngeal mask, Postoperative Complications, Intubation, Intratracheal, Pressure, Hepatectomy, Humans, Prospective Studies, airway management, Stomach, Pharyngitis, Clinical Trial/Experimental Study, Middle Aged, laparoscopic surgery, Treatment Outcome, Cough, Female, Laparoscopy, Esophagogastric Junction, Pneumoperitoneum, Artificial, Research Article
Abstract

Background: Supraglottic airway (SGA) devices do not definitively protect the airway from regurgitation of gastric contents. Increased gastric pressure and long operation time are associated with development of complications such as aspiration pneumonia. The aim of this study was to compare intragastric pressure between second-generation SGA and endotracheal tube (ETT) devices during long-duration laparoscopic hepatectomy. Methods: A total of 66 patients was randomly assigned to 2 groups; 33 patients each in the ETT and SGA groups. Intragastric pressure was continuously measured via a gastric drainage tube with a three-way stopcock connected to the pressure monitoring device. Normal saline was added to the end of the gastric drainage tube at each operation time point. Results: Intragastric pressure during pneumoperitoneum was no different between the 2 groups (P = .146) or over time (P = .094). The mean (standard deviation [SD]) pH of the SGA tip measured after operation was 6.7 (0.4), and a pH

Published
2021

50. Comparison of postoperative analgesic effects of posterior quadratus lumborum block and intrathecal morphine in laparoscopic donor hepatectomy: a prospective randomized non-inferiority clinical trial.

Author

Seungwon Lee, Kang, Ryung A., Gaab Soo Kim, Mi Sook Gwak, Gyu-Seong Choi, Jong Man Kim, Sangwook Ko, Justin, Lee, Seungwon, Kim, Gaab Soo, Gwak, Mi Sook, Choi, Gyu-Seong, Kim, Jong Man, and Ko, Justin Sangwook

Abstract

Background: Posterior quadratus lumborum block (QLB) and intrathecal morphine are accepted analgesic strategies in laparoscopic liver resection, but their effects have not been compared after laparoscopic donor hepatectomy. This study was planned to perform this comparison.Methods: Fifty-six donors were randomized to receive bilateral posterior (QLB2, 20 mL of 0.375% ropivacaine on each side, 150 mg total) or preoperative injection of 0.4 mg morphine sulfate intrathecally. Primary outcome was resting pain score at 24 hour postsurgery. Secondary outcomes included cumulative opioid consumption and recovery parameters. Serial plasma ropivacaine concentrations were measured in QLB group. Only the outcome assessor was properly blinded.Results: Mean resting pain score at 24-hour postsurgery was 4.19±1.66 in QLB group (n=27) and 3.07±1.41 in intrathecal morphine group (n=27, p=0.04). Mean difference (QLB group-intrathecal morphine group) was 1.11 (95% CI 0.27 to 1.95), and the upper limit of CI was higher than prespecified non-inferiority margin (δ=1), indicating an inferior effect of QLB. Cumulative opioid consumption was significantly higher in QLB group at 24 hours and 48 hours postsurgery. QLB group exhibited lower incidence of postoperative pruritus at all time points, and there were no differences in other recovery outcomes. All measured ropivacaine concentrations were below the threshold for systemic toxicity (4.3 µg/mL).Conclusions: Bilateral posterior QLB elicited higher resting pain scores at 24-hour after laparoscopic donor hepatectomy than intrathecal morphine and did not meet the definition of non-inferiority.Trial Registration Number: KCT0005360. [ABSTRACT FROM AUTHOR]

Published
2022
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