Isolated caudate lobe resection is a feasible procedure and can be undertaken with low morbidity and nil mortality. Careful technique and detailed anatomic knowledge of the caudate lobe are essential for this procedure.

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HighlightsSpontaneous migration of synthetic grafts had been described after abdominal vascular procedures.In the setting of liver transplantation, synthetic grafts are commonly used.This is a rare case of spontaneous migration of thrombosed synthetic vascular graft after living-donor liver transplantation.Migration was diagnosed endoscopically during ERCP for biliary stricture.

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Preoperative PVT increases the complexity of LDLT operation, but it does not reduce the OS rates of such patients.

HighlightsSolitary adrenal recurrence of HCC after LDLT is extremely rare.Strict follow up protocol is necessary to allow early detection of tumor recurrence.Curative surgical resection of solitary recurrent HCC is a safe option.It is associated with low morbidity and expected to have a good long-term survival.

Background Hilar cholangiocarcinoma (HCCA) is a challenging problem for surgeons because surgery is the only effective therapy for these patients. In this study, we review 15 years of HCCC cases and treatment at a single Egyptian center. Methods From January 1995 to October 2010, 825 patients with HCCC were referred to Gastroenterology Surgical Center, Mansoura University, Egypt. From those 243 underwent potentially curative resection giving respectability rate of 29.4%, and the remaining patients (70.6%) underwent non-surgical treatment because of advanced disease, advanced cirrhosis, poor general condition and distant metastasis and locally advanced diseases. Data were recorded for the 243 cases (subjected to different types of hepatic resection), including demographics, medical history, presenting symptoms, and biochemical, radiological, and pathological parameters. ResultsThe overall resectability rate of the patients studied was 29.4% (243/825). Localized resection, right hepatectomy, or left hepatectomy were completed in 30.5%, 22.6%, and 46.9% respectively, and segment one in 58 % R0 status was achieved in 49.8% of patients. The overall complication rate was 35%. Operative mortality was 6.6% with a five-year survival rate of 16%. Recurrence occurred in 92 (37.8%) the site of recurrence was hepatic (24.3%) and local (13.5%). Resection margin (R0) (P<0.001), lymph node status (P<0.001) (negative), degree of differentiation (P<0.001), segment one resection (P<0.001) (positive), and status of liver (P<0.001) (normal or cirrhotic) predicted statistically higher survival (P<0.001). According to multivariate analysis, R0 lymph node status and well differentiated status. Prediction improved survival among all patients. Conclusion From these case studies, aggressive surgery with caudate lobe resection with normal liver parenchyma may produce better prognoses in patients with resectable HCCA.