A positive intraoperative bile culture was associated with higher morbidity and mortality rates following pancreaticoduodenectomy. A positive culture in the stented group was related to stent complications and duration of stenting. Uncomplicated stenting was not associated with increased morbidity or mortality.

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Pancreatic endocrine tumors (PETs) are unusual tumors arising from cells belonging generically to the amine precursor uptake and decarboxylation systems. We present a case of a calcitonin-secreting PET in a 56-year-old female who presented with watery diarrhea, dehydration and hypokalemia. Investigation revealed hypercalcemia, hyperphosphatemia, hypercalcitonemia and a well-defined mass in the head of the pancreas on CT scan. Following a pancreaticoduodenectomy her serum calcitonin levels returned to normal and diarrhea disappeared. The identification of this particularly rare presentation of a calcitonin-secreting PET provides the opportunity to examine this pathological entity within the context of the very few previously reported instances of this disease.

Though surgical resection is the main stay of treatment for childhood hepatoblastoma (HB), many are unsuitable for radical surgery at diagnosis due to extensive intrahepatic and/or extra hepatic disease. We report experience in five patients of HB from a single institution (2001-2005) with preoperative Neoadjuvant chemotherapy (NACT) followed by surgery. Three patients received cisplatin, doxorubicin; and two cisplatin / vincristine /5-fluorouracil. All showed more than 50% reduction in tumor size confirmed by CT scan. Hepatic resection R0 was performed in all. There was no chemotherapy related toxicity nor post surgical morbidity or mortality. All are disease free at median follow up of 4 years. NACT produces adequate down staging of the HB with acceptable toxicity. Though cisplatin with doxorubicin produced good results, new protocol with cisplatin, vincristine and 5FU is promising without cardiotoxicity.

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At a median follow up of 12 months (range 10e17) one of the DHOPE preserved livers had developed non-anastomotic biliary strictures (NAS). In contrast, incidence of early NAS was 30% in controls (p = 0.372). Conclusion:This first clinical study of end-ischemic DHOPE in DCD liver transplantation demonstrates that this technique is safe, can restore cellular energy levels, and reduce reperfusion injury.

Introduction: Overexpression of epidermal growth factor receptor (EGFR) in tumor cells has been associated with a poor prognosis, but also offers the therapeutic option of pharmacologically targeting these receptors. The role of EGFR in hepatic malignancies is not clearly understood. The aim of this study was to analyze the expression of the EGFR in gallbladder cancer and cholangiocarcinomas. Methods: Paraffin-embedded samples from 60 patients with carcinomas of the biliary tract were studied. Clinicopathologic features were assessed. The immunohistochemical for EGFR were performed and scored independently by two pathologists. Results: The age of patients was 59 years (range, 28e83). From the 60 patients examined 22 (36.6%) had gallbladder cancer (GB) and 38 (63.3%) cholangiocarcinoma, 9 (23.7%) had intrahepatic, 22 (57.9) perihilar, and 7(18.4%) distal cholangiocarcinomas. Intraductal growth type was identified in 14 (36.8%) cases of cholangiocarcinomas. EFGR was positive in 44% of the GB cancer, and 50% of the cholangiocarcinomas. Conclusions: EGFR was positive in about half of the biliary tract cancer.