Our study demonstrated that hepatic resection for BCLC stage B, Child A HCC patients had better survival rates than TACE group. Thus, hepatic resection is indicated in selected patients with BCLC stage B.

The treatment of ruptured HCC should be tailored to the individual case. Prolonged survival is possible in patients with preserved liver function through curative liver resection. Emergency physicians, radiologists, and surgeons play essential roles in managing these patients.

Hypophosphatemia and early phosphorus administration are associated with a good prognosis in ALF, whereas hyperphosphatemia is predictive of poor recovery.

ICG pulse spectrophotometry clearance is a quick, non-invasive, and reliable liver function test in transplantation patients.

Liver transplantation is performed in the recent decades with great improvements not only technically but also conceptually. However, there is still lack of consensus about the optimal hemodynamic characteristics during liver transplantation. The representative hemodynamic parameters include portal vein pressure, portal vein flow, and hepatic venous pressure gradient; however, there are still others potential valuable parameters, such as total liver inflow and hepatic artery flow. All the parameters are correlated closely and some internal modulating mechanisms, like hepatic arterial buffer response, occur to maintain stable hepatic inflow. To distinguish the unique importance of each hepatic and systemic parameter in different states during liver transplantation, we reviewed the published data and also conducted two transplant cases with different surgical strategies applied to achieve ideal portal inflow and pressure.

Acute abdominal pain with signs and symptoms of peritonitis due to sudden extravasation of chyle into the peritoneal cavity is a rare condition that is often mistaken for other disease processes. The diagnosis is rarely suspected preoperatively. We report a case of spontaneous chylous peritonitis that presented with typical symptoms of acute appendicitis such as intermittent fever and epigastric pain radiating to the lower right abdominal quadrant before admission.

Uterine perforation is one of the serious complications associated with use of the intrauterine contraceptive device (IUD). Uterine perforation by IUD can involve several neighboring organs. A case of acute appendicitis was caused by a Multiload Cu 375 IUD inserted previously. This is a rare complication and only fourteen previous cases were recorded in the literature.

Spontaneously rupture of hepatocellular carcinoma is a life threatening and worse prognosis. Not only the lower rate of resection and hemodynamic unstable, but also the hepatic failure and recurrence. Distilled water irrigation had been applied in several cancer surgeries including colon, stomach, breast, ovary, and bladder; thus had good results in lowering the tumor spreading. We applied distilled water peritoneal lavage after liver resection in patients with spontaneous rupture of hepatocellular carcinoma to define the influence of prognosis. Thirteen patients with spontaneous ruptured hepatocellular carcinoma underwent distilled water peritoneal lavage after curative liver resection (Group A). Nineteen patients with spontaneous ruptured hepatocellular carcinoma did not undergo distilled water peritoneal lavage after curative liver resection (Group B). There were 11 patients of tumor recurrence in Group B; 2 in Group A. The mean disease-free time of Group B was 2.05 +/- 0.74 years; for Group A it was 3.59 +/- 0.60 (P = 0.045). Peritoneal lavage in this series resulted in significantly better survival time for the patients in Group A (P = 0.0158). That implies distilled water peritoneal lavage during liver resection would retard the tumor recurrence and further improve the survival rate in patients with spontaneously ruptured hepatocellular carcinoma.