Surgical treatment of hepato-pancreato-biliary disease in China: the Tongji experience

Abstract

Hepato-pancreato-biliary (HPB) tumors are common in China. However, these tumors are often diagnosed at intermediate/advanced stages because of the lack of a systemic surveillance program in China. This situation creates many technical challenges for surgeons and increases the incidence of postoperative complications. Therefore, Dr. Xiao-Ping Chen has made many important technical improvements, such as Chen's hepatic portal occlusion method, the anterior approach for liver resection of large HCC tumors, the modified technique of Belghiti's liver-hanging maneuver, inserting biliary-enteric anastomosis technique, and invaginated pancreaticojujunostomy with transpancreatic U-sutures. These techniques are simple, practical, and easy to learn. Owing to these advantages, complicated surgical procedures can be simplified, and the curative effects are greatly improved. These improved techniques have been widely applied in China and will benefit many additional patients. In this review, we introduce our experience of surgically treating intermediate/advanced hepatocellular carcinoma (HCC), hilar cholangiocarcinoma (HC), and pancreatic carcinoma, mainly focusing on technical innovations established by Dr. Chen in HPB surgery. hepatocellular carcinoma, liver transplantation, hilar cholangiocarcinoma, pancreaticojejunostomy

Anatomical Resection Improved the Outcome of Intrahepatic Cholangiocarcinoma: A Propensity Score Matching Analysis of a Retrospective Cohort

“…ough surgical treatments improve the survival of ICC patients, systematic surveillance among patients with high-risk factors is necessary to avoid a late diagnosis of ICC in intermediate/ advanced stages [33].…”

“…HCC arising from hepatocytes and ICC from bile duct epithelium are major types of primary liver cancer [ 31 , 32 ]. ICC is located in the second-order bile ducts in the hepatic parenchyma, extinguished with pCCA in left and right common hepatic ducts and dCCA in common bile duct [ 33 ]. ICC can be classified as mass-forming, periductal infiltrating, and intraductal growth types by morphology [ 34 , 35 ].…”

The role of apparent diffusion coefficient values in characterization of solid focal liver lesions: a prospective and comparative clinical study

“…Accurate detection and characterization of solid focal liver lesions (FLLs) is important in clinical work, especially for patients with malignant FLLs, such as hepatocellular carcinoma (HCC) and metastases (Yau et al, 2014;Zhang et al, 2016;Yu et al, 2013). Cysts and hemangiomas can be easily characterized on the basis of their marked and homogeneous high signal intensity on T2-weighted images (T2WI).…”

Resection might be a meaningful choice for hepatocellular carcinoma with portal vein thrombosis

“…Third, therapy for HCC should be an individualized comprehensive treatment based on a surgical operation. [38] Many therapeutic treatments for HCC are currently available. More than 1 treatment should be suggested to obtain a multidisciplinary advantage.…”