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Gall-Bladder and Hepatoduodenal Ligament Lymphangioma – Case Report and Literature Review

100%

Nazarewski Ł. , Patkowski W. , Pacho R. , Marczewska M. , Krawczyk M.

Polish Journal of Surgery

2013

tom 85

nr 1

39-43

Lymphangiomas are rare benign lesions of the lymphatic vessels that are most commonly diagnosed in childhood. Intraperitoneal localization is unusual as, typically, they are located in the head and neck areas. In general, abdominal lymphangiomas seem to be asymptomatic, however, patients may occasionally suffer from acute abdominal symptoms, due to intestinal obstruction or peritonitis. The study presented a case of a 41-year-old female patient, clinically asymptomatic, who was accidentally diagnosed with a multiseptated cystic lesion of the right liver lobe surrounding the gall-bladder fossa in a routine ultrasound examination. Further examinations including computed tomography and magnetic resonance (MR) aroused suspicion of a polycystic lesion of the gall-bladder and hepatoduodenal ligament. The cystic lesion of the gall-bladder and hepatoduodenal ligament filled with lymphatic fluid was diagnosed intraoperatively. Simultaneous cholecystectomy and radical resection of the cystic lesion was undertaken. The histopathological examination revealed the presence of a lymphangioma. Additionally, the authors of the study reviewed literature data concerning gall-bladder lymphangiomas.

Evolution Of The Results Of 1500 Liver Transplantations Performed In The Department Of General, Transplant And Liver Surgery Medical University Of Warsaw

30%

Krawczyk M. , Grąt M. , Grąt K. , Wronka K. , Krasnodębski M. , Stypułkowski J. , Masior Ł. , Hołówko W. , Ligocka J. , Nyckowski P. , Wróblewski T. , Paluszkiewicz R. , Patkowski W. , Zieniewicz K. , Pączek L. , Milkiewicz P. , Ołdakowska-Jedynak U. , Najnigier B. , Dudek K. , Remiszewski P. , Grzelak I. , Kornasiewicz O. , Kotulski M. , Smoter P. , Grodzicki M. , Korba M. , Kalinowski P. , Skalski M. , Zając K. , Stankiewicz R. , Przybysz M. , Cieślak B. , Nazarewski Ł. , Nowosad M. , Kobryń K. , Wasilewicz M. , Raszeja-Wyszomirska J. , Piwowarska J. , Giercuszkiewicz D. , Sańko-Resmer J. , Rejowski S. , Szydłowska-Jakimiuk M. , Górnicka B. , Wróblewska-Ziarkiewicz B. , Mazurkiewicz M. , Niewiński G. , Pawlak J. , Pacho R.

Polish Journal of Surgery

2015

tom 87

nr 5

221-230

Liver transplantation is a well-established treatment of patients with end-stage liver disease and selected liver tumors. Remarkable progress has been made over the last years concerning nearly all of its aspects. The aim of this study was to evaluate the evolution of long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery (Medical University of Warsaw). Material and methods. Data of 1500 liver transplantations performed between 1989 and 2014 were retrospectively analyzed. Transplantations were divided into 3 groups: group 1 including first 500 operations, group 2 including subsequent 500, and group 3 comprising the most recent 500. Five year overall and graft survival were set as outcome measures. Results. Increased number of transplantations performed at the site was associated with increased age of the recipients (p<0.001) and donors (p<0.001), increased rate of male recipients (p<0.001), and increased rate of piggyback operations (p<0.001), and decreased MELD (p<0.001), as well as decreased blood (p=0.006) and plasma (p<0.001) transfusions. Overall survival was 71.6% at 5 years in group 1, 74.5% at 5 years in group 2, and 85% at 2.9 years in group 3 (p=0.008). Improvement of overall survival was particularly observed for primary transplantations (p=0.004). Increased graft survival rates did not reach the level of significance (p=0.136). Conclusions. Long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery are comparable to those achieved in the largest transplant centers worldwide and are continuously improving despite increasing recipient age and wider utilization of organs procured from older donors.

1000 Liver Transplantations at the Department of General, Transplant and Liver Surgery, Medical University of Warsaw - Analysis of Indications and Results

26%

Krawczyk M. , Grąt M. , Barski K. , Ligocka J. , Antczak A. , Kornasiewicz O. , Skalski M. , Patkowski W. , Nyckowski P. , Zieniewicz K. , Grzelak I. , Pawlak J. , Alsharabi A. , Wróblewski T. , Paluszkiewicz R. , Najnigier B. , Dudek K. , Remiszewski P. , Smoter P. , Grodzicki M. , Korba M. , Kotulski M. , Cieślak B. , Kalinowski P. , Gierej P. , Frączek M. , Rdzanek Ł. , Stankiewicz R. , Kobryń K. , Nazarewski Ł. , Leonowicz D. , Urban-Lechowicz M. , Skwarek A. , Giercuszkiewicz D. , Paczkowska A. , Piwowarska J. , Gelo R. , Andruszkiewicz P. , Brudkowska A. , Andrzejewska R. , Niewiński G. , Kilińska B. , Zarzycka A. , Nowak R. , Kosiński C. , Korta T. , Ołdakowska-Jedynak U. , Sańko-Resmer J. , Foroncewicz B. , Ziółkowski J. , Mucha K. , Senatorski G. , Pączek L. , Habior A. , Lechowicz R. , Polański S. , Leowska E. , Pacho R. , Andrzejewska M. , Rowiński O. , Kozieł S. , Żurakowski J. , Ziarkiewicz-Wróblewska B. , Górnicka B. , Hevelke P. , Michałowicz B. , Karwowski A. , Szczerbań J.

Polish Journal of Surgery

2012

tom 84

nr 6

304-312

The aim of the study was to analyze indications and results of the first one thousand liver transplantations at Chair and Clinic of General, Transplantation and Liver Surgery, Medical University of Warsaw.Material and methods. Data from 1000 transplantations (944 patients) performed at Chair and Clinic of General, Transplantation and Liver Surgery between 1994 and 2011 were analyzed retrospectively. These included 943 first transplantations and 55 retransplantations and 2 re-retransplantations. Frequency of particular indications for first transplantation and retransplantations was established. Perioperative mortality was defined as death within 30 days after the transplantation. Kaplan-Meier survival analysis was used to estimate 5-year patient and graft survival.Results. The most common indications for first transplantation included: liver failure caused by hepatitis C infection (27.8%) and hepatitis B infection (18%) and alcoholic liver disease (17.7%). Early (< 6 months) and late (> 6 months) retransplantations were dominated by hepatic artery thrombosis (54.3%) and recurrence of the underlying disease (45%). Perioperative mortality rate was 8.9% for first transplantations and 34.5% for retransplantations. Five-year patient and graft survival rate was 74.3% and 71%, respectively, after first transplantations and 54.7% and 52.9%, respectively, after retransplantations.Conclusions. Development of liver transplantation program provided more than 1000 transplantations and excellent long-term results. Liver failure caused by hepatitis C and B infections remains the most common cause of liver transplantation and structure of other indications is consistent with European data.