11 research outputs found
Experience With Radical Resection in The Management of Proximal Bile Duct Cancer
Multiple surgical and nonsurgical approaches have been advocated for the treatment of proximal bile duct
cancer. However, survival appears longest when a resection can be performed. Fifteen patients treated at a
university center were managed with an aggressive surgical approach. Resection of the tumor was
performed in 13 of 15 patients (87%). Of the patients undergoing resection, major hepatic resection was
performed in 8 (62%), while excision of vessels with reconstruction was performed in 5 (38%). Eleven of
the 13 resected patients (85%) were discharged from the hospital. Clinical symptoms of recurrent disease
occurred between 3 and 36 months after surgery in 7 patients, 6 of whom have died. Three other patients
are alive at 5, 21, and 36 months without clinical evidence of recurrence. There was no correlation between
the completeness of resection and the duration of disease-free survival
Recommended from our members
Promising early results with immunosuppression using rabbit anti-thymocyte globulin and steroids with delayed introduction of tacrolimus in adult liver transplant recipients
Induction therapy with T-cell depleting drugs in liver transplantation is controversial. This study examined the use of rabbit antithymocyte globulin (RATG) with delayed introduction of tacrolimus in liver transplant recipients. Additional subgroup analysis compared patients with or without hepatitis C (HCV) cirrhosis. Over 17 months, 116 adults received 120 liver allografts. Four patients who died before receiving RATG were excluded. Immunosuppression included steroids, 3 doses of RATG (2 mg/kg), and tacrolimus started on postoperative day 3 to 4. Ninety-six percent of patients were alive with a mean follow-up of 12.9±4.5 months. No graft was lost to rejection. Two patients developed hepatic artery thrombosis. Six percent of patients had acute rejection. No patient had steroid resistant or recurrent rejection. RATG related drug events were limited to fever, chills, tachycardia, and oxygen desaturation. There were no cases of lymphoproliferative disease. Forty-two percent of patients were transplanted for HCV. Thirty-two percent of HCV-patients had biopsy proven hepatitis C recurrence occurring at 4 weeks to 10 months posttransplant. RATG induction therapy is associated with good patient and graft survival, a low incidence of rejection, and minimal side effects. In addition, RATG induction is safe in patients transplanted for HCV. (Liver Transpl 2004; 10:404-407.)