- Author
-
P.B. Olthof
- Title
- Enhancement of liver regeneration and liver surgery
- Supervisors
-
T.M. van Gulik
- Co-supervisors
- Award date
- 17 February 2017
- Number of pages
- 390
- ISBN
- 9789462335318
- Document type
- PhD thesis
- Faculty
- Faculty of Medicine (AMC-UvA)
- Abstract
-
Liver regeneration allows surgical resection of up to 75% of the liver and enables curative treatment potential for patients with primary or secondary hepatic malignancies. Liver surgery is associated with substantial risks, reflected by considerable morbidity and mortality rates. Optimization of several aspects in liver resection could enhance the outcomes for patients who require liver surgery. Reduction of intra-operative ischemia could improve liver function and preserve the regenerative capacity. In addition, preoperative optimization using portal vein embolization could reduce morbidity and mortality, but selection of patients for embolization remains difficult. Modulation of the bile acid farnesoid X Receptor (FXR) could be a promising alternative to stimulate lever regeneration. Also, new surgical techniques such as associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) have emerged to overcome some of these limitations, however, not without controversy. The thesis aimed to enhance liver regeneration and liver surgery by using both experimental and clinical approaches.
- Persistent Identifier
- https://hdl.handle.net/11245.1/627594cd-e307-4f19-a75d-ae63bbc905eb
- Downloads
-
Thesis (complete)
Front matter
Introduction and thesis outline
Chapter 1: Warm ischemia time-dependent variation in liver damage, inflammation, and function in hepatic ischemia/reperfusion injury
Chapter 2: IL-23 and IL-17 are not involved in hepatic ischemia reperfusion injury in mouse and man
Chapter 3: Protective mechanisms of hypothermia in liver surgery and transplantation
Chapter 4: Hypothermic perfusion with retrograde outflow improves early liver regeneration following (extended) right hemihepatectomy; results of a randomized controlled trial
Chapter 5: Postoperative peak transaminases correlate with morbidity and mortality after liver resection
Chapter 6: Use of an absorbable embolization material for reversible portal vein embolization in an experimental model
Chapter 7: Comparable liver function and volume increase following portal vein embolization in rabbits and humans
Chapter 8: Risk score for postoperative liver failure to identify patients with resectable perihilar cholangiocarcinoma who may benefit from portal vein embolization
Chapter 9: 99mTc-mebrofenin hepatobiliary scintigraphy predicts liver failure following major liver resection for perihilar cholangiocarcinoma
Chapter 10: External validation of the estimation of physiologic ability and surgical stress (E-PASS) risk model to predict operative risk in perihilar cholangiocarcinoma
Chapter 11: External biliary drainage following major liver resection for perihilar cholangiocarcinoma: impact on development of liver failure and biliary leakage
Chapter 12: Obeticholic acid accelerates liver regeneration following portal vein embolization in a rabbit model
Chapter 13: The FXR agonist obeticholic acid induces liver growth but exacerbates biliary injury in rats with obstructive cholestasis
Chapter 14: The pathophysiology of human obstructive cholestasis is mimicked in cholestatic Gold Syrian hamsters
Chapter 15: The rush to novelty and high expectations in surgery: the case of ALPPS
Chapter 16: Hepatic parenchymal transection increases liver volume but not function after portal vein embolization in rabbits
Chapter 17: Hepatobiliary scintigraphy to evaluate liver function in ALPPS - liver volume overestimates liver function
Chapter 18: Survival after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for advanced colorectal liver metastases: a case-matched comparison with palliative systemic therapy
Chapter 19: High mortality after ALPPS for perihilar cholangiocarcinoma: case-control analysis including the first series from the international ALPPS registry
Summary: Summary and future perspectives | Nederlandse samenvatting
Appendices: List of publications | List of contributing authors | PhD portfolio | Dankwoord | Curriculum vitae
Back cover
Stellingen behorend bij het proefschrift
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