JAIME ARTHUR PIROLA KRUGER
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
2 resultados
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- Liver resection for hepatolithiasis: A multicenter experience in Latin America(2023) GARCIA, Daniel; MARINO, Carlo; COELHO, Fabricio Ferreira; REBOLLEDO, Patricia; ACHURRA, Pablo; FONSECA, Gilton Marques; KRUGER, Jaime A. P.; VINUELA, Eduardo; BRICENO, Eduardo; D'ALBUQUERQUE, Luiz Carneiro; JARUFE, Nicolas; MARTINEZ, Jorge A.; HERMAN, Paulo; DIB, Martin J.Background: Hepatolithiasis is a prevalent disease in Asia but rare in Western countries. An increasing number of cases have been reported in Latin America. Liver resection has been proposed as a definitive treatment for complete stone clearance. The aim of this study was to evaluate the postoperative out-comes of liver resection for the treatment of hepatolithiasis in 2 large hepatobiliary reference centers from South America.Methods: We conducted a retrospective descriptive analysis from patients with hepatolithiasis who underwent liver resection between November 1986 and December 2018, in 2 Latin-American centers in Chile and Brazil.Results: One hundred forty-nine patients underwent liver resection for hepatolithiasis (72 in Chile, 77 in Brazil). The mean age was 49 years and most patients were female (62.4%). Hepatolithiasis was localized in the left lobe (61.7%), right lobe (24.2%), and bilateral lobe (14.1%). Bilateral lithiasis was associated with higher incidence of preoperative and postoperative cholangitis (81% vs 46.9% and 28.6% vs 6.1%) and need for hepaticojejunostomy (52.4%). In total, 38.9% of patients underwent major hepatectomy and 14.1% were laparoscopic. The postoperative stone clearance was 100%. The 30-day morbidity and mortality rates were 30.9% and 0.7%, respectively. Cholangiocarcinoma was seen in 2 specimens, and no post-operative malignancy were seen after a median follow-up of 38 months. Fourteen patients (9.4%) had intrahepatic stones recurrence.Conclusions: Liver resection is an effective and definitive treatment for patients with hepatolithiasis. Bilateral hepatolithiasis was associated with perioperative cholangitis, the need for hepaticojejunostomy, and recurrent disease. Resection presents a high rate of biliary tree stone clearance and excellent long-term results, with low recurrence rates and low risk of malignancy.(c) 2022 Elsevier Inc. All rights reserved.
- Laparoscopic Liver Resection: A South American Experience with 2887 Cases(2020) PEKOLJ, J.; SANCHEZ, R. Claria; SALCEDA, J.; MAURETTE, R. J.; SCHELOTTO, P. B.; PIERINI, L.; CANEPA, E.; MORO, M.; STORK, G.; RESIO, N.; NEFFA, J.; CORMACK, L. Mc; QUINONEZ, E.; RAFFIN, G.; OBEIDE, L.; FERNANDEZ, D.; PFAFFEN, G.; SALAS, C.; LINZEY, M.; SCHMIDT, G.; RUIZ, S.; ALVAREZ, F.; BUFFALIZA, J.; MARONI, R.; CAMPI, O.; BERTONA, C.; SANTIBANES, M. de; MAZZA, O.; OLIVEIRA, M. Belotto de; DINIZ, A. L.; OLIVEIRA, M. Enne de; MACHADO, M. A.; KALIL, A. N.; PINTO, R. D.; REZENDE, A. P.; RAMOS, E. J. B.; OLIVEIRA, A. Talvane T.; TORRES, O. J. M.; CASSIS, N. Jarufe; BUCKEL, E.; TORRES, R. Quevedo; CHAPOCHNICK, J.; GARCIA, M. Sanhueza; MUNOZ, C.; CASTRO, G.; LOSADA, H.; SUAREZ, F. Vergara; GUEVARA, O.; DAVILA, D.; PALACIOS, O.; JIMENEZ, A.; POGGI, L.; TORRES, V.; FONSECA, G. M.; KRUGER, J. A. P.; COELHO, F. F.; RUSSO, L.; HERMAN, P.Background Laparoscopic liver resections (LLR) have been increasingly performed in recent years. Most of the available evidence, however, comes from specialized centers in Asia, Europe and USA. Data from South America are limited and based on single-center experiences. To date, no multicenter studies evaluated the results of LLR in South America. The aim of this study was to evaluate the experience and results with LLR in South American centers. Methods From February to November 2019, a survey about LLR was conducted in 61 hepatobiliary centers in South America, composed by 20 questions concerning demographic characteristics, surgical data, and perioperative results. Results Fifty-one (83.6%) centers from seven different countries answered the survey. A total of 2887 LLR were performed, as follows: Argentina (928), Brazil (1326), Chile (322), Colombia (210), Paraguay (9), Peru (75), and Uruguay (8). The first program began in 1997; however, the majority (60.7%) started after 2010. The percentage of LLR over open resections was 28.4% (4.4-84%). Of the total, 76.5% were minor hepatectomies and 23.5% major, including 266 right hepatectomies and 343 left hepatectomies. The conversion rate was 9.7%, overall morbidity 13%, and mortality 0.7%. Conclusions This is the largest study assessing the dissemination and results of LLR in South America. It showed an increasing number of centers performing LLR with the promising perioperative results, aligned with other worldwide excellence centers.