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Vicente E.,Madrid Norte Sanchinarro San Pablo University Hospital | Quijano Y.,Madrid Norte Sanchinarro San Pablo University Hospital | Ielpo B.,Madrid Norte Sanchinarro San Pablo University Hospital | Duran H.,Madrid Norte Sanchinarro San Pablo University Hospital | And 5 more authors.
Updates in Surgery | Year: 2015

Aim of this study is to assess the incidence and outcome of small for size syndrome after ALPPS procedure. This novel procedure is claimed to induce accelerated and increased growth of future liver remnant after major hepatectomies. We prospectively collected data on nine consecutive patients undergoing ALPPS procedure at our center. Main patients’ characteristics, outcome and postoperative complications, including small for size syndrome were analyzed. Main interval between two stages of ALPPS was 15.1 days. Mean future liver remnant hypertrophy was 93.2 %. Severe complications occurred in 44.4 % of patients and mortality occurred in two cases (22.2 %). Small for size syndrome occurred in two cases (22.2 %). The first one was detected intraoperatively during first stage. It was successfully managed by spleno-renal venous shunt. Second case was not promptly detected and died on postoperative day 64. This case series provides evidence that SFFS can be an important complication after ALPPS procedure. If it is not promptly detected and properly managed it can be a cause of death as occurred in our case. © 2015, Italian Society of Surgery (SIC). Source


Ielpo B.,Madrid Norte Sanchinarro San Pablo University Hospital | Caruso R.,Madrid Norte Sanchinarro San Pablo University Hospital | Prestera A.,Madrid Norte Sanchinarro San Pablo University Hospital | De Luca G.M.,Madrid Norte Sanchinarro San Pablo University Hospital | And 6 more authors.
Journal of the Pancreas | Year: 2015

Context Arterial pseudoaneurysm is an uncommon lethal complication following hepato-pancreato-biliary surgery. Objective Aim of this study is to present and discuss the experience of a high volume oncological center. Methods Since 2007 all major surgeries performed at Sanchinarro Oncological Center have been included in a prospective database looking for postoperative arterial pseudoaneurysm. Results Until June 2014, among 559 hepato-pancreato-biliary procedures, a total of 14 arterial pseudoaneurysms have been identified (2.5%). Sentinel bleeding was in 57% of cases. Failed arterial embolization occurred in 2 cases. Overall mortality rate was 28.5%. We also identified 3 asymptomatic pseudoaneurysms, one of them managed without embolization, developing a sudden bleeding and died after surgery. Conclusions According to our experience, pseudoaneurysm incidence is higher than reported in current literature and it can be successfully managed through arterial embolization. Furthermore, we found 3 asymptomatic pseudoaneurysms, whose management is still controversial. © 2015, E.S. Burioni Ricerche Bibliografiche. All rights reserved. Source


Quijano Y.,Madrid Norte Sanchinarro San Pablo University Hospital | Vicente E.,Madrid Norte Sanchinarro San Pablo University Hospital | Ielpo B.,Madrid Norte Sanchinarro San Pablo University Hospital | Duran H.,Madrid Norte Sanchinarro San Pablo University Hospital | And 9 more authors.
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques | Year: 2016

Introduction: The use of robotic surgery in liver resection is still limited. Our aim is to present our early experience of robotic liver resection. Materials and Methods: It is a retrospective review of Sanchinarro University hospital experience of robotic liver resection performed from 2011 to 2014. Clinicopathologic characteristics, and perioperative and postoperative outcomes were recorded and analyzed. Results: Twenty-one procedures have been performed and 13 (65%) of them were for malignancy. There were 2 left hepatectomies, 1 right hepatectomy, 1 associated liver partition and portal vein ligation staged procedure (both steps by robotic approach), 1 bisegmentectomy and 3 segmentectomies, 9 wedge resections, and 3 pericystectomies. The mean operating time was 282 minutes (range, 90 to 540 min). Overall conversion rate and postoperative complication rate were 4.7% and 19%, respectively. The mean length of hospital stay was 13.4 days (range, 4 to 64 d). Conclusion: From our early experience, robotic liver surgery is a safe and feasible procedure, especially for major hepatectomies. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source

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