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  1. Book ; Online: Surgical Treatment of Hilar and Intrahepatic Cholangiocarcinoma

    Guglielmi, Alfredo / Iacono, Calogero / Ruzzenente, Andrea

    2008  

    Author's details by Alfredo Guglielmi, Andrea Ruzzenente, Calogero Iacono
    Keywords Abdomen/Clinical medicine ; Gastroenterology ; Surgery
    Language English
    Publisher Springer-Verlag
    Publishing place Milano
    Document type Book ; Online
    HBZ-ID TT050387988
    ISBN 978-88-470-0728-4 ; 978-88-470-0729-1 ; 88-470-0728-3 ; 88-470-0729-1
    DOI 10.1007/978-88-470-0729-1
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Book: Surgical treatment of hilar and intrahepatic cholangiocarcinoma

    Guglielmi, Alfredo / Ruzzenente, Andrea / Iacono, Calogero

    2008  

    Author's details Alfredo Guglielmi ; Andrea Ruzzenente ; Calogero Iacono
    Keywords Cholangiocarcinoma / surgery ; Cholangiocarcinoma / diagnosis ; Surgical Procedures, Operative
    Language English
    Size XIII, 241 S. : Ill., graph. Darst., 235 mm x 155 mm
    Publisher Springer
    Publishing place Milan
    Publishing country Italy
    Document type Book
    HBZ-ID HT015434355
    ISBN 978-88-470-0728-4 ; 88-470-0728-3 ; 9788847007291 ; 8847007291
    Database Catalogue ZB MED Medicine, Health

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  3. Article ; Online: The Role of Surgery in the Treatment of Bismuth-Corlette Type IV Perihilar Cholangiocarcinoma.

    Alaimo, Laura / Bagante, Fabio / Ruzzenente, Andrea

    Annals of surgical oncology

    2021  Volume 28, Issue 12, Page(s) 7730

    MeSH term(s) Bile Duct Neoplasms/surgery ; Bile Ducts, Intrahepatic ; Bismuth ; Cholangiocarcinoma/surgery ; Humans ; Klatskin Tumor/surgery
    Chemical Substances Bismuth (U015TT5I8H)
    Language English
    Publishing date 2021-04-21
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-021-09980-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: A novel use of the comprehensive complication index in perihilar cholangiocarcinoma surgery.

    Poletto, Edoardo / Conci, Simone / Campagnaro, Tommaso / De Bellis, Mario / Alaimo, Laura / Ruzzenente, Andrea

    Hepatobiliary surgery and nutrition

    2023  Volume 13, Issue 1, Page(s) 139–142

    Language English
    Publishing date 2023-12-28
    Publishing country China (Republic : 1949- )
    Document type Editorial
    ZDB-ID 2812398-0
    ISSN 2304-389X ; 2304-3881
    ISSN (online) 2304-389X
    ISSN 2304-3881
    DOI 10.21037/hbsn-23-585
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Trends in hospital volume and operative mortality in hepato-biliary surgery in Veneto region, Italy.

    Guglielmi, Alfredo / Tripepi, Marzia / Salmaso, Laura / Fedeli, Ugo / Ruzzenente, Andrea / Saia, Mario

    Updates in surgery

    2023  Volume 75, Issue 7, Page(s) 1949–1959

    Abstract: Hepatobiliary resections are among the most complex and technically challenging surgical procedures. Even though robust evidence showed that complex surgical procedures such as hepatobiliary surgery have better short- and long-term outcomes and lower ... ...

    Abstract Hepatobiliary resections are among the most complex and technically challenging surgical procedures. Even though robust evidence showed that complex surgical procedures such as hepatobiliary surgery have better short- and long-term outcomes and lower mortality rate when performed in high-volume centers, the minimal criteria of centers that can perform hepatobiliary activity are not clearly defined. We conducted a retrospective population study of patients who underwent hepatobiliary surgery for malignant disease in a single Italian administrative region (Veneto) from 2010 to 2021 with the aim to investigate the hospitals annual surgical volume for hepatobiliary malignant diseases and the effect of hospital volume on in-hospital, 30- and 90-day postoperative mortality. The centralization process of hepatobiliary surgery in Veneto is rapidly increasing over the past 10 years (rate of performed in highly specialized centers increased from 62% in 2010 to 78% in 2021) and actually it is really established. The crude and adjusted (for age, sex, Charlson Index) mortality rate after hepatobiliary surgery resulted significantly lower in centers with high-volume activity compared to them with low-volume activity. In the Veneto region, the "Hub and Spoke" model led to a progressive centralization of liver and biliary cancer treatment. High surgical volume has been confirmed to be related to better outcomes in terms of mortality rate after hepatobiliary surgical procedures. Further studies are necessary to clearly define the minimal criteria and associated numerical cutoffs that can help define the characteristics of centers that can perform hepatobiliary activities.
    MeSH term(s) Humans ; Retrospective Studies ; Hospitals ; Biliary Tract Surgical Procedures ; Hospital Mortality ; Biliary Tract Neoplasms/surgery ; Italy/epidemiology ; Hospitals, High-Volume
    Language English
    Publishing date 2023-07-03
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-023-01574-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Book ; Online: Ecografia e procedure interventistiche percutanee

    D’Onofrio, Mirko / Ruzzenente, Andrea

    Fegato, vie biliari e pancreas

    2008  

    Author's details by Mirko D’Onofrio, Andrea Ruzzenente
    Keywords Clinical medicine ; Gastroenterology ; Interventional radiology ; Radiology, Medical
    Language Italian
    Publisher Springer-Verlag Italia
    Publishing place Milano
    Document type Book ; Online
    HBZ-ID TT050388009
    ISBN 978-88-470-1061-1 ; 978-88-470-1062-8 ; 88-470-1061-6 ; 88-470-1062-4
    DOI 10.1007/978-88-470-1062-8
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  7. Article ; Online: Perihilar cholangiocarcinoma: three-dimensional modelling algorithm to estimate tumour extension and bile duct resection margins.

    Ruzzenente, Andrea / Alaimo, Laura / D'Onofrio, Mirko / Marchese, Andrea / Roman, Diletta / Conci, Simone / De Bellis, Mario / Pedrazzani, Corrado / Campagnaro, Tommaso / Guglielmi, Alfredo

    The British journal of surgery

    2024  Volume 111, Issue 1

    MeSH term(s) Humans ; Klatskin Tumor/surgery ; Margins of Excision ; Bile Ducts ; Bile Duct Neoplasms/surgery
    Language English
    Publishing date 2024-01-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znad428
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: The Role of Three-Dimensional Modeling to Improve Comprehension of Liver Anatomy and Tumor Characteristics for Medical Students and Surgical Residents.

    Alaimo, Laura / Marchese, Andrea / Vignola, Damiano / Roman, Diletta / Conci, Simone / De Bellis, Mario / Pedrazzani, Corrado / Campagnaro, Tommaso / Manzini, Gessica / Guglielmi, Alfredo / Ruzzenente, Andrea

    Journal of surgical education

    2024  Volume 81, Issue 4, Page(s) 597–606

    Abstract: Objective: Studying liver anatomy can be challenging for medical students and surgical residents due to its complexity. Three-dimensional visualization technology (3DVT) allows for a clearer and more precise view of liver anatomy. We sought to assess ... ...

    Abstract Objective: Studying liver anatomy can be challenging for medical students and surgical residents due to its complexity. Three-dimensional visualization technology (3DVT) allows for a clearer and more precise view of liver anatomy. We sought to assess how 3DVT can assist students and surgical residents comprehend liver anatomy.
    Design: Data from 5 patients who underwent liver resection for malignancy at our institution between September 2020 and April 2022 were retrospectively reviewed and selected following consensus among the investigators. Participants were required to complete an online survey to investigate their understanding of tumor characteristics and vascular variations based on patients' computed tomography (CT) and 3DVT.
    Setting: The study was carried out at the General and Hepato-Biliary Surgery Department of the University of Verona.
    Participants: Among 32 participants, 13 (40.6%) were medical students, and 19 (59.4%) were surgical residents.
    Results: Among 5 patients with intrahepatic lesions, 4 patients (80.0%) had at least 1 vascular variation. Participants identified number and location of lesions more correctly when evaluating the 3DVT (84.6% and 80.9%, respectively) compared with CT scans (61.1% and 64.8%, respectively) (both p ≤ 0.001). The identification of any vascular variations was more challenging using the CT scans, with only 50.6% of correct answers compared with 3DVT (72.2%) (p < 0.001). Compared with CT scans, 3DVT led to a 23.5%, 16.1%, and 21.6% increase in the correct definition of number and location of lesions, and vascular variations, respectively. 3DVT allowed for a decrease of 50.8 seconds (95% CI 23.6-78.0) in the time needed to answer the questions. All participants agreed on the usefulness of 3DVT in hepatobiliary surgery.
    Conclusions: The 3DVT facilitated a more precise preoperative understanding of liver anatomy, tumor location and characteristics.
    MeSH term(s) Humans ; Retrospective Studies ; Internship and Residency ; Students, Medical ; Comprehension ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/surgery ; Imaging, Three-Dimensional/methods
    Language English
    Publishing date 2024-02-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2023.12.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Portal vein stenting in recurrent or locally advanced peri-hilar cholangiocarcinoma.

    De Bellis, Mario / Contro, Alberto / Bianco, Andrea / Gasparini, Clizia / Tripepi, Marzia / La Raja, Matilde / Alaimo, Laura / Conci, Simone / Campagnaro, Tommaso / Guglielmi, Alfredo / Mansueto, Giancarlo / Ruzzenente, Andrea

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2024  Volume 50, Issue 3, Page(s) 107984

    Abstract: Background: Recurrent or locally advanced peri-hilar cholangiocarcinoma (PHCC) usually involves the portal vein (PV) leading to significant stenosis. With disease progression, clinical symptoms such as ascites, bleeding, and hepatic insufficiency are ... ...

    Abstract Background: Recurrent or locally advanced peri-hilar cholangiocarcinoma (PHCC) usually involves the portal vein (PV) leading to significant stenosis. With disease progression, clinical symptoms such as ascites, bleeding, and hepatic insufficiency are usually observed. Little is know about the benefit of PV stenting in relieving the symptoms associated to portal hypertension and allowing anticancer therapies. The aim of this study is to review our experience in PV stenting for PHCC patients.
    Methods: From 2014 to 2022, data from PHCC patients underwent PV stenting at Verona University Hospital, Italy, were reviewed. The indications were: gastrointestinal bleeding from esophagus-gastric varices, ascites not responsive to medical therapy, severe thrombocytopenia, liver insufficiency (hepatic jaundice, coagulopathy, and/or hyperammoniemia), or asymptomatic high-grade PV stenosis. Cavernous transformation and intrahepatic thrombosis in both sides of the liver were considered contraindication. Systematic anticoagulation therapy was not administered.
    Results: Technical success was achieved in all 16 (100 %) patients. The improvement of clinical symptoms were observed in 12 (75 %) patients. Anticancer therapy was administrated in 11 (69 %) patients. 2 (13 %) complications were observed: 1 biliary injury and 1 recurrent cholangitis that required a percutaneous trans-hepatic biliary drainage placement. Stent occlusion for tumor progression occurred in 1 patient and a re-stenting procedure was successfully performed. No case of thrombotic stent occlusion was observed during follow up. The 1-year stent patency was 86 % and the median patency period was 8 months (IQR, 4-12).
    Conclusion: PV stenting is a feasible and safe palliative treatment that improves clinical condition, allow anticancer therapies, and provide a better quality of life.
    MeSH term(s) Humans ; Klatskin Tumor/pathology ; Portal Vein/surgery ; Treatment Outcome ; Constriction, Pathologic/etiology ; Ascites/etiology ; Quality of Life ; Cholangiocarcinoma/surgery ; Cholangiocarcinoma/pathology ; Bile Ducts, Intrahepatic/surgery ; Bile Ducts, Intrahepatic/pathology ; Bile Duct Neoplasms/surgery ; Bile Duct Neoplasms/complications ; Stents/adverse effects ; Retrospective Studies
    Language English
    Publishing date 2024-01-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2024.107984
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: The Relevance of Radial Margin Status in Perihilar Cholangiocarcinoma: A State-of-the-Art Narrative Review.

    De Bellis, Mario / Mastrosimini, Maria Gaia / Capelli, Paola / Alaimo, Laura / Conci, Simone / Campagnaro, Tommaso / Pecori, Sara / Scarpa, Aldo / Guglielmi, Alfredo / Ruzzenente, Andrea

    Digestive surgery

    2024  Volume 41, Issue 2, Page(s) 92–102

    Abstract: Background: Prognosis of perihilar cholangiocarcinoma (PHCC) is poor, and curative-intent resection is the most effective treatment associated with long-term survival. Surgery is technically demanding since it involves a major hepatectomy with en bloc ... ...

    Abstract Background: Prognosis of perihilar cholangiocarcinoma (PHCC) is poor, and curative-intent resection is the most effective treatment associated with long-term survival. Surgery is technically demanding since it involves a major hepatectomy with en bloc resection of the caudate lobe and extrahepatic bile duct. Furthermore, to achieve negative margins, it may be necessary to perform concomitant vascular resection or pancreatoduodenectomy. Despite this aggressive approach, recurrence is often observed, considering 5-year recurrence-free survival below 15% and 5-year overall survival that barely exceeds 40%.
    Summary: The literature reports that survival rates are better in patients with negative margins, and surprisingly, R0 resections range between 19% and 95%. This variability is probably due to different surgical strategies and the pathologist's expertise with specimens. In fact, a proper pathological examination of residual disease should take into consideration both the ductal and the radial margin (RM) status. Currently, detailed pathological reports are lacking, and there is a likelihood of misinterpreting residual disease status due to the missing of RM description and the utilization of various definitions for surgical margins.
    Key messages: The aim of PHCC surgery is to achieve negative margins including RM. More clarity in reporting on RM is needed to define true radical resection and consistent design of oncological studies for adjuvant treatments.
    MeSH term(s) Humans ; Klatskin Tumor/surgery ; Klatskin Tumor/pathology ; Margins of Excision ; Survival Analysis ; Retrospective Studies ; Hepatectomy ; Bile Duct Neoplasms/pathology ; Cholangiocarcinoma
    Language English
    Publishing date 2024-03-06
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 605888-7
    ISSN 1421-9883 ; 0253-4886
    ISSN (online) 1421-9883
    ISSN 0253-4886
    DOI 10.1159/000535995
    Database MEDical Literature Analysis and Retrieval System OnLINE

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