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  1. Article ; Online: Laparoscopic Anatomic Liver Resection of Segment 8 Using the Transfissural Glissonean Approach: The Ton That Tung Technique Revisited.

    Turco, Célia / Lim, Chetana / Goumard, Claire / Scatton, Oliver

    Journal of the American College of Surgeons

    2020  Volume 230, Issue 5, Page(s) 836

    MeSH term(s) Aleurites ; Hepatectomy ; Humans ; Laparoscopy ; Liver/surgery
    Language English
    Publishing date 2020-04-22
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1181115-8
    ISSN 1879-1190 ; 1072-7515
    ISSN (online) 1879-1190
    ISSN 1072-7515
    DOI 10.1016/j.jamcollsurg.2020.01.003
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  2. Article ; Online: Anticipating Potential Perioperative Complication: In Reply to Monden and Colleagues.

    Turco, Célia / Lim, Chetana / Goumard, Claire / Scatton, Olivier

    Journal of the American College of Surgeons

    2020  Volume 231, Issue 4, Page(s) 499–500

    MeSH term(s) Hepatectomy ; Humans ; Laparoscopy ; Liver ; Postoperative Complications
    Language English
    Publishing date 2020-08-08
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1181115-8
    ISSN 1879-1190 ; 1072-7515
    ISSN (online) 1879-1190
    ISSN 1072-7515
    DOI 10.1016/j.jamcollsurg.2020.06.012
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  3. Article ; Online: Therapeutic potentials of mesenchymal stromal cells-derived extracellular vesicles in liver failure and marginal liver graft rehabilitation: a scoping review.

    Sitbon, Alexandre / Delmotte, Pierre-Romain / Goumard, Claire / Turco, Célia / Gautheron, Jérémie / Conti, Filomena / Aoudjehane, Lynda / Scatton, Olivier / Monsel, Antoine

    Minerva anestesiologica

    2023  Volume 89, Issue 7-8, Page(s) 690–706

    Abstract: Liver failure includes distinct subgroups of diseases: Acute liver failure (ALF) without preexisting cirrhosis, acute-on-chronic liver failure (ACLF) (severe form of cirrhosis associated with organ failures and excess mortality), and liver fibrosis (LF). ...

    Abstract Liver failure includes distinct subgroups of diseases: Acute liver failure (ALF) without preexisting cirrhosis, acute-on-chronic liver failure (ACLF) (severe form of cirrhosis associated with organ failures and excess mortality), and liver fibrosis (LF). Inflammation plays a key role in ALF, LF, and more specifically in ACLF for which we have currently no treatment other than liver transplantation (LT). The increasing incidence of marginal liver grafts and the shortage of liver grafts require us to consider strategies to increase the quantity and quality of available liver grafts. Mesenchymal stromal cells (MSCs) have shown beneficial pleiotropic properties with limited translational potential due to the pitfalls associated with their cellular nature. MSC-derived extracellular vesicles (MSC-EVs) are innovative cell-free therapeutics for immunomodulation and regenerative purposes. MSC-EVs encompass further advantages: pleiotropic effects, low immunogenicity, storage stability, good safety profile, and possibility of bioengineering. Currently, no human studies explored the impact of MSC-EVs on liver disease, but several preclinical studies highlighted their beneficial effects. In ALF and ACLF, data showed that MSC-EVs attenuate hepatic stellate cells activation, exert antioxidant, anti-inflammatory, anti-apoptosis, anti-ferroptosis properties, and promote regeneration of the liver, autophagy, and improve metabolism through mitochondrial function recovery. In LF, MSC-EVs demonstrated anti-fibrotic properties associated with liver tissue regeneration. Normothermic-machine perfusion (NMP) combined with MSC-EVs represents an attractive therapy to improve liver regeneration before LT. Our review suggests a growing interest in MSC-EVs in liver failure and gives an appealing insight into their development to rehabilitate marginal liver grafts through NMP.
    MeSH term(s) Humans ; Liver Transplantation ; Liver Failure/metabolism ; Liver Cirrhosis ; Extracellular Vesicles/metabolism ; Extracellular Vesicles/transplantation ; Mesenchymal Stem Cells/metabolism
    Language English
    Publishing date 2023-04-20
    Publishing country Italy
    Document type Review ; Journal Article
    ZDB-ID 123584-9
    ISSN 1827-1596 ; 0026-4717 ; 0375-9393
    ISSN (online) 1827-1596
    ISSN 0026-4717 ; 0375-9393
    DOI 10.23736/S0375-9393.23.17265-8
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  4. Article ; Online: Perceptions of surgical difficulty in liver transplantation: A European survey and development of the Pitié-Salpêtrière classification.

    Lim, Chetana / Turco, Célia / Goumard, Claire / Jeune, Florence / Perdigao, Fabiano / Savier, Eric / Rousseau, Géraldine / Soubrane, Olivier / Scatton, Olivier

    Surgery

    2023  Volume 174, Issue 4, Page(s) 979–993

    Abstract: Background: Significant variations exist regarding the definition of difficult liver transplantation. The study goals were to investigate how liver transplant surgeons evaluate the surgical difficulty of liver transplantation and to use the identified ... ...

    Abstract Background: Significant variations exist regarding the definition of difficult liver transplantation. The study goals were to investigate how liver transplant surgeons evaluate the surgical difficulty of liver transplantation and to use the identified factors to classify liver transplantation difficulty.
    Methods: A Web-based online European survey was presented to liver transplant surgeons. The survey was divided into 3 parts: (1) participant demographics and practices; (2) various situations based on recipient, liver disease, tumor treatment, and technical factors; and (3) 8 real-life clinical vignettes with different levels of complexity. In part 3 of the survey, respondents were asked whether they would perform liver transplantation but were not aware that these patients eventually underwent liver transplantation.
    Results: A total of 143 invites were sent out, and 97 (67.8%) participants completed the survey. Most participants considered previous spontaneous bacterial peritonitis, previous supra-mesocolic surgery, hypertrophy of segment I, and obesity to be recipient factors for high-difficulty liver transplantation. Most participants considered liver transplantation to be challenging in patients with Budd-Chiari syndrome, Kasai surgery, polycystic liver disease, diffuse portal vein thrombosis, and a history of open hepatectomy. The proportion of participants indicating that liver transplantation was warranted varied across the 8 cases, from 69% to 100%. Our classification of the surgical difficulty of liver transplantation employed these recipient-related, surgical history-related, and liver disease-related variables and 3 difficulty groups were identified: low, intermediate, and high difficulty groups.
    Conclusion: This survey provides an overview of the surgical difficulty of various situations in liver transplantation that could be useful for further benchmark and textbook outcome studies.
    MeSH term(s) Humans ; Liver Transplantation ; Budd-Chiari Syndrome/surgery ; Venous Thrombosis/surgery ; Hypertrophy ; Surveys and Questionnaires
    Language English
    Publishing date 2023-08-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2023.06.041
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  5. Article ; Online: Preclinical validation of a customized circuit for ex situ uninterrupted cold-to-warm prolonged perfusion of the liver.

    Scatton, Olivier / Turco, Célia / Savier, Eric / Pelissié, Jérôme / Legallais, Cécile / Sakka, Medhi / Aoudjehane, Lynda / Wendum, Dominique / Migliazza, John / Spiritelli, Sandra / Conti, Filomena / Goumard, Claire

    Artificial organs

    2024  

    Abstract: Context: Clinical adoption of ex situ liver perfusion is growing. While hypothermic perfusion protects against ischemia-reperfusion injury in marginal grafts, normothermic perfusion enables organ viability assessment and therefore selection of ... ...

    Abstract Context: Clinical adoption of ex situ liver perfusion is growing. While hypothermic perfusion protects against ischemia-reperfusion injury in marginal grafts, normothermic perfusion enables organ viability assessment and therefore selection of borderline grafts. The combination of hypothermic and normothermic perfusion, known as "cold-to-warm," may be the optimal sequence for organ preservation, but is difficult to achieve with most commercial perfusion systems. We developed an adaptable customized circuit allowing uninterrupted "cold-to-warm" perfusion and conducted preclinical studies on healthy porcine livers and discarded human livers to demonstrate the circuit's efficacy.
    Methods: In collaboration with bioengineers, we developed a customized circuit that adapts to extracorporeal circulation consoles used in cardiovascular surgery and includes a proprietary reservoir enabling easy perfusate change without interrupting perfusion. This preclinical study was conducted on porcine and human livers. Perfusion parameters (pressures, flows, oxygenation) and organ viability were monitored.
    Results: The customized circuit was adapted to a LivaNova S5® console, and the perfusions were flow-driven with real-time pressure monitoring. Ten porcine liver and 12 discarded human liver perfusions were performed during 14 to 18 h and 7 to 25 h, respectively. No hyperpressure was observed (porcine and human portal pressure 2-6 and 2-8 mm Hg; arterial pressure 10-65 and 20-65 mm Hg, respectively). No severe histological tissue injury was observed (Suzuki score ≤ 3 at the end of perfusion). Seven (70%) porcine livers and five (42%) human livers met the UK viability criteria.
    Conclusion: The customized circuit and system design enables smooth uninterrupted "cold-to-warm" perfusion not present in current commercial perfusion systems.
    Language English
    Publishing date 2024-03-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 441812-8
    ISSN 1525-1594 ; 0160-564X
    ISSN (online) 1525-1594
    ISSN 0160-564X
    DOI 10.1111/aor.14743
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  6. Article ; Online: Fluorescence-based pancreas stump perfusion is associated with postoperative acute pancreatitis after pancreatoduodenectomy a prospective cohort study.

    Doussot, Alexandre / Decrock, Marc / Calame, Paul / Georges, Pauline / Turco, Célia / Lakkis, Zaher / Heyd, Bruno

    Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.

    2021  

    Abstract: Background: Postoperative acute pancreatitis (POAP) emerges as a distinct pancreas-specific complication increasing both the risk and the burden of POPF after pancreatoduodenectomy. Among various risk factors, pancreas stump (PS) hypoperfusion might ... ...

    Abstract Background: Postoperative acute pancreatitis (POAP) emerges as a distinct pancreas-specific complication increasing both the risk and the burden of POPF after pancreatoduodenectomy. Among various risk factors, pancreas stump (PS) hypoperfusion might play a role in POAP occurrence but has never been investigated. The current study aimed at evaluating the feasibility of intraoperative fluorescence angiography (IOFA) of the PS using ICG and its association with POAP.
    Methods: Consecutive patients who underwent pancreatoduodenectomy for a periampullary tumor with pancreatojejunostomy and PS perfusion assessment using IOFA between January 2020 and November 2020 were prospectively included. Perioperative management and surgical strategy were standardized. IOFA of the pancreas stump was performed before fashioning pancreatojejunostomy. POAP was defined according to the Connor definition and was confirmed upon radiological blind review. Outcomes between patients with normally perfused and hypoperfused PS were compared. POAP was the primary endpoint.
    Results: Among 30 patients, nine patients (30%) developed POAP according to the Connor definition, and six patients (20%) had CT-confirmed POAP. Upon IOFA, six patients (20%) presented PS hypoperfusion; of which one patient underwent extended pancreatectomy further to the left. PS hypoperfusion was statistically associated with the occurrence of POAP (80% vs. 16%; p = 0.011) and CT-confirmed POAP (60% vs. 12%; p = 0.041). Clinically relevant POPF rate was 40% in case of PS hypoperfusion and 4% in case of normal PS perfusion (p = 0.064).
    Conclusions: PS perfusion assessment using IOFA seems safe and reliable to anticipate POAP. PS IOFA could be considered as a potential tool for perioperative assessment of surgical risk after pancreatoduodenectomy.
    Language English
    Publishing date 2021-05-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2056680-3
    ISSN 1424-3911 ; 1424-3903
    ISSN (online) 1424-3911
    ISSN 1424-3903
    DOI 10.1016/j.pan.2021.05.009
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  7. Article ; Online: Local invasion of hepatic alveolar echinococcosis should not be underestimated: Lessons learned from imaging-pathologic correlation.

    Calame, Paul / Doussot, Alexandre / Turco, Celia / Colpart, Prudence / Heyd, Bruno / Delabrousse, Eric

    Diagnostic and interventional imaging

    2021  Volume 102, Issue 3, Page(s) 189–192

    MeSH term(s) Echinococcosis, Hepatic/diagnostic imaging ; Echinococcosis, Hepatic/pathology ; Hepatectomy ; Humans ; Tomography, X-Ray Computed
    Language English
    Publishing date 2021-01-23
    Publishing country France
    Document type Case Reports ; Letter
    ZDB-ID 2648283-6
    ISSN 2211-5684 ; 2211-5684
    ISSN (online) 2211-5684
    ISSN 2211-5684
    DOI 10.1016/j.diii.2021.01.002
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  8. Article: Role of the radiologist in the diagnosis and management of the two forms of hepatic echinococcosis.

    Calame, Paul / Weck, Mathieu / Busse-Cote, Andreas / Brumpt, Eleonore / Richou, Carine / Turco, Celia / Doussot, Alexandre / Bresson-Hadni, Solange / Delabrousse, Eric

    Insights into imaging

    2022  Volume 13, Issue 1, Page(s) 68

    Abstract: Echinococcosis is a parasitic disease caused by two zoonotic tapeworms (cestodes) of the Echinocococcus genus. It can be classified as either alveolar or cystic echinococcosis. Although the two forms differ significantly in terms of imaging findings, ... ...

    Abstract Echinococcosis is a parasitic disease caused by two zoonotic tapeworms (cestodes) of the Echinocococcus genus. It can be classified as either alveolar or cystic echinococcosis. Although the two forms differ significantly in terms of imaging findings, they share similarities in terms of management and treatment. In parallel to medical treatment with albendazole (ABZ), and surgery, historically used in these diseases, various imaging-guided interventional procedures have recently emerged (drainage, stenting, or Puncture, aspiration, injection, and reaspiration (PAIR)). These options open up a new range of therapeutic options. As in oncology, multidisciplinary consultation meetings now play a major role in adapted management and patient care in hepatic echinococcosis. Consequently, diagnostic imaging and interventional expertise have brought radiologists to the fore as important members of these multidisciplinary team. The radiologist will need to evaluate parasite activity in both forms of the disease, to guide the choice of the appropriate therapy from among medical treatment, interventional radiology procedures and/or surgical treatment. Knowledge of the specific complications of the two forms of echinococcosis will also help radiologists to discuss the appropriate treatment and management. The aim of this review is to describe the core knowledge that what a radiologist should possess to actively participate in multidisciplinary meetings about hepatic echinococcosis. We discuss the role of imaging, from diagnosis to treatment, in alveolar (AE) and cystic echinococcosis (CE), respectively.
    Language English
    Publishing date 2022-04-08
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2543323-4
    ISSN 1869-4101
    ISSN 1869-4101
    DOI 10.1186/s13244-022-01190-y
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  9. Article ; Online: Preoperative prediction of inadvertent enterotomy during adhesive small bowel obstruction surgery using combination of CT features.

    Zein, Lisa / Calame, Paul / Chausset, Clara / Doussot, Alexandre / Turco, Celia / Malakhia, Alexandre / Heyd, Bruno / Lakkis, Zaher / Delabrousse, Eric

    European radiology

    2022  Volume 32, Issue 10, Page(s) 6646–6657

    Abstract: Objectives: The purpose of this study was to identify the preoperative CT features that are associated with inadvertent enterotomy (IE) during adhesive small bowel obstruction (ASBO) surgery.: Methods: From January 2015 to December 2019, all patients ...

    Abstract Objectives: The purpose of this study was to identify the preoperative CT features that are associated with inadvertent enterotomy (IE) during adhesive small bowel obstruction (ASBO) surgery.
    Methods: From January 2015 to December 2019, all patients with ASBO who underwent an abdominal CT were reviewed. Abdominal CT were retrospectively reviewed by two radiologists with a consensus read in case of disagreement. IE during ASBO surgery was retrospectively recorded. Univariate and multivariate analyses of CT features associated with IE were performed and a simple CT score was built to stratify the risk of IE. This score was validated in an independent retrospective cohort. Abdominal CT of the validation cohort was reviewed by a third independent reader.
    Results: Among the 368 patients with ASBO during the study period, 169 were surgically treated, including 129 ASBO for single adhesive band and 40 for matted adhesions. Among these, there were 47 IE. By multivariate analysis, angulation of the transitional zone (OR = 4.19, 95% CI [1.10-18.09]), diffuse intestinal adhesions (OR = 4.87, 95% CI [1.37-19.76]), a fat notch sign (OR = 0.32, 95% CI [0.12-0.85]), and mesenteric haziness (OR = 0.13, 95% CI [0.03-0.48]) were independently associated with inadvertent enterotomy occurrence. The simple CT score built to stratify risk of IE displayed an AUC of 0.85 (95% CI [0.80-0.90]) in the study sample and 0.88 (95% CI [0.80-0.96]) in the validation cohort.
    Conclusion: A simple preoperative CT score is able to inform the surgeon about a high risk of IE and therefore influence the surgical procedure.
    Key points: • In this retrospective study of 169 patients undergoing abdominal surgery for adhesive small bowel obstruction, 47 (28%) inadvertent enterotomy occurred. • A simple preoperative CT score enables accurate stratification of inadvertent enterotomy risk (area under the curve 0.85). • By multivariable analysis, diffuse intestinal adhesions and angulation of the transitional zone were predictive of inadvertent enterotomy occurrence.
    MeSH term(s) Adhesives ; Humans ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/etiology ; Intestinal Obstruction/surgery ; Intestine, Small/diagnostic imaging ; Intestine, Small/surgery ; Retrospective Studies ; Tomography, X-Ray Computed/methods
    Chemical Substances Adhesives
    Language English
    Publishing date 2022-06-28
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-022-08951-9
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  10. Article ; Online: Open Versus Laparoscopic Right Hepatectomy for Hepatocellular Carcinoma Following Sequential TACE-PVE: A Multicentric Comparative Study.

    Turco, Célia / Hobeika, Christian / Allard, Marc-Antoine / Tabchouri, Nicolas / Brustia, Raffaele / Nguyen, Tu / Cauchy, François / Barbier, Louise / Salamé, Ephrem / Cherqui, Daniel / Vibert, Eric / Soubrane, Olivier / Scatton, Olivier / Goumard, Claire

    Annals of surgical oncology

    2023  Volume 30, Issue 11, Page(s) 6615–6625

    Abstract: Background: Right hepatectomy (RH) for hepatocellular carcinoma (HCC) is ideally preceded by transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE). Laparoscopic approach improves short-term outcome and textbook outcome (TO), ...

    Abstract Background: Right hepatectomy (RH) for hepatocellular carcinoma (HCC) is ideally preceded by transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE). Laparoscopic approach improves short-term outcome and textbook outcome (TO), which reflects the "ideal" surgical outcome, after RH. However, laparoscopic RH on an underlying diseased liver and after TACE/PVE remains a challenging procedure. The aim of this study was to compare the outcomes in patients who underwent laparoscopic liver resection (LLR) or open liver resection (OLR) following TACE/PVE.
    Patients and methods: All patients with HCC who underwent RH after TACE/PVE in five French centers were retrospectively included. Outcomes were compared between the LLR group and the OLR group using propensity score matching (PSM). Quality of surgical care was defined by TO.
    Results: Between 2005 and 2019, 117 patients were included (41 in LLR group, 76 in OLR group). Overall morbidity was comparable (51% versus 53%, p = 0.24). In LLR group, TO was completed in 66% versus 37% in OLR group (p = 0.02). LLR and absence of clamping were the only factors associated with TO completion [hazard ratio (HR) 4.27, [1.77-10.28], p = 0.001]. After PSM, 5-year overall survival (OS) and progression-free survival (PFS) were 55% in matched LLR versus 77% in matched OLR, p = 0.35, and 13% in matched LLR versus 17% in matched OLR, p = 0.97. TO completion was independently associated with a better 5-year OS (65.2% versus 42.5%, p = 0.007).
    Conclusion: Major LLR after TACE/PVE should be considered as a valuable option in expert centers to increase the chance of TO, the latter being associated with a better 5-year OS.
    MeSH term(s) Humans ; Carcinoma, Hepatocellular/surgery ; Hepatectomy ; Liver Neoplasms/surgery ; Retrospective Studies ; Chemoembolization, Therapeutic ; Laparoscopy/methods ; Propensity Score ; Length of Stay ; Treatment Outcome
    Language English
    Publishing date 2023-07-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-023-13752-5
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