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Ramírez-Maldonado E, López Gordo S, Major Branco RP, Pavel MC, Estalella L, Llàcer-Millán E, Guerrero MA, López-Gordo E, Memba R, Jorba R. Clinical Application of Liquid Biopsy in Pancreatic Cancer: A Narrative Review. Int J Mol Sci 2024; 25:1640. [PMID: 38338919 PMCID: PMC10855073 DOI: 10.3390/ijms25031640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/21/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Pancreatic ductal adenocarcinoma contributes significantly to global cancer-related deaths, featuring only a 10% survival rate over five years. The quest for novel tumor markers is critical to facilitate early diagnosis and tailor treatment strategies for this disease, which is key to improving patient outcomes. In pancreatic ductal adenocarcinoma, these markers have been demonstrated to play a crucial role in early identification, continuous monitoring, and prediction of its prognosis and have led to better patient outcomes. Nowadays, biopsy specimens serve to ascertain diagnosis and determine tumor type. However, liquid biopsies present distinct advantages over conventional biopsy techniques. They offer a noninvasive, easily administered procedure, delivering insights into the tumor's status and facilitating real-time monitoring. Liquid biopsies encompass a variety of elements, such as circulating tumor cells, circulating tumor DNA, extracellular vesicles, microRNAs, circulating RNA, tumor platelets, and tumor endothelial cells. This review aims to provide an overview of the clinical applications of liquid biopsy as a technique in the management of pancreatic cancer.
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Affiliation(s)
- Elena Ramírez-Maldonado
- HBP Unit, General Surgery Department, Joan XXIII University Hospital, 43005 Tarragona, Spain; (M.-C.P.); (L.E.); (M.A.G.); (R.M.); (R.J.)
- Medicine and Surgery Department, Rovira i Virgili University, 43204 Reus, Spain
| | - Sandra López Gordo
- General Surgery Department, Maresme Health Consortium, 08304 Mataro, Spain;
| | | | - Mihai-Calin Pavel
- HBP Unit, General Surgery Department, Joan XXIII University Hospital, 43005 Tarragona, Spain; (M.-C.P.); (L.E.); (M.A.G.); (R.M.); (R.J.)
- Medicine and Surgery Department, Rovira i Virgili University, 43204 Reus, Spain
| | - Laia Estalella
- HBP Unit, General Surgery Department, Joan XXIII University Hospital, 43005 Tarragona, Spain; (M.-C.P.); (L.E.); (M.A.G.); (R.M.); (R.J.)
- Medicine and Surgery Department, Rovira i Virgili University, 43204 Reus, Spain
| | - Erik Llàcer-Millán
- HBP Unit, General Surgery Department, Joan XXIII University Hospital, 43005 Tarragona, Spain; (M.-C.P.); (L.E.); (M.A.G.); (R.M.); (R.J.)
- Medicine and Surgery Department, Rovira i Virgili University, 43204 Reus, Spain
| | - María Alejandra Guerrero
- HBP Unit, General Surgery Department, Joan XXIII University Hospital, 43005 Tarragona, Spain; (M.-C.P.); (L.E.); (M.A.G.); (R.M.); (R.J.)
- Medicine and Surgery Department, Rovira i Virgili University, 43204 Reus, Spain
| | | | - Robert Memba
- HBP Unit, General Surgery Department, Joan XXIII University Hospital, 43005 Tarragona, Spain; (M.-C.P.); (L.E.); (M.A.G.); (R.M.); (R.J.)
- Medicine and Surgery Department, Rovira i Virgili University, 43204 Reus, Spain
| | - Rosa Jorba
- HBP Unit, General Surgery Department, Joan XXIII University Hospital, 43005 Tarragona, Spain; (M.-C.P.); (L.E.); (M.A.G.); (R.M.); (R.J.)
- Medicine and Surgery Department, Rovira i Virgili University, 43204 Reus, Spain
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Jorba R, Pavel MC, Llàcer-Millán E, Memba R. Robotic Pancreatoduodenectomy (I): Standardization of the resective phase in 4 steps. Cir Esp 2023; 101:708. [PMID: 36963630 DOI: 10.1016/j.cireng.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/19/2022] [Accepted: 01/07/2023] [Indexed: 03/26/2023]
Affiliation(s)
- Rosa Jorba
- Unidad de Cirugía HBP, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain.
| | - Mihai C Pavel
- Unidad de Cirugía HBP, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - Erik Llàcer-Millán
- Unidad de Cirugía HBP, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - Robert Memba
- Unidad de Cirugía HBP, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
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Llàcer-Millán E, Pavel MC, Memba R, Coronado D, González S, Achalandabaso M, Estalella L, Julià-Verdaguer E, Padilla-Zegarra E, Collins C, Jorba R. Comparison between Comprehensive Complication Index (CCI®) and Clavien-Dindo Classification for laparoscopic single-stage treatment of choledocholithiasis with concomitant cholelithiasis. Langenbecks Arch Surg 2023; 408:100. [PMID: 36813935 DOI: 10.1007/s00423-023-02840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE The Clavien-Dindo Classification (CDC) and the Comprehensive Complication Index (CCI®) are both widely used methods for reporting postoperative complications. Several studies have compared the CCI® with the CDC in evaluating postoperative complications of major abdominal surgery. However, there are no published reports comparing both indexes in single-stage laparoscopic common bile duct exploration with cholecystectomy (LCBDE) for the treatment of common bile duct stones. This study aimed to compare the accuracy of the CCI® and the CDC in evaluating the complications of LCBDE. METHODS In total, 249 patients were included. Spearman's rank test was used to calculate the correlation coefficient between CCI® and CDC with length of postoperative stay (LOS), reoperation, readmission, and mortality rates. Student t-test and Fisher's exact test were used to study, if higher ASA, age, larger surgical time, history of previous abdominal surgery, preoperative ERCP, and intraoperative cholangitis finding were associated with higher CDC grade or higher CCI® score. RESULTS Mean CCI® was 5.17 ± 12.8. CCI® ranges overlap among three CDC grades: II (20.90-36.20), IIIa (26.20-34.60), and IIIb (33.70-52.10). Age > 60 years, ASA ≥ III, and intraoperative cholangitis finding were associated with higher CCI® (p = 0.010, p = 0.044, and p = 0.031) but not with CDC ≥ IIIa (p = 0.158, p = 0.209, and p = 0.062). In patients with complications, LOS presented a significantly higher correlation with CCI® than with CDC (p = 0.044). CONCLUSION In LCBDE, the CCI® assesses better the magnitude of postoperative complications in patients older than 60 years, with a high ASA as well as in those who present intraoperative cholangitis. In addition, the CCI® correlates better with LOS in patients with complications.
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Affiliation(s)
- Erik Llàcer-Millán
- General Surgery Department, Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.
- School of Medicine, Rovira i Virgili University, Reus, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain.
| | - Mihai-Calin Pavel
- General Surgery Department, Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
- School of Medicine, Rovira i Virgili University, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Robert Memba
- General Surgery Department, Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
- School of Medicine, Rovira i Virgili University, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Daniel Coronado
- General Surgery Department, Hepato-Pancreato-Biliary Unit, Sant Joan Despí-Moises Broggi Hospital, Sant Joan Despí, Spain
| | - Sergio González
- General Surgery Department, Hepato-Pancreato-Biliary Unit, Sant Joan Despí-Moises Broggi Hospital, Sant Joan Despí, Spain
| | - Mar Achalandabaso
- General Surgery Department, Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Laia Estalella
- General Surgery Department, Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
- School of Medicine, Rovira i Virgili University, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Elisabet Julià-Verdaguer
- General Surgery Department, Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Erlinda Padilla-Zegarra
- General Surgery Department, Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Chris Collins
- Upper Gastrointestinal Surgery Department, Galway University Hospital, Galway, Ireland
| | - Rosa Jorba
- General Surgery Department, Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
- School of Medicine, Rovira i Virgili University, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
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Memba R, Morató O, Estalella L, Pavel MC, Llàcer-Millán E, Achalandabaso M, Julià E, Padilla E, Olona C, O'Connor D, Jorba R. Prevention of Incisional Hernia after Open Hepato-Pancreato-Biliary Surgery: A Systematic Review. Dig Surg 2021; 39:6-16. [PMID: 34875657 DOI: 10.1159/000521169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/21/2021] [Indexed: 12/10/2022]
Abstract
INTRODUCTION Most hepato-pancreato-biliary (HPB) procedures are still performed through open approach. Incisional hernia (IH) is one of the most common complications after open surgery. To date, published data on IH after HPB surgery are scarce; therefore, the aim of this study was to assess the current evidence regarding incidence, risk factors, and prevention. METHODS Medline/PubMed (1946-2020), EMBASE (1947-2020), and the Cochrane library (1995-2020) were searched for studies on IH in open HPB surgery. Animal studies, editorials, letters, reviews, comments, short case series and liver transplant, laparoscopic, or robotic procedures were excluded. The protocol was registered with PROSPERO (CRD42020163296). RESULTS A total of 5,079 articles were retrieved. Eight studies were finally included for the analysis. The incidence of IH after HPB surgery ranges from 7.7% to 38.8%. The identified risk factors were body mass index, surgical site infection, ascites, Mercedes or reversed T incisions, and previous IH. Prophylactic mesh might be safe and effective. CONCLUSIONS IH after open HPB surgery is still an important matter. Some of the risk factors are specific for the HPB operations and the incision type should be carefully considered. Randomized controlled trials are required to confirm the role of prophylactic mesh after HPB operations.
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Affiliation(s)
- Robert Memba
- Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.,School of Medicine, Rovira i Virgili University, Reus, Spain
| | - Olga Morató
- Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Laia Estalella
- Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.,School of Medicine, Rovira i Virgili University, Reus, Spain
| | - Mihai C Pavel
- Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.,School of Medicine, Rovira i Virgili University, Reus, Spain
| | - Erik Llàcer-Millán
- Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.,School of Medicine, Rovira i Virgili University, Reus, Spain
| | - Mar Achalandabaso
- Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.,School of Medicine, Rovira i Virgili University, Reus, Spain
| | - Elisabet Julià
- Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Erlinda Padilla
- Abdominal Wall Surgery Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Carles Olona
- School of Medicine, Rovira i Virgili University, Reus, Spain.,Abdominal Wall Surgery Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Donal O'Connor
- Department of Surgery, School of Medicine, Trinity College Dublin, College Green, Dublin, Ireland
| | - Rosa Jorba
- Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.,School of Medicine, Rovira i Virgili University, Reus, Spain
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Jorba R, Pavel MC, Llàcer-Millán E, Estalella L, Achalandabaso M, Julià-Verdaguer E, Nve E, Padilla-Zegarra ED, Badia JM, O'Connor DB, Memba R. Contemporary management of concomitant gallstones and common bile duct stones: a survey of Spanish surgeons. Surg Endosc 2021; 35:5024-5033. [PMID: 32968916 DOI: 10.1007/s00464-020-07984-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/14/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Concomitant gallstones and common bile duct stones (CBDS) is a relatively frequent presentation. The optimal treatment remains controversial and the debate persists between two strategies. The one-stage approach: laparoscopic cholecystectomy with laparoscopic common bile duct exploration (LCBDE) has been shown to be equally safe and more cost-effective than the more traditional two-stage approach: endoscopic retrograde cholangiography followed by laparoscopic cholecystectomy (ERCP + LC). However, many surgeons worldwide still prefer the two-stage procedure. This survey evaluated contemporary management of CBDS in Spain and assessed the impact of surgeon and hospital factors on provision of LCBDE. METHODS A 25-item, web-based anonymous survey was sent to general surgeons members of the Spanish Surgeons Association. Descriptive statistics were applied to summarize results. RESULTS Responses from 305 surgeons across 173 Spanish hospitals were analyzed. ERCP is the initial approach for preoperatively suspected CBDS for 86% of surgeons. LCBDE is the preferred method for only 11% of surgeons and only 11% treat more than 10 cases per year. For CBDS discovered intraoperatively, 59% of respondents attempt extraction while 32% defer to a postoperative ERCP. The main reasons cited for not performing LCBDE were lack of equipment, training and timely availability of an ERCP proceduralist. Despite these barriers, most surgeons (84%) responded that LCBDE should be implemented in their departments. CONCLUSIONS ERCP was the preferred approach for CBDS for the majority of respondents. There remains limited use of LCBDE despite many surgeons indicating it should be implemented. Focused planning and resourcing of both training and operational demands are required to facilitate adoption of LCBDE as option for patients.
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Affiliation(s)
- Rosa Jorba
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain.
| | - Mihai C Pavel
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Erik Llàcer-Millán
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Laia Estalella
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Mar Achalandabaso
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Elisabet Julià-Verdaguer
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Esther Nve
- Department of General Surgery, Hospital de Granollers, Granollers, Spain
| | - Erlinda D Padilla-Zegarra
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Josep M Badia
- Department of General Surgery, Hospital de Granollers, Granollers, Spain
| | - Donal B O'Connor
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Robert Memba
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
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Pavel MC, Casanova R, Estalella L, Memba R, Llàcer-Millán E, Achalandabaso M, Julià E, Geoghegan J, Jorba R. The effect of preoperative chemotherapy on liver regeneration after portal vein embolization/ligation or liver resection in patients with colorectal liver metastasis: a systematic review protocol. Syst Rev 2020; 9:279. [PMID: 33276812 PMCID: PMC7718667 DOI: 10.1186/s13643-020-01545-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/26/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Liver resection (LR) in patients with liver metastasis from colorectal cancer remains the only curative treatment. Perioperative chemotherapy improves prognosis of these patients. However, there are concerns regarding the effect of preoperative chemotherapy on liver regeneration, which is a key event in avoiding liver failure after LR. The primary objective of this systematic review is to assess the effect of neoadjuvant chemotherapy on liver regeneration after (LR) or portal vein embolization (PVE) in patients with liver metastasis from colorectal cancer. The secondary objectives are to evaluate the impact of the type of chemotherapy, number of cycles, and time between end of treatment and procedure (LR or PVE) and to investigate whether there is an association between degree of hypertrophy and postoperative liver failure. METHODS This meta-analysis will include studies reporting liver regeneration rates in patients submitted to LR or PVE. Pubmed, Scopus, Web of Science, Embase, and Cochrane databases will be searched. Only studies comparing neoadjuvant vs no chemotherapy, or comparing chemotherapy characteristics (bevacizumab administration, number of cycles, and time from finishing chemotherapy until intervention), will be included. We will select studies from 1990 to present. Two researchers will individually screen the identified records, according to a list of inclusion and exclusion criteria. Primary outcome will be future liver remnant regeneration rate. Bias of the studies will be evaluated with the ROBINS-I tool, and quality of evidence for all outcomes will be determined with the GRADE system. The data will be registered in a predesigned database. If selected studies are sufficiently homogeneous, we will perform a meta-analysis of reported results. In the event of a substantial heterogeneity, a qualitative systematic review will be performed. DISCUSSION The results of this systematic review may help to better identify the patients affected by liver metastasis that could present low regeneration rates after neoadjuvant chemotherapy. These patients are at risk to develop liver failure after extended hepatectomies and therefore are not good candidates for such aggressive procedures. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42020178481 (July 5, 2020).
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Affiliation(s)
- Mihai-Calin Pavel
- HPB Unit, Department of General Surgery, Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain. .,Departament de Medicina i Cirugia, Universitat Rovira i Virgili, Reus, Spain.
| | - Raquel Casanova
- HPB Unit, Department of General Surgery, Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain
| | - Laia Estalella
- HPB Unit, Department of General Surgery, Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain.,Departament de Medicina i Cirugia, Universitat Rovira i Virgili, Reus, Spain
| | - Robert Memba
- HPB Unit, Department of General Surgery, Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain.,Departament de Medicina i Cirugia, Universitat Rovira i Virgili, Reus, Spain
| | - Erik Llàcer-Millán
- HPB Unit, Department of General Surgery, Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain.,Departament de Medicina i Cirugia, Universitat Rovira i Virgili, Reus, Spain
| | - Mar Achalandabaso
- HPB Unit, Department of General Surgery, Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain
| | - Elisabet Julià
- HPB Unit, Department of General Surgery, Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain
| | - Justin Geoghegan
- HPB and Liver Transplant Surgery Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Rosa Jorba
- HPB Unit, Department of General Surgery, Hospital Universitari de Tarragona Joan XXIII, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain.,Departament de Medicina i Cirugia, Universitat Rovira i Virgili, Reus, Spain
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Ramirez P, Sáenz L, Cascales-Campos P, González Sánchez M, Llàcer-Millán E, Sánchez-Lorencio M, Díaz-Rubio E, De La Orden V, Mediero-Valeros B, Navarro J, Revilla Nuin B, Baroja-Mazo A, Noguera-Velasco J, Sánchez B, de la Peña J, Pons-Miñano J, Sánchez-Bueno F, Robles-Campos R, Parrilla P. Oncological Evaluation by Positron-emission Tomography, Circulating Tumor Cells and Alpha Fetoprotein in Patients With Hepatocellular Carcinoma on the Waiting List for Liver Transplantation. Transplant Proc 2016; 48:2962-2965. [DOI: 10.1016/j.transproceed.2016.07.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 07/27/2016] [Indexed: 02/07/2023]
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Llàcer-Millán E, Ramírez P, Sanmartín J, Zamarro J, Parrilla P. Cervical and Mediastinal Hematoma Caused by a Carotid Injury After Jugular Vein Cannulation, Treated by Stent. Cir Esp 2014; 93:342-4. [PMID: 24655796 DOI: 10.1016/j.ciresp.2013.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 12/23/2013] [Indexed: 11/20/2022]
Affiliation(s)
- Erik Llàcer-Millán
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
| | - Pablo Ramírez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - José Sanmartín
- Unidad de Cuidados Intensivos, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Joaquín Zamarro
- Sección de Neurorradiología Intervencionista, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Pascual Parrilla
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
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