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【基金】：ealed that all lesions that were negative for all markers or positive for only one marker were negative for lymph node metastasis. CONCLUSION: Analysis of a combination of immuno- histochemical molecular markers in endoscopically resected specimens of submucosal colorectal cancer allows prediction of curability regardless of the pathologic features visible of hematoxylin-eosin-stained sections.Immunohistochemical molecular markers as predictors of curability of endoscopically resected submucosal colorectal cancerIwao Kaneko, Kazuaki Chayama, Department of Medicine and Molecular Science, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan Shinji Tanaka, Shiro Oka, Shigeto Yoshida, Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan Toru Hiyama, Health Service Center, Hiroshima University, Hiroshima, Japan Koji Arihiro, Department of Pathology, Hiroshima University Hospital, Hiroshima, Japan Fumio Shimamoto, Department of Health Science, Prefectural University of Hiroshima, Faculty of Human Culture and Society, Hiroshima, JapanAIM: To clarify the usefulness of immunohistochemical molecular markers in predicting lymph node metastasis of submucosal colorectal cancer. METHODS: We examined microvessel density, lymphatic vessel density, the Ki-67 labeling index, expression of MUC1 and Matrix metalloproteinase-7 (MMP-7) in tumor cells, and expression of cathepsin D in stromal cells at the invasive front by immunostaining of samples resected from 214 patients with submucosal colorectal cancer. Pathologic features were assessed on hematoxylin-eosin- stained samples. We evaluated the relations between clinicopathologic/immunohistochemical features and lymph node metastasis. RESULTS: Lesions of the superficial type, with an unfavorable histologic grade, budding, lymphatic involvement, high microvessel density (≥ 40), high lymphatic vessel density (≥ 9), high Ki-67 labeling index (≥ 42), and positivity of MUC1, cathepsin D, and MMP-7 showed a significantly high incidence of lymph node metastasis. Multivariate analysis revealed that high microvessel density, unfavorable histologic grade, cathepsin D positivity, high lymphatic vessel density, superficial type, budding, and MUC1 positivity were independent risk factors for lymph node metastasis.A combined examination with four independent immunohistochemical markers (microvessel density, cathepsin D, lymphatic vessel density, and MUC1) revealed that all lesions that were negative for all markers or positive for only one marker were negative for lymph node metastasis. CONCLUSION: Analysis of a combination of immuno- histochemical molecular markers in endoscopically resected specimens of submucosal colorectal cancer allows prediction of curability regardless of the pathologic features visible of hematoxylin-eosin-stained sections.Submucosal colorectal cancer;Microvessel density;Lymphatic vessel density;Mucin 1;Ki-67;Cathepsin D;Matrix metalloproteinase-7;Lymph node metastasis;Immunohistochemistrya Grant from the Japanese Society of Gastro-enterological Endoscopy, Chugoku Branch0World Journal of Gastroenterology世界胃肠病学杂志(英文版)57-63R735.3E07254E;E072_54Iwao Kaneko;3829-3835Improvement in symptoms after H_2-receptor antagonist-based therapy for eradication of H pylori infectionTakeshi Hagiwara;Mototsugu Kato;Tomonori Anbo;Akimichi Imamura;Toshihiro Suga;Takumi Uchida;Akira Fujinaga;Manabu Nakagawa;Soichi Nakagawa;Yuichi Shimizu;Jyunji Yamamoto;Hiroshi Takeda;Masahiro Asaka;Department of Gastroenterology Sapporo-Kosei General Hospital,Sapporo,Hokkaido 060-4876,Japan,Division of Endoscopy,Hokkaido University Hospital,Sapporo,Hokkaido 060-4876,Japan,Department of Gastroenterology,Sapporo-Kosei General Hospital,Sapporo,Hokkaido 060-4876,Japan,Department of Gastroenterology,Sapporo-Kosei General Hospital,Sapporo,Hokkaido 060-4876,Japan,Department of Gastroenterology,Sapporo-Kosei General Hospital,Sapporo,Hokkaido 060-4876,Japan,Department of Internal Medicine,Abashiri-Kosei General Hospital,Abashiri,Japan,Department of Internal Medicine,Abashiri-Kosei General Hospital,Abashiri,Japan,Division of Endoscopy,Hokkaido University Hospital,Sapporo,Hokkaido 060-4876,Japan,Division of Endoscopy,Hokkaido University Hospital,Sapporo,Hokkaido 060-4876,Japan,Division of Endoscopy,Hokkaido University Hospital,Sapporo,Hokkaido 060-4876,Japan,Department of Gastroenterology,Graduate School of Medicine Hokkaido University,Sapporo,Hokkaido 060-4876,Japan,Department of Gastroenterology,Graduate School of Medicine Hokkaido University,Sapporo,Hokkaido 060-4876,Japan,Department of Gastroenterology,Graduate School of Medicine Hokkaido University,Sapporo,Hokkaido 060-4876,Japan,AIM: To investigate the therapeutic effects of triple therapy combining lafutidine with clarithromycin and amoxicillin on H pylori infection and the resolution of gastroesophageal symptoms after eradication. METHODS: We conducted a randomized, multicenter, open-label controlled trial to compare the effective-ness of a triple therapy of lafutidine, clarithromycin, and amoxicillin (lafutidine group) with that of a triple therapy of lansoprazole, clarithromycin, and amoxicillin (lansopra- zole group) in patients with H pylori infection. The study group comprised 22 patients with gastric ulcers and 18 patients with duodenal ulcers who had H pylori infection. RESULTS: H pylori eradication rates were similar in the lafutidine group (14/20, 70%) and the lansoprazole group (14/20, 70%). Gastroesophageal reflux and ab-dominal symptoms improved after eradication therapy in both groups, whereas abdominal discomfort, diarrhea, and constipation were unchanged. H pylori status had no apparent effect on improvement of gastroesophageal reflux or abdominal symptoms after treatment. Adverse events were similar in both groups. CONCLUSION: The triple therapy including lafutidine is equivalent to triple therapy including lansoprazole in terms of H pylori eradication rates and improvement in gastroesophageal reflux and abdominal symptoms.These results are attributed to the fact that lafutidine has strong, continuous antisecretory activity, unaffected by CYP2C19 polymorphisms.Improvement in symptoms after H_2-receptor antagonist-based therapy for eradication of H pylori infectionTakeshi Hagiwara, Tomonori Anbo, Akimichi Imamura, Toshihiro Suga, Department of Gastroenterology, Sapporo-Kosei General Hospital, Sapporo, Hokkaido 060-4876, Japan Mototsugu Kato, Manabu Nakagawa, Soichi Nakagawa, Yuichi Shimizu, Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido 060-4876, Japan Takumi Uchida, Akira Fujinaga, Department of Internal Medicine, Abashiri-Kosei General Hospital, Abashiri, Japan Jyunji Yamamoto, Hiroshi Takeda, Masahiro Asaka, Department of Gastroenterology, Graduate School of Medicine Hokkaido University, Sapporo, Hokkaido 060-4876, JapanAIM: To investigate the therapeutic effects of triple therapy combining lafutidine with clarithromycin and amoxicillin on H pylori infection and the resolution of gastroesophageal symptoms after eradication. METHODS: We conducted a randomized, multicenter, open-label controlled trial to compare the effective-ness of a triple therapy of lafutidine, clarithromycin, and amoxicillin (lafutidine group) with that of a triple therapy of lansoprazole, clarithromycin, and amoxicillin (lansopra- zole group) in patients with H pylori infection. The study group comprised 22 patients with gastric ulcers and 18 patients with duodenal ulcers who had H pylori infection. RESULTS: H pylori eradication rates were similar in the lafutidine group (14/20, 70%) and the lansoprazole group (14/20, 70%). Gastroesophageal reflux and ab-dominal symptoms improved after eradication therapy in both groups, whereas abdominal discomfort, diarrhea, and constipation were unchanged. H pylori status had no apparent effect on improvement of gastroesophageal reflux or abdominal symptoms after treatment. Adverse events were similar in both groups. CONCLUSION: The triple therapy including lafutidine is equivalent to triple therapy including lansoprazole in terms of H pylori eradication rates and improvement in gastroesophageal reflux and abdominal symptoms.These results are attributed to the fact that lafutidine has strong, continuous antisecretory activity, unaffected by CYP2C19 polymorphisms.H pylori;Gastroesophageal symptoms;Lafu-tidine;Lansoprazole0World Journal of Gastroenterology世界胃肠病学杂志(英文版)64-68R573.1E06442E;E064_42Takeshi Hagiwara;3836-3840Interaction of L-Arginine-methyl ester and Sonic hedgehog in liver ischemia-reperfusion injury in the ratsMehmet Cudi Tuncer;Hayrettin Ozturk;Huseyin Buyukbayram;Hulya Ozturk;Dicle University Medical School,Departments of Anatomy,Diyarbakir,Turkey,Abanty Izzet Baysal University,Medical School,Departments of Pediatric Surgery,Bolu,Turkey,Dicle University,Medical School,Departments of Pathology,Diyarbakir,Turkey,Izzet Baysal Obstetric and Children Hospital,Department of Pediatric Surgery,Bolu,Turkey,AIM: To investigate the role of Sonic hedgehog (Shh) on the course of liver ischemia and reperfusion (I/R) in rats, and the interaction between treatment with nitric oxide donor L-Arginine-methyl ester (L-Arg) and up-regulation of Shh expression. METHODS: A total of 30 male Sprague-Dawley rats weighing 220-240 g were used in this study. Sham-control group (G1, n = 10): a sham operation was performed (except for liver I/R). I/R-untreated group (G2, n = 10): rats underwent liver ischemia for 1 h followed by reperfusion for 45 min. I/R-L-Arg group (G3, n = 10): after performing the same surgical procedure as in group 2, animals were treated with L-Arg. Liver tissues were taken for determination of malondialdehyde (MDA) levels, and biochemical and histological evaluations were made. RESULTS: Plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and γ-glutamyltranspeptidase (GGT) activities were higher in group 2 than in group 3. MDA values and the hepatic injury score decreased in the L-Arg treated group compared to the I/R-untreated group. In group 2, the hepatocytes were swollen with marked vacuolization. Group 3 rats showed well-preserved liver parenchyma, with hepatocytes extending from the central vein. The morphology of the hepatocytes and the sinusoidal structures was normal, without any signs of congestion. Mild Shh positive immunostaining was detected in group 2 animals. The expression of immunoreactive cells was increased markedly in liver tissue from I/R-L-Arg rats.CONCLUSION: Our findings suggest that Shh molecules are critical factors in the pathophysiology of inflammatory liver injury induced by I/R. In addition, NO plays an important role in the immunohistochemical expression of these molecules.Interaction of L-Arginine-methyl ester and Sonic hedgehog in liver ischemia-reperfusion injury in the ratsMehmet Cudi Tuncer, Dicle University, Medical School, Departments of Anatomy, Diyarbakir, Turkey Hayrettin Ozturk, Abanty Izzet Baysal University, Medical School, Departments of Pediatric Surgery, Bolu, Turkey Huseyin Buyukbayram, Dicle University, Medical School, Departments of Pathology, Diyarbakir, Turkey Hulya Ozturk, Izzet Baysal Obstetric and Children Hospital, Department of Pediatric Surgery, Bolu, TurkeyAIM: To investigate the role of Sonic hedgehog (Shh) on the course of liver ischemia and reperfusion (I/R) in rats, and the interaction between treatment with nitric oxide donor L-Arginine-methyl ester (L-Arg) and up-regulation of Shh expression. METHODS: A total of 30 male Sprague-Dawley rats weighing 220-240 g were used in this study. Sham-control group (G1, n = 10): a sham operation was performed (except for liver I/R). I/R-untreated group (G2, n = 10): rats underwent liver ischemia for 1 h followed by reperfusion for 45 min. I/R-L-Arg group (G3, n = 10): after performing the same surgical procedure as in group 2, animals were treated with L-Arg. Liver tissues were taken for determination of malondialdehyde (MDA) levels, and biochemical and histological evaluations were made. RESULTS: Plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and γ-glutamyltranspeptidase (GGT) activities were higher in group 2 than in group 3. MDA values and the hepatic injury score decreased in the L-Arg treated group compared to the I/R-untreated group. In group 2, the hepatocytes were swollen with marked vacuolization. Group 3 rats showed well-preserved liver parenchyma, with hepatocytes extending from the central vein. The morphology of the hepatocytes and the sinusoidal structures was normal, without any signs of congestion. Mild Shh positive immunostaining was detected in group 2 animals. The expression of immunoreactive cells was increased markedly in liver tissue from I/R-L-Arg rats.CONCLUSION: Our findings suggest that Shh molecules are critical factors in the pathophysiology of inflammatory liver injury induced by I/R. In addition, NO plays an important role in the immunohistochemical expression of these molecules.Ischemia/reperfusion;Liver;Sonic hedgehog;L-Arginine-methyl ester0World Journal of Gastroenterology世界胃肠病学杂志(英文版)69-74R575E06461E;E064_61Mehmet Cudi Tuncer;3841-3846Molecular mechanism of immune response induced by foreign plasmid DNA after oral administration in miceAIM: To study immune response induced by foreign plasmid DNA after oral administration in mice. METHODS: Mice were orally administered with 200 μg of plasmid pcDNA3 once and spleen was isolated 4 h and 18 h after administration. Total RNA was extracted from spleen and gene expression profile of BALB/c mice spleen was analyzed by using Affymetrix oligonucleotide GeneChip. Functional cluster analysis was conducted by GenMAPP software. RESULTS: At 4 h and 18 h after oral plasmid pcDNA3 administration, a number of immune-related genes, including cytokine and cytokine receptors, chemokines and chemokine receptor, complement molecule, proteasome, histocompatibility molecule, lymphocyte antigen complex and apoptotic genes, were up-regulated. Moreover, MAPPFinder results also showed that numerous immune response processes were up-regulated. In contrast, the immunoglobulin genes were down-regulated. CONCLUSION: Foreign plasmid DNA can modulate the genes expression related to immune system via the gastrointestinal tract, and further analysis of the related immune process may help understand the molecular mechanisms of immune response induced by foreign plasmid via the gastrointestinal tract.Molecular mechanism of immune response induced by foreign plasmid DNA after oral administration in miceJian-Wen Liu, Jun Cheng, Institute of Infectious Diseases, Beijing Ditan Hospital, Beijing 100011, China Jian-Wen Liu, School of Food Science & Technology, Southern Yangtze University, Wuxi 214036, Jiangsu Province, ChinaAIM: To study immune response induced by foreign plasmid DNA after oral administration in mice. METHODS: Mice were orally administered with 200 μg of plasmid pcDNA3 once and spleen was isolated 4 h and 18 h after administration. Total RNA was extracted from spleen and gene expression profile of BALB/c mice spleen was analyzed by using Affymetrix oligonucleotide GeneChip. Functional cluster analysis was conducted by GenMAPP software. RESULTS: At 4 h and 18 h after oral plasmid pcDNA3 administration, a number of immune-related genes, including cytokine and cytokine receptors, chemokines and chemokine receptor, complement molecule, proteasome, histocompatibility molecule, lymphocyte antigen complex and apoptotic genes, were up-regulated. Moreover, MAPPFinder results also showed that numerous immune response processes were up-regulated. In contrast, the immunoglobulin genes were down-regulated. CONCLUSION: Foreign plasmid DNA can modulate the genes expression related to immune system via the gastrointestinal tract, and further analysis of the related immune process may help understand the molecular mechanisms of immune response induced by foreign plasmid via the gastrointestinal tract.Foreign plasmid;Microarray;Immune system;Gastrointestinal tract;Gene expressionthe National Natural Science Foundation of China, No. 302709700World Journal of Gastroenterology世界胃肠病学杂志(英文版)75-82R392E059AE;E059_A3847-3854Relationship between post-ERCP pancreatitis and the change of serum amylase level after the procedureKei Ito;Naotaka Fujita;Yutaka Noda;Go Kobayashi;Jun Horaguchi;Osamu Takasawa;Takashi Obana;Department of Gastroenterology Sendai City Medical Center,5-22-1,Tsurugaya,Miyagino-ku,Sendai,Miyagi 983-0824,Japan,Department of Gastroenterology,Sendai City Medical Center,5-22-1,Tsurugaya,Miyagino-ku,Sendai,Miyagi 983-0824,Japan,Department of Gastroenterology,Sendai City Medical Center,5-22-1,Tsurugaya,Miyagino-ku,Sendai,Miyagi 983-0824,Japan,Department of Gastroenterology,Sendai City Medical Center,5-22-1,Tsurugaya,Miyagino-ku,Sendai,Miyagi 983-0824,Japan,Department of Gastroenterology,Sendai City Medical Center,5-22-1,Tsurugaya,Miyagino-ku,Sendai,Miyagi 983-0824,Japan,Department of Gastroenterology,Sendai City Medical Center,5-22-1,Tsurugaya,Miyagino-ku,Sendai,Miyagi 983-0824,Japan,Department of Gastroenterology,Sendai City Medical Center,5-22-1,Tsurugaya,Miyagino-ku,Sendai,Miyagi 983-0824,Japan,AIM: To clarify the relationship between the change of serum amylase level and post-ERCP pancreatitis. METHODS: Between January 1999 and December 2002, 1291 ERCP-related procedures were performed. Serum amylase concentrations were measured before the procedure and 3, 6, and 24 h afterward. The frequency and severity of post-ERCP pancreatitis and the relationship between these phenomena and the change in amylase level were estimated. RESULTS: Post-ERCP pancreatitis occurred in 47 patients (3.6%). Pancreatitis occurred in 1% of patients with normal amylase levels 3 h after ERCP, and in 1%, 5%, 20%, 31% and 39% of patients with amylase levels elevated 1-2 times, 2-3 times, 3-5 times, 5-10 times and over 10 times the upper normal limit at 3 h after ERCP, respectively (level < 2 times vs ≥ 2 times, P < 0.001). Of the 143 patients with levels higher than the normal limit at 3 h after ERCP followed by elevation at 6 h, pancreatitis occurred in 26%. In contrast, pancreatitis occurred in 9% of 45 patients with a level higher than two times the normal limit at 3 h after ERCP followed by a decrease at 6 h (26% vs 9%, P < 0.05). CONCLUSION: Post-ERCP pancreatitis is frequently associated with an increase in serum amylase level greater than twice the normal limit at 3 h after ERCP with an elevation at 6 h. A decrease in amylase level at 6 h after ERCP suggests the unlikelihood of development of post-ERCP pancreatitis.Relationship between post-ERCP pancreatitis and the change of serum amylase level after the procedureKei Ito, Naotaka Fujita, Yutaka Noda, Go Kobayashi, Jun Horaguchi, Osamu Takasawa, Takashi Obana, Department of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai, Miyagi 983-0824, JapanAIM: To clarify the relationship between the change of serum amylase level and post-ERCP pancreatitis. METHODS: Between January 1999 and December 2002, 1291 ERCP-related procedures were performed. Serum amylase concentrations were measured before the procedure and 3, 6, and 24 h afterward. The frequency and severity of post-ERCP pancreatitis and the relationship between these phenomena and the change in amylase level were estimated. RESULTS: Post-ERCP pancreatitis occurred in 47 patients (3.6%). Pancreatitis occurred in 1% of patients with normal amylase levels 3 h after ERCP, and in 1%, 5%, 20%, 31% and 39% of patients with amylase levels elevated 1-2 times, 2-3 times, 3-5 times, 5-10 times and over 10 times the upper normal limit at 3 h after ERCP, respectively (level < 2 times vs ≥ 2 times, P < 0.001). Of the 143 patients with levels higher than the normal limit at 3 h after ERCP followed by elevation at 6 h, pancreatitis occurred in 26%. In contrast, pancreatitis occurred in 9% of 45 patients with a level higher than two times the normal limit at 3 h after ERCP followed by a decrease at 6 h (26% vs 9%, P < 0.05). CONCLUSION: Post-ERCP pancreatitis is frequently associated with an increase in serum amylase level greater than twice the normal limit at 3 h after ERCP with an elevation at 6 h. A decrease in amylase level at 6 h after ERCP suggests the unlikelihood of development of post-ERCP pancreatitis.Acute pancreatitis;Endoscopic retrograde cholangiopancreatography;Serum amylase0World Journal of Gastroenterology世界胃肠病学杂志(英文版)83-88R576E0647E;E064_7Kei Ito;3855-3860Simultaneous endoscopic ultrasound fine needle aspiration and endoscopic retrograde cholangio-pancreatography:Evaluation of safetyIlaria Tarantino;Luca Barresi;Marta Di Pisa;Mario Traina;Istituto Mediterraneo Trapianti e Terapie ad alta specializzazione University of Pittsburgh Medical Center,Italy,Istituto Mediterraneo Trapianti e Terapie ad alta specializzazione,University of Pittsburgh Medical Center,Italy,Istituto Mediterraneo Trapianti e Terapie ad alta specializzazione,University of Pittsburgh Medical Center,Italy,Istituto Mediterraneo Trapianti e Terapie ad alta specializzazione,University of Pittsburgh Medical Center,Italy,AIM: To investigate the rate of complications of endoscopic retrograde cholangio-pancreatography (ERCP) performed immediately after endoscopic ultrasound fine needle aspiration (EUS-FNA) in a large series of patients. METHODS: Patients with the following conditions were considered candidates for EUS-FNA and ERCP: diagnosis of locally advanced or metastatic pancreatic lesion not eligible for surgery, and patients with pancreatic lesion of unknown nature causing jaundice. Data were prospectively collected on the following parameters: indication for FNA, EUS findings, pathological diagnosis, procedure duration of EUS-FNA and combined EUS-FNA and ERCP, and immediate and late complications. RESULTS: From January 2004 to October 2006, 72 patients were deemed eligible for combined EUS and ERCP. In 25/72 EUS-FNA was performed to obtain a pathology diagnosis of lesions causing biliary obstruction, and ERCP sequentially performed to drain the biliary system. No immediate complications occurred except for two mild bleeding episodes post sphincterotomy. No late complications were recorded except for one patient who experienced fever, promptly recovered with antibiotic therapy. CONCLUSION: Simultaneous approach appears to be feasible and safe. When possible, this can be considered the reference standard to avoid double sedation and reduce duration of the procedure and hospital stay.Simultaneous endoscopic ultrasound fine needle aspiration and endoscopic retrograde cholangio-pancreatography:Evaluation of safetyIlaria Tarantino, Luca Barresi, Marta Di Pisa, Mario Traina, Istituto Mediterraneo Trapianti e Terapie ad alta specializzazione, University of Pittsburgh Medical Center, ItalyAIM: To investigate the rate of complications of endoscopic retrograde cholangio-pancreatography (ERCP) performed immediately after endoscopic ultrasound fine needle aspiration (EUS-FNA) in a large series of patients. METHODS: Patients with the following conditions were considered candidates for EUS-FNA and ERCP: diagnosis of locally advanced or metastatic pancreatic lesion not eligible for surgery, and patients with pancreatic lesion of unknown nature causing jaundice. Data were prospectively collected on the following parameters: indication for FNA, EUS findings, pathological diagnosis, procedure duration of EUS-FNA and combined EUS-FNA and ERCP, and immediate and late complications. RESULTS: From January 2004 to October 2006, 72 patients were deemed eligible for combined EUS and ERCP. In 25/72 EUS-FNA was performed to obtain a pathology diagnosis of lesions causing biliary obstruction, and ERCP sequentially performed to drain the biliary system. No immediate complications occurred except for two mild bleeding episodes post sphincterotomy. No late complications were recorded except for one patient who experienced fever, promptly recovered with antibiotic therapy. CONCLUSION: Simultaneous approach appears to be feasible and safe. When possible, this can be considered the reference standard to avoid double sedation and reduce duration of the procedure and hospital stay.Pancreatic mass;Endoscopic ultrasound fine needle aspiration;Biliary stent;Jaundice;Endoscopic therapy0World Journal of Gastroenterology世界胃肠病学杂志(英文版)89-91R445E060251E;E060_251Ilaria Tarantino;3861-3863A new approach to the surgical treatment of parasitic cysts of the liver:Hepatectomy using the liver hanging maneuverAydin Unal;Yazici Pinar;Zeytunlu Murat;Kilic Murat;Coker Ahmet;Department of General Surgery Ege University School of Medicine,Izmir,Turkey,Department of General Surgery,Ege University School of Medicine,Izmir,Turkey,Department of General Surgery,Ege University School of Medicine,Izmir,Turkey,Department of General Surgery,Ege University School of Medicine,Izmir,Turkey,Department of General Surgery,Ege University School of Medicine,Izmir,Turkey,AIM: To review 11 patients with parasitic cysts of the liver, who were treated by hepatic lobectomy using the liver hanging maneuver (LHM). METHODS: Between January 2003 and June 2006, we retrospectively analyzed patients who underwent surgical treatment due to parasitic cysts of the liver, at the Ege University School of Medicine, Department of General Surgery. Of these, the patients who underwent hepatic lobectomy using the LHM were reviewed and evaluated for surgical treatment outcome. RESULTS: Over a three-year period, there were 102 patients who underwent surgical treatment for parasitic cysts of the liver. Of these, 11 (10%) patients with parasitic cysts of the liver underwent hepatic lobectomy using the LHM. Presenting symptoms were abdominal pain, dyspepsia, and cholangitis. Cyst locations were as follows: right lobe filled with cyst, 7 (63%);segmental location, 2 (18%);and multiple locations, 2 patients (18%). All patients underwent hepatic lobectomy with an anterior approach using the LHM. The intraoperative blood transfusion requirement was one unit for 3 patients and two units for one patient. Postoperative complications included pulmonary atelectasy (2, 18%) and pleural effusion (2, 18%). No significant morbidity or mortality was observed. CONCLUSION: We concluded that hepatic lobectomy using the LHM should be considered, not only for hepatic tumors or donor hepatectomy, but also to treat parasitic cysts of the liver.A new approach to the surgical treatment of parasitic cysts of the liver:Hepatectomy using the liver hanging maneuverAydin Unal, Yazici Pinar, Zeytunlu Murat,