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Öğe Embolization of liver hemangiomas(Hepatitis Monthly, 2015) Kayaalp, Cüneyt; Sabuncuoğlu, Mehmet ZaferThere is debate on the technique of surgery on liver hemangiomas in terms of liver parenchymal resection and enucleation through the hemangioma capsule. There is no randomized study yet to compare both techniques. It seems to us that preoperative hepatic arterial embolization and enucleation is a reasonable combination instead of embolization plus the formal liver resection. Selective embolization does not decrease the arterial supply of the line of the formal resection and it may even relatively increase the arterial supply of the remaining liver. This hypothesis may explain the more blood loss in the cases of preoperative selective hepatic arterial embolization combined with the formal hepatic resection.Öğe Use of the right lobe graft with double hepatic arteries in living donor liver transplant(Experimental and Clinical Transplantation, 2016) Çakır, Tuğrul; Sabuncuoğlu, Mehmet Zafer; Soyer, Vural; Sarıcı, Kemal Barış; Koç, Süleyman; Onur, Asım; Ünal, Bülent; Akbulut, Ahmet Sami; Yılmaz, SezaiObjectives: We aimed to examine management of double hepatic artery reconstruction in patients under going living-donor liver transplant. Materials and Methods: Between January 2002 and June 2014, one thousand thirty-six living-donor liver transplants were performed at the Liver Transplant Institute of Malatya Inonu University. Living liver grafts with a single hepatic artery were used in 983 living-donor liver transplants, while grafts with double hepatic artery branches were used in 53 livingdonor liver transplants. All of the liver grafts with double hepatic artery branches were right lobe grafts. Hepatic artery anastomosis technique and the other medical data of recipients who used grafts with double hepatic arteries were analyzed retrospectively. Results: A double hepatic artery anastomosis was created in 43 recipients, while a single anastomosis was created in the remaining 10 because of ligation of the nondominant hepatic artery branch. In 40 recipients, double hepatic artery branches in the graft were anastomosed with the recipient’s right and left hepatic artery. In the remaining 3 recipients, double hepatic artery branches in the graft were anastomosed with the recipient’s right hepatic artery and large segment 4 hepatic arteries. Postoperative complications related with hepatic artery anastomoses developed in 3 recipients: hepatic artery thrombosis (n = 1), hepatic artery aneurysm (n = 1), and hepatic artery stenosis (n = 1). A recipient with hepatic artery aneurysm immediately underwent a retransplant. A recipient with a hepatic artery thrombosis relapsed and required retransplant, which was treated with thrombectomy on postoperative day 10. A recipient with hepatic artery stenosis was followed conservatively. In our series, the incidence of complications related with double hepatic artery anastomosis was found to be 6.9%. Conclusions: According to our experiences, a double hepatic artery anastomosis does not increase the risk of hepatic artery thrombosis and can be performed safely by surgeons who are experienced with hepatic vascular reconstructions in a living-donor liver transplant recipient.