Browsing by Author "Guerra Castro, Juan Francisco"

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    Accuracy of the BAR score in the prediction of survival after liver transplantation
    (2019) Martinez Castillo, Jorge Arturo; Pacheco, Sergio; Bachler, J.; Jarufe Cassis, Nicolás; Briceño, Eduardo; Guerra Castro, Juan Francisco; Benitez, Carlos; Wolff, Rodrigo; Barrera Martínez, Francisco José; Arrese Jiménez, Marco
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    Actualización en el manejo de pacientes con insuficiencia intestinal
    (2014) Alberti Reus, Gigliola Loredana; Le Roy Olivos, Catalina María; Cofré Dougnac, Colomba Del Carmen; Pattillo Silva, Juan Carlos; Domínguez Bustamante, María del Pilar; Guerra Castro, Juan Francisco
    Intestinal failure is defined as the reduction of a functional gut mass below the minimal necessary for adequate digestion and absorption of nutrients and fluids. Intestinal failure is the final result of a number of different causes, being short bowel syndrome the most recognized. Its prevalence is low, but the impact in quality of life among patients and their families is critical. Furthermore, is associated with high economic costs, both for the patient and the health provider. Its main feature is the need for long-term parenteral nutritional support with high morbidity and mortality associated complications, such as line-derived bloodstream infections and liver disease. The management of these patients should be performed by a multidisciplinary team, and be aimed at promoting adaptation and recovery of bowel function to achieve intestinal autonomy.
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    Amylase Level in Drains After Pancreatoduodenectomy as a Predictor of Clinically Significant Pancreatic Fistula
    (2014) Ceroni Villanelo, Marco; Galindo, J.; Guerra Castro, Juan Francisco; Salinas, J.; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás
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    Arteria hepática izquierda de arteria gastroduodenal. Un desafío técnico durante cirugía de Whipple. Caso clínico
    (2015) Avila, R.; Vander, G.; Navia, A.; Altamirano, A.; Guerra Castro, Juan Francisco; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás
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    Complicaciones neurológicas en pacientes adultos sometidos a trasplante hepático ortotópico. Experiencia de un centro universitario
    (2008) Mellado T., Patricio; Peredo Orellana, Pilar Andrea; Valenzuela Mangini, Raúl Francisco; Arrese Jiménez, Marco; Pérez Ayuso, Rosa María; Domínguez, Pilar; Guerra Castro, Juan Francisco; Jarufe Cassis, Nicolás; Martínez Castillo, Jorge
    Background: Orthotopic liver transplantation (OLT) is the treatment of choice for multiple acute and chronic end-stage liver diseases as well as for selected cases of liver malignancy and liver-site metabolic disorders. Neurological impairment is a major source of morbidity and mortality following OLT. Aim: To describe the incidence and the type of neurological complications occurring in the post-operative period of OLT in patients transplanted in our hospital. Material and methods: Between March 1994 and August 2007, 76 adult patients underwent OLT. Data on incidence, time of onset, and outcome of central nervous system (CNS) complications have been obtained from our program data base and patient charts. Results: Twenty three patients (30.3%) had CNS complications following OLT. The leading complications were immunosuppressive drug-related neurological impairment in nine patients (39.1%), peripheral nerve damage in five patients (21.7%), central pontine myelinolysis in four patients (17.4%), cerebrovascular disease in three (13%) and CNS infection in three (13%). Most CNS events (90%) occurred in the first 2 weeks after OLT. Five patients with neurological complications died (22%). Conclusions: CNS complications occurred in almost one fifth of the population studied, and they had a poor outcome, as previously reported
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    Definiciones y conceptos en hepatolitiasis
    (2013) Jarufe Cassis, Nicolás; Muñoz C., César; Martínez Castillo, Jorge; Guerra Castro, Juan Francisco; Pimentel Muller, Fernando
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    Emergency right hepatectomy after laparoscopic tru-cut liver biopsy
    (2015) Quezada Sanhueza, Nicolás; León, Felipe; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Guerra Castro, Juan Francisco
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    Gastrointestinal neuroendocrine tumor with unresectable liver metastases : an example of multimodal therapeutic approach
    (2015) Martínez Castillo, Jorge; Besa, Santiago; Arab Verdugo, Juan Pablo; Quintana, Juan Carlos; Regonesi, Carlos; Huete, Isidro; Jarufe Cassis, Nicolás; Guerra Castro, Juan Francisco; Benítez, Carlos; Arrese Jiménez, Marco; Martínez Castillo, Jorge; Besa, Santiago; Arab Verdugo, Juan Pablo; Quintana, Juan Carlos; Regonesi, Carlos; Huete, Isidro; Jarufe Cassis, Nicolás; Guerra Castro, Juan Francisco; Benítez, Carlos; Arrese Jiménez, Marco
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    ¿Influye el medio de preservación del injerto en los resultados y costos del trasplante hepático de donante fallecido? Comparación de dos soluciones de preservación
    (2014) Martínez Castillo, Jorge; Bächler, Jean P.; Moisan Paravic, Fabrizio Robertino; Torres Montes, Paula Javiera; Duarte, Ignacio; Pérez Ayuso, Rosa María; Benítez Gajardo, Carlos Esteban; Arrese, Marco; Domínguez, Pilar; Guerra Castro, Juan Francisco; Jarufe Cassis, Nicolás
    Background: Preservation solutions are critical for organ transplantation. In liver transplant (LT), the solution developed by the University Of Wisconsin (UW) is the gold-standard to perfuse deceased brain death donor (DBD) grafts. Histidine-Tryptophan-Ketoglutarate (HTK), formerly a cardioplegic infusion, has been also used in solid organ transplantation. Aim: To compare the outcomes of LT in our center using either HTK or UW solution. Patients and Methods: Retrospective study including 93 LT DBD liver grafts in 89 patients transplanted between March 1994 and July 2010. Forty-eight grafts were preserved with UW and 45 with HTK. Donor and recipient demographics, total infused volume, cold ischemia time, post-reperfusion biopsy, liver function tests, incidence of biliary complications, acute rejection and 12-month graft and patient survival were assessed. Preservation solution costs per liver graft were also recorded. Results: Donor and recipient demographics were similar. When comparing UW and HTK, no differences were observed in cold ischemia time (9.6 ± 3 and 8.7 ± 2 h respectively, p = 0.23), biliary complications, the incidence of acute rejection, primary or delayed graft dysfunction. Histology on post-reperfusion biopsies revealed no differences between groups. The infused volume was significantly higher with HTK than with UW (9 (5-16) and 6 (3-11) l, p < 0.001). The cost per procurement was remarkably lower using HTK. Conclusions: Perfusion of DBD liver grafts with HTK is clinically equivalent to UW, with a significant cost reduction.
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    Metástasis hepática de origen no colorrectal ni neuroendocrino. Tratamiento quirúrgico
    (2010) Yáñez M, R.; Gamboa C, C.; Crovari Eulufi, Fernando; Guzmán Bondiek, Sergio; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Curi Tuma, Maximiliano; Weisse Ayach, Osvaldo; Guerra Castro, Juan Francisco
    Introducción: Existe un claro beneficio en el tratamiento quirúrgico de las metástasis hepáticas de origen colorrectal y neuroendocrinas; sin embargo, todavía no está bien definida la efectividad de la resección quirúrgica en tumores de origen diferente a los anteriores. El objetivo del presente estudio es dar a conocer los resultados del tratamiento quirúrgico en este grupo de pacientes. Pacientes y Método: Análisis de la base de datos electrónica de los pacientes con metástasis hepáticas de origen no colorrectal ni neuroendocrina que fueron sometidos a resección hepática en nuestro centro entre los años 2000-2009. Resultados: La serie estuvo constituida por 17 pacientes, nueve mujeres, mediana de edad de 51 años (rango, 22-78). Los principales sitios de origen del tumor primario fueron estómago, hígado, glándulas suprarrenales y útero. En dos casos se realizó cirugía sincrónica del primario y las metástasis; la técnica utilizada fue segmentectomía anatómica en 10 pacientes (58,8%) y resección anatómica mayor los siete restantes (41,2%). En 15 pacientes (88,2%) se logró borde quirúrgico libre de tumor, tres pacientes presentaron complicaciones postoperatorias y en tres hubo recidiva de la lesión hepática. No hubo mortalidad operatoria. Tras un seguimiento de 21 meses (rango, 9-56) la supervivencia al año, a los dos y a los tres años fue de 85%, 51% y 51% respectivamente. Discusión: El tratamiento quirúrgico de los pacientes con metástasis hepáticas de origen no colorrectal ni neuroendocrino es seguro y parece beneficioso en pacientes seleccionados, con baja tasa de complicaciones y con supervivencia favorable.
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    Nucleotide oligomerization domain 2 polymorphisms in patients with intestinal failure
    (2013) Guerra Castro, Juan Francisco; Zasloff, Michael; Lough, Denver; Abdo, Joseph; Hawksworth, Jason; Mastumoto, Cal; Girlanda, Raffaele; Island, Eddie; Shetty, Kirty; Kaufman, Stuart; Fishbein, Thomas
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    Resección hepática laparoscópica
    (2013) Marambio Granic, Andrés Javier; Llera Martin, Juan Carlos de la; Varas, Julián; Sanhueza García, Marcel Paolo; Martínez Castillo, Jorge; Guerra Castro, Juan Francisco; Jarufe Cassis, Nicolás
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    Resultados del tratamiento laparoscópico de los quistes hidatídicos hepáticos no complicados. Results of laparoscopic treatment of uncomplicated hepatic hydatid cysts
    (2017) Pacheco, Sergio; Galindo, José; Bächler, Jean Phillipe; Ahumada, Vanessa; Rolando, Rebolledo; Crovari Eulufi, Fernando; Briceño, Eduardo; Guerra Castro, Juan Francisco; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Pacheco, Sergio; Galindo, José; Bächler, Jean Phillipe; Ahumada, Vanessa; Rolando, Rebolledo; Crovari Eulufi, Fernando; Briceño, Eduardo; Guerra Castro, Juan Francisco; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás
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    Sublingual tacrolimus administration provides similar drug exposure to per-oral route employing lower doses in liver transplantation: a pilot study
    (2017) Solari Gajardo, Sandra; Cancino, Alejandra; Wolff, Rodrigo; Norero, Blanca; Vargas, J. I.; Barrera Martínez, Francisco José; Guerra Castro, Juan Francisco; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Soza, Alejandro; Arrese Jiménez, Marco; Benitez, Carlos
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    Trasplante hepático en pacientes con trombosis de la vena porta
    (2013) Gabrielli Nervi, Mauricio; Galindo, J.; Figueroa, E.; Moisan, F.; Arrese Jiménez, Marco; Benítez, Carlos; Soza, Alejandro; Dominguez, P.; Pérez Ayuso, Rosa María; Guerra Castro, Juan Francisco; Jarufe Cassis, Nicolás; Martínez, J.
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    Trasplante hepático exitoso en un paciente portador del Virus de la Inmunodeficiencia Humana (VIH): casos clínicos
    (2018) Guerra Castro, Juan Francisco; Troncoso T., Andrés; Ceballos, María Elena; Arrese Jiménez, Marco; Barrera Martínez, Francisco José; Norero, Blanca; Soza, Alejandro; Rivas, Violeta; Wolff, Rodrigo; Arias, Alejandra; Cancino, Alejandra; Torres Montes, Paula Javiera; Briceño, Eduardo; Jarufe Cassis, Nicolás; Martínez Castillo, Jorge; Benítez, Carlos
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    Trasplante hepático: Evolución, curva de aprendizaje y resultados después de los primeros 300 casos
    (2019) Quezada González, José Luis; Cancino, Alejandra; Arrese Jimenez, Marco Antonio; Wolff, Rodrigo; Benitez Gajardo, Carlos Esteban; Pattillo Silva, Juan Carlos; Gana Ansaldo, Juan Cristobal; Concha Pinto, Mario Rodrigo; Cortinez Fernandez, Luis Ignacio; Vera Alarcón, María Magdalena; Miranda, Paula; Rubilar, Francisco; Troncoso, Andrés; Briceno Valenzuela, Eduardo Andres; Dib Marambio, Martin Javier; Jarufe Cassis, Nicolas Patricio; Martínez, Jorge; Guerra Castro, Juan Francisco
    Liver transplantation (LT) is an option for people with liverfailure who cannot be cured with other therapies and for some people with liver cancer. Aim: To describe, and analyze the first 300 LT clinical results, andto establish our learning curve. Material and Methods: Retrospective cohortstudy with data obtained from a prospectively collected LT Program database.We included all LT performed at a single center from March 1994 to September2017. The database gathered demographics, diagnosis, indications for LT, surgicalaspects and postoperative courses. We constructed a cumulative summation testfor learning curve (LC-CUSUM) using 30-day post-LT mortality. Mortality at 30days, and actuarial 1-, and 5-year survival rate were analyzed. Results: A total of281 patients aged 54 (0-71) years (129 women) underwent 300 LT. Ten percentof patients were younger than 18 years old. The first, second and third indicationsfor LT were non-alcoholic steatohepatitis, chronic autoimmune hepatitis andalcoholic liver cirrhosis, respectively. Acute liver failure was the LT indication in51 cases (17%). The overall complication rate was 71%. Infectious and biliarycomplications were the most common of them (47 and 31% respectively). TheLC-CUSUM curve shows that the first 30 patients corresponded to the learningcurve. The peri-operative mortality was 8%. Actuarial 1 and 5-year survival rateswere 82 and 71.4%, respectively. Conclusions: Outcome improvement of a LTprogram depends on the accumulation of experience after the first 30 transplantsand the peri-operative mortality directly impacted long-term survival.
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    Tratamiento quirúrgico de las lesiones iatrogénicas de la vía biliar poscolecistectomía. Surgical treatment of iatrogenic bile duct injury post cholecystectomy
    (2017) Pacheco, Sergio; Tejos, Rodrigo; Rodríguez, Javier; Briceño, Eduardo; Guerra Castro, Juan Francisco; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás
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    Tratamiento resectivo del hepatocarcinoma
    (2015) Bächler, Jean Phillipe; Martínez Castillo, Jorge; Guerra Castro, Juan Francisco; Jarufe Cassis, Nicolás
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    Tumores neuroendocrinos del páncreas. Resultados quirúrgicos y sobrevida alejada
    (2013) Galindo, J.; Gabrielli Nervi, Mauricio; Barros, D.; Moisan, F.; Martínez, M.; Torres, J.; Flores, M.; Guerra Castro, Juan Francisco; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás