Browsing by Author "Hepp, Juan"

Now showing 1 - 4 of 4
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    Angiomiolipoma hepático epitelioide: reporte de un caso
    (2022) Ahumada, Oscar; Hepp, Juan; Gallegos, Marcela; Schiappacasse, Giancarlo
    Angiomyolipomas (AML) are mesenchymal tumors belonging to the group of perivascular epithelioid cell tumors, which, rarely, can display a malignant behavior. They are composed of adipose tissue, vessels, and muscle tissue in different proportions, and constitute a differential diagnosis for other focal liver lesions. We report a 34-year-old woman in whom a focal hepatic lesion was discovered incidentally. The pathology report of an ultrasound guided biopsy informed an epithelioid angiomyolipoma, a rare variant of these lesions. During ten years of imaging follow, the size and features of the lesion has not changed. The patient rejected a surgical excision.
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    Donación y trasplante de órganos: propuesta desde la Academia Chilena de Medicina
    (2020) Hepp, Juan; Beca, Juan Pablo; Moran, Sergio; Roessler, Emilio; Uribe, Mario; Palacios, José Manuel
    The Chilean Academy of Medicine designated a group of specialists to evaluate the practice and to propose reforms for organ donation and transplantation, due to the general insufficiencies at the national level with these procedures. In the last six years the mean number of organ transplants in Chile was 340 cases per year while effective cadaveric donors ranged between 6 and 10 per million inhabitants. These averages remained stable during this period and are among the lowest in the region. Our analysis attributed these deficient results mainly to low organ donation and inefficient procurement due to lack of compliance with protocols and little accountability. The committee proposes several measures for improvement. These are a systematic and obligatory report of potential organ donors by all emergency and critical care centers, frequent evaluation of results, empowering of health authorities to correct insufficiencies in organ procurement, education programs for primary, secondary, technical and university students to improve their knowledge about the social significance and solidarity required for transplantation policies and specialized updated training of all health professionals involved. Organ donation and transplantation must be based on clear and fair ethical considerations in order to be accepted by the general public
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    Importancia del liderazgo e innovación para el futuro de la cirugía
    (2022) Braghetto, Italo; Hepp, Juan
    Históricamente, desde los inicios de la cirugía han existido líderes innovadores que ha hecho posible el progreso continuo de la cirugía a lo largo del tiempo hasta nuestros días. El proceso innovador cada vez más tecnológico que si bien trae consigo enormes avances se ha hecho más complejo por múltiples razones tales como su desarrollo e implementación, los costos, factores éticos, su correcta indicación y obviamente su evaluación en cuanto a los beneficios que aporta para el paciente y la sociedad. En este artículo se hace una somera revisión del desarrollo histórico de la innovación en cirugía y se presenta la opinión de los autores basado en la literatura respecto del proceso de innovación y del rol de líder innovador haciendo un análisis los múltiples factores involucrados.
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    Resección hepática extendida con vena cava inferior por colangiocarcinoma intrahepático. Presentación de 2 casos
    (2019) Rencoret, Guillermo; Vivanco, Marcelo; Castillo, Felipe; Schiappacasse, Giancarlo; de Aretxabala, Xabier; Bianchi, Víctor; Hepp, Juan; Ríos, Horacio
    Introduction: Intrahepatic cholangiocarcinoma is the second most common primary liver tumor and surgical resection the only valid curative treatment. Case reports: We describe two patients harboring an intrahepatic cholangiocarcinoma with cava vein involvement who underwent resection at Clinica Alemana of Santiago. Both patients were females with ages of 39 and 47 years old. Both patients underwent left liver resection, associated to resection of segment I and of a portion of cava vein. Reconstruction of resected portion of the cava vein was performed by using a pericardium bovine patch and primary closure respectively. Postoperative period was uneventfully being discharged at 13 and 23 days respectively. Discussion: Although surgical resection is the only way to get curativeness, frequent involvement of large vascular structures make treatment unfeasible. A multidisciplinary approach associated with a meticulous technique performed by an experienced surgical team make possible to accomplish the above objective.

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