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https://www.readbyqxmd.com/read/28639036/customization-of-laparoscopic-gastric-devascularization-and-splenectomy-for-gastric-varices-based-on-ct-vascular-anatomy
#1
Hirofumi Kawanaka, Tomohiko Akahoshi, Yoshihiro Nagao, Nao Kinjo, Daisuke Yoshida, Yoshihiro Matsumoto, Norifumi Harimoto, Shinji Itoh, Tomoharu Yoshizumi, Yoshihiko Maehara
BACKGROUND: Laparoscopic gastric devascularization(Lap GDS) and splenectomy (SPL) for gastric varices is technically challenging because of highly developed collateral vessels and bleeding tendency. We investigated the feasibility of customization of Lap GDS and SPL based on CT vascular anatomy. METHODS: We analyzed 61 cirrhotic patients with gastric varices who underwent Lap GDS and SPL between 2006 and 2014. Lap GDS was customized according to the afferent feeding veins (left gastric vein (LGV) and/or posterior gastric vein (PGV)/short gastric vein (SGV)) and efferent drainage veins (gastrorenal shunt and/or gastrophrenic shunt, or numerous retroperitoneal veins) based on CT imaging...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28634319/common-hepatic-artery-quadrifurcation-associated-with-right-hepatic-artery-from-superior-mesenteric-artery-during-laparoscopic-total-splenopancreasectomy
#2
Francesco Caruso, Giorgio Alessandri, Francesca Ciccarese, Giovanni Cesana, Matteo Uccelli, Giorgio Castello, Roberta Villa, Stefano Olmi
Hepatobiliopancreatic surgery is challenging becouse of the complexity of resections and reconstructions and variability of vascular anatomy. The arterial vascularization of the liver is susteined by the common hepatic artery (CHA) that originates from the celiac trunk (CT). The CHA bifurcates into the gastroduodenal artery (GDA) and proper hepatic artery (PHA) 0.5-1 cm medial to the common bile duct (CBD), and the PHA bifurcates into a right and a left branch at hepatic hilum. The most frequent variants are the right hepatic artery (RHA) from the superior mesenteric artery (SMA), the left hepatic artery (LHA) from the left gastric artery (LGA) or a combination of these two variants...
June 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28631148/early-postoperative-imaging-after-non-bariatric-gastric-resection-a-primer-for-radiologists
#3
REVIEW
Massimo Tonolini, Elena Bracchi
Surgical resection represents the mainstay treatment and only potentially curative option for gastric carcinoma, and is increasingly performed laparoscopically. Furthermore, other tumours and selected cases of non-malignant disorders of the stomach may require partial or total gastrectomy. Often performed in elderly patients, gastric resection remains a challenging procedure, with significant morbidity (14-43% complication rate) and non-negligible postoperative mortality (approximately 3%). This paper provides an overview of contemporary surgical techniques for non-bariatric gastric resection, reviews and illustrates the expected postoperative imaging appearances, common and unusual complications after partial and total gastrectomy...
June 19, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28625308/the-role-of-ultrasonography-in-obstetric-anesthesia
#4
REVIEW
Allison Lee, John P R Loughrey
Ultrasonography is increasingly being viewed as an everyday tool in obstetric anesthesia. For the administration of spinal or epidural anesthesia, it reduces needle redirection attempts in patients with difficult anatomy. In the less frequent scenario of a collapsed patient, it helps with assessment in the form of transthoracic echocardiography. Abdominal blocks require ultrasound guidance for safe and anatomically correct placement. Accurate assessment of gastric volume status with ultrasound would be a useful everyday skill if it is adopted into mainstream practice...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28624053/radiologic-evaluation-of-vasculobiliary-anatomy-in-the-umbilical-fissure
#5
Gu-Wei Ji, Fei-Peng Zhu, Ke Wang, Yong-Xiang Xia, Chen-Yu Jiao, Zi-Cheng Shao, Xiang-Cheng Li
BACKGROUND: Preoperative evaluation of vasculobiliary anatomy in the umbilical fissure (U-point) is pivotal for perihilar cholangiocarcinoma (PCCA) applied to right-sided hepatectomy. The purpose of our study was to review the vasculobiliary anatomy in the U-point using three-dimensional (3D) reconstruction technique, to investigate the diagnostic ability of 2D scans to evaluate anatomic variations, and to discuss its surgical implications. METHODS: A retrospective study of 159 patients with Bismuth type I, II, and IIIa PCCA, who received surgery at our institution from November 2012 to September 2016, was conducted...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28621295/efficacy-and-safety-in-case-of-technical-success-of-endoscopic-ultrasound-guided-transhepatic-antegrade-biliary-drainage-a-report-of-a-monocentric-study
#6
Sébastien Godat, Erwan Bories, Fabrice Caillol, Christian Pesenti, Jean Philippe Ratone, Chiara de Cassan, Marc Giovannini
BACKGROUND AND OBJECTIVES: Endoscopic ultrasound (EUS)-guided biliary drainage techniques are alternative procedures in cases of obstructive jaundice with altered anatomy or failed ERCP. Complications related to EUS-guided antegrade drainage (EUS-AD) are still present in up to 10% of cases, and combination of procedures is sometimes suggested to avoid adverse events. The purpose of our study is to evaluate the efficacy and safety of EUS-AD with transhepatic access in case of technical success...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28609220/reconstruction-options-for-pancreaticoduodenectomy-in-patients-with-prior-roux-en-y-gastric-bypass
#7
Mihir M Shah, Benjamin M Martin, Jamil L Stetler, Ankit D Patel, S Scott Davis, Juan M Sarmiento, Edward Lin
BACKGROUND: Patients with prior Roux-en-Y gastric bypass (RYGB) operations for weight loss present reconstruction challenges during a pancreaticoduodenectomy (PD). With over 60,000 RYGB performed annually, the increasing odds of encountering such patients during a PD make it imperative to understand the RYGB anatomy and anticipate reconstruction options. This article describes the possible reconstruction options and their rationale. METHODS: We reviewed our PD reconstruction options, compared them to what have been described in the literature, and derived a consensus from internal conferences comprising bariatric and hepatopancreatobiliary surgeons to describe known reconstruction options...
June 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28572086/functional-morphology-of-the-lower-esophageal-sphincter-and-crural-diaphragm-determined-by-3-d-high-resolution-pressure-profile-ct-imaging
#8
Ravinder K Mittal, Ali Zifan, Dushyant Kumar, Melissa Ledgerwood-Lee, Erika Ruppert, Gary Ghahremani
The lower esophageal sphincter (LES) and crural diaphragm (CD) provide the closure mechanism at esophago-gastric junction (EGJ). We used CT imaging in combination with 3D EGJ pressure recordings to determine the functional morphology of the LES and CD and its relationship to the EGJ anatomy. A 3D-HRM catheter recorded the EGJ pressure in 10 healthy subjects. A 0.5 mm diameter metal ball (BB) was taped to the catheter, adjacent to transducer #1. The EGJ pressure was recorded under following conditions; 1) end-expiration (LES pressure) a) before swallow, b) after swallow, and 2) peak inspiration (CD contraction) c) tidal inspiration and d) forced inspiration...
June 1, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28560528/success-of-percutaneous-endoscopic-gastrostomy-by-single-balloon-enteroscopy-in-patients-who-have-undergone-roux-en-y-gastric-bypass
#9
Eric Sellers, Andrew S Brock
Data is limited regarding the success and safety of percutaneous endoscopic gastrostomy (PEG) placements by single balloon enteroscopy (SBE) in patients with Roux-en-Y gastric bypass (RNY-GB) anatomy. We report on 23 cases of PEG placements by SBE with overall technical success of reaching the excluded stomach 70% and with PEG placement success rate of 69%. No intra-procedural adverse events occurred. This technique seems safe when feasible for PEG placement in patients with RNY-GB anatomy.
May 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28534559/-gastric-volvulus-an-infrequent-cause-of-acute-abdominal-pain
#10
D Ruiz-Clavijo García, A Zuñiga Ripa, L Casanova Ortíz, I García de Eulate Martín-Moro, B González de la Higuera Carnicer, J Urman Fernández
Gastric volvulus (GV) is characterized by the abnormal rotation of a portion of the stomach around a horizontal or vertical axis that can cause obstruction, vascular disorder and even strangulation, and may evolve into necrosis or even perforation. It can be classified according to its aetiology into primary or secondary GV, according to its anatomy into axial organ or into axial mesenteric GV, and according to its presentation into chronic or acute GV. Both types of volvulus require treatment; however, in spite of the classic treatment being open surgery, there is no standard treatment, nor is there consensus on the alternative of choice at present...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28522175/pharmacological-inhibition-of-soluble-epoxide-hydrolase-or-genetic-deletion-reduces-diclofenac-induced-gastric-ulcers
#11
Sumanta Kumar Goswami, Amelia Ann Rand, Debin Wan, Jun Yang, Bora Inceoglu, Melany Thomas, Christophe Morisseau, Guang-Yu Yang, Bruce D Hammock
AIMS: This research was conducted to evaluate the hypothesis that gastric ulcers caused by the NSAID diclofenac sodium (DCF) can be prevented by the soluble epoxide hydrolase inhibitor TPPU. MAIN METHODS: Mice were administered a single dose of 10, 30 or 100mg/kg of DCF. Once an ulcerative dose of DCF was chosen, mice were pretreated with TPPU for 7days at 0.1mg/kg to evaluate anti-ulcer effects of the sEH inhibitor on anatomy, histopathology, pH, inflammatory markers and epithelial apoptosis of stomachs...
July 1, 2017: Life Sciences
https://www.readbyqxmd.com/read/28516004/endoscopic-ultrasound-reaching-where-others-can-t
#12
Fady G Haddad, Magda Daoud, Ying Liu, Sherif Andrawes
Endoscopic ultrasound (EUS) has been increasingly used for the diagnosis and staging of pancreatic cancer. It has recently become the modality of choice in assessing pancreatic lesions overcoming other traditional modalities. Typically lesions located at the tail of the pancreas are best accessed through the stomach. We present a patient with pancreatic tail mass occurring in the setting of a large hiatal hernia, intrathoracic stomach, and severe lumbar levoscoliosis. Due to altered anatomy and extensive vascular connections of the mass, any surgical or radiological intervention was considered high risk for the patient...
April 15, 2017: Curēus
https://www.readbyqxmd.com/read/28491180/transbiliary-intravascular-ultrasound-guided-diagnostic-biopsy-of-an-inaccessible-pancreatic-head-mass
#13
Jeffrey Forris Beecham Chick, Benjamin B Roush, Minhaj S Khaja, Dennis Prohaska, Kyle J Cooper, Wael E Saad, Ravi N Srinivasa
Percutaneous image-guided biopsies of pancreatic malignancies may prove challenging and nondiagnostic due to a variety of anatomic considerations. For patients with complex post-surgical anatomy, such as a Roux-en-Y gastric bypass, diagnosis via endoscopic ultrasound with fine-needle aspiration may not be possible because of an inability to reach the proximal duodenum. This report describes the first diagnostic case of transbiliary intravascular ultrasound-guided biopsy of a pancreatic head mass in a patient with prior Roux-en-Y gastric bypass for which a diagnosis could not be achieved via percutaneous and endoscopic approaches...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28489166/anatomic-variations-of-hepatic-artery-a-study-in-479-liver-transplantations
#14
Olival Cirilo Lucena da Fonseca-Neto, Heloise Caroline de Souza Lima, Priscylla Rabelo, Paulo Sérgio Vieira de Melo, Américo Gusmão Amorim, Cláudio Moura Lacerda
Background: The incidence of anatomic variations of hepatic artery ranges from 20-50% in different series. Variations are especially important in the context of liver orthotopic transplantation, since, besides being an ideal opportunity for surgical anatomical study, their precise identification is crucial to the success of the procedure. Aim: To identify the anatomical variations in the hepatic arterial system in hepatic transplantation. Methods: 479 medical records of transplanted adult patients in the 13-year period were retrospectively analyzed, and collected data on hepatic arterial anatomy of the deceased donor...
January 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28488091/outcomes-of-endoscopic-retrograde-cholangiopancreatography-ercp-and-sphincterotomy-for-suspected-sphincter-of-oddi-dysfunction-sod-post-roux-en-y-gastric-bypass
#15
Chin Hong Lim, Cyrus Jahansouz, Martin L Freeman, Daniel B Leslie, Sayeed Ikramuddin, Stuart K Amateau
BACKGROUND: Sphincter of Oddi dysfunction (SOD) is thought to be a cause of chronic abdominal pain post Roux-en-Y gastric bypass, and current practice of performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy is not supported by evidence. In addition to the complexity and risks of the procedure in patients with Roux-en-Y anatomy, the outcomes are uncertain and debatable. We performed a retrospective review and analysis of post-gastric bypass patients who had undergone ERCP with sphincterotomy to determine the effectiveness in patients with suspected SOD...
May 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28469915/theoretical-investigation-of-transgastric-and-intraductal-approaches-for-ultrasound-based-thermal-therapy-of-the-pancreas
#16
Serena J Scott, Matthew S Adams, Vasant Salgaonkar, F Graham Sommer, Chris J Diederich
BACKGROUND: The goal of this study was to theoretically investigate the feasibility of intraductal and transgastric approaches to ultrasound-based thermal therapy of pancreatic tumors, and to evaluate possible treatment strategies. METHODS: This study considered ultrasound applicators with 1.2 mm outer diameter tubular transducers, which are inserted into the tissue to be treated by an endoscopic approach, either via insertion through the gastric wall (transgastric) or within the pancreatic duct lumen (intraductal)...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28467284/clinical-topographical-anatomy-of-the-gastro-oesophageal-junction-in-the-cat
#17
Agni Voutsinou, Lysimachos G Papazoglou, Ioannis Antonopoulos, Timoleon S Rallis
Objectives The purpose of the present study was to describe histologically the gastro-oesophageal junction in the cat and interrelationships of this region. Our hypothesis was that cats are devoid of abdominal oesophagus. Methods Three centimetres of the terminal oesophagus, the phreno-oesophageal membrane with 1-2 cm margins of the diaphragmatic crural muscle and the proximal 3 cm of the gastric cardia were obtained from nine domestic shorthair cats and one domestic longhair cat that were euthanased for reasons other than digestive tract pathology...
May 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28447199/a-novel-reconstruction-technique-during-pancreaticoduodenectomy-after-roux-en-y-gastric-bypass-how-i-do-it
#18
George Younan, Susan Tsai, Douglas B Evans, Kathleen K Christians
The altered anatomy in patients after bariatric surgery who have undergone a Roux-en-Y gastric bypass may pose a technical challenge for surgical removal of the pancreatic head. We treat patients with pancreas cancer with multimodality therapy in a neoadjuvant fashion followed by pancreaticoduodenectomy (PD). In patients with Roux-en-Y gastric bypass anatomy, the gastric remnant is preserved and used for pancreaticogastrostomy reconstruction and subsequently drained by the same jejunal limb used for the hepaticojejunostomy...
April 26, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28447058/development-of-lymph-node-dissection-in-laparoscopic-gastrectomy-safety-and-technical-tips
#19
REVIEW
Ru-Hong Tu, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Qi-Yue Chen, Long-Long Cao, Mi Lin, Chang-Ming Huang, Chao-Hui Zheng
With the accumulation of experience in laparoscopic radical gastrectomy and the progress in surgical instruments, the laparoscopic technique has been widely applied in gastric cancer. Combining previous reports with data from our center, we believe that laparoscopic surgery for gastric cancer is safe and feasible, and its surgery-related complications have an incidence that is not higher, and perhaps even lower, than that of traditional laparotomy. However, the stomach has many anatomical levels and an abundant blood supply; additionally, laparoscopic surgery is relatively difficult...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28447049/surgical-anatomy-of-gastric-lymphatic-drainage
#20
REVIEW
Maria Carmen Lirosi, Alberto Biondi, Riccardo Ricci
The lymphatic system of the stomach is a multidirectional and complex network composed of lymphatic nodes and vessels. Lymph node metastasis is the most important prognostic factor in curable gastric cancer and lymph node dissection is one of the main areas of surgical research in gastric cancer. Therefore the anatomical classification and embryological development of the gastric lymphatic system have been well described in the literature. The current description of the gastric lymphatic system of the stomach has a surgical orientation and follows the recommendations of the Japanese Gastric Cancer Association...
2017: Translational Gastroenterology and Hepatology
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