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Hepatojejunostomy

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https://www.readbyqxmd.com/read/26527428/iatrogenic-bile-duct-injury-with-loss-of-confluence
#1
Miguel-Angel Mercado, Mario Vilatoba, Alan Contreras, Pilar Leal-Leyte, Eduardo Cervantes-Alvarez, Juan-Carlos Arriola, Bruno-Adonai Gonzalez
AIM: To describe our experience concerning the surgical treatment of Strasberg E-4 (Bismuth IV) bile duct injuries. METHODS: In an 18-year period, among 603 patients referred to our hospital for surgical treatment of complex bile duct injuries, 53 presented involvement of the hilar confluence classified as Strasberg E4 injuries. Imagenological studies, mainly magnetic resonance imaging showed a loss of confluence. The files of these patients were analyzed and general data were recorded, including type of operation and postoperative outcome with emphasis on postoperative cholangitis, liver function test and quality of life...
October 27, 2015: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/26518942/orthotopic-liver-transplantation-in-an-adult-with-biliary-atresia-situs-inversus-and-inferior-cava-vein-absence-a-case-report
#2
N Fernández Soria, M A García Novoa, J I Rivas Polo, C Fernández Sellés, M de Los Ángeles Vázquez, M Marini Milagros, M Gómez Gutiérrez
BACKGROUND: We report the case of a 34-year-old man who underwent Kasai portoenterostomy for biliary atresia at 6 weeks of age. In 2011, pulmonary hypertension was diagnosed and he began treatment with sildenafil. In 2012, he presented with an episode of upper gastrointestinal bleeding secondary to esophageal varices resistant to treatment. Later, he exhibited liver dysfunction. He was included on the waiting list for transplantation on May 29, 2013, with a Model for End-stage Liver Disease score of 24...
October 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/25713811/ruptured-choledochal-cyst-a-rare-presentation-and-unique-approach-to-management
#3
Michael Meschino, Carlos García-Ochoa, Roberto Hernandez-Alejandro
We present the rare case of a ruptured choledochal cyst (CC) in a young woman presenting with a two-day history of worsening upper abdominal pain. Imaging revealed a contracted gallbladder, dilated common bile duct (CBD), and a large amount of peritoneal fluid. Percutaneous paracentesis was performed, obtaining bilious fluid. Further imaging revealed cystic dilatation of the CBD and the diagnosis of rupture CC type I was made. The patient was initially managed conservatively with percutaneous drains, IV antibiotic therapy, and sphincterotomy through an ERCP...
February 2015: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/25630013/laparoscopy-assisted-transjejunal-endoscopic-retrograde-cholangiography-for-treatment-of-intrahepatic-duct-stones-in-a-post-roux-en-y-patient
#4
Salah M Mansor, Salem I Abdalla, Rashed S Bendardaf
We report a case of a 17-year-old female patient, who was operated on for choledocal cyst with Roux-en Y hepatojejunostomy. She was admitted to hospital with recurrent attacks of acute ascending cholangitis due to left intrahepatic duct stones. After a failed attempt at conventional endoscopic retrograde cholangiopancreatography through the anatomical route, she was treated successfully with laparoscopy assisted transjejunal endoscopic retrograde cholangiography. 
January 2015: Saudi Medical Journal
https://www.readbyqxmd.com/read/25192487/caution-for-diagnosis-and-surgical-treatment-of-recurrent-cholangitis-lessons-from-5-cases-of-bile-duct-tumor-thrombus-without-a-detectable-intrahepatic-tumor
#5
Zheng Wu, Kun Guo, Hao Sun, Liang Yu, Yi Lv, Bo Wang
The hepatocellular carcinoma (HCC) patients with bile duct tumor thrombus (BDTT) usually have no specific clinical symptoms at early stages. HCC with BDTT was usually misdiagnosed when the intrahepatic tumor was small, even undetectable. In this study, 5 cases of HCC with BDTT misdiagnosed as choledocholithiasis and cholangitis in the local hospital are described. We analyzed retrospectively and summarized our experiences of these 5 HCC patients with BDTT misdiagnosed in the local hospital during the past 5 years...
September 2014: Medicine (Baltimore)
https://www.readbyqxmd.com/read/24516837/transhepatic-transanastomotic-stent-a-reliable-method-for-hepatojejunostomy-and-prevention-of-anastomotic-leakage-following-radical-resection-in-patients-suffering-from-klatskin-tumor
#6
Sayyed Abbas Tabatabaee, Sayyed Mozaffar Hashemi, Mohamad Reza Fazel, Soraya Dadkhah, Amir Hosein Davarpanah Jazi
No abstract text is available yet for this article.
2013: Advanced Biomedical Research
https://www.readbyqxmd.com/read/23560658/single-incision-pediatric-endosurgery-a-systematic-review
#7
REVIEW
Lily J Saldaña, Eduardo M Targarona
BACKGROUND: Single-incision pediatric endosurgery (SIPES) is defined as minimally invasive surgery performed through a unique incision in the abdomen, chest, or retroperitoneum. Several publications exist, but no previous systematic review has been made to evaluate the real benefits of this approach in terms of feasibility and clinical outcomes. MATERIALS AND METHODS: We performed an electronic search in PubMed up to March 2012 with the terms "single AND incision OR site OR port OR trocar AND children" including related articles and obtained 197 articles...
May 2013: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/23179515/-biliodigestive-anastomosis-indications-complications-and-interdisciplinary-management
#8
REVIEW
H Goessmann, S A Lang, S Fichtner-Feigl, M N Scherer, H J Schlitt, C Stroszczynski, A G Schreyer, A A Schnitzbauer
Techniques for biliodigestive anastomoses are a frequent indication in primary surgical interventions. Moreover, they are required to manage secondary complications of hepatobiliary surgery. Evidence for the management of complications following biliodigestive anastomoses is low. Biliodigestive anastomoses can be performed as hepaticojejunostomy, hepatojejunostomy/portoenterostomy and hepaticoduodenostomy using running or single stitch suture techniques. Complication management in the hands of experienced hepatopancreatobiliary surgeons should consider a time delay to the primary operation and an interdisciplinary surgical and/or endoscopic or radiologic interventional approach...
December 2012: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/22901904/to-drain-or-not-to-drain-in-roux-en-y-hepatojejunostomy-for-children-with-choledochal-cysts-in-the-laparoscopic-era-a-prospective-randomized-study
#9
RANDOMIZED CONTROLLED TRIAL
Mei Diao, Long Li, Wei Cheng
BACKGROUND/PURPOSE: Routine drain placement after choledochal cyst (CDC) excision and Roux-en-Y hepatojejunostomy (RYHJ) is commonly practiced to predict and prevent bile/pancreatic leaks and hemorrhage. Recently, laparoscopic excision of CDC has decreased postoperative morbidity. The necessity of drainage has been questioned. We undertook a prospective randomized trial to assess the need for drainage. METHOD: Between 2009 and 2011, 121 CDC children were randomized into 2 groups before the laparoscopic RYHJ: drainage group (n = 61) and nondrainage group (n = 60)...
August 2012: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/22882912/routine-use-of-a-transanastomotic-stent-is-unnecessary-for-hepatojejunostomy-in-liver-transplantation
#10
Gen-Shu Wang, Yang Yang, Nan Jiang, Bin-Sheng Fu, Hua Li, Shi-Hui Li, Hai Jin, Jian-Xu Yang, Jian Zhang, Gui-Hua Chen
BACKGROUND: The use of transanastomotic stents for Roux-en-Y hepatojejunostomy (RYHJ) in liver transplantation (LT) remains controversial. The aim of this retrospective study was to assess the role of transanastomotic stent for RYHJ in LT. METHODS: RYHJ for biliary reconstruction in LT was performed in 52 patients. Twenty-five patients had bile duct reconstruction by RYHJ with transanastomotic stents (S group), while 27 patients underwent the same procedure without transanastomotic stents (non-S group)...
July 2012: Chinese Medical Journal
https://www.readbyqxmd.com/read/21724487/-current-management-of-benign-and-malignant-bile-duct-strictures
#11
REVIEW
M A Mercado
Benign and malignant bile duct strictures require multidisciplinary management. The radiologist, endoscopist and surgeon must assess the general conditions of the patient, as well as the etiology of the stenosis and the therapeutic options (palliative, temporal, or definitive). Stenotic injuries that maintain bilioenteric continuity are susceptible to radiologic and/or endoscopic treatment, specially benign lesions, usually appearing in the postsurgical period. Injuries with loss of continuity require surgical management in almost every case...
April 2011: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/21528093/classification-and-management-of-bile-duct-injuries
#12
Miguel Angel Mercado, Ismael Domínguez
To review the classification and general guidelines for treatment of bile duct injury patients and their long term results. In a 20-year period, 510 complex circumferential injuries have been referred to our team for repair at the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" hospital in Mexico City and 198 elsewhere (private practice). The records at the third level Academic University Hospital were analyzed and divided into three periods of time: GI-1990-99 (33 cases), GII- 2000-2004 (139 cases) and GIII- 2004-2008 (140 cases)...
April 27, 2011: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/21431961/is-it-necessary-to-ligate-distal-common-bile-duct-stumps-after-excising-choledochal-cysts
#13
COMPARATIVE STUDY
Mei Diao, Long Li, Wei Cheng
PURPOSE: After excision of choledochal cysts (CDC), the distal common bile duct (CBD) stumps are conventionally ligated. Yet, the distal common bile duct stump mobilization and ligation carries certain risk of pancreatic duct injury. The current study investigates the feasibility of selectively leaving distal stump unligated in CDC children with stenotic distal CBD. METHODS: Between 2001 and 2010, 270 CDC children successfully underwent laparoscopic cyst excision and Roux-en-Y hepatojejunostomy and were recruited into this study...
August 2011: Pediatric Surgery International
https://www.readbyqxmd.com/read/21264774/hemostasis-of-the-liver-spleen-and-bone-achieved-by-electrocautery-greased-with-lidocaine-gel
#14
Andy Petroianu
Despite advances in surgical techniques, achieving hemostasis of the liver, spleen, and bone during major surgery, especially after trauma, is still difficult. I describe a new procedure my colleagues and I devised to achieve parenchymatous hemostasis using electrocautery greased with lidocaine gel. After achieving good results in experimental studies and obtaining approval from our ethics committee, we used electrocautery greased with lidocaine gel for hemostasis in the following 36 procedures: multisegmental hepatectomy to remove hepatic tumors (n = 6); partial hepatectomy to allow hepatojejunostomy for intrahepatic biliary obstruction (n = 10); laparoscopic liver biopsy (n = 4); subtotal splenectomy (n = 8; for portal hypertension in 5 patients, splenic ischemia in 2, and Gaucher's disease in 1); laparoscopic splenic biopsy (n = 1); and bone resection (n = 7; as pelvic-femoral resection in 6 patients and to remove a rectal tumor invading the coccyx in 1)...
February 2011: Surgery Today
https://www.readbyqxmd.com/read/21052722/laparoscopic-versus-open-roux-en-y-hepatojejunostomy-for-children-with-choledochal-cysts-intermediate-term-follow-up-results
#15
COMPARATIVE STUDY
Mei Diao, Long Li, Wei Cheng
BACKGROUND: Laparoscopic hepatojejunostomy (LH) for children with choledochal cysts (CDC) has been gaining popularity recently. However, its safety and efficacy remain unknown. The purpose of this study was to evaluate the intermediate-term results of LH for CDC children. METHODS: We reviewed 218 patients who underwent LH between October 2001 and October 2009 and 200 patients who underwent open hepatojejunostomy (OH) between September 1993 and September 2001. Ultrasonography, upper gastrointestinal contrast studies, and laboratory tests were performed during the follow-up period...
May 2011: Surgical Endoscopy
https://www.readbyqxmd.com/read/20970584/covered-metal-stents-for-the-treatment-of-biliary-complications-after-orthotopic-liver-transplantation
#16
F García-Pajares, G Sánchez-Antolín, S L Pelayo, S Gómez de la Cuesta, M T Herranz Bachiller, M Pérez-Miranda, C de La Serna, M A Vallecillo Sande, N Alcaide, R V Llames, D Pacheco, A Caro-Patón
BACKGROUND: Biliary complications, a major source of morbidity after orthotopic liver transplantation (OLT), are increasingly being treated by endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic management has been shown to be superior to percutaneous therapy and surgery. Covered self-expandable metal stents (CSEMSs) may be an alternative to the current endoscopic standard treatment with periodic plastic stent replacement. OBJECTIVE: To assess the safety and efficacy of temporary CSEMS insertion for biliary complications after OLT...
October 2010: Transplantation Proceedings
https://www.readbyqxmd.com/read/20920739/laparoscopic-assisted-clearance-of-protein-plugs-in-the-common-channel-in-children-with-choledochal-cysts
#17
COMPARATIVE STUDY
Mei Diao, Long Li, Jin-Shan Zhang, Wei Cheng
BACKGROUND: The purpose of the study was to assess the efficacy of laparoscopic-assisted removal of protein plugs from the common channel in choledochal cysts. METHODS: Between 2001 and 2009, 34 patients with choledochal cysts (mean age, 4.98 years) with protein plugs in the common channel successfully underwent laparoscopic cyst excision and Roux-en-Y hepatojejunostomy. Under direct vision during laparoscopy, urethroscopes or catheters were inserted into the common channel to irrigate and remove the protein plugs...
October 2010: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/20815126/right-and-left-partial-iatrogenic-injuries-of-the-biliary-tree-therapeutic-options
#18
Miguel Angel Mercado, Ismael Domínguez, Juan Carlos Arriola, Fernando Ramirez-Del Val, Miguel Urencio, Norberto Sánchez-Fernández
BACKGROUND: Bile duct injuries (BDI) have a wide array of presentation. Left partial injuries (Strasberg D) of the hepatic duct are the result of excessive traction, which dissects the hepatic hilum and provokes medial perforations without continuity loss. Right partial injuries (Strasberg A, B and C) are produced by direct damage to the hepatic duct or isolated injury to the right and accessory ducts. It is important to determine frequency, spectrum and treatment outcome of this BDI in the surgical scenario...
May 2010: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/20385300/a-shorter-loop-in-roux-y-hepatojejunostomy-reconstruction-for-choledochal-cysts-is-equally-effective-preliminary-results-of-a-prospective-randomized-study
#19
RANDOMIZED CONTROLLED TRIAL
Mei Diao, Long Li, Jin-Zhe Zhang, Wei Cheng
BACKGROUND: Conventionally, an adult's standard of a 40-cm loop is adopted in Roux-Y hepatojejunostomy (RYHJ) in choledochal cyst (CDC) in children, irrespective of patient size. The redundant length of the jejunal limb may lead to complications. We compared the outcome of an individualized short Roux loop with the standard loop length in RYHJ in children with CDC. METHODS: Two hundred eighteen children with CDC undergoing laparoscopic RYHJ were prospectively randomized into 2 groups: (1) conventional group (CG; n = 108) where a standard 35-40 cm Roux-loop length was used regardless of the child's size and (2) short loop group (SLG; n = 110) in which the Roux-loop length was based on the distance between hepatic hilum and umbilicus...
April 2010: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/20226129/choledochal-cysts-in-adults
#20
José Luis Martínez-Ordaz, Javier Niño-Solís
BACKGROUND: Choledochal cysts are usually diagnosed during childhood. They mainly affect females. Abdominal pain and jaundice are the two most common symptoms. Our objective was to report the experience of a third-level referral center in the management of choledochal cysts in adults. METHODS: We performed a 17-year retrospective review of patients with choledochal cysts who underwent surgical interventions in a gastrointestinal surgery department. RESULTS: There were 23 patients with a median age of 26 years; 16 were females...
January 2010: Cirugia y Cirujanos
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