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Zijah Rifatbegovic, Maja Kovacevic, Branka Nikic
INTRODUCTION: Most of the case reports about high type iatrogenic hepatic duct injuries reports how to treat and make Roux-en-Y hepaticojejunostomy below the junction of the liver immediately after this condition is recognised during surgical procedure when the injury was made. Hereby we present a case where we made Roux-en-Y hepaticojejunostomy without transhepatic billiary stent and also without Witzel drainage one month after the iatrogenic injury. PRESENTATION OF CASE: A 21-year-old woman suffered from iatrogenic high transectional lesion of both hepatic ducts during laparoscopic cholecystectomy in a local hospital...
2018: International Journal of Surgery Case Reports
Fatema Alhashem, Ebru Yilmaz, Mehmet A Ozdemir, Kemal Deniz, Ali Yikilmaz, Turkan Patiroglu, Musa Karakukcu, Ekrem Unal
Different types of malignancies can be seen in patients with neurofibromatosis type 1 (NF-1). Herein we present a rare combination of NF-1 and biliary rhabdomyosarcoma in a male infant. An 11-month-old boy, who was recently diagnosed with NF-1, presented to the outpatient clinic with a 3-month history of prolonged jaundice, and failure to thrive. Clinical examination showed >20 café au let spots distributed mainly over the abdominal trunk. Hepatomegaly (4 cm below the costal margin) was additionally observed...
April 20, 2018: Journal of Pediatric Hematology/oncology
Fang-Min Liao, Mei-Hwei Chang, Ming-Chih Ho, Huey-Ling Chen, Yen-Hsuan Ni, Hong-Yuan Hsu, Jia-Feng Wu
BACKGROUND/PURPOSE: Biliary complications remain a major morbidity after liver transplantation in children. Inadequate arterial supply to the bile duct after transplantation plays an important role in developing anastomotic biliary complications. We aimed to elucidate the relationship between the resistance index (RI) of hepatic artery and the anastomotic biliary complications after liver transplantation in children. METHODS: This is a retrospective, case-control design study...
April 16, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Matias E Czerwonko, Pablo Huespe, Cristina M Elizondo, Juan Pekolj, Adrian Gadano, Laura Barcán, Sung-Ho Hyon, Eduardo de Santibañes, Martín de Santibañes
BACKGROUND: Adult liver recipients (ALR) differ from the general population with pyogenic liver abscess (PLA) as they exhibit: reconstructed biliary anatomy, recurrent hospitalizations, poor clinical condition and are subjected to immunosuppression. The aim of this study was to identify risk factors associated with PLA in ALR and to analyze the management experience of these patients. METHODS: Between 1996 and 2016, 879 adult patients underwent liver transplantation (LT), 26 of whom developed PLA...
July 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Himerón Limaylla-Vega, Emilio Vega-Gonzales
Iatrogenic bile duct injuries (IBDI) represent a serious surgical complication of laparoscopic cholecystectomy (LC). Often it occurs when the bile duct merges with the cystic duct; and they have been ranked by Strasberg and Bismuth, depending on the degree and level of injury. About third of IBDI recognized during LC, to detect bile leakage. No immediate repair is recommended, especially when the lesion is near the confluence or inflammation is associated. The drain should be established to control leakage of bile and prevent biliary peritonitis, before transferring the patient to a specialist in complex hepatobiliary surgery facility...
October 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Matias E Czerwonko, Pablo Huespe, Oscar Mazza, Martin de Santibanes, Rodrigo Sanchez-Claria, Juan Pekolj, Miguel Ciardullo, Eduardo de Santibanes, Sung Ho Hyon
BACKGROUND: Percutaneous biliary balloon dilation (PBBD) stands as a safe, useful, and inexpensive treatment procedure performed on patients with benign anastomotic stricture of Roux-en-Y hepatojejunostomy (BASH). However, the optimal mode of application is still under discussion. METHODS: A retrospective cohort study was conducted including patients admitted between 2008 and 2015 with diagnosis of BASH. Patients were divided into 2 groups: group I (n = 22), included patients treated after the implementation of an institutional protocol of 3 PBBD sessions within a fixed time interval and group II (n = 24) consisted of our historical control of patients who underwent one or 2 dilation sessions...
2018: Digestive Surgery
Kosei Takagi, Takahito Yagi, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kenjiro Kumano, Takeshi Kojima, Takuro Fushimi, Toshiyoshi Fujiwara
INTRODUCTION: Pancreaticoduodenectomy (PD) combined with extended right hemicolectomy (RH) is a challenging procedure for locally advanced malignancies. However, information concerning the reconstruction method of the digestive system is limited. Here, we present a case and surgical technique of a novel intestinal rotation method for digestive reconstruction after PD combined with RH. PRESENTATION OF CASE: A 62-year-old man with locally advanced pancreatic cancer received conversion surgery combined with PD and RH after preoperative chemotherapy...
2017: International Journal of Surgery Case Reports
Georgios C Sotiropoulos, Eleftherios Spartalis, Nikolaos Machairas, Gregory Kouraklis
The geographical distribution of Greece and the growing proportion of uninsured patients make imperative the need for effective and efficient palliative solutions regarding obstructive jaundice due to hepatic malignancy, while repeated endoscopic interventions and all associated materials are either not accessible to the whole population or not even available on a daily basis due to the economic crisis and the difficulties on the hospital supply. On this basis, palliative hepatojejunostomy, introduced more than 50 years ago, could be revisited in the Greek reality in very selected cases and under these special circumstances...
July 31, 2017: BMJ Case Reports
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
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
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
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
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)
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
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
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
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
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
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
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
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