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Hepatojejunostomy failure

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)
Edip Akpinar, Gennaro Selvaggi, David Levi, Jang Moon, Seigo Nishida, Eddie Island, Werviston DeFaria, Ernesto Pretto, Philip Ruiz, Andreas G Tzakis
BACKGROUND: Transplantation of more than two livers for recurring graft failure has not been specifically addressed in the literature. METHODS: A retrospective analysis was conducted from a total of 2527 overall liver transplants at our institution. Main indications for multiple retransplant included primary nonfunction, chronic rejection, hepatic artery thrombosis, and recurrent disease. RESULTS: We identified 39 patients who received more than two grafts (32 received 3 grafts, 5 received 4 grafts, and 2 received 5 grafts)...
October 15, 2009: Transplantation
Miguel Angel Mercado, Mario Vilatobá, Carlos Chan, Ismael Domínguez, Rafael Paulino Leal, Marco Antonio Olivera
BACKGROUND: Biliary complications after orthotopic liver transplantation (OLT) are multifactorial in origin. In most series, the frequency of such complications ranges from 5-20%. Most can be treated by endoscopy and/or interventional radiology. For cases in which this option is not successful, surgical approach is indicated. We report the results of reoperation using an intrahepatic bilioenteric anastomosis. METHODS: The medical charts of patients with biliary complications after OLT during a 10-year period (1997-2007), who failed to respond to nonsurgical treatment and were surgically treated, were reviewed...
March 2009: World Journal of Surgery
Miguel Angel Mercado-Díaz, Rebeca Ramírez-Morales, Mario Arturo Medinilla-Cruz, Fernando Poucel-Sánchez Medal
BACKGROUND: With loss of continuity of the bile ducts after injury, surgery is the only feasible treatment option. Roux-en-Y hepatojejunostomy is the best choice. The use of transhepatic and transanastomotic tubes is still controversial. We evaluated patients who were operated on in which a transhepatic, transanastomotic tube was used because the characteristics of the ducts were inadequate. METHODS: We conducted a retrospective, descriptive study between January 1995 and December 2006 for patients with iatrogenic bile duct injuries with a Roux-en-Y hepatojejunostomy and with placement of a transhepatic and transanastomotic tube...
May 2008: Cirugia y Cirujanos
Miguel Angel Mercado, Carlos Chan, Héctor Orozco, Eitan Podgaetz, David Estuardo Porras-Aguilar, Antonio Ramos De la Medina, Carlos A Hinojosa, Juan José Plata-Muñoz, César Jaramillo, F I Oki
UNLABELLED: Most iatrogenic bile duct injuries are recognized in the early postoperative period (first 48 hours). These patients usually have additional complications such as a suboptimal hydroelectrolitic status, subhepatic collections, external biliary fistula and malnutrition. In these circumstances, besides the elevation of bilirubin and transaminases associated with the injury, hypoalbuminemia is frequently encountered. The timing for repair is decided according to the condition of each patient...
July 2005: Annals of Hepatology
Miguel Angel Mercado, Carlos Chan, Héctor Orozco, Carlos A Hinojosa, Juan Carlos Jacinto Tinajero, Leonardo N Santamaría Galeotti, Luis E Alarcón Mora, Jonathan Mendoza Reyes
UNLABELLED: Bile duct injuries occur with a frequency of 1 to 5 per 1000 cases as a result of an increase in the number of procedures performed. Elderly patients have more severe lithiasis- related diseases than the younger population. This fact increases the likelihood of conversion from laparoscopic to open surgery, and the probability of injury. We report the results of bile duct reconstruction after injury in these patients. SETTING: A tertiary care academic university hospital...
October 2004: Annals of Hepatology
S A Meylaerts, T M van Gulik, E A Rauws, D J Gouma
Obstructive jaundice occurred in 3 patients, 2 women, aged 44 and 60 years, and one man aged 62 years: 17 years after choledochojejunostomy following a complicated cholecystectomy, 8 years after hepatojejunostomy following choledochal cyst removal, and 1 year after laparoscopic cholecystectomy. Percutaneous or endoscopic stent placement was performed in all patients to relieve biliary obstruction. However, stent dysfunction repeatedly resulted in re-stenting of the obstruction. Imaging techniques, as well as endoscopic brush pathology could not distinguish between a benign or malignant stenosis...
June 5, 2004: Nederlands Tijdschrift Voor Geneeskunde
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