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Hepatobiliary interventions

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https://www.readbyqxmd.com/read/29016233/metabolic-complications-of-home-parenteral-nutrition
#1
Jamie Davila, Denise Konrad
Home parenteral nutrition (HPN) has benefited countless patients since its initiation almost 5 decades ago. Over time, HPN has been found to be associated with various complications, including metabolic disorders. Metabolic complications can be grouped into short-term (eg, fluid imbalance, electrolyte disturbances, glucose abnormalities) and long-term (eg, hepatobiliary disorders, metabolic bone disease, iron deficiency anemia, manganese toxicity) categories. There are a number of treatment options for each complication...
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28921009/radiation-overexposure-from-repeated-ct-scans-in-young-adults-with-acute-abdominal-pain
#2
Massimo Tonolini, Elena Valconi, Angelo Vanzulli, Roberto Bianco
PURPOSE: The purpose of this study is to assess the dose of ionizing radiation caused by repeated CT scans performed to investigate non-traumatic acute abdominal conditions in young adults. METHODS: Over 26 months, we collected a cohort of patients aged 18 to 45 years who were subject to at least one urgent contrast-enhanced abdomen/pelvis CT. Patients affected with urolithiasis, HIV infection, tumors, and vascular and chronic inflammatory bowel diseases were excluded...
September 18, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28911286/the-effect-of-a-surgery-specific-cardiac-output-guided-haemodynamic-algorithm-on-outcomes-in-patients-undergoing-pancreaticoduodenectomy-in-a-high-volume-centre-a-retrospective-comparative-study
#3
L Weinberg, J Banting, L Churilov, R L McLeod, K Fernandes, I Chao, T Ho, D Ianno, V Liang, V Muralidharan, C Christophi, M Nikfarjam
In this retrospective observational study performed in a high-volume hepatobiliary-pancreatic unit, we evaluated the effect of a surgery-specific goal-directed therapy (GDT) physiologic algorithm on complications and length of hospital stay. We compared patients who underwent pancreaticoduodenectomy with either a standardised Enhanced Recovery After Surgery program (usual care group), or a standardised Enhanced Recovery After Surgery program in combination with a surgery-specific cardiac output-guided algorithm (GDT group)...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28860900/portal-vein-stenting-for-delayed-jejunal-varix-bleeding-associated-with-portal-venous-occlusion-after-hepatobiliary-and-pancreatic-surgery
#4
Dongho Hyun, Kwang Bo Park, Sung Ki Cho, Hong Suk Park, Sung Wook Shin, Sung Wook Choo, Young Soo Do, In Wook Choo, Dong Wook Choi
OBJECTIVE: The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. MATERIALS AND METHODS: Eleven consecutive patients (age range, 2-79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated...
September 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28832091/co-existence-of-the-double-inferior-vena-cava-with-complex-interiliac-venous-communication-and-aberrant-common-hepatic-artery-arising-from-superior-mesenteric-artery-a-case-report
#5
Vilai Chentanez, Natcha Nateniyom, Thanasil Huanmanop, Sithiporn Agthong
Variations of the arterial and venous system of the abdomen and pelvis have important clinical significance in hepatobiliary surgery, abdominal laparoscopy, and radiological intervention. A case of double inferior vena cava (IVC) with complex interiliac communication and variation of the common hepatic artery (CHA) arising from superior mesenteric artery (SMA) in a 79-year-old male cadaver is presented. Both IVCs ascended on either side of the abdominal aorta. The left-sided IVC crossed anterior to the aorta at the level of the left renal vein...
August 23, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28808803/a-prototype-educational-model-for-hepatobiliary-interventions-unveiling-the-role-of-graphic-designers-in-medical-3d-printing
#6
Ramin Javan, Merissa N Zeman
In the context of medical three-dimensional (3D) printing, in addition to 3D reconstruction from cross-sectional imaging, graphic design plays a role in developing and/or enhancing 3D-printed models. A custom prototype modular 3D model of the liver was graphically designed depicting segmental anatomy of the parenchyma containing color-coded hepatic vasculature and biliary tree. Subsequently, 3D printing was performed using transparent resin for the surface of the liver and polyamide material to develop hollow internal structures that allow for passage of catheters and wires...
August 14, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28680700/ultrasonographic-and-clinicopathologic-features-of-segmental-dilatations-of-the-common-bile-duct-in-four-cats
#7
Heather N Spain, Dominique G Penninck, Cynthia Rl Webster, Evence Daure, Samuel H Jennings
CASE SERIES SUMMARY: This case series documents ultrasonographic and clinicopathologic features of four cats with marked segmental dilatations of the common bile duct (CBD). All cats had additional ultrasonographic changes to the hepatobiliary system, including hepatomegaly, tubular to saccular intra/extrahepatic biliary duct dilatation and biliary debris accumulation. Based on all available data the presence of extrahepatic biliary duct obstruction (EHBDO) was ruled out in 3/4 cases and was equivocal in one case...
January 2017: JFMS open reports
https://www.readbyqxmd.com/read/28611566/periorbital-ecchymosis-raccoon-eye-and-orbital-hematoma-following-endoscopic-retrograde-cholangiopancreatography
#8
Jafar Nasiri, Farhad Zamani
Endoscopic retrograde cholangiopancreatography (ERCP) is a conventional technique for diagnosis and treatment of pancratobiliary diseases, which is associated with various complications, including pancreatitis, hemorrhage, cholangitis, perforation, and mortality. In our case, a 69-year-old woman with positive hepatobiliary symptoms underwent ERCP, at the end of which a rare complication (raccoon eye) occurred, which was hypothesized to be due to amyloidosis, but the patient refused to complete the diagnostic procedure and became symptom free after 3 weeks...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28600711/what-s-in-a-name-tensions-between-formal-and-informal-communities-of-practice-among-regional-subspecialty-cancer-surgeons
#9
Simon C Kitto, Rachel E Grant, Jennifer Peller, Carol-Anne Moulton, Steven Gallinger
In 2007 the Cancer Care Ontario Hepatobiliary-Pancreatic (HPB) Community of Practice was formed during the wake of provincial regionalization of HPB services in Ontario, Canada. Despite being conceptualized within the literature as an educational intervention, communities of practice (CoP) are increasingly being adopted in healthcare as quality improvement initiatives. A qualitative case study approach using in-depth interviews and document analysis was employed to gain insight into the perceptions and attitudes of the HPB surgeons in the CoP...
June 9, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28593266/wireless-monitoring-program-of-patient-centered-outcomes-and-recovery-before-and-after-major-abdominal-cancer-surgery
#10
Virginia Sun, Sinziana Dumitra, Nora Ruel, Byrne Lee, Laleh Melstrom, Kurt Melstrom, Yanghee Woo, Stephen Sentovich, Gagandeep Singh, Yuman Fong
Importance: A combined subjective and objective wireless monitoring program of patient-centered outcomes can be carried out in patients before and after major abdominal cancer surgery. Objective: To conduct a proof-of-concept pilot study of a wireless, patient-centered outcomes monitoring program before and after major abdominal cancer surgery. Design, Setting, and Participants: In this proof-of-concept pilot study, patients wore wristband pedometers and completed online patient-reported outcome surveys (symptoms and quality of life) 3 to 7 days before surgery, during hospitalization, and up to 2 weeks after discharge...
September 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28589237/choledochal-malformation-in-children-lessons-learned-from-a-dutch-national-study
#11
Maria H A van den Eijnden, Ruben H J de Kleine, Ivo de Blaauw, Paul G J M Peeters, Bart P G Koot, Matthijs W N Oomen, Cornelius E J Sloots, W G van Gemert, David C van der Zee, L W E van Heurn, Henkjan J Verkade, Jim C H Wilde, Jan B F Hulscher
INTRODUCTION: A choledochal malformation (CM) is a rare entity, especially in the Western world. We aimed to determine the incidence of CM in the Netherlands and the outcome of surgery for CM in childhood. METHODS: All pediatric patients who underwent a surgical procedure for type I-IV CM between 1989 and 2014 were entered into the Netherlands Study group on choledochal cyst/malformation. Patients with type V CM were excluded from the present analysis. Symptoms, surgical details, short-term (<30 days) and long-term (>30 days) complications were studied retrospectively...
June 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28523968/gastrointestinal-system-involvement-in-systemic-lupus-erythematosus
#12
Z Li, D Xu, Z Wang, Y Wang, S Zhang, M Li, X Zeng
Systemic lupus erythematosus (SLE) is a multisystem disorder which can affect the gastrointestinal (GI) system. Although GI symptoms can manifest in 50% of patients with SLE, these have barely been reviewed due to difficulty in identifying different causes. This study aims to clarify clinical characteristics, diagnosis and treatment of the four major SLE-related GI system complications: protein-losing enteropathy (PLE), intestinal pseudo-obstruction (IPO), hepatic involvement and pancreatitis. It is a systematic review using MEDLINE and EMBASE databases and the major search terms were SLE, PLE, IPO, hepatitis and pancreatitis...
October 2017: Lupus
https://www.readbyqxmd.com/read/28486007/concomitant-laparoscopic-perisplenic-artery-ligation-facilitates-surgery-for-hepatobiliary-disease-coexisting-with-portal-hypertension
#13
Youlong Wang, Fei Chen, Yajuan Chu, Xiaofang Tan, Jingwang Tan, Wenbin Ji
BACKGROUND: Although liver cirrhosis with portal hypertension (PH) contributes significantly to morbidity and mortality in abdominal surgery, many authors still consider this disease as an indication for surgery. In many reports, however, numerous treatment modalities focus on hypersplenism secondary to PH, irrespective of splenomegaly and PH. The proven benefits of laparoscopy seem especially applicable to patients with this complex disease. This study evaluates the safety and efficacy of laparoscopic perisplenic artery ligation (SAL) in patients with hepatobiliary disease and PH...
October 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28452912/effects-of-a-brief-team-training-program-on-surgical-teams-nontechnical-skills-an-interrupted-time-series-study
#14
Brigid M Gillespie, Emma Harbeck, Evelyn Kang, Catherine Steel, Nicole Fairweather, Kriengsak Panuwatwanich, Wendy Chaboyer
BACKGROUND: Up to 60% of adverse events in surgery are the result of poor communication and teamwork. Nontechnical skills in surgery (NOTSS) are critical to the success of surgery and patient safety. The study aim was to evaluate the effect of a brief team training intervention on teams' observed NOTSS. METHODS: Pretest-posttest interrupted time-series design with statistical process control analysis was used to detect longitudinal changes in teams' NOTSS. We evaluated NOTSS using the revised NOTECHS weekly for 20 to 25 weeks before and after implementation of a team training program...
April 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28447062/modified-palliative-biliary-stenting-in-situs-inversus-totalis-patient-with-carcinoma-gallbladder-feasibility-and-technical-details
#15
Nishant Gupta, Pradeep Goyal, Itisha Bansal, Shuo Li, Yogesh Kumar, Sanjay S Baijal
Knowledge of the anatomical variants is essential for all invasive hepatobiliary procedures such as endoscopy, surgery and radiologic interventions. Modification in standard therapeutic interventions may be required based on variant anatomy. We report a technical modification in a 75-year-old female with known situs inversus (SI) totalis with carcinoma gallbladder. Present case highlights the finer technical details of the modified percutaneous transhepatic biliary drainage (PTBD) procedure and biliary stenting in a SI patient with carcinoma gallbladder causing malignant biliary obstruction...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28442470/late-outcomes-in-children-with-langerhans-cell-histiocytosis
#16
Tin Wai Chow, Wing Kwan Leung, Frankie Wai Tsoi Cheng, Shekhar Medhukar Kumta, Winnie Chiu Wing Chu, Vincent Lee, Matthew Ming Kong Shing, Chi Kong Li
INTRODUCTION: Langerhans cell histiocytosis (LCH) is a rare disease with diverse clinical courses. Despite improvement in survival outcomes in the recent decades, sequelae of the disease remain a concern. This study aimed to provide information on the long-term outcomes in patients with LCH, particularly on the sequelae and any associated factors. METHOD: Medical records of patients with diagnosis of LCH and being managed in our centre were retrospectively reviewed...
September 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28417463/pharmacological-interventions-for-primary-sclerosing-cholangitis-an-attempted-network-meta-analysis
#17
REVIEW
Francesca Saffioti, Kurinchi Selvan Gurusamy, Neil Hawkins, Clare D Toon, Emmanuel Tsochatzis, Brian R Davidson, Douglas Thorburn
BACKGROUND: Primary sclerosing cholangitis is a chronic cholestatic liver disease that is associated with both hepatobiliary and colorectal malignancies, which can result in liver cirrhosis and its complications. The optimal pharmacological treatment for patients with primary sclerosing cholangitis remains controversial. OBJECTIVES: To assess the comparative benefits and harms of different pharmacological interventions in people with primary sclerosing cholangitis by performing a network meta-analysis, and to generate rankings of available pharmacological interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28365715/gall-bladder-agenesis-a-rare-embryonic-cause-of-recurrent-biliary-colic
#18
Aarthi Rajkumar, Albina Piya
BACKGROUND Gallbladder agenesis (GA) is an extremely rare anatomic anomaly with a reported incidence of less than 0.5%. It is usually asymptomatic, but can present with features of biliary colic and cholecystitis. We present here a case of GA in a patient with recurrent biliary colic.  CASE REPORT A 24-year-old African American woman presented with recurrent episodes of right upper-quadrant abdominal pain. During her first episode, she was found to have elevated transaminases and clinical features of cholecystitis, but ultrasound did not visualize a gallbladder and she was discharged with a diagnosis of biliary colic...
April 2, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28360525/the-importance-of-a-multidisciplinary-approach-to-hepatocellular-carcinoma
#19
REVIEW
Osama Siddique, Eric R Yoo, Ryan B Perumpail, Brandon J Perumpail, Andy Liu, George Cholankeril, Aijaz Ahmed
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. The rising incidence, genetic heterogeneity, multiple etiologies, and concurrent chronic liver diseases make diagnosis, staging, and selection of treatment options challenging in patients with HCC. The best approach to optimize the management of HCC is one that utilizes a core multidisciplinary liver tumor board, consisting of hepatologists, pathologists, interventional radiologists, oncologists, hepatobiliary and transplant surgeons, nurses, and general practitioners...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28349225/hepatobiliary-phase-mri-impact-on-planning-image-guided-liver-tumor-ablations
#20
Paul B Shyn, Ailbhe C O'Neill, Walter F Wiggins, Nisha I Sainani, Servet Tatli, Kemal Tuncali, Vincent M Levesque, Stuart G Silverman
PURPOSE: To assess the impact of hepatobiliary phase images obtained during intravenous gadoxetate disodium-enhanced liver MRI in the planning of image-guided liver tumor ablations. METHODS: This institutional review board-approved retrospective study included 34 patients (21 men, 13 women, ages 25-80) who underwent 36 liver MRI examinations with gadoxetate disodium within 12 weeks prior to image-guided thermal ablation of 62 liver tumors during 36 procedures. Visibility of bile ducts, subdivided by branch order, on hepatobiliary phase images was compared to standard MRI sequence images by an attending abdominal radiologist and fellow...
March 27, 2017: Abdominal Radiology
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