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Biliary fistula

Han Qin, Lin Luo, Zexin Zhu, Jiwei Huang
OBJECTIVE: To examine whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the best reconstruction method to reduce occurrence of postoperative complications, especially pancreatic fistula (PF), after pancreaticoduodenectomy (PD). BACKGROUND: PF is one of the most severe complications after PD. The best reconstruction method to reduce occurrence of PF is controversial. Therefore, we carried out this meta-analysis to compare PG with PJ. METHODS: A systematic review was conducted in PubMed, EMBASE, and Cochrane Library to identify studies comparing PG with PJ, published up to October 2015...
October 18, 2016: International Journal of Surgery
Enio Campos Amico, José Roberto Alves, Samir Assi João, Priscila Luana Franco Costa Guimarães, Joafran Alexandre Costa de Medeiros, Élio José Silveira da Silva Barreto
Background: Hepatectomies have been increasingly recommended and performed in Brazil; they present great differences related to immediate complications. Aim: Assessing the immediate postoperative complications in a series of 88 open liver resections. Method: Prospective database of patients subjected to consecutive hepatectomies over nine years. The post-hepatectomy complications were categorized according to the Clavien-Dindo classification; complications presenting grade equal to or greater than 3 were considered major complications...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Kumble S Madhusudhan, Nihar R Dash, Adil Afsan, Shivanand Gamanagatti, Deep N Srivastava, Arun K Gupta
Biliovenous fistula occurs due to development of a communication between hepatic duct and portal vein branches and is a rare complication of percutaneous transhepatic biliary drainage (PTBD). Most of them are self-limiting and only occasionally they need interventional management. Placement of biliary stent graft is a viable option. We present here a case of a 56-year-old male with carcinoma of gall bladder presenting with hemodynamic shock due to severe hemobilia after PTBD and treated successfully by biliary covered stent placement...
September 2016: Journal of Clinical and Experimental Hepatology
Kosuke Minaga, Masayuki Kitano, Chimyon Gon, Kentaro Yamao, Hajime Imai, Takeshi Miyata, Ken Kamata, Shunsuke Omoto, Mamoru Takenaka, Masatoshi Kudo
BACKGROUND AND AIMS: Endoscopic ultrasonography (EUS)-guided choledochoduodenostomy (EUS-CDS) is increasingly utilized in the treatment of malignant distal biliary obstruction. Standardized use of this technique requires improvements in instruments, including more convenient and safer devices. This study was designed to evaluate the resistance force to migration (RFM) of a newly designed laser-cut metal stent and the feasibility of EUS-CDS using this stent. METHODS: This experimental study utilized a porcine model of biliary dilatation involving five male pigs...
September 28, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Ronald Reverdito, André DE Moricz, Tércio DE Campos, Adhemar Monteiro Pacheco, Rodrigo Altenfelder Silva
OBJECTIVE: : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. METHODS: : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. RESULTS: : the incidence of MS was 0...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
Adrienne Carr, Nelson Gonzalez, Roberto Hernandez-Alejandro, Ramiro Arellano
A 64-year-old woman with a previous liver transplant developed graft failure with biliary complications including a bronchobiliary fistula, which did not respond to preoperative conservative therapy. Liver retransplantation provided definitive therapy for the liver failure and bronchobiliary fistula. We present anesthestic considerations for the intraoperative management of a liver retransplant with one-lung ventilation.
September 7, 2016: A & A Case Reports
Cinthia G Pérez, Aixa Reusmann
Congenital tracheo-or-bronchobiliary fistula or congenital he-patopulmonary fistula is a rare malformation with high morbidity and mortality if the diagnosis is not made early. The tracheo-or-bronchobiliary fistula is a communication between the respiratory (trachea or bronchus) and biliary tract. To date, only 35 cases have been published worldwide. We report a case of a neonate with right pneumonia and bilious fluid in the endotracheal tube. Diagnosis was made using bronchoscopy with fluoroscopy. Videothoracoscopy was used to remove the bronchobiliary fistula...
October 1, 2016: Archivos Argentinos de Pediatría
Carmelo Luigiano, Giuseppe Iabichino, Benedetto Mangiavillano, Leonardo H Eusebi, Monica Arena, Pierluigi Consolo, Carmela Morace, Sharmila Fagoonee, Matteo Barabino, Enrico Opocher, Rinaldo Pellicano
Bile duct injuries are the most serious complications after hepatobiliary surgery and are associated with high morbidity and mortality. The incidence of iatrogenic injuries of bile ducts has increased after the advent of laparoscopic cholecystectomy. Bile duct injuries present with biliary leak or biliary obstruction or a combination of both. Successful treatment of these complications requires a multidisciplinary team that includes biliary endoscopists, interventional radiologists and hepatobiliary surgeons...
September 2, 2016: Minerva Chirurgica
Paschalis Gavriilidis, Ernest Hidalgo, Nicola de'Angelis, Peter Lodge, Daniel Azoulay
AIM: The benefit of prophylactic drainage after uncomplicated hepatectomy remains controversial. The aim of this study was to update the existing evidence on the role of prophylactic drainage following uncomplicated liver resection. METHODS: Cochrane, Medline (Pubmed), and Embase were searched. The Medline search strategy was adopted for all other databases. A grey literature search was performed. Meta-analyses were performed with Review Manager 5.3. Primary outcomes were mortality and ascitic leak, secondary outcomes were infected intra-abdominal collection, chest infection, wound infection of the surgical incision, biliary fistula, and length of stay...
August 26, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Aurélien Gracient, Lionel Rebibo, Richard Delcenserie, Thierry Yzet, Jean-Marc Regimbeau
Despite the ongoing decrease in the frequency of complications after hepatectomy, biliary fistulas still occur and are associated with high morbidity and mortality rates. Here, we report on an unusual technique for managing biliary fistula following left hepatectomy in a patient in whom the right posterior segmental duct joined the left hepatic duct. The biliary fistula was treated with a combined radiologic and endoscopic procedure based on the "rendezvous technique". The clinical outcome was good, and reoperation was not required...
August 14, 2016: World Journal of Gastroenterology: WJG
Z Mughal, J Green, P J Whatling, R Patel, T C Holme
INTRODUCTION Cholecystectomy is one of the most common elective procedures carried out by general surgeons. Most patients present with typical biliary anatomy and simple gallstone disease. Intraoperative and postoperative courses are frequently predictable and uncomplicated. Nevertheless, a small but significant number of patients experience complicated disease with rare presentations and complex biliary anatomy. Unfortunately, consensus on appropriate care for such patients is lacking. CASE HISTORY We describe three patients who presented with complex manifestations of gallbladder perforation: acute perforation of the gallbladder; a spontaneous cholecystocutaneous fistula; a cholecystoduodenal fistula...
August 23, 2016: Annals of the Royal College of Surgeons of England
T V Prasad, A K Gupta, P Garg, S Pal, S Gamanagatti
Hemobilia is a well known cause for upper gastrointestinal (UGI) bleed seen commonly in setting of iatrogenic or accidental trauma and various inflammatory and neoplastic conditions. Patients present with UGI bleed and symptoms of associated biliary obstruction. Management options in intractable cases are surgery and endovascular embolisation. We report a series of eighteen patients presented with severe hemobilia from January 2010 to October 2014, who were managed by endovascular approach in our department...
July 2015: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
Rachel M Gomes, Nilesh H Doctor
INTRODUCTION: Reconstructive hepatico-jejunostomy is recommended for major bile duct injuries (BDIs) during cholecystectomy. Complications of biliary leak, cholangitis, bleeding, anastomotic strictures and biliary cirrhosis remain a major concern affecting a patient's outcome after surgery. The aim of this study was to analyse the results of surgical repair of major BDIs at our institution and identify predictors for the development of major complications. METHODS: A retrospective study of 57 patients with major BDI after cholecystectomy referred to a tertiary hepato-biliary centre from July 1999 to July 2011 and subsequently managed with reconstructive bilio-enteric anastomosis was performed...
October 2015: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
Sangram Patil, Shahid Roomi, M H Shiwani
No abstract text is available yet for this article.
August 8, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
John S Richey, Benjamin M Manning, Wesley B Jones
The role of endoscopic retrograde cholangiopancreatography (ERCP) in the trauma patient is limited. Therefore, reporting of outcomes is sparse in the literature. The purpose of this study was to review outcomes of patients who underwent ERCP for traumatic biliopancreatic injury. We retrospectively reviewed 1550 ERCPs, from a prospectively maintained database, performed by a single surgical endoscopist consulted by the trauma surgical service for the management of traumatic fistulae. Referral was made for patients with high output (greater than 200 mL/d) and/or persistent (failure to resolve within 30 days) fistulae and traumatic biliary stricture...
July 2016: American Surgeon
S N Shirbur, H Ramachandran, S Gokhale, J Falleiro
Agenesis of gall bladder is a clinical rarity, as most of the diagnoses are made at autopsy. Preoperative diagnosis of this anomaly is fraught with follies. External biliary fistulae are usually result of complications of trauma or biliary surgery. Internal fistulae on the other hand may result from erosion of wall by a stone, cancerous growth or peptic ulcer. Sites of opening of internal fistulae are stomach, duodenum, jejunum, ileum or colon. These should be suspected if gas shadows are seen in biliary tree...
April 2001: Medical Journal, Armed Forces India
Sezgin Yilmaz, Murat Akici, Nazan Okur, Serkan Türel, Ogun Erşen, Enes Şahin
INTRODUCTION: Bile leak after cholecystectomy which is the frequency less than 2% is an important problem for patients. Some bile duct injuries occuring after laparoscopic cholecystectomy are the complex bile duct injuries and can cause bile leak and fistula. PRESENTATION OF CASE: A 74-year-old woman has high output bile drainage from abdominal drain after laparoscopic cholecystectomy so an ERCP was performed. It was clear that there was a complete transaction of bile ducts, however this finding was inconsistent with the patient's clinical situation...
2016: International Journal of Surgery Case Reports
Yohei Horibe, Seiji Adachi, Mitsuru Okuno, Tomohiko Ohno, Naoe Goto, Midori Iwama, Osamu Yamauchi, Koshiro Saito, Ichiro Yasuda, Masahito Shimizu
A 65-year-old woman with recurrent breast cancer was repeatedly treated with bevacizumab, an anti-VEGF antibody. In addition, she was also frequently prescribed a nonsteroidal anti-inflammatory drug for abdominal pain. Melena was revealed 2 months after the final treatment with bevacizumab, and an endoscopic study revealed a duodenal ulcer (DU) that was resistant to anti-ulcer therapy. A cholangiography identified a biliary-duodenal fistula with bile juice leaking from the ulcer base. Therefore, a biliary stent was placed into the common bile duct for 3 months until the DU healed...
July 2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Ramon Sanchez-Ocaña, Carlos Chavarria-Herbozo, Andrés Figueroa Marrero, Maria-Teresa Herranz Bachiller, Irene Peñas-Herrero, Carlos de la Serna-Higuera, Manuel Perez-Miranda
No abstract text is available yet for this article.
2016: Endoscopy
María Victoria Vieiro Medina, Ramón Gómez Sanz, Eneida Bra Insa, Iván Domínguez Sánchez, Marta de la Fuente Bartolomé, David Díaz Pérez, Oana Anisa Nutu, Felipe de la Cruz Vigo
We present the case of a 69 year old woman with a history of cholecystitis, who consulted for severe abdominal pain, nausea and vomiting. Abdominal CT showed duodenal obstruction caused by a gallstone, cholecystoduodenal fistula and pneumobilia, what is known as Bouveret's syndrome, a rare form of gallstone ileus. Additionally, she presented free duodenal and vesicular perforation to retroperitoneum at the same level of the cholecystoduodenal transit point. The patient underwent a difficult cholecystectomy, enterolithotomy, repair of the duodenal defect, extensive washing and drainage of the retroperitoneum...
June 2016: Revista Española de Enfermedades Digestivas
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