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Biliary fistula

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https://www.readbyqxmd.com/read/28331537/combined-totally-mini-invasive-approach-in-necrotizing-pancreatitis-a-case-report-and-systematic-literature-review
#1
REVIEW
Luca Sorrentino, Osvaldo Chiara, Massimiliano Mutignani, Fabrizio Sammartano, Paolo Brioschi, Stefania Cimbanassi
BACKGROUND: Currently, both the step-up approach, combining percutaneous drainage (PD) and video-assisted retroperitoneal debridement (VARD), and endoscopic transgastric necrosectomy (ETN) are mini-invasive techniques for infected necrosis in severe acute pancreatitis. A combination of these approaches could maximize the management of necrotizing pancreatitis, conjugating the benefits from both the experiences. However, reporting of this combined strategy is anecdotal. This is the first reported case of severe necrotizing pancreatitis complicated by biliary fistula treated by a combination of ETN, PD, VARD, and endoscopic biliary stenting...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28331267/laparoscopic-management-of-a-proximal-jejunal-gallstone-ileus-with-patulous-ampulla-and-choledochal-cyst-a-report-of-unusual-presentation-and-a-review
#2
REVIEW
Rajvilas Anil Narkhede, Vijaykumar C Bada, Lakshmi Kumari Kona
Gallstone ileus is a diagnosis of rarity, and a proximal site of obstruction in a young patient is even rare. Of the three cases in our experience, we found two cases of gallstone ileus (GSI) with typical epidemiology and presentation, one had combination of multiple rare associations. We report such a case, suspected to have gallstone ileus on ultrasound and confirmed diagnosis on computed tomography. Presence of biliary-enteric fistula, old age, and obstructive features, as in typical cases, was a bigger asset for diagnosis, but it was difficult to entertain diagnosis of GSI in young girl in absence of a demonstrable biliary-enteric fistula, with uncommon association of choledochal cyst and sickle cell disease...
February 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28322898/biliary-stent-migration-a-rare-cause-of-a-bladder-stone
#3
Neha R Malhotra, Carlos Amir Esparza Monzavi, Jean-Sebastien Trepanier, Johan Nordenstam, Michael R Abern
Our patient presented with dysuria and pneumaturia without any prior urologic instrumentation. History included choledocolithiasis requiring ERCP and biliary stenting. Imaging showed a large bladder stone. She was taken to surgery and found to have diverticulitis. The sigmoid was resected and the bladder found to have a small fistula tract. The bladder was opened and a large calculus was identified and extracted. The stone was opened and found to contain a biliary stent. While biliary stenting is generally considered safe, migration can occur...
March 17, 2017: Urology
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#4
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28251830/disparities-in-the-management-and-prophylaxis-of-surgical-site-infection-and-pancreatic-fistula-after-pancreatoduodenectomy
#5
Francisco Igor B Macedo, Mia Mowzoon, Janak Parikh, Sandeep A Sathyanarayana, Michael J Jacobs
BACKGROUND: Pancreatoduodenectomy (PD) carries a high morbidity. Over time, pancreatic surgeons have altered their perioperative management in efforts to reduce morbidity rates, thereby creating major technical and management variations. We aim to evaluate the practice patterns of hepato-pancreato-biliary (HPB) surgeons across multiple regions worldwide. METHODS: Between May and August 2015, an anonymous 25-item survey questionnaire was electronically distributed to IHPBA (International Hepato-Pancreato-Biliary Association) members regarding practice patterns and perioperative care of patients undergoing PD...
March 2, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28251661/reduced-complication-rates-of-percutaneous-transhepatic-biliary-drainage-with-ultrasound-guidance
#6
Andrej Wagner, Christian Mayr, Tobias Kiesslich, Frieder Berr, Paul Friesenbichler, Gernot W Wolkersdörfer
BACKGROUND: We aimed to analyze the benefits of adding ultrasound (US) guidance to the standard fluoroscopically assisted percutaneous transhepatic biliary drainage (F-PTBD). We also performed a systematic literature review of success and complication rates of US-PTBD in a wide field of indications. METHODS: We evaluated a total of 81 US-PTBDs carried out in our institution, 74% of which were part of the management of malignancy. In addition, we compared our results with those of a total of 5,272 procedures (3,779 F-PTBD and 1,493 US-PTBD) reported in the literature...
March 2, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28230033/postoperative-infectious-complications-after-liver-resection-for-hepatocellular-carcinoma
#7
Yuan Zhao, Yi Jin, Yueming Wu
OBJECTIVE: The purpose of this study was to evaluate the postoperative infectious complications after liver resection for hepatocellular carcinoma by logistic regression analysis. MATERIALS AND METHODS: One hundred and sixty-six hepatocellular carcinoma patients who received surgery were retrospectively reviewed and included in this study. Of the included 166 patients, 42 patients had the postoperative infectious complications (case group) and other 124 patients did not develop postoperative infection (control group)...
December 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28141556/ultrasound-measurement-of-the-gallbladder-wall-thickness-in-the-assessment-of-the-risk-of-conversion-from-elective-laparoscopic-cholecystectomy-to-open-surgery-olkusz-county-experience
#8
Dariusz Kania
The aim of the study was to assess the risk of intraoperative difficulties, conversion and biliary-intestinal fistula during laparoscopic cholecystectomy on the basis of an ultrasound-measured gall-bladder wall thickness. MATERIAL AND METHODS: A prospective study was conducted in 50 patients undergoing laparoscopic cholecystectomy for chronic gallstone-induced cholecystitis. To calculate the relationships between categorical variables, a chi-square (χ2) independence test was used, and the results were interpreted for the significance threshold of α = 0...
December 1, 2016: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28110901/-gastrointestinal-bleeding-and-delirium-challenges-in-the-diagnosis-of-gallstone-ileus-a-case-report-and-review-of-literature
#9
Francisco Aguilar-Espinosa, José Luis Gálvez-Romero, Jesús Falfán-Moreno, Gustavo Adolfo Guerrero-Martínez, Facundo Vargas-Solís
BACKGROUND: Gallstone ileus is a non-strangulated mechanical obstruction of the small bowel or colon as a result of the passage of gallstones through a biliary enteric fistula. It is a rare complication of cholelithiasis, affects patients over 65 years, and the disease occurs predominantly in females. Preoperative diagnosis is difficult due to the lack of specific signs and symptoms in elderly patients with multiple comorbidities. CLINICAL CASE: A 93-year-old female presenting with a one-week history of upper gastrointestinal bleeding, electrolyte imbalance and community- acquired pneumonia pneumonia...
January 19, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28087319/biliary-fistula-after-pancreaticoduodenectomy-data-from-1618-consecutive-pancreaticoduodenectomies
#10
Stefano Andrianello, Giovanni Marchegiani, Giuseppe Malleo, Tommaso Pollini, Deborah Bonamini, Roberto Salvia, Claudio Bassi, Luca Landoni
BACKGROUND: Biliary fistula (BF) occurs in 3-8% of patients following pancreaticoduodenectomy (PD). It usually pursues a benign course, but rarely may represent a life-threatening event. STUDY DESIGN: Data from 1618 PDs were collected prospectively. BF was defined as the presence of bile stained fluid from drains by post-operative day 3 and confirmed by sinogram in the majority of cases. Three classifications were validated. RESULTS: BF occurred in 58 (3...
January 11, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28078460/imbedding-pancreaticojejunostomy-used-in-pure-laparoscopic-pancreaticoduodenectomy-for-nondilated-pancreatic-duct
#11
Min Wang, Simiao Xu, Hang Zhang, Shuyou Peng, Feng Zhu, Renyi Qin
BACKGROUND: LPD has been cautiously regarded as feasible and safe for resection and reconstruction. However, anastomosis of the remnant pancreas is still thought to be a critical obstacle to the dissemination of LPD in general practice. This study presents a new technique of pancreaticojejunostomy for nondilated pancreatic duct and evaluates its safety and reliability. METHODS: From July 2014 to June 2015, a total of 52 patients underwent LPD with the new technique...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28076484/an-innovative-ex-vivo-model-for-rapid-change-of-the-papilla-for-teaching-advanced-endoscopic-retrograde-cholangiopancreatography-procedures
#12
Everson L A Artifon, Thaisa S Nakadomari, Leandro Y Kashiwagui, Emilio A Belmonte, Cláudio R Solak, Spencer Cheng, Carlos K Furuya, Jose P Otoch
Background: Models for endoscopic retrograde cholangiopancreatography training allow practice with an expert feedback and without risks. A method to rapidly exchange the papilla can be time saving and accelerate the learning curve. Aim: To demonstrate a newly method of rapid exchange papilla in ex-vivo models to teach retrograde cholangiopancreatography advanced procedures. Methods: A new model of ex-vivo papilla was developed in order to resemble live conditions of procedures as cannulation, papilotomy or fistula-papilotomy, papiloplasty, biliary dilatation, plastic and metallic stentings...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28076477/pediatric-liver-transplantation-with-ex-situ-liver-transection-and-the-application-of-the-human-fibrinogen-and-thrombin-sponge-in-the-wound-area
#13
COMPARATIVE STUDY
Fernando Pompeu Piza Vicentine, Adriano Miziara Gonzalez, Ramiro Anthero de Azevedo, Barbara Burza Benini, Marcelo Moura Linhares, Gaspar de Jesus Lopes-Filho, Jose Luiz Martins, Alcides Augusto Salzedas-Netto
Background: Surgical strategy to increase the number of liver transplants in the pediatric population is the ex-situ liver transection (reduction or split). However, it is associated with complications such as hemorrhage and leaks. The human fibrinogen and thrombin sponge is useful for improving hemostasis in liver surgery. Aim: Compare pediatric liver transplants with ex-situ liver transection (reduction or split) with or without the human fibrinogen and thrombin sponge...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28067465/cholestyramine-alters%C3%A2-bile-acid%C3%A2-amounts-and-the-expression-of-cholesterol-related-genes-in-rabbit-intestinal-and-hepatic-tissues
#14
Dong Ni Qiu, Quan Shang, Da Yu Sun, Wei Qun Ding, Zhong Guang Luo, Jian Chen, Wei Ru Jiang, Jian Ping Huang, Xiao Yun Jiang
OBJECTIVE: Cholestyramine, as a bile acid sequestering exchange resin, has been wildly used to treat hypercholesterolemia. The aim of this study was to explore how cholestyramine regulated serum cholesterol amounts and bile acid levels in animal models. METHODS: The New Zealand White rabbits were randomly assigned to the control (given distilled water) and cholestyramine (CHO)-treated (given cholestyramine 1 g/kg/day for 2 weeks) groups. To assess bile acid pool size, bile fistulas were generated in five rabbits in each group...
January 9, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28066983/endoscopic-ultrasound-guided-antegrade-biliary-stenting-for-unresectable-malignant-biliary-obstruction-in-patients-with-surgically-altered-anatomy-a-single-center-prospective-pilot-study
#15
Takuji Iwashita, Ichiro Yasuda, Tsuyoshi Mukai, Keisuke Iwata, Shinpei Doi, Shinya Uemura, Masatoshi Mabuchi, Mitsuru Okuno, Masahito Shimizu
BACKGROUND AND AIMS: Endoscopic retrograde cholangiography (ERCP) with biliary stenting for the treatment of unresectable malignant biliary obstruction (MBO) is challenging among patients with surgically altered anatomy. Endoscopic ultrasound-guided antegrade biliary stenting (EUS-ABS) was introduced as an alternative biliary drainage method, although it has not been well studied yet. In this single-center prospective pilot study, we aimed to evaluate the feasibility and safety of EUS-ABS for MBO in patients with surgically altered anatomy...
January 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28044956/retained-common-bile-duct-lithiasis-at-a-pacient-with-periampullary-duodenal-diverticulum
#16
Ionuţ Simion Coman, Elena-Violeta Radu, Vasile Șandru, Ionuţ Cristinel Bârsan, Cristinel Dumitru Badiu, Gabriel Constantinescu, Valentin Titus Grigorean
Periampullary duodenal diverticula are associated with the presence of common bile duct stones, being encountered more frequently with the increase of age. We present the case of a 76 years old female patient, who underwents emergency surgery for a perforated lithiasic gangrenous acute cholecystitis and for whom we perform a cholecystectomy and an external biliary drainage using a transcystic tube. Both preoperative and postoperative imaging and endoscopic examinations certify the presence of a periampullary duodenal diverticulum...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28044954/haemobilia-a-rare-cause-of-upper-gastro-intestinal-bleeding
#17
Daniel Ion, Carmen Iuliana Mavrodin, Mihai Bogdan Șerban, Tudor Marinescu, Dan Nicolae Păduraru
Haemobilia is a rare cause of upper gastrointestinal bleeding that consists of haemorrhage within the biliary tree. Most cases of haemobilia are due to iatrogenic cause, laparoscopic or open cholecystectomy, abdominal trauma, gallstones, hepatic tumours, vascular aneurism. We present the case of a male patient admitted in the surgery department for epigastric and right hypochondria pain, nausea and vomiting. Open cholecystectomy was performed with a trans-cystic tube drainage. Postoperative outcome was favourable but with a continuous decrease in haemoglobin level...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28043693/preoperative-biliary-stenting-versus-operation-first-in-jaundiced-patients-due-to-malignant-lesions-in-the-pancreatic-head-a-meta-analysis-of-current-literature
#18
REVIEW
Florian Scheufele, Stephan Schorn, Ihsan Ekin Demir, Mine Sargut, Elke Tieftrunk, Lenika Calavrezos, Carsten Jäger, Helmut Friess, Güralp Onur Ceyhan
BACKGROUND: Obstructive jaundice is a common presenting symptom among patients with pancreatic cancer. While benefits of preoperative biliary drainage have been suggested by previous studies, recent evidence has shown no significant improvements of preoperative biliary drainage on the postoperative outcome but rather an increase of complications. There is no clear consensus on whether to treat malignant obstructive jaundice with preoperative biliary drainage prior to operative intervention or to proceed directly to resection...
December 30, 2016: Surgery
https://www.readbyqxmd.com/read/28028561/management-of-paediatric-liver-trauma
#19
REVIEW
A B van As, Alastair J W Millar
Of all the intra-abdominal solid organs, the liver is the most vulnerable to blunt abdominal trauma. The majority of liver ruptures present in combination with other abdominal or extra-abdominal injuries. Over the last three decades, the management of blunt liver trauma has evolved from obligatory operative to non-operative management in over 90% of cases. Penetrating liver injuries more often require operative intervention and are managed according to adult protocols. The greatest clinical challenge remains the timely identification of the severely damaged liver with immediate and aggressive resuscitation and expedition to laparotomy...
April 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/27975049/risk-factors-and-treatment-for-hemorrhage-after-pancreaticoduodenectomy-a-case-series-of-423-patients
#20
Feng Gao, Jianguo Li, Shengwei Quan, Fujun Li, Donglai Ma, Lei Yao, Ping Zhang
The study aimed to investigate the risk factors of postpancreatectomy hemorrhage (PPH) after pancreaticoduodenectomy (PD). A retrospective analysis of 423 patients who underwent PD between January 2008 and January 2014 was conducted. The overall incidence and all-cause mortality of PPH were 9.9% (42/423) and 2.1% (9/423), respectively. Independent risk factors of early PPH were revascularization (odds ratio (OR) = 6.786; 95% confidence interval (95% CI): 1.785-25.792; P = 0.005), history of abdominal surgery (OR = 5...
2016: BioMed Research International
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