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Biliary fistula

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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...
December 27, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27975049/risk-factors-and-treatment-for-hemorrhage-after-pancreaticoduodenectomy-a-case-series-of-423-patients
#13
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
https://www.readbyqxmd.com/read/27955973/value-of-preoperative-biliary-drainage-on-postoperative-outcome-after-pancreaticoduodenectomy-a-case-control-study
#14
Ayman El Nakeeb, Ali Salem, Yousef Mahdy, Mohamed El Dosoky, Rami Said, Mohamed Abd Ellatif, Helmy Ezzat, Ahmed M Elsabbagh, Hosam Hamed, Talaat Abd Alah, Gamal El Ebidy
BACKGROUND/OBJECTIVE: The potential benefit of preoperative biliary drainage (PBD) on postoperative outcomes remains controversial. The aim of this study was to elucidate surgical outcomes of pancreaticoduodenectomy (PD) in patients with PBD and to show the impact of bilirubin level. METHODS: We retrospectively studied all patients who underwent PD in our center between January 2003 and June 2015. Patients were divided into: Group A (PBD) and Group B (no PBD). The primary outcome was the rate of postoperative complication...
December 9, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27931638/complications-of-diagnostic-and-therapeutic-endoscopic-ultrasound
#15
REVIEW
Sundeep Lakhtakia
Endoscopic Ultrasound (EUS) provides the unique opportunity to visualize, interrogate and intervene gastrointestinal (GI) luminal, mural or peri-luminal structures and pathology with negligible adverse effects. Diagnostic, upper GI and rectal EUS is feasible, extremely safe, and efficacious. Most EUS guided interventions are safe, effective and minimally invasive, compared to peers in the percutaneous radiological or surgical procedures. As with any endoscopic procedure, EUS and its guided interventions may be accompanied by adverse events...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27921278/bronchobiliary-fistula-caused-after-hepatectomy-for-hepatocellular-carcinoma-a-case-report
#16
Seikan Hai, Yuji Iimuro, Tadamichi Hirano, Kazuhiro Suzumura, Akito Yada, Jiro Fujimoto
BACKGROUND: A bronchobiliary fistula, an intercommunication between the biliary tract and bronchial trees, is an extremely rare complication after hepatectomy. CASE PRESENTATION: A 70-year-old male underwent partial resection of the liver for recurrent hepatocellular carcinoma under a thoracoabdominal approach. The immediate postoperative clinical course was uneventful, but the patient was febrile and laboratory examinations revealed leukocytosis on the 15th postoperative day...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27920850/choledochoduodenal-fistula-in-the-setting-of-crohn-s-disease
#17
Shane Knipping, Ravi Rajpoot, Roozbeh Houshyar
Of all the spontaneous fistulas that occur between the extrahepatic biliary system and the intestine, a choledochoduodenal fistula is rarely seen. When it does occur, it is most often secondary to a perforated duodenal ulcer, choledocholithiasis, or cholelithiasis. It may also be seen following complications related to iatrogenic injury or tuberculosis. Generally, choledochoduodenal fistulas are asymptomatic, but may present with vague abdominal pain, fever, and other symptoms related to cholangitis. As a result, they can be difficult to diagnose clinically before imaging is obtained...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920840/unusual-use-of-gd-eob-dtpa-in-mrcp-in-order-to-reveal-the-source-of-bile-leakage-in-a-patient-with-neuroendocrine-tumor-case-report
#18
Rafał Mazur, Aleksander Pawluś, Kinga Szymańska, Mateusz Patyk, Anna Otlewska, Krzysztof Międzybrodzki, Dąbrówka Sokołowska-Dąbek, Eliza Kubicka, Urszula Zaleska-Dorobisz
BACKGROUND: MRCP is the method of choice in diagnosing pathologies of the biliary system. One of them is bile fistulae. They are uncommon but tend to cause many diagnostic problems. The possible way to improve MRCP is using it with intravenous injection of hepatobiliary-specific contrast agents. As it is eliminated via the hepatobiliary system, it can be visualized in the bile ducts and may help to reveal disorders undetected by a standard MRCP. CASE REPORT: We report a case of a 36-year-old woman with leakage in the biliary system which led to creation of a subcutaneous bile reservoir...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27905290/postoperative-wound-myiasis-caused-by-sarcophaga-carnaria
#19
Sefa Ergün, Ozan Akıncı, Serhat Sirekbasan, Ahmet Kocael
Myiasis is a parasitic infection caused by dipteran larvae settling in living tissue and organs. Infestation is generally found in tropical and rural areas, where interaction with animals is common. It is diagnosed based on the evidence of the existence of dipteran larvae in tissues and organs. When planning the treatment, identifying the type of larvae is as important as identifying the infected organ or system. In this case report, we present the case of a female who had a biliary tract injury caused by laparoscopic cholecystectomy and who developed a postoperative enterocutaneous fistula and myiasis caused by third-stage Sarcophaga sp...
September 2016: Türkiye Parazitolojii Dergisi
https://www.readbyqxmd.com/read/27861347/the-safety-and-efficacy-of-nasobiliary-drainage-versus-biliary-stenting-in-malignant-biliary-obstruction-a-systematic-review-and-meta-analysis
#20
Huapeng Lin, Shengwei Li, Xi Liu
BACKGROUND: Preoperative biliary drainage (PBD) has been widely used to treat patients with malignant biliary obstruction. However, it is still unclear which method of PBD (endoscopic nasobiliary drainage or endoscopic biliary stenting) is more effective. Thus, we carried out a meta-analysis to compare the safety and efficacy of endoscopic nasobiliary drainage (ENBD) and endoscopic biliary stenting (EBS) in malignant biliary obstruction in terms of preoperative and postoperative complications...
November 2016: Medicine (Baltimore)
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