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strasberg lesion

Himerón Limaylla-Vega, Emilio Vega-Gonzales
Iatrogenic bile duct injuries (IBDI) represent a serious surgical complication of laparoscopic cholecystectomy (LC). Often it occurs when the bile duct merges with the cystic duct; and they have been ranked by Strasberg and Bismuth, depending on the degree and level of injury. About third of IBDI recognized during LC, to detect bile leakage. No immediate repair is recommended, especially when the lesion is near the confluence or inflammation is associated. The drain should be established to control leakage of bile and prevent biliary peritonitis, before transferring the patient to a specialist in complex hepatobiliary surgery facility...
October 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Massimiliano Mutignani, Edoardo Forti, Stefanos Dokas, Francesco Pugliese, Paola Fontana, Alberto Tringali, Lorenzo Dioscoridi
BACKGROUND: Bile leakage is a common complication after hepatic resection [1-4] (Donadon et al., 2016; Dechene et al., 2014; Zimmitti et al., 2013; Yabe et al., 2016). Endotherapy is the treatment of choice for this complication except for bile leaks originating from isolated ducts; a condition resembling the post laparoscopic cholecystectomy Strasberg type C lesions [5-9] (Lillemo et al., 2000; Gupta and Chandra, 2011; Park et al., 2005; Colovic, 2009; Mutignani et al., 2002). In such cases, surgical repair is complex, often of uncertain result and with a high morbidity and mortality [1] (Donadon et al...
August 2017: Digestive and Liver Disease
David Martin, Emilie Uldry, Nicolas Demartines, Nermin Halkic
Incidence of bile duct injuries (BDI) is low but remains a dramatic complication after laparoscopic cholecystectomy (LC). This study aimed to assess BDI incidence and management strategies. All patients treated in our institution for BDI after LC between 2000 and 2011 were retrospectively analyzed. Patients referred from others centers were excluded. Strasberg classification was used to determine the type of lesion. Thirteen patients presented iatrogenic BDI among 2,840 consecutive cholecystectomies performed (0...
July 19, 2016: Bioscience Trends
Mehmet Velidedeoglu, Akif Enes Arikan, Sezgin Server Uludag, Deniz Cebi Olgun, Fahrettin Kilic, Metin Kapan
BACKGROUND/AIMS: Due to being a severe complication, iatrogenic bile duct injury is still a challenging issue for surgeons in gallbladder surgery. However, a commonly accepted classification describing the type of injury has not been available yet. This study aims to evaluate ability of six current classification systems to discriminate bile duct injury patterns. METHODOLOGY: Twelve patients, who were referred to our clinic because of iatrogenic bile duct injury after laparoscopic cholecystectomy were reviewed retrospectively...
May 2015: Hepato-gastroenterology
Adolfo Cuendis-Velázquez, Carlos Morales-Chávez, Itzé Aguirre-Olmedo, Fernanda Torres-Ruiz, Martín Rojano-Rodríguez, Luis Fernández-Álvarez, Eduardo Cárdenas-Lailson, Mucio Moreno-Portillo
BACKGROUND: The incidence of bile duct injuries (BDI) after cholecystectomy, which is a life-threatening condition that has several medical and legal implications, currently stands at about 0.6%. The aim of this study is to describe our experience as the first center to use a laparoscopic approach for BDI repair. METHODS: A prospective study between June 2012 and September 2014 was developed. Twenty-nine consecutive patients with BDI secondary to cholecystectomy were included...
March 2016: Surgical Endoscopy
Marcos V Perini, Paulo Herman, Andre L Montagnini, Jose Jukemura, Fabricio F Coelho, Jaime A Kruger, Telesforo Bacchella, Ivan Cecconello
AIM: To report experience with liver resection in a select group of patients with postoperative biliary stricture associated with vascular injury. METHODS: From a prospective database of patients treated for benign biliary strictures at our hospital, cases that underwent liver resections were reviewed. All cases were referred after one or more attempts to repair bile duct injuries following cholecystectomy (open or laparoscopic). Liver resection was indicated in patients with Strasberg E3/E4 (hilar stricture) bile duct lesions associated with vascular damage (arterial and/or portal), ipsilateral liver atrophy/abscess, recurrent attacks of cholangitis, and failure of previous hepaticojejunostomy...
February 21, 2015: World Journal of Gastroenterology: WJG
Juan Pekolj, Alejandro Yanzón, Agustin Dietrich, Gabriela Del Valle, Victoria Ardiles, Eduardo de Santibañes
BACKGROUND: Common bile duct injuries (CBDI) are serious complications of cholecystectomies which are often associated with vascular involvement, meaning that their management represents a major challenge to the physician. We present our experience in major hepatectomy due to CBDI, highlighting indications, postoperative complications, and long-term outcomes. METHODS: From August 1993 to September 2013, 287 patients with CBDI were treated in our centre. In 15 patients of this group (5 %), a major hepatectomy was performed...
May 2015: World Journal of Surgery
N Al Hajjar, C Tomuş, L Mocan, T Mocan, F Graur, C Iancu, F Zaharie
BACKGROUND: Bile duct injury following cholecystectomy remains a severe complication with major implications for the patient outcome. AIM: To assess the outcome of surgical treatment and study the risk factor infuencing biliary reconstruction in patients with bile duct injuries following laparoscopic cholecystectomy. METHODS: Between January 2005 and December 2010, 43 patients with bile duct injuries following laparoscopic cholecystectomy were treated to our center...
July 2014: Chirurgia
Ileana Lorenzana-Bautista, Aníbal Flores-Plascencia, Francisco Javier Barrios-Pineda, Georgia Alderete-Vázquez, Enrique Alejandro Sánchez-Valdivieso
BACKGROUND: A significant number of people suffer iatrogenic bile duct injury during laparoscopic cholescystectomy. Biliary-digestive bypass may be complicated by stenosis and biliary sepsis, affecting both quality of life and life expectancy. To avoid bypass synthetic grafts have been used, which are expensive. OBJECTIVE: Evaluating autologous implantation of peritoneus as alternative of bile duct repair. METHODS: Under general anesthesia, ten New Zealand adult rabbits were operated, common bile duct approached and sectioned underneath the cystic duct followed by a liver biopsy...
September 2013: Cirugia y Cirujanos
C De Werra, R Del Giudice, R Di Micco, S Aloia, L Bracciano, M Cervotti, G Galloro, L Bucci
AIM: The main aim of our study is to evaluate the incidence, the type, the causes and the therapy of biliary duct injuries which occurred after the video laparoscopic cholecystectomies performed in our Department during the period from 1990 to 2012. PATIENTS AND METHODS: A retrospective analysis of 1186 VLC has been made in our Department from March 1990 to June 2012. Before the cholecystectomy all patient were evaluated with trans abdominal echography. Beyond the incidence of BDI was evaluated damaging mechanism, etiology, therapy and time of diagnosis...
March 2013: Il Giornale di Chirurgia
Juan Pekolj, Fernando A Alvarez, Martin Palavecino, Rodrigo Sánchez Clariá, Oscar Mazza, Eduardo de Santibañes
BACKGROUND: Bile duct injury (BDI) remains the most serious complication of laparoscopic cholecystectomy (LC). The best strategy in terms of timing of repair is still controversial. The purpose of the current study is to review the experience in the intraoperative repair of bile duct injuries sustained during LC at a high-volume referral center. STUDY DESIGN: Single-institution retrospective analysis of a prospectively collected database. Patients with diagnosis of BDI sustained during LC between October 1991 and November 2010 were extracted...
May 2013: Journal of the American College of Surgeons
F Mihăileanu, F Zaharie, L Mocan, C Iancu, L Vlad
UNLABELLED: Cholecystectomy is one of the most performed surgical interventions in general surgery. Laparoscopic cholecystectomy was associated with an increasing occurrence of biliary ducts lesions. The aim of this study is to draw the attention towards the permanent risk of these kind of complications, the curative difficulties and identifying the best therapeutic solution in order to obtain favorable results on long term. METHOD: There were retrospectively and prospectively analysed all the cases with diagnosis of iatrogenic biliary ducts lesion hospitalized and operated during 1987-2008 in the Surgical Clinic No 3 Cluj Napoca...
July 2012: Chirurgia
M A Mercado
Benign and malignant bile duct strictures require multidisciplinary management. The radiologist, endoscopist and surgeon must assess the general conditions of the patient, as well as the etiology of the stenosis and the therapeutic options (palliative, temporal, or definitive). Stenotic injuries that maintain bilioenteric continuity are susceptible to radiologic and/or endoscopic treatment, specially benign lesions, usually appearing in the postsurgical period. Injuries with loss of continuity require surgical management in almost every case...
April 2011: Revista de Gastroenterología de México
F Turcu, C Dragomirescu, S Pletea, B Bănescu
UNLABELLED: The goal of this study was to increase the awareness of the problem of iatrogenic common bile duct injury. METHODS: A retrospective review of the biliary primary or redo reconstructions performed at our clinic, for iatrogenic injuries, was done. A total of 34 cases were followed for 2 to 16 (mean 8.5 +/- 4.5) years in order to asses their long-term outcomes. RESULTS: There were 8 Strasberg D lesions and 26 Strasberg E lesions. The mortality rate was 6% (2 patients)...
March 2011: Chirurgia
Miguel Angel Mercado, Ismael Domínguez, Juan Carlos Arriola, Fernando Ramirez-Del Val, Miguel Urencio, Norberto Sánchez-Fernández
BACKGROUND: Bile duct injuries (BDI) have a wide array of presentation. Left partial injuries (Strasberg D) of the hepatic duct are the result of excessive traction, which dissects the hepatic hilum and provokes medial perforations without continuity loss. Right partial injuries (Strasberg A, B and C) are produced by direct damage to the hepatic duct or isolated injury to the right and accessory ducts. It is important to determine frequency, spectrum and treatment outcome of this BDI in the surgical scenario...
May 2010: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
Joseph F Buell, Daniel Cherqui, David A Geller, Nicholas O'Rourke, David Iannitti, Ibrahim Dagher, Alan J Koffron, Mark Thomas, Brice Gayet, Ho Seong Han, Go Wakabayashi, Giulio Belli, Hironori Kaneko, Chen-Guo Ker, Olivier Scatton, Alexis Laurent, Eddie K Abdalla, Prosanto Chaudhury, Erik Dutson, Clark Gamblin, Michael D'Angelica, David Nagorney, Giuliano Testa, Daniel Labow, Derrik Manas, Ronnie T Poon, Heidi Nelson, Robert Martin, Bryan Clary, Wright C Pinson, John Martinie, Jean-Nicolas Vauthey, Robert Goldstein, Sasan Roayaie, David Barlet, Joseph Espat, Michael Abecassis, Myrddin Rees, Yuman Fong, Kelly M McMasters, Christoph Broelsch, Ron Busuttil, Jacques Belghiti, Steven Strasberg, Ravi S Chari
OBJECTIVE: To summarize the current world position on laparoscopic liver surgery. SUMMARY BACKGROUND DATA: Multiple series have reported on the safety and efficacy of laparoscopic liver surgery. Small and medium sized procedures have become commonplace in many centers, while major laparoscopic liver resections have been performed with efficacy and safety equaling open surgery in highly specialized centers. Although the field has begun to expand rapidly, no consensus meeting has been convened to discuss the evolving field of laparoscopic liver surgery...
November 2009: Annals of Surgery
Jennifer L Gnerlich, Jon H Ritter, David C Linehan, William G Hawkins, Steven M Strasberg
OBJECTIVE: To determine the safety and efficacy of saline-linked surface radiofrequency ablation (SLSRFA) in a clinical setting. SUMMARY BACKGROUND DATA: We have previously identified safe and effective parameters for use of SLSRFA in a porcine model. METHODS: An initial study was conducted to determine if parameters defined in the porcine model were safe and effective in human livers. In 16 patients undergoing liver resection, normal areas of liver were treated with SLSRFA using various power/diameter combinations (10 W/1 cm; 15 W/2 cm; 45 W/4 cm) for 9 minutes with and without inflow occlusion...
July 2009: Annals of Surgery
D Vintiă, C N Neacşu, P Popa, E Târcoveanu, St O Georgescu
BACKGROUND: Bile duct injuries are the main serious technical complication of laparoscopic cholecystectomy (LC). Each lesion is peculiar in its features as well as the surgeon's reaction when face it. AIM: To reveal the place of the human error according to accepted principles of cognitive psychology, beside other risk-factors involved in biliary accidents during LC. METHOD: Retrospective study on 18 patients treated for severe biliary lesions during LC in 1st Surgical Clinic of "Sf...
January 2009: Chirurgia
David A Kooby, Theresa Gillespie, David Bentrem, Attila Nakeeb, Max C Schmidt, Nipun B Merchant, Alex A Parikh, Robert C G Martin, Charles R Scoggins, Syed Ahmad, Hong Jin Kim, Jaemin Park, Fabian Johnston, Matthew J Strouch, Alex Menze, Jennifer Rymer, Rebecca McClaine, Steven M Strasberg, Mark S Talamonti, Charles A Staley, Kelly M McMasters, Andrew M Lowy, Johnita Byrd-Sellers, William C Wood, William G Hawkins
OBJECTIVES: To compare perioperative outcomes of laparoscopic left-sided pancreatectomy (LLP) with traditional open left-sided pancreatectomy (OLP) in a multicenter experience. SUMMARY AND BACKGROUND DATA: LLP is being performed more commonly with limited data comparing results with outcomes from OLP. METHODS: Data from 8 centers were combined for all cases performed between 2002-2006. OLP and LLP cohorts were matched by age, American Society of Anesthesiologists, resected pancreas length, tumor size, and diagnosis...
September 2008: Annals of Surgery
Jacqueline Osuna-Rubio, José Manuel Hermosillo-Sandoval, Germán López-Guillén, Alejandro Maciel-Miranda, Clotilde Fuentes-Orozco, Andrea Socorro Alvarez-Villaseñor, Alejandro González-Ojeda, Alejandro López-Ortega
BACKGROUND: Transoperative biliary tract injury during open or laparoscopic cholecystectomy is a catastrophic event associated with significant morbidity and mortality. Our objective was to determine if wound size during open cholecystectomy is associated with more complex biliary tract injuries. METHODS: Prospective cohort study performed between March 2006 and February 2007. Sixty-six patients with biliary tract injuries after open cholecystectomy were included...
May 2008: Gaceta Médica de México
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