Cpre complication

BACKGROUND: Inguinal hernias are common in the bladder exstrophy population. As these hernias may present with incarceration following bladder closure, several groups recommend inguinal exploration and hernia repair at the time of initial bladder closure. However, the benefits of such an approach are not well defined. In 2006, we modified our approach to this condition by routinely performing concomitant inguinal herniorraphy (CIH) repair at the time of initial exstrophy repair. The aim of this study was to test the hypothesis that simultaneous inguinal hernia repair will be safe and effective in reducing subsequent unplanned inguinal procedures in this high-risk group...

INTRODUCTION: Duodenal perforations are an uncommon adverse event during ERCP. Patients can develop significant morbidity and mortality. Even though surgery has been used to manage duodenal complications, therapeutic endoscopy has seen significant advances. OBJECTIVE: To compare endoscopic approach with surgical intervention in patients with duodenal perforations post-ERCP. MATERIAL AND METHODS: prospective randomized study in a tertiary center with 23 patients divided in 2 groups...

INTRODUCTION/OBJECTIVE: Secure closure of the pubic diastasis during bladder exstrophy and epispadias repair decreases the abdominal wall tension at the time of reconstruction. Pelvic osteotomies are routinely performed at the time of abdominal wall and bladder reconstruction in order to more easily facilitate pubic symphyseal diastasis approximation. Postoperative pelvic immobilization is performed by methods that include modified Buck's traction, modified Bryant's traction, and spica casting...

OBECTIVES: Spinal cord ischaemia with resulting paraplegia remains a devastating and unpredictable complication after thoraco-abdominal aortic surgery. With the advent of stem cell therapy and its potential to induce nervous tissue regeneration processes, the interest in the use of these cells as a treatment for neurological disorders has increased. Human stem cells, derived from the umbilical cord, are one of the strong candidates used in cell therapy for spinal cord injury because of weak immunogenicity and ready availability...

OBJECTIVE: To study the problems faced during the surgery and follow-up of modified complete primary repair of exstrophy (CPRE) technique. Initial experience with CPRE and its short- and long-term outcomes with respect to continence status and psychosocial impact are reported. MATERIALS AND METHODS: A retrospective review of the hospital case records from March 2008 to September 2012 was performed. Data of patients with bladder exstrophy managed by a single paediatric surgeon using modified CPRE technique were analysed...

Pancreatitis is a flogistic disease, caused by activation and digestion of pancreas by its enzymes. Diagnosis is based on integrated evaluation of clinical and laboratoristic data and morphological imaging. To evaluate the severity of pancreatitis there is a clinical classification in interstitial--mild pancreatitis and severe--necrotic one. The evaluation of severity is basic, because it is strictly correlated to the prognosis of the patient. CT has revealed the best method for diagnosis, staging and for evaluate the complications and follow-up and in some cases it is useful for therapeutic change...

This first French national survey of the deep vein thrombosis and embolism risk during plastic and aesthetic surgery shows the reality of this complication. Eighty percent of the french plastic surgeons had deep vein thrombosis in their patients and 53% had pulmonary embolism. There are no guidelines in our speciality in French. The author reviews the bibliography and guidelines of all the other societies around the world as experts' recommendations during the national congress of the French Plastic Reconstructrice and Aesthetic Surgery (SOF...

OBJECTIVE: To describe the management and outcome after endoscopic treatment of hematemesis by Mallory-Weiss Syndrome (MWS) occurred after CPRE (suspected choledocolithiasis). BACKGROUND DATA: Although cough and retching is common during EGD or CPRE, MWS resulting from endoscopy seems to be uncommon (0.0001-0.04%) and always self-limiting. CASE REPORT: The patient was submitted to CPRE with the suspicion of choledocholithiasis. Eight hours after CPRE the patient presented with hematemesis and hypotension...

PURPOSE: The major goals of complete primary repair of exstrophy (CPRE) are the re-creation of normal anatomy which allows bladder cycling and to reduce the number of future procedures necessary to achieve continence. It is unclear whether CPRE is associated with a higher bladder neck fistula rate than the traditional staged repair. We review a multi-institutional experience with the CPRE technique to evaluate the rate of bladder neck fistula. MATERIALS AND METHODS: A retrospective review of 18 boys and 4 girls who underwent CPRE at 4 tertiary pediatric urology referral centers during the last 6 years was performed...

PURPOSE: Complete primary repair of bladder exstrophy (CPRE) represents a paradigm shift from the staged approach for surgical management. We present early clinical outcomes in our patients following CPRE. MATERIALS AND METHODS: From 1996 to 2004 all newborns with bladder exstrophy were treated with CPRE within 48 hours of birth. We reviewed parameters including transfusions (packed red blood cells), urethral meatal position, complications, findings on renal ultrasound and renal scan, and post-CPRE procedures and infections...

OBJECTIVE: Evaluation of three cases of Mirizzi's syndrome (MS), a rare condition of non neoplastic biliary tree obstruction. MATERIALS AND METHODS: We reviewed three cases of MS, operated from July 1998 to December 2000 in our institution. All patients were preoperatively evaluated by clinical examination, Ultrasound (US) and Endoscopic retrograde colangiopancreatography (CPRE) for jaundice. Computed Tomography (TC) was also performed in two. RESULTS: Abdominal pain was the main symptom in two patients, jaundice in one (17 mg/dl); Courvoisier-Terrier sign, suggestive for a biliopancreatic neoplasm, was present in two patients...

Iatrogenic lesions of the biliary tract have always represented a problem of real actuality in the abdominal surgery. The incidence of post-cholecystectomy complications is from 0.1% to 0.25% and it's increased to 0.3-0.6% for laparoscopic surgery. Potential predisposing factors to iatrogenic biliary lesions are anatomic anomalies, acute and chronic phlogosis and technical mistakes. Anatomic anomalies are present in 6-25% of all cases according to different statistics; an incomplete knowledge of the biliary tract can predispose to a mistake legating or dissecting a wrong branch...

Several simple equations exist for the calculation of K1/V from predialysis (Cpre) and postdialysis (Cpost) measurements of urea concentration. Analogous equations are needed for precise determination of patients protein catabolic rate (nPCR) from Cpre and Cpost. In this study we develop three simple nPCR equations from urea mass balance theory. The equations, which include a term for residual function, may be applied to any session of the week for patient dialyzed three times weekly who are in steady state with respect to dialysis dose and protein catabolism...

A patient with post-laparoscopic cholecystectomy cystic duct leak successfully treated with conservative treatment is presented. The cystic duct leak was diagnosed through a CPRE where a Oddy sphyncter spasm was noted. The use of a topic Nytroglicerine resulted in a sphincter release and resolution of the fistula. A literature review of the importance of CPRE in the diagnosis and treatment of biliary injuries was carried out. In patients with nondilated bile ducts where the sphincterotomy or endoprothesis undergo with high morbidity, the use of topic nitroglycerine could be an effective alternative procedure...

We present a study of 28 patients, treated for adenocarcinoma of Vater's ampulla. We emphasize the distinct behavior of each one of the peri-ampullar tumors, those which affect Vater's ampulla yielding the best prognosis. We gathered data regarding gender, age, clinical manifestations, and analytical data. The confirmatory diagnosis gives us 100% of CPRE cases. All of the patients were submitted to surgical treatment with anatomic pathological confirmation of the diagnosis, be it pre or postoperative. We practiced curative surgery in 57...

The authors analyse their experience of 30 cases of which 25 underwent surgery. In addition to the onset of complications, indications for surgery were based on the presence of severe painful symptoms which did not respond to medical treatment. Over the past few years the latter have represented one of the main indications with a success rate of between 80-90% of cases. The type of surgery must be personalized to the characteristics of each individual patient on the basis of morphological alterations of the gland, which are easily defined during a preoperative study using CPRE, ultrasonography and CT...

Although there is a decrease in the total number of complications observed on performance of laparoscopy cholecystectomy (LC) there does appear to be an increase in biliary tract lesions. Seven cases of postcholecystectomy biliary leakage treated with endoscopic methods are presented. These cases include 4 patients with leakage from the cystic canal stump and 3 with leakage from the common bile duct. In 5 cases the biliary tract lesion occurred following LC, 1 after conventional cholecystectomy and in 1 reconverted LP...