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Bile duct injury

Philip H Pucher, L Michael Brunt, Neil Davies, Ali Linsk, Amani Munshi, H Alejandro Rodriguez, Abe Fingerhut, Robert D Fanelli, Horacio Asbun, Rajesh Aggarwal
BACKGROUND: Laparoscopic cholecystectomy (LC), one of the most commonly performed surgical procedures, remains associated with significant major morbidity including bile leak and bile duct injury (BDI). The effect of changes in practice over time, and of interventions to improve patient safety, on morbidity rates is not well understood. The aim of this review was to describe current incidence rates and trends for BDI and other complications during and after LC, and to identify risk factors and preventative measures associated with morbidity and BDI...
March 19, 2018: Surgical Endoscopy
Omar Safi Zuberi, Lu Anne V Dinglasan
We report the case of a 55-year-old patient presenting with biliary obstruction caused by coil migration from a recently performed embolization of a post-traumatic gastroduodenal artery pseudoaneurysm. Based on imaging findings, biliary drain placement was initially performed and the subsequent endoscopy demonstrated coil erosion into the common bile duct and duodenum, resulting in choledochoduodenal fistula. Choledochojejunostomy was thereafter performed to bypass the area of injury.
February 2018: Radiology Case Reports
Daniele Alberti, Laura Righetti, Adrian Bianchi, Gian Luigi de'Angelis, Giovanni Boroni
BACKGROUND: Bowel dilatation is a common adaptive mechanism after intestinal resection. The symptomatic dilated dysmotile duodenum is difficult to manage, since conventional bowel tailoring and lengthening techniques are potentially hazardous because of the anatomy of the duodenal blood supply, the proximity to the pancreas, and the risk of injury to the common bile duct. METHODS: A 2-month-old child with short bowel and a symptomatic massively dilated duodenum was treated with a Transverse Flap Duodenoplasty (TFD)...
March 14, 2018: Pediatric Surgery International
Bader Hamza Shirah, Hamza Asaad Shirah, Syed Husham Zafar, Khalid B Albeladi
Backgrounds/Aims: Postcholecystectomy syndrome represents a heterogeneous group of symptoms and findings in patients who have previously undergone cholecystectomy. It is rare and under-reported in Saudi Arabia. It can be attributed to many complications such as bile duct injury, biliary leak, retained common bile duct stones, recurrent bile duct stones, and bile duct strictures. In this study, we aimed to analyze the causes and evaluate the approach to postcholecystectomy syndrome in our local Saudi Arabian community because of the vast number of cases encountered in our hospital for gallbladder clinical conditions and its related complications...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
B Joseph Elmunzer, Derek J Feussner, K Mark Payne, Satish N Nadig, Ricardo Yamada
No abstract text is available yet for this article.
March 2018: American Journal of Gastroenterology
Floyd W van de Graaf, Jacqueline van den Bos, Laurents P S Stassen, Johan F Lange
BACKGROUND: Bile duct injury remains a dilemma in laparoscopic cholecystectomy, with an incidence still higher than in conventional cholecystectomy. The Critical View of Safety technique is used as one of the important operating technique to reduce bile duct injury incidence. The objective of this study was to determine current practices in laparoscopic cholecystectomy and the use of the Critical View of Safety technique among surgeons and residents in surgical training. METHODS: We conducted an electronic survey among all affiliated members of the Association of Surgeons of the Netherlands containing questions regarding the current practice of laparoscopic cholecystectomy, essential steps of the Critical View of Safety technique, reasons for conversion to open cholecystectomy, and the use of other safety techniques...
March 7, 2018: Surgery
Sofia Ferreira-Gonzalez, Wei-Yu Lu, Alexander Raven, Benjamin Dwyer, Tak Yung Man, Eoghan O'Duibhir, Philip J Starkey Lewis, Lara Campana, Tim J Kendall, Thomas G Bird, Nuria Tarrats, Juan-Carlos Acosta, Luke Boulter, Stuart J Forbes
Cellular senescence is a mechanism that provides an irreversible barrier to cell cycle progression to prevent undesired proliferation. However, under pathological circumstances, senescence can adversely affect organ function, viability and regeneration. We have developed a mouse model of biliary senescence, based on the conditional deletion of Mdm2 in bile ducts under the control of the Krt19 promoter, that exhibits features of biliary disease. Here we report that senescent cholangiocytes induce profound alterations in the cellular and signalling microenvironment, with recruitment of myofibroblasts and macrophages causing collagen deposition, TGFβ production and induction of senescence in surrounding cholangiocytes and hepatocytes...
March 9, 2018: Nature Communications
Tao Wang, Hao Zou, Yun-Xia Liu, Xiao-Wen Zhang
Background: Paclitaxel (PTX) could inhibit the growth of fibroblasts, which occurs in proliferative cholangitis and leads to biliary stricture. However, its use has been limited due to poor bioavailability and local administration for short time. This study designed and synthesized a new PTX-conjugated chitosan film (N-succinyl-hydroxyethyl chitosan containing PTX [PTX-SHEC]) and evaluated its safety and efficiency using in vivo and in vitro experiments. Methods: The SHEC conjugated with PTX was confirmed by nuclear magnetic resonance (NMR) and Fourier-transform infrared spectroscopy (FT-IR) measurements...
March 20, 2018: Chinese Medical Journal
Gustavo Alain Flores-Rangel, Oscar Chapa-Azuela, Alejandro José Rosales, Carmen Roca-Vasquez, Simone Teresa Böhm-González
BACKGROUND: There are only a few reports regarding the quality of life of patients who underwent a complicated cholecystectomy with an iatrogenic bile duct injury (IBDI); the results have been heterogeneous and realized with unspecific measures. METHODS: The objective was to determine whether the quality of life of the subjects with a history of IBDI repaired with bilioenteric derivation is modified in the long term with respect to a control group, for which a group of patients with a history of IBDI (group A) was compared with a group of patients with a history of uncomplicated cholecystectomy (group B)...
March 8, 2018: World Journal of Surgery
Eun Young Kim, Tae Ho Hong
Purpose: We introduce a training porcine model for laparoscopic common bile duct (CBD) repair with T-tube insertion. The model could be the feasible training tool for a surgeon learning hepatobiliary surgery. Methods: Totally laparoscopic CBD repair with T-tube insertion was performed on 9 pigs by 9 trainees naïve in hepatobiliary surgery. Similar to the situation of iatrogenic injury, CBD was transected by laparoscopic scissors at the middle part about 1 cm in length, and the transected CBD was repaired through end-to-end anastomosis with T-tube insertion...
March 2018: Annals of Surgical Treatment and Research
Feng Xu, Xiaolin Liu, Chao Wang, Chaoliu Dai
The aim of this study is to explore the hepatoprotective effect of intraportal prostaglandin E1 (PGE1) on liver ischemia reperfusion (IR) injury using an extrahepatic cholestatic model, observing oxidative stress markers, proinflammatory factors, apoptotic marker proteins, and an adhesion molecule. The extrahepatic cholestatic model was induced by common bile duct ligation. After seven days, rats were subjected to ischemia by Pringle maneuver for 15 min, followed by 1, 6, or 24 h of reperfusion. Prostaglandin E1 (PGE group) or normal saline (NS group) was continuously infused from 15 min before liver ischemia to 1 h after reperfusion...
2018: BioMed Research International
Michael Riverso, Michael Chang, Consuelo Soldevila-Pico, Jinping Lai, Xiuli Liu
Kratom is an herbal product derived from the leaves of Southeast Asian Mitragyna speciosa trees. It has traditionally been used by indigenous people to relieve fatigue and manage pain, diarrhea, or opioid withdrawal. The use of kratom has become more commonplace in the United States for similar purposes. Only rare reports of kratom liver toxicity exist in the literature but without histologic characterization. Herein, we report one case of kratom use-associated liver toxicity in a 38-year-old patient. The patient complained of dark colored urine and light colored stools after using kratom...
February 2018: Gastroenterology Research
Brandon Haugen, Shannon E Karinshak, Victoria H Mann, Anastas Popratiloff, Alex Loukas, Paul J Brindley, Michael J Smout
The liver fluke Opisthorchis viverrini is a food-borne, zoonotic pathogen endemic to Thailand and adjacent countries in Southeast Asia. The adult developmental stage of the O. viverrini parasite excretes and secretes numerous proteins within the biliary tract including the gall bladder. Lesions caused by the feeding activities of the liver fluke represent wounds that undergo protracted cycles of healing and re-injury during chronic infection, which can last for decades. Components of the excretory/secretory (ES) complement released by the worms capably drive proliferation of bile duct epithelial cells and are implicated in establishing the oncogenic milieu that leads to bile duct cancer, cholangiocarcinoma...
2018: Frontiers in Medicine
Miguel A Mercado
No abstract text is available yet for this article.
February 27, 2018: Annals of Surgery
Ekaterina Saukko, Juha M Grönroos, Paulina Salminen, Anja Henner, Miika T Nieminen
OBJECTIVES: Recently, both the number and the complexity with associated increased technical difficulty of therapeutic ERCP procedures have significantly increased resulting in longer procedural and fluoroscopy times. During ERCP, the patient is exposed to ionizing radiation and the consequent radiation dose depends on multiple factors. The aim of this study was to identify factors affecting fluoroscopy time and radiation dose in patients undergoing ERCP. MATERIALS AND METHODS: Data related to patient demographics, procedural characteristics and radiation exposure in ERCP procedures (n = 638) performed between August 2013 and August 2015 was retrospectively reviewed and analyzed...
February 28, 2018: Scandinavian Journal of Gastroenterology
James Meek, Savannah Fletcher, Kristen Crumley, W C Culp, Mary Meek
The rendezvous technique typically involves combined efforts of interventional radiology, endoscopy, and surgery. It can be done solely percutaneously, whereby the interventionalist gains desired access to one point in the body by approaching it from two different access sites. We present the case of a woman who underwent cholecystectomy complicated by a bile duct injury. A percutaneous rendezvous procedure enabled placement of an internal-external drain from the intrahepatic ducts through the biloma and distal common bile duct and into the duodenum...
February 2018: Radiology Case Reports
Klaske A C Booij, Robert J Coelen, Philip R de Reuver, Marc G Besselink, Otto M van Delden, Erik A Rauws, Olivier R Busch, Thomas M van Gulik, Dirk J Gouma
BACKGROUND: Hepaticojejunostomy is commonly indicated for major bile duct injury after cholecystectomy. The debate about the timing of hepaticojejunostomy for bile duct injury persists since data on postoperative outcomes, including postoperative strictures, are lacking. The aim of this study was to analyze short- and long-term outcomes of hepaticojejunostomy for bile duct injury, including risk factors for strictures. METHOD: Analysis of outcome of hepaticojejunostomy in bile duct injury patients referred to a multidisciplinary team...
February 20, 2018: Surgery
Xiaoxiao Fan, Lifeng He, P Asutosh Khadaroo, Daizhan Zhou, Hui Lin
RATIONALE: Duplication of the extrahepatic bile duct is an extremely rare congenital anomaly of the biliary system. PATIENT CONCERNS: A 44-year-old woman presented with a history of continuous upper abdominal pain and vomiting. DIAGNOSES: Magnetic resonance cholangiopancreatography (MRCP) disclosed diffuse dilatation of the intrahepatic and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) showed the presence of two extrahepatic bile ducts with calculus at the distal end of the CBD...
February 2018: Medicine (Baltimore)
V I Greyasov, V M Chuguevsky, N I Sivokon, M A Agapov, R S Abubakarov
AIM: To analyze the effect of gallbladder's morpho-functional changes as a risk factor for injury of extrahepatic bile ducts during cholecystectomy. MATERIAL AND METHODS: Laparoscopic cholecystectomy was performed in 20 564 patients. There were 147 64 (71.8%) patients with chronic gallbladder inflammation and 5800 (28.2%) - with acute process. It was performed a retrospective analysis of the incidence and causes of intraoperative trauma of extrahepatic bile ducts and bile outflow...
2018: Khirurgiia
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
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