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https://www.readbyqxmd.com/read/28790783/hydrogen-peroxide-test-for-intraoperative-bile-leak-detection
#1
V Trehan, Pankaj P Rao, C S Naidu, Anuj K Sharma, A K Singh, Sanjay Sharma, Amit Gaur, S V Kulkarni, N Pathak
BACKGROUND: Bile leakage (BL) is a common complication following liver surgery, ranging from 3 to 27% in different series. To reduce the incidence of post-operative BL various BL tests have been applied since ages, but no method is foolproof and every method has their own limitations. In this study we used a relatively simpler technique to detect the BL intra-operatively. Topical application of 1.5% diluted hydrogen peroxide (H2O2) was used to detect the BL from cut surface of liver and we compared this with conventional saline method to know the efficacy...
July 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28763814/three-modalities-on-common-bile-duct-exploration
#2
Yong Zhou, Xu-Dong Wu, Wen-Zhang Zha, Ren-Gen Fan, Biao Zhang, Yong-Hua Xu, Cheng-Lin Qin, Jing Jia
Background Choledocholithiasis can be managed by transcystic (TC) and transduct (TD) stone extraction or using cholangioscopy through the left hepatic duct orifice (LHD). Objective The aim of this study is to evaluate the safety and effectiveness of common bile duct exploration through the TC approach, TD approach, and LHD approach for choledocholithiasis, with a specific emphasis on the TC and LHD approaches versus the TD approach. Methods Between January 2011 and June 2014, a total of 172 choledocholithiasis patients accompanied by cholecystitis and/or left intrahepatic gallstones were scheduled for laparoscopic or open common bile duct (CBD) exploration using cholangioscopy through the CBD (TD group: n = 72), cystic duct (TC group: n = 63), or LHD orifice (LHD group: n = 37)...
August 1, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28760630/predictors-and-implications-of-unplanned-conversion-during-minimally-invasive-hepatectomy-an-analysis-of-the-acs-nsqip-database
#3
Zachary E Stiles, Stephen W Behrman, Evan S Glazer, Jeremiah L Deneve, Lei Dong, Jim Y Wan, Paxton V Dickson
BACKGROUND: Minimally-invasive hepatectomy (MIH) is increasingly utilized; however, predictors and outcomes for patients requiring conversion to an open procedure have not been adequately studied. METHODS: The 2014-15 ACS-NSQIP database was analyzed. Unplanned conversion was compared to successful MIH and elective open hepatectomy. RESULTS: Among 6918 hepatectomies, 1062 (15.4%) underwent attempted MIH: 989 laparoscopic, 73 robotic. Conversion occurred in 203 (19...
July 28, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28684726/hepatic-artery-pseudoaneurysm-following-orthotopic-liver-transplantation-increasing-clinical-suspicion-for-a-rare-but-lethal-pathology
#4
Jon Harrison, Meredith Harrison, Cataldo Doria
BACKGROUND Despite an incidence of between 1% and 2%, the mortality rate in ruptured hepatic artery pseudoaneurysm after orthotopic liver transplantation approaches 69%. Our aim is to report operative and outcomes data for 7 patients with pseudoaneurysm following transplant at 1 institution, with emphasis on suspected risk factors for aneurysm formation. From these risk factors, we performed a systematic review to assess their clinical saliency. MATERIAL AND METHODS Using PRISMA guidelines, we completed a PubMed and online database review to gather studies addressing risk factors for pseudoaneurysm following transplant...
July 7, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28668286/three-modalities-on-management-of-choledocholithiasis-a-prospective-cohort-study
#5
Yong Zhou, Wen-Zhang Zha, Xu-Dong Wu, Ren-Gen Fan, Biao Zhang, Yong-Hua Xu, Cheng-Lin Qin, Jing Jia
BACKGROUND: Choledocholithiasis can be managed by endoscopic retrograde cholangiopancreaticography/endoscopic sphincterotomy (ERCP/EST) or laparoscopic common bile duct (CBD) exploration by transcystic (TC) or transductal (TD) stone extraction. OBJECTIVE: The aim of this study was to evaluate the safety and effectiveness of common bile duct stones extraction by ERCP/EST, TC approach and TD approach for choledocholithiasis, with specific emphasis on ERCP/EST, TC approach versus TD approach...
June 28, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28663533/conversion-to-endoscopic-ultrasound-guided-biliary-drainage-by-temporary-nasobiliary-drainage-placement-in-patients-with-prior-biliary-stenting
#6
Yousuke Nakai, Hiroyuki Isayama, Natsuyo Yamamoto, Saburo Matsubara, Yukiko Ito, Naoki Sasahira, Gyotane Umefune, Naminatsu Takahara, Tsuyoshi Hamada, Dai Mohri, Hirofumi Kogure, Minoru Tada, Kazuhiko Koike
BACKGROUND AND OBJECTIVES: Endoscopic ultrasound-guided biliary drainage (EUS-BD), first reported as an alternative to percutaneous transhepatic BD in failed endoscopic retrograde cholangiography, is sometimes performed as reintervention for transpapillary stent dysfunction such as in patients with new onset gastric outlet obstruction, but direct conversion to EUS-BD can potentially have a risk of leakage of infected bile. The aim of this study is to evaluate the safety and efficacy of conversion to EUS-BD using a temporary endoscopic nasobiliary drainage (ENBD) tube placement as a reintervention for prior BD...
February 8, 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28658786/xanthogranulomatous-cholecystitis-with-florid-ducts-of-luschka-double-trouble-mimicking-malignancy
#7
Archana Shetty, Mudasser Rehan, V Geethamani
Xanthogranulomatous Cholecystitis (XGC) is an uncommon inflammatory condition of gall bladder, which is often misdiagnosed as malignancy preoperatively, leading to extensive surgical resections which may not be necessary for the patient. Ducts of Luschka are a rare developmental variant of the biliary tree, which are prone to injury and bile leak during cholecystectomy. We report a case of a 52-year-old male patient who was taken up for surgery with a provisional diagnosis of chronic calculous cholecystitis...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28651227/double-cystic-duct-preoperatively-diagnosed-and-successfully-treated-with-laparoscopic-cholecystectomy-a-case-report
#8
Atsushi Fujii, Masatsugu Hiraki, Noriyuki Egawa, Hiroshi Kono, Takao Ide, Junichi Nojiri, Junji Ueda, Hiroyuki Irie, Hirokazu Noshiro
INTRODUCTION: A single gallbladder with a double cystic duct is a very rare finding. In addition, few cases with this rare condition are preoperatively diagnosed. However, the preoperative confirmation or suspicion of this rare condition could facilitate safe laparoscopic cholecystectomy, which is a minimally invasive therapeutic modality for gallbladder disease. We herein present a case of gallstone disease in a patient with a double cystic duct who was preoperatively diagnosed and successfully treated with laparoscopic cholecystectomy...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28624111/biliary-complications-after-liver-transplantation-recent-developments-in-etiology-diagnosis-and-endoscopic-treatment
#9
REVIEW
Floris J M Roos, Jan-Werner Poley, Wojciech G Polak, Herold J Metselaar
Biliary complications are considered to be the Achilles' heel of liver transplantation. The most common complications are leaks and bile duct strictures. Strictures can arise at the level of the anastomosis (anastomotic strictures; AS) or at other locations in the biliary tree (non-anastomotic strictures; NAS). Endoscopic treatment via endoscopic retrograde cholangiopancreatography (ERCP) is considered to be the preferred therapy for these complications. This review will focus on the diagnostic modalities, new insights in etiology of biliary complications and outcomes after different endoscopic therapies, in both deceased donor transplantation and living-donor liver transplantations...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28617155/thirteen-year-evaluation-of-the-management-of-biliary-tract-complication-after-deceased-donor-liver-transplantation
#10
Alireza Shamsaeefar, Saman Nikeghbalian, Kourosh Kazemi, Nasrin Motazedian, Bita Geramizadeh, Seyed Ali Malekhosseini
INTRODUCTION: Although patient and graft survival rate has increased in recent years, biliary complications after liver transplantation are associated with significant morbidity and mortality. METHODS AND MATERIALS: We reviewed the database of 1930 patients who underwent deceased donor liver transplantation between 2000 and 2013. The patients had abnormal results in liver tests, as well as fever and jaundice. Abdominal sonography was performed, and if complication was identified, the patient underwent an interventional procedure by endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28573070/endoscopic-therapy-for-biliary-strictures-complicating-living-donor-liver-transplantation-factors-predicting-better-outcome
#11
Harshavardhan B Rao, Hasim Ahamed, Suprabha Panicker, Surendran Sudhindran, Rama P Venu
AIM: To identify factors predicting outcome of endoscopic therapy in bile duct strictures (BDS) post living donor liver transplantation (LDLT). METHODS: Patients referred with BDS post LDLT, were retrospectively studied. Patient demographics, symptoms (Pruritus, Jaundice, cholangitis), intra-op variables (cold ischemia time, blood transfusions, number of ducts used, etc.), peri-op complications [hepatic artery thrombosis (HAT), bile leak, infections], stricture morphology (length, donor and recipient duct diameters) and relevant laboratory data both pre- and post-endotherapy were studied...
May 15, 2017: World Journal of Gastrointestinal Pathophysiology
https://www.readbyqxmd.com/read/28554966/the-yin-and-yang-of-bile-acid-action-on-tight-junctions-in-a-model-colonic-epithelium
#12
Jayashree Sarathy, Sally Jo Detloff, Mei Ao, Nabihah Khan, Sydney French, Hafsa Sirajuddin, Tanushree Nair, Mrinalini C Rao
Gastrointestinal epithelial barrier loss due to tight junction (TJ) dysfunction and bile acid-induced diarrhea are common in patients with inflammatory diseases. Although excess colonic bile acids are known to alter mucosal permeability, few studies have compared the effects of specific bile acids on TJ function. We report that the primary bile acid, chenodeoxycholic acid (CDCA), and its 7α-dehydroxylated derivative, lithocholic acid (LCA) have opposite effects on epithelial integrity in human colonic T84 cells...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28525933/one-step-endoscopic-ultrasound-directed-gastro-gastrostomy-ercp-for-treatment-of-bile-leak
#13
Ming-Ming Xu, Carlos Carames, Aleksey Novikov, Monica Saumoy, Che Afaneh, Michel Kahaleh, Reem Z Sharaiha
No abstract text is available yet for this article.
July 2017: Endoscopy
https://www.readbyqxmd.com/read/28516371/perforated-emphysematous-cholecystitis-managed-by-endoscopic-transpapillary-gallbladder-drainage
#14
Chikara Iino, Tadashi Shimoyama, Takasato Igarashi, Tomoyuki Aihara, Kentaro Ishii, Juichi Sakamoto, Hiroshi Tono, Shinsaku Fukuda
An 88-year-old woman with dementia was diagnosed as having perforated emphysematous cholecystitis with localized peritonitis. Because she was at high risk for surgery, gallbladder drainage was required before surgery. Endoscopic transpapillary gallbladder drainage instead of percutaneous transhepatic biliary drainage was performed because bile could leak from the puncture site to free space around the perforated gallbladder. After the insertion of a nasobiliary drainage tube, the gallbladder was drained and cleaned with saline solution...
August 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28512772/subspecialty-approach-for-the-management-of-acute-cholecystitis-an-alternative-to-acute-surgical-unit-model-of-care
#15
Sonia Tran, Vincent Choi, Kirsten Hepburn, Nathan Hewitt, Joel Zhou, Daniel L Chan, Michael L Talbot
BACKGROUND: Acute cholecystitis is a common condition. Recent studies have shown an association between creation of an acute surgical unit (ASU) and improved outcomes. This study aimed to evaluate the outcomes of a subspecialty based approach to the management of acute cholecystitis as an alternative to the traditional 'generalist' general surgery approach or the ASU model. METHOD: A 6-year retrospective analysis of outcomes in patients admitted under a dedicated upper gastrointestinal service for acute cholecystitis undergoing emergency laparoscopic cholecystectomy...
July 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28457903/endotherapy-for-bile-leaks-from-isolated-ducts-after-hepatic-resection-a-long-awaited-challenge
#16
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
https://www.readbyqxmd.com/read/28429278/-trans-hepatico-cystic-coledochostomy-for-the-opening-hydatid-cyst-in-the-biliary-tract-indications-and-outcome-evaluation-of-25-cases
#17
S Daldoul, G H El Kebir, I Messoudi, A Mabrouk, M Tahar Bouzidi, M Ben Moussa
The treatment of hydatid cysts of the liver opened in the bile ducts is sometimes difficult and complex. The trans-hepaticocystic coledochostomy (CTHK) is one of these processes. We conducted a review of the indications for this surgical procedure and its perioperative outcomes through a series of 25 patients and then we analyzed predictor factors of complications. During the period's study, 909 patients with liver hydatid cyst went under the surgery. Ninety two (92, i.e. 10.1%) of them had an opening in the bile ducts through a large fistula...
April 20, 2017: Bulletin de la Société de Pathologie Exotique
https://www.readbyqxmd.com/read/28411765/hepatic-artery-disease-and-anastomotic-bile-leaks-after-liver-transplantation-shining-the-light-on-the-true-achilles-heel
#18
EDITORIAL
Irene Peñas-Herrero, Manuel Perez-Miranda
No abstract text is available yet for this article.
May 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28382295/acetic-acid-sclerotherapy-for-treatment-of-biliary-leak-from-an-isolated-right-posterior-sectoral-duct-after-cholecystectomy
#19
Jeong-Ik Park, Young-Kil Choi, Bo-Hyun Jung
Bile duct injury is one of the most serious complications of both laparoscopic and open cholecystectomy. Isolated bile duct injury can occur from the misidentification of aberrant right hepatic ducts, and it is troublesome because the early diagnosis is easy to miss and the definite treatment is controversial. We report a case of an isolated right posterior sectoral duct injury following cholecystectomy managed successfully with acetic acid sclerotherapy combined with coil embolization for a fistula tract.
April 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28372450/a-bronchobiliary-fistula-treated-with-cyanoacrylate-glue-in-a-patient-with-liver-cirrhosis
#20
Raúl Honrubia López, Ana Barbado Cano, Gloria Ruiz Fernández, Katherine Yelenia Bustamante Robles
A 60-year-old male was operated upon in 2002 for liver hydatidosis, which included partial right hepatectomy with cholecystectomy and bilioduodenal anastomosis. He then developed liver cirrhosis secondary to left hepatic duct stricture. He presents at the emergency room with dry cough, which he had for a month and then became associated with yellowish, bitter-tasting "fluid" expectoration. A chest-abdominal CT scan revealed a 6 x 5-cm collection roughly located somewhere between the middle pulmonary lobe and subphrenic area ...
April 2017: Revista Española de Enfermedades Digestivas
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