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https://www.readbyqxmd.com/read/28217251/biliary-complications-following-liver-transplantation-single-center-experience-over-three-decades-and-recent-risk-factors
#1
Alexander Kaltenborn, André Gutcke, Jill Gwiasda, Jürgen Klempnauer, Harald Schrem
AIM: To identify independent risk factors for biliary complications in a center with three decades of experience in liver transplantation. METHODS: A total of 1607 consecutive liver transplantations were analyzed in a retrospective study. Detailed subset analysis was performed in 417 patients, which have been transplanted since the introduction of Model of End-Stage Liver Disease (MELD)-based liver allocation. Risk factors for the onset of anastomotic biliary complications were identified with multivariable binary logistic regression analyses...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28208922/role-of-routine-subhepatic-abdominal-drain-placement-following-uncomplicated-laparoscopic-cholecystectomy-a-prospective-randomised-study
#2
Ankur Sharma, Sushil Mittal
INTRODUCTION: Routine abdominal drainage after laparoscopy cholecystectomy is an issue of considerable debate. Reason for draining is to detect early bile/blood leak and allow CO2 insufflate during laparoscopy to escape via drain site thereby decreased shoulder tip pain and post-operative nausea and vomiting. But some studies show no difference in post-operative nausea /vomiting/pain between drain and no drain group. AIM: To assess the role of drains following uncomplicated laparoscopic cholecystectomy...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28202234/endoscopic-ultrasound-guided-transmural-drainage-of-walled-off-pancreatic-necrosis-using-a-step-up-approach-a-single-centre-experience
#3
Surinder S Rana, Vishal Sharma, Ravi Sharma, Rajesh Gupta, Deepak K Bhasin
BACKGROUND: Walled off necrosis (WON) can be treated endoscopically using multiple transmural plastic stents or fully covered self-expandable metallic stent (FCSEMS) and direct endoscopic necrosectomy (DEN). We evaluated the efficacy of "step-up" endoscopic transmural approach for treatment of WON. METHODS: Retrospective analysis of data of 86 patients with WON who were treated with attempted endoscopic ultrasound (EUS) guided "step up" transmural drainage during last 5 years was done...
February 8, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28188033/success-and-safety-of-endoscopic-retrograde-cholangiopancreatography-in-children
#4
Jordan D Rosen, Rebecca S Lane, Jose M Martinez, Eduardo A Perez, Jun Tashiro, Amy E Wagenaar, Robert M Van Haren, Ashwini Kumar, Juan E Sola
PURPOSE: Despite its diagnostic and therapeutic utility, endoscopic retrograde cholangiopancreatography (ERCP) is underutilized in children. METHODS: Patients younger than 18years undergoing ERCP from 2000 to 2014 at a children's hospital were identified. Patient characteristics and outcomes were evaluated. RESULTS: Overall, 215 ERCPs (78% therapeutic) were performed in 184 patients. Our cohort was 67% female, with a median age (IQR) of 14 (8) years...
February 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28181823/diagnostic-value-of-gd-eob-dtpa-enhanced-mr-cholangiography-in-non-invasive-detection-of-postoperative-bile-leakage
#5
Melahat M Kul, Ayşe A Erden, Ebru E Düşünceli Atman
OBJECTIVE: To assess the diagnostic value of dynamic T1-weighted (T1w) gadolinium ethoxybenzyl diethylentriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced MR Cholangiography (MRC) for the detection of active bile leaks. METHODS: A total of 28 patients with suspected biliary leakage who underwent routine T2w-MRC and T1w-GD-EOB-DTPA-enhanced MRC at our institution from February 2013 to June 2016 were included in this study. The image sets were retrospectively analysed in consensus by 3 radiologists...
February 9, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28178122/mortality-after-portal-vein-embolization-two-case-reports
#6
Eung Chang Lee, Sang-Jae Park, Sung-Sik Han, Hyeong Min Park, Seung Duk Lee, Seong Hoon Kim, In Joon Lee, Hyun Beom Kim
Portal vein embolization (PVE) is increasingly performed worldwide to reduce the possibility of liver failure after extended hepatectomy, by inducing future liver remnant (FLR) hypertrophy and atrophy of the liver planned for resection. The procedure is known to be very safe and to have few procedure-related complications.In this study, we described 2 elderly patients with Bismuth-Corlette type IV Klatskin tumor who underwent right trisectional PVE involving the embolization of the right portal vein, the left medial sectional portal branch, and caudate portal vein...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28163089/comparative-effectiveness-of-minimally-invasive-surgery-and-conventional-approaches-to-major-or-challenging-hepatectomy
#7
Lucas W Thornblade, Xu Shi, Alex Ruiz, David R Flum, James O Park
BACKGROUND: The benefits of minimally invasive surgery (MIS) for low-risk or minor liver resection are well established. There is growing interest in MIS for major hepatectomy (MH) and other challenging resections, but there remain unanswered questions of safety that prevent broad adoption of this technique. STUDY DESIGN: Retrospective cohort study of patients undergoing hepatectomy at 65 hospitals participating in the NSQIP Hepatopancreatobiliary Collaborative in 2014...
February 2, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28152569/changing-pattern-of-biliary-complications-in-an-evolving-liver-transplant-unit
#8
A Rammohan, S Govil, J Vargese, V Kota, M S Reddy, M Rela
BACKGROUND: Biliary complications remain a significant cause of morbidity following liver transplantation. This series of 640 Liver transplant recipients with a blend of living and deceased donor transplants was analyzed to determine the incidence, risk factors, management protocol and outcomes in these patients. METHODS: Review of a prospectively collected database of transplant recipients operated between Aug 2009 and June 2016 was performed. Patients were divided into those with and without biliary complications and data was analyzed...
February 2, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28138446/management-of-an-accessory-bile-duct-leak-following-pancreaticoduodenectomy-a-novel-approach-utilizing-a-percutaneous-and-endoscopic-rendezvous
#9
George A Rapp, Kari J Nelson, David K Imagawa, Jason Y Huang, John G Lee
Biliary leaks are uncommon but morbid complications of pancreaticoduodenectomies, which have historically been managed with percutaneous drainage, reoperation, or a combination of both. We report a de novo percutaneous-endoscopic hepaticojejunostomy from an anomalous right hepatic duct injured during pancreaticoduodenectomy to the afferent bowel limb. The percutaneous-endoscopic hepaticojejunostomy was stented to allow for tract formation with successful stent removal after 5.5 months. One year after the creation of the percutaneous-endoscopic hepaticojejunostomy, the patient remains clinically well without evidence of biliary leak or obstruction...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28129610/aberrant-subvesical-bile-ducts-identified-during-laparoscopic-cholecystectomy-a-rare-case-report-and-review-of-the-literature
#10
Theodoros Mariolis-Sapsakos, Maria Zarokosta, Menelaos Zoulamoglou, Theodoros Piperos, Ioannis Papapanagiotou, Markos Sgantzos, Konstantinos Birbas, Ioannis Kaklamanos
INTRODUCTION: Aberrant subvesical bile ducts are a scarce anatomical variation, consisted by a network of bile ducts located in the peri-hepatic capsule of the gallbladder fossa. These rare ducts are usually discovered intraoperatively and their presence poses the risk of bile injury and clinically significant bile leak. PRESENTATION OF CASE: Aberrant subvesical bile ducts were unexpectedly identified in a young woman during laparoscopic cholecystectomy. These three ducts were clipped carefully for avoidance of bile duct injury and subsequent bile leak...
January 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28128721/effect-of-right-posterior-bile-duct-anatomy-on-biliary-complications-in-patients-undergoing-right-lobe-living-donor-liver-transplant
#11
Tugan Tezcaner, Nadire Dinç, Feza Y Karakayalı, Mahir Kırnap, Mehmet Coşkun, Gökhan Moray, Mehmet Haberal
OBJECTIVES: Our aim was to evaluate the influence of the localization of right posterior bile duct anatomy relative to portal vein of the donors on posttransplant bile duct complications. MATERIALS AND METHODS: We retrospectively investigated 141 patients who had undergone living donor liver transplant using right hemiliver grafts. The patients were classified based on the pattern of the right posterior bile duct and divided into infraportal and supraportal types...
January 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28123732/a-giant-and-insidious-subphrenic-biloma-formation-due-to-gallbladder-perforation-mimicking-biliary-cystic-tumor-a-case-report
#12
Guwei Ji, Feipeng Zhu, Ke Wang, Chenyu Jiao, Zicheng Shao, Xiangcheng Li
Gallbladder perforation (GBP) represents a rare, but potentially life-threatening, complication of acute cholecystitis. GBP is subdivided into three categories whereas the development of biloma is extremely rare. The present case study reports on a 40-year-old man with a 10-year history of calculus cholecystitis, who was referred to The First Affiliated Hospital of Nanjing Medical University (Nanjing, China) for the surgical treatment of an emerging massive hepatic entity with insidious symptoms and normal laboratory tests...
January 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28099327/a-meta-analysis-and-systematic-review-success-of-endoscopic-ultrasound-guided-biliary-stenting-in-patients-with-inoperable-malignant-biliary-strictures-and-a-failed-ercp
#13
Harsha Moole, Matthew L Bechtold, David Forcione, Srinivas R Puli
BACKGROUND: In patients with inoperable malignant biliary strictures, endoscopic retrograde cholangiopancreatography (ERCP) guided biliary stenting fails in 5% to 10% patients due to difficult anatomy/inability to cannulate the papilla. Recently, endoscopic ultrasound guided biliary drainage (EUS-BD) has been described.Primary outcomes were to evaluate the biliary drainage success rates with EUS and compare it to percutaneous transhepatic biliary drainage (PTBD). Secondary outcomes were to evaluate overall procedure related complications...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28090474/post-laparoscopic-cholecystectomy-biloma-in-a-child-managed-by-endoscopic-retrograde-cholangio-pancreatography-and-stenting-a-case-report
#14
Charu Tiwari, Om Prakash Makhija, Deepa Makhija, Shalika Jayaswal, Hemanshi Shah
Laparoscopic cholecystectomy, though an uncommon surgical procedure in paediatric age group is still associated with a higher risk of post-operative bile duct injuries when compared with the open procedure. Small leaks from extra hepatic biliary apparatus usually lead to the formation of a localized sub-hepatic bile collection, also known as biloma. Such leaks are rare complication after laparoscopic cholecystectomy, especially in paediatric age group. Minor bile leaks can usually be managed non-surgically by percutaneous drainage combined with endoscopic retrograde cholangio-pancreatography (ERCP)...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28062891/surgical-techniques-for-esophageal-replacement-in-children
#15
REVIEW
Shilpa Sharma, Devendra K Gupta
PURPOSE: Surgical techniques for esophageal replacement (ER) in children include colon interposition, gastric tube, gastric transposition, and jejunal interposition. This review evaluates the merits and demerits of each. METHOD: Surgical techniques, complications, and outcome of ER are reviewed over last seven decades. RESULTS: Colon interposition is the time-tested procedure with minimal and less serious complications. Long-term complications include reflux, halitosis, colonic segment dilatation, and anastomotic stricture, sometimes requiring surgical interventions especially for dilatation and reflux...
January 6, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28045732/hepatobiliary-scintigraphy-findings-lead-to-the-diagnosis-of-spontaneous-common-bile-duct-rupture-in-an-infant
#16
Ashwani Sood, Ashwin Singh Parihar, Babu Ram Thapa, Ravi Prakash Kanojia, Bhagwant Rai Mittal, Anish Bhattacharya
Hepatobiliary scintigraphy is a widely used functional imaging modality for diagnosis of a variety of liver diseases, as well as for detecting biliary tract abnormalities. Neonates or infants with persistent jaundice beyond the physiological period are usually evaluated with hepatobiliary scintigraphy. The authors present a 5-month-old girl with neonatal jaundice, ascites, and umbilical and bilateral inguinal hernias in whom spontaneous rupture of the biliary duct resulted in intraperitoneal bile leak with passage of tracer into bilateral inguinal hernial sacs...
March 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28032655/predictive-factors-for-outcomes-of-patients-undergoing-endoscopic-therapy-for-bile-leak-after-hepatobiliary-surgery
#17
Shuntaro Yabe, Hironari Kato, Sho Mizukawa, Yutaka Akimoto, Daisuke Uchida, Hiroyuki Seki, Takeshi Tomoda, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada
BACKGROUND AND AIM: Endoscopic procedures are used as first-line treatment for bile leak after hepatobiliary surgery. Advances have been made in endoscopic techniques and devices, but few reports have described the effectiveness of endoscopic procedures and the management principles based on severity of bile leak. We evaluated the effectiveness of an endoscopic procedure for the treatment of bile leak after hepatobiliary surgery. METHODS: Fifty-eight patients underwent an endoscopic procedure for suspected bile leak after hepatobiliary surgery; the presence of bile leak on endoscopic retrograde cholangiopancreatography (ERCP) was evaluated retrospectively...
December 29, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28008467/readmissions-after-laparoscopic-cholecystectomy-in-a-uk-district-general-hospital
#18
Olugbenga Awolaran, Tabitha Gana, Nehemiah Samuel, Kenneth Oaikhinan
INTRODUCTION: Laparoscopic cholecystectomy is the gold standard for the treatment of symptomatic gallstones and its practice as day case where possible is considered the standard over the last decade. However, readmission after surgery is recognised as a new problem. AIM: The aim of this cohort observational study was to investigate the readmission rate in a district general hospital and identify the causes of readmission in order to explore ways by which this can be reduced or managed more cost effectively...
December 23, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27996365/laparoscopic-management-of-mirizzi-syndrome-without-dissection-of-calot-s-triangle
#19
Daisuke Koike, Yusuke Suka, Motoki Nagai, Yukihiro Nomura, Nobutaka Tanaka
BACKGROUND: Mirizzi syndrome (MS) is a rare complication of cholecystolithiasis that causes compacted gallstones and is often accompanied by severe inflammation of Calot's triangle. This study compared the use of laparoscopic surgery for MS without dissection of Calot's triangle with routine laparoscopic cholecystectomy (LC). METHODS: A total of 411 consecutive patients underwent laparoscopic surgery for benign gallbladder (GB) disease between January 2013 and December 2014...
February 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27931575/bile-duct-anastomosis-supplied-with-biodegradable-stent-in-liver-transplantation-the-initial-experience
#20
L Janousek, S Maly, M Oliverius, M Kocik, M Kucera, J Fronek
BACKGROUND: The most common biliary complications after orthotopic liver transplantation are bile leaks, anastomotic and intrahepatic strictures, stones, and ampullary dysfunction. These complications can occur in up to 10% to 30% of liver transplant recipients. Leaks occur early in the posttransplant period; the stricture formation typically graduates over time. METHODS: Ten patients underwent transplantation in our preliminary study: 5 were randomized to the group with stent placement and 5 to the control group...
December 2016: Transplantation Proceedings
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