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https://www.readbyqxmd.com/read/28624111/biliary-complications-after-liver-transplantation-recent-developments-in-etiology-diagnosis-and-endoscopic-treatment
#1
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
#2
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
#3
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
#4
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
#5
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.
May 19, 2017: Endoscopy
https://www.readbyqxmd.com/read/28516371/perforated-emphysematous-cholecystitis-managed-by-endoscopic-transpapillary-gallbladder-drainage
#6
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...
May 17, 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
#7
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...
May 16, 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
#8
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...
April 6, 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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28364154/impact-of-intraoperative-blood-loss-on-the-short-term-outcomes-of-laparoscopic-liver-resection
#13
Rahul Gupta, David Fuks, Christophe Bourdeaux, Pejman Radkani, Takeo Nomi, Christian Lamer, Brice Gayet
BACKGROUND: Intraoperative blood loss is one of the predictors of outcome of open hepatectomy. But the impact of blood loss in laparoscopic hepatectomy (LH) on postoperative outcomes is poorly understood. The aim of this study is to analyze the association between blood loss and postoperative outcomes after LH. METHODS: A retrospective analysis of prospectively maintained database of patients undergoing LH from 1995 to 2016 was performed. The data were divided into two groups based on the extent of blood loss: Group 1 (<250 ml) and Group 2 (≥250 ml)...
March 31, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28348491/percutaneous-intraductal-radiofrequency-ablation-for-treatment-of-biliary-stent-occlusion-a-preliminary-result
#14
Ning Xia, Ju Gong, Jian Lu, Zhi-Jin Chen, Li-Yun Zhang, Zhong-Min Wang
AIM: To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction. METHODS: We specifically report a retrospective study presenting the results of percutaneous intraductal RF in patients with biliary stent occlusion. A total of 43 cases involving biliary stent obstruction were treated by placing an EndoHPB catheter and percutaneous intraductal RF was performed to clean stents...
March 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28340928/the-difficult-gall-bladder-outcomes-following-laparoscopic-cholecystectomy-and-the-need-for-open-conversion
#15
A Ashfaq, K Ahmadieh, A A Shah, A B Chapital, K L Harold, D J Johnson
INTRODUCTION: Surgery for the difficult gallbladder (DGB) is associated with increased risk compared to more routine laparoscopic cholecystectomies (LC). Laparoscopic "damage control" methods including cholecystostomy, fundus-down approach and subtotal cholecystectomy (SC) have been proposed to avoid conversion to open. We hypothesized that a Total LC (TLC) for DBG can be completed safely with an acceptably low conversion rate. MATERIAL AND METHODS: All patients that underwent LC from January 2005-June 2015 were retrospectively reviewed...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28331447/novel-biliary-reconstruction-techniques-during-liver-transplantation
#16
Ian C Carmody, John Romano, Humberto Bohorquez, Emily Bugeaud, David S Bruce, Ari J Cohen, John Seal, Trevor W Reichman, George E Loss
BACKGROUND: Biliary complications remain a significant problem following liver transplantation. Several surgical options can be used to deal with a significant size mismatch between the donor and recipient bile ducts during the biliary anastomosis. We compared biliary transposition to recipient biliary ductoplasty in cadaveric liver transplant. METHODS: A total of 33 reconstructions were performed from January 1, 2005 to December 31, 2013. In the biliary transposition group (n=23), 5 reconstructions were performed using an internal stent (5 or 8 French pediatric feeding tube), and 18 were performed without...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331262/percutaneous-transhepatic-biliary-drainage-in-the-management-of-post-surgical-biliary-leaks
#17
Bhavesh Popat, Dev Thakkar, Hemant Deshmukh, Krantikumar Rathod
The aim of this study was to evaluate the efficacy of percutaneous transhepatic biliary drainage (PTBD) in the treatment of post-surgical biliary leaks and its efficacy in restoring the integrity of bile ducts. One hundred and fifty-seven patients with a post-surgical biliary leak were treated by means of percutaneous transhepatic biliary drainage. The biliary leak was due to laparoscopic procedures in 114 patients, while 43 patients had postoperative leak following open surgery. Percutaneous transhepatic biliary drainage was performed with an 8- to 10-F catheter, with the side holes positioned proximal to the site of extravasation to divert bile flow away from the leak site...
February 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28325053/-iatrogenic-biliary-tract-lesions-requiring-surgical-reconstruction-presentation-and-classification-of-the-lesions-their-reconstruction-and-evaluation-of-the-results
#18
M Straka, E Holášková, L Burda, M Vávrová, P Fojtík, M Škrovina
INTRODUCTION: The incidence of biliary duct injuries requiring surgical reconstruction has stabilised between 0.30.7%. Biliary reconstruction in the hands of a trained hepatobiliary surgeon may lead to better short- and long-term outcomes in patients with this infrequent, but serious complication. METHODS: This study presents a retrospective analysis of single surgeon experience with biliary injury repair during the period of 20072016. Extramucosal hepaticojejunostomy on the excluded segment of the jejunal loop was performed without the use of any transanastomotic drain...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28296012/randomized-trial-of-laparoscopic-cholecystectomy-procedure-specific-consent-form
#19
Jack Crozier, Ann Williams, Steven T F Chan, Graeme Thompson
BACKGROUND: Prior to all surgical procedures, possible risks are outlined to patients during an informed consent discussion, and they are invited to ask questions. Written consent records this discussion and signals a patient's willingness to proceed with surgery. This study aims to improve the documentation of complications discussed during laparoscopic cholecystectomy consent through the introduction of a procedure-specific consent form. METHODS: Phase 1 included a retrospective analysis of possible complications documented on standard consent forms for laparoscopic cholecystectomy...
March 14, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28292633/the-outcomes-of-pancreaticoduodenectomy-in-patients-aged-80-or-older-a-systematic-review-and-meta-analysis
#20
REVIEW
Sandy Y Kim, Laurence Weinberg, Christopher Christophi, Mehrdad Nikfarjam
BACKGROUND: There is an increasing needed to consider pancreaticoduodenectomy (PD) for the treatment of pancreatic and periampullary malignancy in patients aged 80 and over, given the increasing aging population. METHODS: A systematic literature search was undertaken to identify selected studies that compared the outcomes of patients aged 80 years or over to those younger undergoing PD. RESULTS: In total 18 studies were included for evaluation...
June 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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