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https://www.readbyqxmd.com/read/27904246/noninvasive-imaging-of-the-biliary-system-relevant-to-percutaneous-interventions
#1
REVIEW
Stephen Thomas, Kayleen Jahangir
Clinical data such as history, physical examination, and laboratory tests are useful in identifying patients with biliary obstruction and biliary sources of infection. However, if intervention is planned, noninvasive imaging is needed to confirm the presence, location, and extent of the disease process. Currently, the most commonly available and used noninvasive modalities are ultrasound (US), computed tomography (CT), magnetic resonance (MR), and nuclear medicine hepatobiliary scintigraphy (HIDA). US is quick, portable, readily available, and is commonly the first imaging modality used when biliary pathology is suspected...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27899118/surgical-intervention-for-paediatric-liver-injuries-is-almost-history-a-12-year-cohort-from-a-major-scandinavian-trauma-centre
#2
Tomohide Koyama, Jorunn Skattum, Peder Engelsen, Torsten Eken, Christine Gaarder, Pål Aksel Naess
BACKGROUND: Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. METHODS: Patients <17 years old with liver injury admitted to Oslo University Hospital Ullevaal during the period 2002-2013 were retrospectively reviewed...
November 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27873011/laparoscopic-resection-of-choledochal-cyst-with-roux-en-y-hepaticojejunostomy-a-case-report-and-review-of-the-literature
#3
Bestoun Ahmed, Priya Sharma, Cynthia L Leaphart
BACKGROUND: Choledochal cysts are associated with ductal strictures, stone formation, cholangitis, rupture, secondary biliary cirrhosis and increased incidence of cholangiocarcinoma. The surgical approach to choledochal cysts has evolved from the cyst-enterostomy to a complete excision with more recent use of minimally invasive approaches. We report a complete minimally invasive approach to a Type 1 choledochal cyst and summarize the literature containing large case series of similar approaches...
November 21, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27862815/systematic-review-and-meta-analysis-of-studies-of-biliary-reconstruction-in-adult-living-donor-liver-transplantation
#4
REVIEW
Kenneth S H Chok, Chung Mau Lo
BACKGROUND: The chance of biliary complication after living donor liver transplantation (LDLT) is considerable. The objective of this study was to investigate the impact of biliary reconstruction method on post-LDLT biliary complications. Data sources are from PubMed and Web of Science. METHODS: A systematic search was conducted using the search term '[biliary complications] OR [biliary complication] OR [biliary stricture] OR [bile leak] AND [living donor liver transplantation]'...
November 11, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27833330/bile-leak-detection-after-trauma-by-radionuclide-scintigraphy
#5
Parul Mohan, Harsh Mahajan
No abstract text is available yet for this article.
October 2016: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/27829281/percutaneous-biliary-interventions-and-complications-in-malignant-bile-duct-obstruction
#6
Hooman Yarmohammadi, Anne M Covey
Malignant bile duct obstruction can be a challenging clinical problem for patients and physicians alike. Indications for intervention include pruritus, cholangitis, lowering bilirubin pre-operatively or to allow for administration of some chemotherapeutic agents, and to divert bile from a post-operative leak. Low biliary obstruction, obstruction below the common hepatic duct, is usually straightforward and is often treated endoscopically. High bile duct obstruction is more complicated because it often involves isolation of ductal segments...
October 2016: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/27819646/from-laparoscopic-cholecystectomy-to-liver-transplantation-when-the-gallbladder-becomes-the-pandora-s-box
#7
Georgios C Sotiropoulos, Peter Tsaparas, Stylianos Kykalos, Nikolaos Machairas, Ernesto P Molmenti, Andreas Paul
Bile duct injuries (BDI) tend to be more complex in laparoscopic than in open cholecystectomy procedures, and frequently involve young adults with benign pathologies. The ultimate consequence may be a liver transplantation (LT), making this situation one of the most rare transplant indications. Fatal post-transplant outcome is extreme infrequently reported. Aim of this study is to report on our single-case experience and to review the literature concerning lethal outcome after LT for major BDI following cholecystectomy...
2016: Chirurgia
https://www.readbyqxmd.com/read/27814912/treatment-of-benign-biliary-leaks-with-transhepatic-placement-of-coated-self-expanding-metallic-stents
#8
M Páramo, P García-Barquín, M Carrillo, M Millor Muruzábal, I Vivas, J I Bilbao
OBJECTIVES: To analyze the safety and efficacy of percutaneous placement of coated self-expanding metallic stents (SEMS) in patients with biliary leaks. MATERIAL AND METHODS: This ethics committee at our center approved this study. We retrospectively reviewed all coated SEMS placed between October 2008 and September 2015. We analyzed patient-related factors such as the primary underlying disease, prior hepatic procedures, and clinical outcome. We evaluated the location, the number and type of leak (anastomotic or non-anastomotic), and the characteristics of the interventional procedure (number of stents deployed, location of the stents, technical success, and primary functionality)...
November 1, 2016: Radiología
https://www.readbyqxmd.com/read/27810250/a-clinical-prediction-rule-to-determine-the-need-for-repeat-ercp-after-endoscopic-treatment-of-postsurgical-bile-leaks
#9
Apostolos V Tsolakis, Paul D James, Gilaad G Kaplan, Robert P Myers, James Hubbard, Todd Wilson, Scott Zimmer, Rachid Mohamed, Martin Cole, Sydney Bass, Mark G Swain, Steven J Heitman
BACKGROUND AND AIMS: In patients who have undergone ERCP with biliary stenting for post-surgical bile leaks, the optimal method (ERCP or gastroscopy) and timing of stent removal is controversial. We developed a clinical prediction rule to identify cases in which a repeat ERCP is unnecessary. METHODS: Population-based study of all patients who underwent ERCP for management of surgically induced bile leaks between 2000 and 2012. Multivariate and binary recursive partitioning analyses were performed to generate a rule predicting the absence of biliary pathology on repeat endoscopic evaluation...
October 31, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27806807/intraoperative-dilatation-and-air-tight-testing-of-the-hepaticojejunostomy-a-new-technique
#10
Hamad Hadi Al-Qahtani
OBJECTIVE: To evaluate the effect of creating an air-tight anastomosis and intraoperative dilatation of the hepaticojejunostomy (HJ) in reducing the early and long-term complications. STUDY DESIGN: Interventional study. PLACE AND DURATION OF STUDY: Department of Surgery, King Saud University, Riyadh, between March 2008 and January 2016. METHODOLOGY: After completion of HJ, the anastomosis was tested for air-tightness, and dilated with Kelly clamp in all patients undergoing the procedure...
October 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27793459/operative-site-drainage-after-hepatectomy-a-propensity-score-matched-analysis-using-the-american-college-of-surgeons-nsqip-targeted-hepatectomy-database
#11
David G Brauer, Timothy M Nywening, David P Jaques, M B Majella Doyle, William C Chapman, Ryan C Fields, William G Hawkins
BACKGROUND: Operative site drainage (OSD) after elective hepatectomy remains widely used despite data suggesting limited benefit. Multi-institutional, quality-driven databases and analytic techniques offer a unique source from which the utility of OSD can be assessed. STUDY DESIGN: Elective hepatectomies from the 2014 American College of Surgeons (ACS) NSQIP Targeted Hepatectomy Database were propensity score matched on the use of OSD using preoperative and intraoperative variables...
December 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27778253/emergency-versus-delayed-cholecystectomy-after-percutaneous-transhepatic-gallbladder-drainage-in-grade-ii-acute-cholecystitis-patients
#12
Ahmed El-Gendi, Mohamed El-Shafei, Doaa Emara
INTRODUCTION: In grade II acute cholecystitis patients presenting more than 72 h after onset of symptoms, we prospectively compared treatment with emergency (ELC) to delayed laparoscopic cholecystectomy performed 6 weeks after percutaneous transhepatic gallbladder drainage (PTGBD). METHODS: Four hundred ninety-five patients with acute cholecystitis were assessed for eligibility; 345 were excluded or declined to participate. One hundred fifty patients were treated after consent with either ELC or PTGBD...
October 24, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27766594/prospective-survey-to-study-factors-which-could-influence-same-day-discharge-after-elective-laparoscopic-cholecystectomy-in-a-tertiary-care-hospital-of-a-developing-country
#13
Samina Ismail, Aliya Ahmed, Muhammad Qamarul Hoda, Muhammad Sohaib, Zia-Ur-Rehman
All laparoscopic cholecystectomy (LC) patients in our hospital setting are admitted overnight. This article assesses the contribution of factors like postoperative nausea and vomiting (PONV), postoperative pain and surgical complications to overnight stay after elective LC. This 1-year observational study included patients having normal liver functions undergoing elective LC before 1400 h. The collected data included patient demographics, co-morbidities, PONV, pain scores, complications, surgical time, anesthesia technique, use of prophylactic antiemetics, analgesics, patient satisfaction and desire to have this surgery as day case or in-patient procedure...
October 20, 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27738836/role-of-drain-placement-in-major-hepatectomy-a-nsqip-analysis-of-procedure-targeted-hepatectomy-cases
#14
Chaya Shwaartz, Adam C Fields, Jeffrey J Aalberg, Celia M Divino
BACKGROUND: The value of drain placement in hepatic surgery has not been conclusive. The aim of this study was to determine whether drain placement during major hepatectomy was associated with negative postoperative outcomes and whether its placement reduced the need for secondary procedures. METHODS: The American College of Surgeons National Surgical Quality Improvement Program Procedure-Targeted Hepatectomy Database was used to identify patients who underwent major hepatectomy...
October 13, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27716860/safety-and-effectiveness-of-a-long-partially-covered-metal-stent-for-endoscopic-ultrasound-guided-hepaticogastrostomy-in-patients-with-malignant-biliary-obstruction
#15
Yousuke Nakai, Hiroyuki Isayama, Natsuyo Yamamoto, Saburo Matsubara, Yukiko Ito, Naoki Sasahira, Ryunosuke Hakuta, Gyotane Umefune, Naminatsu Takahara, Tsuyoshi Hamada, Suguru Mizuno, Hirofumi Kogure, Minoru Tada, Kazuhiko Koike
Background and study aims: Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is potentially complicated by bile leak and stent migration. The aim of this study was to evaluate the safety and effectiveness of a long (≥ 10 cm), partially covered metal stent (LP-CMS) for EUS-guided hepaticogastrostomy (EUS-HGS) for malignant biliary obstruction. Both the stent length and the uncovered portion at the proximal end of the LP-CMS are designed to prevent stent migration. Patients and methods: A total of 33 patients undergoing EUS-HGS using an LP-CMS in four centers were retrospectively studied...
December 2016: Endoscopy
https://www.readbyqxmd.com/read/27677284/percutaneous-hepaticojejunostomy-using-a-radiofrequency-wire-for-management-of-a-postoperative-bile-leak
#16
Orrie N Close, Olaguoke Akinwande, Rakesh K Varma, Ernesto Santos, Hyun S Kim
Postoperative biliary complications following extensive hepatic resections are complex, often requiring a multidisciplinary team approach. We describe a case of a free bile duct leak following extended right hepatectomy and surgical hepaticojejunostomy treated with percutaneous transhepatic hepaticojejunostomy in which a radiofrequency guidewire was used to gain enteral access. A modified internal/external biliary catheter was left in place. The patient was enrolled in a benign biliary stricture protocol, and 8 months later, the catheter was removed following a normal cholangiogram and biliary manometric perfusion testing...
September 27, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27659373/complications-of-biliary-enteric-anastomoses
#17
R S Kadaba, K A Bowers, S Khorsandi, R R Hutchins, A T Abraham, S-J Sarker, S Bhattacharya, H M Kocher
INTRODUCTION Biliary-enteric anastomoses are performed for a range of indications and may result in early and late complications. The aim of this study was to assess the risk factors and management of anastomotic leak and stricture following biliary-enteric anastomosis. METHODS A retrospective analysis of the medical records of patients who underwent biliary-enteric anastomoses in a tertiary referral centre between 2000 and 2010 was performed. RESULTS Four hundred and sixty-two biliary-enteric anastomoses were performed...
September 23, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27623104/refractory-anastomotic-bile-leaks-after-orthotopic-liver-transplantation-are-associated-with-hepatic-artery-disease
#18
Tomas DaVee, Sunil K Geevarghese, James C Slaughter, Patrick S Yachimski
BACKGROUND AND AIMS: Anastomotic bile leaks are common after orthotopic liver transplant (OLT), and standard treatment consists of placement of a biliary endoprosthesis. The objectives of this study were to identify risk factors for refractory anastomotic bile leaks and to determine the morbidity associated with refractory bile leaks after OLT. METHODS: Consecutive adult patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for treatment of post-OLT biliary adverse events between 2009 and 2014 at a high-volume transplant center were retrospectively identified...
September 10, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27619809/albumin-bilirubin-score-predicting-short-term-outcomes-including-bile-leak-and-post-hepatectomy-liver-failure-following-hepatic-resection
#19
Nikolaos Andreatos, Neda Amini, Faiz Gani, Georgios A Margonis, Kazunari Sasaki, Vanessa M Thompson, David J Bentrem, Bruce L Hall, Henry A Pitt, Ana Wilson, Timothy M Pawlik
INTRODUCTION: Post-operative bile leak (BL) and post hepatectomy liver failure (PHLF) are the major potential sources of morbidity among patients undergoing liver resection. We sought to define the incidence of BL and PHLF among a large cohort of patients, as well as examine the prognostic impact of model for end-stage liver disease (MELD) and albumin-bilirubin (ALBI) scores to predict these short-term outcomes. MATERIALS AND METHODS: Patients who underwent a hepatectomy between January 1, 2014 and December 31, 2014 were identified using the National Surgical Quality Improvement Program (NSQIP) liver-targeted database...
September 12, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27606045/endoscopic-multiple-metal-stenting-for-the-treatment-of-enteral-leaks-near-the-biliary-orifice-a-novel-effective-rescue-procedure
#20
Massimiliano Mutignani, Lorenzo Dioscoridi, Stefanos Dokas, Paolo Aseni, Pietro Carnevali, Edoardo Forti, Raffaele Manta, Mariano Sica, Alberto Tringali, Francesco Pugliese
Between April 2013 and October 2015, 6 patients developed periampullary duodenal or jejunal/biliary leaks after major abdominal surgery. In all patients, percutaneous drainage of the collection or re-operation with primary surgical repair was attempted at first but failed. A fully covered enteral metal stent was placed in all patients to seal the leak. Subsequently, we cannulated the common bile duct and, in some cases, and the main pancreatic duct inserting hydrophilic guidewires through the stent after dilating the stent mesh with a dilatation balloon or breaking the meshes with Argon Plasma Beam...
August 10, 2016: World Journal of Gastrointestinal Endoscopy
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