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https://www.readbyqxmd.com/read/28331447/novel-biliary-reconstruction-techniques-during-liver-transplantation
#1
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
#2
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
#3
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
#4
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-the-pancreaticoduodenectomy-in-patients-aged-80-or-older-a-systematic-review-and-meta-analysis
#5
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...
March 11, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28262591/robotics-in-hepatobiliary-surgery-initial-experience-first-reported-case-series-from-india
#6
S Goja, M K Singh, A S Soin
INTRODUCTION: Robotic surgical system's ability to perform complex hepatobiliary surgeries is gaining momentum with outcomes similar to open surgery and advantages of minimal access surgery. The authors present their initial experience of a heterogenous spectrum of robotic hepatobiliary cases and the first reported case series from India. METHODS: Retrospective review of hepatobiliary cases done robotically from February 2015 to January 2016 was done. RESULTS: The series has ten patients; with median age of 45 years (range 15-72)...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28241370/evolution-of-laparoscopic-liver-surgery-as-standard-procedure-for-hcc-in-cirrhosis
#7
Daniel Seehofer, Robert Sucher, Moritz Schmelzle, Robert Öllinger, Andri Lederer, Timm Denecke, Eckart Schott, Johann Pratschke
Patients with hepatocellular carcinoma (HCC) in cirrhosis have an increased risk for postoperative complications including liver failure. However, there is some evidence that the use of laparoscopy markedly decreases this risk. Patients Between 2010 - 2015, a total of 21 laparoscopic liver resections were performed for HCC in Child-A cirrhosis at our center. Mean MELD score was 9 (6 - 12), and the mean LiMAx was 261 µg/h/kg (101 - 489). All resections were performed by conventional laparoscopy using 4 - 6 trocars...
February 27, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28240463/incidence-and-management-of-postoperative-bile-leaks-a-prospective-cohort-analysis-of-467-liver-resections
#8
A J Dell, J E J Krige, E Jonas, S R Thomson, S J Beningfield, U K Kotze, S A Tromp, S Burmeister, M M Bernon, P C Bornman
BACKGROUND: Bile leaks from the parenchymal transection margin are a major cause of morbidity following major liver resections. The aim of this study was to benchmark the incidence and identify the risk factors for postoperative bile leakage after hepatic resection. PATIENTS AND METHODS: A prospective database of 467 consecutive liver resections performed by the University of Cape Town HPB surgical unit between January 1990 and January 2016 was analysed. The relationship of demographic, clinical and perioperative factors to the development of bile leakage was determined...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28240461/outcomes-in-laparoscopic-cholecystectomy-in-a-resource-constrained-environment
#9
S Z Mbatha, F Anderson
BACKGROUND: Laparoscopic cholecystectomy (LC) is a common surgical procedure performed for symptomatic gallstones. There is a trend towards early cholecystectomy for patients with acute cholecystitis who present timeously. Local inflammation has been identified as a risk factor for bile duct injuries. This study sought to assess the outcomes of LC in patients managed within a resource constrained environment where late presentation is common. METHOD: We performed a retrospective analysis of laparoscopic cholecystectomy performed from January 2010 to June 2011...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28239085/endoscopic-nasobiliary-drainage-for-bile-leak-caused-by-injury-to-the-ducts-of-luschka
#10
Soon Young Ko, Jeong Rok Lee, Joon Ho Wang
A 51-year-old man underwent laparoscopic cholecystectomy for gallbladder stones. He had developed fever, chills, and abdominal pain four days after the procedure. In the drain tube, bile was persistently observed. An endoscopic retrograde cholangiopancreatography (ERCP) showed a leakage from the small duct into the right intrahepatic duct. We determined that the bile leak was caused by an injury to the ducts of Luschka. An endoscopic sphincterotomy (ES) using a 5-F nasobiliary tube (NBT) was performed, and the leak was resolved in five days...
February 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28228943/a-case-series-of-cholecystectomy-in-jamaican-sickle-cell-disease-patients-the-need-for-a-new-strategy
#11
Pierre-Anthony Leake, Marvin Reid, Joseph Plummer
High morbidity rates related to cholecystectomy in sickle cell disease (SCD) patients have been previously reported in the region. This study serves to assess the current outcomes related to cholecystectomy in a Jamaican SCD population. METHODS: A retrospective chart review of SCD patients undergoing elective cholecystectomy at the University Hospital of the West Indies over a 6-year period was performed providing relevant information for analysis. Patients were grouped on an intention-to-treat basis into an open and laparoscopic group...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28223090/roux-en-y-gastric-bypass-for-the-treatment-of-severe-complications-after-omega-loop-gastric-bypass
#12
Tigran Poghosyan, Clementine Caille, David Moszkowicz, Mouna Hanachi, Claire Carette, Jean-Luc Bouillot
BACKGROUND: Omega-loop gastric bypass (OLGB) may be associated with severe complications, including anastomotic leak, refractory ulcer or stenosis, undernutrition, and disabling digestive disorders (chronic diarrhea, steatorrhea, bile reflux, and vomiting). OLGB conversion to Roux-en-Y gastric bypass (RYGB) was suggested to treat these complications. OBJECTIVES: To evaluate the efficacy and risk of severe complications after OLGB conversion to RYGB. SETTING: University hospital...
December 9, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28217251/biliary-complications-following-liver-transplantation-single-center-experience-over-three-decades-and-recent-risk-factors
#13
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
#14
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
#15
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
#16
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
#17
Melahat Kul, Ayşe Erden, Ebru Düşünceli Atman
OBJECTIVE: To assess the diagnostic value of dynamic T1 weighted (T1w) gadolinium ethoxybenzyl diethylenetriamine 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 T2 weighted (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 analyzed in consensus by three radiologists...
April 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28178122/mortality-after-portal-vein-embolization-two-case-reports
#18
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
#19
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
#20
Ashwin Rammohan, Sanjay Govil, Joy Vargese, Venugopal Kota, Mettu S Reddy, Mohamed Rela
Biliary complications (BCs) remain a significant cause of morbidity following liver transplantation (LT). This series of 640 LT 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. Review of a prospectively collected database of transplant recipients operated between August 2009 and June 2016 was performed. Patients were divided into those with and without BCs and data analyzed. The 640 LT recipients from both living (n = 481) and deceased donors (n = 159) were evaluated for BCs...
April 2017: Liver Transplantation
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