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https://www.readbyqxmd.com/read/28820145/endoscopic-ultrasound-guided-gastroenterostomy-are-we-ready-for-prime-time
#1
REVIEW
Mihai Rimbas, Alberto Larghi, Guido Costamagna
Interventional endoscopic ultrasonography (EUS) is currently becoming the less invasive therapeutic approach for the drainage of pancreatic fluid collections, of acute cholecystitis in patients unfit for surgery and for biliary drainage after failed endoscopic retrograde cholangiopancreatography. In addition, EUS-guided gastroenterostomy (EUS-GE) has recently emerged as a feasible procedure to treat patients with gastric outlet obstruction, as an alternative to surgery or to standard endoscopy when endoscopic stent placement is not possible...
July 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28758243/enteroscopy-overtube-assisted-over-the-wire-stent-placement-to-treat-an-enteral-stenosis
#2
Antonino Granata, Michele Amata, Mario Traina
A 77-year-old man underwent duodeno-cephalo-pancreatectomy with Roux-en-Y reconstruction for pancreatic head cancer. After two years developed recurrent cholangitis with obstructive jaundice. In suspicion of obstruction of biliary tree, a percutaneous transhepatic cholangiography (PTC) was attempted. Contrast dye injected troughs the catheter shower an intestinal stenosis about 10 centimeters above the bilio-enteric anastomosis. Following PET-CT scan showed no cancer recurrence. This article is protected by copyright...
July 31, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28755968/surgical-and-medical-approach-to-patients-requiring-total-small-bowel-resection-managing-the-no-gut-syndrome
#3
Ruy J Cruz, Laurie Butera, Kristine Poloyac, Jenee McGurgan, William Stein, David Binion, Abhinav Humar
BACKGROUND: Total resection of the jejunum and ileum, a rarely performed procedure, is indicated after mesenteric vascular events, trauma, or resection of abdominal neoplasms. We describe our recent experience with the operative and medical management of patients with "no gut syndrome." METHODS: We retrospectively reviewed 341 adult patients who were referred to our center between January 2013 and December 2016. RESULTS: Thirteen patients with a mean age of 42...
July 26, 2017: Surgery
https://www.readbyqxmd.com/read/28755161/usefulness-of-three-dimensional-image-navigation-system-for-evaluation-of-hepatic-artery-before-living-donor-liver-transplantation-a-case-report
#4
Michinori Matsumoto, Shigeki Wakiyama, Hiroaki Shiba, Yuichi Ishida, Yoshiaki Kita, Katsuhiko Yanaga
BACKGROUND: The evaluation of the hepatic vascular anatomy in living liver donors is increasingly being performed by three-dimensional (3D) computed tomography (CT) angiography. However, details of hepatic artery anatomy obtained by 3D CT angiography are not always superior to those obtained by angiography. Here, we report a case in which the 3D image navigation system helped to detect segment II, III, and IV arteries (A2, A3, and A4, respectively) that individually originated from the proper hepatic artery (PHA); this could not be detected by 3D CT angiography...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28744740/acute-cholangitis-after-bilioenteric-anastomosis-for-bile-duct-injuries
#5
Edgar Ortiz-Brizuela, José Sifuentes-Osornio, Daniel Manzur-Sandoval, Santiago Mier Y Terán-Ellis, Sergio Ponce-de-León, Pedro Torres-González, Miguel Ángel Mercado
BACKGROUND/PURPOSE: The study aims to describe the clinical features, microbiology, and associated factors of acute cholangitis (AC) after bilioenteric anastomosis (BEA) for biliary duct injury (BDI). Additionally, we assessed the performance of the Tokyo Guidelines 2013 (TG13) recommendations in these patients. METHODS: We conducted a case-control study of 524 adults with a history of BEA for BDI from January 2000 to January 2014. A propensity score adjustment was performed for the analysis of the independent role of the main factors identified during the univariate logistic regression procedure...
July 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28735936/combined-surgical-and-transhepatic-rendezvous-procedure-for-relieving-anastomotic-biliary-obstruction-in-children-with-liver-transplants
#6
John Crowley, Kyle Soltys, Rakesh Sindhi, Kevin Baskin, Sabri Yilmaz, Orrie Close, Avinash Medsinge
Four children (3 boys and 1 girl, age 1.4-9.4 y) presented 2-70 months after liver transplantation (mean 26 months) with high-grade narrowing at the surgical anastomosis that could not be crossed at percutaneous transhepatic cholangiography. Each patient was treated with a combined surgical and interventional radiology "rendezvous" procedure. Biliary drainage catheters were left in place for an average of 6 months after the procedure. At a mean 7.5 months after biliary drainage catheter removal, all children were catheter-free without clinical or biochemical evidence of biliary stricture recurrence...
August 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28733743/therapeutic-peroral-direct-cholangioscopy-using-a-single-balloon-enteroscope-in-patients-with-roux-en-y-anastomosis-with-videos
#7
Hiroshi Yamauchi, Mitsuhiro Kida, Kosuke Okuwaki, Shiro Miyazawa, Takaaki Matsumoto, Kazuho Uehara, Eiji Miyata, Rikiya Hasegawa, Toru Kaneko, Issaree Laopeamthong, Yang Lei, Tomohisa Iwai, Hiroshi Imaizumi, Wasaburo Koizumi
BACKGROUND: Peroral cholangioscopic lithotripsy is a useful procedure in patients with a normal gastrointestinal anatomy who have difficult-to-treat stones. We evaluated the usefulness of peroral direct cholangioscopy (PDCS) using single-balloon enteroscope (SBE) in patients with difficult-to-treat stones who had undergone Roux-en-Y reconstruction. METHODS: Among 118 patients (169 sessions) who underwent SBE-assisted endoscopic retrograde cholangiopancreatography to treat biliary stones after Roux-en-Y reconstruction, patients in whom it was difficult to remove biliary stones via a transpapillary or transanastomotic approach and difficult to switch to ultra-slim endoscope, were retrospectively enrolled...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28695433/reconstruction-of-bile-duct-injury-and-defect-with-the-round-ligament
#8
Safi Dokmak, Béatrice Aussilhou, Emilia Ragot, Camille Tantardini, François Cauchy, Philippe Ponsot, Jacques Belghiti, Alain Sauvanet, Olivier Soubrane
Lateral injury of the bile duct can occur after cholecystectomy, bile duct dissection, or exploration. If direct repair is not possible, conversion to bilioenteric anastomosis can be needed with the risk of long-term bile duct infections and associated complications. We developed a new surgical technique which consist of reconstructing the bile duct with the round ligament. The vascularized round ligament is completely mobilized until its origin and used for lateral reconstruction of the bile duct to cover the defect...
July 10, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28694670/new-totally-intracorporeal-reconstructive-approach-after-robotic-total-gastrectomy-technical-details-and-short-term-outcomes
#9
Amilcare Parisi, Francesco Ricci, Alessandro Gemini, Stefano Trastulli, Roberto Cirocchi, Giorgio Palazzini, Vito D'Andrea, Jacopo Desiderio
AIM: To show outcomes of our series of patients that underwent a total gastrectomy with a robotic approach and highlight the technical details of a proposed solution for the reconstruction phase. METHODS: Data of gastrectomies performed from May 2014 to October 2016, were extracted and analyzed. Basic characteristics of patients, surgical and clinical outcomes were reported. The technique for reconstruction (Parisi Technique) consists on a loop of bowel shifted up antecolic to directly perform the esophago-enteric anastomosis followed by a second loop, measured up to 40 cm starting from the esojejunostomy, fixed to the biliary limb to create an enteroenteric anastomosis...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28651522/the-role-of-enterococcus-spp-and-multidrug-resistant-bacteria-causing-pyogenic-liver-abscesses
#10
Marcus M Mücke, Johanna Kessel, Victoria T Mücke, Katharina Schwarzkopf, Michael Hogardt, Christoph Stephan, Stefan Zeuzem, Volkhard A J Kempf, Christian M Lange
BACKGROUND: Pyogenic liver abscesses (PLA) remain a significant clinical problem. Unfortunately, little is known about current bacterial susceptibility profiles and the incidence of multidrug resistant organisms (MDROs) causing PLA in Western countries. Yet, this crucial information is pivotal to guide empirical antibiotic therapy. Aim of this study was to provide detailed characteristics of PLA with a special focus on underlying bacterial pathogens and their susceptibility to antibiotics...
June 26, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28646282/surgery-for-pancreatic-ductal-adenocarcinoma
#11
REVIEW
R Vera, L Díez, E Martín Pérez, J C Plaza, A Sanjuanbenito, A Carrato
Surgical resection is the only potentially curative option in the treatment of pancreatic ductal adenocarcinoma. Preoperative radiological imaging allows to rule out the presence of metastases. Three resectability categories are established based on the radiological findings depending on the degree of contact between the tumor and the blood vessels. Histological confirmation of malignancy is only required in cases of borderline or non-resectable tumors, prior to neoadjuvant treatment initiation. Diagnostic laparoscopy is recommended in the presence of large tumors of the body or tail and in borderline tumors to explore the possibility of resection and to apply treatment with curative intent, as well as in those cases with high level of biomarkers to rule out peritoneal involvement...
June 23, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28643070/laparoscopic-revision-of-billroth-ii-with-braun-anastomosis-into-roux-en-y-anatomy-in-a-patient-with-intestinal-malrotation
#12
Fabio Garofalo, Omar Abouzahr, Henri Atlas, Ronald Denis, Pierre Garneau, Hai Huynh, Radu Pescarus
INTRODUCTION: Various reconstructions of the gastro-intestinal tract have been described in the past after distal gastrectomy. Among these, a Billroth II (BII) anastomosis can be performed with the addition of the Omega entero-enterostomy that may theoretically reduce the alkaline reflux. Given the significant complications associated with this procedure such as biliary reflux, marginal ulceration, and afferent loop syndrome, a revision into a Roux-en-Y anatomy is generally recommended...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28626977/magnetic-compression-anastomosis-for-postoperative-biliary-atresia
#13
Rei Matsuura, Takehisa Ueno, Yuko Tazuke, Natsumi Tanaka, Hiroaki Yamanaka, Yuichi Takama, Kengo Nakahata, Taku Yamamichi, Noboru Maeda, Keigo Osuga, Eigoro Yamanouchi, Hiroomi Okuyama
We report a case of successful magnetic compression anastomosis (MCA) for obstructed cyst-jejunostomy in a young woman who had undergone surgery for type 1 biliary atresia (BA) on day 78 of life. A 16-year-old girl was admitted with obstructive jaundice. Jaundice resolved with percutaneous trans-hepatic cholangiodrainage (PTCD) but contrast medium injected from the PTCD tube did not flow through the anastomosis. Magnets were placed on each side of the anastomosis, in the cyst and the jejunum, to compress the partition...
June 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28624111/biliary-complications-after-liver-transplantation-recent-developments-in-etiology-diagnosis-and-endoscopic-treatment
#14
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/28600688/endoscopic-management-of-biliary-strictures-after-living-donor-liver-transplantation
#15
REVIEW
Takeshi Tsujino, Hiroyuki Isayama, Hirofumi Kogure, Tatsuya Sato, Yousuke Nakai, Kazuhiko Koike
Living donor liver transplantation (LDLT) is an effective alternative to deceased liver transplantation (DDLT) for end-stage liver disease. Although advances in surgical techniques, immunosuppressive management, and post-transplant care have improved the overall outcomes of LDLT, biliary strictures remain the major unsolved problem. Endoscopic retrograde cholangiopancreatography (ERCP) is currently considered the first-line therapy for biliary strictures following LDLT with duct-to-duct reconstruction, with percutaneous and surgical interventions reserved for patients with unsuccessful management via ERCP...
August 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597680/fishbone-impaction-in-the-colon
#16
Armando Peixoto, Marco Silva, Branca Órfão, Guilherme Macedo
Postoperative benign biliary stricture in the anastomotic site is one of the most common complications of biliary-enteric anastomosis, with a rate of 6.87% after 2-13 years of follow-up. If untreated, biliary strictures can induce other complications such as recurrent cholangitis, intrahepatic stones, pancreatitis and secondary biliary cirrhosis. We report our experience with extracorporeal shock wave lithotripsy (ESWL) in a patient with a massive symptomatic stone proximal to an anastomotic biliary stricture...
June 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28597679/successful-extracorporeal-shock-wave-lithotripsy-eswl-treatment-of-a-symptomatic-massive-biliary-stone-proximal-to-an-anastomotic-biliary-stricture
#17
Rosangela Muratori, Daniele Mandolesi, Maria Cristina Galaverni, Francesco Azzaroli
Postoperative benign biliary stricture in the anastomotic site is one of the most common complications of biliary-enteric anastomosis, with a rate of 6.87% after 2-13 years of follow-up. If untreated, biliary strictures can induce other complications such as recurrent cholangitis, intrahepatic stones, pancreatitis and secondary biliary cirrhosis. We report our experience with extracorporeal shock wave lithotripsy (ESWL) in a patient with a massive symptomatic stone proximal to an anastomotic biliary stricture...
June 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28589138/appendectomy-as-a-risk-factor-for-bacteremic-biliary-tract-infection-caused-by-antibiotic-resistant-pathogens
#18
Koki Kawanishi, Jun Kinoshita, Hiroko Abe, Tetsuhiro Kakimoto, Yuko Yasuda, Takeshi Hara, Jun Kato
BACKGROUND/AIMS: Recent evidence has suggested that appendix plays a pivotal role in the development and preservation of intestinal immune system. The aim of this study is to examine whether prior appendectomy is associated with an increased risk for the development of antibiotic-resistant bacteria in bacteremia from biliary tract infection (BTI). METHODS: Charts from 174 consecutive cases of bacteremia derived from BTI were retrospectively reviewed. Using multivariate analysis, independent risk factors for development of antibiotic-resistant bacteria were identified among the clinical parameters, including a history of appendectomy...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28583556/duct-to-duct-biliary-reconstruction-in-living-donor-liver-transplantation-for-primary-sclerosing-cholangitis-report-of-a-case
#19
T Motomura, T Yoshizumi, H Wang, A Nagatsu, S Itoh, N Harada, N Harimoto, T Ikegami, H Uchiyama, Y Soejima, Y Maehara
Although Roux-en Y hepaticojejunostomy was previously recommended for the biliary reconstruction in liver transplantation for primary sclerosing cholangitis (PSC), some recent reports showed no difference in the graft survival between Roux-en Y and duct-to-duct anastomosis in deceased-donor liver transplantation. On the other hand, considering the risk of recurrence and the short length of the bile duct of the graft, duct-to-duct biliary anastomosis has never been reported in a patient undergoing living-donor liver transplantation (LDLT) for PSC...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28583546/surgical-techniques-of-allogeneic-liver-transplantation-in-a-nonhuman-primate-model
#20
H Kim, H Kim, J-I Lee, S W Ahn, S K Hong, K C Yoon, H-S Kim, J-Y Choi, D Oh, N-J Yi, J Yang, K-W Lee, K-S Suh
Herein, we report our experience of performing allogeneic orthotopic liver transplantation (LT) in nonhuman primates. We designed an allogeneic ABO-compatible orthotopic LT model in monkeys in a manner similar to that used in humans. We applied almost the same surgical procedures used for human conventional deceased donor LT. A total of 6 monkeys underwent allogeneic LT. One cynomolgus monkey aged 45 months (3.4 kg) and 5 rhesus macaque monkeys aged 50.2 ± 14.8 months (5.40 ± 0.33 kg) were used as recipients...
June 2017: Transplantation Proceedings
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