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https://www.readbyqxmd.com/read/29202352/intrahepatic-portal-vein-thrombosis-due-to-postoperative-biliary-obstruction-successfully-treated-by-a-partial-thrombectomy-combined-with-thrombolytic-drug-therapy
#1
Naoya Imamura, Atsushi Nanashima, Yuki Tsuchimochi, Takeomi Hamada, Koichi Yano, Masahide Hiyoshi, Yoshiro Fujii, Kunihide Nakamura
INTRODUCTION: This case report aims to inform pancreatic surgeons about our perioperative management of intrahepatic portal vein thrombosis caused by an obstruction of hepaticojejunostomy (HJ) after pancreaticoduodenectomy (PD). CASE PRESENTATION: A 65-year-old woman was diagnosed with pancreas head carcinoma involving the superior mesenteric vein (SMV). Pancreaticoduodenectomy combined with SMV resection was followed by HJ. Twisting or narrowing was not evident during anastomosis...
November 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29163966/risk-factors-and-survival-outcomes-of-biliary-complications-after-adult-to-adult-living-donor-liver-transplantation
#2
Seogsong Jeong, Xin Wang, Ping Wan, Meng Sha, Jianjun Zhang, Lei Xia, Ying Tong, Yi Luo, Qiang Xia
The objective of this study was to evaluate the risk factors and survival outcomes of biliary complications (BCs) after living donor liver transplantation (LDLT) based on our single-center experience. From 2007 to 2010, 112 adult patients were assessed. Forty-nine patients (43.8%) experienced at least one episode of BCs, including biliary stricture and bile leak, occurring in 37.5% and 16.1% of the patients, respectively. Multivariate analysis indicated that hepatic artery thrombosis (relative risk (RR), 5...
November 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29152792/novel-technique-using-a-non-tip-and-short-wire-papillotome-for-biliary-cannulation-of-intradiverticular-papilla-in-patients-with-roux-en-y-anastomosis
#3
Maya Suguro, Kenjiro Yamamoto, Takao Itoi
Balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) has enabled the endoscopic treatment of pancreatobiliary disease in patients with a surgically altered gastrointestinal anatomy.1-3 However, even though the endoscope can reach the papilla, successful cannulation of the common bile duct may be difficult in the papilla located within a diverticulum because of an insufficient distance from the papilla in the tangential direction. Therefore endoscopic ultrasound-guided biliary drainages have been reported as useful and safety methods...
November 20, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29129486/a-nationwide-analysis-of-re-exploration-after-liver-transplant
#4
Zhobin Moghadamyeghaneh, Mahmoud Alameddine, Joshua S Jue, Giselle Guerra, Gennaro Selvaggi, Seigo Nishida, J Fan, Thiago Beduschi, Rodrigo Vianna
BACKGROUND: A retrospective review to investigate rate and outcomes of re-exploration following liver transplantation in the United States. METHODS: The NIS database was used to examine outcomes of patients who underwent re-exploration following liver transplantation from 2002 to 2012. Multivariate regression analysis was performed to compare outcomes of patients with and without reoperation. RESULTS: We sampled a total of 12,075 patients who underwent liver transplantation...
November 9, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29118687/renoportal-anastomosis-in-left-lateral-lobe-living-donor-liver-transplantation-a-pediatric-case
#5
Hiroyuki Ogasawara, Chikashi Nakanishi, Shigehito Miyagi, Kazuaki Tokodai, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Hiroyuki Kumata, Hitoshi Goto, Masafumi Goto, Michiaki Unno, Takashi Kamei
In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29116490/impact-of-sarcopenic-obesity-on-failure-to-rescue-from-major-complications-following-pancreaticoduodenectomy-for-cancer-results-from-a-multicenter-study
#6
Nicolò Pecorelli, Giovanni Capretti, Marta Sandini, Anna Damascelli, Giulia Cristel, Francesco De Cobelli, Luca Gianotti, Alessandro Zerbi, Marco Braga
BACKGROUND: Failure to rescue (FTR) is a quality-of-care indicator in pancreatic surgery, but may also identify patients who may not tolerate major postoperative complications despite being treated with best available care. Previous studies found that high visceral adipose tissue-to-skeletal muscle ratio is associated with poor outcomes following pancreaticoduodenectomy (PD). The aim of the study is to assess the impact of sarcopenic obesity on occurrence of FTR from major complications in cancer patients undergoing PD...
November 7, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29089716/robotic-roux-en-y-bilioenteric-reconstruction
#7
Sanjay Goja, Manoj K Singh, Sujeet Saha, Varun Mahabaleshwar, Arvinder S Soin
The authors report technical details of robotic bilioenteric reconstruction done for variable indications: choledochal cyst and biliary stricture. Robotic bilioenteric anastomosis as alternative to open reconstruction, offers advantages of minimal access surgery without compromising the precision of open surgery for hilar dissection and reconstruction. Both patients recovered uneventfully and remain symptom-free 18 and 15 months after surgery.
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29065234/improvement-of-refractory-pruritus-after-lipoprotein-apheresis-in-arthrogryposis-renal-failure-cholestasis-syndrome
#8
A Rosales, M Muñoz, A Madrid, S Chocron, J M Hernández, G Ariceta
Accumulation of bile acids can lead to invalidating pruritus in cholestatic patients. Few reports exist on the influence of lipoprotein-apheresis (LA) on plasma level of total bile acids (tBA). We report of significant decrease in tBA levels and drastic improvement of pruritus in a 5-year-old girl with arthrogryposis-renal failure-cholestasis syndrome. We present LA as a suitable rescue treatment option in therapy-refractory cholestasis-associated pruritus, at least as bridge until a long-term solution such as entero-biliary anastomosis or transplantation is possible...
October 24, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29063849/prognostic-factors-and-patterns-of-locoregional-failure-after-surgical-resection-in-patients-with-cholangiocarcinoma-without-adjuvant-radiation-therapy-optimal-field-design-for-adjuvant-radiation-therapy
#9
Zahra Ghiassi-Nejad, Paola Tarchi, Erin Moshier, Meng Ru, Parissa Tabrizian, Myron Schwartz, Michael Buckstein
PURPOSE: To identify prognostic factors and patterns of local failure in patients with cholangiocarcinoma (CCA), after surgical resection in the absence of adjuvant radiation, for optimal definition of target volumes encompassing the majority of local recurrences. METHODS AND MATERIALS: A chart review was performed in patients who underwent resection for primary CCA (intrahepatic, hilar, and distal) between 1999 and 2014. Local failure was defined as recurrence in a theoretical reasonable postoperative radiation volume...
November 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29033759/sump-syndrome-a-rare-long-term-complication-of-choledochoduodenostomy
#10
Hrudya Abraham, Sajan Thomas, Amit Srivastava
Biliary sump syndrome is a rare condition. It is seen as a rare long-term complication in patients with a history of a side-to-side choledochoduodenostomy. In the era before endoscopic retrograde cholangiopancreatography, side-to-side choledochoduodenostomy was a common surgical procedure for the management of biliary obstruction. In the setting of a side-to-side choledochoduodenostomy, the bile does not drain through the distal common bile duct anymore. Therefore, the part of the common bile duct distal from the choledochoduodenostomy anastomosis consequently transforms into a poorly drained reservoir, making this so-called "sump" prone to accumulation of debris...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28994866/multiple-bile-duct-stones-comparison-of-two-surgical-techniques-done-at-laparotomy
#11
Sami Daldoul, Aymen Mabrouk, Ikram Messoudi, Anis Ben Dhaou, Sofiène Sayari, Aymen Baccari, Faten Souai, Mounir Ben Moussa
BACKGROUND: Biliary lithiasis is the most common surgical disease in Tunisia. Multiple bile duct stones are one of his most rare complications.It poses real problems with the best therapeutic approach. AIMS: To analyze the results of conventional surgery for multiple bile duct stones by comparing two techniques: The choledochotomy for stoneextraction followed by external biliary drainage and biliary-enteric anastomosis, to identify and to analyze the factors influencing the therapeuticchoice...
November 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28984750/postoperative-changes-of-liver-enzymes-can-distinguish-between-biliary-stricture-and-graft-rejection-after-living-donor-liver-transplantation-a-longitudinal-study
#12
Young Sik Woo, Kwang Hyuck Lee, Kyu Taek Lee, Jong Kyun Lee, Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Danbee Kang, Juhee Cho
There is no known useful clinical parameter that can specifically predict a biliary stricture and differentiate it from other related complications after living donor liver transplantations (LDLT). The aims of this study were to determine whether the changes of liver enzymes can predict postoperative biliary stricture apart from other complications. We reviewed the medical records of 203 patients who underwent LDLT with duct to duct anastomosis from 2008 to 2010. The longitudinal changes of liver enzyme over time and the occurrence of complication were evaluated...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28980499/the-occurrence-of-enterococcus-faecium-and-faecalis-is-significantly-associated-with-anastomotic-leakage-after-pancreaticoduodenectomy
#13
M Belmouhand, P S Krohn, L B Svendsen, A Henriksen, C P Hansen, M P Achiam
BACKGROUND AND AIMS: Enterococcus has emerged as a virulent species; Enterococcus faecium especially has arisen as a source of nosocomial infections. Furthermore, specific Enterococcus faecalis species are significantly associated with anastomotic leakage in rodent studies. The objective of this study was to investigate whether the occurrence of Enterococci ( E. faecium and E. faecalis) obtained from drain samples was associated with leakage in humans undergoing pancreaticoduodenectomy...
October 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28975996/laparoscopic-pancreaticoduodenectomy-for-tumors-of-the-head-of-pancreas-10-cases-for-a-single-center-experience
#14
F Caruso, G Alessandri, G Cesana, G Castello, M Uccelli, F Ciccarese, R Giorgi, R Villa, B Scotto, S Olmi
OBJECTIVE: The tumors of the head of the pancreas are one of the leading causes of cancer-related death in Western countries. The current gold standard for these tumors is a Whipple procedure. This procedure did not change in its surgical steps since when it was initially introduced in 1935. More recently, a laparoscopic approach with similar outcomes has been described. The aim of this paper is to describe the laparoscopic surgical technique performed in our unit, reporting single center postoperative outcomes...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28955001/aggressive-resection-of-metachronous-triple-biliary-cancer
#15
Masato Yoshikawa, Tetsuya Ikemoto, Yuji Morine, Satoru Imura, Yu Saito, Shinichiro Yamada, Hiroki Teraoku, Atsushi Takata, Toshiaki Yoshimoto, Mitsuo Shimada
Radical resection of recurrent cholangiocellular carcinoma (CCC) is rare. To date, only two patients have been reported to undergo major hepatectomy twice after pancreatoduodenectomy (PD) for metachronous CCC. This report describes a patient who underwent three metachronous radical resections of CCC with curative intent, consisting of PD followed by two hepatectomies, for cancer of the middle bile duct. A 60 year old male, who had undergone a distal gastrectomy for duodenal ulcer perforation in 23 years ago, underwent PD (Honjo method) for middle bile duct cancer (papillary adenocarcinoma) in 20 years ago at another hospital...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28916322/intraductal-transanastomotic-stenting-in-duct-to-duct-biliary-reconstruction-after-living-donor-liver-transplantation-a-randomized-trial
#16
K Y Santosh Kumar, Johns Shaji Mathew, Dinesh Balakrishnan, Viju Kumar Bharathan, Binoj Sivasankara Pillai Thankamony Amma, Unnikrishnan Gopalakrishnan, Ramachandran Narayana Menon, Puneet Dhar, Sudheer Othiyil Vayoth, Surendran Sudhindran
BACKGROUND: Biliary complications continue to be the "Achilles heel" of living-donor liver transplantation (LDLT). The use of biliary stents in LDLT to reduce biliary complications is a controversial issue. We performed a randomized trial to study the impact of intraductal biliary stents on postoperative biliary complications after LDLT. STUDY DESIGN: Of the 94 LDLTs that were performed during a period of 16 months, ABO-incompatible transplants, left lobe grafts, 3 or more bile ducts on the graft, and those requiring bilioenteric drainage were excluded...
December 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28915429/neuroendocrine-tumor-of-the-extrahepatic-bile-duct-a-case-report
#17
Tsuyoshi Abe, Azuma Nirei, Nobuyasu Suzuki, Yukitoshi Todate, Ayaka Azami, Mitsuru Waragai, Atai Sato, Yoshinao Takano, Noriyuki Nishino, Hideo Sakuma, Yasushi Teranishi
INTRODUCTION: Neuroendocrine tumors (NETs) of the extrahepatic bile ducts are extremely rare neoplasms arising from endocrine cells and have variable malignant potential. They most commonly occur in young females and usually present with painless jaundice. PRESENTATION OF CASE: Here we present the case of an asymptomatic 57-year-old woman with NET of the common bile duct that was incidentally discovered on abdominal ultrasound during a medical examination. She was admitted to our hospital with a diagnosis of hepatic hilar tumor...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28912914/intraductal-ultrasonography-as-a-local-assessment-before-magnetic-compression-anastomosis-for-obstructed-choledochojejunostomy
#18
Hideaki Kawabata, Misuzu Hitomi, Naonori Inoue, Yukino Kawakatsu, Yuji Okazaki, Masatoshi Miyata
Magnetic compression anastomosis (MCA) has been developed as a non-surgical alternative treatment for biliary obstruction without serious complications. A 70-year-old woman who had undergone pancreaticoduodenectomy with modified Child reconstruction for pancreatic head cancer suffered from obstructed choledochojejunostomy with no recurrent findings 4 months after the operation. Cholangiography using the percutaneous transhepatic cholangiographic drainage (PTCD) and fluoroscopy revealed complete obstruction of the upper common bile duct, and the length of the obstruction was 7 mm...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28898919/comparison-of-two-fluoroscopic-images-to-ensure-efficient-scope-insertion-for-biliary-intervention-in-patients-with-roux-en-y-hepaticojejunostomy
#19
Koichiro Tsutsumi, Hironari Kato, Ken Hirao, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Takeshi Tomoda, Shigeru Horiguchi, Shuntaro Yabe, Hiroyuki Seki, Yasuhiro Noma, Naoki Yamamoto, Ryo Harada, Tsuneyoshi Ogawa, Hiroyuki Okada
Background and study aims No standard procedure for endoscopic retrograde cholangiopancreatography is available for patients with Roux-en-Y hepaticojejunostomy (RYHJ) with side-to-end hepaticojejunostomy. We therefore explored methods of efficient scope insertion at a hepaticojejunostomy site. Patients and methods Patients with suspected biliary disease were prospectively enrolled. Based on two fluoroscopic images obtained on scope insertion into each lumen of a two-pronged Roux-en-Y anastomosis, we selected the lumen in which the distal end of the scope progressed toward the patient's liver or head...
September 12, 2017: Endoscopy
https://www.readbyqxmd.com/read/28889961/analysis-of-the-reversibility-of-biliary-cirrhosis-in-young-rats-submitted-to-biliary-obstruction
#20
Maria Julia de Aro Braz, Leonardo Ervolino Corbi, Ana Cristina Aoun Tannuri, Maria Cecília Mendonça Coelho, Josiane Oliveira Gonçalves, Suellen Serafini, Uenis Tannuri
BACKGROUND/PURPOSE: Biliary atresia and other liver biliary obstructions are relevant conditions in pediatric surgery due to their progression to biliary cirrhosis and indication for liver transplantation. It is known that the period during which biliary obstruction persists determines the development of cirrhosis and its reversibility after a biliary drainage procedure. However, no time or histological markers of biliary cirrhosis reversibility have been established. MATERIALS AND METHODS: One hundred and twenty-nine young Wistar rats underwent surgery for ligation of the common bile duct and were maintained until 8weeks...
August 24, 2017: Journal of Pediatric Surgery
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