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biliary anastomosis

Toru Ikegami, Tomonari Shimagaki, Junji Kawasaki, Tomoharu Yoshizumi, Hideaki Uchiyama, Noboru Harada, Norifumi Harimoto, Shinji Itoh, Yuji Soejima, Yoshihiko Maehara
INTRODUCTION: Biliary anastomosis stricture (BAS) is still among the major concerns after living donor liver transplantation (LDLT), even after the technical refinements including the universal use of the blood flow-preserving hilar dissection technique. The aim of this study is to investigate what are still the factors for BAS after LDLT. METHODS: An analysis of 279 adult-to-adult LDLT grafts (left lobe, n=161; right lobe, n=118) with duct-to-duct (DD) biliary reconstruction, since the universal application of minimal hilar dissection technique and gradual introduction of eversion technique, was performed...
October 12, 2016: Transplantation
Min-Ho Shin, Deok-Bog Moon, Sung-Gyu Lee, Shin Hwang, Ki-Hun Kim, Chul-Soo Ahn, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Young-In Yun, Wan-Jun Kim, Woo-Hyoung Kang, Seok-Hwan Kim, Gi-Young Ko
BACKGROUND: Although perioperative portal vein (PV) stent implantation is an effective treatment for steno-occlusive disease in adult living donor liver transplantation (LDLT) recipients, we experienced high incidence of biliary anastomotic strictures (BAS) after PV stenting. In this study, we sought to clarify the relation between BAS and PV stenting and to suggest the possible mechanism of BAS and measures to reduce its incidence. METHODS: We retrospectively analyzed 44 LDLT recipients who underwent PV stent implantation across the line of PV anastomosis regardless of the location of steno-occlusion (stent group) and their matched controls (non-stented LDLT recipients, n=131)...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
A V Semenkov, E F Kim, A V Filin, D S Burmistrov, A V Metelin, Yu R Kamalov, T N Galyan, A V Goncharova
AIM: to estimate the effect of decompressive stented drainage of biliary anastomosis on incidence of biliary complications. MATERIAL AND METHODS: 294 patients aged from 5 months to 61 years (mean 13.8±0.81) were enrolled. They underwent liver fragments transplantation in the Department of Liver Transplantation of Petrovsky Russian Research Center of Surgery for the period from March 1997 to January 2016. Decompressive stented drainage tubes were used in 28 (9.5%) patients...
2016: Khirurgiia
Francesco Greco
BACKGROUND: Recent data show that some patients will have insufficient weight loss or experience weight regain after sleeve gastrectomy. Dilation of the sleeve over time or use of an inadequate technique may contribute to relapse of morbid obesity. Repeat sleeve gastrectomy is the most obvious option but requires stapling of scarred tissue, has a higher risk of leakage, and is prone to re-enlargement with time. We herein describe a simple and innovative technique with which to revise vertical sleeve gastrectomy (VSG) into functional single-anastomosis gastric bypass (f-SAGB)...
October 5, 2016: Obesity Surgery
Ronald Reverdito, André DE Moricz, Tércio DE Campos, Adhemar Monteiro Pacheco, Rodrigo Altenfelder Silva
OBJECTIVE: : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. METHODS: : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. RESULTS: : the incidence of MS was 0...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
Dennis Eurich, S Henze, S Boas-Knoop, J Pratschke, D Seehofer
Biliary leakage is a serious complication after liver resection and represents the major cause of post-operative morbidity. In spite of already identified risk factors, little is known about the role of intra-biliary pressure following liver surgery in the development of biliary leakage. Biliary decompression may have a positive impact and reduce the incidence of biliary leakage at the parenchymal resection site. 397 patients undergoing liver resection without bilioenteric anastomosis were included in the retrospective analysis of the risk factors for the development of biliary leakage focusing on the intra-operative reduction of the biliary pressure by T-tube and liver histology...
September 27, 2016: Updates in Surgery
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
Hyoung-Chul Oh
Bilioenteric anastomosis strictures are a serious complication of biliary surgery, and often result in recurrent cholangitis, choledocholithiasis, biliary cirrhosis, and hepatic failure. Bilioenteric reconstructive surgery is the standard treatment of choice for such complications. However, percutaneous transhepatic cholangioscopy (PTCS), also known as per-oral endoscopic-guided intervention, is a less invasive procedure that is becoming an increasingly popular alternative. This review describes the PTCS procedure (including the preparation process), as well as the diagnostic and therapeutic role of PTCS in bilioenteric anastomosis strictures...
September 19, 2016: Clinical Endoscopy
Ken Liu, Vikram Joshi, Payal Saxena, Arthur J Kaffes
BACKGROUND AND AIM: Endoscopic retrograde cholangiopancreatography (ERCP) in patients with roux-en-Y anastomosis (REYA) is challenging. Use of double balloon enteroscope-assisted ERCP (DBE-ERCP) has been successful. We aim to determine predictors of successful biliary cannulation with DBE-ERCP in patients with REYA. METHODS: We retrospectively studied patients with REYA who had DBE-ERCP between 2009 and 2015. RESULTS: 86 DBE-ERCP were done on 52 patients...
September 17, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Mohammad Sadegh Fazeli, Ali Reza Kazemeini, Ali Jafarian, Mohammad Bashashati, Mohammad Reza Keramati
BACKGROUND: Bile Duct Injuries (BDI) during cholecystectomy are now being recognized as major health problems. OBJECTIVES: Herein, we present our experience with handling major BDIs and report long-term outcome of hepaticojejunostomies followed by trans-jejunal hepatic duct stenting performed to reconstruct extra-hepatic biliary tracts. MATERIALS AND METHODS: In this case series, we prospectively collected data of 22 patients, who underwent first time biliary reconstruction through Roux-en-y hepaticojejunostomy followed by hepatic duct stenting using a trans-jejunal bifurcated 6F tube drain...
May 2016: Trauma Monthly
Sung Ill Jang, Kwang-Hun Lee, Hong Jin Yoon, Dong Ki Lee
BACKGROUND & AIMS: Although non-surgical methods produce high clinical success rates in the treatment of benign biliary stricture (BBS), conventional methods are not always successful in cases of severe biliary stricture or complete obstruction. Therefore, the efficacy of magnetic compression anastomosis (MCA) for treatment of refractory BBS was evaluated in a single-center, nonrandomized study. METHODS: MCA was performed in patients with BBS that was not resolved by conventional endoscopic or percutaneous treatments...
September 9, 2016: Gastrointestinal Endoscopy
Dian-Bo Yao, Shuo-Dong Wu
The liver is a vascular-rich solid organ. Safe and effective dissection of the vessels and liver parenchyma, and control of intraoperative bleeding are the main concerns when performing liver resection. Several studies have confirmed that intraoperative blood loss and postoperative transfusion are predictors of postoperative morbidity and mortality in liver surgery. Various methods and instruments have been developed during hepatectomy. Stapling devices are crucial for safe and rapid anastomosis. They are used to divide hepatic veins and portal branches, and to transect liver parenchyma in open liver resection...
August 21, 2016: World Journal of Gastroenterology: WJG
Masaaki Shimatani, Makoto Takaoka, Kazuichi Okazaki
We report a successful endoscopic stone extraction using a short type double-balloon endoscope (DBE) (EI-530 B; FUJIFILM Co, Tokyo, Japan) combined with long-type ultra-slim endoscope (L-USE) (EC-530XP; FUJIFILM Co, Tokyo, Japan) without using contrast media for intrahepatic stones in patient allergic to iodine with post-operation. A 43 year-old man with a history of congenital biliary dilatation who had undergone choledocojejunostomy and Roux-en Y reconstruction 37 years previously (Fig. 1-A) and posterior lateral hepatic segmentectomy and caudate lobectomy for intrahepatic stone 10 years previously was admitted for acute cholangitis caused by recurrence of intrahepatic stone and stenosis in choledochojejunal anastomosis (Fig...
September 8, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Cinthia G Pérez, Aixa Reusmann
Congenital tracheo-or-bronchobiliary fistula or congenital he-patopulmonary fistula is a rare malformation with high morbidity and mortality if the diagnosis is not made early. The tracheo-or-bronchobiliary fistula is a communication between the respiratory (trachea or bronchus) and biliary tract. To date, only 35 cases have been published worldwide. We report a case of a neonate with right pneumonia and bilious fluid in the endotracheal tube. Diagnosis was made using bronchoscopy with fluoroscopy. Videothoracoscopy was used to remove the bronchobiliary fistula...
October 1, 2016: Archivos Argentinos de Pediatría
Binhao Zhang, Wei Dong, Hongping Luo, Xuanru Zhu, Lin Chen, Changhai Li, Peng Zhu, Wei Zhang, Shuai Xiang, Wanguang Zhang, Zhiyong Huang, Xiao-Ping Chen
Hepato-pancreato-biliary (HPB) tumors are common in China. However, these tumors are often diagnosed at intermediate/ advanced stages because of the lack of a systemic surveillance program in China. This situation creates many technical challenges for surgeons and increases the incidence of postoperative complications. Therefore, Dr. Xiao-Ping Chen has made many important technical improvements, such as Chen's hepatic portal occlusion method, the anterior approach for liver resection of large HCC tumors, the modified technique of Belghiti's liver-hanging maneuver, inserting biliary-enteric anastomosis technique, and invaginated pancreaticojujunostomy with transpancreatic U-sutures...
October 2016: Science China. Life Sciences
Erkan Parlak, Aydın Seref Koksal, Fahrettin Kucukay, Ahmet Tarık Eminler, Bilal Toka, Mustafa Ihsan Uslan
BACKGROUND AND AIMS: Magnetic compression anastomosis is a rescue technique for recanalization of complete biliary strictures. Here, we present magnetic compression anastomosis with novel through-the-scope magnets in patients with complete duct-to-duct anastomosis obstruction after liver transplantation. METHODS: The magnets were 2 and 2.4 mm in diameter, with a hole at the center for inserting a guidewire. One of the magnets was advanced through the scope up to the distal site of the stricture by using a 7F pusher...
August 24, 2016: Gastrointestinal Endoscopy
Michael De Koning, Tom G Moreels
BACKGROUND: Roux-en-Y reconstructive surgery excludes the biliopancreatic system from conventional endoscopic access. Balloon-assisted enteroscopy allows therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in these patients, avoiding rescue surgery. The objective of the current study is to compare success and complication rate of double-balloon (DBE) and single-balloon enteroscope (SBE) to perform ERCP in Roux-en-Y patients. METHODS: Seventy three Roux-en-Y patients with suspected biliary tract pathology underwent balloon-assisted enteroscopy in a tertiary-care center...
2016: BMC Gastroenterology
T Mahdy, A Al Wahedi, C Schou
INTRODUCTION: The single anastomosis sleeve ileal (SASI) bypass is a Novel Metabolic/Bariatric Surgery operation based on mini gastric bypass operation and Santoro's operation in which a sleeve gastrectomy is followed by a side to side gastro-ileal anastomosis. The purpose of this Study is to report the clinical results of the outcomes of SASI bypass as a therapeutic option for obese T2DM patients. METHODS: We conducted a retrospective cohort study of type 2 diabetic obese patients who underwent SASI bypass at one hospital from March 1, 2013 to December 31, 2014...
August 19, 2016: International Journal of Surgery
V P Mali, A Fukuda, T Shigeta, H Uchida, Y Hirata, T H Rahayatri, H Kanazawa, K Sasaki, J de Ville de Goyet, M Kasahara
LT for PFIC type 1 is often complicated by postoperative diarrhea and recurrent graft steatosis. A 26-month-old female child with cholestatic jaundice, pruritus, diarrhea, and growth retardation revealed total bilirubin 9.1 mg/dL, gamma-glutamyl transpeptidase 64 IU/L, and TBA 295.8 μmol/L. Genetic analysis confirmed ATP8B1 defects. A LT (segment 2, 3 graft) from the heterozygous father was performed. Biliary diversion was performed by a 35-cm jejunum conduit between the graft hepatic duct and the mid-transverse colon...
August 17, 2016: Pediatric Transplantation
İsmail Okan, Servet Tali, Zeki Özsoy, Çağlar Deniz, Berat Acu, Erdinç Yenidoğan, Hüseyin Ayhan Kayaoğlu, Mustafa Şahin
Pneumobilia is the detection of gas within the biliary system. It usually develops after bilioenteric anastomosis, percutaneous or endoscopic biliary interventions, infections and abscesses. The treatment is surgical, especially in cases with no prior interventions to the biliary system. The development of pneumobilia is quite rare after blunt trauma. Therefore, both the diagnosis and management are challenging for surgeons. Herein, we present the diagnosis and conservative management of a patient with pneumobilia after blunt trauma...
2016: Ulusal Cerrahi Dergisi
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