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https://www.readbyqxmd.com/read/29683997/pancreaticojejunostomy-versus-pancreaticogastrostomy-after-pancreaticoduodenectomy-an-up-to-date-meta-analysis-of-rcts-applying-the-isgps-2016-criteria
#1
Yunxiao Lyu, Ting Li, Yunxiao Cheng, Bin Wang, Liang Chen, Sicong Zhao
The goal of our study was to compare the impact of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) on the incidence of complications after pancreaticoduodenectomy. A systematic search was performed using RevMan 5.3 software. A meta-analysis showed that PG was not superior to PJ in terms of postoperative pancreatic fistula (POPF). In multicenter randomized controlled trials, the incidence of POPF was lower in patients undergoing PG than in those undergoing PJ. However, PG was associated with an increased risk of postoperative intraluminal hemorrhage, but no significant difference was observed between 2-layer PG and PJ...
April 20, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29675635/intussusception-after-roux-en-y-gastric-bypass-laparoscopic-management
#2
Enrico Facchiano, Emanuele Soricelli, Luca Leuratti, Viviana Caputo, Giovanni Quartararo, Marcello Lucchese
INTRODUCTION: Intussusception represents an uncommon cause of intestinal obstruction after Rouxen-Y gastric bypass. Symptoms are not specific and clinical presentation may vary from acute intestinal obstruction with or without bowel necrosis to intermittent or chronic pain. CT scan is the diagnostic test of choice. MATERIALS AND METHODS: A 38-year-old woman who had undergone RYGBP 5 months prior was admitted to our Emergency Department with acute abdominal pain, alimentary and bilious vomiting, and fever...
April 19, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29629353/comparison-of-surgical-outcomes-of-intracorporeal-hepaticojejunostomy-in-the-excision-of-choledochal-cysts-using-laparoscopic-versus-robot-techniques
#3
Hongeun Lee, Wooil Kwon, Youngmin Han, Jae Ri Kim, Sun-Whe Kim, Jin-Young Jang
Purpose: Increasing surgical expertise in minimally invasive surgery has allowed laparoscopic surgery to be performed in many abdominal surgeries. Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy are challenging and sophisticated surgeries because of the difficult anastomosis. Recent advances in robotic surgery have enabled more delicate and precise movements, and Endowrist instruments allow for securing sutures during anastomosis. This study aimed to compare surgical outcomes of laparoscopic and robotic hepaticojejunostomy in choledochal cyst excision...
April 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29605038/biliary-reconstruction-with-a-pedicled-gallbladder-flap-in-patients-during-pancreaticoduodenectomy
#4
Jiqiao Zhu, Jiantao Kou, Hongmeng Dong, Jun Ma, Huanye Liu, Chun Bai, Xianliang Li, Qiang He
BACKGROUND: Stricture formation at the biliary-enteric anastomosis can cause serious complications after pancreaticoduodenectomy while the anastomotic size is reported to significantly affect stricture formation. In this study, we aimed to determine the effect of a pedicled gallbladder flap used as an alternative to biliary reconstruction during pancreaticoduodenectomy in patients with a nondilated extrahepatic bile duct. METHODS: Data of patients with a nondilated extrahepatic bile duct, who underwent pancreaticoduodenectomy between October 2012 and July 2015 at the Department of Hepatobiliary and Pancreaticosplenic Surgery at Beijing Chaoyang Hospital, were collected...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29604232/clinical-course-of-hepatic-artery-thrombosis-after-living-donor-liver-transplantation-using-the-right-lobe
#5
Ho Joong Choi, Dong Goo Kim, Yumi Kim, Bong Jun Kwak, Jae Hyun Han, Tae Ho Hong, Young Kyoung You
Background Hepatic artery thrombosis (HAT) can result in biliary tree necrosis and graft loss necessitating re-transplantation. The most effective treatment approach is still controversial. This study was performed to review the outcomes of HAT after living donor liver transplantation (LDLT), and to clarify the feasibility of different strategies. Methods From May 1996 to August 2017, LDLT using the right lobe was performed in 827 adult patients in our center. Our technique of hepatic artery (HA) reconstruction is end-to-end anastomosis under a microscope (× 10)...
March 31, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29582020/the-effect-of-preoperative-biliary-and-pancreatic-drainage-on-postoperative-pancreatic-fistula-a-retrospective-cohort-study
#6
John Mathew Manipadam, Mahesh S, Jacob Mathew Kadamapuzha, Ramesh H
Background  Surgeons and endoscopists welcome routine preoperative biliary drainage prior to pancreaticoduodenectomy despite evidence that it increases complications. Its effect on postoperative pancreatic fistula is variably reported in literature. Simultaneous biliary and pancreatic drainage is rarely performed for very selected indications and its effects on postoperative pancreatic fistula are largely unknown. Our aim was to analyze the same while eliminating confounding factors. Methods  Retrospective single center cohort study of patients who underwent pancreaticoduodenectomy over the past 10 years for carcinoma obstructing the lower common bile duct...
January 2018: Surgery Journal
https://www.readbyqxmd.com/read/29525612/a-novel-combined-interventional-radiologic-and-hepatobiliary-surgical-approach-to-a-complex-traumatic-hilar-biliary-stricture
#7
Rachel E NeMoyer, Mihir M Shah, Omar Hasan, John L Nosher, Darren R Carpizo
INTRODUCTION: Benign strictures of the biliary system are challenging and uncommon conditions requiring a multidisciplinary team for appropriate management. PRESENTATION OF CASE: The patient is a 32-year-old male that developed a hilar stricture as sequelae of a gunshot wound. Due to the complex nature of the stricture and scarring at the porta hepatis a combined interventional radiologic and surgical approach was carried out to approach the hilum of the right and left hepatic ducts...
March 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29519336/how-the-experts-do-it-step-by-step-guide
#8
REVIEW
Ji Young Bang, Shyam Varadarajulu
Lumen-apposing metal stents are integrated in a single-step delivery system for draining intra-abdominal fluid collections. The theoretic advantage of lumen-apposing stents is the ability to approximate the wall of the drained cavity or organ to the gastrointestinal tract lumen. The use of lumen-apposing stents now includes drainage of organs adjacent to the stomach/duodenum and creation of anastomosis between the stomach and jejunum. The lumen-apposing stents may also serve as a conduit for accessing the remnant stomach for performing biliary tract interventions...
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29516398/one-anastomosis-gastric-bypass-and-risk-of-cancer
#9
REVIEW
Ahmed Guirat, Hassan Majed Addossari
The one anastomosis gastric bypass (OAGB) is a recent procedure, which still raises controversies concerning its presumed role in the genesis of biliary reflux and the risk of developing esophageal or gastric cancer. A review of the literature in order to have evidence in favor of or against the risk of cancer after OAGB. We have conducted a review of the English literature using the MEDLINE database. The theoretical risk of asymptomatic chronic biliary reflux after OAGB exists and may be responsible for gastroesophageal cancer...
March 8, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29479444/comparative-analysis-of-different-hepatico-jejunostomy-techniques-for-treating-adult-type-i-choledochal-cyst
#10
Wenjie Ma, Yongqiong Tan, Anuj Shrestha, Fuyu Li, Rongxing Zhou, Junke Wang, Haijie Hu, Qin Yang
Objective: To compare Roux-en-Y hepatico-jejunostomy with complete resection of the cyst or incomplete resection with 1-cm remnant proximal cyst wall in treating adult type I choledochal cyst (CC). Methods: The medical records of 267 adult patients with type I CC from January 1998 to December 2015 were reviewed retrospectively. Among them, 171 underwent Roux-en-Y hepatico-jejunostomy with complete resection (PBD 0-cm group) and 96 underwent Roux-en-Y hepatico-jejunostomy with 1-cm proximal cyst wall left (PBD 1-cm group)...
February 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29459806/-iatrogenic-lesions-of-the-biliary-tract
#11
Himerón Limaylla-Vega, Emilio Vega-Gonzales
Iatrogenic bile duct injuries (IBDI) represent a serious surgical complication of laparoscopic cholecystectomy (LC). Often it occurs when the bile duct merges with the cystic duct; and they have been ranked by Strasberg and Bismuth, depending on the degree and level of injury. About third of IBDI recognized during LC, to detect bile leakage. No immediate repair is recommended, especially when the lesion is near the confluence or inflammation is associated. The drain should be established to control leakage of bile and prevent biliary peritonitis, before transferring the patient to a specialist in complex hepatobiliary surgery facility...
October 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/29459613/complete-annular-pancreas-with-concurrent-entero-pancreatico-biliary-symptoms-in-adult-a-case-report
#12
M M Chowdhury, A A Ullah, R Karim, A Ahmed, S Mohammed, S A Sobhan, A A Farmidi, F Zuwaida, R Pradan, R Mahmud, B Rai, S Pervin, R Habib
Complete Annular pancreas (AP) is a rare congenital anomaly, often presented and operated at the early age of life. Adult presentation group usually presents with either biliary or duodenal or pancreatic symptoms. We report a case of 43 years old female presenting with concurrent enteric, biliary and pancreatic symptoms admitted on April 2016 in Hepatobiliary and Pancreatic Surgery Department of BSMMU, Dhaka, Bangladesh. A complete type of annular pancreas with partial duodenal stenosis and dilated common bile duct was observed during laparotomy...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29456414/high-prevalence-of-hepatitis-b-antibody-loss-and-a-case-report-of-de-novo-hepatitis-b-virus-infection-in-a-child-after-living-donor-liver-transplantation
#13
Palittiya Sintusek, Nawarat Posuwan, Piyaporn Wanawongsawad, Suttiruk Jitraruch, Yong Poovorawan, Voranush Chongsrisawat
AIM: To assess the seroprevalence of hepatitis B virus (HBV) immunity among previously vaccinated pediatric liver transplant recipients and present a case report of de novo hepatitis B infection after liver transplantation. METHODS: This study focused on children with chronic liver diseases who received primary hepatitis B immunization and had a complete dataset of anti-HBs before and after liver transplantation between May 2001 and June 2017. Medical records were retrospectively reviewed for potential factors relating to HBV immunity loss...
February 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29456198/a-modified-single-loop-reconstruction-after-pancreaticoduodenectomy-reduces-severity-of-postoperative-pancreatic-fistula-in-high-risk-patients
#14
Ilgar Aghalarov, Torsten Herzog, Waldemar Uhl, Orlin Belyaev
BACKGROUND: Double-loop (DL) reconstruction after pancreaticoduodenectomy (PD), diverting pancreatic from biliary secretions, has been reported to reduce rates and severity of postoperative pancreatic fistula (POPF) compared to single loop (SL) reconstruction at the price of prolonged operative duration. This study investigated the feasibility of a new reconstruction method combining the advantages of DL with the simplicity of SL in patients with high-risk pancreas. METHODS: A modified single-loop (mSL) reconstruction was used in patients undergoing PD with a soft pancreatic remnant and a pancreatic duct smaller than 3 mm (n = 50)...
February 15, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29435318/endoscopic-management-of-bile-leaks-after-liver-transplantation-an-analysis-of-two-high-volume-transplant-centers
#15
Oriol Sendino, Alejandro Fernández-Simon, Ryan Law, Barham Abu Dayyeh, Michael Leise, Karina Chavez-Rivera, Henry Cordova, Jordi Colmenero, Gonzalo Crespo, Cristina Rodriguez de Miguel, Constantino Fondevila, Josep Llach, Miquel Navasa, Todd Baron, Andrés Cárdenas
Background: Bile leak after liver transplantation (LT) is commonly treated with endoscopic retrograde cholangiopancreatography (ERCP); however, there are limited data regarding the optimal treatment strategy. Objective: We aimed to examine the role of ERCP in LT recipients with bile leaks at two large institutions. Methods: We reviewed all ERCPs performed in LT recipients with bile leak and duct-to-duct biliary anastomosis at two high-volume transplant centers...
February 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29388161/modified-end-to-side-double-layer-open-pancreaticogastrostomy-after-whipple-procedure-surgical-tips-for-a-safe-anastomosis
#16
Raffaele Dalla Valle, Matteo Rossini, Laura Lamecchi, Maurizio Iaria
Pancreatic fistula (PF) remains the Achilles' heel of pancreaticoduodenectomy (PD). Pancreaticogastrostomy (PG) appears to be associated with a lower risk of postoperative leak according to recent evidence. We started to fashion PG, especially in soft pancreas, modifying the original technique described by Bassi. At our institution, 105 PD procedures were carried out from January 2011 to December 2016; pancreatic-enteric continuity was restored by PG in 35 cases. Superior mesenteric/portal vein resection/reconstruction was necessary in three patients...
January 31, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29386762/antireflux-status-post-roux-en-y-anastomosis-an-experimental-study-for-optimal-antireflux-technique
#17
Ajay Kumar Verma, Om Prakash Purbey, Shiv Narain Kureel, Archika Gupta, Anand Pandey, Kanoujia Sunil, Digamber Chaubey
Background: Roux-en-Y hepaticojejunostomy has been a gold standard to establish biliary-enteric anastomosis for various surgical indications, but associated with variable incidences of cholangitis. This experimental study was conducted to report a modification in Roux-en-Y anastomosis for possible better alternative to provide antireflux procedure after Roux-en-Y biliary-enteric anastomosis with the aim to minimize the possibility of reflux and its consequences. Materials and Methods: For experimental study, the required fresh segment of Lamb's small intestine was procured...
January 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/29360615/patient-and-graft-survival-biliary-complications-after-liver-transplantation
#18
Michael Senter-Zapata, Adeel S Khan, Tanvi Subramanian, Neeta Vachharajani, Leigh Anne Dageforde, Jason R Wellen, Surendra Shenoy, Maria B Majella Doyle, William C Chapman
BACKGROUND: Biliary complications (BCs) affect up to to 34% of liver transplant recipients and are a major source of morbidity and cost. This is a 13-year review of BCs after liver transplantation (LT) at a tertiary care center. STUDY DESIGN: We conducted a single-center retrospective review of our prospective database to assess BCs in adult (aged 18 years or older) liver transplant recipients during a 13-year period (2002 to 2014). Biliary complications were divided into 3 subgroups: leak alone (L), stricture alone (S), and both leak and strictures (LS)...
April 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29340917/biliary-bypass-with-laparoscopic-choledochoduodenostomy
#19
Joshua K Kays, Leonidas G Koniaris, Daniel P Milgrom, Attila Nakeeb
Laparoscopic choledochoduodenostomy (LCDD) is employed to treat many benign biliary diseases when endoscopic or percutaneous techniques are not feasible. We describe our technique for LCDD, which utilizes common bile duct transection and an end-to-side biliary-enteric anastomosis. This procedure includes the following elements: isolation and transection of the common bile duct, mobilization of the duodenum (Kocher maneuver), inspection of the common bile duct, and end-to-side biliary-enteric anastomosis. Key details and pitfalls are discussed...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29317267/spiral-enteroscopy-assisted-ercp-in-bariatric-length-roux-en-y-anatomy-a-large-single-center-series-and-review-of-the-literature-with-video
#20
Mohammad F Ali, Rani Modayil, Krishna C Gurram, Collin E M Brathwaite, David Friedel, Stavros N Stavropoulos
BACKGROUND: Deep enteroscopy-assisted ERCP (DEA-ERCP) in post-bariatric Roux-en-Y (RY) anatomy is challenging. Laparoscopy-assisted ERCP (LA-ERCP) and EUS-directed transgastric ERCP (EDGE) are technically easier and faster but are more invasive and morbid procedures. Therefore, we have used DEA-ERCP as our first-line approach, reserving EDGE and LA-ERCP for cases in which adjunctive techniques that cannot be performed through an enteroscope are required (eg, EUS-FNA, sleeve sphincter of Oddi manometry), or DEA-ERCP failures...
January 6, 2018: Gastrointestinal Endoscopy
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