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biliary anastomosis

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https://www.readbyqxmd.com/read/28527479/-biliary-anastomosis-in-liver-transplantation-with-or-without-t-tube
#1
Janine Carmelino, Susana Rodrigues, Hugo Pinto Marques, Vasco Ribeiro, Daniel Virella, Marta Alves, Américo Martins, Eduardo Barroso
INTRODUCTION: Biliary complications occur in 10-30% of liver transplants. The aim of this study was to compare the incidence of these complications in liver transplants when the T-tube was or was not used during the biliary anastomosis. MATERIAL AND METHODS: Analysis of 2 groups of patients undergoing liver transplantation between 2008 and 2012. Patients were divided considering if the T-tube was used (G1) or if it was not (G2). We sought explanatory models of the occurrence of biliary complications by logistic regression, including the variables identified in the univariate analysis...
February 27, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28523061/duel-stage-treatment-for-biliary-cysts-with-cholangitis-during-pregnancy
#2
Baoxing Jia, Ludong Tan, Zhe Jin, Yahui Liu
BACKGROUND & OBJECTIVE: Biliary cysts in pregnant women are a complex medical issue, especially when complicated with cholangitis. It is a serious and life-threatening diagnosis that can seriously endanger both the expectant mother and the fetus. However, during pregnancy, surgical treatment would lead to further complications and higher fetal mortality. Here, we propose a novel therapeutic approach that would be safe for both mother and child during pregnancy, with a definitive treatment postponed until after delivery...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28497648/intrahepatic-cholangiojejunostomy-for-complex-biliary-stenosis-after-pediatric-living-donor-liver-transplantation
#3
Fernando A Alvarez, Rodrigo Sanchez Claria, Juan Glinka, Martin de Santibañes, Juan Pekolj, Eduardo de Santibañes, Miguel A Ciardullo
The treatment of biliary stenosis after pediatric LDLT is challenging. We describe an innovative technique of peripheral IHCJ for the treatment of patients with complex biliary stenosis after pediatric LDLT in whom percutaneous treatment failed. During surgery, the percutaneous biliary drainage is removed and a flexible metal stylet is introduced trough the tract. Subsequently, the most superficial aspect of the biliary tree is recognized by palpation of the stylet's round tip in the liver surface. The liver parenchyma is then transected until the bile duct is reached...
May 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28457413/hepatic-artery-thrombosis-after-liver-transplantation-five-year-experience-at-the-state-university-of-campinas
#4
C H Puliti Reigada, E C de Ataide, T de Almeida Prado Mattosinho, I F S F Boin
BACKGROUND: Hepatic artery thrombosis (HAT) is reported in 4%-15% of orthotopic liver transplants. Risk factors include technical error in the anastomosis, vascular anatomic variation, and high microvascular resistance. The aim of this study was to verify the incidence of HAT, early or late, and possible risk factors. METHODS: This was a retrospective study from January 2007 to December 2012 at the State University of Campinas. Variables analyzed were age, sex, cold and warm ischemia times, underlying disease, presence of hepatocellular carcinoma, Model for End-Stage Liver Disease (MELD) score, arterial anatomic variation in the graft, cytomegalovirus (CMV) infection, rejection, biliary complications, retransplantation rate, and survival...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457378/electrospun-polyhydroxyethyl-aspartamide-polylactic-acid-scaffold-for-biliary-duct-repair-a-preliminary-in%C3%A2-vivo-evaluation
#5
S Buscemi, G Damiano, S Fazzotta, A Maffongelli, V D Palumbo, S Ficarella, C Fiorica, G Cassata, M Licciardi, F S Palumbo, L Gulotta, G Buscemi, A I Lo Monte
Tissue engineering has emerged as a new approach with the potential to overcome the limitations of traditional therapies. The objective of this study was to test whether our polymeric scaffold is able to resist the corrosive action of bile and to support a cell's infiltration and neoangiogenesis with the aim of using it as a biodegradable tissue substitute for serious bile duct injuries. In particular, a resorbable electrospun polyhydroxyethyl-aspartamide-polylactic acid (90 mol% PHEA, 10 mol% PLA)/polycaprolactone (50:50 w/w) plate scaffold was implanted into rabbit gallbladder to assess the in vivo effects of the lytic action of the bile on the scaffold structure and then as a tubular scaffold to create a biliary-digestive anastomosis as well...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28427741/management-of-biliary-anastomotic-strictures-after-liver-transplantation
#6
REVIEW
Aydin Seref Koksal, Ahmet Tarik Eminler, Erkan Parlak, Ahmet Gurakar
Biliary strictures constitute 40% to 60% of the biliary complications after liver transplantation. They are more common after living donor related liver transplantation (LDLT) than orthotopic liver transplantation (OLT). Balloon dilation followed by multiple plastic stent insertion leads to a mean resolution rate of 84% in the treatment of ASs after OLT. Endoscopic treatment of ASs after LDLT is more difficult because of the small size of the ASs, their multiple number and peripheral location. Balloon dilation followed by multiple plastic stent insertion had a mean resolution rate of 53%...
March 30, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28422840/case-report-a-female-case-of-isolated-igg4-related-sclerosing-cholangitis-mimicking-cholangiocarcinoma
#7
Jianchun Xiao, Guanqiao Li, Gang Yang, Congwei Jia, Binglu Li
RATIONALE: IgG4-related disease is a newly recognized fibroinflammatory disorder, characterized by tumefactive lesions, storiform fibrosis and IgG4-positive plasma cells infiltration. IgG4-related sclerosing cholangitis (IgG4-SC) is the most common extrapancreatic manifestation of IgG4-related disease, but it is frequently associated with autoimmune pancreatitis(AIP). Only few case was reported to be diagnosed with IgG4-SC in the absence of AIP, with a striking male preponderance. Here we report a female case of isolated IgG4 related sclerosing cholangitis mimicking cholangiocarcinoma...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28415168/an-update-on-endoscopic-management-of-post-liver-transplant-biliary-complications
#8
Hyun Woo Lee, Najmul Hassan Shah, Sung Koo Lee
Biliary complications are the most common post-liver transplant (LT) complications with an incidence of 15%-45%. Furthermore, such complications are reported more frequently in patients who undergo a living-donor LT (LDLT) compared to a deceased-donor LT (DDLT). Most post-LT biliary complications involve biliary strictures, bile leakage, and biliary stones, although many rarer events, such as hemobilia and foreign bodies, contribute to a long list of related conditions. Endoscopic treatment of post-LT biliary complications has evolved rapidly, with new and effective tools improving both outcomes and success rates; in fact, the latter now consistently reach up to 80%...
April 17, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28403531/short-term-effects-of-extracorporeal-graft-rinse-versus-circulatory-graft-rinse-in-living-donor-liver-transplantation-a-prospective-randomized-controlled-trial
#9
Amr M Yassen, Waleed R Elsarraf, Mohamed A Elmorshedi, Mohamed Abdel Wahab, Tarek Salah, Ahmed M Sultan, Ahmed N Elghawalby, Mohamed M Elshobari, Mohamed Elsadany, Khaled Zalata, Usama Shiha
BACKGROUND: Living donor liver transplantation has shorter cold ischemia time, less preservative volume and lower metabolic load compared to transplantation from deceased donors. We investigated the impact of rinsing the graft contents into the systemic circulation on operative course and post-operative outcomes. PATIENTS AND METHODS: Donors had right hepatectomy and grafts were preserved with cold Histidine-Tryptophan-Ketoglutarate solution. On ending portal vein anastomosis, grafts were flushed by patient's portal blood; either through incompletely anastomosed hepatic vein (Extracorporeal Rinse group, EcRg, n=40) or into systemic circulation (Circulatory Rinse group, CRg, n=40)...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28399882/liver-necrosis-shortly-after-pancreaticoduodenectomy-with-resection-of-the-replaced-left-hepatic-artery
#10
Michihiro Yamamoto, Masazumi Zaima, Hidekazu Yamamoto, Hideki Harada, Junichiro Kawamura, Masahiro Yamada, Tekefumi Yazawa, Junya Kawasoe
BACKGROUND: Surgeons, in general, underestimate the replaced left hepatic artery (rLHA) that arises from the left gastric artery (LGA), compared with the replaced right hepatic artery (rRHA), especially in standard gastric cancer surgery. During pancreaticoduodenectomy (PD), preservation of the rRHA arising from the superior mesenteric artery (SMA) is widely accepted to prevent critical postoperative complications, such as liver necrosis, bile duct ischemia, and biliary anastomotic leakage...
April 11, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28372450/a-bronchobiliary-fistula-treated-with-cyanoacrylate-glue-in-a-patient-with-liver-cirrhosis
#11
Raúl Honrubia López, Ana Barbado Cano, Gloria Ruiz Fernández, Katherine Yelenia Bustamante Robles
A 60-year-old male was operated upon in 2002 for liver hydatidosis, which included partial right hepatectomy with cholecystectomy and bilioduodenal anastomosis. He then developed liver cirrhosis secondary to left hepatic duct stricture. He presents at the emergency room with dry cough, which he had for a month and then became associated with yellowish, bitter-tasting "fluid" expectoration. A chest-abdominal CT scan revealed a 6 x 5-cm collection roughly located somewhere between the middle pulmonary lobe and subphrenic area ...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28350200/does-the-level-of-transection-of-the-biliary-remnant-affect-outcome-after-laparoscopic-kasai-portoenterostomy-for-biliary-atresia
#12
Hiroki Nakamura, Hiroyuki Koga, Go Miyano, Manabu Okawada, Takashi Doi, Atsuyuki Yamataka
BACKGROUND: We assessed postoperative outcome in relation to the level of transection of the biliary remnant at the time of laparoscopic Kasai portoenterostomy (LKP) in biliary atresia (BA) patients. METHODS: The subjects for this study were 12 consecutive nonsyndromic type III BA patients who had LKP at our institute between 2009 and 2014. All LKPs were video recorded. Four board-certified pediatric surgeons assessed the level of transection of the biliary remnant and suturing during the anastomosis in each video blindly...
March 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28340834/hepatic-artery-reconstruction-with-autologous-inferior-mesenteric-artery-graft-in-living-donor-liver-transplant-recipients
#13
M Özbilgin, T Ünek, T Egeli, C Ağalar, S Ozkardesler, F Obuz, H Ellidokuz, S Karademir, I Astarcıoğlu
INTRODUCTION: In living donor liver transplantation (LDLT), hepatic arterial continuity is crucial to avoid biliary leakage, biliary stricture, cholangitis, and graft and patient loss. Sometimes there exist factors making anastomosis difficult or even impossible. In these cases, a vascular graft may be needed to bridge the two arteries for revascularization. METHOD: Medical records of 297 patients who underwent LDLT between June 2000 and July 2016 at the Hepatopancreatobiliary Surgery and Liver Transplantation Unit of Dokuz Eylul University Hospital were reviewed retrospectively...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340833/telescopic-biliary-reconstruction-in-patients-undergoing-liver-transplantation-with-1-year-follow-up
#14
S Karakas, K B Sarici, F Ozdemir, V Ersan, V Ince, A Baskiran, C Kayaalp, R Kutlu, S Yilmaz
BACKGROUND: Biliary complications are important during liver transplantation because of their effect on recipient and graft survival, incidence, and the long treatment period. These complications are associated with 50% morbidity and 30% mortality rates in recent studies. One of the most important reasons for biliary anastomosis complications is arterial ischemia. We present the results of our telescopic biliary anastomosis technique performed on the mucosa of the main biliary duct. PATIENTS AND METHODS: Fifty-six cases of telescopic biliary reconstruction were performed in 203 patients during 2015...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28331447/novel-biliary-reconstruction-techniques-during-liver-transplantation
#15
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/28319567/treatment-of-biliary-stricture-after-live-donor-liver-transplantation-with-combined-metal-and-plastic-stent-%C3%A4-nsertion-a-feasibility-and-safety-study
#16
Erkan Parlak, Aydin Seref Koksal, Ahmet Tarik Eminler, Bilal Toka, Mustafa Ihsan Uslan
BACKGROUND: Fully covered-self expandable metal stents (Fc-SEMSs) have a challenging use in the treatment of anastomosis strictures (ASs) after live donor liver transplantation (LDLT) because they can occlude secondary branch biliary ducts when placed above the biliary bifurcation. In this study we evaluated the technical feasibility and safety of combining Fc-SEMSs with plastic stent(s) inserted to the secondary branch biliary ducts for the treatment of ASs after LDLT. METHODS: The study group included 22 patients (12 men, aged 51±11 years) with anastomotic biliary stricture after LDLT...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28314602/endoscopic-rendez-vous-reconstruction-of-complete-biliary-obstruction
#17
B Neu, S Nennstiel, S von Delius, M Abdelhafez, M Bajbouj, R M Schmid, H Berger, H Feussner, A Meining
BACKGROUND AND STUDY AIMS: Complete biliary strictures normally require surgical intervention. We describe an alternative, minimally invasive endoscopic/percutaneous rendez-vous technique for the reconstruction of complete benign biliary strictures. PATIENTS AND METHODS: Complete biliary strictures were reconstructed in four patients using a rendez-vous percutaneous-endoscopic or percutaneous-percutaneous route guided by fluoroscopic and visual (transillumination) control...
February 27, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28303507/laparoscopic-conversion-of-one-anastomosis-gastric-bypass-to-a-standard-roux-en-y-gastric-bypass
#18
Imed Ben Amor, Niccolo Petrucciani, Radwan Kassir, Abdullah Al Munifi, Thierry Piche, Tarek Debs, Jean Gugenheim
INTRODUCTION: One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. METHODS: We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014...
March 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28301681/biliary-reconstruction-in-liver-transplant-patients-with-primary-sclerosing-cholangitis-duct-to-duct-or-roux-en-y
#19
Alireza Shamsaeefar, Mohammad Shafiee, Saman Nikeghbalian, Kourosh Kazemi, Mohsenreza Mansorian, Nasrin Motazedian, Farsad Afshinnia, Bita Geramizadeh, Seyed Ali Malekhosseini
INTRODUCTION: Roux-en-Y choledochojejunostomy and duct-to-duct (D-D) anastomosis are biliary reconstruction methods for liver transplantation. However, there is a controversy over which method produces better results. We have compared the outcome of D-D anastomosis vs. Roux-en-Y hepaticojejunostomy in patients with primary sclerosing cholangitis who had undergone liver transplant in Shiraz Organ Transplant Center. MATERIALS: The medical records of 405 patients with primary sclerosing cholangitis (PSC) who had undergone liver transplant from 1996 to 2015 were reviewed...
March 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28293485/a-long-term-survivor-of-metastatic-pancreatic-adenocarcinoma-free-of-recurrence-12-years-after-treatment-of-oligometastatic-disease
#20
John M Stahl, Zenta Walther, Bryan W Chang, Howard S Hochster, Kimberly L Johung
Aggressive local therapy for patients with oligometastatic pancreatic ductal adenocarcinoma (PDAC) has traditionally not been pursued due to high rates of distant progression. We describe a 62-year-old male initially presenting with resectable PDAC who underwent the Whipple procedure but developed multiple liver metastases within two months of starting adjuvant gemcitabine. Oxaliplatin was added to the regimen and complete resolution of the liver lesions resulted. He remained disease-free for five years until re-staging revealed a small lung nodule...
February 2, 2017: Curēus
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