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https://www.readbyqxmd.com/read/28931801/elizabethkingia-meningoseptica-in-a-case-of-biliary-tract-infection-following-liver-transplantation
#1
Hebah M Musalem, Yazan N Honjol, Lin M Tuleimat, Saleh I Al Abbad, Fahad I Alsohaibani
BACKGROUND Elizabethkingia meningoseptica (E. meningoseptica) is an aerobic Gram-negative bacillus known to thrive in moist environments, and is now recognized as a hospital-acquired infection, being found to contaminate hospital equipment, respiratory apparatus, hospital solutions, water, and drainage systems. Nosocomial infection with E. meningoseptica occurs in immunocompromised patients, requires specialized identification methods, and is resistant to conventional antibiotics. We report a case of E. meningoseptica infection arising from a percutaneous transhepatic biliary drainage (PTBD) tube...
September 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28930104/liver-transplantation-in-the-obese-cirrhotic-patient
#2
Erin K Spengler, Jacqueline G O'Leary, Helen S Te, Shari Rogal, Anjana A Pillai, Abdullah Al-Osaimi, Archita Desai, James N Fleming, Daniel Ganger, Anil Seetharam, Georgios Tsoulfas, Martin Montenovo, Jennifer C Lai
Despite the rapidly increasing prevalence of obesity in the transplant population, the optimal management of obese liver transplant candidates remains undefined. Setting strict body mass index cutoffs for transplant candidacy remains controversial, with limited data to guide this practice. Body mass index is an imperfect measure of surgical risk in this population, partly due to volume overload and variable visceral adiposity. Weight loss before transplantation may be beneficial, but it remains important to avoid protein calorie malnutrition and sarcopenia...
October 2017: Transplantation
https://www.readbyqxmd.com/read/28928333/liver-hydatid-cyst-with-cystobiliary-communication-laparoscopic-surgery-remains-an-effective-option
#3
Nikhil Chopra, Vivek Gupta, Saket Kumar, Pradeep Joshi, Vishal Gupta, Abhijit Chandra
INTRODUCTION: Most centres offer laparoscopic treatment for liver hydatid cyst (LHC). There have been concerns about the management of intra-peritoneal spillage, bleeding, and cystobiliary communication (CBC) during laparoscopic surgery for LHC. CBC can exist in 13%-37% of cases of LHC. No randomised studies have compared open versus laparoscopic approach for the treatment of LHC. We specifically analysed the outcomes of laparoscopic treatment of LHC with special reference to associated biliary complications...
September 20, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28927042/surgical-bypass-and-permanent-iodine-125-seed-implantation-vs-surgical-bypass-for-the-treatment-of-pancreatic-head-cancer
#4
Zhenjiang Zheng, Yinglong Xu, Shu Zhang, Guangchun Pu, Chi Cui
The present study aimed to investigate the efficacy and safety of Iodine-125 ((125)I) seed implantation in the treatment of locally advanced unresectable pancreatic head cancer. A prospective nonrandomized study was performed using data collected from patients between January 2009 and December 2012. A total of 34 patients underwent surgical bypass and permanent (125)I seed implantation (group A), and 32 patients underwent biliary and gastric bypass (group B). The preoperative variables, operative data, postoperative complications and follow-up information were examined...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28926171/biliary-reconstructive-techniques-and-associated-anatomic-variants-in-adult-living-donor-liver-transplants-the-a2all-experience
#5
Talia B Baker, Michael A Zimmerman, Nathan P Goodrich, Benjamin Samstein, Elizabeth A Pomfret, James J Pomposelli, Brenda W Gillespie, Carl L Berg, Jean C Emond, Robert M Merion
INTRODUCTION: Living donor liver transplantation (LDLT) is a technically demanding endeavor, requiring command of the complex anatomy of partial liver grafts. We examined the influence of anatomic variation and reconstruction technique on surgical outcomes and graft survival in the nine-center A2ALL Study. METHODS: Data from 272 adult LDLT recipients (2011-2015) included details on anatomic characteristics and types of intraoperative biliary reconstruction. Associations were tested between reconstruction technique and complications, which included first biliary complication ([BC]; leak, stricture, or biloma) and first vascular complication (hepatic artery thrombosis [HAT] or portal vein thrombosis [PVT])...
September 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28923636/effect-of-preoperative-growth-status-on-clinical-outcomes-after-living-donor-liver-transplantation-in-infants
#6
Y Lu, Q Xia, Y Yang, P Wan, J Hou, Y Wang, B Qiu, M Feng, K He, M Huang, X Ren, L Gao, J Zhang
OBJECTIVE: The aim of this study was to evaluate the impact of preoperative growth status on clinical outcomes of infantile living-donor liver transplantation (LDLT). METHODS: From January 2009 to December 2014, 131 LDLT recipients ≤1 year of age met the eligibility criteria of this study, of whom 31 patients with weight z-scores less than -2 constituted the abnormal growth group. Patients in the abnormal growth group were randomly matched (1:1) to patients with normal growth status by means of a multivariate case-matched method, and thus 31 patients in the normal growth group and 31 patients in the abnormal growth group were finally enrolled into the study...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28922437/molecular-biomarkers-as-predictors-for-biliary-complications-following-liver-transplantation-a-prospective-study
#7
Bogdan Dorobantu, Irinel Popescu, Simona Dima, Anca Nastase, Speranta Iacob
BACKGROUND: The biliary complications (BC) have been always considered the "Achilles' heel" of liver transplantation (LT), being one of the leading causes of postoperative morbidity. AIM: To analyse predictors of BC, by monitoring in the peripheral blood the biomarkers involved in the inflammation and hepatic fibrosis, such as the matrix metalloproteinases (MMP 2, 9) and their tissue inhibitors (TIMP1), the interleukins (IL 2, 8), alfa-TNF, the endothelins and their receptors...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28922301/hypothermic-liver-perfusion
#8
Andrea Schlegel, Xavier Muller, Philipp Dutkowski
PURPOSE OF REVIEW: The review describes recent developments in hypothermic machine liver perfusion with a special focus on underlying protective mechanisms, and the role of this perfusion technique in high-risk donor-recipient combinations. RECENT FINDINGS: To maximize the number of transplantable donor livers, several centres are exploring new machine preservation techniques. In this context, hypothermic machine perfusion has been recently introduced into the clinical setting of human liver transplantation, and the effect of endischemic cold liver perfusion on posttransplant complications is currently under investigation in two multicentre, randomized controlled trials...
September 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28921801/complications-symptoms-quality-of-life-and-pregnancy-in-cholestatic-liver-disease
#9
Kais Zakharia, Anilga Tabibian, Keith D Lindor, James H Tabibian
Cholestatic liver diseases (CLDs) encompass a variety of disorders of bile formation and/or flow which generally result in progressive hepatobiliary injury and ultimately end-stage liver disease. Many patients with CLD are diagnosed between the ages of 20-50 years, a particularly productive period of life professionally, biologically, and in other respects; it is not surprising, thus, that CLD is often associated with impaired health-related quality of life (HRQOL) and uncertainty regarding implications for and outcomes of pregnancy...
September 18, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28918963/laparoscopic-subtotal-cholecystectomy-a-surgical-alternative-to-reduce-complications-in-complex-cases
#10
Génesis Jara, José Rosciano, Wuendys Barrios, Liumariel Vegas, Omaira Rodríguez, Renata Sánchez, Alexis Sánchez
INTRODUCTION: Laparoscopic cholecystectomy is a common procedure in general surgery, and in complex cases it is important for the surgeon to know all the alternatives with low associated morbidity. Laparoscopic subtotal cholecystectomy should be considered as an option when a critical view of safety cannot be obtained, because it has a low complication rate and gives the advantages of minimally invasive surgery. METHODS: Retrospective study of laparoscopic subtotal cholecystectomies in an eight years period...
September 14, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28918345/meta-analysis-on-the-impact-of-the-acute-care-surgery-model-of-disease-specific-and-patient-outcomes-in-appendicitis-and-biliary-disease
#11
Patrick B Murphy, Kristin DeGirolamo, Theunis Jean Van Zyl, Laura Allen, Elliott Haut, W Robert Leeper, Ken Leslie, Neil Parry, Morad Hameed, Kelly N Vogt
BACKGROUND: The acute care surgery (ACS) model was developed to acknowledge the complexity of a traditionally fractured emergency general surgery patient population; however there are variations in the design of ACS service models. This meta-analysis analyzes the impact of implementation of different ACS models on the outcomes for appendicitis and biliary disease. STUDY DESIGN: A systematic, English-language search of major databases was conducted. From 1,827 papers, 2 independent reviewers identified 25 studies that reported on outcomes for patients with appendicitis (13) biliary disease (7) or both (5) before and after implementation of an ACS service...
September 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28916962/effects-of-cholecystectomy-on-recurrent-biliary-complications-after-endoscopic-treatment-of-common-bile-duct-stone-a-population-based-cohort-study
#12
Chi-Tung Cheng, Chun-Nan Yeh, Kun-Chun Chiang, Ta-Sen Yeh, Kuan-Fu Chen, Shao-Wei Chen
BACKGROUND: The aim of this study was to evaluate the benefits of cholecystectomy on mitigating recurrent biliary complications following endoscopic treatment of common bile duct stone. METHODS: We used the data from the Taiwan National Health Insurance Research Database to conduct a population-based cohort study. Among 925 patients who received endoscopic treatment for choledocholithiasis at the first admission from 2005 to 2012, 422 received subsequent cholecystectomy and 503 had gallbladder (GB) left in situ...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916322/intraductal-transanastomotic-stenting-in-duct-to-duct-biliary-reconstruction-after-living-donor-liver-transplantation-a-randomized-trial
#13
Ky 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, Sudhindran Surendran
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 complication is a controversial issue. We performed a randomized trial to study the impact of intraductal biliary stents on postoperative biliary complications following LDLT. STUDY DESIGN: Of the 94 LDLT's, that were performed during a period of 16 months, ABO incompatible transplants, left lobe grafts, ≥3 ducts on the graft and those requiring bilio-enteric drainage were excluded...
September 12, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28913712/surgical-site-infection-is-associated-with-tumor-recurrence-in-patients-with-extrahepatic-biliary-malignancies
#14
Stefan Buettner, Cecilia G Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Matthew Weiss, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Bas Groot Koerkamp, Shishir K Maithel, Timothy M Pawlik
BACKGROUND: Surgical site infections (SSI) are one of the most common complications after hepato-pancreato-biliary surgery. Infectious complications may lead to an associated immune-modulatory effect that inhibits the body's response to cancer surveillance. We sought to define the impact of SSI on long-term prognosis of patients undergoing surgical resection of extrahepatic biliary malignancies (EHBM). METHODS: Patients undergoing surgery for EHBM between 2000 and 2014 were identified using a large, multi-center, national cohort dataset...
September 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28913118/the-course-and-outcomes-of-complicated-gallstone-disease-in-pregnancy-experience-of-a-tertiary-center
#15
Mehmet İlhan, Gülşah İlhan, Ali Fuat Kaan Gök, Kayıhan Günay, Cemalettin Ertekin
OBJECTIVE: To evaluate the course and outcomes of pregnant patients with complicated gallstone disease and to reveal the experience of a tertiary center. MATERIALS AND METHODS: The records of 92.567 patients were evaluated using searches for diagnoses with the terms of pregnant, pregnancy, gallstone, cholecystitis, cholangitis, choledocholithiasis, pancreatitis, and endoscopic retrograde cholangiopancreatography in pregnancy in the hospital database. Patients' age, week of gestation, parity, body mass index, definitive diagnosis, attack episodes, treatment modalities, and obstetric and neonatal complications were evaluated...
December 2016: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28912914/intraductal-ultrasonography-as-a-local-assessment-before-magnetic-compression-anastomosis-for-obstructed-choledochojejunostomy
#16
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/28912821/thyrotoxicosis-and-choledocholithiasis-masquerading-as-thyroid-storm
#17
Christian L Horn, Patricia A Short
A 26-year-old female, thirteen months postpartum, presented to the emergency department for four weeks of epigastric abdominal pain, pruritus, new onset jaundice, and 11.3 kgs (25 lbs) unintentional weight loss. On examination, she was afebrile, tachycardic, alert, and oriented and had jaundice with scleral icterus. Labs were significant for undetectable TSH, FT4 that was too high to measure, and elevated total bilirubin, direct bilirubin, alkaline phosphatase, and transaminases. Abdominal ultrasound revealed cholelithiasis without biliary ductal dilation...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28906410/augmented-reality-navigation-in-open-surgery-for-hilar-cholangiocarcinoma-resection-with-hemihepatectomy-using-video-based-in-situ-three-dimensional-anatomical-modeling-a-case-report
#18
Rui Tang, Longfei Ma, Canhong Xiang, Xuedong Wang, Ang Li, Hongen Liao, Jiahong Dong
RATIONALE: Patients who undergo hilar cholangiocarcinoma (HCAC) resection with concomitant hepatectomy have a high risk of postoperative morbidity and mortality due to surgical trauma to the hepatic and biliary vasculature. PATIENT CONCERNS: A 58-year-old Chinese man with yellowing skin and sclera, abdominal distension, pruritus, and anorexia for approximately 3 weeks. DIAGNOSES: Magnetic resonance cholangiopancreatography and enhanced computed tomography (CT) scanning revealed a mass over the biliary tree at the porta hepatis, which diagnosed to be s a hilar cholangiocarcinoma...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906357/ercp-related-complication-is-not-the-only-cause-of-gi-bleeding-in-post-liver-transplantation-patients-a-case-report
#19
Zhen Ding, Xue-Lian Tang, Rong Lin, Chaoqun Han, Jun Liu
RATIONALE: Endoscopic retrograde cholangiopancreatography (ERCP) is the treatment of choice for biliary complications in liver transplantation (LT) recipients as it is both diagnostic and therapeutic. The specific risks following ERCP among LT recipients have not been well studied. PATIENT CONCERNS: A 56-year-old man with a history of orthotopic LT underwent endoscopic retrograde cholangiopancreatography (ERCP) as a treatment of biliary strictures, whereby a plastic stent was implanted...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905807/buttressing-hepaticojejunostomy-apos-s-with-hepatic-round-ligament-flap-may-be-beneficial
#20
Jayant Kumar Banerjee, Ramanathan Saranga Bharathi, Pankaj Purushotam Rao
BACKGROUND: Bile leaks and anastomotic strictures are important complications of hepaticojejunostomy (HJ). Evidence suggests that the use of hepatic round ligament (HRL) to buttress HJ may be beneficial. This study evaluates the feasibility of this approach. METHODS: HJs performed over 2 years (Jun 2014- May 2016), with HRL reinforcement, were analyzed. Operative outcomes measured included technical difficulty, blood loss, time necessary for flap harvest, and reinforcement of HJ...
August 31, 2017: Polski Przeglad Chirurgiczny
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