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https://www.readbyqxmd.com/read/28647717/a-large-choledochocystolithiasis-mimicking-mirizzi-syndrome
#1
Mustafa Belal Hafeez Chaudhry, Muhammad Azeemuddin, Muhammad Rizwan Khan, Om Parkash
An 18-year-old man presented with spontaneous severe epigastric pain, progressing and radiating to back since 3 days. It was associated with epigastric tenderness, bilious vomiting and jaundice. He had been intermittently experiencing these symptoms for the last 1 year. No known comorbid. Ultrasound showed a poorly visualised heterogeneous focus at porta hepatis; considering poor visualisation, this might represent an enlarged calcified lymph node or cystic duct calculus causing extrinsic compression or a large sludge ball within the common bile duct (CBD), leading to dilatation of common hepatic duct and intrahepatic biliary system...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28646282/surgery-for-pancreatic-ductal-adenocarcinoma
#2
REVIEW
R Vera, L Díez, E Martín Pérez, J C Plaza, A Sanjuanbenito, A Carrato
Surgical resection is the only potentially curative option in the treatment of pancreatic ductal adenocarcinoma. Preoperative radiological imaging allows to rule out the presence of metastases. Three resectability categories are established based on the radiological findings depending on the degree of contact between the tumor and the blood vessels. Histological confirmation of malignancy is only required in cases of borderline or non-resectable tumors, prior to neoadjuvant treatment initiation. Diagnostic laparoscopy is recommended in the presence of large tumors of the body or tail and in borderline tumors to explore the possibility of resection and to apply treatment with curative intent, as well as in those cases with high level of biomarkers to rule out peritoneal involvement...
June 23, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28644311/hemobilia-an-uncommon-but-notable-cause-of-upper-gastrointestinal-bleeding
#3
Scott Cathcart, John W Birk, Michael Tadros, Micheal Schuster
GOAL AND BACKGROUND: A literature review to improve practitioners' knowledge and performance concerning the epidemiology, diagnosis, and management of hemobilia. STUDY: A search of Pubmed, Google Scholar, and Medline was conducted using the keyword hemobilia and relevant articles were reviewed and analyzed. The findings pertaining to hemobilia etiology, investigation, and management techniques were considered and organized by clinicians practiced in hemobilia. RESULTS: The majority of current hemobilia cases have an iatrogenic cause from either bile duct or liver manipulation...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28643979/-acute-pancreatitis-new-aspects-for-the-management
#4
Olivier Windisch, Toni Raffoul, Catrina Hansen, Jean-Louis Frossard, Philippe Morel, Léo Bühler
Acute pancreatitis is a frequent disease, with a simple course in 80 % of the cases but a high morbidity and mortality in its severe form. Biliary origin and alcohol represent 80 % of the etiologies. Except endoscopic removal of gallstone for biliary origin, treatment remains symptomatic and focuses on fluid resuscitation, effective antalgia and adapted management of nutrition. This article focuses on the novelties introduced by the revision of the Classification of Atlanta in 2012 and details current guidelines for the management of the disease...
June 14, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28643856/coding-in-surgery-impact-of-a-specialized-coding-proforma-in-hepato-pancreato-biliary-surgery
#5
Jennifer Murphy, Charlotte May, Sara Di Carlo, Ian Beckingham, Iain C Cameron, Dhanny Gomez
BACKGROUND: Coding inaccuracies in surgery misrepresent the productivity of hospitals and outcome data of surgeons. The aim of this study was to audit the extent of coding inaccuracies in hepato-pancreato-biliary (HPB) surgery and assess the financial impact of introducing a coding proforma. METHODS: Coding of patients who underwent elective HPB surgery over a 3-month period was audited. Codes were based on International Classification of Diseases 10 and Office of Population and Census Surveys-4 codes...
June 23, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28643070/laparoscopic-revision-of-billroth-ii-with-braun-anastomosis-into-roux-en-y-anatomy-in-a-patient-with-intestinal-malrotation
#6
Fabio Garofalo, Omar Abouzahr, Henri Atlas, Ronald Denis, Pierre Garneau, Hai Huynh, Radu Pescarus
INTRODUCTION: Various reconstructions of the gastro-intestinal tract have been described in the past after distal gastrectomy. Among these, a Billroth II (BII) anastomosis can be performed with the addition of the Omega entero-enterostomy that may theoretically reduce the alkaline reflux. Given the significant complications associated with this procedure such as biliary reflux, marginal ulceration, and afferent loop syndrome, a revision into a Roux-en-Y anatomy is generally recommended...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28639336/classification-of-pancreaticobiliary-maljunction-and-clinical-features-in-children
#7
Naoto Urushihara, Yoshinori Hamada, Terumi Kamisawa, Hideki Fujii, Tsugumichi Koshinaga, Yoshiki Morotomi, Takeshi Saito, Takao Itoi, Kenitiro Kaneko, Hiroaki Fukuzawa, Hisami Ando
PURPOSE: In 2015, the Committee on Diagnostic Criteria of the Japanese Study Group on Pancreaticobiliary Maljunction (PBM) proposed a classification of PBM into four types: (A) stenotic type, (B) non-stenotic type, (C) dilated channel type, and (D) complex type. To validate this classification and clarify the clinical features of the four types of PBM, a retrospective multicenter study was conducted. METHODS: We divided the study group of 317 children with PBM into the four types of PBM...
June 21, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28638176/gallbladder-carcinoma-in-the-united-states-a-population-based-clinical-outcomes-study-involving-22-343-patients-from-the-surveillance-epidemiology-and-end-result-database-1973-2013
#8
Christine S M Lau, Aleksander Zywot, Krishnaraj Mahendraraj, Ronald S Chamberlain
INTRODUCTION: Gallbladder carcinoma (GBC) is the most common malignancy of the biliary tract and the third most common gastrointestinal tract malignancy. This study examines a large cohort of GBC patients in the United States in an effort to define demographics, clinical, and pathologic features impacting clinical outcomes. METHODS: Demographic and clinical data on 22,343 GBC patients was abstracted from the SEER database (1973-2013). RESULTS: GBC was presented most often among Caucasian (63...
2017: HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery
https://www.readbyqxmd.com/read/28637565/is-percutaneous-cholecystostomy-a-good-alternative-treatment-for-acute-cholecystitis-in-high-risk-patients
#9
Davide Papis, Eiman Khalifa, Ricky Bhogal, Amit Nair, Saboor Khan, Zaed Hamady, Jawad Ahmed, Gabriele Marangoni
Cholecystectomy is the treatment of choice for acute cholecystitis but the management of high-risk surgical patients is a difficult dilemma. Percutaneous cholecystostomy (PC) could represent a safer and less invasive option. The aim of the study was to assess the outcomes of PC in high-risk patients. This is a retrospective single-center study; data were collected from our hospital electronic record system. From February 2009 to March 2014, there were 753 patients admitted with acute cholecystitis. Of these 39 were considered high risk for surgery and underwent PC during their hospital stay...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28633652/spontaneous-rupture-of-the-common-hepatic-duct-associated-with-acute-pancreatitis-a-case-report
#10
Makram Moussa, Wissem Triki, Omar Karray, Ines Marzouk, Bouchoucha Sami
BACKGROUND: Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity. CASE PRESENTATION: We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed...
June 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28632515/p4-stump-approach-for-intraoperative-portal-vein-stenting-in-pediatric-living-donor-liver-transplantation-an-innovative-technique-for-a-challenging-problem
#11
Chao-Long Chen, Yu-Fan Cheng, Viola Huang, Ting-Lung Lin, Yi-Chia Chan, Hsin-You Ou, Chee-Chien Yong, Shih-Ho Wang, Chih-Che Lin
OBJECTIVE: The aim of this study was to evaluate the utility of the P4 stump stenting approach for treating portal vein (PV) complications in pediatric living donor liver transplantation (LDLT). BACKGROUND: PV complications cause significant morbidity and mortality in pediatric LDLT. Biliary atresia in the backdrop of pathological PV hypoplasia and sclerosis heightens the complexity of PV reconstruction. The authors developed a novel approach for intraoperative PV stenting via the graft segment 4 PV stump (P4 stump) to address this challenge...
June 19, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28626977/magnetic-compression-anastomosis-for-postoperative-biliary-atresia
#12
Rei Matsuura, Takehisa Ueno, Yuko Tazuke, Natsumi Tanaka, Hiroaki Yamanaka, Yuichi Takama, Kengo Nakahata, Taku Yamamichi, Noboru Maeda, Keigo Osuga, Eigoro Yamanouchi, Hiroomi Okuyama
We report a case of successful magnetic compression anastomosis (MCA) for obstructed cyst-jejunostomy in a young woman who had undergone surgery for type 1 biliary atresia (BA) on day 78 of life. A 16-year-old girl was admitted with obstructive jaundice. Jaundice resolved with percutaneous trans-hepatic cholangiodrainage (PTCD) but contrast medium injected from the PTCD tube did not flow through the anastomosis. Magnets were placed on each side of the anastomosis, in the cyst and the jejunum, to compress the partition...
June 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28624053/radiologic-evaluation-of-vasculobiliary-anatomy-in-the-umbilical-fissure
#13
Gu-Wei Ji, Fei-Peng Zhu, Ke Wang, Yong-Xiang Xia, Chen-Yu Jiao, Zi-Cheng Shao, Xiang-Cheng Li
BACKGROUND: Preoperative evaluation of vasculobiliary anatomy in the umbilical fissure (U-point) is pivotal for perihilar cholangiocarcinoma (PCCA) applied to right-sided hepatectomy. The purpose of our study was to review the vasculobiliary anatomy in the U-point using three-dimensional (3D) reconstruction technique, to investigate the diagnostic ability of 2D scans to evaluate anatomic variations, and to discuss its surgical implications. METHODS: A retrospective study of 159 patients with Bismuth type I, II, and IIIa PCCA, who received surgery at our institution from November 2012 to September 2016, was conducted...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28622426/experimental-study-on-the-friction-effect-of-plastic-stent-for-biliary-stone-fragmentation-with-video
#14
Chang-Il Kwon, Gwangil Kim, Seok Jeong, Sung Hoon Choi, Kwang Hyun Ko, Don Haeng Lee, Joo Young Cho, Sung Pyo Hong
OBJECTIVES: In patients with irretrievable or intractable bile duct stone, temporary insertion of plastic stent (PS) followed by further ERCP or surgery has been recommended as a "bridge" therapy. However, the exact mechanism of stone fragmentation has not been discovered. The aim of this study was to evaluate whether PS shape can facilitate stone fragmentation. METHODS: Using a new in vitro bile flow phantom model, we compared the friction effect among the three different PS groups (straight PS group; double pigtail-shaped PS group, and screw-shaped PS group) and the control group...
June 16, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28621295/efficacy-and-safety-in-case-of-technical-success-of-endoscopic-ultrasound-guided-transhepatic-antegrade-biliary-drainage-a-report-of-a-monocentric-study
#15
Sébastien Godat, Erwan Bories, Fabrice Caillol, Christian Pesenti, Jean Philippe Ratone, Chiara de Cassan, Marc Giovannini
BACKGROUND AND OBJECTIVES: Endoscopic ultrasound (EUS)-guided biliary drainage techniques are alternative procedures in cases of obstructive jaundice with altered anatomy or failed ERCP. Complications related to EUS-guided antegrade drainage (EUS-AD) are still present in up to 10% of cases, and combination of procedures is sometimes suggested to avoid adverse events. The purpose of our study is to evaluate the efficacy and safety of EUS-AD with transhepatic access in case of technical success...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28614364/serum-levels-of-bupivacaine-after-pre-peritoneal-bolus-vs-epidural-bolus-injection-for-analgesia-in-abdominal-surgery-a-safety-study-within-a-randomized-controlled-trial
#16
Timothy H Mungroop, Ganapathy van Samkar, Bart F Geerts, Susan van Dieren, Marc G Besselink, Denise P Veelo, Philipp Lirk
BACKGROUND: Continuous wound infiltration (CWI) has become increasingly popular in recent years as an alternative to epidural analgesia. As catheters are not placed until the end of surgery, more intraoperative opioid analgesics might be needed. We, therefore, added a single pre-peritoneal bolus of bupivacaine at the start of laparotomy, similar to the bolus given with epidural analgesia. METHODS: This was a comparative study within a randomized controlled trial (NTR4948)...
2017: PloS One
https://www.readbyqxmd.com/read/28614198/the-almost-normal-liver-biopsy-presentation-clinical-associations-and-outcome
#17
Thomas W Czeczok, John S Van Arnam, Laura D Wood, Michael S Torbenson, Taofic Mounajjed
Liver biopsies obtained for abnormal liver enzymes or unexplained ascites occasionally appear histologically almost normal. The differential diagnosis for these cases is challenging because literature addressing this topic is lacking. We aimed to establish a differential diagnosis and determine clinical associations and outcomes for almost-normal liver biopsies. Ninety-seven histologically almost-normal liver biopsies were collected from 2 institutions. All cases lacked significant inflammation, fatty change, biliary tract disease, vascular disease, nodular regenerative hyperplasia, iron overload, inherited metabolic or storage disorder, viral hepatitis, or fibrosis...
June 13, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28607283/natural-orifice-transluminal-endoscopic-surgery-hybrid-cholecystectomy-the-dhillon-technique
#18
Kanwarjit Singh Dhillon, Divya Awasthi, Arshbir Singh Dhillon
INTRODUCTION: This study presents a novel technique to perform cholecystectomy and assess its outcome and feasibility. PATIENTS AND METHODS: This study presents the novel Dhillon technique and experience of hybrid natural orifice transluminal endoscopic surgery (NOTES) technique, that is, laparoscopic-assisted transvaginal cholecystectomy. We have evaluated the outcomes in terms of cosmesis, post-operative recovery and analgesic requirement. The study included 257 patients who underwent hybrid NOTES cholecystectomy at single tertiary hospital...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28606484/short-and-long-term-outcomes-after-a-reconstituting-and-fenestrating-subtotal-cholecystectomy
#19
Aafke H van Dijk, Sandra C Donkervoort, Wytze Lameris, Eefje de Vries, Quirijn Aj Eijsbouts, Bart C Vrouenraets, Olivier R Busch, Marja A Boermeester, Philip R de Reuver
BACKGROUND: Multiple surgical techniques are advised to safely perform cholecystectomy in difficult cases, such as conversion to open surgery or subtotal cholecystectomy (STC). A reconstituting and a fenestrating STC are techniques for STC. The aim of this study was to investigate short and long-term morbidity and quality of life associated with STC and to compare the outcomes after fenestrating and reconstituting STC. STUDY DESIGN: Patients who underwent STC were identified...
June 9, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28603823/early-versus-delayed-laparoscopic-cholecystectomy-for-lithiasic-acute-cholecystitis-during-emergency-admissions-results-of-a-monocentric-experience-and-review-of-the-literature
#20
Mohamed Salah Jarrar, Ibrahim Chouchène, Houssem Fadhl, Rafik Ghrissi, Amine Elghali, Fehmi Ferhi, Hedi Mraidha, Fehmi Hamila, Rached Letaief
BACKGROUND: It is established that the standard treatment for lithiasic acute cholecystitis is the laparoscopic cholecystectomie. However, the question of the timing of cholecystectomy remains controversial. AIM: To compare early laparoscopic cholecystectomies (within 72 hours of symptom onset) and delayed laparoscopic cholecystectomies (beyond 72 hours) for lithiasic acute cholecystitis in terms of intra-operative difficulties and post-operative complications. METHODS: The patients operated on for acute cholecystitis, between January 2007 and December 2012, were included in a retrospective study...
August 2016: La Tunisie Médicale
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