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Biliary surgery

Eva Roos, Lowiek M Hubers, Robert J S Coelen, Marieke E Doorenspleet, Niek de Vries, Joanne Verheij, Ulrich Beuers, Thomas M van Gulik
BACKGROUND: Distinguishing perihilar cholangiocarcinoma (PHC) from benign forms of sclerosing cholangitis affecting the hilar bile ducts is challenging, since histological confirmation of PHC is difficult to obtain and accurate non-invasive diagnostic tests are not available. IgG4-associated cholangitis (IAC), an imitator of PHC, may present with clinical and radiographical signs of PHC. IAC can be accurately diagnosed with a novel qPCR test. The aim of this study was to investigate the incidence and long-term activity of IAC in patients resected for PHC in a single tertiary center over a period of 30 years...
March 16, 2018: American Journal of Gastroenterology
Ryota Matsuki, Masanori Sugiyama, Shinya Yoshiike, Junji Shibahara, Masaharu Kogure, Masaaki Yokoyama, Yutaka Suzuki, Nobutsugu Abe, Tadahiko Masaki, Toshiyuki Mori
A 72-year-old woman with advanced ascending colon cancer and an intraductal papillary mucinous neoplasm (IPMN) of the pancreatic head was treated by right hemicolectomy (RHC) and pylorus-preserving pancreaticoduodenectomy (PpPD). Adjuvant chemotherapy was not administered. Multimodal examinations at 5 months after surgery detected a solitary metastatic liver tumor derived from cancer of the ascending colon. Liver resection proceeded at 7 months after the first surgery. A pathological study of a surgical specimen of the liver identified a necrotic nodule that did not contain viable tumor cells...
March 15, 2018: Clinical Journal of Gastroenterology
N Pinsker, M Papoulas, M Sodergren, P Harrison, N Heaton, K Menon
Introduction A bronchobiliary fistula (BBF) following liver directed therapy (resection/ablation) is a rare complication in which an abnormal communication between the biliary tract and bronchial tree is formed. This case report describes the successful management of a persistent BBF following multiple liver wedge resections and microwave ablation in a patient with a metastatic neuroendocrine tumour of the terminal ileum. Case history A 69-year-old man presented with unexplained weight loss and was subsequently diagnosed with a neuroendocrine tumour of the terminal ileum and liver metastasis...
March 15, 2018: Annals of the Royal College of Surgeons of England
Adrián Róbert Gál, Károly Kalmár-Nagy, András Fincsur, Örs Péter Horváth, András Vereczkei
The authors present a case of a 67-year-old male patient, who previously had been diagnosed with a malignant liver tumor localized in segment II. He underwent bisegmentectomy (II and III) and partial IV segmentectomy. After the primary surgery jaundice developed, the level of bilirubin increased and after several imaging modalities reoperation was indicated. During the surgery a rare bile duct anatomy variant was found. The right hepatic duct joined the left duct in the parenchyma of the left lobe, and was ligated at the resection...
March 2018: Magyar Sebészet
Ashwin Rammohan, Sripriya Srinivas, Yahya Al Azri, Mettu Srinivas Reddy, Mohamed Rela
Roux-en-Y (RY) hepaticojejunostomy (HJ) is a critical component of complex hepatobiliary operations, and it is the treatment of choice for post-cholecystectomy biliary strictures (PCBS). Complications related to the Roux limb, particularly those leading to cholangitis, can severely compromise outcomes. We present a case of a 54-year-old lady who had previously undergone two HJ procedures for recurrent PCBS. The same Roux limb had been used in each of the operations. Short Roux/Roux reflux syndrome led to recurrent cholangitis in this patient, as proven by the reflux of oral contrast into the biliary tree on imaging...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Ashish Singh, Abhimanyu Kapoor, Rajneesh Kumar Singh, Anand Prakash, Anu Behari, Ashok Kumar, Vinay Kumar Kapoor, Rajan Saxena
Backgrounds/Aims: A residual gallbladder (RGB) following a partial/subtotal cholecystectomy may cause symptoms that require its removal. We present our large study regarding the problem of a RGB over a 15 year period. Methods: This study involved a retrospective analysis of patients managed for symptomatic RGB from January 2000 to December 2015. Results: A RGB was observed in 93 patients, who had a median age of 45 (25-70) years, and were comprised of 69 (74...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
M Garrido, C Escobar, C Zamora, C Rejas, J Varas, C Córdova, C Papuzinski, M Párraga, S San Martín, S Montedonico
Purpose: Biliary atresia precedes liver cirrhosis and liver transplantation. Amniotic membrane (AM) promotes tissue regeneration, inhibits fibrosis, and reduces inflammation. Here, we test amniotic membrane potential as a therapeutic tool against cholestatic liver fibrosis. Methods: Three groups of rats were used: sham surgery (SS), bile duct ligature (BDL), and bile duct ligature plus human amniotic membrane (BDL + AM). After surgery, animals were sacrificed at different weeks...
2018: Stem Cells International
Andrew A Gumbs, Despoina Daskalaki, Luca Milone
Although minimally invasive pancreatectomy has been performed increasingly for pancreatic malignancies, many authors feel that a history of pancreatitis is a contraindication to either laparoscopic or robotic-assisted pancreatectomy. Shown here is a video (Supplemental Digital Content 1, of a laparoscopic total pancreatectomy with splenectomy for chronic pancreatitis. This patient was denied auto-islet cell transplantation because of insurance restraints. In total, 4 laparoscopic total pancreatectomies have been attempted and completed...
March 8, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Bibigul Ilyassova, Yevgeny Yenin, Bolatbek Baymakhanov, Maksat Doskhanov
OBJECTIVES: At the National Scientific Center of Surgery named A. Syzganova, more than 100 liver transplants have been conducted from 2012 to November 2017. Survival and quality of life of patients in the posttransplant period largely depend on the compliance of patients, monitoring of complications, cause of liver disease, the severity of the condition of patients in the pretransplant period, and the technical features of the operation. The aims of the study were to analyze the results of liver biopsy in patients after liver transplant and to evaluate the value of morphologic studies of the liver for the diagnosis of complications in the posttransplant period...
March 2018: Experimental and Clinical Transplantation
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
Amy Tyberg, Isaac Raijman, Ali Siddiqui, Urban Arnelo, Douglas G Adler, Ming-Ming Xu, Najib Nassani, Divyesh V Sejpal, Prashant Kedia, Yun Nah Lee, Frank G Gress, Sammy Ho, Monica Gaidhane, Michel Kahaleh
INTRODUCTION: In patients with pancreaticobiliary lesions anticipating surgical resection, digital pancreaticocholangioscopy can be used to identify the extent of disease. This presurgical"mapping" could change the surgical plan and optimize patient care. MATERIALS AND METHODS: Patients with pancreaticobiliary lesions anticipating surgery who underwent endoscopic retrograde cholangiopancreatography with digital pancreaticocholangioscopy from 9 international centers were included...
March 6, 2018: Journal of Clinical Gastroenterology
Morten Rune Blichfeldt-Eckhardt
The thesis comprises an overview and four papers, all published or submitted for publication in international peer-reviewed scientific journals.
Chronic pain after surgery is a common and debilitating complication after many types of surgery. The cause and pathology behind is still mainly uncovered, though several risk factors have been proposed. One of the strongest risk factors for persistent postsurgical pain is the intensity of the acute pain response though the mechanisms involved remain unsettled...
March 2018: Danish Medical Journal
Jim C H Wilde, Ana M Calinescu, Barbara E Wildhaber
Biliary atresia (BA) and congenital choledochal malformations (CCM) are rare. Both pathologies must (BA) or may (CCM) be operated during the neonatal period or early infancy. We briefly describe the classical operative techniques for both pathologies, followed by the most common and severe perioperative complications encountered during and up to 30 days after surgery in children operated for BA and CCM early in life. For patients with BA, intestinal complications represent the most common and hazardous perioperative surgical complications...
March 6, 2018: European Journal of Pediatric Surgery
Yong Zhou, Wen-Zhang Zha, Xu-Dong Wu, Ren-Gen Fan, Biao Zhang, Yong-Hua Xu, Cheng-Lin Qin, Jing Jia
BACKGROUND: Hepatectomy and additional common bile duct exploration are required for the treatment of left-sided hepatolithiasis (LSH). METHODS: Eligible LSH patients (n = 62) scheduled for open left lateral segmentectomy or left hemihepatectomy with intraoperative biliary exploration via the left hepatic duct orifice (LHD group, n = 35) or the common bile duct (CBD group, n = 27) were retrospectively studied. T-tube insertion was performed on selected patients...
January 2018: Medicine (Baltimore)
Syed Fahd Shah, Sania Hameed, Jehanzeb Khan Aurakzai, Ali Raza, Muhammad Amjad Chaudhry, Syed Hussain Shah, Syed Zubair Shah
BACKGROUND: Some 20-40% of the periampullary carcinoma is irresectable at the time of diagnosis. Biliary stenting and surgical bypass are commonly used palliative procedure. There is no consensus favouring one procedure over the other. This study compares the both procedures. METHODS: This Randomized Controlled Trial included 47 patients who presented with diagnosis of obstructive jaundice due to periampullary carcinoma to the Department of Surgery, Federal General Hospital, Islamabad from July 2012 to December 2014...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Imen Samaali, Ibtissem Bouasker, Héla Khézami, Akram Sbai, Mohamed Wejih Dougaz, Hichem Jarraya, Ramzi Nouira, Chadli Dziri
BACKGROUND: Patients with malignant obstructive jaundice should undergo surgery on the basis of results of preoperative imaging. However, about half of patients are found to be unsuitable forresection during surgical exploration. Our study aimed to determine the clinicobiologicalcharacteristics that predict the resecability of ampullary and periampullary tumors. METHODS: We retrospectively reviewed the medical records of 49 patients (45% men and 55% women) who had malignant obstructive jaundice collected in the Department B of generalsurgery, Charles Nicolle hospital between July 1, 2008 and December 31, 2013...
April 2017: La Tunisie Médicale
Paola Di Carlo, Nicola Serra, Gaspare Gulotta, Anna Giammanco, Claudia Colomba, Giuseppina Melfa, Teresa Fasciana, Consolato Sergi
Bile is a lipid-rich sterile solution produced in the liver that can be infected resulting in bactibilia. A higher incidence of postoperative infectious complications has been seen in patients with bactibilia. Recently, gram-negative bacteria have been linked to a tumor-associated inflammatory status. This study is a retrospective cohort study of 39 patients, who are over 80 years of age only (53.85% males and 46.15% females), hospitalized with diseases of the biliopancreatic system in one teaching hospital in Italy from January 2011 to December 2012 with a follow-up of 5 years...
February 27, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Edward Yi-Yung Yu, Fei-Shih Yang, Yu-Jen Chiu, Fuu-Jen Tsai, Chi-Cheng Lu, Jai-Sing Yang
Biliopleural fistula (BF) and formation of biliopleural effusion is a rare complication following percutaneous transhepatic biliary drainage (PTBD). It occurs when the pleura is traversed by the catheter before entering the bile duct. Biliopleural fistula should be suspected when right side pleural effusion develops following the PTBD procedure. The diagnosis of biliopleural fistula is made when greenish pleural fluid with high concentration of bilirubin is aspirated. Here we present a case where a patient develops a biliopleural fistula following PTBD due to obstructive jaundice caused by neuroendocrine tumor of pancreas...
March 2018: BioMedicine
A Ten Hove, V E de Meijer, J B F Hulscher, R H J de Kleine
BACKGROUND: Choledochal malformations comprise various congenital cystic dilatations of the extrahepatic and/or intrahepatic biliary tree. Choledochal malformation is generally considered a premalignant condition, but reliable data on the risk of malignancy and optimal surgical treatment are lacking. The objective of this systematic review was to assess the prevalence of malignancy in patients with choledochal malformation and to differentiate between subtypes. In addition, the risk of malignancy following cystic drainage versus complete cyst excision was assessed...
February 26, 2018: British Journal of Surgery
Marco Vito Marino, Anastasiia Glagolieva, Domenico Guarrasi
INTRODUCTION: Firstly described in 2002, the robotic liver surgery has not spread widely due to its high cost and the lack of a standardized training program. Still being considered as a 'development in progress' technique, it has however a potential to overcome the traditional limitations of the laparoscopic approach in liver interventions. METHODS: We analyzed the postoperative outcomes of 10 patients who had undergone robotic partial resection of the caudate lobe (Spiegel lobe) from March 2014 to May 2016 in order to evaluate the advantages of robotic technique in hands of a young surgeon...
February 21, 2018: Cirugía Española
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