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Surgical jaundice

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https://www.readbyqxmd.com/read/28090475/use-of-omega-3-polyunsaturated-fatty-acids-to-treat-inspissated-bile-syndrome-a-case-report
#1
Woo Young Jun, Min Jeng Cho, Hye Seung Han, Sun Hwan Bae
Inspissated bile syndrome (IBS) is a rare condition in which thick intraluminal bile, including bile plugs, sludge, or stones, blocks the extrahepatic bile ducts in an infant. A 5-week-old female infant was admitted for evaluation of jaundice and acholic stool. Diagnostic tests, including ultrasound sonography, magnetic resonance cholangiopancreatography, and a hepatobiliary scan, were not conclusive. Although the diagnosis was unclear, the clinical and laboratory findings improved gradually on administration of urodeoxycholic acid and lipid emulsion containing omega-3 polyunsaturated fatty acids (PUFAs) for 3 weeks...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28088598/are-the-current-guidelines-for-the-surgical-management-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-adequate-a-multi-institutional-study
#2
Gregory C Wilson, Shishir K Maithel, David Bentrem, Daniel E Abbott, Sharon Weber, Clifford Cho, Robert Cg Martin, Charles R Scoggins, Hong Jin Kim, Nipun B Merchant, David A Kooby, Michael J Edwards, Syed A Ahmad
BACKGROUND: Controversy persists regarding the management of patients with IPMN. International consensus guidelines stratify patients into high risk, worrisome, and low risk categories. STUDY DESIGN: The medical records of 7 institutions were reviewed for patients that underwent surgical management of IPMN between 2000-2015. RESULTS: 324 patients were included in the analysis. 60.4% of patients had main-duct / mixed type, and 39.7% had branch-duct IPMN...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28062877/-right-hepatectomy-in-block-with-hiliar-extra-hepatic-bile-duct-for-gallbladder-cancer-clinical-case
#3
Claudio Mengoa Quintanilla, Giovanni De la Cruz Robles, Sergio Puma Condori, Carol Durand Mendoza
Gallbladder cancer is the most common malignancy of the biliary tract. Usually seen in advanced stages. There are still many controversies about the type of curative surgical treatment for each stage of the disease. The only chance of long term survival for patients with advanced tumors is aggressive, large surgeries that implies multiorgan resection.We report the case of a patient with gallbladder cancer with jaundice at diagnosis, who underwent extended hepatectomy (segment IV B, segment I and extra hepatic hilar bile duct included)...
October 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28051047/evaluation-of-the-use-of-laparoscopic-guided-cholecystocholangiography-and-liver-biopsy-in-definitive-diagnosis-of-neonatal-cholestatic-jaundice
#4
Khalid Shreef, Abdullah Alhelal
BACKGROUND: Once it is established that a jaundiced infant has direct hyperbilirubinemia, the principal diagnostic concern is to differentiate hepatocellular from obstructive cholestasis. Traditional tests such as ultrasonography, percutaneous liver biopsy and technetium 99 m hepatobiliary iminodiacetic acid (HIDA) scan are often not sufficiently discriminating. Definitive exclusion of biliary atresia (BA) in the infant with cholestatic jaundice usually requires mini-laparotomy and intra-operative cholangiography...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28018098/therapeutic-approaches-for-portal-biliopathy-a-systematic-review
#5
REVIEW
Irene Franceschet, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Marco Senzolo
Portal biliopathy (PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma (PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC (77%-100%), only a part of these (5%-38%) are symptomatic...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28012336/forgotten-cbd-stent-102-months-with-stone-stent-complex-a-case-report
#6
Varsha Barai, Jagadish Hedawoo, Sanjay Changole
INTRODUCTION: Choledocholithiasis is presence of stone in Common bile duct (CBD) which can be treated by endoscopy or surgery [1]. Retained foreign bodies like stents forms a nidus for stone formation resulting in pain, fever, jaundice. CASE PRESENTATION: 60 years female patient admitted in surgery ward with features of cholangitis with computed tomography showing cholangitic abscess with dilated common bile duct and sludge around stent in situ. Stone was found at proximal end of stent during surgery...
December 7, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27977604/the-importance-of-igg4-screening-in-patients-diagnosed-with-primary-sclerosing-cholangitis-in-the-past-a-case-rediagnosed-as-igg4-sc-after-10-years
#7
Yanni Li, Lu Zhou, Xin Zhao, Wenjing Song, Nathasha Karunaratna, Bangmao Wang
RATIONALE: While primary sclerosing cholangitis (PSC) has been recognized for decades, immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) has been correctly diagnosed only in recent years. PSC and IgG4-SC show similar clinical symptoms, serologic markers, and imaging results, but the treatment strategies and prognosis of patients differ. PATIENT CONCERNS: Here, we present the case report of a patient diagnosed with PSC for 10 years and rediagnosed with IgG4-SC recently, to emphasize the importance of screening serum IgG4 levels in patients with previous diagnosis of PSC...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27930504/aberrant-hepatic-arteries-running-through-pancreatic-parenchyma-encountered-during-pancreatoduodenectomy-two-rare-case-reports-and-strategies-for-surgical-treatment
#8
Lei Wang, Jianwei Xu, Dong Sun, Zongli Zhang
BACKGROUND: Aberrant hepatic arteries (HAs) encountered during pancreatoduodenectomy are difficult to manage. MEHTODS: Two cases with rare types of aberrant HA running through the pancreatic parenchyma were reviewed. RESULTS: The first case, a 68-year-old man, was admitted with obstructive jaundice. A tumor of the pancreatic head and aberrant HAs were suspected on computed tomography (CT) scan. At laparotomy, a new variation was identified; namely, 2 aberrant arteries-a right replaced HA and middle HA (RMHA) that both originated from the superior mesenteric artery (SMA) and ran via intrapancreatic paths posterior and anterior to the pancreatic head, respectively...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27914884/clinical-presentation-diagnosis-and-survival-in-cholangiocarcinoma-a-prospective-study
#9
Larisa Vasilieva, Stefanos I Papadhimitriou, Alexandra Alexopoulou, Ioannis Kostopoulos, Konstantinos Papiris, Dimitrios Pavlidis, Dimitrios Xinopoulos, Andreas Romanos, Spyridon P Dourakis
BACKGROUND AND STUDY AIMS: The diagnosis of cholangiocarcinoma (CCA) is difficult. The present study aimed to assess the clinical features, diagnosis, and survival in CCA. PATIENTS AND METHODS: This is a prospective study on 46 patients with CCA who underwent endoscopic retrograde cholangiopancreatography (ERCP) or surgical resection and 20 controls with a clinical and ERCP suspicion for CCA in whom surgical biopsy and/or 4-year follow-up showed a benign biliary stricture...
December 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/27909644/primary-squamous-cell-carcinoma-of-the-pancreas-as-a-cause-of-biliary-obstruction
#10
Kyle Rowe, Jeet Mehta, Fredy Nehme, William Salyers
Primary squamous cell carcinoma of the pancreas (SCCP) is a rare neoplasm, given a lack of naturally occurring squamous cells within the pancreas, accounting for only 0.2% of all pancreatic cancers. The etiology is unknown. Symptomatology is non-specific and similar to other pancreatic neoplasms. No non-invasive testing can adequately rule in SCCP, and workup should proceed similarly to any pancreatic mass. Tissue sampling is required for diagnosis and guidance of further management, most commonly by endoscopic ultrasound with fine needle aspirate...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27905370/-surgical-management-of-chronic-pancreatitis-complicated-by-biliary-and-duodenal-obstruction
#11
G M Barvanyan
AIM: To compare different surgical approaches to chronic pancreatitis complicated by biliary and duodenal obstruction. MATERIAL AND METHODS: In the study (n=42) and control (n=36) groups 18 and 4 resections were performed respectively (p=0.004). Early postoperative complications occurred in 15 cases of the study group and 4 cases of the control group (p=0.024). 7 and 1 re-operations were made in both groups respectively (p=0.99). There was no postoperative mortality in both groups...
2016: Khirurgiia
https://www.readbyqxmd.com/read/27904860/interventional-therapy-for-pancreatic-cancer
#12
REVIEW
Jianwei Zhu, Zhendong Jin
BACKGROUND: Palliative therapy and primarily chemoradiotherapy are the mainstream treatments in patients with locally advanced or metastatic pancreatic cancer (PC). Conventional endoscopy and endoscopic ultrasound (EUS)-guided interventional therapy has emerged as an important procedure for PC management. In this review, the progress in conventional endoscopy and EUS for PC management is discussed. SUMMARY: For local palliative therapy against PC, EUS-guided fine needle injection (FNI) could deliver different kinds of agents, such as radioactive seeds and fiducials...
October 2016: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/27902955/extrahepatic-biliary-obstrution-secondary-to-neuroendocrine-tumor-of-the-common-hepatic-duct
#13
Faraz A Khan, Anastasia Stevens-Chase, Rahman Chaudhry, Asra Hashmi, David Edelman, Donald Weaver
INTRODUCTION: Primary neuroendocrine tumors (NET) of the extrahepatic biliary tree are a rare entity with less than 100 reported cases in the literature. PRESENTATION OF CASE: Here, we report a case of NET of the extrahepatic bile duct in a 64-year-old male patient presenting with painless jaundice, direct hyperbilirubinemia, and mildly elevated transaminases. Diagnostic workup with an ultrasound revealed dilation of the intrahepatic biliary ducts, without cholelithiasis or choledocholithiasis...
November 23, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27883325/solitary-fibrous-tumor-of-the-pancreas-a-case-report-and-review-of-the-literature
#14
Liljana Spasevska, Vesna Janevska, Vlado Janevski, Biljana Noveska, Julija Zhivadinovik
Pancreas is an extremely rare abdominal localization of the solitary fibrous tumor (SFT). It usually grows asymptomatically for a long time before a diagnosis can be made on the basis of symptoms and/or mechanical complications. Due to the rarity and nonspecific clinical presentation, this entity is diagnostically challenging. We present a 47-year-old man with a history of progressive epigastric pain for the last two weeks, and jaundice, who was admitted to hospital for further investigation. Cystadenocarcinoma was suspected based on the radiologic findings, and a pancreatoduodenectomy was performed...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27882019/plasma-bnp-level-combined-with-surgical-apgar-score-to-predict-operative-major-cardiac-adverse-events-in-malignant-obstructive-jaundice-patients
#15
Wei Yu, Changshan Huang, Qian Wang, Erjiang Zhao, Yuechao Ding, Tao Huang, Chao Ma, Bo Meng
OBJECTIVE: To investigate the predictive effect of major adverse cardiac events (MACE) in malignant obstructive jaundice (OJ) patients using plasma brain natriuretic peptide (BNP) level and surgical Apgar scoring (SAS) system. METHODS: Forty one malignant OJ patients undergoing surgical treatments were studied at a single center. Pre-and postoperative plasma BNP level, total bilirubin (TBil) and data of cardiac function (HR, CVP, CI, LVEF%) were detected, the SAS was calculated during the surgery, the relationship of both plasma BNP level and SAS with MACE after surgery was analyzed...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27877011/analysis-of-clinical-characteristics-and-treatment-of-pancreatic-cystic-tumors
#16
Lei You, Jianchun Xiao, Zhe Cao, Wanying Zhang, Quan Liao, Menghua Dai, Taiping Zhang, Yupei Zhao
OBJECTIVE: To summarize experience in the diagnosis and treatment of pancreatic cystic neoplasms. METHODS: This is a retrospective study of 207 patients who were diagnosed with pancreatic cystic tumors at Peking Union Medical College Hospital between Jan 2009 and Mar 2014. Clinical data, such as clinical manifestations, radiological and pathological images and surgical recordings, were collected. RESULTS: Of the 207 included patients, females accounted for 76...
October 2016: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/27865285/palliative-care-for-pancreatic-and-periampullary-cancer
#17
REVIEW
Jennifer A Perone, Taylor S Riall, Kelly Olino
Most patients with pancreatic cancer will present with metastatic or locally advanced disease. Unfortunately, most patients with localized disease will experience recurrence even after multimodality therapy. As such, pancreatic cancer patients arrive at a common endpoint where decisions pertaining to palliative care come to the forefront. This article summarizes surgical, endoscopic, and other palliative techniques for relief of obstructive jaundice, relief of duodenal or gastric outlet obstruction, and relief of pain due to invasion of the celiac plexus...
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27862628/history-physical-exam-laboratory-testing-and-emergency-department-ultrasonography-for-the-diagnosis-of-acute-cholecystitis
#18
Ashika Jain, Ninfa Mehta, Michael Secko, Joshua Schecter, Dimitri Papanagnou, Shreya Pandya, Richard Sinert
BACKGROUND: Acute Cholecystitis (AC) is a common differential for patients presenting to the Emergency Department (ED) with abdominal pain. The diagnostic accuracy of history, physical exam and bedside lab tests for AC have not been quantitatively described. OBJECTIVES: We performed a systematic review to determine the utility of History/Physical exam (H&P), Laboratory studies and Ultrasonography (US) in diagnosing AC in the ED. METHODS: We searched medical literature from January 1965 to March 2016 in PubMed, EMBASE and SCOPUS using a strategy derived from the following formulation of our clinical question: Patients: ED patients suspected of AC...
November 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27852277/right-hepatectomy-for-a-detoured-left-hepatic-artery-in-hilar-cholangiocarcinoma-report-of-a-rare-but-rational-resection
#19
Chun-Yi Tsai, Nobuyuki Watanabe, Tomoki Ebata, Takashi Mizuno, Yuzuru Kamei, Masato Nagino
BACKGROUND: Curative hepatectomy with bile duct resection is the treatment for perihilar cholangiocarcinoma. A locally advanced tumor necessitates hepatectomy with simultaneous vascular resection, and reconstruction remains an obstacle for surgeons. Studies have focused on the variations of hepatic arteries. Nevertheless, the anatomical alignment of the portal veins, bile ducts, and hepatic arteries are equally critical in surgical planning of curative resection for advanced tumors. We have reported promising outcomes of hepatectomy with simultaneous resection and reconstruction of the hepatic artery...
November 16, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27813710/usefulness-of-three-dimensional-modeling-in-surgical-planning-resident-training-and-patient-education
#20
Ciro Andolfi, Alejandro Plana, Patrick Kania, P Pat Banerjee, Stephen Small
BACKGROUND: Imaging has a critical impact on surgical decision making and three-dimensional (3D) digital models of patient pathology can now be made commercially. We developed a 3D digital model of a cancer of the head of the pancreas by integrating actual CT data with 3D modeling process. After this process, the virtual pancreatic model was also produced using a high-quality 3D printer. PATIENTS AND METHODS: A 56-year-old female with pancreatic head adenocarcinoma presented with biliary obstruction and jaundice...
November 4, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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