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Amanda Pereira Lima, Felipe José Vieira, Gabriela Procópio DE Moraes Oliveira, Plínio Dos Santos Ramos, Marielle Elisa Avelino, Felipe Garcia Prado, Gilson Salomão, Francisco Campos Silva, João Vicente Linhares Rodrigues
OBJECTIVE: to describe the clinical and epidemiological profile of acute appendicitis (AA) of the patients treated at a referral center in the Juiz de Fora macro-region, Minas Gerais State, Brazil. METHODS: we conducted a retrospective, observational study in the Dr. Mozart Geraldo TeixeiraEmergency Hospital. We selected 638 patients diagnosed with AA, and analyzed the variables gender, age, evolutionary phase, length of hospital stay, pathological diagnosis, use of antibiotics, use of drains, complications and mortality...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
Ronald Reverdito, André DE Moricz, Tércio DE Campos, Adhemar Monteiro Pacheco, Rodrigo Altenfelder Silva
OBJECTIVE: : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. METHODS: : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. RESULTS: : the incidence of MS was 0...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
Mario Testini, Lucia Ilaria Sgaramella, Giuseppe Massimiliano De Luca, Alessandro Pasculli, Angela Gurrado, Antonio Biondi, Giuseppe Piccinni
INTRODUCTION: Mirizzi syndrome (MS) is a rare complication of cholelithiasis. Despite the success of laparoscopic cholecystectomy as a minimally invasive approach to gallstone disease, MS remains a challenge, also for open and robotic approaches, due to the subverted anatomy of the hepatocystic triangle. Moreover, when emergency surgery is needed, the optimal preoperative diagnostic assessment could not be always achievable. We aim to analyze our experience of MS treated in emergency and to assess the feasibility of a diagnostic and therapeutic decisional algorithm...
September 9, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Sujit S Kulkarni, Mayo Hotta, Linda Sher, Robert R Selby, Dilipkumar Parekh, James Buxbaum, Maria Stapfer
BACKGROUND: Mirizzi syndrome (MS) is characterized by an obstruction of the proximal bile duct due to extrinsic compression by either an impacted stone in the gallbladder neck or local inflammatory changes. Although this is a rare syndrome in developed countries (0.7-1.4 %), preoperative diagnosis and careful surgical management are essential to avoid bilio-vascular injuries and misdiagnosed malignancy. METHODS: The purpose of this study was to review our experience in the diagnosis and management of MS, assess the role of laparoscopy and the risk of concomitant gallbladder carcinoma...
September 1, 2016: Surgical Endoscopy
Meng Wang, Yufei Xing, Quangen Gao, Zhiqiang Lv, Jianmao Yuan
Mirizzi syndrome (MS) is a rare complication of chronic cholelithiasis, which is always caused by a calculus in the cystic duct or neck of the gallbladder, resulting in mechanical compression of common bile duct and the gallbladder. It is clinically characterized by abdominal pain, fever, as well as obstructive jaundice. During cholecystectomy, MS is seen as a dangerous adherent and inflammatory tissue in the area of Calot's triangle. In the general population, aberrant right posterior hepatic duct, one of the causes of bile duct injury during duct surgery, is present in 4...
2016: International Medical Case Reports Journal
A Aimo, C Borrelli, G Vergaro, M F Piepoli, A R De Caterina, G Mirizzi, A Valleggi, V Raglianti, C Passino, M Emdin, A Giannoni
Mitochondria are cellular organelles responsible for energy production, calcium handling, controlled synthesis of reactive oxygen species (ROS), and regulation of apoptosis. All these functions are crucial for cardiac homeostasis, and may be impaired in chronic heart failure (CHF). Therefore, mitochondrial dysfunction might represent a crucial element in the onset and progression of CHF and, as such, a promising therapeutic target. Mitochondrial dysfunction can be ascribed to neuro-humoral activation and cardiac remodeling associated with CHF...
June 30, 2016: Current Pharmaceutical Design
Eleni-Aikaterini Nagorni, Georgios Kouklakis, Alexandra Tsaroucha, Soultana Foutzitzi, Nikos Courcoutsakis, Konstantinos Romanidis, Konstantinos Vafiadis, Michael Pitiakoudis
BACKGROUND: Laparoscopic cholecystectomy is the gold standard treatment of gallbladder disease. Post-cholecystectomy syndrome is a severe postoperative complication which can be caused by multiple mechanisms and can present with multiple disorders. The wide use of laparoscopy induces the need to understand more clearly the presentation and pathophysiology of this syndrome. Post-cholecystectomy Mirizzi syndrome is one form of this syndrome and, according to literature, this is the first report that clearly describes it...
2016: Journal of Medical Case Reports
Nooman Gilani, Muhammad Farooq Hanif, Veronika Karasek
We report the first case of Mirizzi syndrome in a patient who presented with biliary obstruction caused by pure calcium carbonate stones. A 61 years old male with history of portal vein thrombosis presented with rash, nausea and jaundice. An ultrasound of biliary tree showed gallstones with dilatation of hepatic duct and intrahepatic biliary tree. There was suspicion of a stone in proximal CBD. CT scan showed an opaque gallbladder with dense radio-opaque material in its lumen. An ERCP was then performed revealing external common hepatic duct obstruction at the neck of the gallbladder...
June 2016: JPMA. the Journal of the Pakistan Medical Association
Fahri Yetışır, Akgün Ebru Şarer, H Zafer Acar, Yılmaz Polat, Gokhan Osmanoglu, Muhittin Aygar, A Erdinc Ciftciler, Omer Parlak
Mirizzi syndrome (MS) is an impacted stone in the cystic duct or Hartmann's pouch that mechanically obstructs the common bile duct. We would like to report laparoscopic treatment of type III MS. A 75-year-old man was admitted with the complaint of abdominal pain and jaundice. The patient was accepted as MS type III according to radiological imaging and intraoperative view. Laparoscopic subtotal cholecystectomy, extraction of impacted stone by opening anterior surface of dilated cystic duct and choledochus, and repair of this opening by using the remaining part of gallbladder over the T-tube drainage were performed in a patient with type III MS...
2016: Case Reports in Surgery
Hirdaya H Nag, Vageesh Bettageri Gangadhara, Amit Dangi
INTRODUCTION: Laparoscopic management of patients with Mirizzi's syndrome (MS) is not routinely recommended due to the high risk of iatrogenic complications. PATIENTS AND METHODS: Intra-cholecystic (IC) or inside-gall bladder (GB) approach was used for laparoscopic management of 16 patients with MS at a tertiary care referral centre in North India from May 2010 to August 2014; a retrospective analysis of prospectively collected data was performed. RESULTS: Mean age was 40...
October 2016: Journal of Minimal Access Surgery
Mohan Raj Harilingam, Ashish Kiran Shrestha, Sanjoy Basu
AIM: Laparoscopic cholecystectomy (LC) is considered the 'gold standard' intervention for gall bladder (GB) diseases. However, to avoid serious biliovascular injury, conversion is advocated for distorted anatomy at the Calot's triangle. The aim is to find out whether our technique of laparoscopic modified subtotal cholecystectomy (LMSC) is suitable, with an acceptable morbidity and outcome. PATIENTS AND METHODS: A retrospective analysis of prospectively collected data of 993 consecutive patients who underwent cholecystectomy was done at a large District General Hospital (DGH) between August 2007 and January 2015...
October 2016: Journal of Minimal Access Surgery
V F Kulikovsky, A V Soloshenko, A A Karpachev, A L Yarosh, Yu Yu Vlasyuk
AIM: To define the role of endoscopic interventions in diagnosis and treatment of Mirizzi syndrome. MATERIAL AND METHODS: Results of treatment of 41 patients with Mirizzi syndrome are presented. Endoscopic transpapillary interventions including cholangiography, papillosphincterotomy lithoextraction, nazobiliary drainage were used as a first step in all cases. RESULTS AND DISCUSSION: In 4 cases laparoscopic cholecystectomy was performed after biliary tree sanitation...
2016: Khirurgiia
Yi-Chang Chen, Chin-Chen Chang, Kao-Lang Liu
No abstract text is available yet for this article.
May 2016: American Journal of Gastroenterology
Shu-Hung Chuang, Meng-Ching Yeh, Chien-Jen Chang
BACKGROUND: Laparoscopic treatment is a viable option for Mirizzi syndrome (MS) type I, but it is not recommended for MS type II (McSherry classification). We introduce laparoscopic transfistulous bile duct exploration (LTBDE) as a simplified standardized technique for MS type II. METHODS: Eleven consecutive LTBDEs performed by a surgeon for MS type II were analyzed retrospectively, including three successful single-incision LTBDEs (SILTBDEs). Transfistulous stone removal followed by primary closure of gallbladder remnant and partial cholecystectomy was performed...
April 29, 2016: Surgical Endoscopy
Gianluca Mirizzi, Alberto Giannoni, Andrea Ripoli, Giovanni Iudice, Francesca Bramanti, Michele Emdin, Claudio Passino
BACKGROUND: Peripheral and central chemoreflex sensitivity, assessed by the hypoxic or hypercapnic ventilatory response (HVR and HCVR, respectively), is enhanced in heart failure (HF) patients, is involved in the pathophysiology of the disease, and is under investigation as a potential therapeutic target. Chemoreflex sensitivity assessment is however demanding and, therefore, not easily applicable in the clinical setting. We aimed at evaluating whether common clinical variables, broadly obtained by routine clinical and instrumental evaluation, could predict increased HVR and HCVR...
2016: PloS One
Michele Emdin, Gianluca Mirizzi, Luigi E Pastormerlo, Roberta Poletti, Elena Giannelli, Concetta Prontera, Claudio Passino, Giuseppe Vergaro
Several biomarkers have been tested for screening, diagnosis and prognosis purposes, as well as to guide treatment in heart failure, but only the assay of circulating B-type natriuretic peptides has widely recognized applications for clinical decision-making. Natriuretic peptides are sensitive in detecting the clinically overt or subclinical myocardial damage, but their plasma levels are increased following every generic insult to the cardiovascular system. Novel biomarkers are required to identify specific pathways of disease progression, such as diverse neurohormonal axes activation, inflammation and fibrogenesis, and to act as a tool for therapeutic tailoring...
May 2016: Future Cardiology
Haicheng Yuan, Tian Yuan, Xiangyu Sun, Mingwei Zheng
BACKGROUND: Mirizzi syndrome (MS) is a rare complication of the gallstone disease. Despite the fact that successful laparoscopic treatments have been reported for MS type I, open surgery remains the gold standard approach for MS type II because of the technical difficulties involved. OBJECTIVE: The aim of this study is to determine the best technique for patients with MS type II by comparing the duration of surgery, loss of blood, rates of complication, duration of hospitalization, and outcomes of long-term follow-up...
June 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Arpit Amin, Yuriy Zhurov, George Ibrahim, Anthony Maffei, Jonathan Giannone, Thomas Cerabona, Ashutosh Kaul
Mirizzi syndrome has been defined in the literature as common bile duct obstruction resulting from calculi within Hartmann's pouch or cystic duct. We present a case of a 78-year-old female, who developed postcholecystectomy Mirizzi syndrome from a remnant cystic duct stone. Diagnosis of postcholecystectomy Mirizzi syndrome was made on endoscopic retrograde cholangiography (ERCP) performed postoperatively. The patient was treated with a novel strategy by combining advanced endoscopic and laparoscopic techniques in three stages as follows: Stage 1 (initial presentation): endoscopic sphincterotomy with common bile duct stent placement; Stage 2 (6 weeks after Stage 1): laparoscopic ultrasonography to locate the remnant cystic duct calculi followed by laparoscopic retrieval of the calculi and intracorporeal closure of cystic duct stump; Stage 3 (6 weeks after Stage 2): endoscopic removal of common bile duct stent along with performance of completion endoscopic retrograde cholangiogram...
2016: Case Reports in Surgery
Ashok Kumar, Ganesan Senthil, Anand Prakash, Anu Behari, Rajneesh Kumar Singh, Vinay Kumar Kapoor, Rajan Saxena
BACKGROUNDS/AIMS: Mirizzi's syndrome (MS) poses great diagnostic and management challenge to the treating physician. We presented our experience of MS cases with respect to clinical presentation, diagnostic difficulties, surgical procedures and outcome. METHODS: Prospectively maintained data of all surgically treated MS patients were analyzed. RESULTS: A total of 169 MS patients were surgically managed between 1989 and 2011. Presenting symptoms were jaundice (84%), pain (75%) and cholangitis (56%)...
February 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Fahri Yetişir, Akgün Ebru Şarer, Hasan Zafer Acar, Omer Parlak, Basar Basaran, Omer Yazıcıoğlu
The Mirizzi syndrome (MS) is an impacted stone in the cystic duct or Hartmann's pouch that mechanically obstructs the common bile duct (CBD). We would like to report laparoscopic subtotal cholecystectomy (SC) and resection of cholecystocolic fistula by the help of Tri-Staple™ in a case with type V MS and cholecystocolic fistula, for first time in the literature. A 24-year-old man was admitted to emergency department with the complaint of abdominal pain, intermittent fever, jaundice, and diarrhea. Two months ago with the same complaint, ERCP was performed...
2016: Case Reports in Hepatology
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