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bile leakage

A V Semenkov, E F Kim, A V Filin, D S Burmistrov, A V Metelin, Yu R Kamalov, T N Galyan, A V Goncharova
AIM: to estimate the effect of decompressive stented drainage of biliary anastomosis on incidence of biliary complications. MATERIAL AND METHODS: 294 patients aged from 5 months to 61 years (mean 13.8±0.81) were enrolled. They underwent liver fragments transplantation in the Department of Liver Transplantation of Petrovsky Russian Research Center of Surgery for the period from March 1997 to January 2016. Decompressive stented drainage tubes were used in 28 (9.5%) patients...
2016: Khirurgiia
Felix J Hüttner, Rosa Klotz, Alexis Ulrich, Markus W Büchler, Markus K Diener
BACKGROUND: Pancreatic cancer remains one of the five leading causes of cancer deaths in industrialized nations. For adenocarcinomas in the head of the gland and premalignant lesions, partial pancreaticoduodenectomy represents the standard treatment for resectable tumours. The gastro- or duodenojejunostomy after partial pancreaticoduodenectomy can be reestablished via either an antecolic or a retrocolic route. The debate about the more favourable technique for bowel reconstruction is ongoing...
September 30, 2016: Cochrane Database of Systematic Reviews
Yakun Xu, Chengyong Dong, Kexin Ma, Fei Long, Keqiu Jiang, Ping Shao, Rui Liang, Liming Wang
Several studies have shown the safety and feasibility of laparoscopic common bile duct exploration (LCBDE) as a minimally invasive treatment options for choledocholithiasis. Use of T-tube or biliary stent drainage tube placement after laparoscopic choledochotomy for common bile duct (CBD) stones is still under debate. This study tried to confirm the safety of spontaneously removable biliary stent in the distal CBD after LCBDE to allow choledochus primary closure. A total of 47 patients with choledocholithiasis underwent LCBDE with primary closure and internal drainage using a spontaneously removable biliary stent drainage tube (stent group, N = 22) or T-tube (T-tube group, N = 25)...
September 2016: Medicine (Baltimore)
Kengo Fukuoka, Satoshi Nara, Yoshitaka Honma, Yoji Kishi, Minoru Esaki, Kazuaki Shimada
BACKGROUND: Recently, an increasing number of patients with liver metastases from colorectal cancer have received chemotherapy before hepatectomy. However, the effect of chemotherapy on postoperative short-term outcome is not well defined. METHODS: We retrospectively investigated the postoperative complications of 439 patients who underwent hepatectomy for colorectal liver metastases in our division from 2005 to 2014. Patients were classified into two groups according to the presence (Cx; 84 patients) or absence (NCx; 355 patients) of preoperative chemotherapy...
September 27, 2016: World Journal of Surgery
Ryoga Hamura, Koichiro Haruki, Jun Tsutsumi, Sumio Takayama, Hiroaki Shiba, Katsuhiko Yanaga
Spontaneous biliary peritonitis is rare in adults. We herein report a case of spontaneous biliary peritonitis. An 84-year-old man was admitted to our hospital for abdominal pain for 5 days. He developed fever, jaundice, and abdominal rigidity. Computed tomography (CT) revealed massive ascites in the omental bursa and around the liver. The ascites obtained by diagnostic paracentesis was dark yellow-green in color, which implied bile leakage. With a diagnosis of bile peritonitis, the patient underwent emergency exploratory laparotomy...
December 2016: Surgical Case Reports
Fei Liu, Jingyi Zhang, Chuanfen Lei, Yonggang Wei, Bo Li
BACKGROUND: Though accumulated evidence proved that laparoscopic major hepatectomy was technically feasible, it remains a challenging procedure and is limited to highly specialized centers. Paragonimiasis is one of the most important food-borne parasitic zoonoses caused by the trematode of the genus Paragonimus. Although hepatic paragonimiasis is rare, the previous studies had investigated hepatic paragonimiasis from different perspectives. However, the safety and feasibility of laparoscopic major hepatectomy for hepatic paragonimiasis have not yet been reported in the literature...
September 2016: Medicine (Baltimore)
Mohammad Sadegh Fazeli, Ali Reza Kazemeini, Ali Jafarian, Mohammad Bashashati, Mohammad Reza Keramati
BACKGROUND: Bile Duct Injuries (BDI) during cholecystectomy are now being recognized as major health problems. OBJECTIVES: Herein, we present our experience with handling major BDIs and report long-term outcome of hepaticojejunostomies followed by trans-jejunal hepatic duct stenting performed to reconstruct extra-hepatic biliary tracts. MATERIALS AND METHODS: In this case series, we prospectively collected data of 22 patients, who underwent first time biliary reconstruction through Roux-en-y hepaticojejunostomy followed by hepatic duct stenting using a trans-jejunal bifurcated 6F tube drain...
May 2016: Trauma Monthly
Jintao Guo, Siyu Sun, Xiang Liu, Sheng Wang, Nan Ge, Guoxin Wang
Background and Study Aims. Endoscopic ultrasound- (EUS-) guided biliary drainage (EUS-BD) is an alternative treatment for biliary obstruction after failed endoscopic retrograde cholangiopancreatography (ERCP). In this study, we present the outcomes of inpatients with obstructive jaundice treated with EUS-BD using a fully covered metallic stent after failed ERCP. Patients and Methods. A total of 21 patients with biliary obstruction due to malignant tumors and prior unsuccessful ERCP underwent EUS via an intra- or extrahepatic approach with fully covered metallic stent between March 2014 and October 2015...
2016: Gastroenterology Research and Practice
P P Li, H Liu, S Y Fu, C Lin, Z Y Pan, J Zhang, J S Ni, S X Yuan, W P Zhou
OBJECTIVE: To discuss the application of liver visualization technology in complex liver tumor resection at the second hepatic portal area. METHODS: Clinical data of 80 cases who received surgery at the second hepatic portal area from August 2014 to September 2015 in the Third Department of Hepatic Surgery of Eastern Hepatobiliary Surgery Hospital were analyzed retrospectively. There were 58 male and 22 female patients aged from 21 to 70 years with median age of 52 years...
September 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
A Ciftci, M B Yazicioglu, C Tiryaki, H T Turgut, O Subasi, M Ilgoz, O Civil, S Y Yildiz
BACKGROUND: There have been many changes in number and place of trocars that have been described, since the first laparoscopic cholecystectomy (LC), but, in fact, all authors agree that laparoscopic procedure is accepted as gold standard. However, four trocars use in standard laparoscopic cholecystectomy, it has been argued that the fourth port is not necessary for grasping fundus of gallbladder so as to expose Calot's triangle. The aim of this study is to establish the safety of three-trocar LC in symptomatic gallbladder disease and also to determine the ratio of technical requirements of the fourth trocar...
August 31, 2016: Irish Journal of Medical Science
Jacqueline van den Bos, Rutger M Schols, Misha D Luyer, Ronald M van Dam, Alexander L Vahrmeijer, Wilhelmus J Meijerink, Paul D Gobardhan, Gooitzen M van Dam, Nicole D Bouvy, Laurents P S Stassen
INTRODUCTION: Misidentification of the extrahepatic bile duct anatomy during laparoscopic cholecystectomy (LC) is the main cause of bile duct injury. Easier intraoperative recognition of the biliary anatomy may be accomplished by using near-infrared fluorescence (NIRF) imaging after an intravenous injection of indocyanine green (ICG). Promising results were reported for successful intraoperative identification of the extrahepatic bile ducts compared to conventional laparoscopic imaging...
August 26, 2016: BMJ Open
Anja Schaible, Peter Schemmer, Thilo Hackert, Christian Rupp, Anna E Schulze Schleithoff, Daniel N Gotthardt, Markus W Büchler, Peter Sauer
BACKGROUND: Bile leaks after hepatic resection are serious complications associated with substantial morbidity and mortality. The aim of this prospective observational study was to determine the therapeutic success of endoscopic treatment of biliary leakage after liver resection. PATIENTS AND METHODS: Grade B biliary leaks were considered for endoscopic treatment in patients after liver resection between 1/09 and 4/12. Endoscopic treatment (sphincterotomy only, plastic stent distal to leak or bridging) was defined as successful when the patient remained without symptoms after drain removal and without extravasation follow-up ERC 8 weeks later...
August 17, 2016: Surgical Endoscopy
Jiayu Zhou, Yucheng Zhou, Yiping Mou, Tao Xia, Xiaowu Xu, Weiwei Jin, Renchao Zhang, Chao Lu, Ronggao Chen
BACKGROUND: Solid pseudopapillary neoplasms (SPNs) of the pancreas are uncommon neoplasms and are potentially malignant. Complete resection is advised due to rare recurrence and metastasis. Duodenum-preserving pancreatic head resection (DPPHR) is indicated for SPNs located in the pancreatic head and is only performed using the open approach. To the best of our knowledge, there are no reports describing laparoscopic DPPHR (LDPPHR) for SPNs. METHODS: Herein, we report a case of 41-year-old female presented with a 1-week history of epigastric abdominal discomfort, and founded an SPN of the pancreatic head by abdominal computed tomography/magnetic resonance, who was treated by radical LDPPHR without complications, such as pancreatic fistula and bile leakage...
August 2016: Medicine (Baltimore)
Jacqueline Scott, Ameet Singh, Philipp D Mayhew, J Brad Case, Jeffrey J Runge, Matthieu Gatineau, Jessica Kilkenny
OBJECTIVE: To report the complications and outcome of dogs undergoing laparoscopic cholecystectomy for uncomplicated gall bladder disease. STUDY DESIGN: Multi-institutional case series. ANIMALS: Client-owned dogs (n=20). METHODS: Medical records of dogs that underwent laparoscopic cholecystectomy were reviewed and signalment, history, clinical and ultrasound examination findings, surgical variables, and complications were collated...
August 9, 2016: Veterinary Surgery: VS
Karen McKenzie, Michelle Maclean, M Helen Grant, Praveen Ramakrishnan, Scott J MacGregor, John G Anderson
Bacterial inactivation by 405 nm light is accredited to the photoexcitation of intracellular porphyrin molecules resulting in energy transfer and the generation of reactive oxygen species that impart cellular oxidative damage. The specific mechanism of cellular damage, however, is not fully understood. Previous work has suggested that destruction of nucleic acids may be responsible for inactivation; however, microscopic imaging has suggested membrane damage as a major constituent of cellular inactivation. This study investigates the membrane integrity of Escherichia coli and Staphylococcus aureus exposed to 405 nm light...
September 2016: Microbiology
Milljae Shin, Jae-Won Joh
Apart from noticeable improvements in surgical techniques and immunosuppressive agents, biliary complications remain the major causes of morbidity and mortality after living donor liver transplantation (LDLT). Bile leakage and stricture are the predominant complications. The reported incidence of biliary complications is 15%-40%, and these are known to occur more frequently in living donors than in deceased donors. Despite the absence of a confirmed therapeutic algorithm, many approaches have been used for treatment, including surgical, endoscopic, and percutaneous transhepatic techniques...
July 21, 2016: World Journal of Gastroenterology: WJG
Claire Goumard, David Fuks, François Cauchy, Jacques Belghiti, Catherine Paugam-Burtz, Yves Castier, Olivier Soubrane
BACKGROUND: Postoperative pleural empyema following liver resection has not been thoroughly described in the literature yet. Hence, we aimed to describe characteristics of patients experiencing this complication. METHODS: Characteristics and outcomes of 21 patients who developed pleural empyema after hepatectomy, defined as a bacteriologically proven pleural infection with clinical and biological inflammatory signs requiring antibiotherapy and thoracic drainage, from 2001 to 2014, were retrospectively analyzed...
July 27, 2016: World Journal of Surgery
Dieter Paul Hoyer, Andreas Paul, Sebastian Luer, Henning Reis, Patrik Efferz, Thomas Minor
Different nonhypothermic preservation modalities have shown beneficial effects in liver transplantation models. This study compares controlled oxygenated rewarming (COR) to normothermic machine perfusion (NMP) to resuscitate liver grafts following cold storage (CS). Porcine livers were preserved for 18 hours by CS. Before reperfusion, the grafts were put on a machine perfusion device (Liver Assist) for 3 hours and were randomly assigned to COR (n = 6) or NMP (n = 5) and compared to standard CS. COR was carried out with the new Custodiol-N solution, slowly increasing temperature from 8 °C to 20 °C during the first 90 minutes...
September 2016: Liver Transplantation
Lei Zhao, Zhifei Wang, Jun Xu, Yunwei Wei, Yinghui Guan, Chunfu Liu, Lishan Xu, Chang Liu, Bo Wu
BACKGROUND: To evaluate the safety and feasibility of single incision laparoscopic cholecystectomy (SILC) using a novel instrument. MATERIALS AND METHODS: From September 2011 to June 2012, eligible patients (150 cases) were divided randomly into three groups: group A, SILC using a novel instrument; group B, SILC using a conventional instrument; and group C, conventional laparoscopic cholecystectomy (LC). Operative and postoperative outcomes were analyzed. RESULTS: The operative times for Group A [mean 40 min; rang 30-50 min] and Group B [mean 37...
August 2016: International Journal of Surgery
Seon Ung Yun, Young Koog Cheon, Chan Sup Shim, Tae Yoon Lee, Hyung Min Yu, Hyun Ah Chung, Se Woong Kwon, Taek Gun Jeong, Sang Hee An, Gyung Won Jeong, Ji Wan Kim
Background/Aims: Despite improvements in surgical techniques and postoperative patient care, bile leakage can occur after hepatobiliary surgery and may lead to serious complications. The aim of this retrospective study was to evaluate the efficacy of endoscopic treatment of bile leakage after hepatobiliary surgery. Methods: The medical records of 20 patients who underwent endoscopic retrograde cholangiopancreatography because of bile leakage after hepatobiliary surgery from August 2009 to September 2014 were reviewed retrospectively...
July 8, 2016: Korean Journal of Internal Medicine
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