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Hepaticojejunostomy

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https://www.readbyqxmd.com/read/28774506/single-stage-operation-for-perforated-choledochal-cyst
#1
Go Ohba, Hiroshi Yamamoto, Masato Nakayama, Shohei Honda, Akinobu Taketomi
BACKGROUND: The option of either single- or two-staged cyst excision has been proposed for perforated choledochal cysts (CCs), but which of the two methods is more effective remains controversial. We examined the complications and short-term outcomes of single-stage excision of perforated and non-perforated CCs. METHODS: The medical records of patients treated for CCs from 2003 to 2016 were retrospectively reviewed. Outcomes were compared between patients with perforated CCs (Group A) and non-perforated CCs (Group B)...
July 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28765486/peripheral-hepatojejunostomy-a-last-resort-palliative-solution-in-greece-during-the-economic-crisis
#2
Georgios C Sotiropoulos, Eleftherios Spartalis, Nikolaos Machairas, Gregory Kouraklis
The geographical distribution of Greece and the growing proportion of uninsured patients make imperative the need for effective and efficient palliative solutions regarding obstructive jaundice due to hepatic malignancy, while repeated endoscopic interventions and all associated materials are either not accessible to the whole population or not even available on a daily basis due to the economic crisis and the difficulties on the hospital supply. On this basis, palliative hepatojejunostomy, introduced more than 50 years ago, could be revisited in the Greek reality in very selected cases and under these special circumstances...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28763696/long-term-observation-and-treatment-of-a-widespread-intraductal-papillary-neoplasm-of-the-bile-duct-extending-from-the-intrapancreatic-bile-duct-to-the-bilateral-intrahepatic-bile-duct-a-case-report
#3
Daisuke Hokuto, Takeo Nomi, Satoshi Yasuda, Takahiro Yoshikawa, Kohei Ishioka, Takatsugu Yamada, Takahiro Akahori, Kenji Nakagawa, Minako Nagai, Kota Nakamura, Shinsaku Obara, Hiromichi Kanehiro, Masayuki Sho
INTRODUCTION: Few studies have reported the long-term outcomes of surgical resected intraductal papillary neoplasm of the bile duct (IPNB). Here, we describe the long-term observation and treatment of a case of widespread IPNB. PRESENTATION OF CASE: A 57-year-old male was referred to our hospital due to jaundice and dilation of the intrahepatic bile duct. Computed tomography showed dilation and irregularities of the right intrahepatic and extrahepatic bile ducts together with a 3cm nodule in the common hepatic duct...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28761800/pancreatic-kaposiform-hemangioendothelioma-not-responding-to-sirolimus
#4
Paloma Junco Triana, Mariela Dore, Vanesa Cerezo Nuñez, Javier Gomez Jimenez, Miriam Ferrero Miguel, Mercedes González Díaz, Joan Novo Ricardo, Ane Andres, Manuel Lopez Santamaria, Juan Carlos Lopez-Gutierrez
Background  Kaposiform hemangioendothelioma (KHE) is a vascular tumor frequently associated with Kasabach-Merritt phenomenon (KMP), characterized by severe thrombocytopenia and consumptive coagulopathy. Visceral involvement in KHE is rare. In our recent experience, sirolimus has shown to be an effective treatment in cutaneous KHE, becoming indeed the treatment of choice in KMP. We report a case of pancreatic KHE associated with KMP and refractory to sirolimus. Case Report  A 4-month-old infant is referred for obstructive jaundice (10 mg/dL conjugated bilirubin) secondary to vascular pancreatic tumor...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28730255/primary-neuroendocrine-tumors-an-extremely-rare-cause-of-obstruction-of-extrahepatic-bile-ducts-a-case-report
#5
Andrei IonuŢ Costin, Ion Păun, Mariana Păun, Vlad Denis Constantin, Flore Vârcuş
Primary neuroendocrine tumors of the extrahepatic bile ducts are extremely rare - up to date, only 77 cases have been reported in the literature, which represents between 0.2-2% of all gastrointestinal carcinoid tumors. The paper focuses on the case of a woman patient, aged 37 years, admitted to the Clinic with the diagnosis of obstructive jaundice, unaccompanied by pain and where imaging indicates a tumor in the third average of the common bile duct (CBD). The surgery involved the excision of CBD, lymphadenectomy and restoring the biliodigestive continuity of Roux-en-Y hepaticojejunostomy...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28715721/pushing-the-boundaries-in-liver-graft-utilisation-in-transplantation-case-report-of-a-donor-with-previous-bile-duct-injury-repair
#6
Asma Sultana, James J Powell, Gabriel C Oniscu
INTRODUCTION: Liver transplantation is a recognised treatment for extensive bile duct injuries with secondary biliary cirrhosis or recurring sepsis. However, there have been no reports of successful liver transplantation from a donor who sustained a previous bile duct injury. PRESENTATION OF CASE: Here we discuss the case of a liver transplant from a 51-year-old brain dead donor who had suffered a Strasberg E1 bile duct injury and had undergone a Roux-en-Y hepaticojejunostomy 24 years prior to donation...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28688649/better-long-term-outcomes-with-hilar-ductoplasty-and-a-side-to-side-roux-en-y-hepaticojejunostomy
#7
Hong-Tian Xia, Yang Liu, Tao Yang, Bin Liang, Jing Wang, Jia-Hong Dong
BACKGROUND: Whether a wide hilar hepaticojejunostomy after bile duct cyst (BDC) excision can prevent the development of postoperative complications remains an unanswered question. We compared our outcomes after a minimum of 2-y follow-up in patients with Todani type Ia choledochal cyst treated with hilar ductoplasty followed by a side-to-side Roux-en-Y hepaticojejunostomy (ductoplasty group) or radical cyst resection with an end-to-side Roux-en-Y hepaticojejunostomy (conventional group)...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28684726/hepatic-artery-pseudoaneurysm-following-orthotopic-liver-transplantation-increasing-clinical-suspicion-for-a-rare-but-lethal-pathology
#8
Jon Harrison, Meredith Harrison, Cataldo Doria
BACKGROUND Despite an incidence of between 1% and 2%, the mortality rate in ruptured hepatic artery pseudoaneurysm after orthotopic liver transplantation approaches 69%. Our aim is to report operative and outcomes data for 7 patients with pseudoaneurysm following transplant at 1 institution, with emphasis on suspected risk factors for aneurysm formation. From these risk factors, we performed a systematic review to assess their clinical saliency. MATERIAL AND METHODS Using PRISMA guidelines, we completed a PubMed and online database review to gather studies addressing risk factors for pseudoaneurysm following transplant...
July 7, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28661596/-diagnosis-and-surgical-treatment-of-mirizzi-syndrome
#9
V A Syplyvy, D V Levtushenko, G D Petrenko, S A Andreyeshchev, Levtushenko A V
Retrospective analysis of the surgical treatment results in 34 patients, operated for intraoperatively diagnosed Mirizzi syndrome (MS), was done. Analysis of intraoperative changes have witnessed, that while transition occurrence of MS from the first to the fifth type a severity of morphological changes in a gallbladder-biliary ducts-duodenum system enhanced with duodenal integrity loss and development of cholecystobiliary or cholecystodigestive fistula. Surgical correction of MS have envisaged cholecystectomy performance or subtotal resection of gallbladder, plastic closure of biliary fistula, using various procedures, external biliary draining and formation of hepaticojejunostomy in accordance to Roux method...
August 2016: Klinichna Khirurhiia
https://www.readbyqxmd.com/read/28640107/a-nomogram-prediction-of-postoperative-surgical-site-infections-in-patients-with-perihilar-cholangiocarcinoma
#10
Long Li, Jie Ding, Jun Han, Hong Wu
Surgical site infection (SSI) is one of the major morbidities after radical resection for perihilar cholangiocarcinoma (PHCC). This study aimed to clarify the risk factors and construct a nomogram to predict SSIs in patients with PHCC.A total of 335 consecutive patients who underwent hepatectomy combined with hepaticojejunostomy between January 2013 and December 2015 were analyzed retrospectively. SSIs, including incisional (superficial and deep) and space/organ infection, were defined according to the Centers for Disease Control and Prevention (CDC)'s National Nosocomial Infection Surveillance (NNIS) system...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28601317/iatrogenic-injuries-of-the-extrahepatic-biliary-system
#11
Ghodratollah Maddah, Mohammad Taghi Rajabi Mashhadi, Mehdi Parvizi Mashhadi, Mehdi Jabbari Nooghabi, Masoumeh Hassanpour, Abbas Abdollahi
BACKGROUND: Iatrogenic traumatic extrahepatic biliary tract injuries though rarely occur; they can lead to exceedingly morbid complications. The aim of this study was to evaluate the management strategies and outcomes of patients presented with iatrogenic bile duct injuries. METHODS: This is a retrospective study. Over 19 y, 124 patients were managed for iatrogenic biliary injuries at our institution. The data related to the etiology of biliary tract injury, symptoms of injury, laboratory and radiologic studies, injury-to-diagnosis time, type of biliary tract injury, injury management, hospitalization time, and postoperative complications were reviewed...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28600688/endoscopic-management-of-biliary-strictures-after-living-donor-liver-transplantation
#12
REVIEW
Takeshi Tsujino, Hiroyuki Isayama, Hirofumi Kogure, Tatsuya Sato, Yousuke Nakai, Kazuhiko Koike
Living donor liver transplantation (LDLT) is an effective alternative to deceased liver transplantation (DDLT) for end-stage liver disease. Although advances in surgical techniques, immunosuppressive management, and post-transplant care have improved the overall outcomes of LDLT, biliary strictures remain the major unsolved problem. Endoscopic retrograde cholangiopancreatography (ERCP) is currently considered the first-line therapy for biliary strictures following LDLT with duct-to-duct reconstruction, with percutaneous and surgical interventions reserved for patients with unsuccessful management via ERCP...
August 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28589237/choledochal-malformation-in-children-lessons-learned-from-a-dutch-national-study
#13
Maria H A van den Eijnden, Ruben H J de Kleine, Ivo de Blaauw, Paul G J M Peeters, Bart P G Koot, Matthijs W N Oomen, Cornelius E J Sloots, W G van Gemert, David C van der Zee, L W E van Heurn, Henkjan J Verkade, Jim C H Wilde, Jan B F Hulscher
INTRODUCTION: A choledochal malformation (CM) is a rare entity, especially in the Western world. We aimed to determine the incidence of CM in the Netherlands and the outcome of surgery for CM in childhood. METHODS: All pediatric patients who underwent a surgical procedure for type I-IV CM between 1989 and 2014 were entered into the Netherlands Study group on choledochal cyst/malformation. Patients with type V CM were excluded from the present analysis. Symptoms, surgical details, short-term (<30 days) and long-term (>30 days) complications were studied retrospectively...
June 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28583556/duct-to-duct-biliary-reconstruction-in-living-donor-liver-transplantation-for-primary-sclerosing-cholangitis-report-of-a-case
#14
T Motomura, T Yoshizumi, H Wang, A Nagatsu, S Itoh, N Harada, N Harimoto, T Ikegami, H Uchiyama, Y Soejima, Y Maehara
Although Roux-en Y hepaticojejunostomy was previously recommended for the biliary reconstruction in liver transplantation for primary sclerosing cholangitis (PSC), some recent reports showed no difference in the graft survival between Roux-en Y and duct-to-duct anastomosis in deceased-donor liver transplantation. On the other hand, considering the risk of recurrence and the short length of the bile duct of the graft, duct-to-duct biliary anastomosis has never been reported in a patient undergoing living-donor liver transplantation (LDLT) for PSC...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28578981/robotic-pancreatoduodenectomy-biotissue-curriculum-has-validity-and-improves-technical-performance-for-surgical-oncology-fellows
#15
Vernissia Tam, Mazen Zenati, Stephanie Novak, Yong Chen, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
OBJECTIVE: Obtaining the proficiency on the robotic platform necessary to safely perform a robotic pancreatoduodenectomy is particularly challenging. We hypothesize that by instituting a proficiency-based robotic training curriculum we can enhance novice surgeons' skills outside of the operating room, leading to a shorter learning curve. DESIGN: A biotissue curriculum was designed consisting of sewing artificial organs to simulate a hepaticojejunostomy (HJ), gastrojejunostomy (GJ), and pancreaticojejunostomy (PJ)...
June 1, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28539991/importance-of-surgical-margin-in-the-outcomes-of-hepatocholangiocarcinoma
#16
Ka Wing Ma, Kenneth Siu Ho Chok
AIM: To evaluate the significance of resection margin width in the management of hepatocholangiocarcinoma (HCC-CC). METHODS: Data of consecutive patients who underwent hepatectomy for hepatic malignancies in the period from 1995 to 2014 were reviewed. Patients with pathologically confirmed HCC-CC were included for analysis. Demographic, biochemical, operative and pathological data were analyzed against survival outcomes. RESULTS: Forty-two patients were included for analysis...
May 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28523061/duel-stage-treatment-for-biliary-cysts-with-cholangitis-during-pregnancy
#17
Baoxing Jia, Ludong Tan, Zhe Jin, Yahui Liu
BACKGROUND & OBJECTIVE: Biliary cysts in pregnant women are a complex medical issue, especially when complicated with cholangitis. It is a serious and life-threatening diagnosis that can seriously endanger both the expectant mother and the fetus. However, during pregnancy, surgical treatment would lead to further complications and higher fetal mortality. Here, we propose a novel therapeutic approach that would be safe for both mother and child during pregnancy, with a definitive treatment postponed until after delivery...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28496535/spontaneous-rupture-of-a-choledochal-cyst-during-post-partum-a-rare-presentation
#18
Ashish Gupta, Karikal Chakaravarthi, Lileswar Kaman
With the advent of newer radiological investigations, choledochal cysts are being diagnosed more often in present era. These cysts are commonly diagnosed in early childhood and infancy, although some go undetected to be diagnosed in adulthood. These malformations are associated with multiple complications like cholangitis, jaundice, pancreatitis, rupture or even malignancy. Here we describe a post partum female, who was diagnosed to have choledochal cyst during sixth month of pregnancy. She presented with obstructive jaundice in cholangitis and was subjected to endoscopic retrograde cholangiopancreatography (ERCP) with stenting...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28447199/a-novel-reconstruction-technique-during-pancreaticoduodenectomy-after-roux-en-y-gastric-bypass-how-i-do-it
#19
George Younan, Susan Tsai, Douglas B Evans, Kathleen K Christians
The altered anatomy in patients after bariatric surgery who have undergone a Roux-en-Y gastric bypass may pose a technical challenge for surgical removal of the pancreatic head. We treat patients with pancreas cancer with multimodality therapy in a neoadjuvant fashion followed by pancreaticoduodenectomy (PD). In patients with Roux-en-Y gastric bypass anatomy, the gastric remnant is preserved and used for pancreaticogastrostomy reconstruction and subsequently drained by the same jejunal limb used for the hepaticojejunostomy...
July 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28439596/comparative-clinical-study-of-laparoscopic-and-open-surgery-in-children-with-choledochal-cysts
#20
Guoxin Song, Xiangyu Jiang, Jian Wang, Aiwu Li
To investigate the safety and effectiveness of laparoscopic management of choledochal cysts compared with the open approach, even in early childhood.  Methods: We conducted a retrospective study of 206 patients with choledochal cysts between June 2003 and May 2015. Of these, 104 patients underwent open cyst excision and hepaticojejunostomy (open operation [OP]) and 102 patients received laparoscopic management and hepaticojejunostomy (laparoscopic operation [LP]). The patients who underwent a laparoscopic approach were further divided by the age of 3 years...
May 2017: Saudi Medical Journal
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