Biliary-Caval Fistula following Y90 Radioembolization

2021 ◽  
Vol 38 (04) ◽  
pp. 488-491
Author(s):  
Alexander D. Hall ◽  
Sarah B. White ◽  
William S. Rilling

AbstractThe safety of radioembolization with yttrium-90 (90Y) is well documented and major complications are rare. Previous studies have demonstrated that biliary complications following 90Y, including bile duct injury and hepatic abscess formation, occur at an increased rate in patients who have had prior biliary surgery and interventions. This article reviews a case of a patient who developed recurrent cholangitis and sepsis as well as a biliary-caval fistula following radioembolization. Additionally, we review current data regarding biliary complications following radioembolization in patients with prior biliary intervention.

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Norman Oneil Machado

Laparoscopic cholecystectomy has emerged as a gold standard therapeutic option for the management of symptomatic cholelithiasis. However, adaptation of LC is associated with increased risk of complications, particularly bile duct injury ranging from 0.3 to 0.6%. Occurrence of BDI results in difficult reconstruction, prolonged hospitalization, and high risk of long-term complications. Therefore, more emphasis is placed on preventing these complications. In addition to adequate training, several techniques have been proposed to prevent bile duct injury including use of 30∘ scope, adequate delineation of structures in Calot's triangle (critical view), avoidance of diathermy close to common hepatic duct, and intraoperative cholangiogram, and to maintain a low threshold to conversion to open approach when uncertain. Management of Bile duct injury depends on the nature of injury, time of detection, and the expertise available, and would range from simple subhepatic drainage to Roux-en-Y hepaticojejunostomy particularly performed at specialised centers. This article based on the literature review aims to review the biliary complications following laparoscopic cholecystectomy with reference to its mechanism , preventive measures to be taken, and the management approach.


2015 ◽  
Vol 53 (12) ◽  
Author(s):  
F Glaser ◽  
B Engel ◽  
C John ◽  
T Krech ◽  
A Carambia ◽  
...  

2020 ◽  
Vol 22 (1) ◽  
pp. 25-29
Author(s):  
Zubayer Ahmad ◽  
Mohammad Ali ◽  
Kazi lsrat Jahan ◽  
ABM Khurshid Alam ◽  
G M Morshed

Background: Biliary disease is one of the most common surgical problems encountered all over the world. Ultrasound is widely accepted for the diagnosis of biliary system disease. However, it is a highly operator dependent imaging modality and its diagnostic success is also influenced by the situation, such as non-fasting, obesity, intestinal gas. Objective: To compare the ultrasonographic findings with the peroperative findings in biliary surgery. Methods: This prospective study was conducted in General Hospital, comilla between the periods of July 2006 to June 2008 among 300 patients with biliary diseases for which operative treatment is planned. Comparison between sonographic findings with operative findings was performed. Results: Right hypochondriac pain and jaundice were two significant symptoms (93% and 15%). Right hypochondriac tenderness, jaundice and palpable gallbladder were most valuable physical findings (respectively, 40%, 15% and 5%). Out of 252 ultrasonically positive gallbladder, stone were confirmed in 249 cases preoperatively. Sensitivity of USG in diagnosis of gallstone disease was 100%. There was, however, 25% false positive rate detection. Specificity was, however, 75% in this case. USG could demonstrate stone in common bile duct in only 12 out of 30 cases. Sensitivity of the test in diagnosing common bile duct stone was 40%, false negative rate 60%. In the series, ultrasonography sensitivity was 100% in diagnosing stone in cystic duct. USG could detect with relatively good but less sensitivity the presence of chronic cholecystitis (92.3%) and worm inside gallbladder (50%). Conclusion: Ultrasonography is the most important investigation in the diagnosis of biliary disease and a useful test for patients undergoing operative management for planning and anticipating technical difficulties. Journal of Surgical Sciences (2018) Vol. 22 (1): 25-29


2021 ◽  
Vol 07 (01) ◽  
pp. 037-043
Author(s):  
Vinoth M. ◽  
Abhijit Joshi

Abstract​ Laparoscopic cholecystectomy (LC) is one of the most frequently performed surgical procedures worldwide. Iatrogenic bile duct injury (IBDI) is a serious complication of LC and has an incidence of 0.3 to 0.7%. Since it is associated with a significant and potentially lifelong morbidity as well as mortality, diagnosing IBDI as early as possible is of paramount importance. Management of bile duct injuries and prognosis of their surgical repair depend on the timing of its recognition, type and the extent of the injury. In this paper, we present a case of IBDI and attempt to discuss all its dimensions.


HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S170
Author(s):  
J.L. Beristain-Hernandez ◽  
M. Garcia-Sanchez

2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Adam Bobkiewicz ◽  
łukasz Krokowicz ◽  
Tomasz Banasiewicz ◽  
Tomasz Kościński ◽  
Maciej Borejsza-Wysocki ◽  
...  

AbstractIatrogenic bile duct injuries (BDI) are still a challenging diagnostic and therapeutic problem. With the introduction of the laparoscopic technique for the treatment of cholecystolithiasis, the incidence of iatrogenic BDI increased.was a retrospective analysis of 69 patients treated at the department due to iatrogenic BDI in the years 2004-2014.. In this paper, we presented the results of a retrospective analysis of 69 patients treated at the Department due to iatrogenic BDI in the years 2004-2014. The data were analysed in terms of age, sex, type of biliary injury, clinical symptoms, the type of repair surgery, the time between the primary surgery and the BDI management, postoperative complications and duration of hospital stay.. 82.6% of BDI occurred during laparoscopic cholecystectomy, 8.7% occurred during open cholecystectomy, whereas 6 cases of BDI resulted from surgeries conducted for other indications. In order to assess the degree of BDI, Bismuth and Neuhaus classifications were used (for open and laparoscopic cholecystectomy respectively). 84.1% of patients with confirmed BDI, were transferred to the Department from other hospitals. The average time between the primary surgery and reoperation was 6.2 days (SD 4). The most common clinical symptom was biliary fistula observed in 78.3% of patients. In 28 patients, unsuccessful attempts to manage BDI were made prior to the admission to the Department in other centres. The repair procedure was mainly conducted by laparotomy (82.6%) and by the endoscopic approach (15.9%). Hepaticojejunostomy was the most common type of reconstruction following BDI (34.7%).. The increase in the rate of iatrogenic bile duct injury remains a challenging surgical problem. The management of BDI should be multidisciplinary treatment. Referring patients with both suspected and confirmed iatrogenic BDI to tertiary centres allows more effective treatment to be implemented.


2021 ◽  
Author(s):  
Narendra Pandit ◽  
Tek Narayan Yadav ◽  
Kunal Bikram Deo ◽  
Laligen Awale ◽  
Lokesh Shekher Jaiswal

Sign in / Sign up

Export Citation Format

Share Document