scholarly journals Combined Interventional Radiological and Endoscopical Approach for the Treatment of a Postoperative Biliary Stricture and Fistula

HPB Surgery ◽  
1995 ◽  
Vol 8 (4) ◽  
pp. 257-262
Author(s):  
Jürgen Triller ◽  
Adrian Schmassmann ◽  
Walter Schweizer ◽  
Abraham Czerniak
Keyword(s):  
Biliary Stricture ◽  
Open Cholecystectomy ◽  
Bile Leakage ◽  
Biliary Fistula ◽  
Emergency Laparotomy ◽  
Percutaneous Balloon ◽  
External Drain ◽  
Percutaneous Balloon Dilatation ◽  
Iatrogenic Bile Duct Injury

A 43-year old woman was admitted 11 days after open cholecystectomy with a iatrogenic bile duct injury. On admission the patient showed an uncontrolled biliary fistula through an external drain placed at an emergency laparotomy for biliary peritonitis with fever and jaundice. PTC showed a biliary stricture type II (Bismuth). A percutaneous drainage was performed to decompress the biliary system. Three weeks later, percutaneous balloon dilatation of the stricture was performed. However, bile leakage persisted. In a combined transhepatic/ endoscopic procedure, the percutaneous biliary drainage was replaced by a nasobiliary tube. One week later, no stricture was found and the biliary leak was sealed. The patient could be discharged without symptoms or signs of cholestasis. The multidisciplinary management of post-operative biliary fistula is presented, comparing the role of interventional radiology, endoscopy and surgery.

Iatrogenic Bile Duct Injury. A Significant Surgical Problem. Assessment of Treatment Outcomes in the Department's Own Material

2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Adam Bobkiewicz ◽  
łukasz Krokowicz ◽  
Tomasz Banasiewicz ◽  
Tomasz Kościński ◽  
Maciej Borejsza-Wysocki ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Retrospective Analysis ◽  
Bile Duct Injury ◽  
Clinical Symptoms ◽  
Open Cholecystectomy ◽  
Multidisciplinary Treatment ◽  
Laparoscopic Technique ◽  
Primary Surgery ◽  
Iatrogenic Bile Duct Injury

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.

scholarly journals Consensus Guidelines on the Role of Cholangioscopy to Diagnose Indeterminate Biliary Stricture

HPB ◽  
2021 ◽  
Author(s):  
Phonthep Angsuwatcharakon ◽  
Santi Kulpatcharapong ◽  
Jong Ho Moon ◽  
Mohan Ramchandani ◽  
James Lau ◽  
...  
Keyword(s):  
Biliary Stricture ◽  
Consensus Guidelines

Role of Transesophageal Echocardiography in Percutaneous Balloon Mitral Valvuloplasty

1990 ◽  
Vol 7 (2) ◽  
pp. 115-123 ◽  
Author(s):  
KWAN-LEUNG CHAN ◽  
JEAN-FRANCOIS MARQUIS ◽  
CATHERINE ASCAH ◽  
BRIAN MORTON ◽  
MICHAEL BAIRD
Keyword(s):  
Transesophageal Echocardiography ◽  
Mitral Valvuloplasty ◽  
Percutaneous Balloon Mitral Valvuloplasty ◽  
Percutaneous Balloon

Thoracoabdominal impalement injury during pregnancy

2021 ◽  
Vol 14 (8) ◽  
pp. e244463
Author(s):  
Charisse Anne F Aquino ◽  
Maria Jesusa B Banal-Silao
Keyword(s):  
Multidisciplinary Team ◽  
Major Trauma ◽  
Trauma Centre ◽  
Emergency Laparotomy ◽  
Penetrating Abdominal Trauma ◽  
Penetrating Wound ◽  
Primigravid Woman ◽  
Thick Steel ◽  
Trauma In Pregnancy

Trauma has emerged as the leading cause of death during pregnancy. Penetrating abdominal trauma in pregnancy requires a rigorous clinical evaluation to establish a complete assessment of obstetric and non-obstetric lesions. In the case of major trauma, treatment is essentially carried out in a trauma centre with a multidisciplinary team to improve maternal and fetal prognosis. This is a case of a 20-year-old primigravid woman, 33 weeks and 4 days age of gestation, who was admitted for impaled foreign body. She was brought to the emergency department for a penetrating wound of the chest and abdomen after being accidentally impaled by a metre-long, inch-thick steel rod. Emergency laparotomy, caesarean section and thoracotomy were performed. The aim of this report is to discuss the assessment, management and role of the multidisciplinary team in the management of a pregnant trauma patient.

Percutaneous balloon dilatation of stenotic truncal valve in a newborn

1989 ◽  
Vol 23 (2) ◽  
pp. 270-272 ◽  
Author(s):  
Luigi Ballerini ◽  
Alberta Cifarelli ◽  
Duccio Di Carlo
Keyword(s):  
Balloon Dilatation ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Dilatation

Feasibility and safety in difficult laparoscopic cholecystectomies; a single surgeon experience.

2020 ◽  
Vol 11 (4) ◽  
pp. 12-16
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Bile Leakage ◽  
Cross Sectional Study ◽  
City Hospital ◽  
Class Iii ◽  
Cross Sectional ◽  
Surgeon Experience ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery

Background: laparoscopic cholecystectomy is commonly used for the treatment of gallstones. Objective: To determine the feasibility and safety of difficult laparoscopic cholecystectomies. Methodology: This cross sectional study was based on retrospective collection of data from patient records, including 323 patients with difficult laparoscopic cholecystectomies was conducted in Department of Surgery, Sharif Medical City Hospital, and Rasheed Hospital, Lahore from June 2010 to December 2019. Difficult cholecystectomy was defined on intraoperative findings based on Nassar intraoperative scoring system. Feasibility was defined as successful accomplishment of procedure without complication and safety was defined as having no intraoperative or postoperative complications. Results: There were 75 (23.21%) male and mean age was 48±8 years. Class I difficulty was observed in 185 (57.3%) patients, class II difficulty in 83 (25.7%) patients, class III difficulty in 44 (13.6%) patients and class IV difficulty in 11 (3.4%) patients. Mean duration of surgery and mean hospital stay were 98.87±11.76 minutes and 1.91±1 days, respectively. Conversion to open cholecystectomy was done in 10 (3.1%). The procedure was feasible in 313 (96.9%) patients. Overall complications were seen in 19 (5.9%) patients. The complications included Common Bile Duct injury in 1 (0.31%) patient, intraoperative bleeding in 1 (0.3%) patients, bile leakage in 2 (0.62%) patients, postoperative jaundice in 3 (0.93%) patients, superficial infections in 10 (3.1%) patients and deep infections in 2 (0.62%) patients. Safety of laparoscopic surgery was seen in 304 (94.1%) patients. Conclusion: Laparoscopic cholecystectomy in difficult situations was found to be feasible and safe in majority of patients. However, it was associated with a longer operative time.

scholarly journals Intraoperative Treatment of Duct of Luschka during Laparoscopic Cholecystectomy: A Case Report and Revision of Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Luigi Masoni ◽  
Leandro Landi ◽  
Riccardo Maglio
Keyword(s):  
Case Report ◽  
Bile Leak ◽  
Bile Leakage ◽  
Medical Systems ◽  
Invasive Treatment ◽  
Endoscopic Clip ◽  
First Case ◽  
Duct Of Luschka ◽  
Clinically Significant

Background. Bile leakage still remains a serious complication during cholecystectomies. In limited cases, this complication may occur from injury of the so-called ducts of Luschka. These rare ducts are usually discovered intraoperatively, and their presence poses the risk of bile injury and clinically significant bile leak. Presentation Case. We present a unique case of a 59-year-old male patient with acute cholecystitis. After removal of the gallbladder, thorough inspection of the hepatic bed was made and a little bile leak was identified from a duct of Luschka 1 cm away from the gallbladder hilum. We report on the use of endoscopic QuickClip Pro® clips (Olympus Medical Systems Corp., Tokyo, Japan) to avoid further more invasive treatment. Discussion. Endoscopic retrograde cholangiopancreatography with sphincterotomy played a crucial role for diagnosis and treatment of bile leaks with success rate near 94%. Many authors have argued the role of relaparoscopy, Diagnosis may be intraoperatively but this option does not seem to occur very often; in fact, there is a lack of data in literature. Conclusion. This is the first case report of bile leak from duct of Luschka treated during the cholecystectomies with endoscopic clip.

scholarly journals Hemorrhagic Shock as a Sequela of Splenic Rupture in a Patient with Infectious Mononucleosis: Focus on the Potential Role of Salicylates

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Konstantinos Bouliaris ◽  
Dimos Karangelis ◽  
Marios Daskalopoulos ◽  
Konstantinos Spanos ◽  
Michael Fanariotis ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Infectious Mononucleosis ◽  
Potential Role ◽  
Splenic Rupture ◽  
Emergency Laparotomy ◽  
Hemorrhagic Complication ◽  
Spontaneous Splenic Rupture ◽  
Predisposing Factor ◽  
Life Threatening

Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed.

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