scholarly journals Long-Term Results of Hepatic Resection for Hepatolithiasis

HPB Surgery ◽  
1995 ◽  
Vol 9 (1) ◽  
pp. 37-41 ◽  
Author(s):  
M. Sato ◽  
Y. Watanabe ◽  
S. Horiuchi ◽  
Y. Nakata ◽  
N. Sato ◽  
...  
Keyword(s):  
Hepatic Resection ◽  
Long Term Results ◽  
Bile Stasis ◽  
Bilioenteric Anastomosis ◽  
The Right ◽  
Duct Stricture ◽  
Segmental Involvement ◽  
Retained Stones

Long-term results of hepatic resection for hepatolithiasis in 34 patients having intrahepatic biliary strictures were studied. The left lateral and the right posterior segmental ducts were commonly and often simultaneously involved. Fourteen patients had multiple segmental involvement. Hepatic resection included left sided resection (n=27), right sided resection (n=6), and repeated bilateral resection (n=1). Seven patients had biliary tumors: 3 cholangiocarcinomas, 2 gall bladder cancers, cystadenocarcinoma, and dysplasia of intrahepatic ducts. Nineteen patients received bilioenteric anastomosis. Retained stones and recurrent stones developed in 3 and 4 patients, respectively. Twenty-six patients had no remaining symptoms; 2 died of operative complication or cholangiocarcinoma; 6 presented symptoms caused by retained stones (n=2), recurrent stones (n=2), bile stasis (n=1), or neuralgia (n=1). In 4 of the 6 patients, unrelieved posterior duct strictures caused the symptoms. With a mean follow-up period of 4.5 years, 30 patients are symptoms free, and 27 are stone free. In patients with right lobar or bilobar type, intra- and extrahepatic type, and confluence strictures, bilioenteric anastomosis is required. Hepatic resection is a rational treatment for hepatolithiasis, however, meticulous management of biliary tract abnormalities, particularly the posterior duct stricture, is mandatory.

scholarly journals Type IVA Choledochal Cyst: Is Hepatic Resection Necessary?

HPB Surgery ◽  
1996 ◽  
Vol 10 (1) ◽  
pp. 61-63 ◽  
Author(s):  
Russell Strong
Keyword(s):  
Hepatic Resection ◽  
Choledochal Cyst ◽  
Study Design ◽  
Operative Management ◽  
Late Complications ◽  
Long Term Results ◽  
Cyst Excision ◽  
Percutaneous Transhepatic Cholangioscopy

Background: This study concerns patients who have choledochal cyst with intrahepatic and extrahepatic involvement (type IVA cyst). The extent of excision and the necessity of hepatectomy, including the intrahepatic cyst in these patients have not been clarified.Study design: We have performed excision of the extrahepatic cyst with hepaticojejunostomy upon 13 patients with type IVA cyst during a 16 year period. The present study was done to examine the size of the anastomotic opening by direct cholangiography two weeks postoperatively. The long-term results were assessed to find the appropriate operative management for patients with type IVA cysts.Results: Intrahepatic cysts were present in both hepatic lobes in 11 patients (85 percent). None of the patients had carcinoma after excision of extrahepatic cyst during the follow-up period, which ranged from two months to 16 years. Postoperative late complications occurred in three patients (23 percent), hepatolithiasis in two and cholangitis in one. The anastomotic opening of hepaticojejunostomy was 13.3±4.5 mm in diameter two weeks postoperatively, which was not significantly different when compared with that in ten patients without late complications (13.4±4.9 mm). The late complications were successfully treated with either antibiotics or percutaneous transhepatic cholangioscopy, and none required a reoperation.Conclusions: The results suggest that additional hepatectomy is not required because carcinoma has rarely occurred from the intrahepatic cyst. Excision of an extrahepatic cyst with a wide hepaticojejunostomy is an acceptable operative management for patients with type IVA cysts.

Long-term results of percutaneous transluminal coronary rotational atherectomy for localized stenosis caused by Kawasaki disease

2021 ◽  
pp. 1-19
Author(s):  
Etsuko Tsuda ◽  
Yasuhide Asaumi ◽  
Teruo Noguchi ◽  
Satoshi Yasuda
Keyword(s):  
Kawasaki Disease ◽  
Rotational Atherectomy ◽  
Long Term Results ◽  
First Year ◽  
Cardiac Events ◽  
Main Trunk ◽  
The Right ◽  
Percutaneous Transluminal

Abstract Thirteen boys and one girl, 5–30 years (median 13 years), underwent percutaneous transluminal coronary rotational atherectomy. The interval from the onset of Kawasaki disease to PTCRA ranged from 5 to 29 years (median 12 years). The follow-up period was 1–22 years (median 13 years). The target vessels were the right coronary artery (7), left anterior descending artery (3), left circumflex (2), and left main trunk (2). The maximum burr size used was 1.75 mm in four, 2.00 mm in four, and 2.15 mm in six. The immediate results of rotational atherectomy were successful in all patients, and the mean stenosis degree improved from 86 ± 15% (mean ± standard deviation) to 37 ± 14% (p < 0.001). Cardiac events in the late period were found in four patients (29%). Acute myocardial infarction occurred in two, and syncope and ventricular fibrillation in one each. The cardiac event-free rate at 10 and 20 years was 79% (95% confidence interval 50–92) and 39% (6–87), respectively, (n = 14). The overall 20-year patency rate was 54% (95% CI 28–78). That in patients more than 10 years old was 77% (95% CI 42–94, n = 10). PTCRA alone is suitable for severe localised stenosis with calcification caused by KD in young adults except for small children. Re-stenosis within the first year after PTCRA often develops because of reactive intimal thickening after the procedure. If a target vessel is a patent 1 year after the procedure, long-term patency may be expected in patients more than 10 years old.

scholarly journals Bentall procedure with the CarboSeal™ and CarboSeal Valsalva™ composite conduits: long-term outcomes

2021 ◽  
Author(s):  
Andrea Lechiancole ◽  
Igor Vendramin ◽  
Sandro Sponga ◽  
Daniela Piani ◽  
Giovanni Benedetti ◽  
...  
Keyword(s):  
Long Term Results ◽  
Long Term Outcomes ◽  
Mechanical Prosthesis ◽  
Actuarial Survival ◽  
Bentall Operation ◽  
Type A Aortic Dissection ◽  
Bentall Procedure ◽  
The Right

Abstract OBJECTIVES Data on the long-term results with the standard CarboSeal™ mechanical conduit used for the modified Bentall procedure are lacking as well as information on performance of the Valsalva CarboSeal™ conduit. METHODS We have analysed 208 recipients of a standard (n = 110) or a Valsalva (n = 98) CarboSeal™ conduit. The median age was 60 years and 90% were males; 35 (17%) had type A aortic dissection and 65 (30%) a bicuspid aortic valve. Data were retrospectively analysed and results were compared between the 2 conduit models. RESULTS Early mortality was 1.9%; the mean follow-up was 175 ± 95 for standard and 94 ± 51 months for Valsalva conduits (P &lt; 0.01). Actuarial survival was 86 ± 4%, 75 ± 6%, 59 ± 7% and 51 ± 9% at 5, 10, 15 and 20 years, respectively. There were 13 thromboembolic episodes with 3 deaths with an actuarial freedom of 98 ± 1%, 94 ± 2%, 90 ± 3% and 89 ± 4% at 5, 10, 15 and 20 years, respectively. Reoperation on the aortic root was performed in 9 patients for endocarditis (n = 8) and pseudoaneurysm at the right coronary button (n = 1) with an actuarial freedom of 97 ± 1%, 95 ± 2%, 92 ± 3% and 87 ± 4% at 5, 10, 15 and 20 years, respectively. There were no differences between the 2 conduit models in survival and major postoperative complications. CONCLUSIONS The CarboSeal™ conduit has shown gratifying overall performance up to 20 years and appears a valid option for a modified Bentall operation, when a mechanical prosthesis is indicated. Both CarboSeal™ conduit models provided not statistically different overall long-term results.

scholarly journals Long-Term Follow-Up After Bilioenteric Anastomosis for Benign Bile Duct Stricture

1996 ◽  
Vol 223 (6) ◽  
pp. 639-648 ◽  
Author(s):  
William H. Nealon ◽  
Fernando Urrutia
Keyword(s):  
Bile Duct ◽  
Bile Duct Stricture ◽  
Bilioenteric Anastomosis ◽  
Long Term Follow Up ◽  
Benign Bile Duct Stricture ◽  
Duct Stricture

scholarly journals Coronary Artery Bypass With Only In Situ Bilateral Internal Thoracic Arteries and Right Gastroepiploic Artery

Circulation ◽  
2001 ◽  
Vol 104 (suppl_1) ◽  
Author(s):  
Hiroshi Nishida ◽  
Yasuko Tomizawa ◽  
Masahiro Endo ◽  
Hitoshi Koyanagi ◽  
Hiroshi Kasanuki
Keyword(s):  
Patency Rate ◽  
Graft Patency ◽  
Left Ventricular ◽  
Long Term Results ◽  
Gastroepiploic Artery ◽  
Left Ventricular Ejection ◽  
Right Gastroepiploic Artery ◽  
The Right

Background With the rapid advance of catheter intervention, the direction taken by surgeons is not only to make conventional CABG less invasive but also to pursue better long-term results by using more arterial conduits. Methods and Results Between July 1989 and April 2000, 239 patients (218 men, 21 women) with a mean age of 59.7 (range 39 to 79) years underwent CABG with exclusive use of both internal thoracic arteries (ITAs) and the right gastroepiploic artery (RGEA). ITA grafts were harvested by using the skeletonization technique. Most patients (96%) had either triple-vessel or left main disease. Fifty percent of the patients were diabetic, and 16 were being treated with insulin. The left ventricular ejection fraction was ≤40% in 46 patients (19%). Eleven patients (5%) had chronic renal failure and were on hemodialysis. Follow-up was completed in 235 patients (98%). Postoperative follow-up averaged 43 (range 1 to 129) months. Sequential grafting was performed in 64 patients, and the mean number of anastomoses was 3.3. One patient (0.4%) died of mediastinitis on the 53rd postoperative day. Graft patency was confirmed angiographically in 230 patients (96%) 2 to 3 weeks after surgery. The patency rate was 97.1% for the left ITA, 99.6% for the right ITA, and 95.5% for the RGEA. Five-year actuarial survival rate was 92.9%, and the cardiac death-free rate was 97.8%. Conclusions Complete arterial grafting with both ITAs and RGEA was associated with minimal operative risk, a high early graft patency rate, and excellent long-term results.

Surgical reconstruction for unilateral iliac artery lesions in patients younger than 50 years

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Radak ◽  
Babic ◽  
Ilijevski ◽  
Jocic ◽  
Aleksic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Limb Salvage ◽  
Iliac Artery ◽  
Graft Patency ◽  
Long Term Results ◽  
Surgical Reconstruction ◽  
Safe Procedure ◽  
Term Survival

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

Long-Term Results of a Cementless Knee Prosthesis with a Metal-Backed Patellar Component: Clinical and Radiological Follow-Up with Histology from Retrieved Components

2003 ◽  
Vol 13 (4) ◽  
pp. 14 ◽  
Author(s):  
Mikael Sundfeldt ◽  
Carina B. Johansson ◽  
Lars Regner ◽  
Tomas Albrektsson ◽  
Lars V Carlsson
Keyword(s):  
Knee Prosthesis ◽  
Long Term Results ◽  
Patellar Component
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