scholarly journals Laparoscopic Resection of Cholecystocolic Fistula and Subtotal Cholecystectomy by Tri-Staple in a Type V Mirizzi Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Fahri Yetişir ◽  
Akgün Ebru Şarer ◽  
Hasan Zafer Acar ◽  
Omer Parlak ◽  
Basar Basaran ◽  
...  
Keyword(s):  
Laparoscopic Resection ◽  
Normal Liver ◽  
Liver Function Tests ◽  
Mirizzi Syndrome ◽  
Intermittent Fever ◽  
Subtotal Cholecystectomy ◽  
Type V ◽  
First Time ◽  
Cholecystocolic Fistula

The Mirizzi syndrome (MS) is an impacted stone in the cystic duct or Hartmann’s pouch that mechanically obstructs the common bile duct (CBD). We would like to report laparoscopic subtotal cholecystectomy (SC) and resection of cholecystocolic fistula by the help of Tri-Staple™in a case with type V MS and cholecystocolic fistula, for first time in the literature. A 24-year-old man was admitted to emergency department with the complaint of abdominal pain, intermittent fever, jaundice, and diarrhea. Two months ago with the same complaint, ERCP was performed. Laparoscopic resection of cholecystocolic fistula and subtotal cholecystectomy were performed by the help of Tri-Staple. At the eight-month follow-up, he was symptom-free with normal liver function tests. In a patient with type V MS and cholecystocolic fistula, laparoscopic resection of cholecystocolic fistula and SC can be performed by using Tri-Staple safely.

scholarly journals Laparoscopic Treatment of Type III Mirizzi Syndrome by T-Tube Drainage

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Fahri Yetışır ◽  
Akgün Ebru Şarer ◽  
H. Zafer Acar ◽  
Yılmaz Polat ◽  
Gokhan Osmanoglu ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Normal Liver ◽  
Liver Function Tests ◽  
Mirizzi Syndrome ◽  
Laparoscopic Treatment ◽  
Tube Drainage ◽  
Type Iii ◽  
T Tube ◽  
Impacted Stone

Mirizzi syndrome (MS) is an impacted stone in the cystic duct or Hartmann’s pouch that mechanically obstructs the common bile duct. We would like to report laparoscopic treatment of type III MS. A 75-year-old man was admitted with the complaint of abdominal pain and jaundice. The patient was accepted as MS type III according to radiological imaging and intraoperative view. Laparoscopic subtotal cholecystectomy, extraction of impacted stone by opening anterior surface of dilated cystic duct and choledochus, and repair of this opening by using the remaining part of gallbladder over the T-tube drainage were performed in a patient with type III MS. Application of reinforcement suture over stump was done in light of the checking with oliclinomel N4 injection trough the T-tube. At the 18-month follow-up, he was symptom-free with normal liver function tests.

scholarly journals Subtotal Cholecystectomy

HPB Surgery ◽  
1996 ◽  
Vol 9 (3) ◽  
pp. 133-136 ◽  
Author(s):  
C. Katsohis ◽  
J. Prousalidis ◽  
E. Tzardinoglou ◽  
A. Michalopoulos ◽  
E. Fahandidis ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Mirizzi Syndrome ◽  
Syndrome Type ◽  
Subtotal Cholecystectomy ◽  
Standard Operation ◽  
Definitive Operation ◽  
Follow Up Studies ◽  
The Common ◽  
Severe Fibrosis

Subtotal cholecystectomy has been carried out in 34 patients from 1972 to 1992. In the same period 1620 total cholecystectomies were performed. The indications were severe inflammation and/or severe fibrosis in 31 patients, and Mirizzi syndrome type in 3 patients. The morbidity was insignificant, but one patient died, due to severe sepsis. In follow up studies ranging from 6 months to 9 years, there was one patient with retained stones in the common bile duct. No other post cholecystectomy sequelae were noticed in the remaining 32 patients. Subtotal cholecystectomy is a safe, feasible and definitive operation in patients for whom the standard operation could be dangerous. This operation is less burdensome to the patient, and is accompanied by fewer complications than ordinary cholecystostomy.

scholarly journals Laproscopic cholecystectomy an analysis of 787 cases with reference to predictors on level of difficulty and the influence of early conversion to reduce IBDI and other complications

2017 ◽  
Vol 4 (9) ◽  
pp. 3034
Author(s):  
Suresh Kalyanasundar ◽  
Ashok Bhatnagar
Keyword(s):  
Average Rate ◽  
Normal Liver ◽  
Liver Function Tests ◽  
Normal Liver Function ◽  
Careful Planning ◽  
Subtotal Cholecystectomy ◽  
History Of ◽  
Elective Surgical Procedure ◽  
The Right ◽  
Iatrogenic Bile Duct Injury

Background: Laparoscopic cholecystectomy is the most common major elective surgical procedure all over the globe. The complications associated with the procedure also become important for surgeons to manage well, strive to prevent them from occurring.Methods: The study was prospective and involved 787 cases in a period of 60 months starting from January 2013 to January 2017 which were diagnosed to have cholelithiasis sonologically, features to suggest acute cholecystitis and a normal CBD, with normal liver function tests, clinical examination did not reveal a palpable lump in the right hypochondrium and the history of acute pain was less than 72 hours.Results: The total number of cases 787 and 127 (16%) there were complications of which 0.2 % was biliary injuries and rest were nonbiliary. IBDI occurred in 02cases in this series which is 0.25% and 125 cases there was Nonbiliary complications. The incidence of iatrogenic bile duct injury (IBDI) in LC is 0.4%- 1.3 % compared to 0.2%- 0.3% for OC. 108 cases were converted to an open procedure (13%) and the average rate globally 5 % to 10%.Conclusions: LC should be planned in all cases of cholelithiasis, it is helpful to preoperatively and operatively grade the cases for the operative ease and cases which fall in the category of extreme it is better to resort to conversion early or even a planned open surgery. The low complication rate especially biliary is because of a careful planning preoperatively and operatively as per prediction scales which we used, a low tolerance to conversion and because of adopting the practice of subtotal cholecystectomy.

scholarly journals A potential pathogenic role of interleukin-6 in a child with ANCA-negative pauci-immune crescentic glomerulonephritis: case report and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ling Hou ◽  
Lu Yin ◽  
Yubin Wu ◽  
Chengguang Zhao ◽  
Yue Du
Keyword(s):  
Crescentic Glomerulonephritis ◽  
Pulse Therapy ◽  
Methylprednisolone Pulse Therapy ◽  
Intermittent Fever ◽  
Case Presentation ◽  
Methylprednisolone Pulse ◽  
Type V ◽  
Antibody Tests

Abstract Background Crescentic glomerulonephritis is a disease characterized by severe glomerular injuries that is classified into five different pathological types. Patients with type V disease have pauci-immune crescentic glomerulonephritis (PICGN) that is negative for anti-neutrophil cytoplasmic autoantibodies (ANCAs). There are limited clinical data on the manifestations, treatment, and prognosis of type V crescentic glomerulonephritis, especially in children. Case presentation A 13-year-old girl who had an intermittent fever for more than 10 months was admitted to our hospital. She had no gross hematuria, oliguria, edema, or hypertension, but further tests indicated a decreased glomerular filtration rate, hematuria, proteinuria, and an elevated level of IL-6. The antinuclear antibody spectrum test was positive at 1:1000, and the ANCA and anti-glomerular basement membrane antibody tests were negative. A renal biopsy confirmed the diagnosis of ANCA-negative PICGN. We administered methylprednisolone pulse therapy with intravenous cyclophosphamide and oral mycophenolate mofetil. At the 3-month follow-up, her urine protein level was significantly lower, and her serum creatinine level was in the normal range. Conclusions Fever may be an extrarenal manifestation of ANCA-negative PICGN, and IL-6 may play a role in the pathogenesis of this disease. Early methylprednisolone pulse therapy with an immunosuppressant may reduce symptoms and improve prognosis.

Hepatic abnormalities identified by staging MRI and accuracy of MRI of patients with uveal melanoma

2018 ◽  
Vol 103 (9) ◽  
pp. 1266-1271 ◽  
Author(s):  
Jasmine H Francis ◽  
Federica Catalanotti ◽  
Jonathan Landa ◽  
Christopher A Barker ◽  
Alexander N Shoushtari ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Normal Liver ◽  
Liver Function Tests ◽  
Metastatic Lesion ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Single Centre ◽  
First Finding ◽  
Institutional Review

BackgroundMetastases to the liver are often the first finding in patients with uveal melanoma with extraocular disease, but little has been published on the utility of staging MRI at initial diagnosis. We aimed to evaluate the proportion of abnormal hepatic findings on baseline MRI and accuracy of MRI in patients with newly diagnosed uveal melanoma.MethodsThis is a single-centre, retrospective, institutional review board-approved study of 145 consecutive patients diagnosed with uveal melanoma, at Memorial Sloan Kettering Cancer Center between 2004 and 2016, who had staging MRI within 1 month of diagnosis. Scans were classified as normal or abnormal, and further distinguished as abnormal non-metastatic, uncharacterisable lesions and suspicious for metastasis. Where available, follow-up MRI (at ~1 year) or biopsies were reviewed.ResultsMRI in 145 patients revealed 62% (90) with abnormal hepatic findings; out of these 87% (78) had non-metastatic benign findings, 6.7% (6) had unclassifiable lesions and 6.7% (6) were suspicious for metastasis (6). Abnormal non-metastatic findings included 72 focal (36 solitary and 36 multiple) and 12 diffuse lesions. Lesions suspicious for metastases were found in 6 of 145 patients (4%), despite normal liver function tests. Of these, five had confirmed liver metastases and one patient had a stable, presumed non-metastatic lesion on follow-up. In this study, the sensitivity and specificity of staging MRI for all findings were 83.3% (95% CI 35.9 to 99.6) and 99.0% (95% CI 94.3 to 99.9), respectively.ConclusionStaging MRI of patients with newly diagnosed uveal melanoma accurately identified early metastases. Furthermore, imaging revealed hepatic abnormalities in the majority of patients, although as expected few of these represented metastatic disease.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

RESULTS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE FOR CHALAZION TREATMENT

2011 ◽  
pp. 100-104
Author(s):  
Thi Thu Nguyen ◽  
Viet Hien Vo ◽  
Thi Em Do
Keyword(s):  
Success Rate ◽  
Key Words ◽  
Triamcinolone Acetonide ◽  
Lower Eyelid ◽  
Upper Eyelid ◽  
Interventional Trial ◽  
The Mean ◽  
First Time

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.

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