scholarly journals Clinical application of laparoscopy combined with choledochoscopy in patients with bilioenteric anastomotic stricture with access via the jejunal loops

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110345
Author(s):  
Yi Zhu ◽  
Jinhai Li ◽  
Minjie Xie ◽  
Jing Jin ◽  
Jianying Lou
Keyword(s):  
Bile Duct ◽  
Anastomotic Stricture ◽  
Intrahepatic Bile Duct ◽  
Perioperative Period ◽  
Outcome Analysis ◽  
Term Outcome ◽  
Estimated Blood Loss ◽  
Intrahepatic Lithiasis ◽  
The Mean ◽  
Age Range

Objective Bilioenteric anastomotic stricture is a serious complication following choledochojejunostomy. Some patients develop intrahepatic lithiasis and biliary tract infection without dilation of the intrahepatic bile duct. The present study was performed to investigate the safety and efficacy of laparoscopy combined with choledochoscopy in patients with bilioenteric anastomotic stricture with access via the jejunal loops. Methods The data of 10 patients (7 men and 3 women; mean age, 60.8 ± 9.7 years; age range, 51–76 years) with potential bilioenteric anastomotic stricture without dilation of the intrahepatic bile duct from January 2015 to December 2019 were retrospectively reviewed. Results All 10 patients underwent surgery, and their clinical parameters were recorded. The mean surgery time was 181.5 ± 35.4 minutes, and the mean estimated blood loss was 32.0 ± 15.5 mL. No patients developed serious complications during the perioperative period. The short-term outcome analysis at 12 months indicated that the stenosis had been effectively dilated and that the liver function had improved. Conclusions The results of the present study demonstrated that laparoscopy combined with choledochoscopy with access via the jejunal loops is feasible in the treatment of bilioenteric anastomotic stricture and intrahepatic lithiasis.

scholarly journals Three Ports Laparoscopic Resection for Colorectal Cancer: A Step on Refining of Reduced Port Surgery

ISRN Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Anwar Tawfik Amin ◽  
Tarek M. Elsaba ◽  
Gamal Amira
Keyword(s):  
Colorectal Cancer ◽  
Lymph Nodes ◽  
Colorectal Resection ◽  
Intraoperative Complications ◽  
Perioperative Period ◽  
Reduced Port Surgery ◽  
Estimated Blood Loss ◽  
The Mean ◽  
Reduced Port ◽  
Mean Time

Background. Reduced port surgery (RPS) is becoming increasingly popular for some surgeries. However, the application of RPS to the field of colectomy is still underdeveloped. Patients and Methods. In this series, we evaluated the outcome of laparoscopic colorectal resection using 3 ports technique (10 mm umbilical port plus another two ports of either 5 or 10 mm) for twenty-four cases of colorectal cancer as a step for refining of RPS. Results. The mean estimated blood loss was 70 mL (40–90 mL). No major intraoperative complications have been encountered. The mean time for passing flatus after surgery was 36 hours (12–48 hrs). The mean time for oral fluid intake was 36 hours and for semisolid food was 48 hours. The mean hospital stay was 5 days (4–7 days). The perioperative period passed without events. All cases had free surgical margins. The mean number of retrieved lymph nodes was 14 lymph nodes (5–23). Conclusion. Three ports laparoscopy assisted colorectal surgeries looks to be safe, effective and has cosmetic advantages. The procedure could maintain the oncologic principles of cancer surgery. It’s a step on the way of refining of reduced port surgery.

Healthcare utilization and costs associated with GI cancers in the United States.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 361-361
Author(s):  
Aileen Deng ◽  
Atrayee Basu Mallick
Keyword(s):  
Bile Duct ◽  
Length Of Stay ◽  
Healthcare Utilization ◽  
Pancreas Cancer ◽  
Hospital Admissions ◽  
Intrahepatic Bile Duct ◽  
Hospital Charges ◽  
Gi Cancer ◽  
The Mean ◽  
Gi Cancers

361 Background: In 2009, adults had 4.7 million cancer-related hospitalizations. Adult hospital stays with cancer identified as the principal diagnosis cost $20.1 billion and accounted for 6% of adult inpatient hospital costs. GI cancer-related healthcare utilization has not been well-defined. The aim of this study was to evaluate the trends in the incidence and costs of GI cancer-related hospital admissions in the U.S. Methods: We reviewed the National Inpatient Sample Database (NIS) from 1997-2014. All patients with principle discharge diagnoses of esophageal, stomach, colon, rectum and anus, liver and intrahepatic bile duct and pancreas cancer were analyzed. Temporal trends in the number of hospital admissions, length of stay, hospitalization cost and mortality rates were obtained by HCUPnet. Results: GI cancer-related hospital admissions decreased from 230,537 in 1997 to 221,220 in 2014. Although the number of hospital admissions decreased for esophageal (12,157 to 11,885), stomach (23,528 to 21,800), colon (110,939 to 90,135), rectum and anus cancer (43,807 to 40,160), it has increased for liver and intrahepatic bile duct (11,243 to 21,775, p < 0.001) and pancreas cancer (28,862 to 35,465, p < 0.001). While the mean length of stay decreased from 9.6 days in 1997 to 7.6 days in 2014, the mean hospital charges per patient (adjusted for inflation) increased 127% from $34,747 in 1997 to $78,742 in 2014. The highest increase in mean hospital charges per patient were in liver and intrahepatic bile duct ($27,128 to $74,619 (175%), p < 0.001), rectum and anus ($32,566 to $80,789 (148%), p < 0.001) and pancreas cancer ($33,562 to $75,981 (126%), p < 0.001). Conclusions: GI cancer-related hospital admissions decreased from 1997 to 2014. Despite decrease in the mean length of hospital stay, the costs of hospitalizations have increased substantially, especially in liver and intrahepatic bile duct, rectum and anus and pancreas cancer. Our study suggests that shorter length of stay alone has not reduced costs of hospitalizations in GI cancers. There remains a growing need to understand healthcare costs and to develop effective value-based interventions in GI cancer-related hospital admissions.

Minimally Invasive Atlantoaxial Fusion

Neurosurgery ◽  
2010 ◽  
Vol 66 (suppl_3) ◽  
pp. A193-A197 ◽  
Author(s):  
Langston T. Holly ◽  
Robert E. Isaacs ◽  
Anthony K. Frempong-Boadu
Keyword(s):  
Minimally Invasive ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Long Term Results ◽  
Os Odontoideum ◽  
Tubular Retractor ◽  
Estimated Blood Loss ◽  
Atlantoaxial Fixation ◽  
The Mean ◽  
Age Range

Abstract BACKGROUND C1–C2 fusion has significantly advanced from predominantly wiring/cable modalities to more biomechanically stable screw-rod techniques. Minimally invasive surgical techniques represents the most recent modification of atlantoaxial fixation. The indications, rationale, and surgical technique of this novel procedure are described. METHODS Six patients requiring C1–C2 fusion (5 type II odontoid fractures and 1 os odontoideum) underwent minimally invasive C1–C2 fusion over a 2-year period. The cohort consisted of 5 men and 1 woman with a mean age of 51 years (age range, 39–64 y). All 6 patients underwent bilateral segmental atlantoaxial fixation using an expandable tubular retractor. RESULTS The mean follow-up time was 32 months (age range, 24–46 mo) There were no intraoperative complications, and the mean estimated blood loss was 100 mL. Solid fusion was achieved in all 6 patients, without pathological motion on dynamic studies. Postoperative computed tomographic images showed no hardware malposition in the scanned patients (4 of the 6 patients). CONCLUSIONS Placement of C1 and C2 instrumentation using minimally invasive techniques is technically feasible. Because the instrumentation and the means of obtaining arthrodesis do not differ substantively from the standard approach, we would not anticipate long-term results to be different from those of an open procedure, apart from the approach-related morbidity.

scholarly journals ASSESSMENT OF NORMAL LIVER PORTAL VEIN AND COMMON BILE DUCT USING DOPPLER ULTRASONOGRAPHY

2018 ◽  
Vol 6 (11) ◽  
pp. 384-390
Author(s):  
Ashraf Mustafa ◽  
Mohamad Elfadi ◽  
Mohamed Gar Elnabi ◽  
Mona Ahmed ◽  
Abdelmoneim Sulieman
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Portal Vein ◽  
Doppler Ultrasonography ◽  
Normal Liver ◽  
Vital Role ◽  
Hepatic Portal Vein ◽  
The Mean ◽  
Hepatic Portal ◽  
Age Range

Ultrasound imaging plays a vital role in the evaluation of many tissue or organs disorder. The objective of this study was to evaluate normal liver portal vein (PV) and common bile duct (CBD) using Doppler Ultrasonography (Duplex).  Two ultrasound machines equipped with linear and curvilinear probes used in this study (Toshiba and ALOKA, Japan) during the period from 1st April 2016 to 30th July 2017. A total of 300 (48% males; 52% females) healthy subjects were participated in this study with age range from 16-22 years old. The mean intrahepatic portal vein velocity is between (14.98±1.92) cm/s; and the diameter range is (9.76±2.09). In frequency distribution of the extrahepatic portal vein velocity values, the majority is in the range (14-15 cm/s) which is equal to the half of the examined subjects. The extra hepatic PV versus intra hepatic portal vein velocities was found to be more in  normal liver, where the velocity increased  by 0.31 cm/s inside the liver per each cm/s of the extrahepatic for the normal liver.

Laparoscopic surgery for lithiasis local choledochal dilatation diagnosed a cyst: Case report and literature reviews

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Tuấn Anh Đỗ ◽  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Frozen Section ◽  
Extrahepatic Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Proper Diagnosis ◽  
The Common

Abstract Biliary dilation is common in clinical practice and originates from many pathologies; among them, choledocholithiasis, chronic pancreatitis and periampullary diverticula (PAD) are the most common. Popular signs of cholelithiasis is diffuse dilatation of the intra- and extrahepatic bile duct, however, in some cases, it might be local dilatation of the common bile duct without intrahepatic bile duct dilatation. The long-term outcome is favorable, however, it is necessary to rule out other causes such as choledochal cyst, pancreatitis by frozen section in order to have a proper diagnosis and treatment. We describe a 19-year-old female patient with local dilation of the common bile duct due to choledocholithiasis that was operated laparoscopically with success. Key word: Local common bile duct dilation, gallstones, choledochal cyst, laparoscopy. Tóm tắt Giãn đường mật là một hình thái tổn thương hay gặp trên lâm sàng, do nhiều bệnh lý khác nhau, hay gặp nhất là sỏi ống mật chủ (OMC), viêm tụy mạn và túi thừa Vater 1. Dấu hiệu phổ biến của sỏi mật là giãn đường mật trong và ngoài gan lan tỏa, tuy nhiên có trường hợp OMC giãn đơn thuần không kèm theo giãn đường mật trong gan. Tiên lượng của bệnh này là tốt, tuy nhiên cần loại trừ các nguyên nhân như nang OMC, viêm tụy bằng sinh thiết tức thì để có chẩn đoán và điều trị phù hợp nhất. Chúng tôi xin báo cáo một trường hợp người bệnh (NB) nữ, 19 tuổi mắc sỏi mật gây giãn OMC khu trú dạng nang được phẫu thuật nội soi thành công. Từ khóa: Giãn đường mật khu trú, sỏi mật, nang ống mật chủ, phẫu thuật nội soi.

Localized Intrahepatic Bile Duct Dilatation without a Visible Mass or Stone as depicted on CT Images: Findings of Malignancy Prediction

2008 ◽  
Vol 59 (3) ◽  
pp. 163
Author(s):  
Ju Wan Choi ◽  
Gab Chul Kim ◽  
Han Young Jeong ◽  
Hui Joong Lee ◽  
Jae Hyuck Lee ◽  
...  
Keyword(s):  
Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Ct Images ◽  
Bile Duct Dilatation ◽  
Duct Dilatation

Primary Calvarial Ewing Sarcoma: A Case Series

2021 ◽  
Author(s):  
Sandeep Mohindra ◽  
Manjul Tripathi ◽  
Aman Batish ◽  
Ankur Kapoor ◽  
Ninad Ramesh Patil ◽  
...  
Keyword(s):  
Ewing Sarcoma ◽  
Tumor Resection ◽  
Case Series ◽  
Radical Excision ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Intradural Tumor ◽  
Age Range

Abstract Background Calvarial Ewing tumor is a relatively rare differential among bony neoplasms. We present our experience of managing primary calvarial Ewing sarcoma (EWS), highlighting their clinical and radiological findings. Method In a retrospective analysis, we evaluated our 12-year database for pathologically proven EWS. A literature search was conducted for the comparative presentation and update on the management and outcome. Result From January 2008 to December 2020, we managed eight patients (male:female = 5:3; age range 6 months to 19 years, mean 11.5 years) harboring primary calvarial EWS. All cases underwent wide local excision; two patients required intradural tumor resection, while one required rotation flap for scalp reconstruction. Mean hospital stay was 8 days. All patients received adjuvant chemo- and radiotherapy. Three patients remained asymptomatic at 5 years of follow-up, while two patients died. Conclusion Primary calvarial EWS is a rare entity. It usually affects patients in the first two decades of life. These tumors can be purely intracranial, causing raised intracranial pressure symptoms, which may exhibit rapidly enlarging subgaleal tumors with only cosmetic deformities or symptoms of both. Radical excision followed by adjuvant therapy may offer a favorable long-term outcome.

scholarly journals Cognitive Performance and Its Associations with Dental Caries: Results from the Dental, Oral, Medical Epidemiological (DOME) Records-Based Nationwide Study

Biology ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 178
Author(s):  
Itzhak Abramovitz ◽  
Avraham Zini ◽  
Matan Atzmoni ◽  
Ron Kedem ◽  
Dorit Zur ◽  
...  
Keyword(s):  
Dental Caries ◽  
Cognitive Performance ◽  
Odds Ratio ◽  
Allocation Of Resources ◽  
Cross Sectional ◽  
Intelligence Score ◽  
Health Related ◽  
The Mean ◽  
Nationally Representative ◽  
Age Range

Relatively few studies have analyzed the association between cognitive performance and dental status. This study aimed to analyze the association between cognitive performance and dental caries. Included were data from the dental, oral, medical epidemiological (DOME) study; cross-sectional records-based research, which integrated large socio-demographic, medical, and dental databases of a nationally representative sample of young to middle-aged military personnel (N = 131,927, mean age: 21.8 ± 5.9 years, age range: 18–50). The cognitive function of draftees is routinely measured at age 17 years using a battery of psychometric tests termed general intelligence score (GIS). The mean number of decayed teeth exhibited a gradient trend from the lowest (3.14 ± 3.58) to the highest GIS category (1.45 ± 2.19) (odds ratio (OR) lowest versus highest = 5.36 (5.06–5.68), p < 0.001). A similar trend was noted for the other dental parameters. The associations between GIS and decayed teeth persisted even after adjusting for socio-demographic parameters and health-related habits. The adjustments attenuated the OR but did not eliminate it (OR lowest versus highest = 3.75 (3.38–4.16)). The study demonstrates an association between cognitive performance and caries, independent of the socio-demographic and health-related habits that were analyzed. Better allocation of resources is recommended, focusing on populations with impaired cognitive performance in need of dental care.

scholarly journals Adolescents’ Bipolar Experiences and Suicide Risk: Well-Being and Mental Health Difficulties as Mediators

2021 ◽  
Vol 18 (6) ◽  
pp. 3024
Author(s):  
Ascensión Fumero ◽  
Rosario J. Marrero ◽  
Alicia Pérez-Albéniz ◽  
Eduardo Fonseca-Pedrero
Keyword(s):  
Behavioral Problems ◽  
Suicide Risk ◽  
Well Being ◽  
Self Report ◽  
Emotional Difficulties ◽  
Subjective Well Being ◽  
Mediation Analyses ◽  
Mental Health Difficulties ◽  
The Mean ◽  
Age Range

Bipolar disorder is usually accompanied by a high suicide risk. The main aim was to identify the risk and protective factors involved in suicide risk in adolescents with bipolar experiences. Of a total of 1506 adolescents, 467 (31%) were included in the group reporting bipolar experiences or symptoms, 214 males (45.8%) and 253 (54.2%) females. The mean age was 16.22 (SD = 1.36), with the age range between 14 and 19. Suicide risk, behavioral and emotional difficulties, prosocial capacities, well-being, and bipolar experiences were assessed through self-report. Mediation analyses, taking gender as a moderator and controlling age as a covariate, were applied to estimate suicide risk. The results indicated that the effect of bipolar experiences on suicide risk is mediated by behavioral and emotional difficulties rather than by prosocial behavior and subjective well-being. Specifically, emotional problems, problems with peers, behavior problems, and difficulties associated with hyperactivity were the most important variables. This relationship was not modulated by gender. However, the indirect effects of some mediators varied according to gender. These results support the development of suicide risk prevention strategies focused on reducing emotional difficulties, behavioral problems, and difficulties in relationships with others.

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