biliary tract surgery
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2022 ◽  
Vol 2022 ◽  
pp. 1-7
Author(s):  
Dong Tan ◽  
Yafei Zhang

Objective. To compare the effect of choosing ERCP, OCBDE, and LCBDE for the treatment of patients with recurrent common bile duct stones after biliary tract surgery. Method. 115 patients with recurrent common bile duct stones after biliary surgery in our hospital were retrospectively analyzed and divided into three groups according to the procedure, 36 patients in the ERCP group, 38 patients in the OCBDE group, and 41 patients in the LCBDE group, and compared the efficacy, stress status, and immune status of the three groups. Result. The stone removal rates were 91.67%, 97.37%, and 97.56% in the ERCP, OCBDE, and LCBDE groups, respectively ( P > 0.05 ). There were statistical differences between the ERCP, OCBDE, and LCBDE groups in terms of operative time, postoperative recovery time of exhaustion, recovery time of defecation, recovery time of feeding, and hospitalization time ( P < 0.05 ). The postoperative complication rates were 8.33%, 10.53%, and 7.32% in the ERCP, OCBDE, and LCBDE groups, respectively ( P > 0.05 ). The recurrence rates within 1 year after surgery were 2.78%, 7.89%, and 2.44% in the ERCP, OCBDE, and LCBDE groups, respectively ( P > 0.05 ). Conclusion. ERCP has short operative time, short hospital stay, and rapid postoperative recovery. LCBDE has mild trauma, and OCBDE has a wide range of application. Each of the three procedures has its own advantages and shortcomings, and the most appropriate procedure should be selected on the basis of comprehensive evaluation.


Author(s):  
A. Dinakar Reddy ◽  
Anuroop Thota ◽  
Vanga Devi Harsha

Background: Bactibilia is detrimental to the outcomes of biliary tract surgery. The present study was undertaken to determine the microbial flora of bile and their significance to post-operative infectious complications and morbidity.Methods: A retrospective study of patients with biliopancreatic diseases who underwent surgery from Jan 2017 to March 2020 in a tertiary care hospital were analyzed. The samples were assessed for bile microbiological flora, and a search for their possible link with post-operative infectious complications and morbidity was carried out.Results: A total of 90 bile samples were assessed. The mean age of the study group was 51.8 SD-13.6 years with male predominance. Bactibilia was found in 39 cases (43.3%), mostly in patients with malignant diseases, older than 50 years and females. Escherichia coli was the most common organism. Post-operative infectious complications were seen in twenty cases, thirteen of them in bactibilia-associated patients, showing statistical significance. Statistical significance was found between the presence of pre-operative biliary stent and bactibilia and between diabetes mellitus and bactibilia. Nine out of 24 patients with comorbidities had post-operative infectious complications. No significant relationship was found between pre-operative jaundice and comorbidities with bactibilia. Conclusions: The present study showed a statistically significant relationship between the presence of pre-operative biliary stent and bactibilia and also the incidence of post-operative infectious complications and bactibilia. Microbiological analysis of bile is a valuable tool in prognosticating the post-operative complications, thereby guiding us to provide adequate therapy and helps to establish local antibiotic guidelines.


2021 ◽  
Vol 23 (3) ◽  
pp. 239-246
Author(s):  
Pavel N. Romashchenko ◽  
Nicolay A. Maistrenko ◽  
Arsen K. Aliev ◽  
Rustam K. Aliev

This study highlighted the main stages of the formation and development of surgery of bile ducts by the scientific school of Doctor of Medical Sciences, Honored Scientist of the Russian Soviet Federative Socialist Republic, Professor Sergey Petrovich Fedorov. The current state of this area of surgery and its prospects are also considered. The works of S.P. Fedorov and his students opened a new page in surgery of that time: surgical treatment of patients with liver and biliary tract diseases. The results of research of the last three decades are the subject of particular pride in the successful continuation of the work of the founder of hepatobiliary surgery in our country. The scientific search and relay of the achievements of the scientific school of Professor S.P. Fedorov were performed in numerous publications, such as in periodicals, monographs, manuals, and speeches in our country and abroad, in a cumulated form, and this is presented in dissertations. In the study of the peculiarities of housing and communal services, both fundamental and applied aspects of solving this social problem of modern society are being developed. After the death of Sergey Petrovich, 17 candidate and 5 doctoral dissertations on the problems of biliary tract surgery were defended in the clinic of S.P. Fedorov Faculty of Surgery of S.M. Kirov Military Medical Academy. After over the past years, more than 200 articles, four monographs and manuals were published, and many messages were made at scientific forums in our country and abroad.


2021 ◽  
Vol 32 (1) ◽  
pp. 57-63
Author(s):  
A. V. Vishnevsky

"A physician who finds a remedy that combines the advantages of ether and chloroform, without having their disadvantages, will be the BEST laparotomist of his time."


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Prakash Narayan ◽  
B Oyewole ◽  
A Mandal ◽  
A Belgaumkar ◽  
T Campbell-Smith

Abstract A 30-year-old male presented with a history of recurrent episodes of acute cholecystitis; first acute attack associated with fever and nausea was 18 months prior to this presentation, for which he was managed conservatively for acute cholecystitis with antibiotics and analgesia following an ultrasound that showed features of acute cholecystitis with no obvious gallstones. The patient had further episodes of acute cholecystitis with no signs of obstructive jaundice and subsequent ultrasound showed multiple small gallstones. Due to the severity of his symptoms, he was scheduled for a planned cholecystectomy. During surgery (right subcostal incision)- findings were that of a contracted gall bladder with dense adhesions, after careful dissection a fistulous tract between the appendix and gallbladder was identified along with a cholecystoduodenal fistula. An en-bloc cholecystectomy plus appendicectomy was performed with the duodenotomy repaired. On the first day post op there was approximately 300 ml of bilious effluent in drain, a white cell count-8.1 x 109 and hemoglobin -12.1 g/dL, Serum bilirubin-1.4mg/dL, ALP-104mg/dL. The second and third post-operative days were uneventful with minimal bile mixed serous fluid in drain respectively with no other complains, following which the drains were removed and patient discharged home. Biliary-enteric fistulae have been found in 0.9% of patients undergoing biliary tract surgery. The most common site of communication of the fistula is a cholecystoduodenal (70%), followed by cholecystocolic (10–20%), and the least common is the cholecystogastric fistula accounting for the remainder of cases. No case of cholecystoappendicular fistula has been reported so far.


Author(s):  
T. Sh. Morgoshiya

In this paper, important scientific achievements of S.P. Fedorov as a surgeon and organizer of health care were noted. Little-known facts from the life of the Professor S.P. Fedorov were covered. S.P. Fedorov is the author of over 120 scientific works. He is rightly called the father of russian bile duct surgery. The main directions of scientific research S.P. Fedorov was urinary and biliary tract surgery. He summarized extensive experience in widely known monographs and guides. An important merit of S.P. Fedorov was the organization of the surgical journal “New Surgical Archive”. He was the editor of the first edition of “Big medical encyclopedia”, edited the multivolume “Manual of Practical Surgery”. He created a large domestic surgical school, from which dozens of specialists, heads of surgical departments of medical universities in various cities of the USSR, graduated.


2019 ◽  
Vol 47 (10) ◽  
pp. 4872-4877
Author(s):  
Yong Zhou ◽  
Guo-qin Jiang ◽  
Ren-Gen Fan ◽  
Wen-Zhang Zha ◽  
Xu-dong Wu

Objective This study aimed to assess the safety and efficacy of left liver anatomical resection via the left vertical groove following intraoperative antegrade cholangioscopy (biliary exploration through the left hepatic duct orifice) in patients with left-sided hepatolithiasis (LSH) and previous biliary tract surgery. Methods Between January 2012 and January 2016, eligible patients with LSH (n = 28) who underwent left liver anatomical resection via the left vertical groove followed by intraoperative antegrade cholangioscopy, were referred to our hospital. Clinical results, such as the overall operative time, length of hospital stay, intraoperative complications, residual stones and postoperative bile leaks, were recorded and analyzed. Results No residual stones and bile leakage occurred in the patients. No patients experienced intraoperative complications or T-tube placement. The mean operative time was 135.1 ± 18.9 minutes. The mean postoperative duration of hospitalization was 7.8 ± 1.8 days. Conclusions Left liver anatomical resection via the left vertical groove combined with intraoperative antegrade cholangioscopy is a safe and useful method for patients with LSH and previous biliary tract surgery. This technique simplifies the operative procedure by avoiding dissection of the porta hepatis and subsequent choledochotomy.


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