Choledochostomy: Surgical formation of an opening (stoma) into the COMMON BILE DUCT for drainage or for direct communication with a site in the small intestine, primarily the DUODENUM or JEJUNUM.Hemobilia: Hemorrhage in or through the BILIARY TRACT due to trauma, inflammation, CHOLELITHIASIS, vascular disease, or neoplasms.Hepatitis, Infectious Canine: A contagious disease caused by canine adenovirus (ADENOVIRUSES, CANINE) infecting the LIVER, the EYE, the KIDNEY, and other organs in dogs, other canids, and bears. Symptoms include FEVER; EDEMA; VOMITING; and DIARRHEA.Laparoscopy: A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy.Dog Diseases: Diseases of the domestic dog (Canis familiaris). This term does not include diseases of wild dogs, WOLVES; FOXES; and other Canidae for which the heading CARNIVORA is used.Cholelithiasis: Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS).Surgical Procedures, Minimally Invasive: Procedures that avoid use of open, invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device.Cholecystectomy: Surgical removal of the GALLBLADDER.Gallstones: Solid crystalline precipitates in the BILIARY TRACT, usually formed in the GALLBLADDER, resulting in the condition of CHOLELITHIASIS. Gallstones, derived from the BILE, consist mainly of calcium, cholesterol, or bilirubin.ConnecticutGeneral Surgery: A specialty in which manual or operative procedures are used in the treatment of disease, injuries, or deformities.Internship and Residency: Programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities.Hernia, Hiatal: STOMACH herniation located at or near the diaphragmatic opening for the ESOPHAGUS, the esophageal hiatus.Abdominal Wall: The outer margins of the ABDOMEN, extending from the osteocartilaginous thoracic cage to the PELVIS. Though its major part is muscular, the abdominal wall consists of at least seven layers: the SKIN, subcutaneous fat, deep FASCIA; ABDOMINAL MUSCLES, transversalis fascia, extraperitoneal fat, and the parietal PERITONEUM.Schools, Medical: Educational institutions for individuals specializing in the field of medicine.Faculty, Medical: The teaching staff and members of the administrative staff having academic rank in a medical school.Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another.Living Donors: Non-cadaveric providers of organs for transplant to related or non-related recipients.Alagille Syndrome: A multisystem disorder that is characterized by aplasia of intrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC), and malformations in the cardiovascular system, the eyes, the vertebral column, and the facies. Major clinical features include JAUNDICE, and congenital heart disease with peripheral PULMONARY STENOSIS. Alagille syndrome may result from heterogeneous gene mutations, including mutations in JAG1 on CHROMOSOME 20 (Type 1) and NOTCH2 on CHROMOSOME 1 (Type 2).Biliary Atresia: Progressive destruction or the absence of all or part of the extrahepatic BILE DUCTS, resulting in the complete obstruction of BILE flow. Usually, biliary atresia is found in infants and accounts for one third of the neonatal cholestatic JAUNDICE.Tissue and Organ Procurement: The administrative procedures involved with acquiring TISSUES or organs for TRANSPLANTATION through various programs, systems, or organizations. These procedures include obtaining consent from TISSUE DONORS and arranging for transportation of donated tissues and organs, after TISSUE HARVESTING, to HOSPITALS for processing and transplantation.Tissue Donors: Individuals supplying living tissue, organs, cells, blood or blood components for transfer or transplantation to histocompatible recipients.alpha 1-Antitrypsin Deficiency: Deficiency of the protease inhibitor ALPHA 1-ANTITRYPSIN that manifests primarily as PULMONARY EMPHYSEMA and LIVER CIRRHOSIS.Child Advocacy: Promotion and protection of the rights of children; frequently through a legal process.Bibliometrics: The use of statistical methods in the analysis of a body of literature to reveal the historical development of subject fields and patterns of authorship, publication, and use. Formerly called statistical bibliography. (from The ALA Glossary of Library and Information Science, 1983)Publications: Copies of a work or document distributed to the public by sale, rental, lease, or lending. (From ALA Glossary of Library and Information Science, 1983, p181)Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing.Research: Critical and exhaustive investigation or experimentation, having for its aim the discovery of new facts and their correct interpretation, the revision of accepted conclusions, theories, or laws in the light of newly discovered facts, or the practical application of such new or revised conclusions, theories, or laws. (Webster, 3d ed)Encephalitis Virus, Western Equine: A species of ALPHAVIRUS that is the etiologic agent of encephalomyelitis in humans and equines in the United States, southern Canada, and parts of South America.Biomedical Research: Research that involves the application of the natural sciences, especially biology and physiology, to medicine.Dictionaries, MedicalDictionaries as Topic: Lists of words, usually in alphabetical order, giving information about form, pronunciation, etymology, grammar, and meaning.Dictionaries, ChemicalDictionaryTerminology as Topic: The terms, expressions, designations, or symbols used in a particular science, discipline, or specialized subject area.Dictionaries, PharmaceuticConfidentiality: The privacy of information and its protection against unauthorized disclosure.Nurses: Professionals qualified by graduation from an accredited school of nursing and by passage of a national licensing examination to practice nursing. They provide services to patients requiring assistance in recovering or maintaining their physical or mental health.Maintenance: The upkeep of property or equipment.Trust: Confidence in or reliance on a person or thing.Nurse Practitioners: Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician.Nursing Staff, Hospital: Personnel who provide nursing service to patients in a hospital.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Weight Gain: Increase in BODY WEIGHT over existing weight.Nurse Clinicians: Registered nurses who hold Master's degrees in nursing with an emphasis in clinical nursing and who function independently in coordinating plans for patient care.Cholecystectomy, Laparoscopic: Excision of the gallbladder through an abdominal incision using a laparoscope.Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1.Nurse-Patient Relations: Interaction between the patient and nurse.Anaplasma: A genus of gram-negative bacteria whose organisms are obligate parasites of vertebrates. Species are transmitted by arthropod vectors with the host range limited to ruminants. Anaplasma marginale is the most pathogenic species and is the causative agent of severe bovine anaplasmosis.Anaplasmosis: A disease of cattle caused by parasitization of the red blood cells by bacteria of the genus ANAPLASMA.Tick Infestations: Infestations with soft-bodied (Argasidae) or hard-bodied (Ixodidae) ticks.IraqAnaplasma phagocytophilum: A species of gram-negative bacteria in the genus ANAPLASMA, family ANAPLASMATACEAE, formerly called Ehrlichia phagocytophila or Ehrlichia equi. This organism is tick-borne (IXODES) and causes disease in horses and sheep. In humans, it causes human granulocytic EHRLICHIOSIS.Ticks: Blood-sucking acarid parasites of the order Ixodida comprising two families: the softbacked ticks (ARGASIDAE) and hardbacked ticks (IXODIDAE). Ticks are larger than their relatives, the MITES. They penetrate the skin of their host by means of highly specialized, hooked mouth parts and feed on its blood. Ticks attack all groups of terrestrial vertebrates. In humans they are responsible for many TICK-BORNE DISEASES, including the transmission of ROCKY MOUNTAIN SPOTTED FEVER; TULAREMIA; BABESIOSIS; AFRICAN SWINE FEVER; and RELAPSING FEVER. (From Barnes, Invertebrate Zoology, 5th ed, pp543-44)Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals.

The predictive value of transabdominal ultrasonography in the diagnosis of biliary tract complications after orthotopic liver transplantation. (1/81)

BACKGROUND: In transplant recipients with choledococholedocostomy (CDCD), endoscopic retrograde cholangiopancreatography (ERCP) remains the gold standard for the diagnosis of biliary leak or strictures. Transabdominal ultrasonography (TAUS) has been used to screen patients with suspected biliary tract complications, prior to ERCP, although the clinical effectiveness remains unclear. AIMS: To assess the predictive value of TAUS in the diagnosis of biliary tract complications after liver transplantation. METHODS: 144 consecutive ERCP and corresponding ultrasonogram reports performed over a 67 month period in 79 patients after liver transplantation were analysed retrospectively. RESULTS: 77 ERCP patients had both a TAUS and a successful ERCP. Biliary tract abnormalities were found at TAUS in 49 (64%) of the 77 patients. TAUS had an overall sensitivity of 77%, and specificity of 67%, with positive and negative predictive values of 26% and 95% respectively, when adjusted for the prevalence rate of biliary complications after liver transplantation of 12.8% in our population. The use of bile duct calibre as sole criterion for an abnormal scan improved the specificity (76%) and with a corresponding reduction in sensitivity (66%). The risk of false negative TAUS was similar in both the early and late post-transplant periods. CONCLUSIONS: A normal TAUS after liver transplantation with CDCD makes the presence of biliary complications unlikely.  (+info)

Results of choledochojejunostomy in the treatment of biliary complications after liver transplantation in the era of nonsurgical therapies. (2/81)

Advances in radiological and endoscopic techniques have allowed many biliary complications after orthotopic liver transplantation (OLT) to be managed without surgery. The influence of nonsurgical management on the outcome of patients requiring surgical revision has not been addressed. We reviewed our 10-year experience (October 1988 to January 1998) of Roux-en-Y choledochojejunostomy (CDJ) to treat biliary complications after OLT. Forty-six patients underwent CDJ for biliary complications (32 men, 14 women; age, 22 to 65 years; median, 60 years). Biliary reconstruction at the time of OLT was duct to duct in 41 patients, primary CDJ in 3 patients, and gall bladder conduit in 2 patients. T-tubes were used only in patients with gallbladder conduit. The indication for CDJ was biliary leak (23 patients), stricture (20 patients), biliary stones (2 patients), and biliary sludge (1 patient). Two patients (4.3%) had associated hepatic artery thrombosis. The bile leaks were diagnosed at a median of 29 days post-OLT (range, 2 to 65 days) and strictures at a median of 2 years (range, 33 days to 6.5 years) post-OLT. Before surgery, 25 patients (54%) underwent an attempt at radiological or endoscopic therapeutic intervention that failed. Median follow-up was 5 years (range, 9 months to 10 years). Early complications occurred in 12 patients (26%); the most common was chest infection (4 patients). There were 3 perioperative deaths (6%); 1 death was directly related to surgery. Late complications, mainly anastomotic strictures, occurred in 10 patients (22%), half of which were successfully treated by biliary balloon dilatation. The complication rate post-CDJ was less in those who underwent a failed nonsurgical approach than those proceeding straight to surgery (9 of 25 patients; 36% v 13 of 21 patients; 62%; P =.21, not significant). The procedure-related mortality for surgical revision of biliary complications after OLT is low, but early and late complications are common. A failed attempt at nonsurgical management does not increase the complications of reconstructive surgery. Strictures after CDJ should be considered for biliary balloon dilatation.  (+info)

Internal biliary stenting in orthotopic liver transplantation. (3/81)

Biliary complications account for significant morbidity in orthotopic liver transplantation (OLT), with a reported incidence ranging from 6% to 47%, and many centers are reassessing the need and options available for stenting the biliary anastomosis. We report on our experience using a 6F Silastic, double-J, ureteral stent as an internal biliary stent in OLT. From October 15, 1995, to September 30, 1998, a total of 99 patients at our institution underwent 108 OLTs. Of these, 77 patients received an end-to-end choledochocholedochostomy over an internal stent. Three patients died within 1 week post-OLT, leaving 74 patients for evaluation (follow-up, 2 to 38 months). Stents were placed transanastomotic and transsphincteric at the time of OLT and secured with a dissolvable suture. At 4 to 6 weeks post-OLT, stents visible within the biliary tree on kidney, ureters, and bladder radiograph were removed endoscopically. Graft and patient survival rates were 92% and 96%, respectively. There were 12 biliary complications (18%): anastomotic leak in 6 patients (9%), anastomotic stricture in 5 patients (7.6%), and stent migration in 1 patient (1.5%). Thirty-two patients (43%) passed the biliary stent without intervention, whereas 42 patients (57%) underwent esophagogastro duodenoscopy (EGD) stent removal at 4 to 6 weeks without incident. Treatment of the complications included percutaneous drainage, endoscopic dilatation with stenting, and/or conversion to Roux-en-Y choledochojejunostomy. The use of the 6 F Silastic, double-J, ureteral stent provides a safe and effective means of stenting the biliary anastomosis in OLT. Major advantages to this method are that it: (1) is completely internal, (2) is biliary decompressive, (3) is radiopaque, (4) can be spontaneously passed, and (5) is easily accessible for EGD extraction.  (+info)

Chemoprevention of biliary carcinogenesis in syrian hamsters by the novel carboxamide derivative IS-741 after initiation with N-nitrosobis(2-oxopropyl)amine (BOP). (4/81)

To elucidate the possible inhibitory effect of a novel carboxamide derivative (IS-741) on biliary carcinogenesis, Syrian hamsters were subjected to cholecystoduodenostomy and ligation of the distal end of the common duct, and then given a regular diet (group I) or a diet containing 200 p.p.m. of IS-741 (group II). All hamsters were subcutaneously injected with N-nitrosobis(2-oxopropyl)amine until 10 weeks after surgery, and continued to feed on their respective dietary regimen until termination of the experiment at 16 weeks after surgery. Biliary adenocarcinomas were evaluated histologically. Non-cancerous and cancerous hepatobiliary tract tissues were analyzed for phospholipase A(2) (PLA(2)) activity, myeloperoxidase (MPO) activity, and the concentrations of prostaglandin (PG), i.e., prostaglandin E(2), 6-ketoprostaglandin F(1)alpha and thromboxane B(2). IS-741 significantly inhibited the development and multiplicity of hepatobiliary adenocarcinomas and reduced the proliferating cell nuclear antigen labeling indices in non-cancerous hepatobiliary tissues, compared with group I. The anti-cancerous effect of IS-741 was associated with a significant inhibition of PLA(2) and MPO levels in non-cancerous tissues of the extrahepatic biliary tract and the liver, and in cancerous tissue of the liver. Furthermore, IS-741 reduced the production of PGs in non-cancerous hepatobiliary tissues, compared with group I. Although the precise mechanism of action of IS-741 in preventing biliary tumorigenesis remains to be elucidated, it is likely to be related to modulation of arachidonic acid metabolism and/or suppression of neutrophil accumulation.  (+info)

Biliary anastomosis in living related liver transplantation using the right liver lobe: techniques and complications. (5/81)

Since the introduction of adult-to-adult living donor liver transplantation using the right lobe of the liver, biliary problems have led the list of complications resulting in postoperative morbidity. We report our experience with the first 30 living donor liver transplantations performed in our institution from August 1998 to January 2000. Patients were 21 men and 9 women, with a mean age 45 +/- 16 years. Mean recipient weight was 65.1 +/- 17.9 kg, mean graft weight was 877 +/- 146 g, and the mean graft-recipient weight ratio was 1.5 +/- 0.6. Patient and graft survival rates were 83.3% and 80%, respectively. Biliary anastomosis was either an end-to-end hepaticocholedochostomy with a T-drain or hepaticojejunostomy. Mean follow-up was 217.4 +/- 149.8 days. The overall complication rate was 26.6% (8 of 30 procedures) and was directly correlated to the type of anastomosis and number of bile ducts. Surgical revision was necessary in all cases. Biliary complications were not the primary cause of graft loss. Adult living donor liver transplantation using the right lobe is a successful procedure, with graft and patient survival similar to those in cadaver full-organ transplantation. Postoperative morbidity, mainly caused by biliary leak, was directly related to the number of ducts and type of anastomosis. With increasing experience, we have better defined our plane of transection on the hilar plate, with the goal of obtaining only 1 biliary duct for the anastomosis. We also improved our parenchymal transection technique, which resulted in a decreased incidence of leak at the cut-surface area.  (+info)

Randomized trial of choledochocholedochostomy with or without a T tube in orthotopic liver transplantation. (6/81)

OBJECTIVE: To compare the incidence of biliary complications after liver transplantation in patients undergoing choledochocholedochostomy reconstruction with or without T tube in a multicenter, prospective, randomized trial. SUMMARY BACKGROUND DATA: Several reports have suggested that biliary anastomosis without a T tube is a safe method of biliary reconstruction that could avoid complications related to the use of T tubes. No large prospective randomized trial has so far been published to compare the two techniques. METHODS: One hundred eighty recipients of orthotopic liver transplantation were randomly assigned to choledochocholedochostomy with (n = 90) or without (n = 90) a T tube in six French liver transplantation centers. All types of biliary complications were taken into account. RESULTS: The overall biliary complication rate was increased in the T-tube group, even though these complications did not lead to an increase in surgical or radiologic therapeutic procedures. The major significant complication was cholangitis in the T-tube group; this did not occur in the other group. The incidence of biliary fistula was 10% in the T-tube group and 2.2% in the group without a T tube. Other biliary complications were similar. The complication rate of cholangiography performed with the T tube was greater than with other types of biliary exploration. The graft and patient survival rates were similar in the two groups. CONCLUSION: This study is the first large prospective, randomized trial of biliary complications with or without a T tube. The authors found an increase in the biliary complication rate in the T-tube group, which was linked to minor complications. The T tube did not provide a safer access to the biliary tree compared with the others types of biliary explorations. The authors recommend the performance of choledochocholedochostomy without a T tube in liver transplantation.  (+info)

Late development of bile duct cancer in patients who had biliary-enteric drainage for benign disease: a follow-up study of more than 1,000 patients. (7/81)

OBJECTIVE: To evaluate the correlation between biliary-enteric surgical drainage and the late development of cholangiocarcinoma of the biliary tract. SUMMARY BACKGROUND DATA: In patients with biliary-enteric drainage, reflux of intestinal contents into the bile duct may occur and cause cholangitis, which is regarded as the most serious complication of these procedures. Lithiasis of the biliary tract and a previous biliary-enteric anastomosis have both been suggested to favor the late onset of cholangiocarcinoma. METHODS: Consecutive patients (n = 1,003) undergoing three different procedures of biliary-enteric anastomosis (transduodenal sphincteroplasty, choledochoduodenostomy, and hepaticojejunostomy) between 1967 and 1997 were included in this study. The postoperative clinical course and long-term outcome were evaluated by a retrospective review of the hospital records and follow-up. Mean follow-up was 129.6 months. RESULTS: Fifty-five (5.5%) cases of primary bile duct cancer were found among the 1,003 patients at intervals of 132 to 218 months from biliary-enteric anastomosis. The incidence of cholangiocarcinoma in the three groups was 5.8% in transduodenal sphincteroplasty patients, 7.6% in choledochoduodenostomy patients, and 1.9% in hepaticojejunostomy patients. The incidence of malignancy related to the different underlying diagnosis was 5.9%, 7.2%, and 1.9% in patients with choledocholithiasis, sphincter of Oddi stenosis, and postoperative benign stricture, respectively. Although only one patient who developed cholangiocarcinoma had previous concurrent lithiasis of the biliary tract, 40 patients had experienced mostly severe, recurrent cholangitis. No case of malignancy occurred in patients scored as having no cholangitis in the early and long-term postoperative outcome. Univariate and multivariate analyses have shown the presence of cholangitis as the only factor affecting the incidence of cholangiocarcinoma. CONCLUSIONS: Chronic inflammatory changes consequent to biliary-enteric drainage should be closely monitored for the late development of biliary tract malignancies.  (+info)

Biliary decompression reduces the susceptibility to ethanol-induced ulcer in jaundiced rats. (8/81)

We investigated the gastric response to an ulcerogenic irritant and the change in gastric functions in an experimental rat model of obstructive jaundice, with or without biliary drainage. After biliary obstruction for 14 days, rats with ligated bile duct (BDL) were randomly divided into three groups: BDL group without biliary drainage, BDL followed by choledochoduodenostomy (CD) or a choledochovesical fistula (CVF). The gastric functions were evaluated 2 weeks after the surgery. Gastric damage, induced by orogastric administration of ethanol, was evaluated 30 min later using a lesion index and microscopic scoring was then performed on fixed stomachs. Basal gastric acid secretion was measured by the pyloric ligation method. The lesion index and maximum lesion depth did not differ in the BDL and sham groups, while they were significantly reduced in the CD group. Gastric acid output and secretory volume were reduced in the BDL group compared to the sham group, while these reductions were abolished in the CD group. Afferent denervation with capsaicin further reduced the ulcer index in the later group. Our data suggest that gastric mucosal susceptibility to injury is dependent on the normal flow of bile into the duodenal lumen, which appears to be a requirement for adaptive gastric cytoprotection.  (+info)

Choledocholithotomy definition at Dictionary.com, a free online dictionary with pronunciation, synonyms and translation. Look it up now!
Does any one know the correct CPT code for a choledochojejunostomy with Roux-en-Y? It was performed because the patient had a biliary stricture.
Harga Susu Appeton Weight Gain 2017 - Pancreas inflammation hemorrhaging, peritonitis, cirrhosis, and leads to the perforations of the intestinal organs. Alkaline phosphatase is an issue as well that could lead to back pain. Alkaline phosphatase is any of the bodys phosphatase. The elements are optimally live within the mediums of alkaline and occur from high volumes of concentrations into the liver, bones, placenta, and kidneys. Thoracic spinal column is an element that protects the vital organs. Thoracic protects the backbone also. Thoracic also shields the lungs, liver, and the Harga Susu Appeton Weight Gain 2017 heart. As you can see the disorder or the symptoms emerging from the disorder spread near this area posing thus, threat to the spine. To correct serious conditions, laparoscopic laser cholecystectomy, cholecystectomy, and choledochostomy is considered. The surgical procedures are only conducted in the worst conditions, since doctors use nurse intervention strategies to avert the ...
Proukou В Y. пппп Page 620 Choledochojejunostomy and Cholecystojejunostomy 621 пSTEP 11 Completed cholecystojejunostomy A drain is coming off alesse in situ after finishing the anastomosis, to indicate postoperative bleeding of bile leakage.
Aim: To analyse patients those admitted to our clinic due to perforation in duodenum. Patients and Method: Fourteen patients those have been admitted to our center with perforation in duodenum between 1990 2014 analysed retrospectively. Results: Ten patients (8M, 6F) those have been admitted to our clinic between 1990 2014 have a mean age of 6.2 years (25 days 16 years). Two of cases admitted directly to our clinic and the rest refered from another hospitals. Mean time for appliance to our clinic was 3.2 days ( 1day 1 week). Ulcer in duodenum was the cause of perforation in 10 cases while in 3 the cause was trauma and in 1 case was surgical complication of infantyl persistant hyperinsulinism (IPHH). The case with hyperbilluribinemia after near total pancreatectomy due to IPHH had been explored and perforation in deuedenum diagnosed. Resection in first two parts of duodenum and pylor, choledochojejunostomy, gastrojejunostomy and jejunojejunostomy was performed. Primary repair was performed in the ...
Alright, so a handle has forty US standard drinks in it. That will put you at ten to 13 units each day, 70 to ninety a week. I used to be at 80+ each week and obtaining common GI tract complications, so It will be an excellent time for you to put it down or begin relocating back again towards the reduced-danger drinking zone. In case you are prepared to bust a proceed this, I could get you pointed in the proper direction. Like I reported, it requires months and most people manage to acquire 6-twelve months to get it all of the way all the way down to The purpose where by their alternative inside the website matter is restored and so they drink like "ordinary men and women" (or just kick booze to the control completely). Most see a ~40% reduction in the 1st month. The information regarding how to do it can be free. The cost of a doc differs, you could possibly visit your own private doc ...
In an age when operative cholangiography has become increasingly popular, it is timely to find a text in which the collaborative efforts of radiologist and surg
Objective To investigate the occurrence and treatments of iatrogenic duodenum injury. Methods The causes, management and the therapeutic effectiveness of 15 cases of iatrogenic duodenum injuries from Jan. 1995 to Dec. 2004 were analyzed.Results In 15 patients with iatrogenic duodenum injuries, there were 6 cases of duodenums laceration in cholecystectomy, 3 cases of duodenums penetrating wound in choledocholithotomy, 4 cases of duodenums laceration in the second biliary passage operation and 2 cases of duodenums laceration in radical colectomy. Twelve cases only received single suture repair, 3 T-tube drainage and duodenum repair. Among 3 cases of duodeno-leaks happened after the operations, 2 cases were cured and one died.Conclusion Strengthening surgeons responsibilities and improving the quality of surgeries is the key to prevent iatrogenic duodenum injury. Under the condition of valid decompression in duodenum and drainage in abdominal cavity, the majority of iatrogenic duodenum injuries can be
The differential diagnosis includes pneumobilia (usually centrally located gas) and portal venous gas (usually more peripheral). The cause of this finding was a biliary-enteric fistula.
We have some questions on the conclusion in your Oseltamivir review especially about the prevention of complication (sic). You described that Oseltamivir 150 mg daily prevented lower respiratory tract complications (OR 0.32, 95% CI 0.18 to 0.57) in abstract.. However, we have found that this conclusion is based on the other review (Kaiser, 2003) and not on your own data analysis. The authors of the review were four employees of F. Hoffman-La Roche Ltd, one paid consultant to F. Hoffman-La Roche Ltd and Kaiser. We cannot find any raw data about this conclusion from your review.. Kaisers review included 10 RCTs; two RCTs (Nicholson, 2000 and T Treanor, 2000) were published as articles in the peer-reviewed medical journal (JAMA and Lancet), but other 8 RCTs were proceedings of congress (5 RCTs), abstracts of the congress (one RCT) and meeting (one RCT) and data on file, Hoffmann-La Roche, Inc, Nutley, NJ (one RCT).. [There was no significant difference in lower respiratory tract complication ...
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Keyword(s): CBDS, cholangitis, choledochoduodenostomy, ductal calculi, EAES, ERCP, flex choledochoscope, gallstone disease, Holmium laser, lap management, LCBDE, learning curve, MRCP, rigid ureteroscope, T-tube, two-stage, URS ...
Biliary obstruction is importantly influencing quality of life and survival of patients suffering from primary or secondary bile duct malignancies. The
A total of 38 patients were included in this analysis. The patient characteristics were as follows: median age, 60 years (range, 22 to 72); male/female, 26/12; PS 0/1, 22/16; UICC-TNM stage III/IV, 12/26; primary site head/body-tail, 16/22; biliary intervention yes/no, 10/28; UGT genetic polymorphisms wild type/UGT1A1*6 or *28 heterozygote, 26/12. The median number of cycles administered was 6 (range, 1 to 22). During the first 2 cycles of treatment, FN occurred in 23.6% of the patients. There were no treatment-related deaths. A multivariate logistic regression analysis showed that the pretreatment platelet count ≦15*104 /&mgr;L (OR: 8.07, 95% CI: 1.03 to 63.2, p = 0.047) and heterozygous UGT1A1*6 or *28 (OR: 8.60, 95% CI: 1.36 to 54.2, p = 0.022) were significantly associated with higher risk of FN. ...
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Although surgical hepaticojejunostomy plays an important role in the therapy for AS after Roux-en-Y hepaticojejunostomy, reduplicative biliary reconstruction remains a challenging topic for hepatobiliary surgeons, and a considerable percentage of patients still need endoscopic or intercurrent treatment. The standardized regimens in treating AS involve two operational steps: first, to remove the stricture;second, to prevent restricture. Because of this, balloon dilatation and long-term internal/external drainage become the primary approach and gold standard for minimally invasive procedures, especially for patients requiring multiple operations [13].. At present, BD is the main method to relieve AS, and there are several schemes of balloon dilatation, with differing results at follow-up. An early study reported that 93.3 % percent (14/15) of the strictures could be successfully dilated by the BD, but the incidence of restricture was high and could reach up to 45 % within a long-term follow-up ...
Results A total of 203 referrals (n = 109 in 2013, n = 94 in 2014) were analysed: choledocholithiasis (n = 72), hepatobiliary cancers (n = 32), cholelithiasis (n = 36), liver disease (n = 23) and others (n = 40).. For all pathology, we managed to half the average time from referral to first decision by a consultant in 2014. The mean waiting time for ultrasound as the first choice of investigation improved by 3.2 days and for MRCP by 3.1 days in 2014. It took on average 3.2 days longer to obtain a CT in 2014.. For choledocholithiasis, the time interval from referral to ERCP in 2013 (2-49 days, mean = 18.1) were similar to 2014 (2-47 days, mean = 17.0) despite mean improvement of 2.2 days and 2.8 days in the waiting times for ultrasound and MRCP respectively. This was due to selected cases where CT was also required as it took on average 5.8 days longer to obtain a CT in 2014 in this group.. For cancers, the time from referral to biliary decompression (ERCP/PTC) improved by 3.5 days from 2013 ...
In cases where a bile duct blockage is suspected or has been confirmed by blood work and ultrasounds, a veterinarian may recommend that the dog receive a choledochotomy, which is an exploratory surgery where an incision is made into the bile duct. - Wag! (formerly Vetary)
A closed-suction drain always Su hagra be placed in the vicinity of the repair to allow adequate drainage of an eventual biliary fistula. Transfer completely to a volumetric flask and dilute to 100.
Although the incidence of hepatolithiasis is decreasing as the pattern of gallstone disease changes in Asia, the prevalence of hepatolithiasis is persistently high, especially in Far Eastern countries. Hepatolithiasis is an established risk factor for cholangiocarcinoma (CCA), and chronic proliferat …
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TY - JOUR. T1 - EUS-guided Trucut needle biopsy. T2 - Is more tissue really better?. AU - Pungpapong, Surakit. AU - Wallace, Michael B.. PY - 2005/10. Y1 - 2005/10. UR - http://www.scopus.com/inward/record.url?scp=25644457783&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=25644457783&partnerID=8YFLogxK. U2 - 10.1016/j.gie.2005.07.004. DO - 10.1016/j.gie.2005.07.004. M3 - Article. VL - 62. SP - 602. EP - 604. JO - Gastrointestinal Endoscopy. JF - Gastrointestinal Endoscopy. SN - 0016-5107. IS - 4. ER - ...
Malignant bile duct obstruction is a common problem among cancer patients with hepatic or lymphatic metastases. Endoscopic retrograde cholangiography (ERC) with the placement of a stent is the method of choice to improve biliary flow. Only little data exist concerning the outcome of patients with malignant biliary obstruction in relationship to microbial isolates from bile. Bile samples were taken during the ERC procedure in tumor patients with biliary obstruction. Clinical data including laboratory values, tumor-specific treatment and outcome data were prospectively collected. 206 ERC interventions in 163 patients were recorded. In 43 % of the patients, systemic treatment was (re-) initiated after successful biliary drainage. A variety of bacteria and fungi was detected in the bile samples. One-year survival was significantly worse in patients from whom multiresistant pathogens were isolated than in patients, in whom other species were detected. Increased levels of inflammatory markers were associated
Purchase EUS-Guided Tissue Acquisition, An Issue of Gastrointestinal Endoscopy Clinics, Volume 24-1 - 1st Edition. Print Book & E-Book. ISBN 9780323263900, 9780323263917
Publication date: Available online 27 November 2018Source: Cirugía Española (English Edition)Author(s): Unai de Andres Olabarria, Lorena García Bruña, Roberto Maniega Alba, Francisco Javier Ibáñez Aguirre...
1 Answer - Posted in: etodolac, tramadol, medication - Answer: Hi, they are both analgesics, but they work very differently. Tramadol is ...
TY - JOUR. T1 - Impaired hepatic bacterial clearance is reversed by surgical relief of obstructive jaundice. AU - Katz, Schmuel. AU - Yang, Rong. AU - Rodefeld, Mark. AU - Folkening, Walter J.. AU - Grosfeld, Jay L.. PY - 1991. Y1 - 1991. N2 - Sepsis is a major cause of morbidity and mortality in infants with cholestatic jaundice. Previous studies have shown that biliary obstruction in rats causes a significant decrease in hepatic phagocytosis of viable Escherichia coli. This study tests this hypothesis and further evaluates whether the impaired function of the reticuloendothelial system of the liver (Kupffer cells) can be reversed by the relief of the biliary obstruction. Male Sprague-Dawley rats (weighing 140 to 150 g) were placed in three groups. Group I (n = 10) consisted of sham-operated controls. In Group II (n = 30), ligation and division of distal common bile duct (CDL) was performed. Group III (n = 30) underwent choledochoduodenostomy 2 weeks following ligation and division of common ...
Biliary-enteric anastomosis (BEA) is a common surgical procedure performed for the management of biliary obstruction or leakage that results from a variety of benign and malignant diseases. Complications following BEA are not rare. We aimed to determine the incidence and the factors associated with early complications occurring after BEA for benign diseases. We reviewed the medical records of all patients who underwent BEA for benign diseases at our institution between January 1988 and December 2009. The primary outcome was early post operative complication. Logistic regression analysis was done to identify factors predicting the occurrence of complications. Records of 79 patients were reviewed. There were 34 (43%) males and 45 (57% females). Majority (53%) had choledocholithiasis with impacted stone or distal stricture, followed by traumatic injury to the biliary system (33%). Thirty-four patients (43%) underwent a hepaticojejunostomy, 19 patients (24%) underwent a choledochojejunostomy, and
The placement of SEMS with minor ES is better comparable with the incidence of PEP in previous large clinical trials. Post ES bleeding was lower in minor ES comparable to standard sphincterotomy. The bleeding rate of SEMS insertion after minor ES was lower compared with standard sphincterotomy prior to stent placement. Minor ES was safe and effective procedure as not increasing severe bleeding to facilitate the SEMS placement in patients with malignant biliary obstruction.. ...
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... is a medicine used to treat high cholesterol and itching caused by partial biliary obstruction. This eMedTV resource explains how the drug works and offers information on its uses, effects, and dosing guidelines.
Cholecystostomy Choledochostomy Enteric: Cecostomy Colostomy Duodenostomy Ileostomy Jejunostomy Appendicostomy (see Malone ...
... choledochostomy MeSH E04.035.335 --- endolymphatic shunt MeSH E04.035.398 --- gastroenterostomy MeSH E04.035.398.385 --- ... choledochostomy MeSH E04.210.120.775 --- portoenterostomy, hepatic MeSH E04.210.120.850 --- sphincterotomy, endoscopic MeSH ...
The draining of the common bile duct through the abdominal wall Explanation of choledochostomy ... Looking for choledochostomy? Find out information about choledochostomy. ... choledochostomy. Also found in: Medical. choledochostomy. [‚kō·lə‚dä′kä·stə·mē] (medicine) The draining of the common bile duct ... Choledochostomy , Article about choledochostomy by The Free Dictionary https://encyclopedia2.thefreedictionary.com/ ...
choledochocholedochostomy. 22-letter words that start with choledocho. *choledochoduodenostomy. *choledochodochorrhaphy ...
Open Choledochostomy and Choledochoscopy (Rigid or Flexible). *. Blumgart LH, Fong Y. Surgery of the liver and biliary tract. ...
Choledochostomy- Make and leave an opening or form a connection between the Common bile duct. ...
Choledochostomy / methods*. Cholelithiasis / complications, surgery. Cholestasis / etiology, surgery. Female. Hepatectomy / ...
Dr. Duffy is the Director of Bariatric and Minimally Invasive Surgery at Yale New Haven Health System and an Associate Professor of Surgery at Yale University School of Medicine. He received his medical degree from the University of Massachusetts Medical School in 1996, and completed a general surgery residency at the UMass-Memorial Surgical Residency Program in 2003. Dr. Duffy completed a Fellowship in Minimally Invasive Surgery at Cornell and Columbia Medical School in New York in 2004. He has been a full-time faculty member of the Yale University School of Medicine since 2004. He specializes in advanced minimally invasive, bariatric, hernia, and gastrointestinal surgery. He has a special clinical interest in complex recurrent hernia repair, abdominal wall reconstruction, and complex foregut surgery (achalasia, paraesophageal hernias, GERD). ...
Cholecystectomy with common bile duct exploration (choledochostomy) is used to resolve obstructive jaundice caused by ...
Anastomotic biliary strictures arise at the site of the choledocho-choledochostomy. ERCP with multiple plastic stent placements ...
Two-Port Laparoscopic Common Bile Duct Exploration with T-tube Choledochostomy for Management of Choledocholithiasis: An ...
Choledochostomy / methods. Follow-Up Studies. Humans. Neoplasm Staging. Quality of Life. Retrospective Studies. Treatment ...
tion and choledochostomy with T-tube drainage was carried abdominal distention were observed. The liver was palpated. out. ...
TY - JOUR. T1 - Living-related liver transplantation in children. T2 - The Parisian strategy to safely increase organ availability. AU - Révillon, Y.. AU - Michel, J. L.. AU - Lacaille, F.. AU - Sauvat, F.. AU - Farges, O.. AU - Belghiti, J.. AU - Rengeval, A.. AU - Jouvet, P.. AU - Sayegh, N.. AU - Sarnacki, S.. AU - Jan, D.. PY - 1999/5. Y1 - 1999/5. N2 - Purpose: The aim of the authors was to report their experience with living related liver transplantation (LRLT) in children, particularly focusing on the safety of the two-center Parisian strategy. Methods: The records of donors and recipients of 26 pediatric living-related donor liver transplantations performed between November 1994 and March 1998 were reviewed retrospectively. Donors were assessed 1 year after transplantation for medical and overall status. Results: Indications for LRLT included biliary atresia (n = 18), Bylers disease (n = 5), alpha-1-antitrypsin deficiency (n = 1), Alagille syndrome (n = 1), and undefined cirrhosis ...
Bando, K., Turrentine, M. W., Sun, K., Sharp, T. G., Ensing, G. J., Miller, A. P., Kesler, K. A., Binford, R. S., Carlos, G. N., Hurwitz, R. A., Caldwell, R. L., Darragh, R. K., Hubbard, J., Cordes, T. M., Girod, D. A., King, H. & Brown, J. W., Nov 1995, In : The Journal of Thoracic and Cardiovascular Surgery. 110, 5, p. 1543-1554 12 p.. Research output: Contribution to journal › Article ...
Choledochostomy (procedure) {286079005 , SNOMED-CT } Parent/Child (Relationship Type) Choledochostomy with removal of calculus ... procedure) {235860000 , SNOMED-CT } Choledochostomy with transduodenal sphincteroplasty (procedure) {543008 , SNOMED-CT } ...
TY - JOUR. T1 - Dilatation of biliary strictures through the afferent limb of a Roux-en-Y choledochojejunostomy in patients with sclerosing cholangitis. AU - Hutson, Duane G.. AU - Russell, Edward. AU - Levi, Joe U.. AU - Jeffers, Lennox J.. AU - Reddy, K. Rajender. AU - Yrizarry, Jose M.. AU - Scagnelli, Tomas. AU - Sleeman, Danny. AU - Schiff, Eugene R.. AU - Livingstone, Alan S.. PY - 2001/10/22. Y1 - 2001/10/22. N2 - Repeated dilatation of biliary strictures in patients with sclerosing cholangitis through a subcutaneously placed afferent limb of a choledochojejunostomy is technically feasible and safe. This study is a prospective 15-year evaluation of 36 patients treated by repeat dilatation through this jejunal limb. There was one operative death and one major complication of dilatation. The 5-year survival of all patients was 74%. If patients with cirrhosis or unproven cholangiocarcinoma at the time of operation are not included, the 5-year survival is 86%. The 15-year survival of all ...
Ecker, B. L., McMillan, M. T., Asbun, H. J., Ball, C. G., Bassi, C., Beane, J. D., Behrman, S. W., Berger, A. C., Dickson, E. J., Bloomston, M., Callery, M. P., Christein, J. D., Dixon, E., Drebin, J. A., Castillo, C. F. D., Fisher, W. E., Fong, Z. V., Haverick, E., Hollis, R. H., House, M. G. & 18 others, Hughes, S. J., Jamieson, N. B., Javed, A. A., Kent, T. S., Kowalsky, S. J., Kunstman, J. W., Malleo, G., Poruk, K. E., Salem, R. R., Schmidt, C. R., Soares, K., Stauffer, J. A., Valero, V., Velu, L. K. P., Watkins, A. A., Wolfgang, C. L., Zureikat, A. H. & Vollmer, C. M., Jun 7 2017, (Accepted/In press) In : Annals of Surgery.. Research output: Contribution to journal › Article ...
Cholecystostomy Choledochostomy Enteric: Cecostomy Colostomy Duodenostomy Ileostomy Jejunostomy Appendicostomy (see Malone ...
... choledochostomy MeSH E04.035.335 --- endolymphatic shunt MeSH E04.035.398 --- gastroenterostomy MeSH E04.035.398.385 --- ... choledochostomy MeSH E04.210.120.775 --- portoenterostomy, hepatic MeSH E04.210.120.850 --- sphincterotomy, endoscopic MeSH ...
Choledochostomy with cholecystotomy (procedure). Code System Preferred Concept Name. Choledochostomy with cholecystotomy ( ...
1 and 3, the instrument 10 is inserted into a patients duct, for example through a choledochostomy, with the filiform guiding ...
Plana, N. M., Massie, J. P., Stern, M. J., Alperovich, M., Runyan, C. M., Staffenberg, D. A., Koniaris, L., Grayson, B. H., Diaz-Siso, J. R. & Flores, R. L., Feb 1 2017, In : Plastic and Reconstructive Surgery. 139, 2, p. 450-456 7 p.. Research output: Contribution to journal › Article ...
TY - JOUR. T1 - Diagnosis and treatment of biliary tract complications after orthotopic liver transplantation. AU - Stratta, Robert J.. AU - Wood, R. Patrick. AU - Langnas, Alan Norman. AU - Hollins, Ronald Ray. AU - Bruder, Kenneth J.. AU - Donovan, Jeremiah P.. AU - Burnett, David A.. AU - Lieberman, Robert P.. AU - Lund, Gunnar B.. AU - Pillen, Todd J.. AU - Markin, Rodney Smith. AU - Shaw, Byers W.. PY - 1989/10. Y1 - 1989/10. N2 - Biliary tract complications are a continuing source of morbidity after liver transplantation. In a 3.5-year period we performed 264 liver transplants in 226 patients (132 adults, 94 children). Biliary tract reconstruction was via Roux limb choledochojejunostomy (n = 144) or choledochocholedochostomy (n = 118). Fifty (19.1%) biliary complications occurred, and 35 (13.4%) necessitated operative repair. The incidence was similar in adults and children and after each method of reconstruction. Risk factors were vascular thrombosis and reduced-sized transplants. ...
Choledocholithotomy definition at Dictionary.com, a free online dictionary with pronunciation, synonyms and translation. Look it up now!
Cholecystectomy/Choledochostomy. General information Cholecystectomy: removal of the gallbladder with insertion of a T-tube ...
  • A Retrospective Study of 303 cases Benign Biliary Tract Disease Treated with T-tube Choledochostomy T-tube choledochostomy is a useful surgical therapeutic method of biliary. (naver.com)
  • The patient had undergone a BillrothII subtotal gastrectomy for the duodenal ulcer with stenosis 14 years before and cholecystectomy, T-tube choledochostomy and choledochoduodenostomy due to CBD inflammatory stenosis 10 years before. (beds.ac.uk)