Database : MEDLINE
Search on : Biliary and Fistula [Words]
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[PMID]: 29511867
[Au] Autor:Chaudry G; Lillis AP; Shaikh R; Padua HM; Chewning RH; Alomari AI
[Ad] Address:Division of Vascular and Interventional Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA. gulraiz.chaudry@childrens.harvard.edu.
[Ti] Title:Endovascular Treatment of Congenital Arterioportal Fistulas.
[So] Source:Cardiovasc Intervent Radiol;, 2018 Mar 06.
[Is] ISSN:1432-086X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To characterize anatomy of congenital arterioportal fistulas (CAPF) and correlate this with technique and outcomes of transcatheter embolization (TCE). MATERIALS AND METHODS: Retrospective review was conducted of children with CAPF that underwent TCE in a 10-year period. Medical records, imaging and procedure details were reviewed. TCE was performed via transarterial (n = 5), portal (n = 5) or patent ductus venosus (n = 1) approach. Embolic agents used were coils (n = 10), Onyx (n = 1) and Amplatzer septal occluder (n = 1). RESULTS: A total of 7 patients were included (4 female). Median age at treatment was 4 months (2 month-3 year). Most common symptoms were GI bleeding (n = 4), anemia (n = 4) and ascites (n = 3). Hepatopetal flow was seen in all on pre-procedure sonography. On angiography, a simple lesion, with direct fistulous connections, from hepatic arterial (HA) branches to portal venous (PV) system was seen in 3. A complex lesion with multiple connections was identified in 4. In simple lesions, cessation of shunting was achieved in 1 procedure, with embolization of afferent vessels. In complex lesions, multiple procedures were required in 3 of 4 patients. All 4 with complex connections required embolization of the aneurysmal PV segment. There were no major complications. Two minor complications were noted: localized biliary leak in 1 and femoral pseudoaneurysm in 1. There was resolution of symptoms in 6. CONCLUSIONS: TCE is effective as primary treatment of CAPF. Patients with simple arteriovenous connections can be treated with embolization of afferent vessels, but children with multiple complex connections usually require embolization of the dilated PV segment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.1007/s00270-018-1924-1

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[PMID]: 29508272
[Au] Autor:Pasquer A; Pelascini E; Poncet G; Robert M
[Ad] Address:Department of Digestive and Bariatric Surgery, University Hospital of Edouard Herriot, Lyon 1 University, Lyon, France. arnaudp@gmail.com.
[Ti] Title:Laparoscopic Treatment of Gastro-Gastric Fistula After RYGB: Technical Points.
[So] Source:Obes Surg;, 2018 Mar 05.
[Is] ISSN:1708-0428
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: Postoperative abdominal pain after Roux en Y gastric bypass associated with gastro esophageal reflux is difficult to manage. A gastro-gastric fistula can be the etiology and besides pain and weight regain, it can also be revealed by a dilatation of the excluded stomach and duodenum. METHODS: We present the case of a 45-year-old woman who had a medical history of revisional RYGB after failure of gastric band. She recently complained of recurrent epigastric abdominal pain and biliary GERD. Upper gastro intestinal endoscopy found biliary reflux gastritis. The CT scan with gas expansion and opacification revealed a dilated excluded stomach and duodenum leading to the diagnosis of gastro-gastric fistula. Because of pain and GERD correlated to this radiological finding, we decided to perform an exploratory laparoscopy. The patient was placed in a half-sitting position, surgeon between the legs. A 12-mmHg pneumoperitoneum was made. A 4-port technique was used. The first step consisted of a complete adhesiolysis. The second step consisted in the dissection of the excluded stomach, stuck to the gastric pouch, and revealed two gastro-gastric fistulas treated by stapling. An epiploplasty was performed on the excluded stomach and the staple line of the gastric pouch was invaginated. RESULTS: Postoperative course was uneventful. One year later, she had no more reflux and no more pain. CONCLUSION: Causes of abdominal pain and GERD after RYGB are difficult to identify. Gastro-gastric fistula is one of them and should be evoked when biliary reflux and abdominal pain appear.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1007/s11695-018-3164-5

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[PMID]: 29500644
[Au] Autor:Alexander ES; Mick R; Nadolski GJ; Mondschein JI; Stavropoulos SW; Soulen MC
[Ad] Address:Department of Diagnostic Imaging, Hospital of the University of Pennsylvania, 3400 Spruce St, 1 Founders - MRI Education Center, Philadelphia, PA, 19104, USA. Erica.s.alexander@gmail.com.
[Ti] Title:Combined chemoembolization and thermal ablation for the treatment of metastases to the liver.
[So] Source:Abdom Radiol (NY);, 2018 Mar 03.
[Is] ISSN:2366-0058
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: The purpose of the study was to evaluate safety, time to recurrence, and overall survival (OS) in patients with liver metastases (LM), treated with transarterial chemoembolization (TACE) followed by ablation. MATERIALS AND METHODS: This retrospective study included all patients with LM treated with combined TACE and ablation from August 1998 to September 2015. Forty-two patients (12 women, 30 men; age 62.9 ± 11.9 years) were treated for 44 LMs. Tumor characteristics, imaging response to treatment, recurrence, and OS data were reviewed. Statistical analysis included Kaplan-Meier estimation, Cox regression and Fisher's exact, Wilcoxon rank sum, or log rank tests. RESULTS: Median follow-up was 10.3 months. Eighteen patients had 1 hepatic lesion, 16 had 2-5, and 8 had > 5. Median index lesion size was 4.7 cm (range 1.5-8 .0 cm). Tumor response (mRECIST) was available for 41/44 treated lesions, with CR in 32 (78.0%), PR in 8 (19.5%), and PD in 1 (2.4%). Long-term imaging follow-up was available for 38 patients. Freedom from local recurrence was 61% at 1 year and 50% at 2 years. OS was 55% at 1 year and 30% at 2 years (median OS, 14.5 months). Tumor size and histology were not predictors of time to progression or OS. Complications occurred in 19 patients (45%). Major complications occurred in 19% of patients and included hospitalization for fever (n = 2), hepatic abscess (n = 3) and fall requiring transfusion, portal vein thrombus causing lobar infarct, biliary fistula, and retroperitoneal hematoma (n = 1 each). CONCLUSIONS: Combined TACE and ablation is effective for local tumor control of liver metastases up to 8 cm when part of a multidisciplinary treatment strategy. Major complications occurred in 19% of patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:Publisher
[do] DOI:10.1007/s00261-018-1536-x

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[PMID]: 29478737
[Au] Autor:Villafane-Ferriol N; Van Buren G; Mendez-Reyes JE; McElhany AL; Massarweh NN; Silberfein EJ; Hsu C; Tran Cao HS; Schmidt C; Zyromski NJ; Dillhoff ME; Roch A; Oliva E; Smith AC; Zhang Q; Fisher WE
[Ad] Address:Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA.
[Ti] Title:Sequential drain amylase to guide drain removal following pancreatectomy.
[So] Source:HPB (Oxford);, 2018 Feb 23.
[Is] ISSN:1477-2574
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Although used as criterion for early drain removal, postoperative day (POD) 1 drain fluid amylase (DFA) ≤ 5000 U/L has low negative predictive value for clinically relevant postoperative pancreatic fistula (CR-POPF). It was hypothesized that POD3 DFA ≤ 350 could provide further information to guide early drain removal. METHODS: Data from a pancreas surgery consortium database for pancreatoduodenectomy and distal pancreatectomy patients were analyzed retrospectively. Those patients without drains or POD 1 and 3 DFA data were excluded. Patients with POD1 DFA ≤ 5000 were divided into groups based on POD3 DFA: Group A (≤350) and Group B (>350). Operative characteristics and 60-day outcomes were compared using chi-square test. RESULTS: Among 687 patients in the database, all data were available for 380. Fifty-five (14.5%) had a POD1 DFA > 5000. Among 325 with POD1 DFA ≤ 5000, 254 (78.2%) were in Group A and 71 (21.8%) in Group B. Complications (35 (49.3%) vs 87 (34.4%); p = 0.021) and CR-POPF (13 (18.3%) vs 10 (3.9%); p < 0.001) were more frequent in Group B. CONCLUSIONS: In patients with POD1 DFA ≤ 5000, POD3 DFA ≤ 350 may be a practical test to guide safe early drain removal. Further prospective testing may be useful.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:Publisher

  5 / 5872 MEDLINE  
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[PMID]: 29390375
[Au] Autor:Yin X; Lei X; Xu C; Yang J; Zhao Y; Li K
[Ad] Address:Department of Gastroenterology, Shandong Provincial Rongjun Hospital.
[Ti] Title:Hepatic artery embolization cures the acute pancreatitis associated with a tiny arteriobiliary fistula after TIPS: A case report.
[So] Source:Medicine (Baltimore);96(50):e9267, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Esophageal variceal bleeding caused by portal hypertension is massive and life-threatening to those patients with decompensated liver cirrhosis. A transjugular intrahepatic portosystemic shunt (TIPS) can effectively stop bleeding. But the process of puncture may lead to bile duct injury and even form fistulas between the hepatic artery and bile duct. PATIENT CONCERNS: The case report illustrated a 52-year-old Chinese female patient who underwent TIPS. DIAGNOSES: She suffered from acute upper gastrointestinal hemorrhage and acute pancreatitis because of the bile duct injury after TIPS. INTERVENTIONS: The fistulas between the hepatic artery and bile duct was embolized. OUTCOMES: The acute upper gastrointestinal hemorrhage and acute pancreatitis of the patient were cured. LESSONS: The arteriobiliary fistula should be paid more attention after TIPS while early-stage prevention should be carried out.
[Mh] MeSH terms primary: Embolization, Therapeutic/methods
Hemobilia/therapy
Hepatic Artery
Pancreatitis/therapy
Portasystemic Shunt, Transjugular Intrahepatic/adverse effects
Vascular Fistula/therapy
[Mh] MeSH terms secundary: Acute Disease
Female
Hemobilia/etiology
Humans
Middle Aged
Pancreatitis/etiology
Vascular Fistula/etiology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009267

  6 / 5872 MEDLINE  
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[PMID]: 28744748
[Au] Autor:Azzam AZ; Tanaka K
[Ad] Address:General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt. aazzam70@yahoo.com.
[Ti] Title:Biliary complications after living donor liver transplantation: A retrospective analysis of the Kyoto experience 1999-2004.
[So] Source:Indian J Gastroenterol;36(4):296-304, 2017 Jul.
[Is] ISSN:0975-0711
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIM: In living donor liver transplantation (LDLT), biliary complications continue to be the most frequent cause of morbidity and may contribute to mortality of recipients although there are advances in surgical techniques. This study will evaluate retrospectively the short-term and long-term management of biliary complications. METHODS: During the period from May 1999, to May 2004, 505 patients underwent 518 LDLT in the Department of Liver Transplantation and Immunology, Kyoto University Hospital, Japan. The data was collected and analyzed retrospectively. RESULTS: The recipients were 261 males (50.4%) and 257 females (49.6%). Biliary complications were reported in 202/518 patients (39.0%), included; biliary leakage in 79/518 (15.4%) patients, leakage followed by biloma in 13/518 (2.5%) patients, leakage followed by stricture in 9/518 (1.8%) patients, and biliary strictures in 101/518 (19.3%) patients. Proper management of the biliary complications resulted in a significant (p value 0.002) success rate of 96.5% compared to the failure rate which was 3.5%. CONCLUSION: Careful preoperative evaluation and the proper intraoperative techniques in biliary reconstruction decrease biliary complications. Early diagnosis and proper management of biliary complications can decrease their effect on both the patient and the graft survival over the long period of follow up.
[Mh] MeSH terms primary: Anastomotic Leak/epidemiology
Biliary Tract Diseases/epidemiology
Biliary Tract/pathology
Liver Transplantation
Living Donors
Postoperative Complications/epidemiology
[Mh] MeSH terms secundary: Adolescent
Adult
Anastomotic Leak/prevention & control
Biliary Tract Diseases/mortality
Biliary Tract Diseases/pathology
Biliary Tract Diseases/prevention & control
Biliary Tract Surgical Procedures/methods
Child
Child, Preschool
Constriction, Pathologic
Female
Graft Survival
Humans
Japan
Liver Transplantation/mortality
Male
Middle Aged
Postoperative Complications/mortality
Postoperative Complications/prevention & control
Reconstructive Surgical Procedures/methods
Retrospective Studies
Survival Rate
Time Factors
Treatment Outcome
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[Js] Journal subset:IM
[Da] Date of entry for processing:170727
[St] Status:MEDLINE
[do] DOI:10.1007/s12664-017-0771-3

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[PMID]: 29477342
[Au] Autor:Marino MV; Glagolieva A; Guarrasi D
[Ad] Address:Departamento de Cirugía General y Emergencia, Complejo Hospitalario Villa Sofia-Cervello, Palermo, Italia. Electronic address: marco.vito.marino@gmail.com.
[Ti] Title:Resección robótica del lóbulo hepático caudado: descripción técnica y consideraciones iniciales. Robotic resection of the liver caudate lobe: technical description and initial consideration.
[So] Source:Cir Esp;, 2018 Feb 21.
[Is] ISSN:1578-147X
[Cp] Country of publication:Spain
[La] Language:eng; spa
[Ab] Abstract:INTRODUCTION: Firstly described in 2002, the robotic liver surgery has not spread widely due to its high cost and the lack of a standardized training program. Still being considered as a 'development in progress' technique, it has however a potential to overcome the traditional limitations of the laparoscopic approach in liver interventions. METHODS: We analyzed the postoperative outcomes of 10 patients who had undergone robotic partial resection of the caudate lobe (Spiegel lobe) from March 2014 to May 2016 in order to evaluate the advantages of robotic technique in hands of a young surgeon. RESULTS: The mean operative time was 258min (150-522) and the estimated blood loss 137ml (50-359), in none of the cases a blood transfusion was required. No patient underwent a conversion to open surgery; the overall morbidity was 2/10 (20%) and all the complications occurred (biliary fistula and pleural effusion) did not require a surgical revision. At histological examination, the mean tumour size was 2.63cm and we achieved R0-resection rate of 100%. The 90-day mortality rate was null. The 1-year overall and disease free-survival rates were 100% and 80%, respectively. CONCLUSIONS: Despite several concerns regarding the cost-effectiveness, a fully robotic partial resection of caudate lobe is an advantageous, implementable technique providing promising short-term postoperative outcomes with acceptable benefit-risk profile.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:Publisher

  8 / 5872 MEDLINE  
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[PMID]: 29470323
[Au] Autor:Peng CH; Wei CH; Yeung CY
[Ad] Address:Department of Pediatrics.
[Ti] Title:Biliary-enteric Fistula, A Rare Complication of Peptic Ulcer Disease in Children.
[So] Source:J Pediatr Gastroenterol Nutr;66(3):e81, 2018 Mar.
[Is] ISSN:1536-4801
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:In-Data-Review
[do] DOI:10.1097/MPG.0000000000001152

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[PMID]: 29464345
[Au] Autor:Müssle B; Hempel S; Kahlert C; Distler M; Weitz J; Welsch T
[Ad] Address:Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
[Ti] Title:Prognostic Impact of Bacterobilia on Morbidity and Postoperative Management After Pancreatoduodenectomy: A Systematic Review and Meta-analysis.
[So] Source:World J Surg;, 2018 Feb 20.
[Is] ISSN:1432-2323
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Intraoperative bile analysis during pancreatoduodenectomy (PD) is performed routinely at specialized centers worldwide. However, it remains controversial if and how intraoperative bacterobilia during PD affects morbidity and its management. The aim of the study was a systematic review and meta-analysis of intraoperative bacterobilia and its impact on patient outcome after PD. METHODS: Five relevant outcomes of interest were defined, and a systematic review of the literature with meta-analysis was performed according to the PRISMA guidelines. RESULTS: A total of 28 studies (8523 patients) were included. The median incidence of bacterobilia was 58% (interquartile range 51-67%). The most frequently isolated bacteria were Enterococcus species (51%), Klebsiella species (28%), and Escherichia coli (27%). Preoperative biliary drainage was significantly associated with bacterobilia (86 vs. 25%; RR 3.27; 95% confidence interval (CI) 2.42-4.42; p < 0.001). The incidence of surgical site infections (SSI) was significantly increased in cases with bacterobilia (RR 2.84; 95% CI 2.17-3.73; p < 0.001). Postoperative pancreatic fistula, overall postoperative morbidity, and mortality were not significantly influenced. Identical bacteria in bile and the infectious sources were found in 48% (interquartile range 34-59%) of the cases. CONCLUSIONS: Bacterobilia is detected during almost every second PD and is associated with an increased rate of SSI. The microbiome from intraoperative bile and postoperative infectious sources match in ~50% of patients, providing the option of early administration of calculated antibiotics and the determination of resistance patterns.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[St] Status:Publisher
[do] DOI:10.1007/s00268-018-4546-5

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[PMID]: 29459813
[Au] Autor:Galindo Orrego P; Bejarano Rengifo J; Labrador López C; Hernández Cely G; Beltrán Galvis OA; Garzón Olarte MA; Ponce de León Chaux E; Ceballos Hurtado JA; Salinas Gómez DC; Varón Puerta A
[Ad] Address:Universidad del Rosario. Bogotá, Colombia.
[Ti] Title:Fístula biliopleurobronquial: reporte de un caso. [Bronchobiliary fistula. Report of a case].
[So] Source:Rev Gastroenterol Peru;37(4):391-393, 2017 Oct-Dec.
[Is] ISSN:1609-722X
[Cp] Country of publication:Peru
[La] Language:spa
[Ab] Abstract:Bronchobiliary fistula (BBF) is an abnormal communication between the biliary tract and the bronchial tree. Is an infrequent condition, usually secondary to a local infectious process or a traumatic event. Bilioptisis is pathognomonic. We present the case of a 37 year old woman with secondary biliary cirrhosis, in list for liver transplantation, with several episodes of cholangitis and carrier of external biliary diverivation, who presented bilioptisis and HIDA scintigraphy with SPECT confirmed BBF. This case was resolved with percutaneous derivation of the biliary tract.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:In-Process


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