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Prevention and reversal of intestinal failure-associated liver disease in premature infants with short bowel syndrome using intravenous fish oil in combination with omega-6/9 lipid emulsions.

Although premature infants with short bowel syndrome are at the highest risk of developing intestinal failure-associated liver disease (IFALD), they have great capacity for intestinal growth and adaptation if IFALD can be prevented. Conventional soybean oil-based intravenous lipid emulsions have been associated with IFALD. This study presents data on 5 premature neonates with short bowel syndrome treated with a combination of parenteral fish oil- and olive/soybean-based lipid emulsion for periods ranging between 7 and 17 months. Despite an enteral tolerance of less than 50% in 4 of these patie

Laparoscopic choledochal cyst excision, hepaticojejunostomy, and extracorporeal Roux-en-Y anastomosis: a technical skill and intermediate-term report in 62 cases.

BACKGROUND: This study aimed to present the authors' technique and the intermediate-term outcome for laparoscopic choledochal cyst excision … surgery due to anastomotic stricture. CONCLUSIONS: Laparoscopic choledochal cyst excision, hepaticojejunostomy, and extracorporeal Roux-en-Y anastomosis can be safely and quickly performed for children, with satisfactory intermediate-term results. Extracorporeal Roux-en-Y anastomosis could shorten the operative time.

Acute management of aortobronchial and aortoesophageal fistulas using thoracic endovascular aortic repair.

BACKGROUND: Aortobronchial fistula (ABF) and aortoesophageal fistula (AEF) are rare but lethal if untreated; open thoracic surgery is associated with high operative mortality and morbidity. In this case series, we sought to investigate outcomes of thoracic endovascular aortic repair (TEVAR) for emergency cases of ABF and AEF. METHODS: We retrospectively reviewed all patients with AEF and ABF undergoing TEVAR in three European teaching hospitals between 2000 and January 2009. Eleven patients were identified including 6 patients with ABF, 4 patients with AEF, and 1 patient with a combined ABF a

Management of patients of postcholecystectomy benign biliary stricture complicated by portal hypertension.

BACKGROUND: Portal hypertension (PHT) is seen in 15% to 20% of patients with postcholecystectomy benign biliary stricture (BBS). Preliminary portosystemic shunt (PSS) has been recommended to reduce the morbidity and mortality associated with direct stricture repair. Single-center experience of primary repair without preceding PSS in patients of BBS with PHT and a patent portal vein is presented. METHODS: A retrospective study of 13 patients with postcholecystectomy BBS with PHT managed between January 1, 2000 and March 31, 2006. RESULTS: Roux-en-Y hepaticojejunostomy was performed in 11 pati…

Totally Robotic Reversal of Omega-Loop Gastric Bypass to Normal Anatomy.

BACKGROUND: Gastric bypass procedures can potentially lead to middle and long-term complications (Podnos et al. Arch Surg 138(9):957-61, 200 … l adhesiolysis of the left lobe of the liver, small gastric pouch, and omega-loop. Then, the gastro-jejunostomy was transected with a 45-mm Endo GIA endocutter with purple staples. The key-point was the creation of a gastro-gastric anastomosis between the small gastric pouch and the excluded stomach. Omega-loop jejunum was resected and the anastomosis was per …

[Diagnosis and treatment of hepatic artery thrombosis after liver transplantation].

The aim of this study was to examine the clinical presentation and time of hepatic artery thrombosis (HAT) after orthotopic liver transplant … ts were salvaged, but suffered biliary stricture due to ischemic cholangitis and underwent hepatico-jejunostomy. A II Re-OLT was carried out in 4 of 12 patients (33.3%). The overall mortality rate was 41.1% (7/17). One-year and 3-year overall survival rates were 58.8% (10/17) and 47.0% (8/17), respectively. Both 5- and 10-year overall survival rates were 11.7 …

[Congenital dilatation of the common bile duct (congenital choledochal cyst)].

INTRODUCTION: Choledochal cyst, although a rare disease, is the most frequent malformation of the extrahepatic biliary ducts. The review of … tion of bile ducts from the pancreatic duct. This is achieved by the technique of Roux-en-Y hepaticojejunostomy. The paliative method of internal drainage of choledochal cyst consists of cystoduodeno or cystojejunostomy, but is now abandoned, as the disease continues with all its manifestations and complications. The internal drainage was performed in 6 our p …

A case of neuroendocrine carcinoma in the hepatic hilar lymph nodes concomitant with an adenocarcinoma of the gallbladder.

BACKGROUND: Neuroendocrine tumors (NETs) are rare especially in the gallbladder. They have not been elucidated in the pathogenesis, clinicopathological characteristics, and treatment options. CASE PRESENTATION: We present a 76-year-old woman with a gallbladder tumor and hepatic hilar lymph node swelling. The lymph node biopsy demonstrated neuroendocrine carcinoma (NEC). We performed cholecystectomy, hepatic hilar lymphadenectomy, extrahepatic biliary duct resection, and hepaticojejunostomy prior to chemotherapy. Pathological examination revealed the gallbladder mass was an adenocarcinoma inva…

Paediatric intestinal pseudo-obstruction: a scoping review.

Paediatric intestinal pseudo-obstruction (PIPO) encompasses a group of rare disorders in which patients present with the clinical features of bowel obstruction in the absence of mechanical occlusion. The management of PIPO presents a challenge as evidence remains limited on available medical and surgical therapy. Parenteral nutrition is often the mainstay of therapy. Long-term therapy may culminate in life-threatening complications including intestinal failure-related liver disease, central line thrombosis and sepsis. Intestinal transplantation remains the only definitive cure in PIPO but is a

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… In many cases, especially in those with evidence of delayed gastric emptying, the stomach is bypassed with naso-jejunal or percutaneous endoscopic jejunostomy (PEJ) tubes [ 49 , 52 , 53 ]. PN can be commenced alone or in combination with EN if enteral feeds fail or are inadequate. … Cajal Intestinal failure associated liver disease Megacystis microlon intestinal hypoperistalsis syndrome Migrating motor complex Mitochondrial neurogastrointestinal encephalopathy Magnetic resonance imaging Paediatric intestinal pseudo-obstruction Parenteral nutrition Percutaneous endoscopic jejunostomy …

Undifferentiated Intimal Sarcoma of the Large Abdominal Arteries Presenting As Acute Mesenteric Ischemia: A Case Report.

Primary malignant tumors of the large arteries are exceedingly rare and diagnostically challenging. Undifferentiated intimal sarcomas and leiomyosarcomas are the major types encountered. Intimal sarcomas are highly aggressive neoplasms characterized by intraluminal growth and a tendency to mimic thromboembolic disease, often resulting in delayed diagnosis and poor outcomes. We report the case of a 63-year-old man who presented with progressive abdominal pain and weight loss and rapidly developed acute mesenteric ischemia due to extensive intraluminal obstruction of the descending and abdominal

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… Three days later, a third-look laparotomy was performed, during which additional jejunal resection and formation of an end jejunostomy were required. …

Macroglossia due to Systemic Amyloidosis: Is There a Role for Radiotherapy?

BACKGROUND: Macroglossia due to amyloid depositions can cause cosmetic problems and functional disability, and can lead to life-threatening airway obstruction. Management of macroglossia in systemic amyloidosis is controversial, and the role of surgery is unclear. CASE DESCRIPTION: We present a case of a 66-year-old woman affected by macroglossia due to light chain amyloidosis who presented with eating and breathing difficulties. Because of prior successful results of radiotherapy for localized amyloid disease, our patient was treated with external beam radiation therapy (20 Gy in 10 fraction

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… Therefore, tracheostomy and gastrostomy or jejunostomy for enteral alimentation are the only approaches available for the majority of patients affected by systemic amyloidosis [ 1 , 5 ]. The role of radiation therapy in the management of macroglossia secondary to amyloid has not been reported. …

A Review on the Multidisciplinary Approach for Cancer Management in the Eastern Mediterranean Region: A Focus on Nutritional, Lifestyle and Supportive Care.

Cancer is one of the leading causes of global morbidity and mortality and one of the most challenging global health conditions, impacting the lives of millions every year. The Eastern Mediterranean Region (EMR) is not on track to achieve the sustainable development goal (SDG) target 3.4 which aims to reduce premature mortality (i.e., before the age of 70 years) for non-communicable diseases (NCDs), including cancer, by a third by year 2030; instead, it is projected that the EMR will experience the least progress towards achieving this target. This review therefore highlights the importance of

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… Examples of enteral feeding tubes include nasogastric (from the nose to the stomach), nasoduodenal (from the nose to the duodenum), nasojejunal (from the nose to the jejunum), gastrostomy (directly to the stomach), jejunostomy (directly to the jejunum) and a combination of gastrostomy and jejunostomy …

Efficacy and safety of endoscopic ultrasound-guided gastrojejunostomy in patients with malignant gastric outlet obstruction and ascites.

Background and study aims  Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is an endoscopic procedure for treating gastric outlet obstruction (GOO). Limited data exist regarding the safety and efficacy of EUS-GJ in patients with malignant GOO with ascites. Thus, we aimed to study the outcomes and safety of EUS-GJ in GOO patients with vs. without ascites. Patients and methods  This is a retrospective cohort study of patients with malignant GOO who underwent successful EUS-GJ at a tertiary care academic center. Primary outcomes included the efficacy and safety of EUS-GJ. Secondary outcom…

Vascular endothelial growth factor promotes fibrosis resolution and repair in mice.

BACKGROUND & AIMS: Vascular endothelial growth factor (VEGF)-induced angiogenesis is implicated in fibrogenesis and portal hypertension. However, the function of VEGF in fibrosis resolution has not been explored. METHODS: We developed a cholecystojejunostomy procedure to reconstruct biliary flow after bile duct ligation in C57BL/6 mice to generate a model of fibrosis resolution. These mice were then given injections of VEGF-neutralizing (mcr84) or control antibodies, and other mice received an adenovirus that expressed mouse VEGF or a control vector. The procedure was also performed on macrop…

[Clinical effectiveness of fecal microbiota transplantation combined with nutritional support and psychological intervention in patients with "Tetralogy of Tongji"].

Objective: To summarize and analyze the clinical effect of fecal microbiota transplantation (FMT) combined with nutritional support and psyc … es, life-threatening systemic comorbidities, intorlerate to nasojejunal, percutaneous gastrostomy / jejunostomy or FMT. The clinical data of 43 patients at Shanghai Tenth People's Hospital exhibiting the "Tetralogy of Tongji" and who received microflora transplantation combined with nutritional support and psychotherapy from June 2017 to June 2021 was prospec …

Quality of life in dysphagia and functional performance of cancer patients in palliative care.

PURPOSE: To correlate the functional performance and impact of dysphagia on the quality of life of cancer patients in palliative care. METHODS: This cross-sectional, quantitative study was conducted at the outpatient clinic and oncology ward of a university hospital. Inclusion criteria required patients to respond positively to the question: "Do you have difficulty or problems swallowing?". Patients were excluded if they had been diagnosed with head and neck cancer, were unable to answer questionnaires due to actively dying status, were in a state of drowsiness, experienced extreme pain and s

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… Only one patient was not fed orally because they had a jejunostomy (2.6%). Only one patient did not fill in this information and had the data missing (2.6%). The SLH team had not evaluated any of the patients before they were interviewed in the ward. …

Outcomes and quality of life after major bile duct injury in long-term follow-up.

IntroductionRecently new standards for reporting outcomes of bile duct injury (BDI) have been proposed. It is unclear how these treatment outcomes are reflected in quality of life (QOL). The aim of this study was to report outcomes and QOL after repair of major BDI and compare repairs by hepatobiliary surgeon to repairs by non-hepatobiliary surgeons.MethodsThis was a retrospective study of patients treated for major (Strasberg E-type) BDI after cholecystectomy at a tertiary hepatobiliary center. Outcomes were assessed using Cho-Strasberg proposed standards. QOL was assessed using Short Form He

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… Winslow ER Fialkowski EA Linehan DC Hawkins WG Picus DD Strasberg SM "Sideways": results of repair of biliary injuries using a policy of side-to-side hepatico-jejunostomy Ann Surg 2009 249 426 434 10.1097/SLA.0b013e31819a6b2e 19247030 14. …

Clinical applications of palifermin: amelioration of oral mucositis and other potential indications.

Mucositis is one of the most significant toxicities in cancer patients undergoing cytotoxic treatment. It can have a negative impact on both quality of life and health economics. Severe oral mucositis can contribute to hospitalization, need for narcotic analgesics, total parentral nutrition, suboptimal delivery of anti-neoplastic treatment, and morbidity and mortality. Palifermin, a recombinant derivative of human keratinocyte growth factor, is the first active agent approved by the FDA for the prevention of severe oral mucositis in patients undergoing haematopoietic stem cell transplantation

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… Oesophagitis and dysphagia may be severe and disabling, resulting in pain, weight loss, hospitalization and the need for a gastrostomy or jejunostomy tube for enteral feeding. …

2023 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Montréal, Canada, 19 March–April 1 2023: Posters

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Gastric electrical stimulation: an evidence-based analysis.

OBJECTIVE: The objective of this analysis was to assess the effectiveness, safety and cost-effectiveness of gastric electrical stimulation ( … nts with chronic, symptomatic GP who are refractory to drug treatment, surgical options may include jejunostomy tube for feeding, gastrotomy tube for stomach decompression and pyloroplasty for gastric emptying. Few small studies examined the use of botulinum toxin injections into the pyloric sphincter. However, the contribution of excessive pyloric contractio …