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[Clinicopathological features and surgery-related outcomes of duodenal adenocarcinoma: a multicenter retrospective study].

Objective: This multicenter retrospective study aimed to analyze the clinicopathological features of duodenal adenocarcinoma (DA) and identify prognostic factors for postoperative survival. Methods: Demographic characteristics, clinicopathological features, treatment outcomes and survival of DA patients undergoing surgical treatment at 18 Chinese medical centers from January 2012 to December 2023 were retrospectively analyzed. Results: Among the 2 056 DA patients included, 46.8% (963) had extra-ampullary DA (EA-DA), and 53.2% (1 093) had peri-ampullary DA (PA-DA). The 1-, 3-, and 5-year overal

[Sealing of the hepatic resection area using hemostat devices does not improve results of adequate surgery].

PURPOSE: In hepatic resections, there has been a high quality demand. The aim of this systematic clinical, prospective, unblinded unicenter … od cell count (leucocytosis). 5) General and specific complications such as postoperative bleeding, biliary fistula and subhepatic abscess were not further lowered in a significant manner using hemostat device. CONCLUSION: Adequate surgery in the operative management of hepatic resection area cannot further be improved or optimized using hemostat device. In this …

[Computerized tomography-guided drainage of postoperative abdominal fluid collections].

INTRODUCTION: We report our personal technique and the results of CT-guided percutaneous drainage of postoperative abdominal fluid collections. MATERIAL AND METHODS: January 1990 to March 1998, eighty-three patients were treated for postoperative abdominal fluid collections. Forty-eight patients had undergone bowel resection, 11 laparoscopic cholecystectomy, 3 cholecystectomy, 5 splenectomy, 3 cephalopancreasectomy, 6 hepaticojejunal anastomosis, 4 hepatic resection, 2 laparocele, 1 hysterectomy. The complications had developed few days to about one year postoperatively. The suspicion of abdo

Visceral artery aneurysms.

Visceral artery aneurysms (VAA) frequently present as life-threatening emergencies. The purpose of this study was to review our experience with VAA treatment. Between 1988 and April 2002, 31 VAA were treated in 28 patients (14 males, 14 females) with average age of 55 +/- 15 years. The most common locations were the splenic artery (16) and the hepatic artery (7). Three patients underwent emergency surgery, 22 patients had elective open surgery, and 7 patients underwent endovascular treatment. In the surgical group the perioperative mortality rate was 3.6%. The perioperative morbidity rate was

Italian SIGENP (Italian Society of gastroenterology, hepatology and pediatric nutrition) registry of pediatric home artificial nutrition: First report.

BACKGROUND: Home Artificial Nutrition (HAN), including Home Enteral Nutrition (HEN) and Home Parenteral Nutrition (HPN), is essential for managing pediatric patients with complex nutritional needs. This article presents the first report from the Italian Pediatric HAN registry, promoted and endorsed by the Italian Society for Pediatric Gastroenterology, Hepatology, and Nutrition (SIGENP) in order to document HAN practices and clinical outcomes. AIMS: The registry aims to analyze data from the Italian network of pediatric HAN to provide insights into its epidemiology, efficacy and safety. METH

Neoadjuvant chemoradiation followed by orthotopic liver transplantation in cholangiocarcinomas: the emory experience.

BACKGROUND: Cholangiocarcinoma (CCA) is a bile duct tumor with a grim prognosis. The median survival after radiotherapy of unresectable disease is 9-12 months. The following is a review of our experience with neoadjuvant (NEO) chemoradiation followed by orthotopic liver transplantation (OLT) for CCA. METHODS: Ten patients with CCAs were selected as candidates for NEO-OLT between 2008-2011. Patients with unresectable CCA above the cystic duct without intra or extrahepatic metastases were eligible. Primary sclerosing cholangitis (PSC) patients were included due to their poor resection response.

Influence of the heat irrigating effect of radiofrequency ablation on regional liver tissue in Bama miniature pigs.

BACKGROUND: The results of the heat irrigating effect of radiofrequency ablation (RFA) are uncertain, and the accurate impact of the heat ir … successfully underwent ultrasound-guided RFA. No serious complications, such as massive hemorrhage, biliary fistula, severe pleural effusion, pneumothorax, peripheral organ failure, or renal failure occurred in any of the animals during the perioperative period. The RFA coagulative necrosis lesion was spherical and the surrounding liver tissue showed an inflammat …

Comparison between living donor liver transplantation recipients who met the Milan and UCSF criteria after successful downstaging therapies.

BACKGROUND AND AIMS: Various downstaging therapies were introduced to liver recipients who could not meet the relative criteria for liver tr … : intra-abdominal hemorrhage after right hepatectomy, upper gastrointestinal hemorrhage after TACE, biliary fistula after resection, and hand-foot syndrome after taking sorafenib. All complications after LDLT, classified according to the Clavien-Dindo system, were compared within the two groups, and the calculated score of the complications in group 1 was 1.48 ± …

[Long-term results of reconstruction of benign stenoses of the bile ducts].

UNLABELLED: Over 27 year period (1.01.1974-31.12.2001) a 168 patients (pts) were operated on for benign bile duct strictures of types I to IV according to Bismuth's classification. Reconstruction of fresh lesions and lesions and strictures of sectorial or segmental ducts were not taken into account. The later are to be the subject of separate publication. There were 107(63.7%) women and 61(36.3%) men of average age of 46 years (ranging from 14 to 76 years). The average time from injury to our reconstruction was 8.2 years. In 162 pts (96.4%) an operative injury was the cause of the stricture, i

Iatrogenic portobiliary fistula treated by stent-graft placement.

Stent-graft exclusion of an ischemic, hilar portobiliary fistula after liver transplantation has not been reported. Isolated reports have described peripheral or nonischemic fistulas, and alternative treatment options have ranged from balloon tamponade to surgical repair. We present a unique case of a hilar portobiliary fistula successfully treated to resolution by unilateral placement of a stent-graft.

Post Cholecystectomy Bile Duct Injury in an Acute Setting: Categorization, Triaging, and Management Algorithm.

Background Postcholecystectomy bile duct injury (BDI) is a management challenge with significant morbidity, mortality, and effects on long-t … laparotomy, lavage, and drainage (n=7, 6.03%). Another 10 patients (8.62%) had controlled external biliary fistula (green zone), of which four were managed with antibiotics, four underwent endoscopic retrograde cholangiopancreatography stenting, and only two (1.7%) patients could undergo Roux-en-Y hepaticojejunostomy upfront due to late referral. Among patients …

Predictors of outcome after reconstructive hepatico-jejunostomy for post cholecystectomy bile duct injuries.

INTRODUCTION: Reconstructive hepatico-jejunostomy is recommended for major bile duct injuries (BDIs) during cholecystectomy. Complications of biliary leak, cholangitis, bleeding, anastomotic strictures and biliary cirrhosis remain a major concern affecting a patient's outcome after surgery. The aim of this study was to analyse the results of surgical repair of major BDIs at our institution and identify predictors for the development of major complications. METHODS: A retrospective study of 57 patients with major BDI after cholecystectomy referred to a tertiary hepato-biliary centre from July

Chronic inflammatory bowel disease and cancer.

Colorectal cancer represents the major cause for excess morbidity and mortality by malignant disease in ulcerative colitis as well as in Crohn's disease. The risk for ulcerative colitis associated colorectal cancer is increased at least 2-fold compared to the normal population and colorectal cancer is observed in 5.5-13.5% of all patients with ulcerative colitis and 0.4-0.8% of patients with Crohn's disease. Established risk factors include long duration of the disease, large extent of the disease, low activity of the disease, young age at onset, presence of complicating primary sclerosing cho

Imaging of abdominal and pelvic infections in the cancer patient.

Infections are the most commonly encountered complications in patients with cancer. The classical signs and symptoms of infections are often not present in this patient population, which makes the diagnosis more challenging. Host factors play a major role in the development and prognosis of infections in cancer patients; these can be related to the underlying type of malignancy (solid organ versus hematological), tumor burden, anatomic obstruction, altered integrity of barriers (skin or mucosa), treatment-related factors (from chemotherapy, radiation treatment, surgery, interventional procedur

Comparison of Efficacy of ERCP+LC and LC+LCBDE on Cholecysto-Choledocholithiasis and Analysis of Risk Factors for Recurrence of Choledocholithiasis.

OBJECTIVE: Laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde chola … (P > .05). The postoperative complications mainly included incision infection, bile duct bleeding, biliary fistula, abdominal infection, bile duct pneumatosis, cholangitis and acute pancreatitis. Hyperamylasemia occurred in 8 cases after operation in the ERCP+LC group, greatly more than that in the LC+LCBDE group (1 case) (P = .016), while the incidence of other …

Exploratory study of microparticle transcatheter arterial chemoembolization combined with resection for huge hepatocellular carcinoma.

OBJECTIVE: To investigate the safety and clinical efficacy of microparticle transcatheter arterial chemoembolization (mTACE) combined with s … and the amount of intraoperative bleeding was (433 ​± ​158) mL (200-600 ​mL). Complications such as biliary fistula, abdominal bleeding, liver and kidney failure, or abdominal infection were not found. The postoperative hospital stay was (13 ​± ​4) days (9-19 days). No tumor invasion was found at the cutting edge, and hepatic vein invasion was observed in one cas …

63rd Annual Conference of the Indian Society of Gastroenterology, ISGCON 2022-January 5th - 8th, 2023 in Jaipur.

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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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… fistula had occurred and healed within one year. … Grade D result means that stent(s) were present over 24 months, third surgical repair was performed, liver resection or transplantation was performed for unreconstructable biliary tree, biliary fistula was present more than 2 years, and/or liver cirrhosis developed. …