China
Africa
Explore chapters and articles related to this topic
Biliary Leak after Pancreatoduodenectomy for Duodenal Neuroendocrine Tumors
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Gayatri Balachandran, Sadiq S. Sikora
Low-volume fistulae with no features of peritonitis may be managed conservatively with continued abdominal drainage. Imaging is crucial in this group of patients to rule out any undrained intra-abdominal collections; these need to be addressed with percutaneous drainage or drain repositioning/upsizing. Periprocedural antibiotics are administered, but there is usually no indication for long-term antibiotics. Spontaneous closure of biliary fistula occurs in around 50% of cases with expectant management over a variable period ranging from 2–12 weeks. Correction of electrolyte disturbances and nutritional optimization are important in these patients.
The Liver and the Biliary System
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
If such amebic cyst exists and does not respond to such treatment, these patients as well as patients with hydatid cysts should be treated surgically by external drainage. During surgery, extreme caution should be taken to avoid the spilling of either hydatid cyst or amebic cyst contents into the peritoneal cavity. A sump drain can be inserted to drain the cyst out. Some surgeons prefer to resect the wall of the cyst while others prefer to put formaldehyde or a high concentration of saline in the hydatid cyst. If the biliary fistula develops later following the drainage of either of these cysts, Roux-en-y drainage is in order.
The Seventeenth Century
Published in Arturo Castiglioni, A History of Medicine, 2019
Regnier degraaf (1641–73) was a Dutch anatomist and physiologist who was celebrated for his work on digestion as well as on the anatomy of the genital organs, vasa deferentia, and the tubules of the testicle (De virorum organis generationi inservientibus, Leiden, 1668). He discovered the ovarian follicle (1672), to which Haller gave the name “Graafian.” In his De natura et usu sued pancreatici (Leiden, 1664) de Graaf demonstrated the function of this organ after collecting the pancreatic juice in an experimental fistula. He also studied the nature of the bile collected in the same way from a biliary fistula. Philip verheyen (1647–1710) was the author of a treatise on anatomy (1693, and a larger edition in 1710) which contained interesting microscopic studies. He maintained that the blood plasma was the really important part of the blood in the nutrition of the body. Frederik dekkers, of Leiden (1648–1720), enjoyed a wide reputation as physician and surgeon, but concerns us more as an early contributor to clinical pathology with his discovery of albumin in the urine (1694), which could be detected by boiling it with acetic acid.
Risk factors for post-endoscopic retrograde cholangiopancreatography cholangitis in patients with hepatic alveolar echinococcosis—an observational study
Published in Annals of Medicine, 2022
Fei Du, Wenhao Yu, Zhixin Wang, Zhi Xie, Li Ren
The primary endpoint of the analysis was the incidence of post-ERCP cholangitis. It is diagnosed according to the standard dictionary of endoscopic complications [17] issued by the American Society for Gastrointestinal Endoscopy (ASGE). Post-ERCP cholangitis was defined as a postoperative biliary fever (body temperature >38 °C), no preoperative fever, acute cholestasis with no cholecystitis, and other possible infections. The post-surgical biliary fistula was defined as either: fluid with an increased bilirubin concentration in the abdominal drain or the intra-abdominal fluid on or after postoperative day 3; the need for radiologic intervention; grade B bile leakage requiring a change in the patient’s clinical management but manageable without relaparotomy; or a grade A bile leakage lasting for >1 week [18]. The diagnosis of a non-surgical biliary fistula was based on biochemical tests, an imaging examination, or ERCP.
Factors Affecting the Choice of Treatment in Hepatic Hydatid Cyst Surgery
Published in Journal of Investigative Surgery, 2022
In the study, postoperative biliary leakage developed in 7.5% of the patients, and ERCP was applied to these patients. When the radical surgical treatment method was taken as a reference in the study, PAIR increased the state of ERCP implementation and biliary leakage by 29.7 folds, whereas conservative surgical treatment method increased by 3.6 folds. In many studies comparing treatment methods with postoperative biliary fistula and the status of ERCP implementation, a significant difference was found and the number of biliary fistula and ERCP need were found to be higher in patients who underwent conservative surgery [9, 11, 12, 15, 16, 18, 20, 21]. On the other hand, contrary to most studies, in a study in which 34-year data were evaluated (232 cases in total) in Italy, no significant difference was found between treatment methods and postoperative biliary leakage [14].
Mucin-producing hepatic cystic neoplasms: an uncommon but challenging disease often misdiagnosed and mismanaged
Published in Acta Chirurgica Belgica, 2020
J. Frezin, M. Komuta, F. Zech, L. Annet, Y. Horsmans, J. F. Gigot, A. Jouret-Mourin, C. Hubert
Surgical procedures were as follows (Table 4): anatomical resection of two benign and two invasive MHCN (cases 1, 2, 8, 9), enucleation of three benign MHCN (cases 4, 5, 6; case 5 had coexistent cryptogenic liver cirrhosis) and of one large bilobar malignant MHCN (case 7). The latter was presumed benign MHCN but high-grade dysplasia (HGD) with focal invasion was detected on final pathology, resulting in retrospective radical R0 resection. Finally, case 3, a unilocular atypical cystic lesion, underwent the unroofing procedure. Bile – within a macroscopically normal-looking cyst – was thought to stem from previous percutaneous cyst aspirations and alcohol sclerotherapy performed elsewhere. The laparoscopic procedure was converted to open surgery for closure of the biliary fistula.