Neonatal Jaundice
AbstractHyperbilirubinemia is a common occurrence in neonates; it may be physiological or pathological. Conjugated hyperbilirubinemia may result from medical or surgical causes, and can result in irreversible liver damage if untreated. The aim of imaging is the timely diagnosis of surgical conditions like biliary atresia and choledochal cysts. Abdominal ultrasound is the first line imaging modality, and Magnetic resonance cholangiopancreatography (MRCP) also has a role, especially in pre-operative assessment of choledochal cysts (CDCs). For biliary atresia, the triangular cord sign and gallbladder abnormalities are the two...
Source: Indian Journal of Pediatrics - August 17, 2019 Category: Pediatrics Source Type: research
Gallstone Pancreatitis: Admission Versus Normal Cholecystectomy—a Randomized Trial (Gallstone PANC Trial)
Introduction:
Early cholecystectomy shortly after admission for mild gallstone pancreatitis has been proposed based on observational data. We hypothesized that cholecystectomy within 24 hours of admission versus after clinical resolution of gallstone pancreatitis that is predicted to be mild results in decreased length-of-stay (LOS) without an increase in complications.
Methods:
Adults with predicted mild gallstone pancreatitis were randomized to cholecystectomy with cholangiogram within 24 hours of presentation (early group) versus after clinical resolution (control) based on abdominal exam and normalized laborat...
Source: Annals of Surgery - August 15, 2019 Category: Surgery Tags: PAPERS OF THE 139TH ASA ANNUAL MEETING Source Type: research
Acute kidney injury due to high-output external biliary drainage in a patient with malignant obstructive jaundice: a case report
ConclusionAlthough the mechanism by which this occurs in some cases is unclear, early identification and prompt fluid resuscitation prevent acute kidney injury. The adoption of new strategies for internal drainage of long complex strictures will both prevent and ameliorate this problem. (Source: Journal of Medical Case Reports)
Source: Journal of Medical Case Reports - August 12, 2019 Category: General Medicine Source Type: research
Complex bile duct injuries after laparoscopic cholecystectomy: a comparative outcomes analysis of patients treated in tertiary private and public health facilities in Cape Town, South Africa.
CONCLUSION: Despite differences in public and private healthcare system resources, patients were referred early and appropriately from both sectors and had similar postoperative outcomes when treated in a specialised unit.
PMID: 31392861 [PubMed - in process] (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - August 10, 2019 Category: Surgery Tags: S Afr J Surg Source Type: research
Impact of Laparoscopy on Training: Are Open Appendectomy and Cholecystectomy on the Brink of Extinction?
Abstract
The operative experience of present-day surgical residency training has evolved as a result of the contributions of laparoscopic surgery. Some traditional open procedures are now more descriptive and less of a familiarity to many general surgery residents (GSRs). The aim of this study was to investigate how open operative experience compares with laparoscopy for GSRs. A retrospective, multicenter, consecutive cohort study of all patients undergoing surgical intervention involving the appendix and gallbladder identified from the ACS-NSQIP database over a 2.5-year period. All GSR postgraduate year-l...
Source: The American Surgeon - June 30, 2019 Category: Surgery Authors: Melmer PD, Chaconas C, Taylor R, Verrico E, Cockcroft A, Pinnola A, Holmes S, Sciarretta JD, Davis JM Tags: Am Surg Source Type: research
902 peritoneal endosonography for rescue of a fractured jackson-pratt drain
A 68-year-old male with a history of hypertension and chronic cholecystitis underwent open cholecystectomy with intraoperative cholangiogram which demonstrated choledocholithiasis and duct of Luschka leak. The duct was cauterized and a 10 French Jackson-Pratt (JP) drain was placed. The drain put out a small amount of bilious drainage and liver enzymes were normal. HIDA scan was performed and demonstrated minimal tracer at the JP drain site. The patient presented three weeks post-op for ERCP with stone removal and discontinuation of the percutaneous drain. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - May 31, 2019 Category: Gastroenterology Authors: Theodore James, Todd H. Baron Tags: Oral abstract Source Type: research
Pediatric Laparoscopic Common Bile Duct Exploration: An Opportunity to Decrease ERCP Complications
Laparoscopic intraoperative cholangiogram (IOC) with common bile duct exploration (CBDE) and endoscopic retrograde cholangiopancreatography (ERCP) are two therapeutic techniques for choledocholithiasis. The preferred technique is unclear. (Source: Journal of Surgical Research)
Source: Journal of Surgical Research - May 22, 2019 Category: Surgery Authors: R. Elliott Overman, Lily B. Hsieh, Tina T. Thomas, Samir K. Gadepalli, James Geiger Tags: Pediatric/Congenital/Developmental Source Type: research
Biliary features in liver histology of children with autoimmune liver disease
ConclusionsMajority of patients with pediatrics AILD have “moderate” or “severe” features of biliopathy; AIH and ASC are not easily distinguishable on histological ground at diagnosis, and therefore, the cholangiogram remains the only effective tool to differentiate patients with AIH from those with ASC. Further prospective studies are needed to be tter define histological biliary features in AILD, assess if the biliopathy responds to immunosuppressive treatment and evaluate its impact on long-term outcome. (Source: Hepatology International)
Source: Hepatology International - May 7, 2019 Category: Infectious Diseases Source Type: research
Intraoperative Air Leak Test to Prevent Bile Leak After Right Posterior Sectionectomy with En Bloc Diaphragm Resection for Metastatic Teratoma
ConclusionIn cases of combined liver and diaphragmatic resection, prevention of bile leak, with subsequent contamination of the diaphragm repair and even the thoracic cavity, is particularly vital. An easily replicated intraoperative air leak test can mitigate the risk of bile leak and organ-space infection, as well as associated sequelae on quality of life, return to intended oncologic therapy, and oncologic outcomes. (Source: Annals of Surgical Oncology)
Source: Annals of Surgical Oncology - May 6, 2019 Category: Cancer & Oncology Source Type: research
Digital cholangioscopy can detect residual biliary stones missed by occlusion cholangiogram in ERCP: a prospective tandem study
Conclusions Occlusion cholangiogram can miss residual stones in patients with dilated bile ducts and those receiving lithotripsy. Digital POC can increase the yield of residual stone detection in these patients and should be considered to confirm clearance of stones. (ClinicalTrials.gov-NCT03482375). [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | open access Full text (Source: Endoscopy International Open)
Source: Endoscopy International Open - April 11, 2019 Category: Gastroenterology Authors: Sejpal, Divyesh V. Trindade, Arvind J. Lee, Calvin Miller, Larry S. Benias, Petros C. Inamdar, Sumant Singh, Gurshawn Stewart, Molly George, Benley J. Vegesna, Anil K. Tags: Original article Source Type: research
Revision Roux-en-y hepaticojejunostomy for a post-cholecystectomy complex vasculobiliary injury with complete proper hepatic artery occlusion: A Case report literature review
CONCLUSIONAssessment of hepatic arteries should be part of investigation of all complex biliary injuries. Delayed definitive biliary enteric repair ensures a well-perfused anastomosis. Minimum hilar dissection is the key to preserve biliary and hepatic neovasculature. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - April 10, 2019 Category: Surgery Source Type: research
A successful combined laparoscopic cholecystectomy and laparoscopic exploration of common bile duct for acute gangrenous cholecystitis and choledocholithiasis during pregnancy: A case report
ConclusionLap ECBD avoided ionizing radiation for choledocholithiasis during pregnancy, and can combined with LC as an effective minimally invasive procedure for complicated gallstone disease. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - April 9, 2019 Category: Surgery Source Type: research
Natural Course of Acute Cholecystitis in Patients Treated With Percutaneous Transhepatic Gallbladder Drainage Without Elective Cholecystectomy
ConclusionsDefinitive cholecystectomy is still recommended for patients undergoing PTGBD treatment due to the high incidence of later biliary events. A thorough preoperative evaluation is necessary for those patients before elective cholecystectomy because of the inferior life expectancy and physical status. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - April 2, 2019 Category: Surgery Source Type: research
Index Admission Emergency Laparoscopic Cholecystectomy and Common Bile Duct Exploration: Results From a Specialist Center in the United Kingdom
Conclusions:
Index admission laparoscopic cholecystectomy and concomitant CBDE is safe and should be the gold standard treatment for patients presenting with acute biliary complications, reducing readmissions and the need for a 2-stage procedure. (Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques)
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - April 1, 2019 Category: Surgery Tags: Original Articles Source Type: research
Case Report of a Duplicated Cystic Duct: A Unique Challenge for the Laparoscopic Surgeon
CONCLUSIONThe limited success of preoperative biliary tract imaging in demonstrating anatomic aberrancies prior to cholecystectomy clearly highlights the importance of maintaining constant vigilance for even the slightest anatomic abnormality at operation. Any uncertainty or concern for ductal injury mandates immediate operative cholangiogram with cannulation of all structures in question. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - March 1, 2019 Category: Surgery Source Type: research
