Short and long outcomes of endoscopic bilateral metal stent placement for malignant hilar biliary obstruction: Tertiary care oncology centre experience
ConclusionEndoscopic bilateral SEMS in complex malignant hilar obstruction has good outcomes in the form of technical success, functional success and stent patency. Survival is dismal despite optimal biliary drainage. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 18, 2023 Category: Gastroenterology Source Type: research
An Unusual Variant of Anomalous Pancreaticobiliary Junction
Am Surg. 2023 May 4:31348231174017. doi: 10.1177/00031348231174017. Online ahead of print.ABSTRACTA 27-year-old previously healthy African American female presented to the Emergency Department with an acute onset of epigastric abdominal pain and nausea. Laboratory studies proved unremarkable. CT scan demonstrated intrahepatic and extrahepatic biliary ductal dilation with possible stones within the common bile duct. The patient was discharged with a surgery follow-up appointment. Laparoscopic cholecystectomy with intraoperative cholangiography was performed 3 weeks later due to concern for choledocholithiasis. The intraoper...
Source: The American Surgeon - May 4, 2023 Category: Surgery Authors: Samantha Worth Jessica Millard David Jacobs Wesley Jones Source Type: research
Predictors of technical success of percutaneous transhepatic common bile duct stone removal: is it only a matter of stone size?
ConclusionsPTSR is effective for CBD stone removal in older adults and individuals with altered gastrointestinal tract anatomy. The aforementioned risk factors for technical failure should be considered in preoperative evaluation before PTSR to improve the success rate.Key Points•PTSR is effective in symptomatic CBD stone management among older adults and individuals with altered anatomy. Investigating clinical /anatomic factors can guide radiologists toward a more comprehensive preoperative evaluation to maximize the success rate.•Our data indicate that dilated CBD (diameter ≥ 15.5 mm) and left-sided PTBDs red...
Source: European Radiology - April 21, 2023 Category: Radiology Source Type: research
Uncovering patient safety considerations in laparoscopic cholecystectomy using cognitive task analysis
DiscussionLaparoscopic cholecystectomies are complex operations with multiple microsteps. Identification of these steps can lead to explicit strategies that can improve training of surgeons, with an end towards efficacy and safety. The identification of a planning step prior to beginning the operation is a significant finding that should arguably be included in all future cognitive task analyses regardless of operation or procedure, to emphasize to trainees what senior surgeons have learned through experience. These findings inform the development of interventions for surgical training and evaluation of competency. (Source...
Source: Surgical Endoscopy - April 10, 2023 Category: Surgery Source Type: research
High rate of stone-related complications after stapling the cystic duct during laparoscopic cholecystectomy —an underrecognized risk
ConclusionWhether these high complication rates reflect a technical issue with stapling, more challenging anatomy, or worse disease, findings question whether the use of LS during laparoscopic cholecystectomy is truly a safe alternative to the already accepted methods of cystic duct ligation and transection. Based on these findings, an intraoperative cholangiogram should be performed when considering a linear stapler during laparoscopic cholecystectomy to: (1) ensure the biliary tree is free of stones; (2) prevent inadvertent transection of the infundibulum rather than the cystic duct; and, (3) allow opportunity for safe a...
Source: Surgical Endoscopy - March 8, 2023 Category: Surgery Source Type: research
Laparoscopic transcystic common bile duct exploration versus transgastric endoscopic retrograde cholangiography during cholecystectomy after Roux-en-Y gastric bypass
CONCLUSIONS: LTCBDE and transgastric ERC have similarly low complication rates for clearance of intraoperatively encountered CBD stones in RYGB-operated patients, but LTCBDE is faster while transgastric ERC is more often used in conjunction with larger bile duct stones.PMID:36870871 | DOI:10.1016/j.soard.2023.01.023 (Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery)
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - March 4, 2023 Category: Surgery Authors: Hassan Zaigham Lars Enochsson Johan Ottosson Sara Regn ér Source Type: research
Diagnostics in a Surgeon's Pocket-The History of Telepaque and Oral Cholecystograms
Am Surg. 2023 Feb 17:31348231157900. doi: 10.1177/00031348231157900. Online ahead of print.ABSTRACTBiliary diseases such as cholelithiasis, choledocholithiasis, and cholecystitis all rely on imaging modalities to help make diagnoses. In modern times, ultrasound, computer tomography, and nuclear medicine scans help precisely visualize biliary and hepatic anatomy and pathology. The predecessor of these imaging modalities was the cholecystogram. This involved administration of contrast media that reliably had hepatic uptake and biliary excretion without causing significant side effects followed by radiograms of the abdomen. I...
Source: The American Surgeon - February 21, 2023 Category: Surgery Authors: Daud Lodin Anne Lopez Miguel Lopez-Viego Jessica Buicko Source Type: research
Laparoscopic transcystic common bile duct exploration vs transgastric endoscopic retrograde cholangiography during cholecystectomy after Roux-en-Y gastric bypass
Treatment of common bile duct stones after Roux-en-Y gastric bypass (RYGB) poses a particular challenge given the altered anatomy and inability to perform a standard Endoscopic Retrograde Cholangiogram (ERC). The optimal treatment strategy for intraoperatively encountered common bile duct (CBD) stones in post-RYGB patients has not been established. (Source: Surgery for Obesity and Related Diseases)
Source: Surgery for Obesity and Related Diseases - February 3, 2023 Category: Surgery Authors: Hassan Zaigham, Lars Enochsson, Johan Ottosson, Sara Regn ér Tags: Original articles Source Type: research
Laparoscopic transcystic common bile duct exploration versus transgastric endoscopic retrograde cholangiography during cholecystectomy after Roux-en-Y gastric bypass
Treatment of common bile duct (CBD) stones after Roux-en-Y gastric bypass (RYGB) poses a particular challenge given the altered anatomy and inability to perform a standard endoscopic retrograde cholangiogram (ERC). The optimal treatment strategy for intraoperatively encountered CBD stones in post-RYGB patients has not been established. (Source: Surgery for Obesity and Related Diseases)
Source: Surgery for Obesity and Related Diseases - February 3, 2023 Category: Surgery Authors: Hassan Zaigham, Lars Enochsson, Johan Ottosson, Sara Regn ér Tags: Original article Source Type: research
Common bile duct pressure after open intraoperative instrumentation in patients with uncomplicated choledocholithiasis
CONCLUSIONS: CBDP decreases between 2nd and 3rd post-operative weeks. The use of choledochomanometry is useful in clinical scenarios with no access to imaging or interventionism facilities as in remote populations or rural locations.PMID:36480750 | DOI:10.24875/CIRU.21000808 (Source: Cirugia y Cirujanos)
Source: Cirugia y Cirujanos - December 8, 2022 Category: Surgery Authors: David Salda ña-Cortés Abel Jalife-Monta ño No é I Gracida-Mancilla Salvador Vega-Castro Francisco J Galindo-Gonz ález Carlos R Cervantes-S ánchez Source Type: research
Common bile duct pressure after open intraoperative instrumentation in patients with uncomplicated choledocholithiasis
CONCLUSIONS: CBDP decreases between 2nd and 3rd post-operative weeks. The use of choledochomanometry is useful in clinical scenarios with no access to imaging or interventionism facilities as in remote populations or rural locations.PMID:36480750 | DOI:10.24875/CIRU.21000808 (Source: Cirugia y Cirujanos)
Source: Cirugia y Cirujanos - December 8, 2022 Category: Surgery Authors: David Salda ña-Cortés Abel Jalife-Monta ño No é I Gracida-Mancilla Salvador Vega-Castro Francisco J Galindo-Gonz ález Carlos R Cervantes-S ánchez Source Type: research
Common bile duct pressure after open intraoperative instrumentation in patients with uncomplicated choledocholithiasis
CONCLUSIONS: CBDP decreases between 2nd and 3rd post-operative weeks. The use of choledochomanometry is useful in clinical scenarios with no access to imaging or interventionism facilities as in remote populations or rural locations.PMID:36480750 | DOI:10.24875/CIRU.21000808 (Source: Cirugia y Cirujanos)
Source: Cirugia y Cirujanos - December 8, 2022 Category: Surgery Authors: David Salda ña-Cortés Abel Jalife-Monta ño No é I Gracida-Mancilla Salvador Vega-Castro Francisco J Galindo-Gonz ález Carlos R Cervantes-S ánchez Source Type: research
Common bile duct pressure after open intraoperative instrumentation in patients with uncomplicated choledocholithiasis
CONCLUSIONS: CBDP decreases between 2nd and 3rd post-operative weeks. The use of choledochomanometry is useful in clinical scenarios with no access to imaging or interventionism facilities as in remote populations or rural locations.PMID:36480750 | DOI:10.24875/CIRU.21000808 (Source: Cirugia y Cirujanos)
Source: Cirugia y Cirujanos - December 8, 2022 Category: Surgery Authors: David Salda ña-Cortés Abel Jalife-Monta ño No é I Gracida-Mancilla Salvador Vega-Castro Francisco J Galindo-Gonz ález Carlos R Cervantes-S ánchez Source Type: research
