Workye Tigabie, Hadush Tesfay, Dagnachew Tamrat, Kassahun Raya, Tihitena Negussie
INTRODUCTION: Choledochal cyst (CC) is an uncommon congenital disease of the biliary tract. There are five main types of CC with several recognized sub-types. However, occasional variants with a difficulty in diagnosis and management do occur. PRESENTATION OF THE CASE: We report a case of a nine years old female child diagnosed with CC who presented with right quadrant abdominal pain with unremarkable physical findings. Investigation using abdominal CT scan suggested type II choledochal cyst...
September 11, 2020: International Journal of Surgery Case Reports
Marcel Autran C Machado, Bruno H Mattos, Murillo M Lobo Filho, Fabio F Makdissi
BACKGROUND: Surgical resection is the standard treatment for colorectal liver metastases. Parenchyma-sparing technique should always be attemptedto prevent postoperative liver failure and increase the opportunity to perform repeated resections in cases of recurrent malignancy. Postero-superior liverresection is defined as the anatomical removal of liver segments 7 and 8, however, minimally invasive resection of postero-superior liver segments isconsidered a difficult and complex operation and thus is rarely reported...
September 18, 2020: Journal of Gastrointestinal Surgery
Takeshi Aoki, Doaa A Mansour, Tomotake Koizumi, Yusuke Wada, Yuta Enami, Akira Fujimori, Tomokazu Kusano, Kazuhiro Matsuda, Koji Nogaki, Yoshihiko Tashiro, Tomoki Hakozaki, Hideki Shibata, Kodai Tomioka, Takahito Hirai, Tatsuya Yamazaki, Kazuhiko Saito, Satoru Goto, Makoto Watanabe, Koji Otsuka, Masahiko Murakami
BACKGROUND: Recently, virtual navigation system has been applied to hepatic surgery, enabling better visualization of intrahepatic vascular branches and location of tumor. Intraoperative ultrasonography (IOUS) is the most common form of image guidance during liver surgery. However, during laparoscopic hepatectomies (LH), IOUS has several limitations and its reliability has been poorly evaluated. The objective of this work is to evaluate VRCT (virtual real-time CT-guided volume navigation) during LH...
September 8, 2020: Journal of Gastrointestinal Surgery
Cdr Bennett H Shapiro, Ramsey C Cheung, Nicholas J Giori
BACKGROUND: In 2012, we reported on the prevalence of hepatitis C virus (HCV) infection in Veterans Affairs (VA) patients undergoing total joint arthroplasty (TJA) at our center. In this patient population, 8.4% were antibody positive and 4.5% were viremic with HCV. In 2014, the first all-oral direct-acting antiviral treatment for hepatitis C became available. The Department of Veterans Affairs then underwent an aggressive program to eradicate hepatitis C from the veteran population. The purpose of this report is to provide updated information on the prevalence of HCV viremia among patients undergoing primary TJA at the same center...
August 18, 2020: Journal of Arthroplasty
Kwang Yeol Paik
BACKGROUND: The common approach of Lymph node dissection (LND) during laparoscopic radical cholecystectomy (LRC) is an anterior approach [1,2], which emulates the view of open surgery. However, isolating the post-pancreatic nodes and retro-portal nodes completely without any damage to neighboring organs can be difficult in laparoscopic surgery because the dorsal structures of hepatoduodenal ligament are embedded and it is difficult for a surgeon to expose them [3]. On the other hand, the lateral approach offers the better way to expose and dissect dorsal part of hepatoduodenal ligament and it can be useful for dissecting hilar during laparoscopic right hepatectomy without injury of left side vascular structures...
September 2020: Surgical Oncology
Natasha Gabriela Oliveira da Silva, Ana Beatriz Marques Barbosa, Nathalie de Almeida Silva, Diego Neves AraÚjo, Thiago de Oliveira Assis
INTRODUCTION: Superior mesenteric artery (SMA) usually arises from the abdominal aorta, just below the celiac trunk and it supplies the midgut-derived embryonic structures. Anatomical variations in this vessel contribute to problems in the formation and/or absorption of this part of the intestine and its absence has been recognized as the cause of congenital duodenojejunal atresia. OBJECTIVE: To analyze SMA anatomical variations in humans and the possible associated clinical and surgical implications...
2020: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Felix Krenzien, Wenzel Schöning, Philipp Brunnbauer, Christian Benzing, Robert Öllinger, Matthias Biebl, Marcus Bahra, Nathanael Raschzok, Daniel Cherqui, David Geller, Ho-Seong Han, Go Wakabayashi, Moritz Schmelzle, Johann Pratschke
INTRODUCTION: Laparoscopy is becoming the standard approach in liver surgery. As the degree of difficulty varies greatly from core skills to advanced procedures, strategies for teaching young surgeons need to be reconsidered. We here aimed to design a skills curriculum for LLR. METHODS: Using the nominal group technique, 22 substeps of LLR were identified by 61 hepatobiliary surgeons. The raters were asked to rate (1) the difficulty of substeps and (2) the minimum number of times that the substep must be performed for mastery of the technique...
August 21, 2020: Annals of Surgery
Joshua A Villarreal, Dor Yoeli, Prakash M Masand, Nhu Thao Nguyen Galvan, Oluyinka O Olutoye, John A Goss
BACKGROUND: The separation of conjoined twins is a challenging and rare operation. Recent technological advances in imaging and three-dimensional printing (3DP) have allowed for enhancements in preoperative surgical planning and intraoperative anatomical orientation for complex operations. This report aims to consolidate the current clinical evidence utilizing 3DP models as an effective tool for surgical planning of conjoined twin separation and to detail our surgical approach for complex hepatic separation and management...
July 15, 2020: Journal of Pediatric Surgery
Tadashi Furihata, Takafumi Ushiku, Isao Murayama, Jun Sato, Tomohisa Kamo, Fumiyo Naoe, Tetsuo Hasegawa, Yoshihiro Watanabe, Yuichi Kasakura, Makoto Furihata
We herein describe a case of an 83-year-old man who presented with epigastralgia, vomiting, and abdominal distention. The physical abdominal examination revealed mild tenderness. Computed tomography revealed intramural gastric gas spread throughout the stomach, intraabdominal free gas, and hepatic portal venous gas. We diagnosed gastric emphysema with intraabdominal free gas and hepatic portal venous gas. We selected a wait-and-watch approach because physical examination did not show any peritoneal signs, although the radiological examinations showed remarkable findings...
2020: SAGE Open Medical Case Reports
Antoine Camerlo, Cloé Magallon, Charles Vanbrugghe, Laurent Chiche, Chloé Gaudon, Yves Rinaldi, Régis Fara
Liver transection is the most challenging part of hepatectomy due to the risk of hemorrhage which is associated with postoperative morbidity and mortality and reduced long-term survival. Parenchymal ultrasonic dissection (UD) with bipolar coagulation (BPC) has been widely recognized as a safe, effective, and standard technique during open and laparoscopic hepatectomy. We here introduce our technique of robotic liver transection using UD with BPC and report on short-term perioperative outcomes. From a single-institution prospective liver surgery database, we identified patients who underwent robotic liver resection...
August 10, 2020: Journal of Robotic Surgery
Tim R Glowka, Jörg C Kalff, Steffen Manekeller
Background: Bleeding from esophagogastric varices is a life-threatening complication from portal hypertension. It occurs in 15% of patients and has a mortality rate of 20-35%. Summary: The primary therapy for variceal bleeding is medical. In cases of recurrent bleeding, a definitive therapy is required. In cases of parenchymal decompensation, liver transplantation is the causal therapy, but if liver function is preserved, portal decompression is the therapy of choice...
June 2020: Visceral Medicine
Serdar Kirmizi, Celine De Meyere, Isabelle Parmentier, Mathieu D'Hondt
BACKGROUND: Laparoscopic posterosuperior liver resection is a technically difficult and complex surgery. These patients are seen as poor candidates for laparoscopic surgery. This study aimed to show the safe and effective applicability of the posterosuperior segment resections by experienced surgeons in advanced centers. MATERIALS AND METHODS: Patients who underwent laparoscopic posterosuperior liver resection between October 2011 and October 2019 at the Groeninge Hospital were evaluated retrospectively...
August 5, 2020: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Aihemaiti Hasimu, Qiang Fu, Hui Wang, Qing-Jiu Zhou, Shao-Shan Li, Dangmu-Jiafu Geng, Chen Liu, Bo Liu
INTRODUCTION: A meningeal hemangiopericytoma (MHPC) is an aggressive tumor characterized by a high rate of local recurrence and late distant metastasis. The objective of this study was to share our experience with the treatment of a MHPC and how to distinguish this tumor from a meningioma. PATIENT CONCERNS: A 62-year-old woman presented with symptoms of hypomnesia, hyperopia, and double vision for 1 month. Complete tumor excision was performed 6 years before. A biopsy sample was diagnosed as an atypical meningioma...
July 31, 2020: Medicine (Baltimore)
Xiu-Tao Fu, Zheng Tang, Jia-Feng Chen, Ying-Hong Shi, Wei-Ren Liu, Qiang Gao, Guang-Yu Ding, Kang Song, Xiao-Ying Wang, Jian Zhou, Jia Fan, Zhen-Bin Ding
BACKGROUND: The concurrent presence of liver cirrhosis and hepatocellular carcinoma (HCC) poses a challenge for laparoscopic surgeons to establish a routine practice. The aim of this study was to gather evidence and produce recommendations on the safe and effective practice of laparoscopic hepatectomy for patients with solitary HCC (≤ 5 cm) and liver cirrhosis. METHODS: Between October 2013 and October 2014, 356 curative hepatectomies were performed for patients pathologically diagnosed with solitary HCC (≤ 5 cm) accompanied by cirrhosis (stage 4 fibrosis)...
August 3, 2020: Surgical Endoscopy
Shamir O Cawich, Reyad R A Ali, Michael T Gardner, Janet Charles, Sherrise Sandy, Neil W Pearce, Vijay Naraynsingh
PURPOSE: Hepatic surface grooves (HSGs) are prominent depressions on the antero-superior surface of the liver. We sought to document the prevalence of HSGs in an Eastern Caribbean population. METHODS: We observed all consecutive autopsies performed at a facility in Trinidad and Tobago and recorded the presence, number, location, width, length and depth of any HSG identified. Each liver was then sectioned to document intra-parenchymal abnormalities. RESULTS: Sixty Autopsies were observed...
July 31, 2020: Surgical and Radiologic Anatomy: SRA
Y P Zhang, N Shi, Z X Jian, H S Jin
The Laennec capsule of liver was first discovered and reported by French doctor Rene Theophile Hyacinthe Laennec in 1802.However, it has not received enough attention for more than 200 years since then. In recent years, with the rapid development of liver surgery represented by laparoscopic technology, and the deepening of the theory of precise liver surgery, the fine anatomical structure of liver Laennec capsule has returned to the vision of liver surgeons.Recent studies have demonstrated the presence of Laennec capsule in liver histology, covering the whole liver surface, and lining the surface of liver parenchyma around the Glisson pedicle and the main hepatic vein along the inflow and outflow channels of the liver...
August 1, 2020: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Lyonell B Kone, Vijay K Maker, Mihaela Banulescu, Ajay V Maker
BACKGROUND: The impact of epidural analgesia (EA) on postoperative morbidity and length of stay (LOS) after HPB surgery remains to be determined. These specific outcomes have been highlighted by the implementation of multiple enhanced recovery pathways (ERAS). The authors hypothesized that EA in the current environment may be associated with LOS and other outcomes. METHODS: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) databases from 2014 to 2017 for patients undergoing open hepatopancreaticobiliary (HPB) surgery were included in a retrospective cohort analysis with propensity score matching (PSM) comparing EA with control...
July 28, 2020: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Chester J Donnally, Parthik D Patel, Jose A Canseco, Kartik Shenoy, Srikanth N Divi, Vadim Goz, Abdul R Arain, Alexander R Vaccaro
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aim of this study was to identify whether hepatitis C virus (HCV) diagnosis influences in-hospital lengths of stay (LOS), postoperative complications, readmission rates, or costs following primary posterior lumbar fusions in an elective setting. SUMMARY OF BACKGROUND DATA: Although joint arthroplasty literature has shown increased complication rates and costs for patients seropositive with HCV without liver disease compared to those without HCV, this comorbidity has not been explored in the spine literature...
August 15, 2020: Spine
Guru Prasad Painuly, Mini Singhal
Sub hepatic caecum and appendix is an uncommon condition. It occurs due to incomplete rotation of foetal foregut and mal descent of caecum. This condition may be mistaken for acute cholecystitis, liver abscess, duodenal perforation or right renal calculus. Diagnosis may be delayed when acute appendicitis develops complications - appendicular rupture, perforation or localized abscess. The condition may be missed on ultra sound and CT abdomen may be inconclusive. Thus, surgeon should have a high index of suspicion in such undiagnosed right upper abdominal pain...
2020: International Journal of Surgery Case Reports
Tetsuo Ikeda, Shinji Okano, Naotaka Hashimoto, Koichi Kimura, Kensuke Kudo, Ryosuke Tsutsumi, Shun Sasaki, Junji Kawasaki, Yu Miyashita, Hiroya Wada
BACKGROUND/PURPOSE: Computer-assisted tissue imaging and analytical techniques were used to clarify the histomorphological structure of hepatic connective tissue as a practical guide for surgeons. METHODS: Approximately 5000 histological slides were prepared from liver specimens of five autopsied patients. Three-dimensional (3D) reconstruction was performed and subjected to computer imaging analysis. Scanning electron microscopy was also performed on the liver specimens...
July 22, 2020: Journal of Hepato-biliary-pancreatic Sciences
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