Choledoco

BACKGROUND: EUS-guided choledoco-duodenostomy using electrocautery-enhanced lumen-apposing metal stents (ECE-LAMS) is becoming the gold standard in case of endoscopic retrograde cholangio-pancreatography failure for distal malignant obstruction. Long-term data in larger samples are lacking. METHODS: This was a prospective monocentric study including all patients who underwent EUS-guided choledochoduodenostomy (CDS) between September 2016 and December 2021. The primary endpoint was the rate of biliary obstruction during follow-up...

PURPOSE: This multi-media article aims to describe a counter-clockwise approach for pancreatoduodenectomy (CCA-PD) in robotic surgery. METHODS: A CCA-PD was used as a strategy for robotic surgery to treat a 69-year-old woman without comorbidities who presented a ductal adenocarcinoma of the head of the pancreas (2.7 cm) in contact with the portal vein (less than 180°), preoperatively treated with FOLFIRINOX. The procedure was entirely done in the abdominal right upper quadrant (RUQ) following the main steps of CCA-PD resection: section of the first portion of the duodenum; biliary duct transection; Kocherization of the duodenum and retropancreatic lymphadenectomy; section of the jejunum; portal vein dissection; transection of the pancreas and uncinate detachment...

We report the case of a bile duct traumatic neuroma in a 76-year-old man who presented with obstructive jaundice one year after cholecystectomy. Despite the radiological examinations, the preoperative diagnosis was difficult. The patient underwent a biliary resection with choledoco-duodenal anastomosis.

Introduction: Choledochal cysts (CCs) are uncommon with an incidence that ranges from 1 in 100,000-150,000 in Western populations, to 1-1,000 in some Asian populations. The cyst can become complicated with stone disease, pancreatitis, cholangitis and malignancy of the biliary tree; therefore it has to be treated by operative resection of the bile duct, cholecystectomy, and biliodigestive reconstruction, irrespective of the age at presentation. In the long term follow up, postoperative intrahepatic stone and cholangitis present serious complications...

The aim of our study was to explore the feasibility of a novel fluorescence-guided laparoscopic technique to localize the obscure GI haemorrhage, using the vascular wash-out properties of indocyanine green (ICG). Method: The feasability study included patients with previous surgical modifications of the gut architecture, qualified as an overt obscure GI bleeding with an urgent need to be localized and controlled. Five mL of ICG was injected intravenously and laparoscopic infrared inspection was performed 30 minutes after the dye was eliminated from the bloodstream...

INTRODUCTION: Multiple and large pancreatic duct stones concomitant with primary choledochal stones is a rare case. Patients usually present with recurrent jaundice and signs of pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) is the leading method to manage the patients. But ERCP has difficulties when facing the multiple and large stones PRESENTATION OF CASE: Our first case was a 51-years-old man who was admitted to our surgery unit with a diagnosis of chronic pancreatitis...

PURPOSE: Internal biliary stenting (IBS) was reported to decrease biliary complications after liver transplantation (LT) but data in literature is scarce. The aim of the present study was to evaluate our experience with end-to-end choledoco-choledocostomy during liver transplantation with special focus on the influence of IBS on patient and biliary outcomes. METHODS: Between 2009 and 2013, 175 patients underwent deceased donor LT with end-to-end choledoco-choledocostomy and were included in the study...

INTRODUCTION: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is an advanced operation for morbid obesity. To our knowledge, no internal Biliodigestive Fistula has yet been reported as specific complication in the field of metabolic and bariatric Biliopancreatic diversion. CASE PRESENTATION: In this case report, we detail the case of a 57-year-old man who underwent a Single Anastomosis Duodeno-Ileal Switch (SADI-S) bariatric procedure for morbid obesity...

BACKGROUND: Endoscopic ultrasonography (EUS)-guided choledochoduodenostomy (CDS) is an alternative to percutaneous transhepatic cholangiography (PTC) drainage in patients with an obstructed biliary system where conventional endoscopic retrograde biliary drainage (ERBD) has been unsuccessful. METHODS: Five EUS-CDS procedures were reviewed to assess whether successful decompression was achieved and maintained. RESULTS: There was technical success in each instance with no immediate complications...

The authors report three (3) cases of choledoco-duodenal fistula due to perforating duodenal ulcer disease. All of them were male, aged from 35 to 55 years. The ulcer symptomatology summarised the clinical feature. They presented respectively a prestenosis, a stenosis and a chronic ulcer The fistula diagnosis was estasblished at the oesogastro-duodenal radiologic exploration showing an opacification of the common bile duct. The surgical treatment concerned bnly to the ulcer. A gastrectomy of exclusion with digestive continuity re-establishment according to FINSTERER in the pre-stenosis, vagotomy associated to gastrojejunostomy and the pylore closing at both other were performed...

INTRODUCTION: Acute pancreatitis is a local inflammatory process that could be generalized by producing mild to severe gastroenteral manifestations, like multiple organ dysfunction and death. OBJECTIVE: To describe epidemiological, clinical, therapeutical characteristics and evolution of patients with AP of our unit and to compare with other studies of Peru and other countries. MATERIALS AND METHODS: We realized a review of all cases with AP treated in ICU-INCU of Victor Lazarte Echegaray Hospital over 1 degrees January of 2004 to April, 30 of 2007...

PURPOSE: This article aims to study the one layer end to side choledochusduodenal anastomosis creating a "neopapila" which, because of the mucosa recovering it, would prevent stenosis. METHODS: Thirty male pigs were distributed within 3 equal groups = Group I (control)--conventional choledochusduodenal anastomosis. Group II (experiment)--one layer end to side anastomosis with evertion of the choledochus wall (neopapila). Group III (sham)--isolation and mobilization of the biliar tract with no choledocotomy...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

The objective of this study was to demonstrate the safety and feasibility of laparoscopic cholecystectomy in empyematous or gangrenous cholecystitis. During the period from August 1998 to April 2000, we operated laparoscopically on 64 patients, without any selection, in which we established, preoperatively or intraoperatively, the diagnosis of empyematous or gangrenous cholecystitis using clinical criteria (fever, leukocytosis, persistent pain, abdominal tenderness or guarding), echographic findings and intraoperative or pathological aspects of the gallbladder...

Acquired anomalies of the biliary tract are rare. The aim of this work was to examine their frequency and to assess potential associated danger when performing a laparoscopic cholecystectomy. A retrospective analysis of clinical charts of 3.870 patients undergoing elective cholecystectomy between 1959 and 1997 was performed. Eighteen cases of choledoco-duodenal fistula, 9 of cholecysto-duodenal and 12 of cholecysto-choledochal fistulas were observed. Two cases of acquired absence of the cystic duct and one cholecysto-colic fistula were also encountered...

Lactobacillus acidophilus is usually considered to be non pathogenic. We report a case of liver abscess due to Lactobacillus acidophilus in a 39 year-old man with chronic pancreatitis complicated by both endocrine and exocrine insufficiency, and with a choledoco-duodenostomy. Lactobacillus acidophilus was isolated in blood and liver samples. Complete recovery of the liver abscess occurred after antibiotherapy. We suggest that the abnormally low duodenal pH secondary to pancreatic insufficiency may have promoted both Lactobacillus acidophilus adhesion and multiplication in this patient...

Acetaminophen high doses toxicity has been reported in clinical and experimental studies in relation with cytochrome P-450. (Acetaminophen metabolite). Thinking that biliary tract obstructions hould increases drugs toxicity because interferes toxic substances excretion or it modify the activity of P-450 we decided to study acetaminophen toxicity in rats with biliary tract obstruction. Male sprague Dawley rats were used (body weight 250-400 gr) in two groups: Group I control (6 rats) with choledoco bile duct ligated; two doses of saline solution 0...

Despite progress in standardization of reconstruction procedures, arterial and biliary complications remain an important problem in liver transplantation. These complications directly affect graft survival and patient mortality. We review a series of 165 consecutive orthoptic liver transplantations performed in 146 patients including 3 children. Biliary reconstruction included bilio-biliary termino-terminal anastomosis in 88% of the cases and bilio-digestive choledoco-jejunal anastomosis in 12%. Biliary complications occurred in 15% (25/165) with more obstruction (64%, 16/25) than leakages (64%, 7/25); 28% (7/25) of these complications were related to biliary drainage (3 obstructions and 4 leakages)...