4,502 results match your criteria Biliary Trauma


Liver resection in Cirrhotic liver: Are there any limits?

Int J Surg 2020 Jul 8. Epub 2020 Jul 8.

Chairman of HPB Surgical Division. Miguel Servet University Hospital. Zaragoza, Spain.

Liver resection remains one of the most technically challenging surgical procedure in abdominal surgery due to the complex anatomical arrangement in the liver and its rich blood supply that constitutes about 20% of the cardiac output per cycle. The challenge for resection in cirrhotic livers is even higher because of the impact of surgical stress and trauma imposed on borderline liver function and the impaired ability for liver regeneration in cirrhotic livers. Nonetheless, evolution and advancement in surgical techniques as well as knowledge in perioperative management of liver resection has led to a substantial improvement in surgical outcome in recent decade. Read More

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http://dx.doi.org/10.1016/j.ijsu.2020.06.050DOI Listing

Video review reveals technical factors predictive of biliary stricture and cholangitis after robotic pancreaticoduodenectomy.

HPB (Oxford) 2020 Jul 6. Epub 2020 Jul 6.

Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address:

Background: Cholangitis due to anastomotic stricture of the hepaticojejunostomy (HJ) following pancreaticoduodenectomy (PD), while uncommon, adversely affects postoperative quality-of-life. While prior studies have identified patient-related risk factors for these biliary complications, technical risk factors have not been systematically examined. Video review of surgical procedures has helped define technical details predictive of postoperative complications in bariatric and hepato-pancreato-biliary (HPB) surgery. Read More

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http://dx.doi.org/10.1016/j.hpb.2020.05.013DOI Listing

Patterns of prevalence and contemporary clinical management strategies in complicated acute biliary calculous disease: an ESTES 'snapshot audit' of practice.

Eur J Trauma Emerg Surg 2020 Jul 7. Epub 2020 Jul 7.

Emergency Surgery Committee, European Society for Trauma and Emergency Surgery (ESTES), Pölten, Austria.

Background: Acute complications of biliary calculi are common, morbid, and complex to manage. Variability exists in the techniques utilized to treat these conditions at an individual surgeon and unit level.

Aim: To identify, through an international prospective nonrandomized cohort study, the epidemiology and areas of practice variability in management of acute complicated calculous biliary disease (ACCBD) and to correlate them against reported outcomes. Read More

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http://dx.doi.org/10.1007/s00068-020-01433-xDOI Listing

Cholecystectomia során bekövetkező epeútsérülések ellátása.

Magy Seb 2020 Jun;73(2):49-56

I. sz. Sebészeti Klinika,Semmelweis Egyetem Budapest.

Biliary injury is a rare but a very serious complication of laparoscopic cholecystectomy (LC). Our aim was to analyse the incidence of the biliary injuries and its therapeutic outcome on patients who underwent LC or converted LC. Our research was conducted at the 1st Department of Surgery, Semmelweis University, Budapest between 2006 and 2016, retrospectively. Read More

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http://dx.doi.org/10.1556/1046.73.2020.2.1DOI Listing

Non-operative management of pancreatic trauma in adults.

Hepatobiliary Pancreat Dis Int 2020 Jun 11. Epub 2020 Jun 11.

Regional Hepato-Pancreato-Biliary Surgery Unit, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK; Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. Electronic address:

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http://dx.doi.org/10.1016/j.hbpd.2020.06.005DOI Listing

Role of Prophylactic Cholecystectomy After Endoscopic Sphincterotomy for Biliary Stone Disease: A Systematic Review and Meta-Analysis.

Ann Surg 2020 Jun 24. Epub 2020 Jun 24.

Section of Digestive Diseases, Yale University School of Medicine. New Haven, CT.

Objective: The aim of this study was to perform a structured systematic review and meta-analysis to evaluate the effectiveness and complication rate of cholecystectomy deferral versus prophylactic cholecystectomy among patients post-endoscopic biliary sphincterotomy for common bile duct stones.

Background: Although previous reports suggest a decreased risk of biliary complications with prophylactic cholecystectomy, biliary endoscopic cholangiopancreatography (ERCP) with sphincterotomy may provide a role for deferring cholecystectomy with the gallbladder left in situ.

Methods: Searches of PubMed, EMBASE, Web of Science, and Cochrane Library databases were performed through August 2019 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines. Read More

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http://dx.doi.org/10.1097/SLA.0000000000003977DOI Listing

Pushing the limits in DCD donor selection: optimizing graft rehabilitation with ex vivo machine perfusion.

Liver Transpl 2020 Jun 23. Epub 2020 Jun 23.

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.

Background: The use of liver grafts from donors after circulatory death (DCD) is associated with an increased risk of developing severe transplant-related complications. However, a balanced evaluation of risks calculated on both donor's and recipient's specific medical history, may reduce the incidence of post-operative complications avoiding a futile transplant.

Methods: We report a case wherein we transplanted a patient with hepatocellular carcinoma (HCC) outside Milan criteria using a borderline DCD graft. Read More

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http://dx.doi.org/10.1002/lt.25833DOI Listing

Cholecystitis on gallbladder duplication: A case report and literature review.

Int J Surg Case Rep 2020 Jun 12;72:406-410. Epub 2020 Jun 12.

Department of Radiology, Burns and Trauma Center, Street 1er-Mai 2013, Ben Arous, Tunisia.

Introduction: Gallbladder Duplication is an uncommon anomaly of the biliary system that rarely seen during the routine ultrasound examination. It is a challenge that can be encountered by surgeons and associated with an increased risk of complications after cholecystectomy.

Case Presentation: We report the case of a 58-year-old woman, presented to the emergency department with persistent right upper quadrant pain. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.06.053DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306521PMC

Bicycle handlebar injury in a child resulting in complex liver laceration with massive bleeding and bile leakage: A case report.

Int J Surg Case Rep 2020 Jun 12;72:386-390. Epub 2020 Jun 12.

Department of Abdominal Surgery, University Medical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia; Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.

Introduction: Bicycle accidents are a significant cause of traumatic morbidity in the paediatric population. The handlebar injuries are usually isolated and remain a major source of bicycle related morbidity. We present a case of severe liver laceration with left hepatic duct transection caused by handlebar trauma in a 13-year-old boy. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.06.049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306525PMC

Complications of Appendectomy and Cholecystectomy in Acute Care Surgery: A Systematic Review and Meta-Analysis.

J Trauma Acute Care Surg 2020 Jun 10. Epub 2020 Jun 10.

Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Introduction: Acute care surgery (ACS) was initiated two decades ago to address timeliness and quality in emergency general surgery. We hypothesized that ACS has improved the management of acute appendicitis and biliary disease.

Methods: A comprehensive systematic review and meta-analysis of outcome studies for emergent appendectomy and cholecystectomy from 1966 to 2017, comparing studies prior to and following ACS implementation. Read More

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http://dx.doi.org/10.1097/TA.0000000000002825DOI Listing

Biloma: A Rare Manifestation of Spontaneous Bile Leak.

Cureus 2020 May 14;12(5):e8116. Epub 2020 May 14.

Geriatrics, MedStar Franklin Square Medical Center, Baltimore, USA.

A biloma is an intrahepatic or extrahepatic encapsulated collection of bile outside of the biliary tree and within the abdominal cavity. Hepatobiliary interventions and laparoscopic cholecystectomy are the most common etiologies of biloma followed by abdominal trauma, choledocholithiasis, and biliary dilation secondary to biliary stricture. We report a case of a 91-year-old female who presented to the emergency room with an acute onset of epigastric and right upper quadrant sharp pain for one day that radiated to the back, and was associated with two to three episodes of vomiting. Read More

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http://dx.doi.org/10.7759/cureus.8116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292700PMC

[A case study of post-traumatic common bile duct injury: an unusual lesion].

Pan Afr Med J 2020 17;35:77. Epub 2020 Mar 17.

Service de Chirurgie Pédiatrique, Centre Hospitalier Mère et Enfant, Nouakchott, Mauritanie.

Traumatic injury of the common bile duct is extremely rare, especially when it is isolated. It usually occurs after laparoscopic biliary tract surgery. This lesion is often associated with one or multiple lesions of the neighborhood organs. Read More

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http://dx.doi.org/10.11604/pamj.2020.35.77.16703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250220PMC

Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: abdominal, hepatobiliary, and gastrointestinal conditions.

3D Print Med 2020 Jun 8;6(1):13. Epub 2020 Jun 8.

Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.

Background: Medical 3D printing has demonstrated value in anatomic models for abdominal, hepatobiliary, and gastrointestinal conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for abdominal, hepatobiliary, and gastrointestinal 3D printing indications.

Methods: A literature search was conducted to identify all relevant articles using 3D printing technology associated with a number of abdominal pathologic processes. Read More

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http://dx.doi.org/10.1186/s41205-020-00065-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278118PMC

Risk factors for complications after cholecystectomy for common bile duct stones: An EAST multicenter study.

Surgery 2020 Jul 26;168(1):62-66. Epub 2020 May 26.

Department of Surgery, Emory University School of Medicine, Atlanta, GA; Emory Department of Surgery, Grady Memorial Hospital, Atlanta, GA.

Background: We sought to prospectively identify risk factors for biliary complications and 30-day readmission after cholecystectomy for choledocholithiasis and gallstone pancreatitis across multiple US hospitals.

Methods: We performed a prospective, observational study of patients who underwent same admission cholecystectomy for choledocholithiasis and gallstone pancreatitis between 2016 and 2019 at 12 US centers. Patients with prior history of endoscopic retrograde cholangiopancreatography or diagnosis of cholangitis were excluded. Read More

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http://dx.doi.org/10.1016/j.surg.2020.04.011DOI Listing

Roles of trained immunity in the pathogenesis of cholangiopathies: a novel therapeutic target.

Hepatology 2020 May 28. Epub 2020 May 28.

Jiangsu Key Laboratory of Immunity and Metabolism, Department of Pathogenic Biology and Immunology, Laboratory of Infection and Immunity, Xuzhou Medical University, Xuzhou, People's Republic of China.

Cholangiopathies are a group of diseases mainly including primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), biliary atresia (BA), and cholangiocarcinoma (CCA). Very limited treatment options are available for these diseases. Following an injury and exposure to DAMPs (Damage associated molecular patterns) and/or PAMPs (Pathogen-associated molecular patterns), cholangiocytes produce a variety of pro-inflammatory cytokines/chemokines leading to the activation of other innate and also adaptive immune cells. Read More

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http://dx.doi.org/10.1002/hep.31395DOI Listing
May 2020
11.055 Impact Factor

Isolated aberrant right cysticohepatic duct injury during laparoscopic cholecystectomy: Evaluation and treatment challenges of a severe postoperative complication associated with an extremely rare anatomical variant.

Ann Hepatobiliary Pancreat Surg 2020 May;24(2):221-227

First Surgical Department, Thessaloniki, Greece.

A typical bile duct branching patterns represent one of the major causes of bile duct injury (BDI) during laparoscopic cholecystectomy (LC). The most common classified variations of bile duct branching, involve the right posterior sectoral duct (RPSD) and its joining with the right anterior or left hepatic duct. Variant bile duct anatomy can rarely be extremely complex and unclassified. Read More

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http://dx.doi.org/10.14701/ahbps.2020.24.2.221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271109PMC

Bile duct injuries after cholecystectomy, analysis of constant risk.

Ann Hepatobiliary Pancreat Surg 2020 May;24(2):150-155

Hepato Pancreato Biliary Clinic, Hospital General de Mexico, Mexico City, Mexico.

Backgrounds/aims: The bile duct injuries are the most severe complications that occur after the surgical manipulation of the bile duct. The hepaticojejunostomy remained as the best treatment. Several factors identified that affect the result. Read More

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http://dx.doi.org/10.14701/ahbps.2020.24.2.150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271110PMC

Successful Treatment of Bronchobiliary Fistula After Living Donor Liver Transplantation: A Case Report.

Transplant Proc 2020 May 17. Epub 2020 May 17.

Department of Radiology, Kaohsiung Medical University, Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (R.O.C.); Department of Radiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan (R.O.C.). Electronic address:

A bronchobiliary fistula (BBF), which is defined by abnormal communication between the biliary system and the bronchial tree, is usually regarded as a consequence of local infection, such as hydatid or amebic disease of the liver, hepatic abscess, trauma, neoplasm, and other causes of biliary obstruction. We present a 40-year-old female patient who received a living donor liver transplantation for autoimmune hepatitis and who suffered from biliary stricture at the anastomosis, bile leakage in the right subphrenic region, and development of a BBF 1 year later. Magnetic resonance cholangiography (MRC) and fistulography showed a fistula between the subphrenic biloma and right lower bronchus. Read More

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http://dx.doi.org/10.1016/j.transproceed.2020.01.171DOI Listing

Computer-assisted real-time automatic prostate segmentation during TaTME: a single-center feasibility study.

Surg Endosc 2020 May 19. Epub 2020 May 19.

Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.

Background: Urethral injuries (UIs) are significant complications pertaining to transanal total mesorectal excision (TaTME). It is important for surgeons to identify the prostate during TaTME to prevent UI occurrence; intraoperative image navigation could be considered useful in this regard. This study aims at developing a deep learning model for real-time automatic prostate segmentation based on intraoperative video during TaTME. Read More

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http://dx.doi.org/10.1007/s00464-020-07659-5DOI Listing

Fifteen-Year Single-Center Experience of Biliary Complications in Liver Trauma Patients: Changes in the Management of Posttraumatic Bile Leak.

Eur J Pediatr Surg 2020 May 18. Epub 2020 May 18.

Birmingham Children's Hospital, The Liver Unit, Birmingham, United Kingdom.

Introduction:  Management of posttraumatic bile leak has evolved over time in our unit, from endoscopic retrograde cholangiopancreatography (ERCP) stenting to intraperitoneal drainage (IPD) alone as first-line treatment for intraperitoneal bile leak.

Materials And Methods:  Retrospective review of liver trauma patients from 2002 to 2017. Demographics, time and mode of diagnosis of bile leak, management, and outcome were analyzed of the box plot. Read More

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http://dx.doi.org/10.1055/s-0040-1710391DOI Listing
May 2020
0.975 Impact Factor

Self-reported and actual adherence to the Tokyo guidelines in the European snapshot audit of complicated calculous biliary disease.

BJS Open 2020 May 17. Epub 2020 May 17.

Surgery, Örebro University School of Medical Sciences, Örebro, Sweden.

Background: Complicated acute biliary calculous disease poses clinical challenges. The European Society of Trauma and Emergency Surgery (ESTES) snapshot audit of complicated biliary calculous disease aims to make novel comparisons between self-reported institutional adherence to the Tokyo guidelines (TG18) and 'real-world' contemporary practice across Europe.

Methods: A preplanned analysis of a prospective observational multicentre audit that captured patients undergoing emergency admission for complicated biliary calculous disease (complicated cholecystitis, biliary pancreatitis, or choledocholithiasis with or without cholangitis) between 1 and 31 October 2018 was performed. Read More

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http://dx.doi.org/10.1002/bjs5.50294DOI Listing

The Role of Portoenterostomy with Aggressive Hilar Dissection in Biliary Tract Tumors: Report of Case Series and Review of the Literature.

Indian J Surg 2020 May 12:1-7. Epub 2020 May 12.

3Department of Pathology, Atatürk Research and Education Hospital, İzmir Katip Celebi University, İzmir, Turkey.

Hepaticojejunostomy is a challenging and complex procedure to be done with confidence in conditions that contain a large number of segmental bile ducts. Portoenterostomy can be defined as the joining of multiple bile ducts into a single cavity using segmenter bile duct ends, stents, and surrounding connective tissues. During surgery, in cases with advanced stage biliary tract tumors that cannot be performed hepatectomy, after aggressive dissections to provide a negative surgical margin, a large number of segmental bile ducts can be revealed and needs to ensure the continuity of bile flow. Read More

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http://dx.doi.org/10.1007/s12262-020-02259-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222060PMC

SAGES TAVAC safety and efficacy analysis confocal laser endomicroscopy.

Surg Endosc 2020 May 13. Epub 2020 May 13.

VIP Surg. PLLC., Las Vegas, NV, USA.

Background: Confocal laser endomicroscopy (CLE) is a novel endoscopic adjunct that allows real-time in vivo histological examination of mucosal surfaces. By using intravenous or topical fluorescent agents, CLE highlights certain mucosal elements that facilitate an optical biopsy in real time. CLE technology has been used in different organ systems including the gastrointestinal tract. Read More

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http://dx.doi.org/10.1007/s00464-020-07607-3DOI Listing

Two-stage pancreatic head resection after previous damage control surgery in trauma: two rare case reports.

BMC Surg 2020 May 12;20(1):98. Epub 2020 May 12.

Department of Surgery, Centro Hospitalar Universitário do Algarve - Unidade de Portimão, Portimão, Portugal.

Background: This study describes the successful treatment of two clinical settings of grade V pancreaticoduodenal blunt trauma only possible due to the prompt collaboration of a peripheral trauma hospital and a central hepatobiliary and pancreatic unit.

Case Presentation: We reviewed the clinical records of two male patients aged 17 and 47 years old who underwent a two-stage pancreaticoduodenectomy after a previous Damage-Control Surgery (DCS). Both patients were transferred to our Hepatobiliopancreatic Unit 2 days after immediate DCS with haemostasis, debridement, duodenostomy, gastroenterostomy, external drainage and laparostomy. Read More

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http://dx.doi.org/10.1186/s12893-020-00763-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216496PMC

What are the risk factors of conversion from total cholecystectomy to bailout surgery?

Surg Endosc 2020 May 11. Epub 2020 May 11.

Department of Gastroenterological Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Ibaraki, 300-0395, Japan.

Background: Laparoscopic cholecystectomy (LC) is regarded as the first choice for patients with gallbladder diseases, but biliary injury (BDI) still poses serious risks upon implementation of LC. Recently, bailout surgery (BOS; partial cholecystectomy or subtotal cholecystectomy) has been proposed to avoid not only BDI but also major vessels injuries. In this retrospective study, we evaluated the preoperative and perioperative risk factors regarding conversion from total cholecystectomy (TC) to BOS. Read More

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http://dx.doi.org/10.1007/s00464-020-07626-0DOI Listing

Coronavirus Disease-19 (COVID-19) associated with severe acute pancreatitis: Case report on three family members.

Pancreatology 2020 Jun 5;20(4):665-667. Epub 2020 May 5.

Pancreatitis Centre East, Gastrounit, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.

Background/objectives: Abdominal pain is one of the known symptoms associated with coronavirus disease 2019. Little is known about the development of acute pancreatitis as a complication of severe acute respiratory syndrome coronavirus 2 infection. This case report describes the presentation of acute pancreatitis in two of three family members with severe COVID-19 infection. Read More

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http://dx.doi.org/10.1016/j.pan.2020.04.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199002PMC

[Right hepatic bile duct injury: a single stage combined laparoscopic-endoscopic treatment].

Rev Gastroenterol Peru 2020 Jan-Mar;40(1):85-88

Unidad de Cirugía de Mínimo Acceso, Day Hospital. Lechería, Venezuela; Departamento de Cirugía, Hospital Universitario "Dr. Luis Razetti". Barcelona, Venezuela.

Treatment of bile ducts injuries (BDI) treatment, combining minimally access surgical techniques, although their benefits, has been scarcely reported. We described a combined laparoscopic-endoscopic procedure, carried out in a patient with postoperative right hepatic duct (RHD) injury associated to laparoscopic cholecystectomy. Based on a clinical case description, we illustrate the surgical technique and assess their applicability and results. Read More

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Diagnostic and therapeutic approach to pancreatitis in children and adolescents in Latin America.

Rev Esp Enferm Dig 2020 May;112(5):380-382

Hospital Niños V. J. Vilela, Argentina.

Objective: to present the results of a survey applied to Latin American pediatric gastroenterologists (PGs) to learn how they perform the diagnostic and therapeutic approach to pancreatitis.

Material And Methods: a descriptive, exploratory, multicenter study and survey was conducted.

Results: 73. Read More

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http://dx.doi.org/10.17235/reed.2020.6545/2019DOI Listing

Fluorescent Cholangiography in Laparoscopic Cholecystectomy and the Use in Pediatric Patients.

J Laparoendosc Adv Surg Tech A 2020 May 16;30(5):586-589. Epub 2020 Apr 16.

Department of Pediatric Surgery, John R. Oishei Children's Hospital, Buffalo, New York, USA.

Common bile duct (CBD) injury is one of the most serious complications of laparoscopic cholecystectomy and carries an incidence of 0.3%-0.7%. Read More

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http://dx.doi.org/10.1089/lap.2019.0204DOI Listing

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines.

World J Emerg Surg 2020 Apr 15;15(1):27. Epub 2020 Apr 15.

Emergency and Trauma Surgery Department, Maggiore Hospital of Parma, Parma, Italy.

Background And Aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. Read More

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http://dx.doi.org/10.1186/s13017-020-00306-3DOI Listing
April 2020
1.062 Impact Factor

Complex Case of Aggressive Intra-abdominal Desmoid-type Fibromatosis Status Post Cholecystectomy.

Cureus 2020 Mar 6;12(3):e7193. Epub 2020 Mar 6.

Radiology, University of Mississippi Medical Center, Jackson, USA.

Desmoid-type fibromatosis (DF), also known as desmoid tumor, is an extremely rare, benign, mesenchymal fibrous tumor with no potential for metastasis. It can arise from any part of the body, most commonly extra-abdominally. Intra-abdominal DF can present sporadically, in sites of previous trauma, surgical scars and irradiation, or in association with familial adenomatous polyposis and Gardner syndrome. Read More

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http://dx.doi.org/10.7759/cureus.7193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137654PMC

Transarterial Embolization of Iatrogenic Cystic Artery Pseudoaneurysm.

GE Port J Gastroenterol 2020 Feb 7;27(2):115-118. Epub 2019 Aug 7.

Interventional Radiology Unit, Hepato-Biliary-Pancreatic and Transplant Center, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.

Cystic artery pseudoaneurysm (CAP) is a rare entity most often resulting from inflammatory conditions (acute cholecystitis or pancreatitis) or iatrogenic trauma (cholecystectomy). We report the case of a 73-year-old female who presented with abdominal pain and gastrointestinal bleeding after an episode of acute cholecystitis and endoscopic retrograde cholangiopancreatography for choledocolithiasis removal. Computed tomography and angiography revealed a CAP measuring 5 cm. Read More

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http://dx.doi.org/10.1159/000501400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113591PMC
February 2020

Secondary Sclerosing Cholangitis in Critically Ill Patients: An Underdiagnosed Entity.

GE Port J Gastroenterol 2020 Feb 30;27(2):103-114. Epub 2019 Jul 30.

Clínica Universitária de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.

Secondary sclerosing cholangitis in critically ill patients (SSC-CIP) is a recently identified cholestatic liver disease occurring in patients without prior history of hepatobiliary disease, after receiving treatment in the intensive care unit (ICU) in different settings, including cardiothoracic surgery, infection, trauma, and burns. It is a rare entity, being estimated to occur in 1/2,000 patients in an ICU; however, it is a dismal condition, with up to half of the patients dying during the ICU stay and with rapid progression to liver cirrhosis over weeks to months. SSC-CIP should be considered in the differential diagnosis of cholestasis in the ICU, particularly when cholestasis persists after recovery from the critical event. Read More

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http://dx.doi.org/10.1159/000501405DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113589PMC
February 2020

Pancreatic and biliary tract involvement in IgG4-related disease.

Presse Med 2020 Mar 29;49(1):104015. Epub 2020 Mar 29.

Pancreatology unit, Inserm, UMR 1149, pancreatic rare diseases (PaRaDis), centre de reference de maladies rares, Beaujon hospital, 100, boulevard Gal-Leclerc, 92110 Clichy, France.

The diagnosis and treatment of pancreatic and biliary tract involvement in IgG4 disease can be challenging for physicians. A French series shows that the pancreas is the most frequently involved organ in systemic IgG4 disease. Pancreatitis may be found in more than 50% of patients with IgG4 disease and the biliary tract is involved in one third. Read More

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http://dx.doi.org/10.1016/j.lpm.2020.104015DOI Listing

Risk factors and management of different types of biliary injuries in blunt abdominal trauma: Single-center retrospective cohort study.

Ann Med Surg (Lond) 2020 Apr 10;52:36-43. Epub 2020 Mar 10.

Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Menoufia, Egypt.

Background: Biliary injuries after blunt abdominal traumas are uncommon and difficult to be predicted for early management. The aim of this study is to analyze the risk factors and management of biliary injuries with blunt abdominal trauma.

Method: Patients with blunt liver trauma in the period between 2009 to May 2019 were included in the study. Read More

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http://dx.doi.org/10.1016/j.amsu.2020.02.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082429PMC

Extrahepatic cholangiography in near-infrared II window with the clinically approved fluorescence agent indocyanine green: a promising imaging technology for intraoperative diagnosis.

Theranostics 2020 19;10(8):3636-3651. Epub 2020 Feb 19.

Department of General Surgery, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China.

: Biliary tract injury remains the most dreaded complication during laparoscopic cholecystectomy. New intraoperative guidance technologies, including near-infrared (NIR) fluorescence cholangiography with indocyanine green (ICG), are under comprehensive evaluation. Previous studies had shown the limitations of traditional NIR light (NIR-I, 700-900 nm) in visualizing the biliary tract structures in specific clinical situations. Read More

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http://dx.doi.org/10.7150/thno.41127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069080PMC
February 2020
7.827 Impact Factor

Factors leading to loss of patency after biliary reconstruction of major laparoscopic cholecystectomy bile duct injuries: an observational study with long-term outcomes.

HPB (Oxford) 2020 Mar 20. Epub 2020 Mar 20.

Department of Surgery, University of Cape Town Health Sciences Faculty, Surgical Gastroenterology Unit, Groote Schuur Hospital, Cape Town, South Africa. Electronic address:

Background: Small sample size and a lack of standardized reporting for patients requiring reconstruction for laparoscopic cholecystectomy bile duct injuries (LC-BDI) have limited investigation of factors contributing to loss of patency.

Methods: Using a prospective database, patient characteristics, pre-repair investigations, Strasberg-Bismuth level of injury, timing of reconstruction and postoperative complications were compared in successful index reconstruction and revision patients. Multivariate analysis was performed to determine independent predictors of loss of patency. Read More

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http://dx.doi.org/10.1016/j.hpb.2020.02.010DOI Listing

Chest computed tomography semi-quantitative pleural effusion and pulmonary consolidation are early predictors of acute pancreatitis severity.

Quant Imaging Med Surg 2020 Feb;10(2):451-463

Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.

Background: To study the predictive value of semi-quantitative pleural effusion and pulmonary consolidation for acute pancreatitis (AP) severity.

Methods: Thorax-abdominal computed tomography (CT) examinations were performed on 309 consecutive AP patients in a single center. Among them, 196 were male, and 113 were female, and the average age was 50±16 years. Read More

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http://dx.doi.org/10.21037/qims.2019.12.14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063295PMC
February 2020

Endoscopic and surgical management of iatrogenic biliary tract injuries.

Ulus Travma Acil Cerrahi Derg 2020 Mar;26(2):203-211

Department of General Surgery, İzmir Katip Çelebi University Faculty of Medicine, İzmir-Turkey.

Background: Iatrogenic biliary tract injury (BTI) is a rare complication but has high risks of morbidity and mortality when it is not early noticed. Although the treatment varies depending on the size of injury and the time until the injury is noticed, endoscopic and percutaneous interventions are usually sufficient. However, it should be remembered that these interventions may cause major complications in the following years, such as biliary stricture, recurrent episodes of cholangitis and even cirrhosis. Read More

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http://dx.doi.org/10.14744/tjtes.2019.62746DOI Listing

A comprehensive evaluation of the long-term clinical and economic impact of minor bile duct injury.

Surgery 2020 Jun 14;167(6):942-949. Epub 2020 Mar 14.

Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham, Birmingham, United Kingdom. Electronic address:

Background: Outcomes after Strasberg grade E bile duct injury have been widely reported. However, there are comparatively few reports of outcomes after Strasberg A to D bile duct injury. Therefore, the aim of this study was to comprehensively evaluate the long-term clinical and economic impact of Strasberg A to D bile duct injury. Read More

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http://dx.doi.org/10.1016/j.surg.2020.01.022DOI Listing
June 2020
3.380 Impact Factor

Nodular regenerative hyperplasia - An under-recognized vascular disorder of liver.

Pathol Res Pract 2020 Apr 20;216(4):152833. Epub 2020 Jan 20.

Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India.

Introduction: Nodular regenerative hyperplasia (NRH) is a rare hepatic vascular disorder which is often associated with wide variety of systemic diseases. Intrahepatic microvascular injury and subsequent altered perfusion state leads to development of non-cirrhotic portal hypertension in many of these patients. Diagnosis of NRH often remains unsuspected clinically and liver biopsy is essential for the diagnosis and exclusion of fibrosis. Read More

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http://dx.doi.org/10.1016/j.prp.2020.152833DOI Listing
April 2020
1.562 Impact Factor

Biodegradable versus multiple plastic stent implantation in benign biliary strictures: A systematic review and meta-analysis.

Eur J Radiol 2020 Apr 13;125:108899. Epub 2020 Feb 13.

Faculty of Medicine of the University of Coimbra (FMUC), Rua Larga 2; 3000-370 Coimbra, Portugal; Department of Radiology, Centro Hospitalar e Universitário de Coimbra (CHUC) Praceta Mota Pinto, 3000-075 Coimbra, Portugal. Electronic address:

Purpose: Benign biliary strictures arise mostly from iatrogenic injuries during surgical procedures and various inflammatory causes. Endoscopic placement of multiple plastic stents (MPS) is often regarded as the first-line therapy, albeit not without limitations. Biodegradable biliary stents (BDBS) present an alternative therapeutic option aimed at overcoming these shortcomings. Read More

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http://dx.doi.org/10.1016/j.ejrad.2020.108899DOI Listing

Early Versus Delayed Surgical Repair and Referral for Patients With Bile Duct Injury: A Systematic Review and Meta-analysis.

Ann Surg 2020 03;271(3):449-459

Department of Biliary Tract Surgery, Shanghai Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University/Naval Medical University, Shanghai, China.

Objective: The aim of the study was to systematically review and meta-analyze the available evidence regarding the association between timing of repair or referral and clinical outcomes in bile duct injury (BDI).

Background: Surgical repair is recommended for patients with complex BDI following laparoscopic cholecystectomy. However, consensus on the timing of surgery or referral to a specialist is lacking. Read More

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http://dx.doi.org/10.1097/SLA.0000000000003448DOI Listing

Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study.

Heliyon 2020 Feb 17;6(2):e03388. Epub 2020 Feb 17.

Departments of surgery, Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran.

Background: In mild to moderate gallstone pancreatitis, cholecystectomy is the most appropriate treatment for prevention of further biliary attacks. However, the timing of cholecystectomy is not precisely determined. The present study was conducted to compare outcomes of very early (within 48 h) versus delayed (more than 1 week) laparoscopic cholecystectomy in patients with acute biliary pancreatitis (ABP). Read More

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http://dx.doi.org/10.1016/j.heliyon.2020.e03388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031006PMC
February 2020

Pathological fracture of the femur in Alagille Syndrome: A case report.

J Clin Orthop Trauma 2020 Mar-Apr;11(2):298-301. Epub 2019 Dec 19.

Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University, P.B. Sudirman Street, Denpasar Bali, Indonesia.

Alagille Syndrome is a rare autosomal dominant genetic disorder, occur only 1:70,000 in population, and characterized by reduced interlobular bile ducts, and resultant nutritional deficiencies associated with the inability to absorb fat-soluble vitamins such as vitamin D. Patients are at risk for secondary osteoporosis, rickets/osteomalacia, and ultimately may result in fracture. The majority of patients suffer from chronic cholestasis, which can have a variety of adverse effects on bone metabolism. Read More

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http://dx.doi.org/10.1016/j.jcot.2019.12.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026569PMC
December 2019

US Food and Drug Administration and Off-Label Use of Metal Expandable Biliary Stents within the Peripheral Vasculature-Update.

J Vasc Interv Radiol 2020 Apr 21;31(4):622-628. Epub 2020 Feb 21.

Obesity and Hepatobiliary Devices Team, Division of Health Technology 3A, Office of Health Technology 3, Center for Devices and Radiological Health, US Food and Drug Administration, 10903 New Hampshire Avenue, Building 66, Silver Spring, MD 20993-0002.

In the past, some medical device manufacturers were obtaining marketing clearance for metallic stents indicated for biliary use; however, these devices were being promoted and used in the peripheral vasculature, creating a patient safety problem. The US Food and Drug Administration (FDA) acted in 2006-2008 to help decrease off-label use of metal expandable biliary stents. This communication describes the early and continued efforts of the FDA to address safety concerns relating to off-label use of metal expandable biliary stents and the status of this issue. Read More

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http://dx.doi.org/10.1016/j.jvir.2019.10.016DOI Listing

Traumatic rupture of a hydatid cyst of the liver presenting with skin lesions.

Ann Ital Chir 2020 Feb 10;9. Epub 2020 Feb 10.

The hydatid cyst is the evolution of a parasitic infection caused by Echinococcus granulosus and is an endemic disease in Turkey. The hydatid cysts of the liver can give origin to several complications and the rupture is one of them. Rupture can occur spontaneously or as a result of external trauma. Read More

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February 2020

Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis.

Surg Endosc 2020 Feb 18. Epub 2020 Feb 18.

Unit of Colorectal Surgery, Department of General and Digestive Surgery, University Hospital Vall D'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.

Background: The surgical resection of the splenic flexure carcinoma (SFC) is challenging and the optimal surgical procedure for SFCs remains a matter of debate. The present study aimed to compare in a multicenter European sample of patients the short- and long-term outcomes of extended right (ERC) vs. left (LC) vs. Read More

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http://dx.doi.org/10.1007/s00464-020-07431-9DOI Listing
February 2020

A proposal for a comprehensive approach to infections across the surgical pathway.

World J Emerg Surg 2020 Feb 18;15(1):13. Epub 2020 Feb 18.

Emergency Surgery Department, Parma University Hospital, Parma, Italy.

Despite evidence supporting the effectiveness of best practices in infection prevention and management, many healthcare workers fail to implement them and evidence-based practices tend to be underused in routine practice. Prevention and management of infections across the surgical pathway should always focus on collaboration among all healthcare workers sharing knowledge of best practices. To clarify key issues in the prevention and management of infections across the surgical pathway, a multidisciplinary task force of experts convened in Ancona, Italy, on May 31, 2019, for a national meeting. Read More

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http://dx.doi.org/10.1186/s13017-020-00295-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029591PMC
February 2020
1.062 Impact Factor