4,702 results match your criteria Biliary Trauma

A Review of the Management of Bile Leaks.

Cureus 2021 May 10;13(5):e14937. Epub 2021 May 10.

General Surgery, Cleveland Clinic Foundation Euclid Hospital, Cleveland, USA.

Bile leaks can be a complication of abdominal surgeries, specifically trauma to the biliary system during laparoscopic cholecystectomy, and can occur from a variety of sources, commonly a bile duct injury (BDI). Their management involves a multidisciplinary approach and depends on a multitude of factors. This consequence has also led to increased health care costs and morbidity and mortality for patients. Read More

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Feasibility and safety of "bridging" pancreaticogastrostomy for pancreatic trauma in Landrace pigs.

World J Gastrointest Surg 2021 May;13(5):419-428

Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China.

Background: In recent years, we created and employed a new anastomosis method, "bridging" pancreaticogastrostomy, to treat patients with extremely severe pancreatic injury. This surgery has advantages such as short length of surgery, low secondary trauma, rapid construction of shunts for pancreatic fluid, preventing second surgeries, and achieving good treatment outcomes in clinical practice. However, due to the limited number of clinical cases, there is a lack of strong evidence to support the feasibility and safety of this surgical procedure. Read More

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Anticoagulant-induced hemorrhagic cholecystitis with hemobilia after deceased donor kidney transplant and literature review.

Int J Surg Case Rep 2021 May 26;84:106027. Epub 2021 May 26.

Augusta University, Department of Surgery, United States of America. Electronic address:

Introduction And Importance: Hemobilia and hemorrhagic cholecystitis are uncommon causes of right upper quadrant abdominal pain. The development of intra-gallbladder and biliary bleeding has been primarily associated with abdominal trauma, malignancy, liver transplant, and iatrogenic injury to the biliary tree and vasculature. Spontaneous anticoagulant induced hemorrhagic cholecystitis and hemobilia are incredibly rare events and have only been documented by a handful of case reports. Read More

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Laparoscopic-Assisted Transgastric Endoscopic Retrograde Cholangiopancreatography With Placement of a Biliary Stent to Treat Traumatic Intrahepatic Bile Duct Disruption in a Patient With Roux-en-Y Gastric Bypass.

Am Surg 2021 Jun 11:31348211025756. Epub 2021 Jun 11.

Division of General and Trauma Surgery, Department of Surgery, 10848WakeMed Health and Hospitals, Raleigh, NC, USA.

Hepatic injuries are common following blunt trauma and while frequently managed expectantly, biliary injury as a result of the trauma requires a high index of suspicion, a focused workup, and likely interventional treatment. A 44-year-old female with a history of Roux-en-Y gastric bypass presented after a ground level fall and was initially discharged home but represented with worsening abdominal pain and elevated liver enzymes. She was found to have a segment 5/6 biliary injury requiring laparoscopic-assisted transgastric endoscopic retrograde cholangiopancreatography with common bile duct stent placement. Read More

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Surgical site infection prevention and management in immunocompromised patients: a systematic review of the literature.

World J Emerg Surg 2021 Jun 10;16(1):33. Epub 2021 Jun 10.

General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa 1, 56100, Pisa, Italy.

Background: Immunocompromised patients are at higher risk of surgical site infection and wound complications. However, optimal management in the perioperative period is not well established. Present systematic review aims to analyse existing strategies and interventions to prevent and manage surgical site infections and other wound complications in immunocompromised patients. Read More

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We Are Not Immune: Racial and Ethnic Disparities in Autoimmune Liver Diseases.

Hepatology 2021 May 31. Epub 2021 May 31.

USC Research Center for Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles California, USA.

Autoimmune liver diseases are attributed to a complex interplay of biologic, acquired, and environmental factors. Increased prevalence, later stage of presentation, worse response to standard therapy, and transplant-related disparities have all been reported in racial and ethnic minorities such as Black and Latinx patients with autoimmune liver diseases. While biology and inherited genetic predispositions may partly explain these disparities, definitive and universal genetic variations underlying these differences in outcomes have not been defined. Read More

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Evaluation and Management of Malignant Biliary Obstruction.

Surg Oncol Clin N Am 2021 Jul;30(3):491-503

Department of Surgery, Division of Trauma Surgery, University of New Mexico; Division of Palliative Medicine, University of New Mexico, Albuquerque, NM, USA. Electronic address:

There is no reason to be pollyannaish when approaching patients with malignant biliary obstruction (MBO). Although technology has allowed refining diagnosis and resectability of cancers causing biliary obstruction, outcomes have not improved significantly. The previous preponderant place of surgical procedures now is replaced by endoluminal and percutaneous techniques for the management of symptoms of MBO. Read More

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Symptomatic pseudoaneurysms following laparoscopic cholecystectomy: Focus on an unusual and dangerous complication.

J Minim Access Surg 2021 May 24. Epub 2021 May 24.

Department of Surgery, General University Hospital of Patras, Patras, Greece.

Background: Laparoscopic cholecystectomy (LC) has been associated with an increase in the incidence of biliary and vascular injuries. Pseudoaneurysms (PAs) following LC are rare life-threatening events with limited available experience regarding diagnosis and treatment.

Materials And Methods: An extensive review of literature during a 26-year period (1994-2020) using MEDLINE database and Google Scholar academic search engine revealed 134 patients with at least one symptomatic PA following LC. Read More

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Fetal intracranial hemorrhage associated with maternal coagulopathy and vitamin K deficiency after biliary drain placement: A case report and literature review.

Case Rep Womens Health 2021 Jul 20;31:e00329. Epub 2021 May 20.

Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America.

Introduction: Fetal intracranial hemorrhage (ICH) is a rare but serious prenatal diagnosis. Predisposing factors include maternal trauma and fetal coagulation dysfunction. Maternal vitamin K deficiency has been described as an etiology. Read More

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Anaotmical variability in the position of cystic artery during laparoscopic visualization.

BMC Surg 2021 May 27;21(1):263. Epub 2021 May 27.

Department of Surgery, Sindh Government Qatar Hospital, Karachi, Pakistan.

Background: The laparoscopic view of extrahepatic biliary tract and cystic artery is different anatomically from open approach. Consequently iatrogenic injuries due to inadverent damage to cystic artery are not uncommon. These complications can be prevented by careful dissection in Calots triangle and better knowledge of laparoscopic anatomy of cystic artery and its variations. Read More

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Posttraumatic bronchobiliary fistulae due to foreign body remnants after  a road traffic injury: a case report.

J Med Case Rep 2021 May 22;15(1):291. Epub 2021 May 22.

Colorectal Research Center, Department of Surgery, Shiraz University of Medical Sciences, Zand Avenue, P.O. Box 71345-1744, Shiraz, Iran.

Background: Bronchobiliary fistula is an extremely rare disease that involves abnormal communication between a hepatic segment and bronchial tree. It is mostly caused by untreated hydatid cyst, liver abscess, iatrogenic stenosis, and, rarely, trauma.

Case Presentation: We experienced an extremely rare case of bronchobiliary fistula after motor vehicle accident. Read More

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Liver retraction using n-butyl-2-cyanoacrylate glue during laparoscopic cholecystectomy.

Medicine (Baltimore) 2021 May;100(20):e25879

Department of General Surgery, Qilu Hospital of Shan Dong University, Jinan, China.

Abstract: There might be a thick "protrusion" in the visceral surface of hepatic quadrate lobe during the laparoscopic cholecystectomy (LC), which affects the surgical fields and consequently triggers high risks of biliary tract injury. Although n-butyl-2-cyanoacrylate (NBCA) glue has been applied to laparoscopic upper abdominal surgery for liver retraction, there is still no consensus on its safety and feasibility in LC. In this study, we investigated the safety, feasibility, and effectiveness of liver retraction using NBCA glue for these patients which have the thick "protrusion" on the square leaf surface of the liver during LC. Read More

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Acute Pancreatitis in Children: The Clinical Profile at a Tertiary Hospital.

Cureus 2021 May 6;13(5):e14871. Epub 2021 May 6.

Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR.

Objectives The clinical course and progression of acute pancreatitis are poorly understood to date, necessitating more studies of clinical profiles during the disease. Moreover, understanding the etiologies and clinical presentations of acute pancreatitis (AP) in children can contribute to early diagnosis and, hence, earlier interventions. Therefore, this article aims to study the clinical profiles of children with acute pancreatitis (AP) in relation to complications and other variables. Read More

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Long-term outcomes in the repair of intrahepatic iatrogenic bile duct lesions using a combined intraglissonian and extraglissonian approach.

Langenbecks Arch Surg 2021 May 8. Epub 2021 May 8.

Department of Surgery. HBP Unit, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain.

Purspose: Iatrogenic bile duct injuries (IBDI) with intrahepatic involvement are a serious and challenging surgical complication that can have disastrous consequences in terms of morbidity and mortality.

Methods: We collected the patients with IBDI type (E4) between January 1991 and March 2020 in our hospital. The objective of the study was to present the long-term results of a extraglissonian approach and intraglissonian biliary reconstruction in a series of patients with intrahepatic bile duct injuries after cholecystectomy. Read More

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The Efficacy of Intraoperative Fluorescent Imaging Using Indocyanine Green for Cholangiography During Cholecystectomy and Hepatectomy.

Clin Exp Gastroenterol 2021 30;14:145-154. Epub 2021 Apr 30.

Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan.

Purpose: Bile duct injury is one of the most serious complications of laparoscopic cholecystectomy. Intraoperative indocyanine green (ICG) cholangiography is a safe and useful navigation modality for confirming the biliary anatomy. ICG cholangiography is expected to be a routine method for helping avoid bile duct injuries. Read More

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J Trauma Acute Care Surg 2021 May 5. Epub 2021 May 5.

Department of Surgery, University of Calgary.

Introduction: Since the universal adoption of Hans Kehr's biliary T-tube in the early twentieth century, use has shifted from routine towards highly selective. Improved interventional endoscopy, percutaneous techniques, and hepato-pancreato-biliary (HPB) training have resulted in less T-tube experience within general surgery. The aim of this technical review is to discuss T-tube indications, technical nuances, and management. Read More

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Haemobilia secondary to a cystic artery pseudoaneurysm as complication of VLC.

Acta Biomed 2021 04 30;92(S1):e2021125. Epub 2021 Apr 30.

Department of Surgery, Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila.

Introduction: The laparoscopic approach has become the gold standard for cholecystectomy. However, it could have some major complications. Among them, it can be considered postoperative pseudoaneurysms of the cystic or hepatic arteries. Read More

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Challenges in Diagnosis and Management of Hemobilia.

Radiographics 2021 May-Jun;41(3):802-813

From the Departments of Radiology (A.P., J.G.F., S.K.V., J.L.F., A.R.K.) and Gastroenterology (A.C.S.), Mayo Clinic, 200 First St SW, Rochester MN 55905.

Hemobilia, or hemorrhage within the biliary system, is an uncommon form of upper gastrointestinal (GI) bleeding that presents unique diagnostic and therapeutic challenges. Most cases are the result of iatrogenic trauma, although accidental trauma and a variety of inflammatory, infectious, and neoplastic processes have also been implicated. Timely diagnosis can often be difficult, as the classic triad of upper GI hemorrhage, biliary colic, and jaundice is present in a minority of cases, and there may be considerable delay in the onset of bleeding after the initial injury. Read More

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Management of Patients With Acute Cholecystitis After Percutaneous Cholecystostomy: From the Acute Stage to Definitive Surgical Treatment.

Front Surg 2021 15;8:616320. Epub 2021 Apr 15.

Division of General Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Percutaneous cholecystostomy (PC) has become an important procedure for the treatment of acute cholecystitis (AC). PC is currently applied for patients who cannot undergo immediate laparoscopic cholecystectomy. However, the management following PC has not been well-reviewed. Read More

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Emergency surgery for splenic flexure cancer: results of the SFC Study Group database.

World J Emerg Surg 2021 Apr 29;16(1):20. Epub 2021 Apr 29.

Unit of Minimally Invasive and Robotic Digestive Surgery, General Regional Hospital F. Miulli, Acquaviva delle Fonti, Bari, Italy.

Background: The effectiveness of surgical treatment for splenic flexure carcinomas (SFCs) in emergency settings remains unexplored. This study aims to compare the perioperative and long-term outcomes of different alternatives for emergency SFC resection.

Method: This multicenter retrospective study was based on the SFC Study Group database. Read More

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Y-Shaped Vesica Fellea Duplex Gallbladder Causing Acute Biliary Pancreatitis.

Cureus 2021 Apr 25;13(4):e14676. Epub 2021 Apr 25.

Gastroenterology and Hepatology, University Hospitals of Morecambe Bay National Health Service Foundation Trust, Lancaster, GBR.

Gallbladder duplication refers to the splitting of "gallbladder primordium" during the early embryonic development in the fifth or early sixth week. Although it is a very rare congenital abnormality and most of the patients will be asymptomatic, yet the symptomatic cases present with abdominal complaints like nausea vomiting, abdominal pain leads to cholecystitis, cholangitis, biliary colic, or pancreatitis. Herein, we present a case report of duplication of the gallbladder, which was difficult to diagnose on radiology. Read More

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Arq Gastroenterol 2021 Jan-Mar;58(1):71-76

Faculdade Santa Marcelina, São Paulo, Brasil.

Background: Hepatobiliary surgery and hepatic trauma are frequent causes of bile leaks and this feared complication can be safely managed by endoscopic retrograde cholangiopancreatography (ERCP). The approach consists of sphincterotomy alone, biliary stenting or a combination of the two but the optimal form remains unclear.

Objective: The aim of this study is to compare sphincterotomy alone versus sphincterotomy plus biliary stent placement in the treatment of post-surgical and traumatic bile leaks. Read More

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Parameters of biliary hydrodynamic injection during endoscopic retrograde cholangio-pancreatography in pigs for applications in gene delivery.

PLoS One 2021 28;16(4):e0249931. Epub 2021 Apr 28.

Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.

The biliary system is routinely accessed for clinical purposes via endoscopic retrograde cholangiopancreatography (ERCP). We previously pioneered ERCP-mediated hydrodynamic injection in large animal models as an innovative gene delivery approach for monogenic liver diseases. However, the procedure poses potential safety concerns related mainly to liver or biliary tree injury. Read More

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[Risk and control management of endoscopic retrograde cholangiopancreatography in patients with liver cirrhosis].

X M Li L G Lu X B Cai

Zhonghua Gan Zang Bing Za Zhi 2021 Mar;29(3):209-212

Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China.

Endoscopic retrograde cholangiopancreatography (ERCP) is the most direct and effective method for the diagnosis and treatment of biliary and pancreatic diseases. Compared with surgery, ERCP has the advantages of minimal trauma, shorter surgery time, fewer complications, and shorter hospital stay. Liver cirrhosis, as the advanced stage of liver disease, has reduced tolerance to surgical stresses, and complications such as hepatic encephalopathy, esophagogastric varices, and coagulation dysfunction may occur during the decompensated stage, which poses a challenge to ERCP, and thus increase the intraoperative risk and postoperative complications. Read More

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Role of interventional radiology in the management of complex pediatric surgical cases.

Int J Surg Case Rep 2021 May 16;82:105886. Epub 2021 Apr 16.

Department of Neonatal and Paediatric Intensive Care, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India.

Introduction: Minimally-invasive techniques offered by interventional radiology (IR) are really helpful in the management of challenging surgical cases. The current report highlights a series of four complex pediatric surgical cases which were successfully managed by specific image-guided techniques.

Case Presentation: The first two cases in the present report were infants. Read More

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Common hepatic artery pseudoaneurysm: A rare complication following total gastrectomy: A case report.

Int J Surg Case Rep 2021 Apr 23;81:105816. Epub 2021 Mar 23.

Department of Gastrointestinal and General Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Electronic address:

Introduction And Importance: Common Hepatic Artery (CHA) Pseudoaneurysm is a rare entity, attributed to infections, trauma, and upper abdominal surgery. Most cases occur after biliary and pancreatic surgery. CHA pseudoaneurysm after total gastrectomy is uncommon and can be devastating. Read More

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Laparoscopic hepaticojejunostomy for benign biliary stricture: A case series of 16 patients at a tertiary care centre in India.

J Minim Access Surg 2021 Mar 8. Epub 2021 Mar 8.

Department of General Surgery, SCBMCH, Cuttack, Odisha, India.

Background: Gallstone disease is common in India, and since primary management involves surgery, it is one of the most commonly performed surgeries by a general surgeon either laparoscopically or open. There are various factors which are responsible for intra- and post-operative complications. These factors result in significant injuries which cause serious post-operative complications. Read More

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The role of portoenterostomy in the treatment of patients with multiple bile duct trauma: Case series and review of the literature.

Ulus Travma Acil Cerrahi Derg 2021 May;27(3):362-368

Department of General Surgery, İzmir Katip Çelebi Üniversity, Atatürk Training and Research Hospital, İzmir-Turkey.

Background: Hepaticojejunostomy is a challenging and complex procedure to be administered with the confidence, in conditions which contain a large number of bile duct damaged by benign pathologies or major bile duct trauma.

Methods: Here, our clinical series of portoenterostomy (PE), in which we applied in patients who had aggressive hilar dissection for hilar benign biliary pathologies and major bile duct traumas during laparoscopic cholecystectomies were discussed in the light of the literature. The PE procedure was performed in the presence of three or more bile ducts that could not be merged. Read More

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Correction to: 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 2021 Apr 20. Epub 2021 Apr 20.

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

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