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J R Soc Interface 2021 Apr 7;18(177):20201027. Epub 2021 Apr 7.

Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

Fontan patients require a balanced hepatic blood flow distribution (HFD) to prevent pulmonary arteriovenous malformations. Currently, HFD is quantified by tracking Fontan conduit flow, assuming hepatic venous (HV) flow to be uniformly distributed within the Fontan conduit. However, this assumption may be unvalid leading to inaccuracies in HFD quantification with potential clinical impact. Read More

J Endourol 2021 Mar 31. Epub 2021 Mar 31.

Chinese PLA General Hospital, Urology, 28 Fu Xing Road, Beijing 100853, China., Beijing, Beijing, China, 100853;

Objectives: To compare the perioperative hemodynamic consequences and oncology outcomes of robotic retroperitoneal versus transperitoneal inferior vena cava(IVC) thrombectomy(IVCT) for right renal cell carcinoma(RCC) with IVC tumor thrombus(IVCTT) that located below the first porta hepatis.

Patients And Methods: Between January 2018 and June 2019, 35 patients of right RCC with IVCTT that located below the first porta hepatis underwent robotic retroperitoneal IVCT(16 patients) or transperitoneal IVCT(19 patients). We have described the procedures of transperitoneal IVCT earlier. Read More

J Minim Access Surg 2021 Apr-Jun;17(2):153-158

Department of Surgical Gastroenterology, SRM Institutes for Medical Science, Chennai, Tamil Nadu, India.

Background: Acute gallbladder perforation (GBP) is associated with significant mortality and morbidity. Percutaneous drainage followed by interval cholecystectomy has been the preferred management. The outcomes of early surgery, especially by laparoscopy, have not been well studied in GBP. Read More

Surg Endosc 2021 Mar 8. Epub 2021 Mar 8.

Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.

Background: Laparoscopic right posterior hepatectomy is considered difficult on the basis of the surgery difficulty scoring system. In this study, we evaluated the safety and effectiveness of the technical application of indocyanine green (ICG) fluorescence imaging-guided laparoscopic right posterior hepatectomy.

Methods: Twenty-six patients who underwent ICG fluorescence imaging-guided laparoscopic right posterior hepatectomy at Hepatobiliary and Pancreatic Surgery Department of Zhongnan Hospital, Wuhan University, from June 2018 to December 2019, were included. Read More

Yonsei Med J 2021 Feb;62(2):172-176

Department of Surgery, Jeonbuk National University Hospital, Jeonju, Korea.

Purpose: This study evaluated the effectiveness of prophylactic antibiotics in elective laparoscopic cholecystectomy (LCC) for the reduction of postoperative infection rate.

Materials And Methods: Elective LCC was performed on 529 patients at Jeonbuk National University Hospital between April 2015 and August 2017. A total of 509 patients were enrolled based on the inclusion criteria. Read More

Radiol Case Rep 2021 Mar 17;16(3):467-471. Epub 2020 Dec 17.

Unit of Radiology - Riuniti Hospital, Azienda Ospedaliera Grande Ospedale Metropolitano (G.O.M.) "Bianchi-Melacrino-Morelli", Via Giuseppe Melacrino n.21, 89124 Reggio Calabria, Italy.

We present the case of a 73 years old woman with intestinal obstruction caused by a rare cause of biliary ileus, who arrived at our emergency department with lower abdominal quadrants pain (since about 2 months), recently associated with nausea, vomiting and abdominal distension. After clinical and laboratory evaluations, a computed tomography (CT) scan without intravenous contrast medium administration was urgently requested. CT had shown the presence of a large gallstone (diameter of about 6 cms) at the proximal ileum (stopped in this tract after the passage through a biliary-enteric fistula), and another gallstone (diameter of about 2 cms) in the gallbladder, associated with concentric thickening of gallbladder's walls, gas in the biliary tree, obliteration of peri-gallbladder's fat density and fluid in the peri-subhepatic area. Read More

Emerg Microbes Infect 2021 Dec;10(1):81-96

Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.

species are wood-inhabiting fungi and emerging opportunistic pathogens causing phaeohyphomycosis. In this study, we isolated a dematiaceous fungus, HKU44, from the subhepatic abscess pus and drain fluids of a liver transplant recipient with post-transplant biliary and hepatico-jejunostomy bypass strictures. Histology of the abscess wall biopsy showed abundant fungal hyphae. Read More

Pan Afr Med J 2020 18;37:77. Epub 2020 Sep 18.

Service d'Hépato-Gastro-Entérologie du Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc.

Non-alphabetical hepatitis (Epstein Barr virus -EBV-, cytomegalovirus -CMV-, Herpes simplex virus -HSV-, varicella zoster virus -VZV-etc.) may be a mode of revelation of several underlying chronic liver diseases including autoimmune hepatitis (HAI). We report a peculiar case of acute EBV hepatitis, revealing type I autoimmune hepatitis confirmed by liver biopsy through puncture in a female patient on breast cancer treatment. Read More

Ann Transl Med 2020 Sep;8(17):1083

Rehabilitation Center, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China.

Background: This study aimed to compare the differences of ultrasound findings between subhepatic appendicitis and appendicitis at a normal position, then discuss the diagnostic strategies and improve the accuracy of diagnosis.

Methods: A retrospective analysis was performed in our hospital. One thousand five hundred ninety-one patients with appendicitis were diagnosed from January 2014 to January 2018. Read More

Surg Endosc 2021 Mar 30;35(3):1014-1024. Epub 2020 Oct 30.

Hepato-Pancreatico-Biliary Surgery, Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.

Background: Laparoscopic subtotal cholecystectomy (LSC) is a safe bailout procedure in situations when dissection of "critical view of safety" is not possible. After the proposed classification of subtotal cholecystectomy into "fenestrating" and "reconstituting" techniques in 2016, a comparative review of the outcomes of both methods is timely.

Methods: A literature search of the PubMed, Cochrane Library, and Web of Science database was conducted up to January 31, 2020 for studies that reported LSC. Read More

Acta Gastroenterol Belg 2020 Jul-Sep;83(3):488-490

PGY-4 Resident of Internal Medicine, Department of Internal Medicine, Urmia University of medical Sciences, Urmia, Iran.

Background: Biliary system ascariasis can be a rare cause of acute abdomen.

Patient Report: A 70-year-old woman presented with abdominal pain for two weeks. She complained of a right upper quadrant (RUQ) pain, intermittent vomiting and weight loss. Read More

J Med Case Rep 2020 Sep 12;14(1):151. Epub 2020 Sep 12.

Department of General Surgery, Saudi German Hospital, Al-Aseer, Kingdom of Saudi Arabia.

Background: Subhepatic appendicitis is an exceedingly rare presentation, accounting for 0.01% of acute appendicitis cases. It is of prime importance to be aware of variants and manage such challenging cases accordingly. Read More

Surg Endosc 2020 Sep 1. Epub 2020 Sep 1.

Division of Surgical Oncology, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

Background: There are no studies examining the use of subhepatic drains after simultaneous resection of synchronous colorectal liver metastases (sCRLM). This study aimed to (1) describe the current practices regarding primary drain placement, (2) evaluate drain efficacy in mitigating postoperative complications, and (3) determine impact of drain maintenance duration on patient outcomes.

Methods: The ACS-NSQIP targeted data from 2014 to 2017 were analyzed. Read More

Khirurgiia (Mosk) 2020 (8):23-28

Bashkir State Medical University, Ufa, Russia.

Objective: To identify the criteria of smooth postoperative period after cholecystectomy and risk factors of local surgical infection.

Material And Methods: A prospective analysis included 680 patients after laparoscopic cholecystectomy. We assessed incidence and risk factors of infectious complications. Read More

ANZ J Surg 2021 04 28;91(4):E216-E217. Epub 2020 Aug 28.

Upper Gi & General Surgery (UGIG), Footscray Hospital, Western Health, Melbourne, Victoria, Australia.

Pan Afr Med J 2020 9;36:78. Epub 2020 Jun 9.

Maternal and Paediatric Critical Care Unit, Hassan II Academic Hospital, Fez, Morocco.

Hepatic infarction is a rare and fatal complication associated with hemolysis, elevated liver enzymes and low platelets syndrome. It can develop into fulminant liver failure and lead to death in 16% of cases. A 25-year-old woman, with unremarkable prenatal history, was sent to gynecological emergency unit for management of severe preeclampsia at 30 weeks and 4 days of pregnancy. Read More

J Gastrointest Surg 2021 Mar 29;25(3):708-712. Epub 2020 Jul 29.

Department of General, Visceral, and Transplant Surgery, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.

Background: Bilio-enteric diversion is the current surgical standard in patients after deceased donor liver transplantation (DDLT) with a biliary anastomotic stricture failing interventional treatment and requiring surgical repair. In contrast to this routine, the aim of this study was to show the feasibility and safety of a duct-to-duct biliary reconstruction.

Patients: Between 2012 and 2019, we performed a total of 308 DDLT in 292 adult patients. Read More

Acta Radiol 2021 Jan 2;62(1):34-41. Epub 2020 Apr 2.

Department of Radiology, University of Leipzig, Leipzig, Germany.

Background: Acute pulmonary embolism (PE) is a common disease with a high mortality. Computed tomographic pulmonary angiography (CTPA) represents the current gold standard for the evaluation of patients with suspected PE.

Purpose: To search possible CTPA predictors of 24-h and 30-day mortality in PE. Read More

Ultrasound Med Biol 2020 May 5;46(5):1105-1110. Epub 2020 Feb 5.

Department of Imaging, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

Our purpose is to describe the ultrasound sign for a correct non-invasive diagnosis of omental infarction in children. From January 2014 to December 2018, a total of 234 children (109 boys and 125 girls, age range 3-15 y) with acute right-sided abdominal pain, admitted to our hospital with a presumptive diagnosis of acute appendicitis, were prospectively evaluated. In all patients, abdominal ultrasound was performed, and the omental fat was always evaluated. Read More

Cureus 2019 Dec 28;11(12):e6489. Epub 2019 Dec 28.

Department of Surgery, King Khalid General Hospital, Majmaah, SAU.

Appendicitis is a common surgical emergency. When present in an abnormal subhepatic location, it can pose a challenge in its diagnosis and management. Subhepatic appendicitis is a rare phenomenon, especially in the pediatric age group. Read More

Cureus 2019 Oct 30;11(10):e6035. Epub 2019 Oct 30.

Upper Gastrointestinal and Bariatric Surgery, ‎Imperial College Healthcare National Health Service Trust, London, GBR.

Acute appendicitis is a very common surgical emergency diagnosed by combining the history, examination, and investigations to build a clinical picture. This presentation can become more complex with abnormal anatomical variations of the appendix. This case describes the rare clinical finding of a subhepatically located appendix and caecum in a 24-year-old female presenting with right lower quadrant (RLQ) pain. Read More

Int J Surg Case Rep 2020 27;66:85-87. Epub 2019 Nov 27.

Department of General Surgery, St. Andrew's General Hospital, Patras, Greece.

Introduction: Traumatic rupture of the ovary, due to blunt abdominal trauma, is rarely described in literature and is usually related to ovarian cyst or teratoma.

Presentation Of Case: A 21-year-old Greek, female patient was transported to the Emergency Department complaining of abdominal pain as a result of a catapulting fall from a bicycle. It was determined that both right ovary and liver rupture had occurred. Read More

Pan Afr Med J 2019 30;33:276. Epub 2019 Jul 30.

Service de Chirurgie Pédiatrique, CHU Mohamed VI, Oujda, Maroc.

Cystic malformations of the bile ducts are rare congenital disorders, with an incidence of 1/2000000 live births. Complication including the angiocholitis, chronic pancreatitis, progressive biliary cirrhosis, portal hypertension or gallbladder lithiases can reveal severe disorder. Spontaneous perforation is one of the rare complications described for the first time in 1934 by Weber. Read More

Am J Case Rep 2019 Oct 5;20:1466-1470. Epub 2019 Oct 5.

Department of General Surgery, Saint Charles Hospital, Fayadieh, Lebanon.

BACKGROUND Gall bladder volvulus is a rare clinical entity, with only around 500 cases reported in the literature. It is defined as the rotation of the gallbladder on its mesentery along the axis of the cystic pedicle, although cases of torsion of the gallbladder fundus itself have been reported. CASE REPORT A 78-year-old woman presented for severe right upper-quadrant abdominal pain that began acutely 3 days prior. Read More

Surg Endosc 2020 08 26;34(8):3508-3512. Epub 2019 Sep 26.

Department of Surgery, University of Calgary, Calgary, Canada.

Background: We sought to determine the prevalence of common anatomic landmarks around the gallbladder that may be useful in orienting surgeons during laparoscopic cholecystectomy.

Methods: The subhepatic anatomy of 128 patients undergoing elective cholecystectomy was recorded. We searched and recorded the presence of five anatomic landmarks: the bile duct (B), the Sulcus of Rouviere (S), the left hepatic artery (A), the umbilical fissure (F), and the duodenum (E). Read More

Cureus 2019 Jun 29;11(6):e5034. Epub 2019 Jun 29.

Surgery, Hackensack Meridian Health, Hackensack, USA.

In patients with significant comorbid conditions, acute cholecystitis is managed through surgical intervention or with cholecystostomy tube placement (CTP). The literature is not definitive in its recommendations for cholecystectomy versus cholecystostomy. This case report describes a presentation of acute calculous cholecystitis managed with CTP. Read More

Surg Endosc 2020 07 5;34(7):3216-3222. Epub 2019 Sep 5.

Division of Minimally Invasive and Bariatric Surgery, Department of General Surgery, Penn State Milton S. Hershey Medical Center, 500 University Drive, H149, Hershey, PA, 17033, USA.

Introduction: For patients with a gallbladder in situ, choledocholithiasis is a common presenting symptom. Both two-session endoscopic retrograde cholangiopancreatography (ERCP) and subsequent cholecystectomy (CCY) and single-stage (simultaneous CCY/ERCP) have been described. We utilize an antegrade wire, rendezvous cannulation (AWRC) technique to facilitate ERCP during CCY. Read More

Pak J Med Sci 2019 Sep-Oct;35(5):1306-1311

Musa Akoglu, Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.

Background And Objective: To evaluate the clinical role of the routine use of a drain in an elective laparoscopic cholecystectomy operation applied to patients with symptomatic cholelithiasis not showing acute inflammation.

Method: Following laparoscopic removal of the gallbladder, patients were separated into two groups of 30 each, either with subhepatic drain placement or without. The presence of subhepatic fluid collection was evaluated with transabdominal ultrasonography (USG) at 24 hours postoperatively and on the 7th day. Read More

Eur J Case Rep Intern Med 2019 17;6(7):001181. Epub 2019 Jul 17.

Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.

Disease in atypical organ locations can mimic other pathologies, hampering the right diagnosis. Such conditions may even be emergencies, like appendicitis. Subhepatic appendix is a very rare entity which may be caused by caecum dehiscence failure. Read More

J Gastrointest Surg 2019 09 24;23(9):1925-1932. Epub 2019 Jun 24.

Department of Surgery, Morriston Hospital, Heol Maes Eglwys, Swansea, SA6 6NL, UK.

Background: Laparoscopic cholecystectomy (LC) is one of the most commonly performed procedures worldwide but there is considerable variance amongst surgeons regarding intraoperative technique. This review aims to provide a comprehensive summary, with evidence-based recommendations, of intraoperative interventions in LC.

Methods: A literature search was performed using PubMed, EMBASE, Google Scholar and Cochrane Review databases. Read More