Surgical management and long-term outcome of complicated liver hydatid cysts caused by Echinococcus granulosus
|
|
- Prosper Hood
- 6 years ago
- Views:
Transcription
1 Surgical management and long-term outcome of complicated liver hydatid cysts caused by Echinococcus granulosus Roland Chautems, MD, a Leo H. Bühler, MD, a Benjamin Gold, MD, a Emile Giostra, MD, b Pierre Poletti, MD, c Michael Chilcott, MD, a Philippe Morel, MD, a and Gilles Mentha, MD, a Geneva, Switzerland Background. The aim of this retrospective study was to evaluate clinical presentation and long-term outcome of patients treated surgically for complicated liver hydatid cysts. Patients and Methods. Eighty-four patients with liver hydatid cysts underwent an operation at the Geneva University Hospital between 1980 and Clinical presentation, postoperative morbidity, mortality, and long-term recurrence rate were evaluated. Results. Among the 84 patients with liver hydatid disease, 35 patients (41%) presented complicated cysts (ie, cysts that had developed a fistula into adjacent structures or organs). In most patients, the fistula communicated with the biliary tree (n = 25), but we also observed communication with the right lung (n = 3), the right diaphragm (n = 2), liver parenchyma (n = 1), and peritoneal cavity (n = 1). Complete removal of the cystic disease was possible in 24 of 35 patients (70%). In 11 patients, fragments of cysts were not removed because of their location adjacent to main vessels. Postoperatively, 8 patients (23%) developed a severe complication (grade II and III). There were no postoperative deaths, and no recurrences of hydatid disease were observed with a median follow-up of 8.6 years (complete follow-up was obtained in 69% of patients). Conclusions. Complicated liver hydatid disease is frequent and was observed in almost half of patients operated for liver hydatid cysts at our center. Using a surgical strategy aimed at complete removal of cystic and pericystic tissue with simultaneous treatment of the fistulous tract, we observed 23% postoperative morbidity, no mortality, and no recurrence of disease with a median follow-up of >8 years. (Surgery 2005;137:312-6.) From the Department of Surgery, Clinic of Visceral Surgery, a and the Division of Gastroenterology, Departments of Medicine, b and Radiology, c University Hospital of Geneva OVER TIME, LIVER HYDATID DISEASE caused by Echinococcus granulosus can involve adjacent structures or organs by development of fistulous tracts and dissemination of daughter cysts into the biliary tree, pleura, bronchi, or peritoneum. The incidence of complicated hydatid cysts has been reported to be as high as 60% of patients diagnosed and treated for liver hydatid disease. 1 Treatment of liver hydatid disease in general is still a matter of debate, and no clear guidelines are available. It is generally agreed that medical therapy alone is ineffective and unreliable in Accepted for publication September 18, Reprint requests: Dr Leo H. Bühler, Clinic of Visceral Surgery, University Hospital of Geneva, Micheli-du-Crest 24, 1211 Geneva 14, Switzerland. leo.buhler@hcuge.ch /$ - see front matter Ó 2005 Elsevier Inc. All rights reserved. doi: /j.surg curing the disease although stabilization has been reported with albendazole alone or in combination with praziquantel. 2,3 Operative therapies vary from complete resection (eg, total pericystectomy or hepatectomy) to minimal invasive procedures (eg, percutaneous aspiration of cysts). 4-6 More recently, reports 7-9 have been published on laparoscopic approaches to the treatment of hepatic hydatid cysts. The choice of therapy depends on several factors: general condition of the patient, number and localization of the cysts, surgeon s expertise, and type of hospital in which the surgery is performed, including the possibility of intensive postoperative care. Only a few studies have reported the management and outcome of patients with complicated liver hydatid disease. The aim of our current study was to analyze clinical presentation and the long-term outcome of patients treated operatively for complicated liver hydatid cysts at our center. 312 SURGERY
2 Surgery Volume 137, Number 3 Chautems et al 313 Table I. Summarized classification of complications according to Clavien et al 13 Grade I Grade II Grade III Grade IV Alterations from the ideal postoperative course, non life-threatening, and with no lasting disability Complications potentially lifethreatening but without residual disability Complications with a residual disability Death PATIENTS AND METHODS For this retrospective study, we reviewed the charts of 84 patients with liver hydatid cysts caused by Echinococcus granulosus, who were treated at our department between January 1980 and December 1999 of which 35 (41%) presented a complicated hydatid cyst. The remaining 49 patients (59%) presented with one or several cysts without invasion of adjacent organs or biliary vessels. Blood tests including complete blood count, liver function tests, and hydatid serology (ELISA and/or hemagglutination test) were obtained. Radiologic workup included ultrasonography and computed tomography. Angiography was performed selectively in patients who had evidence of close contact between a cyst and the main branches of the portal vein or hepatic artery. Operative strategy was directed toward curative excision of all parasitic tissue and pericystic tissue. Drapes soaked with hypertonic sodium chloride solution (20%) were placed around the cysts before their emptying to produce scolicidal effect. If a possible communication between a cyst and the biliary tree was suspected from the preoperative assessment (eg, cholestasis or dilatation of the biliary tree) or suspected during surgery, intraoperative cholangiography was performed and, if necessary, the biliary tree was explored. Cholecystectomy was not performed routinely. The charts of the patients were reviewed and the complications classified according to Clavien et al 13 (Table I). Postoperative, antiparasitic treatment with albendazole was given to 13 patients up to 6 months. Only patients with residual cystic fragments, a bronchial fistula, or rupture of a cyst into the peritoneal cavity were considered for antiparasitic treatment. The total daily doses varied between 600 and 800 mg. Follow-up was organized by our team or by the primary care physician. Follow-up workup included blood tests (same as above) and abdominal Fig 1. Intraoperative cholangiography showing a fistula between a cyst located in the left liver and the left branch of the common bile duct (arrow). Contrast medium is filling the space left behind after a pericystectomy. A daughter cyst is also visible in the distal common bile duct. This patient underwent a left hepatectomy. ultrasonography on regular intervals. Patients and/or their physicians were sent a questionnaire asking about any recurrence. RESULTS Clinical presentation. All 35 patients with complicated liver hydatid disease were born or had lived several years in endemic areas: Algeria (n = 3), Chile (n = 1), Spain (n = 5), Iraq (n = 1), Italy (n = 5), Lebanon (n = 1), Libya (n = 1), Morocco (n = 2), Portugal (n = 7), Switzerland (n = 2), Turkey (n = 3), and Yugoslavia (n = 4). There were 20 females and 15 males aged between 15 to 71 years (median, 40 years). Clinical presentation was variable and included abdominal pain (n = 10), fever (n = 7), jaundice (n = 4), coughing (n = 2), anaphylaxis (n = 2), unexpected discovery (n = 3), no sign or symptom (n = 2) found during follow-up (n = 2); abdominal pain was the most common symptom. Two patients with recurrent hydatid disease had undergone a previous operation at another center. Between 1 and 20 cysts were found per patient. In most patients, a complicated cyst was diagnosed preoperatively (cholestasis or dilatation of the biliary tree), and in only 3/35 patients (8%) was an unexpected fistula discovered intraoperatively. Description of complicated cysts and surgical therapy. A fistula between a cyst and the biliary tract was detected in 25 patients (30% of all
3 314 Chautems et al Surgery March 2005 Table II. Surgical procedures of the liver (based on Couinaud s anatomic classification) Surgical procedure Right hepatectomy 4 Left hepatectomy (segments II, III, IV) 1 Left hepatectomy (segments II, III) 3 Segmentectomy 4 Total pericystectomy 27 Subtotal pericystectomy 12 Unroofing 6 Cystojejunostomy 1 n Fig 2. Preoperative computed tomography scan showing voluminous hydatic cysts in the right and left liver lobes, with (A) a fistula in the right liver extending through the diaphragm (arrow) and into the (B) right lung (arrow). This patient underwent total pericystectomies, unroofing of the cysts, and resection of the fistulous tract in the right lung. patients with liver hydatid disease and 71% of those with complicated cysts). The fistula was usually revealed by an open bile duct communicating with the removed cyst and confirmed by cholangiography (Fig 1). At cholangiography, daughter cysts were found located within the common bile duct in 12 of 25 patients (Fig 2). For these patients, daughter cysts were removed by choledochotomy with a T tube left in place for 4 weeks. After removal of the cyst and the fistulous tract, any open bile duct was closed with a reabsorbable suture. In 1 patient, a cyst was communicating with the bile duct of segment IV, which was distally obstructed by an inflammatory stricture. The patient was treated by a segmental drainage via a Roux-en-Y jejunal limb. Invasion of the diaphragm was observed in 5 patients (14% of complicated cysts). Surgical treatment consisted of excision of the fistulous tract, local diaphragm excision, direct suture, and pleural drainage. A fistula into the chest was observed in 3 patients (9% of complicated cysts); 2 fistulas involved the bronchial tree and 1 the pleural space. Associated procedures were excision of the fistulous tract, and lung and pleural drainage. Preoperative rupture of a cyst into the peritoneal cavity was observed in 1 patient, who presented with acute abdominal pain. Emergency laparotomy revealed a large left liver cyst with free daughter cysts in the peritoneal cavity. A left liver hepatectomy was performed in association with intraoperative peritoneal lavage with 3 L of hypertonic sodium chloride solution. Before closure, the peritoneal cavity was rinsed again with normal saline (154 mmol/l NaCl) solution. This patient was treated postoperatively with albendazole for 6 months. Intrahepatic rupture of a cyst was found in 1 patient who had undergone a previous operation by pericystectomy for liver hydatid disease. Subtotal pericystectomy and cyst unroofing were performed. Of the 35 patients with complicated hydatid disease, 24 (69%) had a complete removal of the disease by hepatectomy (12 patients) or total pericystectomy (12 patients). For the remaining 11 patients, some pericystic tissue (subtotal pericystectomy) or part of the cyst itself (cyst unroofing) was left in place (Table II). Only small fragments of cysts adjacent to main vessels (which had to be preserved) persisted after resection. The reason for the incomplete resection was to save main hepatic or portal veins to preserve hepatic function. With regard to surgical treatment of cystic hydatid disease, the risk between disease recurrence and postoperative liver failure was carefully weighed.
4 Surgery Volume 137, Number 3 Chautems et al 315 One patient presented with 2 simultaneous lung hydatid cysts and another with a cyst in the retroperitoneum, all of which were removed at the time of the hepatic surgery. Postoperative morbidity, mortality, and recurrence rate. Postoperative complications developed in 13 patients (37%); 8 (23%) of which were classified as severe (grade II and III). Type III complications included a brachial plexus injury in 1 patient after a 10-hour procedure (consisting of unroofing of 4 cysts and 8 total pericystectomies). A post-transfusional hepatitis C developed in 1 patient who received 4 units of blood intraoperatively in Other complications were treated medically or by drainage. There was no postoperative mortality (ie, all patients were discharged from the hospital in stable condition). Of the 35 patients, follow-up was complete in 24 (69%) and partial in 11 (31%) with a median of 103 months (15-240) or 8.6 years. No recurrence was found during our study period. DISCUSSION Complicated hydatid liver cysts have been reported to occur in 15% to 60% of patients with hydatid liver disease at the time of diagnosis. 1,10-12 Specific management and long-term outcome have not been evaluated extensively. Involvement of adjacent structures or organs must be considered in preoperative planning. In our series of 84 patients undergoing an operation for liver hydatid disease, almost half (41%) presented with complicated hydatid liver disease. Most frequently, a communication with the biliary tree was observed (30%). This complication has been reported in the literature to occur in 9% to 30% of patients. 1,10-12 The high rate observed at our center could be explained by referral of patients from non-endemic areas, where delayed diagnosis is more frequent. The fistula was large enough to allow daughter cysts and debris to migrate into the biliary tree in almost half of the patients with biliary fistulas and in 14% of all patients with hydatid liver disease. We recommend performing an intraoperative cholangiography in all patients who present with abnormal liver function tests preoperatively, bile-stained cyst fluid, or intraoperative bile leak after a pericystectomy. Several authors have advocated pre- or postoperative endoscopic retrograde cholangiopancreatography (ECRP) If performed in conjunction with a sphincterotomy, an ECRP may be used to drain an infected biliary tree or to clear the biliary tree before a planned procedure, thereby avoiding the need for an intraoperative cholangiography and bile duct exploration. The reports of such series involved a limited number of patients (n = 11-14), and the success rate was variable (43%-100%) At our center, intraoperative cholangiography with or without subsequent duct exploration remains the method of choice. Using this technique, no postoperative biliary obstruction occurred. However, ERCP and sphincterotomy might play a role in patients with acute cholangitis or postoperative biliary complications. Cysts located at the periphery and at the dome of the liver tend to involve the diaphragm and often the intrathoracic structure. For these patients, local diaphragm excision and suture appeared satisfactory in our experience. Rarely, cysts either rupture into the pleural space or into the bronchial tree ,17 Surgical management of such complicated cysts can be performed by laparotomy through the diaphragm or by thoracotomy with removal of the involved lung tissue, bronchial suture, and pleural drainage. 17 Rupture of a cyst into the peritoneal cavity should be a rare event that can be caused by direct trauma, with the risk of an anaphylactic shock. Profuse peritoneal lavage with hypertonic sodium chloride appears to be mandatory to prevent intraabdominal recurrence of hydatid disease. Postoperative complications involved 37% of the patients presenting complicated hydatid liver disease. Recently, Gollackner et al 18 reported a series of 74 patients treated for liver hydatid cysts. Postoperative morbidity and mortality were 24% and 3%, respectively. 18 The higher complication rate observed in our report might be explained by the selection of patients presenting with complicated hydatid disease, necessitating more complex surgical procedures. In other series, overall postoperative morbidity was only 3% to 12%. 11,19 However, only complications directly related to the surgical procedures were reported; this difference emphasizes the importance of using an internationally accepted classification to analyze and report postoperative complications. We have recently reported a higher recurrence rate of disease in patients undergoing an incomplete resection compared to those undergoing complete surgical resection of liver hydatid disease (ie, 12% vs 0%, respectively). 20 Recurrence is likely due to residual vesicles left in place, even if the cysts were carefully emptied. Vesicles can develop from a main cyst and grow next to it, which is especially the case in older cysts. Recurrences may also develop if peritoneal soiling occurs during emptying of a cyst. Recurrence usually becomes
5 316 Chautems et al Surgery March 2005 symptomatic only 3 to 4 years after the operation In the present study, despite the observation that some patients with complicated liver hydatid disease had incomplete surgical resection, no recurrences have been observed to date in the 11 patients who underwent incomplete pericystectomy of all cysts. One reason might be that only a small fragment of cyst(s) adjacent to preserved main vessels persisted after the resection. CONCLUSION We recommend complete resection of hepatic hydatid lesions with simultaneous treatment of fistulous tracts located in adjacent structures or organs whenever possible. This strategy allowed us to achieve a low recurrence rate with no mortality and a morbidity of 23%. REFERENCES 1. Kammerer WS, Schantz PM. Echinococcal disease. Infect Dis Clin North Am 1993;7: Luchi S, Vincenti A, Messina F, Parenti M, Scasso A, Campatelli A. Albendazole treatment of human hydatid tissue. Scand J Infect Dis 1997;29: Franchi C, Di vico B, Teggi A. Long-term evaluation of patients with hydatidosis treated with benzimidazole carbamates. Clin Infect Dis 1999;29: Khuroo MS, Wani NA, Javid G, Khan BA, Yattoo GN, Shah AH, Jeelani SG. Percutaneous drainage compared with surgery for hepatic hydatid cysts. N Eng J Med 1997;337: Alfieri S, Doglietto GB, Pacelli F, Costamagna G, Carriero C, Mutignani M, et al. Radical surgery for liver hydatid disease: a study of 89 consecutive patients. Hepatogastroenterology 1997;44: Men S, Hekimoglu B, Yucesoy C, Arda IS, Baran I. Percutaneous treatment of hepatic hydatid cysts: an alternative to surgery. Am J Roentgenol 1999;172: Guibert L, Gayral F. Laparoscopic pericystectomy of a liver hydatid cyst. Surg Endosc 1995;9: Khoury G, Jabbour-Khoury S, Bikhazi K. Results of laparoscopic treatment of hydatid cysts of the liver. Surg Endosc 1996;10: Verma GR, Bose SM. Laparoscopic treatment of hepatic hydatid cyst. Surg Laparosc Endosc 1998;8: Erguney S, Tortum O, Taspinar AH, Ertem M, Gazioglu E. Complicated hydatid cysts of the liver. Ann Chir 1991;45: Kösal N, Müftüoglu T, Günerhan Y, Uzun MA, Kurt R. Management of intrabiliary ruptured hydatid disease of the liver. Gastroenterology 2001;48: Atli M, Kama NA, Yuksek YN, et al. Intrabiliary rupture of a hepatic hydatid cyst. Arch Surg 2001;136: Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 1992;111: Ponchon T, Bory R, Chavaillon A. Endoscopic retrograde cholangiography and sphincterotomy for complicated hepatic hydatid cyst. Endoscopy 1987;19: Rodriguez AN, Sanchez del Rio AL, Alguacil LV, De dios Vega JF, Fugarolas GM. Effectiveness of endoscopic sphincterotomy in complicated hepatic hydatid disease. Gastrointestinal Endosc 1998;48: Dumas R, Le Gall P, Hastier P, Buckley MJ, Conio M, Demont JP. The role of endoscopic retrograde cholangiopancreatography in the management of hepatic hydatid disease. Endoscopy 1999;31: Xanthakis DS, Katsaras E, Efthimiadis M, Papadakis G, Varoukakis G, Aligizakis C. Hydatid cysts of the liver with intrathoracic rupture. Thorax 1981;36: Gollackner B, Längle F, Auer H, Maier A, Mittlböck M, Agstner I, et al. Radical surgical therapy of abdominal cystic hydatid disease: factors of recurrence. World J Surg 2000;24: Settaf A, Bargach S, Aghzadi R, Lahlou MK, Oudghiri M. Traitement de la fistule kysto-biliaire du kyste hydatique du foie. J Chir 1991;128: Chautems R, Buhler L, Gold B, Chilcott M, Morel Ph, Mentha G. Long term results after complete or incomplete surgical resection of liver hydatid disease. Swiss Med Wkly 2003;133: Barros JL. Hydatid disease of the liver. Am J Surg 1978;135: Morel Ph, Robert J, Rohner A. Surgical treatment of hydatid disease of the liver: a survey of 69 patients. Surgery 1988; 104: Ozmen V, Igci A, Kebudi A, Kecer M, Bozfakioglu Y, Parlak M. Surgical treatment of hepatic hydatid disease. C J Surg 1992;35: Di Matteo G, Bove A, Chiarini S, Capuano LG, De Antoni E, Lanzi G, et al. Hepatic echinococcus disease: our experience over 22 years. Hepatogastroenterology 1996;43:
RISK FACTORS AND SURGICAL SOLUTIONS OF COMPLICATED LIVER HYDATID CYSTS
RISK FACTORS AND SURGICAL SOLUTIONS OF COMPLICATED LIVER HYDATID CYSTS S. Busuioc 1*, N. Dănilă 2, C. Roata 1,3, O. Motaş 1, St. Mihalache 3, C. Dragomir 4 * PhD student, Gr. T. Popa University of Medicine
More informationScience & Technologies
A GIANT LIVER HYDATIDE CYST SIMULTANEOUSLY PERFORATED TO PERITONEAL AND PLEURAL CAVITIES A RARE CASE REPORT. Ivan P. Novakov Department of Special Surgery; Medical University - Plovdiv Abstract. Background.
More informationSurgical Management of CBD Injury Jin Seok Heo
Surgical Management of CBD Injury Jin Seok Heo Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Bile duct injury (BDI) Introduction Incidence
More informationHydatid Disease of the Abdomen and Other Locations
World J. Surg. 29, 1161 1165 (2005) DOI: 10.1007/s00268-005-7775-3 Hydatid Disease of the Abdomen and Other Locations Alexandra K. Tsaroucha, M.D. Ph.D., 1 Alexandros C. Polychronidis, M.D. Ph.D., 1 Nikolaos
More informationRole of Therapeutic Endoscopy in Hepatic Hydatid Disease after Surgical Intervention: Case Report
ISPUB.COM The Internet Journal of Gastroenterology Volume 10 Number 2 Role of Therapeutic Endoscopy in Hepatic Hydatid Disease after Surgical Intervention: Case Report H Ono, M Okabe, T Kimura, M Kawakami,
More informationORIGINAL ARTICLE. Importance of Cyst Content in Hydatid Liver Surgery. can be managed surgically
ORIGINAL ARTICLE Importance of Cyst Content in Hydatid Liver Surgery Cuneyt Kayaalp, MD; Neriman Sengul, MD; Musa Akoglu, MD Hypothesis: Cyst content in hydatid liver surgery is a determinant of postoperative
More informationSurgical Treatment of Complicated Liver Echinococcosis Our Experience with 184 Cases in 10 Years
ORIGINAL PAPER J. Transl. Med. Res 06;():4-46 Surgical Treatment of Complicated Liver Echinococcosis Our Experience with 84 Cases in 0 Years Sorin Berbece, Cristian Blajut, Silviu Ciurea, Victor Tomulescu,
More informationMD Assistant Professor In Surgery. MD Specialist In Surgery. MD Specialist In Surgery. MD Assistant Professor In Radiology. MD Professor In Surgery
J R Army Med Corps 1998; 144: 139-143 Surgical Management Of Hydatid Disease Of The Liver: A Military Experience Maj MLAkin Assistant Professor In Surgery Capt C Erenoglu Specialist In Surgery EU Uncu
More informationBile Duct Injury during Lap Chole. Bile Duct Injury during cholecystectomy TOPICS. 1. Prevalence, mechanisms, prevention and diagnosis
Bile Duct Injury during cholecystectomy Catherine HUBERT Jean-Fran François GIGOT Benoît t NAVEZ Division of Hepato-Biliary Biliary-Pancreatic Surgery Department of Abdominal Surgery and Transplantation
More informationAtypical manifestations, complications and pathological correlation of hydatid disease.
Atypical manifestations, complications and pathological correlation of hydatid disease. Poster No.: C-2501 Congress: ECR 2012 Type: Educational Exhibit Authors: R. Lerma Ortega, D. J. López Ruiz, L. A.
More informationHydatid cyst ofthe liver with intrathoracic rupture
Thorax 1981 ;36:497-501 Hydatid cyst ofthe liver with intrathoracic rupture DS XANTHAKS, E KATSARAS, M EFTHMADS, G PAPADAKS, G VAROUCHAKS, C ALGZAKS From the Thoracic Surgical Clinic, Sismanoglion Hospital,
More informationSurgical treatment of liver hydatid cysts
HPB, 2006; 8: 38/42 Surgical treatment of liver hydatid cysts ALI EZER 1, TARIK ZAFER NURSAL 1,GÖKHAN MORAY 2, SEDAT YILDIRIM 1, FEZA KARAKAYALI 2, TURGUT NOYAN 1 & MEHMET HABERAL 2 1 Department of General
More informationGum O Jung and Dong Eun Park. Department of Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
Korean J Hepatobiliary Pancreat Surg 2012;16:110-114 Case Report Successful percutaneous management of bronchobiliary fistula after radiofrequency ablation of metastatic cholangiocarcinoma in a patient
More informationCase Report Isolated Retroperitoneal Hydatid Cyst Invading Splenic Hilum
Case Reports in Surgery, Article ID 303401, 4 pages http://dx.doi.org/10.1155/2014/303401 Case Report Isolated Retroperitoneal Hydatid Cyst Invading Splenic Hilum Safak Ozturk, 1 Mutlu Unver, 1 Burcin
More informationPrimary Giant Splenic and Hepatic Echinococcal Cysts Treated by Laparoscopy
CASE REPORT pissn 2234-778X eissn 2234-5248 J Minim Invasive Surg 2017;20(4):155-159 Journal of Minimally Invasive Surgery Primary Giant Splenic and Hepatic Echinococcal Cysts Treated by Laparoscopy Oana
More informationManagement of biliary injury after laparoscopic cholecystectomy N. Dayes Kings County Hospital Center & Long Island College Hospital 8/19/2010
Management of biliary injury after laparoscopic cholecystectomy N. Dayes Kings County Hospital Center & Long Island College Hospital 8/19/2010 Case Presentation 30 y.o. woman with 2 weeks of RUQ abdominal
More informationKurdistan Center for Gastroenterology & Hepatology, Asulaimaneyah, Iraqi Kurdistan, Iraq
Case Reports in Clinical Medicine, 2014, 3, 533-543 Published Online September 2014 in SciRes. http://www.scirp.org/journal/crcm http://dx.doi.org/10.4236/crcm.2014.39117 The Role of Endoscopic Retrograde
More informationOriginal article: new surgical approaches to the Klatskin tumour
Alimentary Pharmacology & Therapeutics Original article: new surgical approaches to the Klatskin tumour T. M. VAN GULIK*, S. DINANT*, O. R. C. BUSCH*, E. A. J. RAUWS, H. OBERTOP* & D. J. GOUMA Departments
More informationThe clinical finding, diagnosis and outcome of patients with complicated lung hydatid cysts
Available online at www.ijmrhs.com ISSN No: 2319-5886 International Journal of Medical Research & Health Sciences, 2016, 5, 8:293-297 The clinical finding, diagnosis and outcome of patients with complicated
More informationPortal Vein in a Patient Undergoing Hepatic Resection
HPB Surgery, 1997, Vol. 10, pp. 323-327 Reprints available directly from the publisher Photocopying permitted by license only (C) 1997 OPA (Overseas Publishers Association) Amsterdam B.V. Published in
More informationPersonal Profile. Name: 劉 XX Gender: Female Age: 53-y/o Past history. Hepatitis B carrier
Personal Profile Name: 劉 XX Gender: Female Age: 53-y/o Past history Hepatitis B carrier Chief complaint Fever on and off for 2 days Present illness 94.10.14 Sudden onset of epigastric pain 94.10.15 Fever
More informationCongenital dilatation of the common bile duct and pancreaticobiliary maljunction clinical implications
Langenbecks Arch Surg (2009) 394:209 213 DOI 10.1007/s00423-008-0330-6 CURRENT CONCEPT IN CLINICAL SURGERY Congenital dilatation of the common bile duct and pancreaticobiliary maljunction clinical implications
More informationPost-operative complications following hepatobiliary surgery: imaging findings and current radiological treatment options
Post-operative complications following hepatobiliary surgery: imaging findings and current radiological treatment options Poster No.: C-1501 Congress: ECR 2015 Type: Educational Exhibit Authors: A. Hadjivassiliou,
More informationOriginal article: SURGICAL TREATMENT FOR BENIGN BILIARY STRICTURES: SINGLE-CENTER EXPERIENCE ON 64 CASES
Original article: SURGICAL TREATMENT FOR BENIGN BILIARY STRICTURES: SINGLE-CENTER EXPERIENCE ON 64 CASES Yunfeng Cui, Hongtao Zhang, Naiqiang Cui, Zhonglian Li* Department of Surgery, Tianjin Nankai Hospital,
More informationAcute intraperitoneal rupture of hydatid cysts: a surgical experience with 14 cases
Mouaqit et al. World Journal of Emergency Surgery 2013, 8:28 WORLD JOURNAL OF EMERGENCY SURGERY RESEARCH ARTICLE Open Access Acute intraperitoneal rupture of hydatid cysts: a surgical experience with 14
More informationCholangiocarcinoma (Bile Duct Cancer)
Cholangiocarcinoma (Bile Duct Cancer) The Bile Duct System (Biliary Tract) A network of bile ducts (tubes) connects the liver and the gallbladder to the small intestine. This network begins in the liver
More informationManagement of Pancreatic Fistulae
Management of Pancreatic Fistulae Jose Ramos University of the Witwatersrand Donald Gordon Medical Centre Fistula definition A Fistula is a permanent abnormal passageway between two organs (epithelial
More informationPerforated peptic ulcer
Perforated peptic ulcer - Despite the widespread use of gastric anti-secretory agents and eradication therapy, the incidence of perforated peptic ulcer has changed little, age limits increase NSAIDs elderly
More informationA CASE REPORT OF SPONTANEOUS BILOMA - AN ENIGMATIC SURGICAL PROBLEM
A CASE REPORT OF SPONTANEOUS BILOMA - AN ENIGMATIC SURGICAL PROBLEM *Sumanta Kumar Ghosh and Biswajit Mukherjee ESIC Medical College, Joka, Kolkata, India *Author for Correspondence ABSTRACT Occurrence
More informationBiliary Anatomy in Living-related Liver Transplantation
The 5th IHPBA Congress - Istanbul Biliary Anatomy in Living-related Liver Transplantation biliary trees hilar plate Assessment for Vascular Anatomy 1. 3DCT portal vein hepatic vein hepatic artery 2. No
More informationPost Laparoscopic Cholecystectomy Biloma in a Child Managed by Endoscopic Retrograde Cholangio-Pancreatography and Stenting: A Case Report
pissn: 2234-8646 eissn: 2234-8840 https://doi.org/10.5223/pghn.2016.19.4.281 Pediatr Gastroenterol Hepatol Nutr 2016 December 19(4):281-285 Case Report PGHN Post Laparoscopic Cholecystectomy Biloma in
More informationBile duct injuries related to misplacement of T tubes
Annals of Hepatology 2006; 5(1): January-March: 44-48 Original Article Annals of Hepatology Bile duct injuries related to misplacement of T tubes Miguel Ángel Mercado;* Carlos Chan; Héctor Orozco;* Alexandra
More informationManagement of the Mucin Filled Bile Duct. A Complication of Intraductal Papillary Mucinous Tumor of the Pancreas
CASE REPORT Management of the Mucin Filled Bile Duct. A Complication of Intraductal Papillary Mucinous Tumor of the Pancreas Anand Patel, Louis Lambiase, Antonio Decarli, Ali Fazel Division of Gastroenterology
More informationComparison Between Primary Closure of Common Bile Duct and T- Tube Drainage After Open Choledocholithiasis: A Hospital Based Study
Original article: Comparison Between Primary Closure of Common Bile Duct and T- Tube Drainage After Open Choledocholithiasis: A Hospital Based Study Kali CharanBansal Principal Specialist (General surgery)
More informationTitle: An intrahepatic cavoportal collateral pathway due to a liver hydatid cyst obstructing the inferior vena cava
Title: An intrahepatic cavoportal collateral pathway due to a liver hydatid cyst obstructing the inferior vena cava Authors: Alba Manuel Vázquez, José Manuel Ramia Ángel, Luis Gijón, Roberto de la Plaza
More informationMAKING CONNECTIONS. Los Angeles Medical Center
MAKING CONNECTIONS Los Angeles Medical Center Resident: Chris Molloy, MD Fellow: Christian Coroian, MD, MBA Attending: Tina Hardley, MD Program/Dept(s): Los Angeles Medical Center CHIEF COMPLAINT & HPI
More informationMirizzi syndrome with an unusual type of biliobiliary fistula a case report
Kawaguchi et al. Surgical Case Reports (2015) 1:51 DOI 10.1186/s40792-015-0052-2 CASE REPORT Mirizzi syndrome with an unusual type of biliobiliary fistula a case report Tsutomu Kawaguchi 1,2*, Tadao Itoh
More informationGreater Manchester EUR Policy Statement on: Asymptomatic Gallstones GM Ref: GM061 Version: 0.2 (21 November 2018)
Greater Manchester EUR Policy Statement on: Asymptomatic Gallstones GM Ref: GM061 Version: 0.2 (21 November 2018) Commissioning Statement Asymptomatic Gallstones Policy Exclusions (Alternative commissioning
More informationEndoscopic management of postoperative bile duct injuries: a single center experience.
1- Endoscopic management of postoperative bile duct injuries: a single center experience. BACKGROUND/AIM: Biliary endoscopic procedures may be less invasive than surgery for management of postoperative
More informationThe Unusual Mass of Retrovesical Space: A Secondary Hydatid Cyst Dısease
Case Study TheScientificWorldJOURNAL (2006) 6, 2481 2485 TSW Urology ISSN 1537-744X; DOI 10.1100/tsw.2006.386 The Unusual Mass of Retrovesical Space: A Secondary Hydatid Cyst Dısease Can Tuygun*, Hasan
More informationLiver Cancer (Hepatocellular Carcinoma or HCC) Overview
Liver Cancer (Hepatocellular Carcinoma or HCC) Overview Recent advances in liver cancer care seek to address the rising incidence of liver cancer, which has steadily increased over the past three decades.
More informationBiliary tree dilation - and now what?
Biliary tree dilation - and now what? Poster No.: C-1767 Congress: ECR 2012 Type: Educational Exhibit Authors: I. Ferreira, A. B. Ramos, S. Magalhães, M. Certo; Porto/PT Keywords: Pathology, Diagnostic
More informationBiliary cancers: imaging diagnosis. Study of 30 cases
Biliary cancers: imaging diagnosis. Study of 30 cases N Hammoune, S Semlali, M Eddarai, T. Amil, M Zentar, S. El Kandri,, M Benameur,, S Chaouir. Radiology Department. Mohamed V Military Hospital. Rabat-
More information6 th August 2018 Day 1 - Gallbladder & Bile duct Topic
Venue: Sterling Hospital Auditorium, Sterling Hospitals, Gurukul Road Ahmedabad, Gujarat 6 th August 2018 Day 1 - Gallbladder & Bile duct Registration(8:00am-8:15am) Inauguration(8:15am-8:30am) Welcome
More informationMore Than 25 Years of Surgical Treatment of Hydatid Cysts in a Nonendemic Area Using the Frozen Seal Method
World J Surg (2010) 34:106 113 DOI 10.1007/s00268-009-0267-0 More Than 25 Years of Surgical Treatment of Hydatid Cysts in a Nonendemic Area Using the Frozen Seal Method J. H. M. B. Stoot C. K. Jongsma
More informationSurgical Workload, Outcome and Research Database: V1.1
Technical Guidance for Surgical Workload, Outcome and Research Database: V1.1 Contents 1. Standard Indicators... 5 1.1. Activity Volume... 5 1.2. Average Length of Stay (Days)... 5 1.3. 2/7/30 day Re-admission
More informationA LEADER IN ADVANCED ENDOSCOPY AND HEPATOBILIARY SURGERY
A LEADER IN ADVANCED ENDOSCOPY AND HEPATOBILIARY SURGERY St. Peter s Hospital Advanced Endoscopy & Hepatobiliary Center Welcome The St. Peter s Hospital Advanced Endoscopy & Hepatobiliary Center is a leader
More informationCase Reports. Intraductal Papillary Cholangiocarcinoma: Case Report and Review of the Literature INTRODUCTION CASE REPORT
Case Reports Kongkam K, Rerknimitr R 45 Case Report and Review of the Literature Pradermchai Kongkam, M.D. Rungsun Rerknimitr, M.D. ABSTRACT A case of papillary cholangiocarcinoma is presented. A 64-year-old
More informationGeneral Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons
General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons MODULE TITLE: UPPER GI & HPB - HEPATIC, PANCREATIC & BILIARY
More informationStudy of post cholecystectomy biliary leakage and its management
Original Research Article Study of post cholecystectomy biliary leakage and its management P. Krishna Kishore 1*, B. Manju Sruthi 2, G. Obulesu 3 1 Assistant Professor, Departmentment of General Surgery,
More informationDisclosures. Extra-hepatic Biliary Disease and the Pancreas. Objectives. Pancreatitis 10/3/2018. No relevant financial disclosures to report
Extra-hepatic Biliary Disease and the Pancreas Disclosures No relevant financial disclosures to report Jeffrey Coughenour MD FACS Clinical Associate Professor of Surgery and Emergency Medicine Division
More informationHilar cholangiocarcinoma. Frank Wessels, Maarten van Leeuwen, UMCU utrecht
Hilar cholangiocarcinoma Frank Wessels, Maarten van Leeuwen, UMCU utrecht Content Anatomy Biliary strictures (Hilar) Cholangiocarcinoom Staging Biliary tract 1 st order Ductus hepatica dextra Ductus hepaticus
More informationThe role of cholangiography with t-tube in the liver transplantation
The role of cholangiography with t-tube in the liver transplantation Poster No.: C-0362 Congress: ECR 2012 Type: Educational Exhibit Authors: S. Magalhães, I. Ferreira, A. B. Ramos, F. Reis, M. Ribeiro
More informationSTRICTURES OF THE BILE DUCTS Session No.: 5. Andrea Tringali Digestive Endoscopy Unit Catholic University Rome - Italy
STRICTURES OF THE BILE DUCTS Session No.: 5 Andrea Tringali Digestive Endoscopy Unit Catholic University Rome - Italy Drainage of biliary strictures. The history before 1980 Surgical bypass Percutaneous
More informationEchinococcus granulosus is frequently encountered in
Surgical Treatment of Pulmonary Hydatid Cysts: Is Capitonnage Necessary? Akif Turna, MD, Muhammet Ali Yılmaz, MD, Gökhan Hacıibrahimoğlu, MD, Cemal Asım Kutlu, MD, and Mehmet Ali Bedirhan, MD Department
More informationRisk Factors for Development of Biliary Stricture in Patients Presenting with Bile Leak after Cholecystectomy
Gut and Liver, Vol. 7, No. 3, May 2013, pp. 352-356 ORiginal Article Risk Factors for Development of Biliary Stricture in Patients Presenting with Bile Leak after Cholecystectomy Hosur Mayanna Lokesh,
More informationSubtotal cholecystectomy for complicated acute cholecystitis: a multicenter prospective observational study
Study title Subtotal cholecystectomy for complicated acute cholecystitis: a multicenter prospective observational study Primary Investigator: Kazuhide Matsushima, MD Co-Primary investigator: Zachary Warriner,
More informationDownloaded from jssu.ssu.ac.ir at 13:10 IRST on Saturday October 28th 2017
Journal of Shahid Sadoughi University of Medical Sciences Vol. 21, No. 5, Nov-Dec 2013 Pages: 675-681 1392 5 21 675-681 : 3 2* 1 1392/8/ : -1-2 -3 1391/8/24 : (). :. 1390 200 :.. SPSS (%0/5) 200 (8%) (%9/5)19
More informationGeneral Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons
General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons MODULE TITLE: UPPER GI & HPB - HEPATIC, PANCREATIC & BILIARY
More informationROLE OF RADIOLOGY IN INVESTIGATION OF JAUNDICE
ROLE OF RADIOLOGY IN INVESTIGATION OF JAUNDICE Dr. Sohan kumar sah *, Dr. Liu Sibin, Dr. sumendra raj pandey, Dr. Prakashmaan shah, Dr. Gaurishankar pandit, Dr. Suraj kurmi and Dr. Sanjay kumar jaiswal
More informationBronchobiliary fistula treated with histoacryl embolization under bronchoscopic guidance: A case report
Respiratory Medicine CME (2008) 1, 164 168 respiratory MEDICINE CME CASE REPORT Bronchobiliary fistula treated with histoacryl embolization under bronchoscopic guidance: A case report Jung Hyun Kim a,
More informationManagement Of Biliocutaneous Fistula: Fistulo-Duodenal Anastomosis - A Case Report.
ISPUB.COM The Internet Journal of Surgery Volume 28 Number 2 Management Of Biliocutaneous Fistula: Fistulo-Duodenal Anastomosis - A Case Report. A Mate, M Tapase, S Jadhav, S Deolekar, A Gvalani Citation
More informationSurgical Management of Liver Hydatid Cyst Related Non-traumatic Emergencies: Single Center Experience
Iran J Parasitol: Vol. 11, No. 4, Oct -Dec 2016, pp.574-579 Iran J Parasitol Tehran University of Medical Sciences Publication http:// tums.ac.ir Open access Journal at http:// ijpa.tums.ac.ir Iranian
More informationMANAGEMENT OF INCIDENTALLY DETECTED GALLBLADDER CANCER
MANAGEMENT OF INCIDENTALLY DETECTED GALLBLADDER CANCER Orlando Jorge M. Torres Full Professor and Chairman Department of Gastrointestinal Surgery Hepatopancreatobiliary Unit Federal University of Maranhão
More informationPERCUTANEOUS DRAINAGE VS. SURGERY FOR HEPATIC HYDATID CYSTS PERCUTANEOUS DRAINAGE COMPARED WITH SURGERY FOR HEPATIC HYDATID CYSTS.
PERCUTANEOUS DRAINAGE COMPARED WITH SURGERY FOR HEPATIC HYDATID CYSTS MOHAMMAD SULTAN KHUROO, D.M., NAZIR A. WANI, M.S., GUL JAVID, M.D., BASHIR A. KHAN, M.D., GHULAM N. YATTOO, M.D., ALTAF H. SHAH, M.D.,
More informationCase Report Pulmonary Embolism Originating from a Hepatic Hydatid Cyst Ruptured into the Inferior Vena Cava: CT and MRI Findings
Case Reports in Radiology Volume 2016, Article ID 3589812, 4 pages http://dx.doi.org/10.1155/2016/3589812 Case Report Pulmonary Embolism Originating from a Hepatic Hydatid Cyst Ruptured into the Inferior
More informationT-TUBE DRAINAGE VERSUS PRIMARY COMMON BILE DUCT CLOSURE AFTER OPEN CHOLEDOCHOTOMY
T-TUBE DRAINAGE VERSUS PRIMARY COMMON BILE DUCT CLOSURE AFTER OPEN CHOLEDOCHOTOMY Khaled Ahmed El- Dabee, Abd Al-Lateif Ahmed, Mohamed Abdel Aziz Abdel Jawad, Taha Bahgat Salam, Ahmed Eisa Ahmed* and Saed
More informationACUTE CHOLANGITIS AS a result of an occluded
Digestive Endoscopy 2017; 29 (Suppl. 2): 88 93 doi: 10.1111/den.12836 Current status of biliary drainage strategy for acute cholangitis Endoscopic treatment for acute cholangitis with common bile duct
More informationVascular complications in percutaneous biliary interventions: A series of 111 procedures
Vascular complications in percutaneous biliary interventions: A series of 111 procedures Poster No.: C-0744 Congress: ECR 2013 Type: Educational Exhibit Authors: A. BHARADWAZ; AARHUS, Re/DK Keywords: Obstruction
More informationPercutaneous Removal of Biliary Stone from Anomalous Right Hepatic Duct
Percutaneous Removal of Biliary Stone from Anomalous Right Hepatic Duct Pages with reference to book, From 94 To 96 Tanveer ul Haq, Mohammed Younus Sheikh, Changes Khan Jadun, M.N. Ahmad, Yousuf H. Husen
More informationRuptured choledochal cyst: a rare presentation and unique approach to management
Case Report Ruptured choledochal cyst: a rare presentation and unique approach to management Michael Meschino, Carlos García-Ochoa, Roberto Hernandez-Alejandro London Health Sciences Centre, Western University,
More informationENDOSCOPIC TREATMENT OF A BILE DUCT
HPB Surgery, 1990, Vol. 3, pp. 67-71 Reprints available directly from the publisher Photocopying permitted by license only 1990 Harwood Academic Publishers GmbH Printed in the United Kingdom CASE REPORT
More informationEn-liang Li 1,2, Rong-fa Yuan 1, Wen-jun Liao 1, Qian Feng 1, Jun Lei 1, Xiang-bao Yin 1, Lin-quan Wu 1* and Jiang-hua Shao 1
Li et al. BMC Surgery (2019) 19:16 https://doi.org/10.1186/s12893-019-0480-1 RESEARCH ARTICLE Open Access Intrahepatic bile exploration lithotomy is a useful adjunctive hepatectomy method for bilateral
More informationNaoyuki Toyota, Tadahiro Takada, Hodaka Amano, Masahiro Yoshida, Fumihiko Miura, and Keita Wada
J Hepatobiliary Pancreat Surg (2006) 13:80 85 DOI 10.1007/s00534-005-1062-4 Endoscopic naso-gallbladder drainage in the treatment of acute cholecystitis: alleviates inflammation and fixes operator s aim
More informationLaparoscopic Cholecystectomy: A Retrospective Study
Bahrain Medical Bulletin, Vol. 37, No. 3, September 2015 Laparoscopic Cholecystectomy: A Retrospective Study Abdullah Al-Mitwalli, LRCPI, LRCSI* Martin Corbally, MBBCh, BAO, MCh, FRCSI, FRCSEd, FRCS**
More informationHYDATID LIVER DISEASE SPECTRUM OF APPEARANCES
HYDATID LIVER DISEASE SPECTRUM OF APPEARANCES DR JAIKISHOR JOTHIRAJ 1 ST YEAR POSTGRADUATE MDRD SRMMCH CHENNAI GUIDED BY PROF & HOD DR SRINIVASA MUDALI PROF DR VINAYAGAM.S PROF DR SARAVANAN K.C CASE 1
More informationBILIARY TRACT & PANCREAS, PART II
CME Pretest BILIARY TRACT & PANCREAS, PART II VOLUME 41 1 2015 A pretest is mandatory to earn CME credit on the posttest. The pretest should be completed BEFORE reading the overview. Both tests must be
More informationCase Report Uncommon Mixed Type I and II Choledochal Cyst: An Indonesian Experience
Case Reports in Surgery Volume 2013, Article ID 821032, 4 pages http://dx.doi.org/10.1155/2013/821032 Case Report Uncommon Mixed Type I and II Choledochal Cyst: An Indonesian Experience Fransisca J. Siahaya,
More informationSurgical Management of Calcified
HPB Surgery, 1999, Vol. 11, pp. 253-259 Reprints available directly from the publisher Photocopying permitted by license only (C) 1999 OPA (Overseas Publishers Association) N.V. Published by license under
More informationcholangiopancreatography
1250 Hepatopancreatic-Biliary Unit, Academic Medical Centre, University of Amsterdam, The Netherlands P H P Davids J Ringers E A J Rauws L Th de Wit K Huibregtse M N van der Heyde G N J Tytgat Correspondence
More informationIs Hepatic Resection Needed in the Patients with Peritoneal Side T2 Gallbladder Cancer?
Is Hepatic Resection Needed in the Patients with Peritoneal Side T2 Gallbladder Cancer? Lee H, Park JY, Youn S, Kwon W, Heo JS, Choi SH, Choi DW Department of Surgery, Samsung Medical Center Sungkyunkwan
More informationA Rare Cause of Recurrent Vaginal Hydrocele: Herniating Mesenteric Hydatid Cyst
Iran J Parasitol Tehran University of Medical Sciences Publication http:// tums.ac.ir Open access Journal at http:// ijpa.tums.ac.ir Iranian Society of Parasitology http:// isp.tums.ac.ir Case Report A
More informationBile duct injuries following laparoscopic cholecystectomy
570088SJS0010.1177/1457496915570088A. Viste, et al. research-article2015 ORIGINAL ARTICLE Bile duct injuries following laparoscopic cholecystectomy A. Viste 1,2, A. Horn 1, K. Øvrebø 1, B. Christensen
More informationHenry A. Pitt, M.D., F.A.C.S. Chief Quality Officer Temple University Health System July 23, 2018 Orlando, Florida
Are All OSIs Pancreatic Fistulas? Henry A. Pitt, M.D., F.A.C.S. Chief Quality Officer Temple University Health System July 23, 2018 Orlando, Florida DISCLOSURES Leader, ACS-NSQIP HPB Collaborative Hepatectomy
More informationGall bladder cancer. Information for patients Hepatobiliary
Gall bladder cancer Information for patients Hepatobiliary page 2 of 12 Who will provide my care? You will be cared for by a number of professionals who work together. These professionals will be specialist
More informationThe authors have declared no conflicts of interest.
Diagnostic Accuracy of Magnetic Resonance Cholangiopancreatography Versus Endoscopic Retrograde Cholangiopancreatography Findings in the Postorthotopic Liver Transplant Population Authors: *Ashok Shiani,
More informationCase Report Heterotopic Pancreas within the Proximal Hepatic Duct, Containing Intraductal Papillary Mucinous Neoplasm
Case Reports in Surgery Volume 2015, Article ID 816960, 4 pages http://dx.doi.org/10.1155/2015/816960 Case Report Heterotopic Pancreas within the Proximal Hepatic Duct, Containing Intraductal Papillary
More informationMalignant Obstructive Jaundice has dismal
Proceeding S.Z.P.G.M.L vol: 22(2}: pp. 79-83, 2008. Anatomic Level of Biliary Obstruction and Outcome of Pre-Operative Biliary Stenting in Malignant Obstructive Jaundice -A Shaikh Zayed Hospital Experience
More informationA Large Hepatic Cyst with Obstructive Jaundice Successfully Treated with Single-Incision Laparoscopic Deroofing
Published online: November 28, 2013 1662 0631/13/0073 0503$38.00/0 This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC)
More informationPenetrating abdominal trauma clinical view. Ari Leppäniemi, MD Department of Abdominal Surgery Meilahti hospital University of Helsinki Finland
Penetrating abdominal trauma clinical view Ari Leppäniemi, MD Department of Abdominal Surgery Meilahti hospital University of Helsinki Finland Meilahti hospital - one of Helsinki University hospitals -
More informationNEW CLASSIFICATION OF MAJOR BILE DUCT INJURIES ASSOCIATED WITH LAPAROSCOPIC CHOLECYSTECTOMY
SCRIPTA MEDICA (BRNO) 75 (6): 283 290, December 2002 NEW CLASSIFICATION OF MAJOR BILE DUCT INJURIES ASSOCIATED WITH LAPAROSCOPIC CHOLECYSTECTOMY MICHEK J., ZELNÍâEK P., OCHMANN J., SVOBODA P., VRASTYÁK
More informationVIDEO ASSISTED RETROPERITONEAL DEBRIDEMENT IN HUGE INFECTED PANCREATIC PSEUDOCYST
Trakia Journal of Sciences, Vol. 13, Suppl. 2, pp 102-106, 2015 Copyright 2015 Trakia University Available online at: http://www.uni-sz.bg ISSN 1313-7050 (print) doi:10.15547/tjs.2015.s.02.022 ISSN 1313-3551
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Adenocarcinoma, pancreatic ductal, laparoscopic distal pancreatectomy for, 61 Adrenal cortical carcinoma, laparoscopic adrenalectomy for, 114
More informationEarly View Article: Online published version of an accepted article before publication in the final form.
Early View Article: Online published version of an accepted article before publication in the final form. Journal Name: International Journal of Hepatobiliary and Pancreatic Diseases (IJHPD) Type of Article:
More informationOptimal Bile Duct Division Using Real- Time Indocyanine Green Near-Infrared Fluorescence Cholangiography During Laparoscopic Donor Hepatectomy
LETTERS FROM THE FRONTLINE Optimal Bile Duct Division Using Real- Time Indocyanine Green Near-Infrared Fluorescence Cholangiography During Laparoscopic Donor Hepatectomy TO THE EDITOR: Despite advances
More informationCardiac Mass in a 15-Year-Old Boy
Cardiac Mass in a 15-Year-Old Boy Echocardiographic Case Report Hortensia Vuçini Department of Cardiology and Cardiac Surgery UHC Mother Theresa Tirana, Albania October 20, 2007 Case Presentation 15 year-old
More informationImaging of liver and pancreas
Imaging of liver and pancreas.. Disease of the liver Focal liver disease Diffusion liver disease Focal liver disease Benign Cyst Abscess Hemangioma FNH Hepatic adenoma HCC Malignant Fibrolamellar carcinoma
More informationWhat to do and not do before seeking surgical consultation for a patient with suspected pancreatic cancer
What to do and not do before seeking surgical consultation for a patient with suspected pancreatic cancer 9 Th Annual Symposium on Gastrointestinal Cancers, St. Louis University School of Medicine Carlos
More informationResearch Article The Role of Perioperative Endoscopic Retrograde Cholangiopancreatography and Biliary Drainage in Large Liver Hydatid Cysts
e Scientific World Journal, Article ID 301891, 6 pages http://dx.doi.org/10.1155/2014/301891 Research Article The Role of Perioperative Endoscopic Retrograde Cholangiopancreatography and Biliary Drainage
More informationEndoscopic Ultrasonography Assessment for Ampullary and Bile Duct Malignancy
Diagnostic and Therapeutic Endoscopy, Vol. 3, pp. 35-40 Reprints available directly from the publisher Photocopying permitted by license only (C) 1996 OPA (Overseas Publishers Association) Amsterdam B.V.
More information