The Experts below are selected from a list of 1125 Experts worldwide ranked by ideXlab platform
Golam Ali Jafary - One of the best experts on this subject based on the ideXlab platform.
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Biliary Peritonitis requiring reoperation after removal of t tubes from the common bile duct
2005Co-Authors: Hemmat Maghsoudi, Abasad Garadaghi, Golam Ali JafaryAbstract:Abstract Background Bile Peritonitis can occur when a T-tube is electively removed from the common bile duct, but this is regarded as a rare complication. Plastic T-tubes are known to increase this risk and should not be used. Latex rubber T-tubes are preferred, but the Peritonitis can still occur. Methods Prospective data were collected on 1375 patients who underwent common bile duct exploration between March 20, 1994 and March 20, 2003. Results Thirty-four (2.47%) patients experienced generalized bile Peritonitis after T-tube removal from the common bile duct. Mean age was 63.65 years. In all cases, a soft silicon-coated latex rubber T-tube was placed into the bile duct. All T-tubes were removed 21 days after surgery. Thirty-four patients developed acute generalized Biliary Peritonitis immediately after T-tube removal and required urgent active intervention. The mortality rate was 5.9%, and the mean hospital stay was 14.6 days. Conclusions The most common causes of lack of formation of T-tube tract and operative procedure were unknown and T-tube reinsertion, respectively. T-tube removal can result in significant morbidity and mortality.
Hemmat Maghsoudi - One of the best experts on this subject based on the ideXlab platform.
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Biliary Peritonitis requiring reoperation after removal of t tubes from the common bile duct
2005Co-Authors: Hemmat Maghsoudi, Abasad Garadaghi, Golam Ali JafaryAbstract:Abstract Background Bile Peritonitis can occur when a T-tube is electively removed from the common bile duct, but this is regarded as a rare complication. Plastic T-tubes are known to increase this risk and should not be used. Latex rubber T-tubes are preferred, but the Peritonitis can still occur. Methods Prospective data were collected on 1375 patients who underwent common bile duct exploration between March 20, 1994 and March 20, 2003. Results Thirty-four (2.47%) patients experienced generalized bile Peritonitis after T-tube removal from the common bile duct. Mean age was 63.65 years. In all cases, a soft silicon-coated latex rubber T-tube was placed into the bile duct. All T-tubes were removed 21 days after surgery. Thirty-four patients developed acute generalized Biliary Peritonitis immediately after T-tube removal and required urgent active intervention. The mortality rate was 5.9%, and the mean hospital stay was 14.6 days. Conclusions The most common causes of lack of formation of T-tube tract and operative procedure were unknown and T-tube reinsertion, respectively. T-tube removal can result in significant morbidity and mortality.
N Gitlin - One of the best experts on this subject based on the ideXlab platform.
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spontaneous rupture of a bile duct and its endoscopic management in a patient with caroli s syndrome
1997Co-Authors: Naga Chalasani, Cuong C Nguyen, N GitlinAbstract:Caroli's syndrome is a condition of cystic dilation of intrahepatic bile ducts that communicate with the extrahepatic Biliary tree. Patients with Caroli's syndrome are prone to develop several complications. These include bacterial cholangitis, Biliary sludge, calculi, and cholangiocarcinoma. We describe an adult patient with Caroli's syndrome in whom spontaneous rupture of a bile duct developed with consequent Biliary Peritonitis, which was successfully managed with endoscopic stent placement.
Kaoru Dohi - One of the best experts on this subject based on the ideXlab platform.
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Biliary Peritonitis due to liver cyst rupture in autosomal dominant polycystic kidney disease
2021Co-Authors: Hiroshi Matsuo, Kan Katayama, Aoi Hayasaki, Yusuke Iizawa, Mayumi Endo, Tomohiro Murata, Shugo Mizuno, Kaoru DohiAbstract:Background Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent genetic kidney disease and polycystic liver disease is its major extrarenal manifestation, however Biliary Peritonitis due to a liver cyst rupture is extremely rare. Case presentation The patient was a 71-year-old Japanese woman who was diagnosed with ADPKD 3 years previously and developed right abdominal pain suddenly 1 month previously. As abdominal computed tomography (CT) showed a ruptured liver cyst in the right lobe, she was admitted to our hospital. Her symptoms improved with conservative management and she was discharged from the hospital after 1 week. Although she was asymptomatic for a while, she noticed abdominal distension and general malaise at 1 month after hospital discharge. Since abdominal CT showed massive ascites, she was admitted to our hospital again. A physical examination revealed abdominal distention without tenderness. Her serum creatinine, alkaline phosphatase, γ-glutamyl transpeptidase, total bilirubin, and CA19-9 were elevated. Abdominal paracentesis revealed amber transparent ascites and the bilirubin and CA19-9 concentrations were high. She was diagnosed with Biliary Peritonitis due to a ruptured liver cyst. Hemodialysis treatment was initiated with drainage of the ascites. The outflow of the ascites was no tendency to decrease and drip infusion cholangiography (DIC)-CT revealed a communication between the ruptured cyst and an intrahepatic bile duct. On day 31, she was transferred to a university hospital and abdominal surgery was performed. After removing the necrotic roof of the ruptured cyst on the right liver lobe, the orifice of the bile leakage was sutured. Cholecystectomy was performed and cholangiography showed no stones in the common bile duct. Abdominal CT one month after the operation showed no recurrence of ascites and she was discharged on day 49. Hemodialysis treatment was discontinued immediately after discharge because urine volume increased and her creatinine level decreased. There has been no recurrence of ascites since then. Conclusions While rare, Biliary Peritonitis can occur in association with the rupture of a liver cyst in ADPKD patients due to communication between the cyst and the intrahepatic bile duct, and DIC-CT should be recommended when Biliary cyst rupture is suspected.
Philippe Wolff - One of the best experts on this subject based on the ideXlab platform.
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randomized trial of choledochocholedochostomy with or without a t tube in orthotopic liver transplantation
2001Co-Authors: Olivier Scatton, Bernard Meunier, Daniel Cherqui, Olivier Boillot, Alain Sauvanet, Karim Boudjema, Bernard Launois, P L Fagniez, Jacques Belghiti, Philippe WolffAbstract:Biliary tract reconstruction is the final step of orthotopic liver transplantation (OLT) and can be carried out according to two main techniques. The first one, end-to-end or side-to-side choledochocholedochostomy (CCS), is rapid, simple, and physiologic. The second one, hepaticojejunostomy, is used when the former is not feasible for anatomical reasons or for causes related to the underlying hepatoBiliary disease. Usually, CCS is done over a T tube. The use of this stent allows monitoring of bile flow and color and easy performance of cholangiography. Moreover, the presence of a T tube may protect against anastomotic strictures. 1 However, the presence of a T tube may also lead to specific complications, which account for 30% to 50% of the overall Biliary complications. 2,3 These complications include bile leakage around the T tube, cholangitis after cholangiography, bile duct obstruction, displacement of the T tube, and Biliary Peritonitis after T tube removal. The disadvantages associated with the use of a T tube led several authors to perform CCS without a T tube. 4–6 This technique was not associated with an increased level of complications. The aim of the present randomized study was to compare the incidence of Biliary complications after CCS performed with or without a T tube in OLT.