The Experts below are selected from a list of 273 Experts worldwide ranked by ideXlab platform

Carlos A. Pellegrini - One of the best experts on this subject based on the ideXlab platform.

  • differential diagnosis of sclerosing cholangiocarcinomas of the Common Hepatic Duct klatskin tumors
    American Journal of Surgery, 1991
    Co-Authors: Albert L Wetter, Ernest J Ring, Carlos A. Pellegrini
    Abstract:

    Abstract Although it is recognized that some other lesion may be the cause, a presumptive diagnosis of Klatskin tumor is usually made when a focal stenotic lesion of the Common Hepatic Duct is seen on a cholangiogram of a jaundiced patient. Biopsy is so often nondiagnostic that decisions about therapy are usually made on the basis of the imaging tests and lack of evidence for some other disease. Because the accuracy and consequences of this strategy have never been tested, we contrasted the preoperative diagnosis of Klatskin tumor with the final diagnosis in 98 consecutive patients treated from 1985 to 1990. Preoperative investigations included ultrasound and computed tomographic scans, percutaneous transHepatic cholangiography, endoscopic retrograde cholangiopancreatography, and angiography. Sclerosing cholangiocarcinomas of the bile Duct were correctly diagnosed in 68 cases. The final diagnosis was other than a sclerosing adenocarcinoma in 30 (31%) cases. There were 5 papillary bile Duct carcinomas, 12 gallbladder carcinomas invading the bile Duct, 5 metastatic tumors to the bile Duct, 2 cases of Mirizzi syndrome, 3 granulomas, and 3 cases of idiopathic benign focal stenosis. Patients with papillary adenocarcinomas had an extensive filling defect of the Duct, which was often thought to be unresectable. However, four of these five lesions could be completely excised, and the tumor was confined to the Duct wall in all four. The outcome of surgical treatment of the other eight patients with benign lesions was good in most cases. These findings demonstrate the pitfalls of assuming that a focal stenosis of the Hepatic Duct represents a sclerosing adenocarcinoma. The diagnosis is much less specific than is generally thought, so there is considerable opportunity for mismanaging such patients.

Hongzhen Liu - One of the best experts on this subject based on the ideXlab platform.

  • laparoscopic treatment for choledochal cysts with stenosis of the Common Hepatic Duct
    Journal of The American College of Surgeons, 2012
    Co-Authors: Jian Wang, Wentong Zhang, Daqing Sun, Qiangye Zhang, Hongzhen Liu
    Abstract:

    Choledochal cyst is an important cause of surgically treated jaundice in infants and children. Although total cyst excision and biliary reconstruction remain the treatment of choice, novel approaches have been developed in the past 2 decades. Neither choledochal cyst duodenostomy nor Roux-en-Y cyst jejunostomy is currently preferred. In order to reduce the incidence of postoperative complications such as recurrent cholangitis, biliary cirrhosis, and chronic inflammation, choledochal cyst excision and Roux-en-Y Hepaticojejunostomy or Hepaticodudenostomy are now Commonly used. Nevertheless, many complications of open surgery are still serious problems and are major causes of morbidity and mortality. Early complications may include bile Duct injury caused by mistakenly placed clips, erroneous cutting of bile Ducts based on misinterpretation of biliary anatomy, periDuctal bile leakages that cause edema, fibrosis and secondary stricturing, and ischemia from injury to the right Hepatic artery. Bile Duct strictures are the most Common of the late complications and can develop a few months to many years after surgery. In addition, some concomitant lesions, such as Hepatic Ductal stenosis, calculus, or embolus in the bile Duct, may not be discovered by open procedures and could be the causes of liver fibrosis. With development of the laparoscopic technique, laparoscopic choledochal cyst excision, biliary reconstruction, and Roux-en-Y Hepaticojejunostomy have been increasingly used in many countries. A number of European studies have confirmed the safety of laparoscopic cholecystectomy. Mortality rates vary between 0% and 0.1%, and Duct injury rates range between 0.2% and 0.6%. Because of the magnification function of the laparoscope and the excellent visualization of tiny structures, we found that the laparoscopic effect on choledochal cysts with stenosis of the Common Hepatic Duct was much better in children. In Asian children, the normal diameter of the Common bile Duct is 3

Takashi Kanematsu - One of the best experts on this subject based on the ideXlab platform.

Mahnaz Akbari - One of the best experts on this subject based on the ideXlab platform.

  • Mirizzi’s syndrome in a cystic Duct variation
    2016
    Co-Authors: Jalaleddin Khoshnevis, Mahnaz Akbari
    Abstract:

    Mirizzi’s syndrome is a rare complication of gallstone disease, that gallbladder lumen can lie alongside the Common Hepatic Duct, resulting in inflammation and resultant bile Duct stricture. Most cases are not identified preoperatively. Variations of the cystic Duct and its point of union with the Common Hepatic Duct are surgically important. Here, we present an unusual case of type I Mirizzi’s syndrome with an unCommon anomalous cystic Duct that long cystic Duct joins Common Hepatic Duct behind the duodenum. Also, there is a high bilirubin level due to gallstone and bile Duct stone

  • Mirizzi's syndrome in a cystic Duct variation.
    Gastroenterology and hepatology from bed to bench, 2014
    Co-Authors: Jalaleddin Khoshnevis, Mahnaz Akbari
    Abstract:

    Mirizzi’s syndrome is a rare complication of gallstone disease , that gallbladder lumen can lie alongside the Common Hepatic Duct, resulting in inflamation and resultan bile Duct stricture . most cases are not indentified preoperatively. variations of the cystic Duct and its point of union with the Common Hepatic Duct are surgically important . Here, we present an unusual case of type I Mirizzi’s syndrome with an un Common anomalous cystic Duct , that long cystic Duct joins Common Hepatic Duct behind the duodenum . Also, there is a high bilirubin level due to gallstone and bile Duct stone.

H. Hamat - One of the best experts on this subject based on the ideXlab platform.