The Experts below are selected from a list of 204 Experts worldwide ranked by ideXlab platform

Okan Akhan - One of the best experts on this subject based on the ideXlab platform.

  • Percutaneous Transhepatic Drainage of inaccessible postoperative abdominal abscesses.
    AJR. American journal of roentgenology, 2012
    Co-Authors: Turkmen Ciftci, Devrim Akinci, Okan Akhan
    Abstract:

    OBJECTIVE. The purpose of this study was to evaluate the safety and efficacy of Transhepatic Drainage of inaccessible postoperative intraabdominal abscesses under sonographic and fluoroscopic guidance. MATERIALS AND METHODS. Between February 2005 and September 2010, 30 abscesses were treated in 30 patients. Procedures were performed with sonographic and fluoroscopic guidance under IV sedation and local anesthesia. Factors affecting results were evaluated statistically. RESULTS. The technical and clinical success rates were 100% and 97%. The procedures were performed with 8-, 10-, and 12-French locking pigtail catheters. The catheters were in place for a mean duration of 75 days if a fistula was present and 15 days in the absence of fistula. Major complications were not detected during treatment. The rate of minor complications (catheter dislodgement, obstruction, kinking) was 20%. Most of the complications were managed by exchange, revision, or increase in size of the catheter. When use of an 8-French cat...

  • Percutaneous Transhepatic Drainage for Treatment of Inaccessible Postoperative Intraabdominal Abscesses
    2011
    Co-Authors: Okan Akhan
    Abstract:

    Poster: "ECR 2011 / C-2251 / Percutaneous Transhepatic Drainage for Treatment of Inaccessible Postoperative Intraabdominal Abscesses" by: "O. Akhan, T. Ciftci, D. Akinci; Ankara/TR"

David W. Crist - One of the best experts on this subject based on the ideXlab platform.

  • Percutaneous Transhepatic Drainage of the Nondilated Biliary System
    Journal of vascular and interventional radiology : JVIR, 1993
    Co-Authors: Veronica J. Harris, Kenyon K. Kopecky, Jon T. Harman, David W. Crist
    Abstract:

    Purpose The authors sought to develop a safe, efficacious technique for Percutaneous Transhepatic Drainage of nondilated biliary systems. Patients and Methods Twenty-three Drainage procedures were performed on 14 consecutive patients with nondilated ducts. Fourteen procedures were carried out for primary placement of a Transhepatic biliary drain, eight for placement of a second drain, and one for placement of a third drain. Drainage catheter access into the biliary tree was gained via direct puncture of a peripheral duct (fourth order or smaller branch) in four procedures. In the remaining 19 procedures, peripheral duct punctures were facilitated by retrograde passage of a 5-F catheter from a previous, remote Percutaneous access site into the fourth-order duct to be punctured. Nine of these 19 duct punctures were facilitated by the use of a nitinol Goose Neck snare passed through the intraductal catheter. Results Of the access methods used, the nitinol snare technique was the fastest. Successful peripheral access was achieved in all patients without bleeding complications. One patient developed symptoms of bacteremia, which resolved within 12 hours with antibiotic therapy and external biliary Drainage. Conclusion Percutaneous peripheral access can be achieved safely in the nondilated biliary tree and can obviate surgery for some patients and facilitate future interventions.

Yuji Nimura - One of the best experts on this subject based on the ideXlab platform.

  • Methods and timing of biliary Drainage for acute cholangitis: Tokyo Guidelines.
    Journal of hepato-biliary-pancreatic surgery, 2007
    Co-Authors: Masato Nagino, Yuji Nimura, Tadahiro Takada, Yoshifumi Kawarada, Yuichi Yamashita, Toshio Tsuyuguchi, Keita Wada, Toshihiko Mayumi, Masahiro Yoshida, Fumihiko Miura
    Abstract:

    Biliary Drainage is a radical method to relieve cholestasis, a cause of acute cholangitis, and takes a central part in the treatment of acute cholangitis. Emergent Drainage is essential for severe cases, whereas patients with moderate and mild disease should also receive Drainage as soon as possible if they do not respond to conservative treatment, and their condition has not improved. Biliary Drainage can be achieved via three different routes/procedures: endoscopic, Percutaneous Transhepatic, and open methods. The clinical value of both endoscopic and Percutaneous Transhepatic Drainage is well known. Endoscopic Drainage is associated with a low morbidity rate and shorter duration of hospitalization; therefore, this approach is advocated whenever it is applicable. In endoscopic Drainage, either endoscopic nasobiliary Drainage (ENBD) or tube stent placement can be used. There is no significant difference in the success rate, effectiveness, and morbidity between the two procedures. The decision to perform endoscopic sphincterotomy (EST) is made based on the patient’s condition and the number and diameter of common bile duct stones. Open Drainage, on the other hand, should be applied only in patients for whom endoscopic or Percutaneous Transhepatic Drainage is contraindicated or has not been successfully performed. Cholecystectomy is recommended in patients with gallbladder stones, following the resolution of acute cholangitis with medical treatment, unless the patient has poor operative risk factors or declines surgery.

  • Percutaneous cholangioscopic bilioenterostomy for unreconstructed segmental bile duct after hepatobiliary resection for hilar cholangiocarcinoma
    Endoscopy, 2001
    Co-Authors: Tsuyoshi Sano, Michio Kanai, Kenichi Uesaka, Masato Nagino, Junichi Kamiya, Yuji Nimura
    Abstract:

    During a major hepatectomy, inadvertent ligation of the major segmental bile-duct branch of the liver remnant is a serious complication. We experienced this serious complication of inadvertent ligation of the bile-duct branch, which should be anastomosed to the jejunal loop, during a left hepatic trisegmentectomy with total caudate lobectomy for a hilar cholangiocarcinoma. A Percutaneous Transhepatic bilioenteric connection was then created, modifying an endoscopic ureteroneocystostomy technique, between the ligated segmental bile duct and the jejunal loop. In this procedure, we used two cholangioscopes; one was introduced through the Percutaneous Transhepatic Drainage route, the other was introduced through an enterostomy which was made during the surgery for postoperative enteral feeding; we also used a transjugular intrahepatic portosystemic shunt (TIPS) kit under fluoroscopic guidance. We present here our technique of Percutaneous Transhepatic bilioenterostomy.

Masato Nagino - One of the best experts on this subject based on the ideXlab platform.

  • Methods and timing of biliary Drainage for acute cholangitis: Tokyo Guidelines.
    Journal of hepato-biliary-pancreatic surgery, 2007
    Co-Authors: Masato Nagino, Yuji Nimura, Tadahiro Takada, Yoshifumi Kawarada, Yuichi Yamashita, Toshio Tsuyuguchi, Keita Wada, Toshihiko Mayumi, Masahiro Yoshida, Fumihiko Miura
    Abstract:

    Biliary Drainage is a radical method to relieve cholestasis, a cause of acute cholangitis, and takes a central part in the treatment of acute cholangitis. Emergent Drainage is essential for severe cases, whereas patients with moderate and mild disease should also receive Drainage as soon as possible if they do not respond to conservative treatment, and their condition has not improved. Biliary Drainage can be achieved via three different routes/procedures: endoscopic, Percutaneous Transhepatic, and open methods. The clinical value of both endoscopic and Percutaneous Transhepatic Drainage is well known. Endoscopic Drainage is associated with a low morbidity rate and shorter duration of hospitalization; therefore, this approach is advocated whenever it is applicable. In endoscopic Drainage, either endoscopic nasobiliary Drainage (ENBD) or tube stent placement can be used. There is no significant difference in the success rate, effectiveness, and morbidity between the two procedures. The decision to perform endoscopic sphincterotomy (EST) is made based on the patient’s condition and the number and diameter of common bile duct stones. Open Drainage, on the other hand, should be applied only in patients for whom endoscopic or Percutaneous Transhepatic Drainage is contraindicated or has not been successfully performed. Cholecystectomy is recommended in patients with gallbladder stones, following the resolution of acute cholangitis with medical treatment, unless the patient has poor operative risk factors or declines surgery.

  • Percutaneous cholangioscopic bilioenterostomy for unreconstructed segmental bile duct after hepatobiliary resection for hilar cholangiocarcinoma
    Endoscopy, 2001
    Co-Authors: Tsuyoshi Sano, Michio Kanai, Kenichi Uesaka, Masato Nagino, Junichi Kamiya, Yuji Nimura
    Abstract:

    During a major hepatectomy, inadvertent ligation of the major segmental bile-duct branch of the liver remnant is a serious complication. We experienced this serious complication of inadvertent ligation of the bile-duct branch, which should be anastomosed to the jejunal loop, during a left hepatic trisegmentectomy with total caudate lobectomy for a hilar cholangiocarcinoma. A Percutaneous Transhepatic bilioenteric connection was then created, modifying an endoscopic ureteroneocystostomy technique, between the ligated segmental bile duct and the jejunal loop. In this procedure, we used two cholangioscopes; one was introduced through the Percutaneous Transhepatic Drainage route, the other was introduced through an enterostomy which was made during the surgery for postoperative enteral feeding; we also used a transjugular intrahepatic portosystemic shunt (TIPS) kit under fluoroscopic guidance. We present here our technique of Percutaneous Transhepatic bilioenterostomy.

M. Classen - One of the best experts on this subject based on the ideXlab platform.

  • Initial experience with a new Yamakawa-type prosthesis for long-term Percutaneous Transhepatic Drainage.
    Endoscopy, 1999
    Co-Authors: P. Born, T. Rösch, G. Willkomm, Sandschin W, Fitz N, N. Weigert, R. Ott, Eckart Frimberger, Hans-dieter Allescher, M. Classen
    Abstract:

    Background and Study Aims: In a previous study evaluating the problems of long-term Percutaneous Transhepatic biliary Drainage (PTBD) using Yamakawa-type prostheses in patients with benign and malignant stenoses, breakage of the tube proved to be a serious problem, occurring in 19.7% of PTBD exchanges. As a consequence of these results, a new PTBD tube made of Tecothane has been developed. Patients and Methods: From September 1997 to September 1998, this new PTBD tube was applied in 64 patients (39 men, 25 women; median age: 70, range 29-89) in the treatment of benign (n = 30) or malignant stenoses (n=31; three stenoses remained indeterminate), and the course was followed. Results: A total of 134 stent exchanges were performed, 52 of these being ahead of schedule (39%). Not a single case of breakage occurred. However, other PTBD-related problems remained unchanged. Patients accepted the new prosthesis very well; among 19 patients who had experience of both the new one and the conventional one, 11 had preferences-eight for the new one and three for the old one. Conclusions: This new Tecothane prosthesis has solved the problem of PTBD breakage, which was often accompanied by serious problems. As was to be expected, other PTBD-related problems were not substantially affected. Nevertheless, this new tube represents progress in the Percutaneous treatment of biliary stenoses.