1,721,176 research outputs found
Cholecystoduodenocolic Fistula by Gallbladder Carcinoma that Presenting as Bouveret's Syndrome: Case Report and Review of the Literature
No full textMinimally invasive treatment of acute intrahepatic fluid collections with acute biliary pancreatitis.
No full textBACKGROUND: Peripancreatic fluid collection suggests the anatomical-clinical scenario of necrotizing acute pancreatitis. However, intrahepatic fluid collection is a rare occurrence with fewer than 30 cases being reported in the medical literature. We describe 2 cases of intrahepatic fluid collection in 2 patients with acute biliary pancreatitis and discuss the therapeutic possibilities.
CASE REPORTS:
The first case report is that of a 68-year-old female with a diagnosis of acute biliary pancreatitis with several necrotizing fluid collections and a large infected intrahepatic collection in the left lobe. The patient was successfully treated by percutaneous US/CT guided drainage. The second case report is that of a 72-year-old female with a diagnosis of acute biliary pancreatitis with several peripancreatic fluid collections and a voluminous intrahepatic fluid collection in the left lobe that caused epigastric pain. This patient was also successfully treated with percutaneous US/CT guided drainage.
CONCLUSION:
Intrahepatic fluid collection in the course of acute biliary pancreatitis is a rare occurrence. The therapeutic approach is the same as that for pancreatic and peripancreatic fluid collections. In case of infection, the patient undergoes percutaneous US/CT guided drainage. This therapeutic procedure can be added to the therapeutic program for necrotizing acute biliary pancreatitis together with ERCP/ES and videolaparocholecystectomy (VLC)
Are there differences between the right and left laparoscopic adrenalectomy? Our experience
No full textAIM:
The purpose of this study was to determine if there are different outcomes between the right and left laparoscopic adrenalectomy according to our experience.
MATERIAL OF STUDY:
From September 2010 to September 2015 forty-two LA were performed. Variables compared include age, body mass index (BMI), ASA score, operative time, estimated blood loss, conversions, gland size, tumor size, postoperative ambulation, postoperative hospitalization, perioperative and postoperative complications.
RESULTS:
Substantially there are no difference in postoperative results between right and left LA.
DISCUSSION:
We report difference in the operative time because left procedure is more complex. The difference in the blood loss due to two intraoperative bleeding in right side, can be considered a given accidental.
CONCLUSIONS:
It's important an adequate learning curve to improve intraoperative and therefore postoperative Outcomes
Mild-moderate acute biliary pancreatitis: role of magnetic resonance cholangiopancreatography in preparation of cholecystectomy.
No full textOBJECTIVES
The importance of papillary obstruction in the pathogenesis of acute biliary pancreatitis is widely
recognized. The aim of this study was to evaluate the usefulness of the MRCP before the VLC in
the patients with mild acute biliary pancreatitis.
METHODS
In the period 2003-2007, 35 patients were submitted to a MRCP (F/M:20/15) with mild ABP without
increase of the cholestasis tests and absence of choledocholithiasis at the abdominal USG. During a followup
from 15 to 60 days after the VLC, the presence of jaundice or relapse of ABP were evaluated in all
patients.
RESULTS
Ten patients had diagnosis of choledocholithiasis at the MRCP and they were submitted to an ERCP,
endoscopic sphincterotomy and stones removal; 25 patients with a negative MRCP were submitted to the
VLC. All the 35 patients submitted to the MRCP before the VLC did not have jaundice or relapse of the ABP
during the follow-up period.
CONCLUSIONS
The MRCP was an accurate investigation for the preoperatory diagnosis of choledocholithiasis; even if it is
not possible to recommend its utilization extensively, it is an important procedure for the patients with
diagnosis of mild ABP to select all those to submit to the ERCP
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