1,720,968 research outputs found
Interventional Radiology in the Biliary Tree, Liver, and Pancreas
No full textInterventional radiology offers the opportunity to perform several diagnostic and therapeutic procedures, with the advantage of a mini-invasive percutaneous approach. Many vascular procedures can be performed, once a transarterial or transvenous access is obtained. Biliary interventions are usually performed to treat bile duct strictures or to reconstitute biliary drainage after major surgical interventions complicated by bile duct damage. Hepatic transvenous procedures offer the opportunity to efficiently treat portal hypertension, one of the major cirrhosis-related problems.
Oncologic patients can be accurately diagnosed through ultrasound-guided or computed tomography-guided acquisition of tissue samples (biopsy) or aspirate. Moreover, they can receive a broad spectrum of percutaneous treatments, developed from the application of different physical principles
Retrograde Percutaneous Transjejunal Creation of Biliary Neoanastomoses in Patients with Complete Hepaticojejunostomy Dehiscence
No full textA technique of percutaneous hepaticojejunostomy (PHJ) was developed to allow creation of a neoanastomosis in cases of hepaticojejunostomy (HJ) dehiscence when endoscopic intervention is unfeasible as a result of postsurgical anatomy. PHJ involves transhepatic biliary catheterization and transjejunal retrograde enterotomy. A rendezvous establishes the communication between the bile ducts and the jejunum. PHJ was performed in five patients, and neoanastomosis creation without residual biliary leak was achieved in all cases, with no procedure-related complications. Bilirubin levels and white blood cell counts quickly decreased after PHJ (median, 1 d; range, 1-4 d). Median survival after PHJ was 210 days (range, 45-540 d)
Successful post-pancreatitis pseudoaneurysm coagulation by percutaneous computed tomography (CT)-guided thrombin injection
No full textBACKGROUND: Pseudoaneurysm is a rare but potentially life-threatening vascular complication of acute pancreatitis, with a mortality rate of 20-43% in untreated patients. The treatment usually involves trans-arterial embolization or surgical resection. CASE REPORT: A 44-year-old man with a history of acute pancreatitis developed a pseudoaneurysm of the pancreatic tail, diagnosed as a splenic artery pseudoaneurysm by CT. Selective arteriography performed with the purpose of embolization did not reveal the pseudoaneurysm. The day after, under CT guidance, human thrombin (1,000 IU) was injected inside the aneurysmatic sac with its complete occlusion. A control MRI 6 months later confirmed a complete resolution of the pseudoaneurysm. CONCLUSIONS: Percutaneous coagulation of a post-pancreatitis pseudoaneurysm is a relatively easy and safe procedure, and it can be considered as an alternative to trans-arterial embolization when the pseudoaneurysm cannot be visualized on selective arteriography
Totally percutaneous rendezvous techniques for the treatment of bile strictures and leakages.
No full textSome challenging pathologic conditions of the biliary tract cannot be treated with endoscopy alone, and a combined approach with rendezvous techniques is frequently needed. Three different totally percutaneous rendezvous techniques were successfully applied in three cases. The rendezvous techniques were performed either with bilateral catheterization of bile ducts to treat a challenging type IV biliary stenosis and iatrogenic biliary damage or with biliary catheterization and percutaneous puncture of the anastomotic loop to treat a biliodigestive anastomosis failure with bile leakage
A Technique to Treat Common Femoral Artery Pseudoaneurysms: Prostar XL Percutaneous Vascular Closure Device
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Local release of renin unveils intrarenal arterial fibromuscular dysplasia
No full text: A previously healthy young man developed severe hypertension requiring triple antihypertensive therapy. Initial evaluation identified hyperreninemic hyperaldosteronism, mild hypokalaemia, hypodensity within the right kidney at computed tomography (CT), normal renal arteries at echography. He was referred to Verona ESH Centre were angio-CT revealed significant stenosis of an aberrant branch artery of the right kidney with hypo-perfused area colocalizing with a hypo-oxygenated area, as assessed by BOLD-MR imaging. Super-selective sampling found high plasma renin concentrations only in the vein draining the lower pole of the right kidney. Renal angiography confirmed tightened stenosis of an aberrant branch artery supplying the lower arterial segments, consistent with unifocal medial fibromuscular dysplasia, successfully treated with angioplasty. Investigating extra-renal sites, angio-MR found an S-shaped loop of extracranial left internal carotid artery, consistent with multisite fibromuscular dysplasia. This clinical case underscores the importance of comprehensive functional and imaging tests to identify elusive causes of secondary hypertension
Left extended hepatectomy with biliary resection and reconstruction for hilar cholangiocarcinoma in patient with Osler-Rendu-Weber disease: a case report and review of literature
No full text: Osler-Rendu-Weber syndrome is a genetic disease that involves organs, liver included, characterized by alterations in the vessel walls, making them more vulnerable to spontaneous rupture and bleeding indeed. Our aim is to report a case of patient with Osler-Rendu-Weber syndrome undergoing extended hepatectomy with biliary resection for hilar cholangiocarcinoma and a review of literature on liver resection performed in patients with this syndrome. Preoperative, intraoperative, postoperative, radiographic, and pathologic data of case report's patient were collected. Review of literature included studies from 2000 to 2024, searching them with following search keywords: (liver resection OR hepatectomy) AND (Osler-Rendu-Weber disease OR hereditary hemorrhagic telangiectasia). A 78-year-old woman with Osler-Rendu-Weber syndrome presented hilar lesion compatible with cholangiocarcinoma. Before surgery, the patient underwent embolization of an aneurysm in segment 6. A left extended hepatectomy with biliary resection was performed. Intraoperative blood loss was 500 cc. Post-operative course was uneventful and length of hospital stay was 10 days. 5 cases of liver resection in patient with this syndrome are reported in literature, including 2 cases of major hepatectomies. Major complications' rate was 60% (3 cases): two cases of post-operative bleeding and one case of ascites decompensation. In one case exitus, consequent to massive bleeding, was reported (20%). This is the first case of extended hepatectomy with biliary resection performed in patient with Osler-Rendu-Weber syndrome. This underlying condition makes surgical approach demanding and challenging also in high volume centers. Proper patient selection and management could allow treatment and execution of a safe liver resection in patients with this syndrome
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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