Timing of Roux-en-Y limb reconstruction for pediatric live donor liver transplantation.

Background: Roux-en-Y (R-Y) hepaticojejunostomy is usually accepted as the standard method of choice for biliary reconstruction in pediatric cases though the potential risks for gastrointestinal complications are higher. In this study, we examined gastrointestinal complications in pediatric patients by comparing two different strategies of R-Y reconstruction with respect to the portal clampage time.

Methods: Forty-three pediatric recipients who underwent Live Donor Liver Transplantation with R-Y for biliary reconstruction between March 2001 and December 2006 in our transplantation center were divided into two groups regarding the time of dissection and creation of the roux limb.

A new technique of biliary reconstruction after "high hilar resection" of hilar cholangiocarcinoma with tumor extension to secondary and tertiary biliary radicals.

Background: Radical operation for hilar cholangiocellular carcinoma, including extended hepatic resection, seems to improve prognosis by increasing the surgical curability rate. Nevertheless, high postoperative morbidity and mortality have been reported in patients with obstructive jaundice. We describe the technique of "high hilar resection" and a modification of bilioenteric anastomosis for drainage of the multiple secondary or tertiary biliary radicals.

The optimal treatment of hydatid cyst of the liver: radical surgery with a significant reduced risk of recurrence.

Background/aims: The management of hydatid cyst of the liver, which is still endemic in Turkey, varies from medical treatment or percutaneous drainage to different surgical procedures. In this study, we aimed to compare the efficacy of radical surgical procedures and conservative interventions with respect to recurrence rates.

Methods: Patients who underwent any type of surgical treatment between March 1994 and March 2007 due to liver cyst hydatid were retrospectively evaluated.

Hamartoma - a rare benign tumor of the spleen: a report of four cases.

Splenic hamartoma is an uncommon benign tumor. We retrospectively analyzed all patients who underwent splenectomy between May 2000 and June 2006 and four cases of splenic hamartoma were encountered. Three patients presented with mild abdominal pain.

Visceral leishmaniasis as a rare cause of granulomatosis hepatitis: a case report.

Visceral leishmaniasis (VL) is one of the parasitic infections causing different pathogeneses of various systems including intraabdominal solid organs. L. donovani and L.

Bimanual 'bi-finger' liver hanging maneuver: an alternative and safe technique for liver hanging.

Background: Currently, a popular method for right hepatectomy is hepatic resection with the liver hanging maneuver. The aim of this study is to present an alternative and safe approach during this maneuver without using any instrument, thus avoiding injury.

Patients And Methods: From March 2005 to April 2006, a bimanual 'bi-finger' liver hanging maneuver (BBLHM) was planned in 22 right hepatectomies and the data were collected prospectively after operation.

Chylous ascites after living related liver transplantation treated with somatostatin analog and parenteral nutrition.

Chylous ascites are the accumulation of chylomicron-rich lymphatic fluid within the peritoneal cavity, resulting from obstruction or disruption of abdominal lymphatic channels. This rare condition may be associated with neoplastic or infectious infiltration of lymphatics, with pancreatitis, and with abdominal surgery. It may occur spontaneously in 0.

The protective effect of aprotinin and alpha-tocopherol on ischemia-reperfusion injury of the rat liver.

Background: Liver injury caused by ischemia-reperfusion (I/R) processes is a complication of hepatic resection surgery and transplantation, particularly using grafts from marginal donors. Despite improvements in organ preservation and advances in surgical techniques, I/R injury remains a significant clinical problem. In this study, we investigated whether aprotinin provided protection against the adverse effects of I/R injury in liver tissue.

Simultaneous air transportation of the harvested heart and visceral organs for transplantation.

Background: The purpose of this study was to evaluate the duration for organ procurement including both heart and visceral organs and outcomes of the simultaneous transportation of the teams back to the recipient hospitals.

Patients And Methods: Between March 2005 and March 2007, 37/82 organ procurement was performed in the district hospitals and transported to our institution for organ transplantation. Combined heart and visceral organ procurement which was simultaneously transported to the recipient hospitals by one air vehicle was reviewed.

A new surgical technique for hepatic vein reconstruction in pediatric live donor liver transplantation.

The hepatic venous reconstruction is one of the corner stones of pediatric LDLT. However, problems associated with hepatic venous outflow still remain to be an issue. In this study, we aimed at comparing two methods used in hepatic venous reconstruction.

Is it more dangerous to perform inadequate packing?

Peri-hepatic packing procedure, which is the basic damage control technique for the treatment of hepatic hemorrhage, is one of the cornerstones of the surgical strategy for abdominal trauma. The purpose of this study was to evaluate the efficacy of the perihepatic packing procedure by comparing the outcomes of appropriately and inappropriately performed interventions. Trauma patients with liver injury were retrospectively evaluated.

Successful resuscitation of cardiac arrest due to postreperfusion syndrome during orthotopic liver transplantation: a case report.

A patient with alcohol induced end-stage liver disease developed cardiac arrest immediately after reperfusion during orthotopic liver transplantation. In our case, advanced age of the patient, alcohol-related severe liver disease with high ASA score, and myocardial dysfunction, combined with acute metabolic and hemodynamic changes throughout the surgery may have contributed to the development of postreperfusion syndrome resulting in cardiac arrest. Our patient required a total of 5 mg epinephrine, 200 mg lidocaine, 100 mEq NaHCO3, and 40 mEq calcium gluconate together with direct cardiac compressions and ventilation enriched 100% oxygen to regain sinusoidal rhythm.

Dressing of the axilla using a water-filled surgical glove after axilla grafting.

Usually, after grafting of the axilla, it is difficult to obtain a reliable dressing using traditional materials including tulls and fluffy gauzes. As an alternative to this traditional approach, a sterile surgical glove filled with saline can be used to obtain a bulky dressing.

Adefovir dipivoxil therapy in liver transplant recipients for recurrence of hepatitis B virus infection despite lamivudine plus hepatitis B immunoglobulin prophylaxis.

Background: Treatment of post-transplantation recurrence of hepatitis B virus (HBV) infection despite prophylaxis with hepatitis B immunoglobulin (HBIG) and lamivudine combination therapy is not easy. Because HBV reinfection has a severe course and could result in graft failure in liver transplant recipients, prompt medication is essential. Herein is reported the authors' experience with adefovir dipivoxil (AD) therapy in 11 liver transplant recipients who had HBV reinfection despite the administration of lamivudine and HBIG.

Living donor liver transplantation for hepatitis B cirrhosis.

Background And Aim: Living donor liver transplantation (LDLT) has particular advantages for Turkey where hepatitis B virus (HBV) infection is the most common cause of cirrhosis, both because LDLT circumvents the difficulties encountered in the emerging world in providing deceased donor organs, and because it allows preemptive antiviral therapy. The aim of this study was to review one institution's experience with LDLT in patients with chronic HBV infection.

Methods: A total of 109 patients with chronic HBV infection underwent LDLT between September 1999 and June 2005, of whom 40 were coinfected with hepatitis D virus and 23 had hepatocellular carcinoma.

Spontaneous rupture of intrahepatic biliary ducts with biliary peritonitis.

Spontaneous rupture of intrahepatic biliary ducts is a rare cause of acute abdomen due to biliary peritonitis. We report a 92-year-old woman with 48-h history of upper abdominal pain, nausea and vomiting and peritoneal signs. CT scan showed free fluid in the abdomen and mild dilatation of the common bile duct.

Management of small bowel volvulus in a patient with simultaneous pancreas-kidney transplantation (SPKT): a case report.

There are several surgical complications which can occur following simultaneous pancreas-kidney transplantation (SPKT). Although intestinal obstruction is known to be a common complication after any type of abdominal surgery, the occurrence of small bowel volvulus, which is one of the rare causes of intestinal obstruction, following SPKT has not been published before. A 24-year-old woman suffering from type I diabetes mellitus with complications of nephropathy resulting in end stage renal disease (ESRD), neuropathy and retinopathy underwent SPKT.

In vivo evaluation of ProPex electronic apex locator.

The aim of this in vivo study was to evaluate the performance of ProPex apex locator after extirpation and in presence of different irrigation solutions: 2.5% NaOCl, 0.9% NaCl, and 0.

Live donor liver transplantation for acute liver failure.

Background: Acute liver failure (ALF) carries a high mortality unless urgent orthotopic liver transplantation (OLT) is performed on time. Live donors are utilized to treat this irreversible condition first in pediatric cases and then in adults. Herein, we aimed to report our experience with live donors for ALF in a country of a deceased donor organ donation rate is only 1.

Success of microvascular surgery; repair mesenteric injury and prevent short bowel syndrome: a case report.

Background: Superior mesenteric injury is a rare entity but when it occurs, short bowel syndrome is one of the uninvited results of the emergency surgical procedures.

Case Presentation: We present a 19-year-old boy with blunt abdominal trauma which caused serious mesenteric injury. Because ultrasound revealed free intraabdominal fluid, he underwent emergency laparotomy.

Epidural anaesthesia and mini-laparotomy for the treatment of abdominal aortic aneurysms in patients with severe chronic obstructive pulmonary disease.

Purpose: The purpose of this study is to compare the use of epidural and general anaesthesia techniques in the treatment of abdominal aortic aneurysms (AAA) through mini-laparotomy in patients with severe chronic obstructive pulmonary disease (COPD).

Methods: Between March 2002 and October 2005, 23 patients with severe COPD underwent elective infrarenal abdominal aortic aneurysm repair. Endovascular therapy could not be established due to financial reasons and health insurance policies.

Carotid endarterectomy under local anesthesia: single institutional experience.

The aim of this study is to review our experience and results of carotid endarterectomy performed under local anesthesia. We evaluated 300 patients who had undergone carotid endarterectomy with local anesthesia in our department. Surgical indication, outcome, operative technique, and complications were assessed.

Patient with hepatocellular carcinoma on the waiting list for liver transplantation: abdominal seeding due to prior surgery: a case report.

Hepatocellular cancer (HCC) is the most common primary malignant hepatic tumor that accounts for over 80% of primary liver tumors. Hepatic resection is a well-accepted therapy for HCC, but 70% to 100% of patients, depending on patient selection, baseline tumor characteristics, and follow-up duration, develop cancer recurrence after resective surgery. Orthotropic liver transplantation is considered more appropriate in cases with HCC related to cirrhosis.

Porto-systemic shunt using adrenal vein as a conduit; an alternative procedure for spleno--renal shunt.

Background: Currently, portal hypertension is still big problem for the patients with serious liver diseases. Variceal bleeding is one of the most important complications of portal hypertension. In case of failure of endoscopic and combined medical treatments, surgical decompressive shunts are required.