Biliary complications associated with weight loss, cholelithiasis and choledocholithiasis.

Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss. Patients with a body mass index > 40 face an eightfold risk of developing cholelithiasis. Post-bariatric surgery, especially after laparoscopic Roux-en-Y gastric bypass (LRYGB), 30% of patients develop biliary disease due to rapid weight loss.

Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma.

Primary biliary tract tumors are malignancies that originate in the liver, bile ducts, or gallbladder. These tumors often present with jaundice of unknown etiology, leading to delayed diagnosis and advanced disease. Currently, several palliative treatment options are available for primary biliary tract tumors.

Investigating the link between frailty and outcomes in geriatric patients with isolated rib fractures.

Background: Studies have shown an increased risk of morbidity in elderly patients suffering rib fractures from blunt trauma. The association between frailty and rib fractures on adverse outcomes is still ill-defined. In the current investigation, we sought to delineate the association between frailty, measured using the Orthopedic Frailty Score (OFS), and outcomes in geriatric patients with isolated rib fractures.

Review and pictorial essay on complications of bariatric surgery.

Obesity is a chronic disease characterized by excess fat in the body and a real public health problem. Bariatric surgery, in recent decades, has gained space in its treatment due to the efficiency obtained in weight loss and significant reduction of the related comorbidities. The most commonly performed bariatric procedures include Roux-en-Y gastric bypass, adjustable gastric band, and laparoscopic sleeve gastrectomy.

Laparoscopic resection of primary retroperitoneal schwannoma: A case report.

Background: Schwannomas are rare, often benign, tumors deriving from Schwann cells that have low incidence in the retroperitoneal region (0.5% to 5%). Their diagnosis is hardly confirmed at early stage due to lack of specific features in signs, symptoms and imaging tests.

Abdominal aortic aneurysms that have ruptured or are at imminent risk of rupture.

The rupture of an abdominal aortic aneurysm (AAA) is considered a high-risk surgical emergency, given the catastrophic consequences and high mortality rate. The objective of this pictorial essay is to illustrate the radiological signs that indicate rupture or imminent rupture. To that end, we describe cases treated at our facility and present a brief review of the literature on the topic.

Comparative study of abdominal cavity temporary closure techniques for damage control.

The damage control surgery, with emphasis on laparostomy, usually results in shrinkage of the aponeurosis and loss of the ability to close the abdominal wall, leading to the formation of ventral incisional hernias. Currently, various techniques offer greater chances of closing the abdominal cavity with less tension. Thus, this study aims to evaluate three temporary closure techniques of the abdominal cavity: the Vacuum-Assisted Closure Therapy - VAC, the Bogotá Bag and the Vacuum-pack.

Discussing the Notion of Decent Work: Senses of Working for a Group of Brazilian Workers without College Education.

Despite recent stability and socioeconomic development, Brazil's history is marked by social inequality, informality, precarious work, and psychosocial vulnerability, with little opportunity for decent and meaningful work, as recommended by the International Labour Office (ILO), for people in the country. Nevertheless, based on a social constructionist view, the hypothesis can be raised that there is no substantive definition of decent work, but rather a psychosocial one, constructed based on the discourse, narratives, and practices produced through the relational processes which grant sense and meaning to work. Therefore, the examination of narratives and discourses is an important methodological strategy to understand the socio-occupational reality of Brazil.

LIVER TRANSPLANTATION AFTER SEVERE HEPATIC TRAUMA: CURRENT INDICATIONS AND RESULTS.

Background: The liver is the most injured organ in abdominal trauma. Currently, the treatment in most cases is non-operative, but surgery may be necessary in severe abdominal trauma with blunt liver damage, especially those that cause uncontrollable bleeding. Despite the damage control approaches in order to achieve hemodynamic stability, many patients develop hypovolemic shock, acute liver failure, multiple organ failure and death.

Complications after Radiofrequency Ablation of 233 Hepatic Tumors.

Objective: The only curative treatment for primary and secondary hepatic malignancies is surgery and liver transplantation. Thus, the majority of the patients are not candidates for resection, and there is a lack of organs. For these reasons, alternative treatment modalities such as radiofrequency ablation (RFA) are employed.

Is there a role for pyloric exclusion after severe duodenal trauma?

Duodenal trauma is an infrequent injury, but linked to high morbidity and mortality. Surgical management of duodenal injuries is dictated by: patient's hemodynamic status, injury severity, time of diagnosis, and presence of concomitant injuries. Even though most cases can be treated with primary repair, some experts advocate adjuvant procedures.

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors.

Radiofrequency ablation (RFA) has become an important option in the therapy of primary and secondary hepatic tumors. Surgical resection is still the best treatment option, but only a few of these patients are candidates for surgery: multilobar disease, insufficient liver reserve that will lead to liver failure after resection, extra-hepatic disease, proximity to major bile ducts and vessels, and co-morbidities. RFA has a low mortality and morbidity rate and is considered to be safe.

Are the imaging findings used to assess the portal triad reliable to perform living-donor liver transplant?

Background: A crucial aspect of living-donor liver transplant is the risk imposed to the donor due to a procedure performed in a healthy individual that can lead to a high postoperative morbidity rate

Aim: To correlate the pre- and intraoperative hepatic imaging findings of living adult donors.

Methods: From 2003 to 2008 the medical charts of 66 donors were revised; in that, 42 were males (64%) and 24 females (36%), mean age of 30 ± 8 years. The preoperative anatomy was analyzed by magnetic resonance cholangiography to study the bile ducts and by computed tomography angiography to evaluate the hepatic artery and portal vein.

[Damage control surgery: an update].

The damage control surgery is a widely accepted concept today among abdominal trauma specialists when it comes to the severely traumatized. In these patients, the death is due, in most cases, to the installation of the lethal triad (hypothermia, coagulopathy and acidosis) and not the inability to repair the serious initial damage. In this review, the authors address the lethal triad in its three phases and emphasize the measures taken to prevent them, as well as discussing the indication and employment of damage control surgery in its various stages.

Relationship between preoperative volume and weight of the right liver lobe graft, with and without the middle hepatic vein, in living-donor transplantation.

Background: The aim of this study was to assess the relationship between the preoperative volume of the right liver lobe (as determined by computed tomography) and the intraoperative graft weight with or without the middle hepatic vein.

Methods: Sixty-three patients who underwent liver transplantation were included in this study. The preoperative volumes of both the left and the right liver lobe were measured in all patients using computed tomography.

Review of experimental models for inducing hepatic cirrhosis by bile duct ligation and carbon tetrachloride injection.

Purpose: To present a review about a comparative study of bile duct ligation versus carbon tetrachloride Injection for inducing experimental liver cirrhosis.

Methods: This research was made through Medline/PubMed and SciELO web sites looking for papers on the content "induction of liver cirrhosis in rats". We have found 107 articles but only 30 were selected from 2004 to 2011.

Spontaneous rupture of hepatic hemangiomas: A review of the literature.

Hepatic hemangiomas are congenital vascular malformations, considered the most common benign mesenchymal hepatic tumors, composed of masses of blood vessels that are atypical or irregular in arrangement and size. Hepatic hemangiomas can be divided into two major groups: capillary hemangiomas and cavernous hemangiomas These tumors most frequently affect females (80%) and adults in their fourth and fifth decades of life. Most cases are asymptomatic although a few patients may present with a wide variety of clinical symptoms, with spontaneous or traumatic rupture being the most severe complication.

Esophagectomy for a traumatic esophageal perforation with delayed diagnosis.

Esophageal perforations are rare, and traumatic perforations are even more infrequent. Due to the rarity of this condition and its nonspecific presentation, the diagnosis and treatment of this type of perforation are delayed in more than 50% of patients, which leads to a high mortality rate. An 18-year-old male patient was brought to the emergency room with a penetrating neck injury, caused by a gunshot wound.

Liver regeneration, stem cells and beyond.

Studies of the liver regenerative process have gained prominence in the last few years, especially with the interest in stem cell therapy. The regenerative capacity of the liver, its mechanisms and the role of stem cells will be discussed in this editorial as well as the role of artificial tissues and organs aiming to produce a new liver based on the current literature.

Living donor right liver lobe transplantation with or without inclusion of the middle hepatic vein: analysis of complications.

Background: For living-related liver transplantation, harvesting a right hepatic graft that includes the middle hepatic vein (MHV) has been recommended to improve venous drainage of the graft. However, it may result in congestion of the donor's remaining segment IV, increasing the potential risk to the donor. This study aimed to compare safety levels for liver donors during procedures with or without removal of the MHV.

Anterior hepatic transection for caudate lobectomy.

Resection of the caudate lobe (segment I- dorsal sector, segment IX- right paracaval region, or both) is often technically difficult due to the lobe's location deep in the hepatic parenchyma and because it is adjacent to the major hepatic vessels (e.g., the left and middle hepatic veins).