Major hepatectomy for the treatment of complex bile duct injury.

Background: Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients.

Methods: From January 1987 to January 2002, 18 patients underwent a major hepatectomy for complex bile duct injuries.

[Malignant biliary papillomatosis: analysis of p53 expression].

Biliary papillomatosis is a papillary adenomatosis of the biliary mucosa of the extra- and the intrahepatic biliary tree. It is a rare neoplasm difficult to manage, characterized by extensive lesions and a great potential for malignant transformation. We report a case of a 75 year-old man, who presented with malignant papillomatosis of the common bile duct without involvement of the intrahepatic biliary ducts.

Incidence and consequence of an hepatic artery injury in patients with postcholecystectomy bile duct strictures.

Objective: To compare the clinical presentation and results of treatment of postcholecystectomy bile duct injuries in patients with and without arterial injuries.

Summary Background Data: Incidence and impact of arterial injuries in patients with a postcholecystectomy biliary injury are unknown, although they are claimed to increase the risk of septic complications, difficulty of biliary repair and risk of recurrent stricture.

Methods: Fifty-five patients referred for postcholecystectomy biliary strictures and who underwent surgical repair were prospectively evaluated by celiac and superior mesenteric angiography.

Can failure of percutaneous drainage of postoperative abdominal abscesses be predicted?

Background: Percutaneous drainage (PD) of complex postoperative abscesses associated with a variety of factors such as multiple location or enteric fistula remains a matter of debate. Accordingly, this retrospective study was designed to determine the predictive factors for failure of PD of postoperative abscess, in order to better select the patients who may benefit from PD.

Methods: From 1992 to 2000, the data of 73 patients who underwent computed tomography (CT)-guided PD for postoperative intra-abdominal abscess, were reviewed.