Purpose: Interposition of a jejunal tube between the common bile duct and duodenum.
Methods: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg), were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum.
Results: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct.
Conclusion: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.
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http://dx.doi.org/10.1590/s0102-86502007000300002 | DOI Listing |
Introduction: Reports of pseudoaneurysms associated with biliary self-expandable metallic stent (SEMS) placement have been increasing. Recently, cases of hepatic pseudoaneurysm rupture caused by double pigtail plastic stents (DPS) have also been reported. The symptoms of pseudoaneurysms are often non-specific, and many cases are diagnosed only after rupture.
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General Surgery, Royal Bolton Hospital, Bolton NHS Foundation Trust, Bolton, GBR.
Laparoscopic cholecystectomy is a widely performed procedure, with securing the cystic duct being a critical step to prevent bile leakage. Traditional metal clips are commonly used, but alternative methods, such as non-absorbable polymer clips, absorbable clips, sutures, and ultrasonic shears, are also utilized. This systematic review and meta-analysis evaluates the safety and efficacy of various cystic duct securing techniques.
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Cardiovascular Epidemiology Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
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Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brazil.
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