Background: Duodenal stump fistula (DSF) after gastrectomy is a complication with a high mortality rate. We report a series of patients with postoperative DSF treated with percutaneous transhepatic biliary drainage and occlusion balloon (PTBD-OB). The aim of this study is to explore the feasibility and efficacy of PTBD-OB in the treatment of DSF.
Patients And Methods: Six patients developing DSF underwent PTBD-OB because of high DSF output and because medical and surgical management was unsuccessful. In these patients, an occlusion balloon was percutaneously inserted into the common bile duct and a biliary drain was positioned above the balloon to obtain external drainage of bile.
Results: In all cases, percutaneous access to the biliary tree was achieved. Patients maintained the PTBD-OB for a median of 43 days. In all patients, DSF output decreased after PTBD-OB placement from a median of 500 to 100 ml/day (p = 0.02). The DSF resolved in three patients and three patients died of sepsis, but in two of them, death was related to other digestive fistulas that developed before PTBD-OB placement.
Conclusions: This paper presents the first published series on DSF management with PTBD-OB and shows that it is a feasible and safe procedure which reduces DSF output.
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http://dx.doi.org/10.1007/s11605-011-1668-6 | DOI Listing |
J Vasc Surg Cases Innov Tech
April 2025
Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX.
We describe a 54-year-old man with type 2 diabetes mellitus, ischemic myopathy, pulmonary hypertension, and end-stage renal disease who was admitted for heart failure and listed for a dual cardiac-renal transplantation. Extensive calcification in the iliac arteries prevented clamping. Proximal endovascular balloon control of the left iliac artery was achieved using contralateral access; distal control was established by passing a Fogarty catheter distally through an iliac arteriotomy, later used for anastomosis of the cadaveric conduit.
View Article and Find Full Text PDFCureus
December 2024
Department of Obstetrics and Gynecology Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
An adherent placenta is a life-threatening condition that impairs the mother's life owing to hemorrhagic shock and disseminated intravascular coagulation. Profound hemorrhage resulting from placental abruption is often managed using hysterectomy to preserve the mother's life, although the consequent loss of fertility can be devastating, particularly in younger women. Thus, strategies that facilitate fertility preservation while effectively controlling hemorrhage should be considered viable alternatives.
View Article and Find Full Text PDFJ Invasive Cardiol
January 2025
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota. Email:
Background: The use of the Ostial Flash balloon (Ostial Corporation) has received limited study in aorto-ostial chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI).
Methods: The authors evaluated the outcomes of Ostial Flash balloon use in a large CTO-PCI registry (PROGRESS-CTO, NCT02061436).
Results: The Ostial Flash balloon was used in 54 of 907 aorto-ostial CTO PCIs in 905 patients (6.
Thorac Cardiovasc Surg
January 2025
Pediatric Cardiology, University Hospital Tuebingen, Tubingen, Germany.
Background: Since patients with congenital heart defects (CHD) frequently require life-long medical care and repeat invasive treatment, radiation exposure during interventional procedures is a relevant issue concerning potential radiation related risks. Therefore, an analysis on radiation data from the German Registry for Cardiac Operations and Interventions in patients with CHD was performed.
Methods: From January 2012 until December 2020 a total of 28,374 cardiac catheter interventions were recorded.
J Neuroimaging
January 2025
Neurointerventional Department CDI, Hospital Clinic de Barcelona, Barcelona, Spain.
Background And Purpose: The safety and effectiveness of endovascular techniques in elderly patients with large vessel occlusion (LVO) remain controversial. We investigated the angiographic and clinical outcomes of nonagenarians treated with different endovascular techniques using a balloon guide catheter (BGC), distal aspiration catheter (DAC), and/or stent retriever (SR).
Methods: We analyzed the data from the Registry of Combined versus Single Thrombectomy Techniques (ROSSETTI) of consecutive nonagenarian patients with anterior circulation LVO and compared the outcomes of those treated with BGC+noDAC+SR (101-group), BGC+DAC+SR (111-group), and noBGC+DAC+SR (011-group).
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