Experience in the treatment of 238 patients for nontumorous lesions of the biliary tract by choledochotomy is generalized. Choledochotomy was performed in obstructive jaundice during the operation, in cholangiolithiasis, suppurative cholangitis, strictures of the terminal part of the choledochus, and indurative pancreatitis which were attended by biliary hypertension. Diagnostic choledochotomy was undertaken only in 5.8% of patients. Twenty-two (9.2%) patients died after choledochotomy. The method of completing choledochotomy was chosen individually according to the character of the pathological changes in the bile ducts and the acuteness of the inflammatory process. Choledochotomy was completed by external drainage of the common bile duct in 116 patients, by complete suturing of the choledochus in 19, by creation of bile-draining anastomoses in 89, and by papillosphincterotomy in 14 patients. Terminal and lateral choledochoduodenoanastomosis was formed in 25 patients, with good immediate results. Mortality was highest after papillosphincterotomy and external drainage of the choledochus.
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Gastroenterol Clin North Am
March 2025
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012, India.
Pancreatic duct (PD) strictures, leaks, and disconnected ducts are important morphologic consequences of inflammatory disease of the pancreas, resulting in abdominal pain, pancreatic ascites, pancreatic pleural effusion, and external pancreatic fistula. Traditionally, these PD complications were treated surgically, but a better understanding of their pathophysiology, along with advancement in endoscopic interventions, has transformed the therapy from morbid surgical interventions to minimally invasive, safe, and effective endoscopic treatment. This review discusses the current diagnostic and management strategies for PD strictures, leaks, and disconnected pancreatic ducts.
View Article and Find Full Text PDFIndian J Nephrol
July 2024
Department of Medicine, INHS Asvini, Mumbai, India.
Background: External jugular vein (EJV) is used to insert tunneled dialysis catheter (TDC) in patients with no AVF and exhausted right internal jugular veins (IJV). There is scarce data on TDC insertion in EJV by nephrologists with fluoroscopy guidance.
Materials And Methods: This was a prospective observational study that included hemodialysis patients with exhausted right IJV access who underwent EJV TDC insertion, and excluded occluded ipsilateral brachiocephalic vein or superior vena cava, EJV < 5 mm diameter, or patients with existing EJV TDC.
Pathogens
December 2024
Intensive Care Unit, Department of Anesthesiology and Critical Care, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Ventriculo-meningitis or nosocomial meningitis/ventriculitis is a severe nosocomial infection that is associated with devastating neurological sequelae. The cerebrospinal fluid isolates associated with the infection can be Gram-positive or -negative, while the spp. is rarely identified.
View Article and Find Full Text PDFSci Rep
January 2025
Universidade Federal de Ouro Preto, Ouro Preto, MG, Brasil.
The South American Transcontinental Drainage Divide (TDD) is roughly oriented NE-SW from its Atlantic termination in SE Brazil to its NW termination in the limits between the southwestern edges of the Amazon Craton and the Andean Foreland. Based on a weak spatial coincidence with 90 - 70 Ma igneous intrusions, the origin and stability of the TDD have been attributed to intraplate magmatic activity. Using geomorphic analysis of drainage divides, we infer an overall southward migration of the TDD, even in areas with constrained uplift associated with intrusions.
View Article and Find Full Text PDFJ Endovasc Ther
January 2025
Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria.
Purpose: To report the occurrence of acute postrenal kidney failure caused by external ureteral obstruction after iliac venous stent placement.
Case Report: A 73-year-old male patient presented with a chronic swelling and feeling of heaviness of his right leg. The presence of venous thrombosis was excluded by duplex ultrasound (DUS).
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