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Timing of surgical repair of bile duct injuries after laparoscopic cholecystectomy: A systematic review

World Journal of Hepatology 2022年第2期14卷 442-455页

作者： Patryk Kambakamba Sinead Cremen Beat Möckli Michael Linecker Department of HPB and Transplant Surgery St.Vincent’s University Hospital DublinDublin d04 T6F4Ireland Department of Surgery Cantonal Hospital GlarusGlarus 8750Switzerland Department of Visceral and Transplantation Surgery University of Geneva HospitalsGeneva 1205Switzerland Department of Surgery and Transplantation University Medical Center Schleswig HolsteinKiel 24105Germany

BACKGROUND The surgical management of bile duct injuries(BDIs)after laparoscopic cholecystectomy(LC)is challenging and the optimal timing of surgery remains unclear.The primary aim of this study was to systematically evaluate the evidence behind the timing of BDI repair after LC in the literature.AIM To assess timing of surgical repair of BDI and postoperative complications.METHODS The MEDLINE,EMBASE,and The Cochrane Library databases were systematically screened up to August 2021.Risk of bias was assessed via the Newcastle Ottawa scale.The primary outcomes of this review included the timing of BDI repair and postoperative complications.RESULTS A total of 439 abstracts were screened,and 24 studies were included with 15609 patients included in this review.Of the 5229 BDIs reported,4934(94%)were classified as major injury.Timing of bile duct repair was immediate(14%,n=705),early(28%,n=1367),delayed(28%,n=1367),or late(26%,n=1286).Standardization of definition for timing of repair was remarkably poor among studies.Definitions for immediate repair ranged fromrepair ranged from24 h to>12 wk after LC)and late repair(>6 wk after LC)showed a broad overlap.CONCLUSION The lack of standardization among studies precludes any conclusive recommendation on optimal timing of BDI repair after LC.This finding indicates an urgent need for a standardized reporting system of BDI repair.

关键词： Bile duct injury Major bile duct injury Laparoscopic cholecystectomy surgical repair Immediate repair Early repair Delayed repair Late repair Biliary reconstruction Standardization of bile duct injury repair reporting

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surgical repair and Detection of Cerebrospinal Fluid Rhinorrhea using Magnetic Resonance Cisternography and Skull Base Coronal Thin-section Computed Tomography Scan

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Chinese Medical Journal 2016年第16期129卷 2005-2006页

作者： Hong-Sheng Du Guang-Shuo Ma Jing-Jian Ma Department of Neurosurgery Tianjin First Central Hospital Tianjin 300192 China

INTRODUCTION Cerebrospinal fluid （CSF） rhinorrhea is a common condition managed by neurosurgeons. The accurate identification of the site of leak plays a key role in facilitating successful surgical repair. We reported two surgery-proven cases of CSF rhinorrhea examined by magnetic resonance （MR） cisternography （Siemens, Berlin, Germany） and skull base coronal thin-section computed tomography （CT） scan （Siemens, Berlin, Germany） before surgical treatment.

关键词： Cerebrospinal Fluid Rhinorrhea Detection Magnetic Resonance Cistemography surgical repair Thin-sectionComputed Tomography Scan

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repair and regeneration of peripheral nerve injuries that ablate branch points

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Neural Regeneration Research 2023年第12期18卷 2564-2568页

作者： JuliAnne E.Allgood George D.Bittner Jared S.Bushman Division of Pharmaceutical Sciences University of WyomingLaramieWYUSA Department of Neuroscience The University of Texas at AustinAustinTXUSA

The peripheral nervous system has an extensive branching organization, and peripheral nerve injuries that ablate branch points present a complex challenge for clinical repair. Ablations of linear segments of the PNS have been extensively studied and routinely treated with autografts, acellular nerve allografts, conduits, wraps, and nerve transfers. In contrast, segmental-loss peripheral nerve injuries, in which one or more branch points are ablated so that there are three or more nerve endings, present additional complications that have not been rigorously studied or documented. This review discusses:(1) the branched anatomy of the peripheral nervous system,(2) case reports describing how peripheral nerve injuries with branched ablations have been surgically managed,(3) factors known to influence regeneration through branched nerve structures,(4) techniques and models of branched peripheral nerve injuries in animal models, and(5) conclusions regarding outcome measures and studies needed to improve understanding of regeneration through ablated branched structures of the peripheral nervous system.

关键词： allograft animal model branched injuries femoral nerve peripheral nerve injury peripheral nervous system regeneration repair sciatic nerve surgical repair

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Post-cholecystectomy iatrogenic bile duct injuries:Emerging role for endoscopic management

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2709-2718页

作者： Mohamed H Emara Mohammed Hussien Ahmed Mohamed I Radwan Emad Hassan Emara Magdy Basheer Ahmed Ali Asem Ahmed Elfert Department of Hepatology Gastroenterology and Infectious DiseasesKafrelsheikh UniversityKafr-Elshikh 33516Egypt Department of Tropical Medicine Zagazig UniversityZagazig 44519Egypt Department of Diagnostic and Interventional Radiology Kafrelsheikh UniversityKafr-Elshikh 33516Egypt Department of Surgery Mansoura UniversityMansours 44176Egypt Department of Emergency Hargeisa Group HospitalHargeisa 1235Somalia Department of Tropical Medicine Tanta UniversityTanta 33120Egypt

Post-cholecystectomy iatrogenic bile duct injuries(IBDIs),are not uncommon and although the frequency of IBDIs vary across the literature,the rates following the procedure of laparoscopic cholecystectomy are much higher than open cholecystectomy.These injuries caries a great burden on the patients,physicians and the health care systems and sometime are life-threatening.IBDIs are associated with different manifestations that are not limited to abdominal pain,bile leaks from the surgical drains,peritonitis with fever and sometimes jaundice.Such injuries if not witnessed during the surgery,can be diagnosed by combining clinical manifestations,biochemical tests and imaging techniques.Among such techniques abdominal US is usually the first choice while Magnetic Resonance Cholangio-Pancreatography seems the most appropriate.surgical approach was the ideal approach for such cases,however the introduction of Endoscopic Retrograde Cholangio-Pancreatography(ERCP)was a paradigm shift in the management of such injuries due to accepted success rates,lower cost and lower rates of associated morbidity and mortality.However,the literature lacks consensus for the optimal timing of ERCP intervention in the management of IBDIs.ERCP management of IBDIs can be tailored according to the nature of the underlying injury.For the subgroup of patients with complete bile duct ligation and lost ductal continuity,transfer to surgery is indicated without delay.Those patients will not benefit from endoscopy and hence should not do unnecessary ERCP.For low–flow leaks e.***.gallbladder bed leaks,conservative management for 1-2 wk prior to ERCP is advised,in contrary to high-flow leaks e.***.cystic duct leaks and stricture lesions in whom early ERCP is encouraged.Sphincterotomy plus stenting is the ideal management line for cases of IBDIs.Interventional radiologic techniques are promising options especially for cases of failed endoscopic repair and also for cases with altered anatomy.Future studies will solve many unsolved issues in the management of

关键词： Iatrogenic bile duct injuries Cholecystectomy surgical repair Endoscopic Retrograde Cholangio-Pancreatography Interventional radiology

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The impact of cleft lip and palate repair on maxillofacial growth

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International Journal of Oral Science 2015年第1期7卷 14-17页

作者： Bing Shi Joseph E Losee State Key Laboratory of Oral Diseases Department of Cleft Lip and Palate Surgery West China Hospital of Stomatology Sichuan University University Cleft-Craniofacial Center Division of Pediatric Plastic Surgery Children’s Hospital of Pittsburgh

surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mid-face and deformed dental arch have constantly been reported after cleft treatments. It is very hard to completely circumvent these postoperative complications by current surgical protocols. In this paper, we discussed the factors that inhibit the maxillofacial growth on cleft patients. These factors included pre-surgical intervention, the timing of cleft palate and alveolae repair, surgical design and treatment protocol. Also, we made a review about the influence on the maxillary growth in un-operated cleft patients. On the basis of previous researches, we can conclude that most of scholars express identity of views in these aspects： early palatoplasty lead to maxilla growth inhibition in all dimensions; secondary alveolar bone graft had no influence on maxilla sagittal growth; cleft lip repair inhibited maxilla sagittal length in patients with cleft lip and palate; Veau＇s pushback palatoplasty and Langenbeck＇s palatoplasty with relaxing incisions were most detrimental to growth; Furlow palatoplasty showed little detrimental effect on maxilla growth; timing of hard palate closure, instead of the sequence of hard or soft palate repair, determined the postoperative growth. Stilt, scholars hold controversial viewpoints in some issues, for example, un-operated clefts have normal growth potential or not, pre-surgical intervention and pharyngoplasty inhibited maxillofacial growth or not.

关键词： cleft growth maxilla surgical repair

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surgical correction for scimitar syndrome by right thoracotomy and direct anastomosis in chUdren

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Pediatric Investigation 2021年第1期5卷 46-51页

作者： Wei Cheng Zhiqiang Li Yaobin Zhu Nan Ding Daole Yan Hanlu Yi Department of Cardiovascular Surgery II Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina

Importance:Scimitar syndrome(SS)is a rare type of congenital heart disease characterized by total or partial anomalous venous drainage of the right lung to the inferior vena cava.However,the surgical repair techniques for SS vary according to patients'anatomical and pathological features.Objective:This study was performed to analyze the mid-term results of a less invasive surgical correction technique for SS in children.Methods:Eleven patients with SS who underwent surgical repair from January 2012 to March 2020 were retrospectively analyzed.The anomalous scimitar vein(SV)was directly reimplanted to the left atrium,and the concomitant atrial septal defect was simultaneously repaired with cardiopulmonary bypass.Results:Three male and eight female patients were included in the study.Their mean age was 3.1±1.3 years,and their mean body weight was 12.8±3.0 kg.Most patients had symptoms,such as upper respiratory tract infection,dyspnea,and recurrent pneumonia,and two patients had pulmonary hypertension.None of the 11 patients who underwent direct SV reimplantation by right thoracotomy developed bleeding,arrhythmia,heart failure,or perioperative death,and no patients required reoperation during a mean follow-up period of 36.6±15.2 months.Postoperative echocardiography revealed no restenosis or obstruction of the anastomosis in any patients.Interpretation:surgical repair for SS by right thoracotomy and direct anastomosis of the SV to the posterior wall of the left atrium is safe and effective,with good long-term patency of the reimplanted SV and a low mortality rate.

关键词： Scimitar syndrome Congenital heart disease surgical repair Right thoracotomy Direct anastomosis

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Stapled transperineal repair for low-and mid-level rectovaginal fistulas:A 5-year experience and comparison with sutured repair

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World Journal of Gastroenterology 2021年第14期27卷 1451-1464页

作者： Qian Zhou Zhi-Min Liu Hua-Xian Chen Dong-Lin Ren Hong-Cheng Lin Department of Coloproctology The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina Guangdong Institute of Gastroenterology The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina

BACKGROUND Currently,rectovaginal fistula(RVF)continues to be a surgical challenge worldwide,with a relatively low healing rate.Unclosed intermittent suture and poor suture materials may be the main reasons for this.AIM To evaluate the efficacy and safety of stapled transperineal repair in treating RVF.METHODS This was a retrospective cohort study conducted in the Coloproctology Department of The Sixth Affiliated Hospital of Sun Yat-sen University(Guangzhou,China).Adult patients presenting with RVF who were surgically managed by perineal repair between May 2015 and May 2020 were included.Among the 82 total patients,37 underwent repair with direct suturing and 45 underwent repair with stapling.Patient demographic data,Wexner faecal incontinence score,and operative data were analyzed.Recurrence rate and associated risk factors were assessed.RESULTS The direct suture and stapled repair groups showed similar clinical characteristics for aetiology,surgical history,fistula features,and perioperative Wexner score.The stapled repair group did not show superior results over the suture repair group in regard to operative time,blood loss,and hospital stay.However,the stapled repair group showed better postoperative Wexner score(1.04±1.89 vs 2.73±3.75,P=0.021),less intercourse pain(1/45 vs 17/37,P=0.045),and lower recurrence rate(6/45 vs 17/37,P=0.001).There was no protective effect from previous repair history,smaller diameter of fistula(repair.Direct suture repair and preoperative high Wexner score(>10)were risk factors for fistula recurrence.Furthermore,stapled repair gave better efficacy in treating complex RVFs(i.e.,multiple transperineal repair history,mid-level fistula position,and poor control of defecation).CONCLUSION Stapled transperineal repair is advantageous for management of RVF,providing a high primary healing rate and low recurrence rate.

关键词： Rectovaginal fistula surgical repair Transperineal approach Stapled technique Recurrence

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surgical Treatment of Tetralogy of Fallot with Pulmonary Valve Agenesis in a 22 Years Old Patient

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World Journal of Cardiovascular Surgery 2021年第4期11卷 29-36页

作者： Papa Salmane Ba Kabulo Yannick Momar Sokhna Diop Papa Amath Diagne Ndeye Fatou Sow Papa Adama Dieng Amadou Gabriel Ciss Thoracic and Cardiovascular Surgery Department CHU Fann Dakar Senegal

Agenesis of pulmonary valve is a rare variant and severe form of Tetralogy of Fallot (ToF). The evolution is usually marked by respiratory and cardiac failure at early age, which needs early surgical correction. Uncorrected treatment of Tetralogy of Fallot diagnosed at adult age is infrequent and only few studies have been described. We present here a rare case of a 22 years old patient who presented with dyspnea since childhood. Subsequent investigations allowed diagnosis of treatment of Tetralogy of Fallot with agenesis of the pulmonary valve. Following the assessment, the patient underwent a surgical repair and the recovery was uneventful. The management of treatment of Tetralogy of Fallot with pulmonary valve agenesis in adult period remains complex, requiring different surgical techniques.

关键词： Tetralogy of Fallot Pulmonary Valve Agenesis Adult surgical repair

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surgical Closure of Coronary Cameral Fistula Draining into the Left Ventricle via a “Fistula Lake”

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World Journal of Cardiovascular Diseases 2020年第8期10卷 545-549页

作者： Yuchen Cao Masaaki Koide Yoshifumi Kunii Minori Tateishi Kazumasa Watanabe Satoshi Okugi Yosuke Sakurai Risa Shimbori Division of Cardiovascular Surgery Seirei Hamamatsu General Hospital Hamamatsu Japan

A left-sided lesion of a coronary cameral fistula (CCF) is extremely rare. surgical closure of the fistula is indicated when symptoms emerge or as a preventive strategy, while surgical approaches depend on the individual anatomical structures. In particular, a CCF forming a “fistula lake” with multiple inflow vessels is so unique that few studies have focused on the technique to close it. We report the successful management of a CCF originating from multiple coronary arteries and draining into the left ventricle via a “fistula lake” by ligation and clipping of associated communication tracts. On the postoperative coronary computed tomography angiography, the fistula lake and the small vessels entering it had all disappeared.

关键词： Coronary Cameral Fistula Fistula Lake surgical repair

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Extended anastomosis with suture-less technique for primary repair of supra-cardiac TAPVC

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South China Journal of Cardiology 2010年第4期11卷 222-227页

作者：丁以群陈寄梅岑坚正许刚温树生庄建 Department of Cardiovascular Surgery Guangdong Cardiovascular Institute Guangdong Academy of Medical Sciences Guangdong General Hospital

Background Total anomalous pulmonary venous connection （TAPVC） is the most important anomaly of the pulmonary veins. Many surgical techniques have been proposed to establish a widely patent connection between the common pulmonary vein and the left atrium while avoiding post-repair pulmonary vein stenosis. However, for patients with hypoplastic common pulmonary vein, the traditional techniques may be limited by the vessel’s length and size. The anastomotic technique can cause trauma to the pulmonary venous endothelium. We propose a novel anastomotic technique for the primary surgical repair of supra-cardiac TAPVC where the venous incision is extended onto the vertical vein and a suture-less anastomosis is performed. Methods From January 2000 to December 2008, 143 patients were surgically treated for TAPVC at Guangdong Cardiovascular Institute, including 59 （41.2 %） cases of supracardiac type, 63 （44.1 %） of cardiac type, 6 （4.2 %） of infracardiac type, and 15 （10.5 %） of mixed type. Twenty one of 59 supracardiac TAPVC were undertaken with the extended anastomotic technique through the pericardial oblique sinus approach. This group included 9 boys and 12 girls. Aged at presentation ranged from 2 days to 13 years with a median of 4 months. Weight ranged from 2.3 kg to 25 kg with a median of 4.8 kg. Results There was no early or late mortality. One case failed to follow-up. The mean aortic cross-clamp time was 42.5 ± 6.4 minutes. The cardiopulmonary bypass time was 75.6 ± 7.2 minutes. Deep hypothermic circulatory arrest was not employed in any case. Intraoperative echocardiogram demonstrated a widely patent anastomosis between the common pulmonary vein and the left atrium. The velocities across the anastomosis were in the range of 0.50 to 0.75 m/s. Four cases required delayed sternal closure due to hemodynamic instability. The mean ICU stay was 8.7 ± 5.3 days with a mean period of artificial ventilation of 4.2 ± 2.9 days. The duration of follow up was 3.8 ± 1.8 years with one case lost to follow up. Assessments with

关键词： total anomalous pulmonary venous connection suture-less technique surgical repair

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