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Biomedical subjects

Y Y Jan

Publications and source records attributed to Y Y Jan.

At least 73 records · Page 4Linked to original sources
PubMed1989

Intrahepatic stones associated with cholangiocarcinoma.

Twenty cases of cholangiocarcinoma associated with hepatolithiasis were treated surgically. The incidence of cholangiocarcinoma associated with hepatolithiasis was 2.4%. Surgical procedures included common bile duct exploration after intraoperative choledochofiberoscopy in 20, with hepatic resection in nine. Overall survival was 8 months, with a range of 3-40 months. The hepatectomy group seemed to have a better prognosis. Accurate preoperative diagnosis of intrahepatic bile duct carcinoma associated with intrahepatic stones is difficult. All 20 patients in this series had surgery for recurrent cholangitis due to intrahepatic stones. From a retrospective review, it became apparent that early diagnosis can be obtained from the following: 1) detection of a hyperechoic mass in the liver parenchyma during abdominal ultrasonography, 2) a scintigraphic defect near the hilum, 3) filling defects or obliteration of intrahepatic ducts in ERCP or PTC, 4) gross appearance of the liver during surgery revealed a nodular tumor mass or an atrophic, fibrotic liver, and 5) intraoperative choledochoscopic findings which showed an intraluminal tumor or infiltrative lesion.

Adenoma, Bile Duct↗
PubMed1988

Surgical treatment for spontaneous rupture of hepatocellular carcinoma.

Twenty-seven patients with spontaneous rupture of hepatocellular carcinoma (HCC) underwent surgical treatment during the past ten years. The indications for emergent laparotomy were hemoperitoneum in 14 and unspecified peritonitis in 13. Twelve were found to have noncirrhotic HCC. The incidence of associated cirrhosis was 55.56 per cent. Surgical procedures included hepatic resection in 14, hepatic arterial ligation in six and packing, suture and electrocauterization in seven. Seven died within one month postoperatively, a surgical mortality rate of 28 per cent. Recently, palliative resection has been used more frequently. The group of patients who underwent resection have a better prognosis.

Adolescent↗
PubMed1987

Percutaneous transhepatic cholangioscopy.

Since 1983, percutaneous transhepatic cholangioscopy has been performed in 50 patients for both therapeutic and diagnostic purposes. Percutaneous transhepatic cholangioscopy was used to evaluate the nature of obstructive jaundice in 15 patients and bile duct stones were removed in 35 patients, 27 of whom also had intrahepatic duct stones. The overall success rate for stone removal was 80 per cent. Complications were few with no mortality. Emergency surgery was necessary in two patients, one for subphrenic haematoma, the other for a bile leak. Percutaneous transhepatic cholangioscopy is an effective and safe method for management of biliary stones and is a useful procedure for establishing the diagnosis of obstructive jaundice.

Adult↗
PubMed1986

Transcatheter hepatic arterial embolization followed by hepatic resection for the spontaneous rupture of hepatocellular carcinoma.

In three cases of the spontaneous rupture of hepatocellular carcinoma, emergent transcatheter hepatic arterial embolization was performed for controlling the intraperitoneal hemorrhage. No more transfusions were required after embolization. Operation was carried out on the 10th, 5th, and 5th day, respectively, after liver function studies returned to the pre-embolization level. Hepatic resection of left hemi-hepatectomy was performed in Case 1, and segmentectomy in Case 2 and Case 3 each. Transcatheter hepatic arterial embolization followed by hepatic resection is a rational treatment in the management of the spontaneous rupture of hepatocellular carcinoma.

Adult↗
PubMed1983

Use of fiberoptic choledochoscope in common bile duct and intrahepatic duct exploration.

This report summarizes our experience with 339 consecutive flexible fiberoptic choledochoscopic examinations performed in the course of 598 common bile duct explorations for biliary tract stones. Routine choledochoscopy added 5 to 10 minutes to the operation and caused no complications. In 81 of the patients, additional stones were discovered with choledochofiberscopy after completion of routine bile duct exploration. Postoperative cholangiography demonstrated a retained stone in 57 patients (two in the common bile duct and 55 in the intrahepatic ducts). Forty-two patients with stones retained in the intrahepatic ducts were diagnosed during operation with the fiberoptic choledochoscope, but those stones were very difficult for us to remove. The accuracy of postexploratory choledochoscopy in diagnosis of stones in the common bile duct and intrahepatic ducts was 99.0% and 90.5%, respectively. Choledochofiberscopy is useful in exploration of the common bile duct and a safe procedure in the diagnosis of biliary tract stones during operation.

Bile Ducts, Intrahepatic↗