Journal of hepato-biliary-pancreatic sciences
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J Hepatobiliary Pancreat Sci · Apr 2019
ReviewA three-step conceptual roadmap for avoiding bile duct injury in laparoscopic cholecystectomy: an invited perspective review.
Bile duct injuries are the most common serious complication of cholecystectomy. Avoidance of bile duct injury is a key aim of biliary surgery. The purpose of this paper is to describe laparoscopic cholecystectomy from the viewpoint of three conceptual goals. ⋯ This "inflection point" is defined as the moment at which the decision is made to halt the attempt to perform a total cholecystectomy laparoscopically and to finish the operation by a different method. Currently the best bail-out procedure seems to be subtotal fenestrating cholecystectomy. Application of conceptual goals of cholecystectomy can help the surgeon to avoid biliary injury.
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J Hepatobiliary Pancreat Sci · Apr 2019
Acute kidney injury after hepatectomy can be reasonably predicted after surgery.
Hepatectomy presents unique challenges potentially heightening acute kidney injury (AKI) risk, but the full spectrum of risk factors has not been identified. ⋯ Postoperative AKI affects one in six hepatectomy patients; preoperative and intraoperative factors can predict the risk of postoperative AKI.