Clinical Application of the Hanover Classification for Iatrogenic Bile Duct Lesions

Background. There is only limited evidence available to justify generalized clinical classification and treatment recommendations for iatrogenic bile duct lesions. Methods. Data of 93 patients with iatrogenic bile duct lesions was evaluated retrospectively to analyse the variety of encountered lesions with the Hanover classification and its impact on surgical treatment and outcomes. Results. Bile duct lesions combined with vascular lesions were observed in 20 patients (21.5%). 18 of these patients were treated with additional partial hepatectomy while the majority were treated by hepaticojejunostomy alone (n = 54). Concomitant injury to the right hepatic artery resulted in additional right anatomical hemihepatectomy in 10 of 18 cases. 8 of 12 cases with type A lesions were treated with drainage alone or direct suture of the bile leak while 2 patients with a C2 lesion required a Whipple's procedure. Observed congruence between originally proposed lesion-type-specific treatment and actually performed treatment was 66–100% dependent on the category of lesion type. Hospital mortality was 3.2% (n = 3). Conclusions. The Hannover classification may be helpful to standardize the systematic description of iatrogenic bile duct lesions in order to establish evidence-based and lesion-type-specific treatment recommendations

The use of weak waves as diagnostic tracers in unsteady flows

Paper presented at the 5th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, South Africa, 1-4 July, 2007.This paper examines the tracing of the trajectories of weak waves behind a shock wave induced flow in order to establish how the domain shape influences the flow both from a spatial and temporal perspective. The basic principle is that if a particle produces a series of point disturbances in a flow field the perturbations induced will propagate outwards at the local sonic velocity whilst at the same time being convected along with the local flow velocity. A number of issues may be identified for an unsteady flow. Firstly the flow field at later times may be influenced by perturbations produced at earlier times. Secondly, if the positions of the perturbations can be monitored as a function of time then the trajectory and velocity of the particle may be deduced. Thirdly, if a perturbation arises from a point on a boundary then its influence, if any, on any particular part of the flow can be established.cs201

On the measurement of laser-induced plasma breakdown thresholds

The breakdown threshold of a gas exposed to intense laser-radiation is a function of gas and laser properties. Breakdown thresholds reported in the literature often vary greatly and these differences can partially be traced back to the method that is typically used to determine breakdown thresholds. This paper discusses the traditional method used to determine breakdown thresholds and the potential errors that can arise using this approach, and presents an alternative method which can yield more accurate data especially when determining breakdown thresholds as functions of gas pressure