Endovascular Management of Massive Hemobilia as a Late Complication of Percutaneous Biliary Drainage in a Pediatric Liver Transplant Recipient: A Case Report

Development of biliary strictures after liver transplantation is not uncommon, and minimally invasive procedures are the first-line treatment of choice in most centers. Hemobilia is an infrequent, usually self-limited complication related to the initial biliary access procedure. Massive hemobilia with severe hemodynamic instability is a rare event, particularly as a delayed complication. the difficulty of obtaining surgical access makes management of this condition highly challenging. Endovascular embolization may represent an important treatment option in this setting.Universidade Federal de São Paulo, Dept Diagnost Imaging, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Diagnost Imaging, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Surg, São Paulo, BrazilWeb of Scienc

Component Analysis of Hospital Cost of Pancreas-Kidney Transplant and Correlations With Different Variables in a Brazilian Hospital

Introduction. Simultaneous pancreas-kidney transplantation is associated with a high rate of complications when it is compared with transplantation of other organs; these increased complications can result in increased financial costs of the procedure. the objective of this study was to determine operating costs and financial results of simultaneous pancreas-kidney transplantation and its different variables in a Brazilian hospital.Patients and Methods. Between January 2008 and December 2011, the monthly costs of 105 patients were calculated. These patients were divided into 2 groups; the first consecutive 53 patients were labeled group I and the second set of 52 patients were labeled group II. the cost evaluation was made in US dollars.Results. A total of 89 patients corresponded to the public health system and 16 patients to the supplementary health system. the percentage of hospital discharge was 92.4%. There was an increase in operating room costs in group II compared with group I with no statistically significant difference ($18,749.33 for group I and$17,608.26 for group II). the outcome of the operation was positive; it was greater for group II than for group I ($16,303.22 vs$3494.53).Conclusions. Simultaneous pancreas-kidney transplantation is a financially feasible procedure in Brazil, with the public health system being the main payment source.Universidade Federal de São Paulo, Unifesp, Dept Surg, Div Abdominal Surg, São Paulo, BrazilHosp Kidney & Hypertens, Fundacao Oswaldo Ramos, São Paulo, BrazilUniversidade Federal de São Paulo, Unifesp, Dept Surg, Div Abdominal Surg, São Paulo, BrazilWeb of Scienc