The Efficacy of Biliary Diversion for Benign Disease: Long-Term Follow-up

Retrospective analysis of 70 patients who underwent biliary bypass operations for benign disease over an eight-year period was undertaken to evaluate long-term complications. Operative procedures included choledochoduodenostomy in 60 patients, choledochojejunostomy in four, and cholecystoduodenostomy, cholecystojejunostomy and hepaticojejunostomy in two patients each. The most common indication for surgery was choledocholithiasis, with or without hepatic stones, viscid bile, and ampullary stenosis (61 to 70 patients). Other indications included chronic pancreatitis, choledochal cyst, and sclerosing cholangitis. One patient died postoperatively from hemorrhage, and two others died from causes unrelated to surgery. Two patients developed cholangitis without reflux and demonstrated anastomotic stenosis at re-operation. Sixty-four patients in the series had reflux but remained asymptomatic. Our study supports the concept that cholangitis results from relative obstruction of the anastomosis rather than from reflux

Intrahepatic-Cutaneous Biliary Fistulas Secondary to Trauma

Biliary fistula is an unusual complication after operations for hepatic trauma, but only scant information is available concerning its management. This report describes biliary fistulas and presents two cases of their successful resolution, by external drainage in one case and internal drainage in the other. These cases illustrate aspects of fistula management and prevention described in the literature and suggest individualized approaches

Appendix B. Bicolor damselfish size distributions during the 2003 and 2004 experiments and for the 2004 experimental reefs used in the larval trait analyses.

Bicolor damselfish size distributions during the 2003 and 2004 experiments and for the 2004 experimental reefs used in the larval trait analyses

Appendix C. Time-averaged damselfish densities and sex ratios in the experiments at Rainbow Reef.

Time-averaged damselfish densities and sex ratios in the experiments at Rainbow Reef

Appendix A. Map of study sites and photographs depicting a clutch of young eggs, an experimental patch reef, a damselfish feeder, and a male bicolor damselfish tending his nest.

Map of study sites and photographs depicting a clutch of young eggs, an experimental patch reef, a damselfish feeder, and a male bicolor damselfish tending his nest

Expanded Polytetrafluoroethylene (PTFE) and External Velour Grafts as Small Artery Substitutes in Dogs

This experimental study compared the clinical patency, angiographic appearance, and histology of 4 mm polytetrafluoroethylene (PTFE) and external double velour grafts which were used as external iliac artery substitutes in dogs. At one week there were no significant differences. However, at two months, none of the PTFE grafts were open, whereas six of the seven external double velour grafts were patent (p\u3c0.05). Thus, in this study the 4 mm PTFE grafts are poor substitutes for canine iliac replacement

Endovascular Repair of Carotid Artery Pseudoaneurysm after Carotid Endarterectomy with Self-Expanding Covered Stents: A Long-Term Follow-Up

A 66-year-old Caucasian man with type 2 diabetes mellitus, peptic ulcer disease, peripheral vascular disease, and a 70% symptomatic carotid stenosis underwent a successful carotid endarterectomy with intraoperative shunting and Dacron patch closure in October 2000. Three months later, he developed a pseudoaneurysm at the site of the surgical repair. This was successfully treated with endovascular covered stents and has continued to remain patent at 9-year follow-up. Carotid artery pseudoaneurysms are secondary to trauma, infection, or previous surgery. Open surgical repair has been the treatment of choice for these pseudoaneurysms. However, open repairs are difficult and carry a high morbidity. Thus, endovascular therapy is a valid treatment for carotid artery pseudoaneurysm. Reviewing the published data, this is the first case report with successful endovascular covered stent placement for a carotid pseudoaneurysm with 9-year follow-up

Open Repair and Endovascular Covered Stent Placement in the Management of Bilateral Axillary Artery Aneurysms

A 72-year-old male with chronic obstructive pulmonary disease and hyperlipidemia presented with acute right upper limb ischemia. Arterial occlusion was found to be secondary to a thrombosed axillary artery aneurysm. An open repair was performed with a polytetrafluoroethylene (PTFE) graft. On further workup, the patient was found to have an asymptomatic axillary artery aneurysm on the left-hand side. Endovascular repair with a covered stent was chosen to treat this aneurysm