180x 1 0.819; R = 0.80; P = .0003). In this series, 2 patients (13.3%) suffered symptomatic hyperperfusion after revascularization and accordingly exhibited increased AR of ASL. Our data indicate that early increases in rCBF in patients with hyperperfusion could be detected
using FAIR ASL supplemental to I-123-IMP SPECT after revascularization. Our data indicate that FAIR ASL is a convenient method for evaluating hyperperfusion that can be performed repeatedly without the use of contrast medium or radioisotopes.”
“Electrophilic substitution reactions (formylation and acylation) in the series of 2-[2-(2-furyl)vinyl]- and 2-[2-(2-thienyl)vinyl]benzothiazoles AZD8186 cost leads to the corresponding derivatives at the alpha-position of the furan or thiophene ring. The presence
of a vinylene bridge weakens deshielding effect of the benzothiazole fragment on pi-excessive heterocycles, so that such compounds react at a higher rate and under milder conditions as compared to hetarylbenzothiazoles JQEZ5 order having no vinylene bridge.”
“Biliary injury is a severe complication of cholecystectomy. The Hepp-Couinaud reconstruction with the hepatic duct confluence and the left duct may offer best long-term outcome as long as the confluence remains intact (Bismuth I-III). Complex liver surgery is usually indicated in most proximal (Bismuth IV) injuries in non-cirrhotic patients. The aim
of this study was to evaluate the surgical treatment and outcome of bile duct injuries managed in a referral hepatobiliary unit.
We retrospectively analyzed surgical management and outcome of biliary injuries following cholecystectomy in 35 patients (27 laparoscopic) referred to our center between June 2001 and December 2009. There was no liver cirrhosis diagnosed in any patient. High injuries (Bismuth III-IV) were found in 14 patients. Management after referral included the Hepp-Couinaud hepaticojejunostomy in 32 patients with Bismuth I-III injuries, which in four cases with biliary peritonitis was preceded by abdominal lavage and prolonged external biliary drainage. Liver transplantation Sapitinib in vitro was performed in two patients with Bismuth IV injuries.
After median follow-up of 59 months (range, 6-102), 34 (97%) patients are alive and 32 (92%) remain in good general condition with normal liver function. One patient who had combined biliary and colonic injury died of sepsis before repair. Recurrent strictures following the Hepp-Couinaud repair developed in two (6%) patients with high injuries combined with right hepatic arterial injury.
The Hepp-Couinaud hepaticojejunostomy offers durable results, even after previous interventions have failed. In case of diffuse biliary peritonitis, delayed biliary reconstruction following external biliary drainage may be the best option.