The new DEAL - a novel technique using a double-entry access loop to facilitate bilateral intrahepatic biliary access for complex intrahepatic stones

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dc.contributor.authorKrige, J E J
dc.contributor.authorBeningfield, S J
dc.date.accessioned2016-02-02T09:40:25Z
dc.date.available2016-02-02T09:40:25Z
dc.date.issued2006
dc.date.updated2016-01-22T12:26:49Z
dc.description.abstractThe management of patients with primary intrahepatic stones may be complex as the natural history is frequently complicated by further episodes of cholangitis after initial treatment because of residual or recurrent intrahepatic stones or strictures.1 Curative segmental or lobar hepatic resection of atrophic segments and diseased ducts is possible in only the 20% of patients with localised stones or strictures.2 Complete stone removal by resection is therefore not feasible in the majority of patients with bilateral lobar stones and strictures. Patients who subsequently develop cholangitis pose a major operative risk if secondary biliary cirrhosis, portal hypertension or the atrophy-hypertrophy complex has occurred.3 Treatment of recurrent stones and strictures via the percutaneous transhepatic biliary route is successful in only 70% of patients.3 In order to avoid these hazards, to reduce the incidence of incomplete operative stone removal and to facilitate extraction of recurrent intrahepatic stones, we have used a multidisciplinary approach in complex hepatolithiasis, combining resection of atrophic liver segments with a modified hepaticojejunostomy incorporating permanent access for interventional radiological procedures via a jejunal access loop.en_ZA
dc.identifierhttp://dx.doi.org/10.7196/sajs.95
dc.identifier.apacitationKrige, J. E. J., & Beningfield, S. J. (2006). The new DEAL - a novel technique using a double-entry access loop to facilitate bilateral intrahepatic biliary access for complex intrahepatic stones. <i>South African Journal of Surgery</i>, http://hdl.handle.net/11427/16671en_ZA
dc.identifier.chicagocitationKrige, J E J, and S J Beningfield "The new DEAL - a novel technique using a double-entry access loop to facilitate bilateral intrahepatic biliary access for complex intrahepatic stones." <i>South African Journal of Surgery</i> (2006) http://hdl.handle.net/11427/16671en_ZA
dc.identifier.citationKriger, J. E. J., & Beningfield, S. J. (2006). The new DEAL-a novel technique using a double-entry access loop to facilitate bilateral intrahepatic biliary access for complex intrahepatic stones. South African Journal of Surgery, 44(2), 56-58.en_ZA
dc.identifier.issn0038-2361en_ZA
dc.identifier.ris TY - Journal Article AU - Krige, J E J AU - Beningfield, S J AB - The management of patients with primary intrahepatic stones may be complex as the natural history is frequently complicated by further episodes of cholangitis after initial treatment because of residual or recurrent intrahepatic stones or strictures.1 Curative segmental or lobar hepatic resection of atrophic segments and diseased ducts is possible in only the 20% of patients with localised stones or strictures.2 Complete stone removal by resection is therefore not feasible in the majority of patients with bilateral lobar stones and strictures. Patients who subsequently develop cholangitis pose a major operative risk if secondary biliary cirrhosis, portal hypertension or the atrophy-hypertrophy complex has occurred.3 Treatment of recurrent stones and strictures via the percutaneous transhepatic biliary route is successful in only 70% of patients.3 In order to avoid these hazards, to reduce the incidence of incomplete operative stone removal and to facilitate extraction of recurrent intrahepatic stones, we have used a multidisciplinary approach in complex hepatolithiasis, combining resection of atrophic liver segments with a modified hepaticojejunostomy incorporating permanent access for interventional radiological procedures via a jejunal access loop. DA - 2006 DB - OpenUCT DP - University of Cape Town J1 - South African Journal of Surgery LK - https://open.uct.ac.za PB - University of Cape Town PY - 2006 SM - 0038-2361 T1 - The new DEAL - a novel technique using a double-entry access loop to facilitate bilateral intrahepatic biliary access for complex intrahepatic stones TI - The new DEAL - a novel technique using a double-entry access loop to facilitate bilateral intrahepatic biliary access for complex intrahepatic stones UR - http://hdl.handle.net/11427/16671 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16671
dc.identifier.vancouvercitationKrige JEJ, Beningfield SJ. The new DEAL - a novel technique using a double-entry access loop to facilitate bilateral intrahepatic biliary access for complex intrahepatic stones. South African Journal of Surgery. 2006; http://hdl.handle.net/11427/16671.en_ZA
dc.languageengen_ZA
dc.publisherHealth and Medical Publishing Groupen_ZA
dc.publisher.departmentDepartment of Surgeryen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSouth African Journal of Surgeryen_ZA
dc.source.urihttp://www.sajs.org.za/index.php/sajs
dc.titleThe new DEAL - a novel technique using a double-entry access loop to facilitate bilateral intrahepatic biliary access for complex intrahepatic stonesen_ZA
dc.typeJournal Articleen_ZA
uct.subject.keywordsdouble-entry access loopen_ZA
uct.subject.keywordsbilateral intrahepatic biliary accessen_ZA
uct.subject.keywordscomplex intrahepatic stonesen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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