The hepatic arterial anatomy is highly variable. A 67 year female with pancreatic mass and replaced common hepatic artery originating from the superior mesenteric artery underwent pancreaticoduodenectomy (PD). The anomalous vessel was discovered on preoperative CT scan and MRI. The vessel was dissected and preserved as it passed dorsal to the pancreas. Preservation of the blood supply to the li...

Background: Cholecystocutaneous fistula is a rare complication of chronic gallstone disease. We present a case of cholecystocutaneous fistula successfully managed with day-case laparoscopic cholecystectomy. Case Outline: An 80-year-old man initially presented with acute biliary sepsis, was treated conservatively, and later developed a right upper quadrant swelling in keeping with an abscess. He...

The aim of this study was to investigate the predictive role preoperative pancreatic density and muscular mass, assessed via CT imaging, in patients undergoing duodenocephalopancreasectomy, specifically relation occurrence postoperative fistula (POPF). A retrospective analysis conducted on a cohort 57 consecutive who had been diagnosed with cephalo-pancreatic disease undergone duodenocephalopan...

Abstract Background Partial peri-cystectomy (PPC) is one of the major surgical approaches for hepatic cystic echinococcosis (CE) and has been practiced in most centers worldwide. Cysto-biliary communication (fistula, leakage, rupture) a problematic issue CE patients. T-tube useful technique situations where an exploration decompression are needed common bile duct (CBD). However, postoperative b...

A 72-year-old man presented with acute cholangitis. He underwent endoscopic retrograde cholangiography (ERCP), which revealed a type IIIb Klatskin tumor. An 8.5-Fr, 12-cm plastic biliary stent was placed. Cholangiocarcinoma was confirmed cytologically and this was deemed unresectable. One month later, the patient presented with abdominal pain and cholestasis without peritoneal signs, fever, or ...

Endoscopic ultrasound (EUS) was developed as a diagnostic modality but rapidly gained a role for a variety of therapeutic applications. Endoscopic ultrasonography (EUS)‐guided cholangio pancreatic drainage has been reported as an alternative to surgery or percutaneous transhepatic cholangiography if endoscopic retrograde cholangiopancreatography (ERCP) is unsuccessful. Its concept includes EUS‐...

A 50-year-old woman with a history of uncomplicated Crohn’s disease presented for esophagogastroduodenoscopy (EGD) for evaluation of acute epigastric pain, nausea, and bilious vomiting. EGD revealed retained food in the stomach and what appeared to be a large, approximately 2-cm obstructing gallstone in the duodenal bulb (Figure 1). After multiple instruments failed to retrieve the gallstone, a...