Monthly Archives: September 2012

My take on Mirrizzi syndrome

Pablo Luis Mirrizzi was a much loved surgeon and medical educator from Cordoba in Argentina. He described obstruction of the common hepatic duct arising from compression by a gall stone in the cystic duct.  He introduced the operative cholangiogram as … Continue reading

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Careless talk costs livers (and kidneys)

I recently overheard a conversation that went along the lines of “Oh no they wouldn’t be interested in my organs I am much too old”. Using my (reasonable) judgement of age I would reckon that the person who made the … Continue reading

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The Y, the T and the backward 7 of portal veins

I previously wrote a blog around rotation of the porta hepatis and the conformational changes that this can cause. Changes in the volume of relative components of the liver can also cause changes in the main portal venous trunk. This … Continue reading

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Pringle Manouevre Explained – an exceptional story

The Pringle manoeuvre describes a technique frequently used in liver surgery to control bleeding while dividing the liver parenchyma (liver substance) by applying a clamp or other compressive device to the porta hepatis at the foramen of Winslow as shown … Continue reading

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Selective or total inflow occlusion? You be the judge

This is my latest highlight from the journal HPB The best way to control bleeding during the parenchymal transection phase of liver resection remains controversial. Using a selective approach to vascular inflow occlusion has the benefit of avoiding ischemia to … Continue reading

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Ultrasound based diagnosis of jaundice.

This is a really simple way to teach medical students or junior doctors about diagnosing jaundice. Obviously they should take a history and examine the patient but when we are talking about diagnosis of jaundice this question usually comes along. … Continue reading

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Avoiding inadvertent injury to the ampulla or distal bile duct during duodenal surgery

Every year we see a few cases where a patient has become yellow a few days after emergency surgery for a bleeding ulcer or trauma surgery involving the duodenum. The reason is usually a well meaning stitch to under-run an … Continue reading

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