ABSTRACT
Bile leak is a well-known complication of cholecystectomy. Endoscopic drainage and decompression of the biliary system including temporary insertion of a biliary stent is generally considered the treatment of choice. We report the successful obliteration of a bile leak using fibered platinum coils placed under fluoroscopic guidance after stent treatment had failed.
Subject(s)
Biliary Fistula/therapy , Cholecystectomy , Cholecystitis/surgery , Embolization, Therapeutic , Postoperative Complications/therapy , Acute Disease , Aged , Biliary Fistula/diagnostic imaging , Cholangiopancreatography, Endoscopic Retrograde , Cholecystitis/diagnostic imaging , Cystic Duct/diagnostic imaging , Cystic Duct/surgery , Duodenoscopy , Fluoroscopy , Humans , Male , Postoperative Complications/diagnostic imaging , Surgical Wound Dehiscence/diagnostic imaging , Surgical Wound Dehiscence/therapyABSTRACT
The clinical efficacy of both oral and parenteral L-ornithine-L-aspartate (OA) was confirmed by randomized, placebo-controlled, double-blind studies in patients with manifest hepatic encephalopathy and hyperammonemia. The drug was able to reduce high blood ammonia levels induced either by ammonium chloride or protein ingestion or existing as a clinical complication of cirrhosis per se. Furthermore, OA improved performance in Number Connection Test-A as well as mental state gradation. In contrast to the positive effects observed in patients with more advanced hepatic encephalopathy, oral OA does not seem to affect minimal hepatic encephalopathy. In a recent trial, OA decreased protein breakdown and stimulated protein synthesis in muscle. The therapy had little side effects, increasing with higher intravenously administered dosages, and was well tolerated after oral and parenteral administration.
