Browsing by Autor "Manuel Alejandro Mahler"

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Laparoscopic cholecystectomy complications: a new case report of a right hepatic artery pseudoaneurysm that caused jaundice
(Arán Ediciones, 2018) Guido Villa‐Gomez; Manuel Alejandro Mahler; Dante Manazzoni
Iatrogenic vascular injuries of the hepatic artery are infrequent and a serious complication of LC. There is no doubt about the many advantages of LC when compared to open cholecystectomy. Despite this, there is an increase in the reported incidence (0.3%-1.0%) of biliary and vascular injuries. Most arterial complications are due to direct injury or diathermy shortening on surgical clips and HAP is one of them. We present a case of a 39-year old male patient who presented with this complication and how it was resolved.
Single-session EUS-guided hepaticogastrostomy and dual-scope gastroenterostomy: a modified technique for palliative double endoscopic biliary and gastric bypass
(Thieme Medical Publishers (Germany), 2017) Manuel Alejandro Mahler; Robín Germán Prieto; Inés Oria; Guido Villa‐Gomez; Gustavo Vidales; Manuel Pérez‐Miranda
Single-session EUS-guided hepaticogastrostomy and dual-scope gastroenterostomy: a modified technique for palliative double endoscopic biliary and gastric bypass A 59-year-old man with unresectable ampullary adenocarcinoma causing gastric outlet and biliary obstruction was palliated by placement of biliary and duodenal self-expandable metal stents (SEMSs). His symptoms relapsed 4 months later and tumor ingrowth was noted through both SEMSs at endoscopy. Single-session endoscopic ultrasound (EUS)-guided biliary drainage and EUSguided gastroenterostomy were undertaken. EUS-guided hepaticogastrostomy was performed first. A curved linear-array echoendoscope was positioned in the upper gastric body. A 19-gauge needle was used to puncture the left intrahepatic bile duct, with access being confirmed by aspiration of bile and by cholangiography. A 0.035-inch guidewire was advanced through the needle. A 6-mm biliary balloon dilator was used to dilate the tract, and this was followed by transgastric placement of a 10-mm 10-cm fully-covered SEMS, which was then clipped to the gastric mucosa. A 7-mm pediatric endoscope was next introduced into the proximal jejunum through the duodenal SEMS, which was partially blocked by tumor ingrowth. Water was instilled through the scope to distend the jejunal lumen. With the echoendoscope placed in the gastric cavity alongside the pediatric endoscope, the water-filled jejunal loop was identified by EUS and punctured with a 19-gauge needle. A 0.035-inch guidewire was passed through the needle and grasped with a forceps that was passed through the pediatric scope. A Hot Axios delivery system was inserted over the wire, while traction was maintained on both ends of the guidewire. The distal end of the stent delivery system was inserted through the stomach wall into the jejunal lumen by applying electrocautery. The lumenapposing metal stent was then deployed under combined EUS, fluoroscopic, and endoscopic guidance. Maximal opening Video 1 The video shows step by step the creation of the endoscopic ultrasound-guided hepaticogastrostomy and the dual-scope gastroenterostomy, as well as images from the follow-up endoscopy 7 months later. Fig.
Spectrum of biliary parasites affecting the biliary tree (Fasciola hepatica, Echinococcus granulosus, and Ascaris lumbricoides)
(Thieme Medical Publishers (Germany), 2018) Guido Villa-Gómez Roig; Manuel Alejandro Mahler; Dante Manazzoni; Miguel Villa-Gomez; Gustavo Vidales; Mariano Marcolongo
Spectrum of biliary parasites affecting the biliary tree (Fasciola hepatica, Echinococcus granulosus, and Ascaris lumbricoides) Fig.