Browsing by Author "Rebolledo, Patricia"

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    Liver resection for hepatolithiasis: A multicenter experience in Latin America
    (2023) Garcia, Daniel; Marino, Carlo; Coelho, Fabricio Ferreira; Rebolledo, Patricia; Achurra, Pablo; Fonseca, Gilton Marques; Kruger, Jaime A. P.; Vinuela, Eduardo; Briceno, Eduardo; D'Albuquerque, Luiz Carneiro; Jarufe, Nicolas; Martinez, Jorge A.; Herman, Paulo; Dib, Martin J.
    Background: Hepatolithiasis is a prevalent disease in Asia but rare in Western countries. An increasing number of cases have been reported in Latin America. Liver resection has been proposed as a definitive treatment for complete stone clearance. The aim of this study was to evaluate the postoperative out-comes of liver resection for the treatment of hepatolithiasis in 2 large hepatobiliary reference centers from South America.Methods: We conducted a retrospective descriptive analysis from patients with hepatolithiasis who underwent liver resection between November 1986 and December 2018, in 2 Latin-American centers in Chile and Brazil.Results: One hundred forty-nine patients underwent liver resection for hepatolithiasis (72 in Chile, 77 in Brazil). The mean age was 49 years and most patients were female (62.4%). Hepatolithiasis was localized in the left lobe (61.7%), right lobe (24.2%), and bilateral lobe (14.1%). Bilateral lithiasis was associated with higher incidence of preoperative and postoperative cholangitis (81% vs 46.9% and 28.6% vs 6.1%) and need for hepaticojejunostomy (52.4%). In total, 38.9% of patients underwent major hepatectomy and 14.1% were laparoscopic. The postoperative stone clearance was 100%. The 30-day morbidity and mortality rates were 30.9% and 0.7%, respectively. Cholangiocarcinoma was seen in 2 specimens, and no post-operative malignancy were seen after a median follow-up of 38 months. Fourteen patients (9.4%) had intrahepatic stones recurrence.Conclusions: Liver resection is an effective and definitive treatment for patients with hepatolithiasis. Bilateral hepatolithiasis was associated with perioperative cholangitis, the need for hepaticojejunostomy, and recurrent disease. Resection presents a high rate of biliary tree stone clearance and excellent long-term results, with low recurrence rates and low risk of malignancy.(c) 2022 Elsevier Inc. All rights reserved.
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    Right Lobe Liver Donation After Bariatric Surgery. A Case Series of 4 Living Donors
    (2022) Garcia, Daniel; Riveros, Sergio; Ochoa, Gabriela; Rebolledo, Patricia; Achurra, Pablo; Briceno, Eduardo; Vinuela, Eduardo; Arab, Juan Pablo; Jarufe, Nicolas; Fernandes, Eduardo; Martinez, Jorge; Dib, Martin
    Background. The increasing prevalence of obesity and need for bariatric surgery as well as the expanding use of living donors for liver transplantation means that potential donors could present with this surgical history. We present 4 cases of liver donors with previous bariatric surgery in our living donor liver transplant program. Methods. A retrospective descriptive analysis of patients with a bariatric surgery history who underwent right hepatectomy in our living donor liver transplant program is presented. Results. Case 1: A 53-year-old man with body mass index (BMI) of 33 who underwent lapa-roscopic sleeve gastrectomy (LSG). Pretransplant BMI was 21.5. Case 2: A 46-year-old woman with a BMI maximum of 40.8 who underwent LSG and required conversion to Roux-en-Y gas-tric bypass. Pretransplant BMI was 35.1. Case 3: A 53-year-old woman with a BMI maximum of 31.6 who underwent LSG. Pretransplant BMI was 24.2. Case 4: A 38-year-old man with a BMI maximum of 41.5 who underwent Roux-en-Y gastric bypass 6 years before the hepatectomy. Pretransplant BMI was 29.4. No complications were observed. Average operative time was 367.5 minutes, with a hospital stay of 5.8 days and 100% graft survival to date. Discussion. Utilization of selected donors with previous bariatric surgery appears to be a safe option and increases the donor pool.
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    Risk factors for readmission after a cholecystectomy: a case-control study
    (2024) Garcia, Daniel; Pastore, Antonia; Rodriguez, Javier; Crovari, Fernando; Cerda, Jaime; Rebolledo, Patricia; Achurra, Pablo; Vinuela, Eduardo; Martinez, Jorge; Dib, Martin; Briceno, Eduardo
    Objective: The aim of this study was to assess the risk factors associated with 30 -day hospital readmissions after a cholecystectomy. Methods: We conducted a case-control study, with data obtained from UC-Christus from Santiago, Chile. All patients who underwent a cholecystectomy between January 2015 and December 2019 were included in the study. We identified all patients readmitted after a cholecystectomy and compared them with a randomized control group. Univariate and multivariate analyses were conducted to identify risk factors. Results: Of the 4866 cholecystectomies performed between 2015 and 2019, 79 patients presented 30 -day hospital readmission after the surgical procedure (1.6%). We identified as risk factors for readmission in the univariate analysis the presence of a solid tumor at the moment of cholecystectomy (OR = 7.58), high pre -operative direct bilirubin (OR = 2.52), high pre -operative alkaline phosphatase (OR = 3.25), emergency admission (OR = 2.04), choledocholithiasis on admission (OR = 4.34), additional surgical procedure during the cholecystectomy (OR = 4.12), and post -operative complications. In the multivariate analysis, the performance of an additional surgical procedure during cholecystectomy was statistically significant (OR = 4.24). Conclusion: Performing an additional surgical procedure during cholecystectomy was identified as a risk factor associated with 30 -day hospital readmission.