Nursing by a yearling Moose, Alces alces gigas, in Alaska

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Choledocholithiasis: Evaluation, Treatment, and Outcomes

Choledocholithiasis occurs in up to approximately 20% of patients with cholelithiasis. A majority of stones form in the gallbladder and then pass into the common bile duct, where they generate symptoms, due to biliary obstruction. Confirmatory diagnosis of choledocholithiasis is made with advanced imaging, including magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Treatment varies locally; however, ERCP with sphincterotomy is most commonly employed with a high degree of success. Difficult anatomy and difficult stone burden require advanced surgical, endoscopic, and percutaneous techniques to extract or expel biliary stones. Knowledge of these treatment strategies will optimize outcomes

Portal Venous Interventions after Liver Transplant

AbstractLiver transplant (LT) recipients are a challenging patient population when presenting with graft dysfunction or sequelae of portal hypertension. When no medical causes for graft dysfunction are found, a hemodynamically significant vascular lesion is suspected. Although rare, a variety of diseases may arise involving the portal system, which inhibit flow and graft function. Herein, we present a review of portal venous interventions performed in the LT setting, with focus on imaging diagnosis, endovascular treatment techniques, and outcomes. Entities addressed include portal venous stenosis, portal venous thrombosis, and recurrent fibrosis/cirrhosis with sequelae of portal hypertension.</jats:p