Purpose
This study aimed to investigate vasculobiliary anatomical variations in living liver donors (LLDs) during pretransplant evaluation using magnetic resonance imaging (MRI). The accuracy of MRI in estimating graft weight was also evaluated.
Methods
Pre-operative MR imaging data of 100 LLDs were retrospectively assessed, and variations in the biliary, arterial, and venous systems were evaluated. Surgical records were used to identify discrepancies between MRI biliary findings and intra-operative cholangiograms. The image quality was classified as poor, fair, or good. The MRI-estimated weight was compared with the actual explant weight measured during surgery.
Results
Ninety-seven right lobe hepatectomies and 3 left lobe hepatectomies were performed, with 19 patients exhibiting classic anatomy in all three components. Pre-transplant MRI detected biliary, arterial, and venous variations in 42, 40, and 32 donors, respectively. Intra-operative cholangiograms were found to be discrepant with pre-operative MRIs in 35% of the cases. Furthermore, only 29 donors had acceptable image quality in all anatomical components. The mean estimated graft volume was 1015 ± 253 grams, while mean actual graft weight was 828 ± 204 grams. There was a linear correlation between the MRI-estimated graft weight and the actual graft weight (r: 0.83).
Conclusion
The utilization of pre-transplantation MRI in the evaluation of LLDs can provide valuable insights into anatomical variations. However, to avoid discrepancies between imaging and operative findings, it is important to exercise caution during graft volumetry and image interpretation. Furthermore, MRCP volumetry is another important step in ensuring that proper graft size is achieved.
Objective: To evaluate the therapeutic results of rubber band ligation inhemorrhoidal disease. Design:. Prospective case series with a minimum follow up of six months. Place and durationof study: At surgical out door department of Combined Military Hospital Rawalpindi from January 2002 to July 2003.Patients and methods: One hundred patients with 1st and 2nd degree hemorrhoids were treated by rubber band ligationand injection scelerothrapy in two groups “A” and “B” with 50 patients in each group respectively. They were followedup for six months and therapeutic effects were assessed by improvement in symptom severity score, post procedurecomplications and number of off days from work. Results: In group “A” 38(76%) patients were cured, 7(14%) showedimprovement and 5(10%) showed no improvement. While in group “B” 25(50%) patients were cured, 13(26%) showedimprovement and 12(24%) showed no improvement. In group “A” complications occurred in 15 patients and in group“B” complications occurred in 27 patients, however no serious and life threatening complications were seen. Conclusion:Rubber band ligation is a rapid, safe, effective and economical method of treating 1st and 2nd degree Hemorrhoids inout door
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