David M. Nagorney

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Intrahepatic arterioportal fistulas (APF) are uncommon complications following hepatic trauma. Large fistulas can result in portal hypertension and cardiovascular compromise. A 46-year-old patient is described who presented with portal hypertension, variceal bleeding, and high output cardiac failure due to a large intrahepatic APF. Surgical closure of the(More)
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary tumor of the liver. To further define its clinicopathology and surgical management, we reviewed our experience. Clinical presentations of 32 patients with ICC was similar to that with hepatocellular carcinoma. Jaundice occurred in only 27 percent. ICC was unresectable due to advanced(More)
Obstruction of the common hepatic duct due to pressure from an impacted stone in the cystic duct or in the gallbladder infundibulum is known as Mirizzi's syndrome. The obstruction is due to direct impression of the stone on the common hepatic duct or to the concomitant inflammatory infiltrate. The diagnostic features are illustrated by 6 recently observed(More)
BACKGROUND Enhanced recovery pathways (ERP) have not been widely implemented for hepatic surgery. The aim of this study was to evaluate the safety of an ERP for patients undergoing open hepatic resection. METHODS A single-surgeon, retrospective observational cohort study was performed comparing the clinical outcomes of patients undergoing open hepatic(More)
PURPOSE Review the safety and long-term success with portosystemic shunts in children at a single institution. METHODS An IRB-approved, retrospective chart review of all children ages 19 and undergoing surgical portosystemic shunt from January 1990-September 2008. RESULTS Ten patients were identified, 8 females and 2 males, with a mean age of 15 years(More)
67 quantitative measures of liver function remained good. These data are consistent with our own study comparing DSRS and sclerotherapy which measured quantitative liver function. We showed that patients successfully managed with sclerotherapy, who had no major rebleeding, showed a significant improvement in galactose elimination capacity over the first(More)
329 cheap. Whether initial treatment should be extended to long-term regimes is a point of contention beyond the scope of the present article. An extremely important point emphasised by the authors is the definition of treatment failure, particularly with reference to injection sclerotherapy. They have clearly shown that repeated attempts to manage bleeding(More)
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