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Öğe Abdominal actinomycosis simulating malignancy of the right colon(Digestive Diseases and Sciences, 2005) Işık, Burak; Aydın, Engin; Söğütlü, Gökhan; Ara, Cengiz; Yılmaz, Sezai; Kırımlıoğlu, VedatActinomycosis is a chronic, suppurative, and granulomatous disease caused by an anaerobic or microaerophilic gram-positive bacterium, Actinomyces israelii, manifesting itself as fistula, sinus, inflammatory pseudotumor, or abscess formation. The cervicofacial region (50 to 65%) accounts for the majority of the cases followed by abdomen (20%) (1–5). Abdominal infection mostly involves the cecal area and can simulate malignant tumor on clinical and radiological examinations (1, 4, 6, 7). The diagnosis is almost always ascertained after surgery and histopathological examination of the specimen. The purpose of this report is to emphasize the possibility of encountering an abdominal mass related to actinomycosis in emergency cases and the benefit of limited surgical procedure.Öğe Abdominal actinomycosis simulating malignancy of the right colon(Digestive Diseases and Sciences, 2005) Işık, Burak; Aydın, Engin; Söğütlü, Gökhan; Ara, Cengiz; Yılmaz, Sezai; Kırımlıoğlu, VedatActinomycosis is a chronic, suppurative, and granulomatous disease caused by an anaerobic or microaerophilic gram-positive bacterium, Actinomyces israelii, manifesting itself as fistula, sinus, inflammatory pseudotumor, or abscess formation. The cervicofacial region (50 to 65%) accounts for the majority of the cases followed by abdomen (20%) (1–5). Abdominal infection mostly involves the cecal area and can simulate malignant tumor on clinical and radiological examinations (1, 4, 6, 7). The diagnosis is almost always ascertained after surgery and histopathological examination of the specimen. The purpose of this report is to emphasize the possibility of encountering an abdominal mass related to actinomycosis in emergency cases and the benefit of limited surgical procedure.Öğe Abdominal actinomycosis simulating malignancy of the right colon(Dig Dis Sci., 2005) Işık, Burak; Aydın, Engin; Söğütlü, Gökhan; Ara, Cengiz; Yılmaz, Sezai; Kırımlıoğlu, VedatActinomycosis is a chronic, suppurative, and granulomatous disease caused by an anaerobic or microaerophilic gram-positive bacterium, Actinomyces israelii, manifesting itself as fistula, sinus, inflammatory pseudotumor, or abscess formation. The cervicofacial region (50 to 65%) accounts for the majority of the cases followed by abdomen (20%) (1–5). Abdominal infection mostly involves the cecal area and can simulate malignant tumor on clinical and radiological examinations (1, 4, 6, 7). The diagnosis is almost always ascertained after surgery and histopathological examination of the specimen. The purpose of this report is to emphasize the possibility of encountering an abdominal mass related to actinomycosis in emergency cases and the benefit of limited surgical procedure.Öğe Abdominal compartment syndrome due to distended rectal stump(Turk J Gastroenterol 2007; 18 (3): 192-194, 2007) Yılmaz, Sezai; Işık, Burak; Uğraş, Murat Yahya; Söğütlü, Gökhan; Ara, Cengiz; Yılmaz, SezaiAbdominal compartment syndrome is a serious and life-threatening condition that requires early recognition and urgent decompressive laparotomy. This case report describes an abdominal compartment syndrome due to a distended rectal stump. The patient had a previous sigmoid resection with colostomy performed for sigmoid volvulus. As far as we know, this is the first report of abdominal compartment syndrome due to rectal stump. In such cases, high index of suspicion and early intervention affect the clinical course.Öğe Abdominal compartment syndrome due to distended rectal stump(Aves, 2007) Yilmaz, Mehmet; Isik, Burak; Ugras, Murat; Soeguetlue, Goekhan; Ara, Cengiz; Yilmaz, SezaiAbdominal compartment syndrome is a serious and life-threatening condition that requires early recognition and urgent decompressive laparotomy. This case report describes an abdominal compartment syndrome due to a distended rectal stump. The patient had a previous sigmoid resection with colostomy performed for sigmoid volvulus. As far as we know, this is the first report of abdominal compartment syndrome due to rectal stump. In such cases, high index of suspicion and early intervention affect the clinical course.Öğe ABO incompatible liver transplantation in acute and acute on chronic liver failure(Hepato-gastroenterology, 2013) Yılmaz, Sezai; Aydın, Cemalettin; Işık, Burak; Kayaalp, Cüneyt; Yılmaz, Mehmet; Ara, Cengiz; Kutlu, Ramazan; Bayındır, Yaşar; Ersan, VeyselABO-incompatible (ABO-I) liver transplantation (LTx) is an inevitable problem in emergency conditions such as acute liver failure or acute-on-chronic liver failure when deceased donor (DD) is not available or living donor (LD) selection is limited. This study spesifically addressed the problem of emergency ABO-I LTx in critically ill adult patients having acute liver failure or severely decompensated end stage liver disease. Methodology: This series included 16 patients, of which 10 underwent ABO-I LD LTx and 6 patients underwent 7 ABO-I DD LTx. Two patients underwent ABO-compatible LD LT before ABO-I DD LT, because of hepatic artery thrombosis. Multiple sessions of plasmapheresis were used to reduce isoaglutinin titres to 1/16 or below before and after the transplantation. Splenectomy was carried out after the graft reperfusion in the last 7 cases. In the first 9 patients splenic artery ligation was performed. Data were prospectively collected and retrospectively analysed. Results: The follow-up period ranged from 1 to 38 months. The mean follw-up period was 10.37 months. Median age of patients was 50 years (17-63 years). The MELD scores ranged from 17 to 30 (median 22.5). Median survival of patients was 9 months and mean survival was 19.5 months. Hospital mortality consisted of 3 patients (18.7 %). Two patients died due to small for size graft syndrome and cerebrovascular bleeding respectively. Hepatic artery thrombosis developed in 3 patients. Two of them died at postoperative 4th and 9th months. Third patient is stil living with hepatic necrosis problem. Conclusion: ABO-I LTx remains an important and unavoidable therapeutic option in adult patients with acute or acute-on-chronic liver failure awaiting an emergency procedure and in the context of living donor liver transplantation. This option should be offered to all patients in cases of immediate need for an allograft without the possibility to allocate a blood group compatible liver graft.Öğe ABO incompatible liver transplantation in acute and acute on chronic liver failure(Hepatogastroenterology, 2013) Yılmaz, Sezai; Aydın, Cemalettin; Işık, Burak; Kayaalp, Cüneyt; Yılmaz, Mehmet; Ara, Cengiz; Kutlu, Ramazan; Bayındır, Yaşar; Ersan, VeyselAbstract BACKGROUND/AIMS: ABO-incompatible (ABO-I) liver transplantation (LTx) may be mandatory in urgent conditions such as acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) when deceased donor (DD) is unavailable or living donor (LD) selection is limited. This study specifically addresses the problem of urgent ABO-I LTx in critically ill adult patients having ALF or severely decompensated end-stage liver disease. METHODOLOGY: This series included 16 patients, 10 underwent ABO-I LD LTx and 6 underwent 7 ABO-I DD LTx. Multiple sessions of plasmapheresis reduced isoaglutinin titres to 1/16 or below, before and after LTx. RESULTS: Mean follow-up period was 10.37 months (1 to 38). Median for MELD scores was 22.5 (17 to 30). Median survival was 9 months and mean survival was 19.5 months. Hospital mortality was 3 (18.7%). Two patients died due to small for size graft syndrome and cerebrovascular bleeding respectively. Hepatic artery thrombosis developed in 3 patients. Two of them died at postoperative 4th and 9th months. Third patient is still alive with hepatic necrosis problem. CONCLUSIONS: ABO-I LTx remains an important and unavoidable therapeutic option in adult patients with ALF or ACLF and urgent need for an allograft without the possibility to allocate a blood group compatible liver graft.Öğe ABO incompatible liver transplantation in acute and acute on chronic liver failure(Hepato-gastroenterology, 2013) Yılmaz, Sezai; Aydın, Cemalettin; Işık, Burak; Kayaalp, Cüneyt; Yılmaz, Mehmet; Ara, Cengiz; Kutlu, Ramazan; Bayındır, Yaşar; Ersan, VeyselBACKGROUND/AIMS: ABO-incompatible (ABO-I) liver transplantation (LTx) may be mandatory in urgent conditions such as acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) when deceased donor (DD) is unavailable or living donor (LD) selection is limited. This study specifically addresses the problem of urgent ABO-I LTx in critically ill adult patients having ALF or severely decompensated end-stage liver disease. METHODOLOGY: This series included 16 patients, 10 underwent ABO-I LD LTx and 6 underwent 7 ABO-I DD LTx. Multiple sessions of plasmapheresis reduced isoaglutinin titres to 1/16 or below, before and after LTx. RESULTS: Mean follow-up period was 10.37 months (1 to 38). Median for MELD scores was 22.5 (17 to 30). Median survival was 9 months and mean survival was 19.5 months. Hospital mortality was 3 (18.7%). Two patients died due to small for size graft syndrome and cerebrovascular bleeding respectively. Hepatic artery thrombosis developed in 3 patients. Two of them died at postoperative 4th and 9th months. Third patient is still alive with hepatic necrosis problem. CONCLUSIONS: ABO-I LTx remains an important and unavoidable therapeutic option in adult patients with ALF or ACLF and urgent need for an allograft without the possibility to allocate a blood group compatible liver graft.Öğe Abo-Incompatible Liver Transplantation in Acute and Acute-On-Chronic Liver Failure(H G E Update Medical Publishing S A, 2013) Yilmaz, Sezai; Aydin, Cemalettin; BurakIsik; Kayaalp, Cuneyt; Yilmaz, Mehmet; Ara, Cengiz; Kutlu, RamazanBackground/Aims: ABO-incompatible (ABO-I) liver transplantation (LTx) may be mandatory in urgent conditions such as acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) when deceased donor (DD) is unavailable or living donor (LD) selection is limited. This study specifically addresses the problem of urgent ABO-I LTx in critically ill adult patients having ALF or severely decompensated end-stage liver disease. Methodology: This series included 16 patients, 10 underwent ABO-I LD LTx and 6 underwent 7 ABO-I DD LTx. Multiple sessions of plasmapheresis reduced isoaglutinin titres to 1/16 or below, before and after LTx. Results: Mean follow-up period was 10.37 months (1 to 38). Median for MELD scores was 22.5 (17 to 30). Median survival was 9 months and mean survival was 19.5 months. Hospital mortality was 3 (18.7%). Two patients died due to small for size graft syndrome and cerebrovascular bleeding respectively. Hepatic artery thrombosis developed in 3 patients. Two of them died at postoperative 4th and 9th months. Third patient is still alive with hepatic necrosis problem. Conclusions: ABO-I LTx remains an important and unavoidable therapeutic option in adult patients with ALF or ACLF and urgent need for an allograft without the possibility to allocate a blood group compatible liver graft.Öğe Advanced alveolar echinococcosis disease associated with Budd Chiari syndrome(International Journal of Surgery Case Reports, 2015) Soyer, Vural; Ara, Cengiz; Yaylak, Faik; Sarıcı, Kemal Barış; Özsoy, Mustafa; Koç, Okay; Yılmaz, SezaiAlveolar echinococceal disease of the liver is rare. Echinococcus multilocularis is responsible for the development of the related clinical conditions. Advanced disease may result with serious complications such as end stage liver disease and Budd–Chiari syndrome. PRESENTATION OF CASE:In this presentation, a 28 years-old woman who was a case with advanced alveolar echinococcosis complicated with a Budd–Chiari syndrome and was performed successful living donor liver transplantation, has been demonstrated with clinical and radiological images. DISCUSSION: Initially there may be no clinical evidence of the disease in humans for years. Severity and fatality are the significant characteristics of the natural history. Extension to the surrounding tissues and metastasis of the parasitic mass may be observed. Prevention is essential in disease control. Serologic assay may identify the parasite. However, early diagnosis is rare. Staging is based on radiologic imaging. Some patients with advanced disease may require surgery. Hepatic resection and liver transplantation are accepted procedures in selected patients. CONCLUSION: The importance of early diagnosis to prevent advanced complications such as development of Budd–Chiari syndrome and metastasis has been underlined.Öğe Advanced alveolar echinococcosis disease associated with Budd Chiari syndrome(International Journal of Surgery Case Reports, 2015) Soyer, Vural; Ara, Cengiz; Yaylak, Faik; Sarıcı, Barış; Özsoy, Mustafa; Koç, OkayINTRODUCTION: Alveolar echinococceal disease of the liver is rare. Echinococcus multilocularis is responsible for the development of the related clinical conditions. Advanced disease may result with serious complications such as end stage liver disease and Budd–Chiari syndrome. PRESENTATION OF CASE:In this presentation, a 28 years-old woman who was a case with advanced alveolar echinococcosis complicated with a Budd–Chiari syndrome and was performed successful living donor liver transplantation, has been demonstrated with clinical and radiological images. DISCUSSION: Initially there may be no clinical evidence of the disease in humans for years. Severity and fatality are the significant characteristics of the natural history. Extension to the surrounding tissues and metastasis of the parasitic mass may be observed. Prevention is essential in disease control. Serologic assay may identify the parasite. However, early diagnosis is rare. Staging is based on radiologic imaging. Some patients with advanced disease may require surgery. Hepatic resection and liver transplantation are accepted procedures in selected patients. CONCLUSION: The importance of early diagnosis to prevent advanced complications such as development of Budd–Chiari syndrome and metastasis has been underlined. © 2015 The Authors. Published by Elsevier Ltd. on behalf of Surgical Associates Ltd. This is an open access article under the CC BY-NC-SA license (http://creativecommons.org/licenses/by-nc-sa/4.0/).Öğe Advanced alveolar echinococcosis disease associated with Budd-Chiari syndrome(Elsevier Sci Ltd, 2015) Soyer, Vural; Ara, Cengiz; Yaylak, Faik; Sarici, Baris; Ozsoy, Mustafa; Koc, Okay; Yilmaz, SezaiINTRODUCTION: Alveolar echinococceal disease of the liver is rare. Echinococcus multilocularis is responsible for the development of the related clinical conditions. Advanced disease may result with serious complications such as end stage liver disease and Budd-Chiari syndrome. PRESENTATION OF CASE: In this presentation, a 28 years-old woman who was a case with advanced alveolar echinococcosis complicated with a Budd-Chiari syndrome and was performed successful living donor liver transplantation, has been demonstrated with clinical and radiological images. DISCUSSION: Initially there may be no clinical evidence of the disease in humans for years. Severity and fatality are the significant characteristics of the natural history. Extension to the surrounding tissues and metastasis of the parasitic mass may be observed. Prevention is essential in disease control. Serologic assay may identify the parasite. However, early diagnosis is rare. Staging is based on radiologic imaging. Some patients with advanced disease may require surgery. Hepatic resection and liver transplantation are accepted procedures in selected patients. CONCLUSION: The importance of early diagnosis to prevent advanced complications such as development of Budd-Chiari syndrome and metastasis has been underlined. (C) 2015 The Authors. Published by Elsevier Ltd. on behalf of Surgical Associates Ltd.Öğe Akut Kolesistitlerde Laparoskopik Kolesistektominin Yeri(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2001) Söğütlü, Gökhan; Ara, Cengiz; Yılmaz, Sezai; Kırımlıoğlu, Hale; Karadağ, Neşe; Lezzan KeskinAkut kolesistitin laparoskopik kolesistektomi ile tedavisinde konversiyon için belirleyici faktörleri ortaya koymayı amaçladık. Gereç ve Yöntem: Ocak 1997-Aralık 2000 tarihleri arasında akut taşlı kolesistit nedeniyle ameliyat edilen 28 olgu incelemeye tabi tutuldu. Olguların 19’u kadın 9’u erkek olup en genç hasta 28 ve en yaşlı hasta ise 75 yaşında olmak üzere ortalama yaş 53.5 ±13.7 idi.Beyaz küre, yaş, cinsiyet, alkalen fosfataz ve akut kolesistitin şidetine göre konversiyon oranları karşılaştırıldı. Bulgular: 28 hastanın 10’unda konversiyon (açık kolesistektomi) gerçekleşti (%35.7). Beyaz küre yüksekliği (>18000/uL) ve kolesistitin şiddeti konversiyon için anlamlı olarak bulundu (sırayla p=0.011 ve p=0.0007). Erkek cinsiyet, hastanın yaşının 60’ın üzerinde olması ve alkalen fosfataz yüksekliğinin, konversiyonla ilişkisi ortaya konulamadı (sırayla p=0.677, p=0.432 ve p=0.601). Hiçbir hastada postoperatif major komp likasyon gözlenmezken uzamış ateş ve yara enfeksiyonu gibi minor komplikasyonlar konversiyon grubunda laparoskopi grubuna göre daha fazla gözlendi. Konversiyon grubunda, hastanede kalış ve operasyon süresi anlamlı olarak daha uzundu (Sırayla; p<0.001 ve p=0.021). Sonuç: Akut kolesistitli hastaların coğunda laparaskopik girişimin güvenle yapılabileceği görüşündeyiz. Ancak, hasta seçimi üzerinde durulması gereken konudur ve beyaz küre yüksekliği (>18.000 u/L) ve kolesititin şiddeti konversiyonla ilişkilidir.Öğe Anastomoz kaçaklarının engellenmesinde kullanılmak üzere doğal bileşeni biouyumlu polimerik yapıştırıcıların sentezi ve uygulaması(2013) Ateş, Burhan; Ara, Cengiz; Parlakpınar, Hakan; Köytepe, Süleyman; Vardı, Nigar; Denkbaş, Emir Baki; Yılmaz, Baki[Abstract Not Available]Öğe Bare stent implantation in iatrogenic dissecting pseudoaneurysm of the superior mesenteric artery(Cardiovasc Intervent Radiol, 2007) Kutlu, Ramazan; Ara, Cengiz; Saraç, KayaLatrogenic arterial dissection leading to the development of dissecting pseudoaneurysms of the superior mesenteric artery (SMA) is a rare complication of angiography. Surgical and endovascular treatment options exist for this important condition. We report a case of bare stent implantation in dissecting pseudoaneurysm of the SMA that developed after angiography in a patient with acute mesenteric ischemia. Although it is rarely published, iatrogenic arterial dissection causing pseudoaneurysm can occur after diagnostic and interventional angiography. Bare stent implantation in dissecting pseudoaneurysm of the SMA could be an advantageous endovascular treatment option in selected cases due its to potential preservation of important side branches of the SMA.Öğe Beneficial Effect of Caffeic Acid Phenethyl Ester (CAPE) on Hepatocyte Damage Induced by Bile Duct Ligation: An Electron Microscopic Examination(Taylor & Francis Inc, 2010) Esrefoglu, Mukaddes; Ara, CengizRecently the authors have reported the potent beneficial effect of caffeic acid phenethyl ester (CAPE) on cholestatic oxidative liver injury induced by acute bile ligation in Swiss albino rats. Herein, they report the ultrastructural hepatocellular alterations induced by acute bile duct ligation and the effect of CAPE administration on these alterations. Bile duct ligation resulted in many degenerative changes, such as vacuolization, mitochondrial degeneration, endoplasmic reticulum dilatation, and lysosome accumulation within the cytoplasm of hepatocytes. Mitochondrial degeneration was also observed within the cytoplasm of the cells of biliary ductular epithelium. CAPE potentially protected the hepatocytes from the cholestasis-induced cellular injury.Öğe Beneficial effect of caffeic acid phenethyl ester CAPE on hepatocyte damage induced by bile duct ligation an electron microscopic examination(Ultrastruct Pathol, 2010) Eşrefoğlu, Mukaddes; Ara, CengizRecently the authors have reported the potent beneficial effect of caffeic acid phenethyl ester (CAPE) on cholestatic oxidative liver injury induced by acute bile ligation in Swiss albino rats. Herein, they report the ultrastructural hepatocellular alterations induced by acute bile duct ligation and the effect of CAPE administration on these alterations. Bile duct ligation resulted in many degenerative changes, such as vacuolization, mitochondrial degeneration, endoplasmic reticulum dilatation, and lysosome accumulation within the cytoplasm of hepatocytes. Mitochondrial degeneration was also observed within the cytoplasm of the cells of biliary ductular epithelium. CAPE potentially protected the hepatocytes from the cholestasis-induced cellular injury.Öğe Beneficial effect of caffeic acid phenethyl ester CAPE on hepatocyte damage induced by bile duct ligation an electron microscopic examination(Ultrastructural Pathology, 34:273–278, 2010., 2010) Eşrefoğlu, Mukaddes; Ara, CengizRecently the authors have reported the potent beneficial effect of caffeic acid phenethyl ester (CAPE) on cholestatic oxidative liver injury induced by acute bile ligation in Swiss albino rats. Herein, they report the ultrastructural hepatocellular alterations induced by acute bile duct ligation and the effect of CAPE administration on these alterations. Bile duct ligation resulted in many degenerative changes, such as vacuolization, mitochondrial degeneration, endoplasmic reticulum dilatation, and lysosome accumulation within the cytoplasm of hepatocytes. Mitochondrial degeneration was also observed within the cytoplasm of the cells of biliary ductular epithelium. CAPE potentially protected the hepatocytes from the cholestasis-induced cellular injuryÖğe Biliary complications in 106 consecutive duct to duct biliary reconstruction in right lobe living donor liver transplantation performed in 1 year in a single center a new surgical technique(Transplant Proc., 2011) Kırımlıoğlu, Vedat; Tatlı, Faik; İnce, Volkan; Aydın, Cemalettin; Ersan, Veysel; Ara, Cengiz; Aladağ, Murat; Kutlu, Ramazan; Kırımlıoğlu, Saime Hale; Yılmaz, SezaiObjective. Biliary complications remain a major source of morbidity after living donor liver transplantation (LDLT). Of 109 consecutive right lobe (RL)-LDLTs performed in 1 year in our institution, we present the biliary complications among 106 patients who underwent a new duct-to-duct anastomosis technique known as University of Inonu. Methods. Of 153 liver transplantations performed in 1 year from January to December of 2008, 128 were LDLTs including 109 RL-LDLTs. The others were left or left lateral grafts. All RL-LDLT patients were adults, all of whom except three included a duct-toduct anastomosis. Results. All, but three, biliary reconstructions were completed with a surgical technique, so called UI, in which 6-0 prolene sutures were used. Nine bile leaks were seen in 106 recipients (8.49%) performed in a duct-to-duct fashion in a time period of 1 to 4 weeks. Seventeen patients (16.03%) posed bile duct stricture (BDS). Five patients had both. Although endoscopic stent placement and percutaneous balloon dilatation, 4 patients continued to suffer from BDS on whom a permanent access hepatico-jejunostomy (PAHJ) procedures were performed. Conclusion. We recommend a duct-to-duct biliary reconstruction because of its de facto advantages over other types of anastomosis provided the native duct is not diseased. After almost 2 years, the bile tract complication rate was 22.64%.Öğe Biliary complications in 106 consecutive duct to duct biliary reconstruction in right lobe living donor liver transplantation performed in 1 year in a single center a new surgical technique(Transplant Proc, pp. 0–0, Apr. 2011., 2011) Kırımlıoğlu, Vedat; Tatlı, Faik; İnce, Volkan; Aydın, Cemalettin; Ersan, Veysel; Ara, Cengiz; Aladağ, Murat; Kutlu, Ramazan; Kırımlıoğlu, Hale; Yılmaz, SezaiABSTRACT Objective. Biliary complications remain a major source of morbidity after living donor liver transplantation (LDLT). Of 109 consecutive right lobe (RL)-LDLTs performed in 1 year in our institution, we present the biliary complications among 106 patients who underwent a new duct-to-duct anastomosis technique known as University of Inonu. Methods. Of 153 liver transplantations performed in 1 year from January to December of 2008, 128 were LDLTs including 109 RL-LDLTs. The others were left or left lateral grafts. All RL-LDLT patients were adults, all of whom except three included a duct-toduct anastomosis. Results. All, but three, biliary reconstructions were completed with a surgical technique, so called UI, in which 6-0 prolene sutures were used. Nine bile leaks were seen in 106 recipients (8.49%) performed in a duct-to-duct fashion in a time period of 1 to 4 weeks. Seventeen patients (16.03%) posed bile duct stricture (BDS). Five patients had both. Although endoscopic stent placement and percutaneous balloon dilatation, 4 patients continued to suffer from BDS on whom a permanent access hepatico-jejunostomy (PAHJ) procedures were performed. Conclusion. We recommend a duct-to-duct biliary reconstruction because of its de facto advantages over other types of anastomosis provided the native duct is not diseased. After almost 2 years, the bile tract complication rate was 22.64%.
