Successful separation of thoracopagus conjoined twins with a single extra-hepatic biliary system.

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dc.contributor.authorSaranrittichai, Surachaien_US
dc.contributor.authorNiramis, Rangsanen_US
dc.contributor.authorSiripornadulsilp, Surachaien_US
dc.contributor.authorThianjaruwatthana, Wichianen_US
dc.contributor.authorHompleum, Taninen_US
dc.contributor.authorTipsunthonsak, Nakhonen_US
dc.contributor.authorPulnitiporn, Aksornen_US
dc.contributor.authorVasanawathana, Sirijitten_US
dc.contributor.authorJarupoonphol, Vithyaen_US
dc.date.accessioned2009-05-27T17:55:27Z
dc.date.available2009-05-27T17:55:27Z
dc.date.issued2007-05-29en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractA pair of thoracopagus conjoined twins were separated at the age of 3 months at Khon Kaen Regional Hospital, Thailand on November 19, 2004. Pre-operative investigations showed separate hearts, joined duodenum, and fusion of the livers. Separation of the extra-hepatic biliary systems was suspected. Operative findings revealed fusion of the intestines from the second part of the duodenum to the terminal ileum with two normal colons. An intussusception was found at the terminal ileum. Fusion of the livers with only one extra-hepatic biliary system was noted In one of the twins, the gastrointestinal tract was anastomosed with Roux-en- Y enteric loop to one area of good bile drainage at the cut surface of liver Post operative course was hectic but both twins recovered satisfactorily. Both are doing well at present, two years after the separation. This was the first reported case of thoracopagus conjoined twins with complex biliary tract anomalies in Thailand. From the literature, pre-operative investigations in most cases of these conjoined twins failed to define the precise anatomy of the biliary system and may be misleading as in the presented case. The mortality rate remains high. Meticulous pre-operative planning, decision-making in the operative field and postoperative management as well as a multidisciplinary team are very important for a successful separation.en_US
dc.description.affiliationDepartment of Surgery, Khon Kaen Regional Hospital, Khon Kaen 40000, Thailand. sarans@kknet.co.then_US
dc.identifier.citationSaranrittichai S, Niramis R, Siripornadulsilp S, Thianjaruwatthana W, Hompleum T, Tipsunthonsak N, Pulnitiporn A, Vasanawathana S, Jarupoonphol V. Successful separation of thoracopagus conjoined twins with a single extra-hepatic biliary system. Journal of the Medical Association of Thailand. 2007 May; 90(5): 994-1000en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/38085
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAbnormalities, Multiple --surgeryen_US
dc.subject.meshBiliary Tract --abnormalitiesen_US
dc.subject.meshBiliary Tract Surgical Proceduresen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshIntussusceptionen_US
dc.subject.meshMaleen_US
dc.subject.meshThorax --abnormalitiesen_US
dc.subject.meshTwins, Conjoined --surgeryen_US
dc.titleSuccessful separation of thoracopagus conjoined twins with a single extra-hepatic biliary system.en_US
dc.typeCase Reportsen_US
dc.typeJournal Articleen_US
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