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Perforations ercp

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https://www.readbyqxmd.com/read/28421150/post-ercp-emphysematous-cholecystitis-in-a-young-woman-a-rare-and-potentially-fatal-complication
#1
Roisin Stack, Joseph McLoughlin, Amy Gillis, Barbara M Ryan
A 45-year-old woman with suspected Functional Biliary Sphincter Disorder (FBSD) developed Clostridium perfringens related emphysematous cholecystitis after ERCP. A low index of suspicion for emphysematous cholecystitis in this young, otherwise healthy woman led to a significant delay in making the correct diagnosis, and air in the gallbladder was wrongly attributed to a possible gallbladder perforation. ERCP is associated with significant risks, particularly in patients with FBSD, where diagnostic uncertainty renders the balance of risk versus benefit even more critical...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28381379/clinical-outcomes-of-ercp-related-retroperitoneal-perforations
#2
Francesco Guerra, Giuseppe Giuliani, Diego Coletta, Stefano Amore Bonapasta, Giovanni Battista Levi Sandri
Endoscopic retrograde cholangiopancreatography (ERCP)-related perforations represent rare but often severe conditions. While lesions with intraperitoneal perforation have an almost imperative indication to surgery, whether or not to manage retroperitoneal perforations surgically is still an area of debate. The aim of the present work was to review the available clinical evidence on the operatively and medically treated ERCP-related retroperitoneal perforations. From MEDLINE/PubMed databases 137 patients with retroperitoneal perforation were included from 12 studies that met the selection criteria for data investigation and analysis...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28372447/gallbladder-perforation-after-closed-thoracoabdominal-trauma-diagnosed-and-treated-by-ercp
#3
David Ruiz-Clavijo, María Rullan, Marian Casi, Jesús María Urman
Single gallbladder injury after abdominal trauma is a rare finding. Early diagnosis of this disease is often difficult due to the variability of symptoms and unspecific results in the usual radiological tests. The usual management in patients with vesical trauma is surgery. We report a case of a patient with a gallbladder perforation after closed thoracoabdominal trauma diagnosed and treated with ERCP and a conservative management with good clinical evolution.
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28356912/toothpick-inside-the-common-bile-duct-a-case-report-and-literature-review
#4
V O Brunaldi, M O Brunaldi, R Masagao, C Silva, H Masuda, J E Brunaldi
The incidence and prevalence of foreign body (FB) ingestion are difficult to estimate. Unlike other foreign bodies, the ingestion of a toothpick is very uncommon and carries high morbidity and mortality rates. We report a case of a 73-year-old female patient presenting mid-term epigastric pain. Abdominal ultrasound revealed a slightly dilated common bile duct (CBD) and magnetic resonance showed an irregular filling failure in distal CBD and gallstones. Endoscopic Retrograde Cholangiopancreatography revealed major papilla on the edge of a diverticulum and confirmed the distal filling failure...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28349752/endoscopic-cystic-duct-stent-as-primary-treatment-for-intrahepatic-gallbladder-perforation-with-abscess-formation
#5
P Williams, A Dosani, R Morgan-Jones
Intrahepatic gallbladder perforation with abscess formation is an uncommon presentation of biliary disease. There is no consensus on how to treat this condition, with strategies varying from percutaneous drainage to open cholecystectomy and washout. We present a case of a novel, minimally invasive treatment, using endoscopic retrograde cholangiopancreatography to place a transcystic drain as a bridge to laparoscopic cholecystectomy.
April 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28337482/efficacy-and-safety-of-novel-digital-single-operator-peroral-cholangioscopy-guided-laser-lithotripsy-for-complicated-biliary-stones
#6
John Ct Wong, Raymond Sy Tang, Anthony Yb Teoh, Joseph Jy Sung, James Yw Lau
Background/study aims Laser lithotripsy can effectively fragment complicated biliary stones, but current cholangioscopes are limited by fragility, restricted mobility or moderate visual resolution. The efficacy and safety of a new digital single-operator peroral cholangioscope to guide laser lithotripsy were evaluated. Patients and methods In this prospective single-center series, consecutive patients with complicated biliary stones, defined as impacted stones > 1.5 cm in size and wider than the more distal common bile duct, or stones that failed extraction by basket mechanical lithotripsy, underwent ERCP and SpyGlass DS peroral cholangioscope (Boston Scientific, Marlborough, United States)-guided laser lithotripsy...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28266293/emergency-pancreatico-duodenectomy-with-superior-mesenteric-and-portal-vein-resection-and-reconstruction-using-a-gore-tex-vascular-graft
#7
Mihai Adrian Eftimie, Vasile Lungu, Marian Tudoroiu, Genady Vatachki, Severina Batca, Leonard David
Emergency pancreatico-duodenectomy(EPD) is a very rare procedure and few reports are present in medical literature. It is an uncommon approach, usually used for emergency surgical treatment of abdominal trauma that involves the head of the pancreas or the duodenum, but it is also a surgical tool for the treatment of ruptured aneurysms, bleeding pseudocysts, duodenal perforations, uncontrollable hemorrhage from ulcers and tumors, severe infectious complications of acute pancreatitis or endoscopic retrograde cholangiopancreatography related complications (1,2)...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28181704/evaluation-of-the-safety-of-endoscopic-radiofrequency-ablation-for-malignant-biliary-stricture-using-a-digital-peroral-cholangioscope-with-videos
#8
Takeshi Ogura, Saori Onda, Tastsushi Sano, Wataru Takagi, Astushi Okuda, Akira Miyano, Nobu Nishioka, Miyuki Imanishi, Mio Amano, Daisuke Masuda, Kazuhide Higuchi
OBJECTIVES: The clinical impact of catheter based radiofrequency ablation (RFA) under ERCP guidance has been recently reported, however severe adverse events have also been noted. If tumor is not present in the biliary tract, severe adverse events such as perforation or bleeding due to vessel injury around the biliary tract may occur. In addition, the effectiveness of RFA may not be sufficient based solely on radiographic guidance. The aim of this study was to evaluate the actual feasibility of intraductal RFA by peroral cholangioscope (POCS) evaluation before/after RFA...
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28173939/outcome-and-management-of-endoscopic-retrograde-cholangiopancreatography-perforations-a-community-perspective
#9
Mallory S Bray, Andrew J Borgert, Milan E Folkers, Shanu N Kothari
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) carries a small but significant risk of perforation. Recent data suggest that select patients can be managed non-operatively. We sought to evaluate the management of ERCP perforations at our community medical center. METHODS: ERCPs performed from 2004 to 2015 were reviewed. RESULTS: Twenty-one of 2423 patients who underwent ERCP had a perforation (0.9%). ERCP procedures included balloon sweep with/without sphincterotomy and pancreatic duct stent (71%), common bile duct brushing (10%), and pancreatic duct stenting (5%)...
January 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28127713/optimal-timing-for-a-second-ercp-after-failure-of-initial-biliary-cannulation-following-precut-sphincterotomy-an-analysis-of-experience-at-two-tertiary-centers
#10
Juan Colan-Hernandez, Alexandra Aldana, Mar Concepción, Karina Chavez, Cristina Gómez, Angela Mendez-Bocanegra, Miguel Martínez-Guillen, Oriol Sendino, Càndid Villanueva, Josep Llach, Carlos Guarner-Argente, Andrés Cárdenas, Carlos Guarner
BACKGROUND AND STUDY AIMS: Precut sphincterotomy increases the success of deep biliary cannulation, but the method fails at the initial ERCP in 5-12% of cases. Although other invasive strategies are often used to access the bile duct, a second ERCP may be effective and safe. We evaluated the efficacy, safety, and factors related to a second ERCP after failed cannulation using a precut sphincterotomy. PATIENTS AND METHODS: We reviewed all patients that underwent an ERCP with native papilla from 2006 to 2014 at two tertiary institutions...
January 26, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28054294/treatment-of-common-bile-duct-stones-in-gastric-bypass-patients-with-laparoscopic-transgastric-endoscopic-retrograde-cholangiopancreatography
#11
Nina A Frederiksen, Louise Tveskov, Frederik Helgstrand, Lars Naver, Andrea Floyd
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass excludes the biliary tree from traditional evaluation and treatment with endoscopic retrograde cholangiopancreatography (ERCP). Due to the initial rapid weight loss, gastric bypass patients have an increased risk of developing gallstones in the gallbladder as well as in the common bile duct. Various techniques to access the biliary tree have been described. The techniques are characterised by complexity and varying results. The aim of the present study was to assess both feasibility and outcome of laparoscopic-assisted transgastric ERCP in patients with gastric bypass...
January 4, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28044956/retained-common-bile-duct-lithiasis-at-a-pacient-with-periampullary-duodenal-diverticulum
#12
Ionuţ Simion Coman, Elena-Violeta Radu, Vasile Șandru, Ionuţ Cristinel Bârsan, Cristinel Dumitru Badiu, Gabriel Constantinescu, Valentin Titus Grigorean
Periampullary duodenal diverticula are associated with the presence of common bile duct stones, being encountered more frequently with the increase of age. We present the case of a 76 years old female patient, who underwents emergency surgery for a perforated lithiasic gangrenous acute cholecystitis and for whom we perform a cholecystectomy and an external biliary drainage using a transcystic tube. Both preoperative and postoperative imaging and endoscopic examinations certify the presence of a periampullary duodenal diverticulum...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28039647/a-multicenter-experience-of-through-the-scope-balloon-assisted-enteroscopy-in-surgically-altered-gastrointestinal-anatomy
#13
Jennifer X Cai, David L Diehl, Ralf Kiesslich, Andrew C Storm, Mohamad H El Zein, Alan H Tieu, Arthur Hoffman, Vikesh K Singh, Mouen A Khashab, Patrick I Okolo, Vivek Kumbhari
BACKGROUND: Surgically altered gastrointestinal anatomy poses challenges for deep enteroscopy. Current overtube-assisted methods have long procedure times and utilize endoscopes with smaller working channels that preclude use of standard accessories. A through-the-scope balloon-assisted enteroscopy (TTS-BAE) device uses standard endoscopes with a large working channel to allow metallic and plastic stent insertion. We aim to determine the efficacy and safety of TTS-BAE in patients with altered surgical anatomy...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28027817/management-of-endoscopic%C3%A2-retrograde-cholangiopancreatography-related-perforations-experience-of-a-tertiary-center
#14
Roi Weiser, Niv Pencovich, Liat Mlynarsky, Adi Berliner-Senderey, Guy Lahat, Erwin Santo, Joseph M Klausner, Ido Nachmany
BACKGROUND: Endoscopic retrograde cholangiopancreatography-induced perforation (EP) is a rare but severe complication. We describe the risk factors, management, and outcome of ERCP-induced perforations in a tertiary center. METHODS: This is a case-control study. All EP cases between March 2004 and February 2015 were compared to a control group without perforation. Data on patients, procedures, presentation, perforation type, radiologic findings, management, and outcome were assessed...
April 2017: Surgery
https://www.readbyqxmd.com/read/28002077/successful-conservative-treatment-of-an-elderly-patient-with-an-ercp-related-duodenal-perforation-associated-with-widespread-subcutaneous-emphysema
#15
Xiaoqing Li, Qinghai Peng, Qiongying Zhang, Yi Liu, Zhiqiang Du, Chunhui Wang
No abstract text is available yet for this article.
December 19, 2016: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/27997966/double-guidewire-technique-in-difficult-biliary-cannulation-for-the-prevention-of-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis
#16
Frances Tse, Yuhong Yuan, Paul Moayyedi, Grigorios I Leontiadis, Alan N Barkun
Background and study aims Difficult cannulation is a risk factor for pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP). The double-guidewire technique (DGT) may improve cannulation success and reduce the risk of post-ERCP pancreatitis (PEP) in patients with difficult cannulation. This systematic review compared the DGT with persistent conventional cannulation or other advanced techniques in patients with difficult cannulation. Patients and Methods CENTRAL, MEDLINE, EMBASE, and CINAHL databases and DDW and UEGW abstracts up to March 2016 were searched for randomized controlled trials (RCTs) comparing DGT with persistent conventional cannulation or other advanced techniques (precut, pancreatic duct [PD] stenting)...
January 2017: Endoscopy
https://www.readbyqxmd.com/read/27988287/endoscopic-multiple-biopsy-and-rapid-diagnosis-by-in-situ-fixation-and-histopathologic-processing
#17
David S Zimmon, Fred B Smith, Forrest Manheimer, Cathy Fan, Chantel Njiwaji, Sergei Aksenov, Premtesh Chattoo
BACKGROUND AND AIMS: Endoscopic forceps biopsy and fixation are laborious and prolong the procedure and anesthesia. Multiple biopsy overcomes these shortcomings with a single endoscope pass that cuts, like a needle biopsy, up to 25 biopsy samples of uniform size and depth during endoscope withdrawal. Biopsy specimens are collected in acquisition order and stored in a perforated plastic storage chamber within the perforated metal tip. The tip is cut off, immersed in fixative, and sent to pathology...
December 15, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27981828/management-of-post-ercp-complications
#18
David J Desilets
ERCP has the highest risk of complication of any endoscopic procedure routinely performed by gastroenterologists or surgeons. Adverse events are inevitable when performing ERCP, and one must learn to manage these appropriately when they occur. One avenue to successful a outcome after a complication of ERCP is to follow the "5R model" of management: recognize, react, reach out, repent, and revisit. Several case studies are used as examples of intervention after complication, especially after retroperitoneal perforation...
December 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27932176/intrahepatic-artery-pseudoaneurysm-induced-hemobilia-caused-by-a-plastic-biliary-stent-after-abo-incompatible-living-donor-liver-transplantation-a-case-report
#19
J M Chun, H T Ha, Y Y Choi, Y J Hwang, J Heo, H K Ryeom, Y S Han
Bile leakage after duct-to-duct anastomosis in living-donor liver transplantation (LDLT) can mostly be managed by therapeutic endoscopic retrograde cholangiopancreatography. Following this, various complications such as biliary infection, pancreatitis, perforation, and bleeding can occur, and endoscopic sphincterotomy is primarily associated with post- endoscopic retrograde cholangiopancreatography bleeding; other causes have been published in case reports. In the present case, a plastic biliary stent used for treating liver abscesses and leakage at the bile duct anastomosis site after ABO-incompatible LDLT resulted in an intrahepatic artery pseudoaneurysm and hemobilia, which were managed by angiography and coil embolization...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931640/the-role-of-surgery-in-the-treatment-of-endoscopic-complications
#20
REVIEW
Peter Dixon, Gopal C Kowdley, Steven Clark Cunningham
As the number, diversity, and complexity of endoscopic complications has increased, so too has the number, diversity, and complexity of operative interventions required to treat them. The most common complications of endoscopy in general are bleeding and perforation, but each endoscopic modality has specific nuances of these and other complications. Accordingly, this review considers the surgical complications of endoscopy by location within the gastrointestinal tract, as opposed to by complication types, since there are many complication types that are specific for only one or few locations, such as buried-bumper syndrome after percutaneous endoscopic gastrostomy and pancreatitis after endoscopic retrograde cholangiopancreatography, and since the management of a given complication, such as perforation, may be vastly different in one area than in another area, such as perforations of the esophagus versus the retroperitoneal duodenum versus the intraperitoneal duodenum...
October 2016: Best Practice & Research. Clinical Gastroenterology
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