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https://www.readbyqxmd.com/read/28523137/complex-multimodality-central-airway-management-of-aspergillus-pseudomembranous-tracheobronchitis
#1
Samjot Singh Dhillon, Marwan Saoud, Kassem Harris
A 69-year-old woman developed central airway obstruction due to invasive Aspergillus infection resulting in pseudomembranous tracheobronchitis (PTB). Several challenges were encountered in the airway management of this patient including her having relatively smaller airways which were more prone to obstruction by pseudomembranes and made airway interventions difficult. The patient had clinical deterioration in spite of antifungal therapy and bronchoscopic debridement. The multimodality airway techniques included the use of smaller biliary balloons for dilatation, using a hybrid stent to slowly dilate and maintain patency of right main stem and finally the insertion of right secondary carina peripheral Y stent, which resulted in clinical improvement and allowed time for antifungal therapy to take effect...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28516371/perforated-emphysematous-cholecystitis-managed-by-endoscopic-transpapillary-gallbladder-drainage
#2
Chikara Iino, Tadashi Shimoyama, Takasato Igarashi, Tomoyuki Aihara, Kentaro Ishii, Juichi Sakamoto, Hiroshi Tono, Shinsaku Fukuda
An 88-year-old woman with dementia was diagnosed as having perforated emphysematous cholecystitis with localized peritonitis. Because she was at high risk for surgery, gallbladder drainage was required before surgery. Endoscopic transpapillary gallbladder drainage instead of percutaneous transhepatic biliary drainage was performed because bile could leak from the puncture site to free space around the perforated gallbladder. After the insertion of a nasobiliary drainage tube, the gallbladder was drained and cleaned with saline solution...
May 17, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28515595/percutaneous-transhepatic-techniques-for-management-of-biliary-anastomotic-strictures-in-living-donor-liver-transplant-recipients
#3
Chinmay B Kulkarni, Nirmal K Prabhu, Nazar P Kader, Ramiah Rajeshkannan, Sreekumar K Pullara, Srikanth Moorthy
AIM: To retrospectively analyze the percutaneous transhepatic techniques and their outcome in the management of biliary strictures in living donor liver transplant (LDLT) recipients. MATERIALS AND METHODS: We retrieved the hospital records of 400 LDLT recipients between 2007 and 2015 and identified 45 patients with biliary strictures. Among them, 17 patients (37.8%) (Male: female = 13:4; mean age, 36.1 ± 17.5 years) treated by various percutaneous transhepatic biliary techniques alone or in combination with endoscopic retrograde cholangiopancreatography (ERCP) were included in the study...
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28512648/revision-of-biliary-sphincterotomy-by-re-cut-balloon-dilation-or-temporary-stenting-comparison-of-clinical-outcome-and-complication-rate-with-video
#4
Gianfranco Donatelli, Jean-Loup Dumont, Fabrizio Cereatti, Thierry Tuszynski, Bertrand Marie Vergeau, Bruno Meduri
Background and study aims Revision of endoscopic retrograde cholangiopancreatography (ERCP) may be necessary following previous biliary endoscopic sphincterotomy for recurrent biliary symptoms related to biliary stone recurrence, cholangitis or post-biliary endoscopic sphincterotomy (bEST) papillary stenosis and cholestasis. The aim of this retrospective study was to evaluate the clinical outcome and complication rate associated with re-cut, balloon dilation and biliary metal stenting in revision ERCP. Patients and methods From January 2010 to January 2015, 139 subjects with stigma of a previous sphincterotomy required a revision ERCP (64 Men/75 Women; mean age 71 years; range 32 - 101 years)...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28507752/effective-treatment-of-benign-biliary-strictures-with-a-removable-fully-covered-self-expandable-metal-stent-a-prospective-multicenter-european-study
#5
Arthur Schmidt, Tilman Pickartz, Markus M Lerch, Fabrizio Fanelli, Fausto Fiocca, Pierleone Lucatelli, Fabrizio Cereatti, Albrecht Hoffmeister, Werner van Steenbergen, Matthias Kraft, Benjamin Meier, Karel Caca
BACKGROUND: Temporary placement of removable, fully covered, self-expandable metal stents (fcSEMS) for treatment of benign biliary strictures (BBS) has been reported to be effective. However, the optimal extraction time point remains unclear and stent migration has been a major concern. OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of this treatment modality using an fcSEMS with a special antimigration design and prolonged stent indwell time...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28497648/intrahepatic-cholangiojejunostomy-for-complex-biliary-stenosis-after-pediatric-living-donor-liver-transplantation
#6
Fernando A Alvarez, Rodrigo Sanchez Claria, Juan Glinka, Martin de Santibañes, Juan Pekolj, Eduardo de Santibañes, Miguel A Ciardullo
The treatment of biliary stenosis after pediatric LDLT is challenging. We describe an innovative technique of peripheral IHCJ for the treatment of patients with complex biliary stenosis after pediatric LDLT in whom percutaneous treatment failed. During surgery, the percutaneous biliary drainage is removed and a flexible metal stylet is introduced trough the tract. Subsequently, the most superficial aspect of the biliary tree is recognized by palpation of the stylet's round tip in the liver surface. The liver parenchyma is then transected until the bile duct is reached...
May 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28479493/bilateral-versus-unilateral-placement-of-metal-stents-for-inoperable-high-grade-malignant-hilar-biliary-strictures-a-multicenter-prospective-randomized-study-with-video
#7
Tae Hoon Lee, Tae Hyeon Kim, Jong Ho Moon, Sang Hyub Lee, Hyun Jong Choi, Young Hwangbo, Jong Jin Hyun, Jun-Ho Choi, Seok Jeong, Jong Hyeok Kim, Do Hyun Park, Joung-Ho Han, Sang-Heum Park
BACKGROUND AND AIMS: The efficacy of palliative biliary drainage using bilateral or unilateral self-expandable metal stents (SEMSs) for a malignant hilar biliary stricture (MHS) remains controversial. This prospective, randomized, multicenter study investigated whether bilateral drainage using SEMSs is superior to unilateral drainage in patients with inoperable MHS. METHODS: Patients with inoperable high-grade MHS who underwent palliative endoscopic insertion of bilateral or unilateral SEMSs were enrolled...
May 4, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28477177/unilateral-versus-bilateral-stent-insertion-for-malignant-hilar-biliary-obstruction
#8
Gang Chang, Feng-Fei Xia, Hong-Fu Li, Su Niu, Yuan-Shun Xu
PURPOSE: To determine the clinical efficiency and long-term outcomes between unilateral and bilateral stent insertion in patients with malignant hilar biliary obstruction. METHODS: From August 2012 to February 2016, 63 consecutive patients with malignant hilar biliary obstruction were treated with unilateral or bilateral stent insertion at our center. The bilateral stents were inserted using the side-by-side technique. The clinical efficiency and long-term outcomes were compared between the two groups...
May 5, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28476904/oesophageal-stent-placement-to-treat-a-massive-iatrogenic-duodenal-defect-after-laparoscopic-cholecystectomy
#9
Alissa Greenbaum, Gulshan Parasher, Gerald Demarest, Edward Auyang
Iatrogenic duodenal injury occurring during laparoscopic cholecystectomy (LC) is managed surgically, though rarely a large, persistent fistula is refractory to surgical interventions. We present the case of a 40-year-old woman transferred to our centre following elective LC for a reported perforated duodenal ulcer. An uncontained leak was found to originate from a 1.5 cm duodenal defect, with no evidence of ulceration. A duodenostomy tube was placed. One month after abdominal closure, the patient continued to have a persistent, large duodenal fistula...
May 5, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28475277/a-stepwise-procedure-for-removal-of-an-embedded-self-expandable-metallic-stent-by-dual-knife
#10
Ya-Wei Bi, Zhao-Shen Li, Liang-Hao Hu
Benign biliary stricture (BBS) occurs in 7.3%-30.0% patients with chronic pancreatitis(1, 2) . In the management of BBS, fully covered self-expandable metallic stent (FCSEMS) is currently well used(3-5) . However, proximal migration of FCSEMS occurs in 10.0% recipients and is much more difficult to manage(5) . A 44-year-old man was admitted with abdominal pain and recurred obstructive jaundice a month after removal of last biliary plastic stents. This article is protected by copyright. All rights reserved.
May 5, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28473850/endoscopic-ultrasound-guided-biliary-drainage-using-self-expandable-metal-stent-for-malignant-biliary-obstruction
#11
Lei Lu, Xiaowei Tang, Hangbin Jin, Jianfeng Yang, Xiaofeng Zhang
Purpose. Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been increasingly reported worldwide. However, studies concerning EUS-BD from Mainland China are sporadic. This study aims to investigate the feasibility, efficacy, and safety of EUS-BD using SEMS in a single center from Mainland China. Methods. Between November 2011 and August 2015, 24 patients underwent EUS-BD using a standardized algorithm. Results. Three patients underwent rendezvous technique (RV), 4 underwent hepaticogastrostomy (HGS), and 17 underwent choledochoduodenostomy (CDS)...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28469208/lack-in-standardized-reporting-of-biliary-stents-a-meta-analysis-complicated-by-the-inconsistency
#12
Tsuyoshi Hamada, Ryunosuke Hakuta, Yousuke Nakai, Hiroyuki Isayama, Kazuhiko Koike
No abstract text is available yet for this article.
May 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28469106/in-vitro-dosimetric-study-of-biliary-stent-loaded-with-radioactive-125-i-seeds
#13
Li-Hong Yao, Jun-Jie Wang, Charles Shang, Ping Jiang, Lei Lin, Hai-Tao Sun, Lu Liu, Hao Liu, Di He, Rui-Jie Yang
BACKGROUND: A novel radioactive 125I seed-loaded biliary stent has been used for patients with malignant biliary obstruction. However, the dosimetric characteristics of the stents remain unclear. Therefore, we aimed to describe the dosimetry of the stents of different lengths - with different number as well as activities of 125I seeds. METHODS: The radiation dosimetry of three representative radioactive stent models was evaluated using a treatment planning system (TPS), thermoluminescent dosimeter (TLD) measurements, and Monte Carlo (MC) simulations...
May 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28465092/biliary-plastic-stent-does-not-influence-the-accuracy-of-endoscopic-ultrasound-guided-sampling-of-pancreatic-head-masses-performed-with-core-biopsy-needles
#14
Filippo Antonini, Lorenzo Fuccio, Sara Giorgini, Carlo Fabbri, Leonardo Frazzoni, Marina Scarpelli, Giampiero Macarri
OBJECTIVE: While the presence of biliary stent significantly decreases the accuracy of endoscopic ultrasound (EUS) for pancreatic head cancer staging, its impact on the EUS-guided sampling accuracy is still debated. Furthermore, data on EUS-fine needle biopsy (EUS-FNB) using core biopsy needles in patients with pancreatic mass and biliary stent are lacking. The aim of this study was to evaluate the influence of biliary stent on the adequacy and accuracy of EUS-FNB in patients with pancreatic head mass...
April 15, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28457903/endotherapy-for-bile-leaks-from-isolated-ducts-after-hepatic-resection-a-long-awaited-challenge
#15
Massimiliano Mutignani, Edoardo Forti, Stefanos Dokas, Francesco Pugliese, Paola Fontana, Alberto Tringali, Lorenzo Dioscoridi
BACKGROUND: Bile leakage is a common complication after hepatic resection [1-4] (Donadon et al., 2016; Dechene et al., 2014; Zimmitti et al., 2013; Yabe et al., 2016). Endotherapy is the treatment of choice for this complication except for bile leaks originating from isolated ducts; a condition resembling the post laparoscopic cholecystectomy Strasberg type C lesions [5-9] (Lillemo et al., 2000; Gupta and Chandra, 2011; Park et al., 2005; Colovic, 2009; Mutignani et al., 2002). In such cases, surgical repair is complex, often of uncertain result and with a high morbidity and mortality [1] (Donadon et al...
April 6, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28456898/predictive-value-of-early-skin-rash-in-cetuximab-based-therapy-of-advanced-biliary-tract-cancer
#16
Gábor Rubovszky, Barna Budai, Erna Ganofszky, Zsolt Horváth, Éva Juhos, Balázs Madaras, Tünde Nagy, Eszter Szabó, Tamás Pintér, Erika Tóth, Péter Nagy, István Láng, Erika Hitre
Randomized trials in advanced biliary tract cancer (BTC) did not show benefit of cetuximab addition over chemotherapy. This is probably due to the lack of predictive biomarkers. The aim of this study was to explore possible predictive factors. Between 2009 and 2014, 57 patients were treated in 3-week cycles with cetuximab (250 mg/m(2)/week, loading dose: 400 mg/m(2)), gemcitabine (1000 mg/m(2) on day 1 and 8), and capecitabine (1300 mg/m(2)/day on days 1-14). The objective response rate (ORR), progression-free (PFS) and overall survival (OS) and the adverse events (AEs) were evaluated...
April 29, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/28455159/metal-versus-plastic-stents-for-anastomotic-biliary-strictures-after-liver-transplantation-a-randomized-controlled-trial
#17
Fernanda Prata Martins, Gustavo Andrade De Paulo, Mônica L C Contini, Angelo Paulo Ferrari
BACKGROUND AND AIMS: biliary anastomotic stricture occurs in 15% to 20% of patients after deceased orthotopic liver transplantation (OLT). Usually treated endoscopically with multiple plastic stents (MPSs), although the use of fully covered self-expandable metal stents (cSEMSs) is emerging. This study aims to compare efficacy and safety of cSEMSs versus MPSs in these patients. METHODS: single center, open-label, randomized clinical trial. Patients were randomized to single cSEMSs for 6 months or to MPS placement, exchanged every 3 months during 1 year...
April 25, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28447062/modified-palliative-biliary-stenting-in-situs-inversus-totalis-patient-with-carcinoma-gallbladder-feasibility-and-technical-details
#18
Nishant Gupta, Pradeep Goyal, Itisha Bansal, Shuo Li, Yogesh Kumar, Sanjay S Baijal
Knowledge of the anatomical variants is essential for all invasive hepatobiliary procedures such as endoscopy, surgery and radiologic interventions. Modification in standard therapeutic interventions may be required based on variant anatomy. We report a technical modification in a 75-year-old female with known situs inversus (SI) totalis with carcinoma gallbladder. Present case highlights the finer technical details of the modified percutaneous transhepatic biliary drainage (PTBD) procedure and biliary stenting in a SI patient with carcinoma gallbladder causing malignant biliary obstruction...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28438130/the-safety-and-efficacy-of-percutaneous-intraductal-radiofrequency-ablation-in-unresectable-malignant-biliary-obstruction-a-single-institution-experience
#19
Wei Cui, Wenzhe Fan, Mingjian Lu, Yingqiang Zhang, Wang Yao, Jiaping Li, Yu Wang
BACKGROUND: Patients with unresectable malignant biliary obstruction have limited life expectancy because of limited stent patency and tumor progression. The aim of our study was to retrospectively evaluate the safety and efficacy of combining intraductal RFA with biliary metal stent placement for patients with malignant biliary obstruction. METHODS: Patients who received percutaneous intraductal RFA and biliary stent placement for malignant biliary obstruction between 2013 and 2015 were identified...
April 24, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28428652/percutaneous-stent-placement-for-the-treatment-of-malignant-biliary-obstruction-nitinol-versus-elgiloy-stents
#20
Charles Edouard Zurstrassen, Almir Galvão Vieira Bitencourt, Marcos Duarte Guimaraes, Aline Cristine Barbosa Santos Cavalcante, Chiang Jeng Tyng, Mauricio Kauark Amoedo, João Paulo Kawaoka Matsushita Junior, Janio Szklaruk, Edson Marchiori, Rubens Chojniak
OBJECTIVE: This study aimed to compare two self-expanding stents, a nitinol stent and an elgiloy stent, both placed percutaneously, in terms of their efficacy in palliating inoperable malignant biliary obstruction. MATERIALS AND METHODS: We retrospectively investigated 99 patients with unresectable malignant biliary obstruction treated with percutaneous placement of a self-expanding metallic stent at our institution between May 2007 and January 2010. Serum bilirubin and liver enzyme levels were measured before and 30 days after stenting...
March 2017: Radiologia Brasileira
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