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Choledocholithiasis

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https://www.readbyqxmd.com/read/28547873/can-clinical-factors-predict-the-need-for-intervention-after-positive-intraoperative-cholangiogram
#1
Mohammed Kaif, Deepak Agrawal, Jayaprakash Sreenarasimhaiah
BACKGROUND/AIMS: Intraoperative cholangiogram (IOC) is commonly used to detect retained bile duct stones. This often leads to another invasive procedure such as endoscopic retrograde cholangiopancreatography (ERCP). However, due to the variation in methods and results of IOC, it is unclear if clinical factors will aid in identifying true choledocholithiasis. METHODS: All cholecystectomies in a 3 year period were examined retrospectively for positive IOC. Sonographic bile duct dilation and transaminase levels at admission including trends during the course of hospitalization and prior to ERCP were evaluated...
May 26, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28534552/-perforations-following-endoscopic-retrograde-cholangiopancreatography-ercp
#2
J Mateo Retuerta, C Chaveli Díaz, A Goikoetxea Urdiain, B Sainz Villacampa, M J Sara Ongay, J J Íñigo Noain
Endoscopic retrograde cholangiopancreatography (ERCP) associated with sphincterotomy is a useful procedure that is widely used in cases of choledocholithiasis and bile duct obstruction. In spite of being a safe test, there is a risk of complications like pancreatitis, haemorrhaging or perforation. Post-ERCP duodenal perforation is a rare event but has serious consequences if it is not treated early. The lesion mechanism, the place and extension of the perforation, as well as the clinical picture and radiographic findings will guide patient management, which must be individualised and constantly reevaluated...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28520653/transenteric-ercp-for-treatment-of-choledocholithiasis-after-duodenal-switch
#3
João C D Marchesini, Rafael W Noda, Vitor M Haida, Rodrigo C D L Medeiros, Silvano Sadowski, Manoel Galvão Neto, João B Marchesini, Josemberg M Campos
This article aims to describe step-by-step technique performed with the aid of a video. We report the performance of an endoscopic approach to the biliary tract on 2 patients who had previously undergone duodenal switch (DS). It was successfully performed a laparoscopic-assisted transenteric endoscopic retrograde cholangiopancreatography (ERCP) in both the patients. Although successful experiences with ERCP after Roux-en-Y gastric bypass have been found, few cases of ERCP after DS have been reported. Nevertheless, this is the first study to include a multimedia video with description of details and all technical steps of the transenteric ERCP performed on 2 patients who had previously undergone DS...
May 17, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28520575/predictors-of-bile-tree-pathology-in-patients-presenting-with-gallbladder-disease
#4
Mahmoud A Rahal, Mohammad O Rammal, Walid Karaoui, Ali Hallal, Hani Tamim, Yasser Shaib
BACKGROUND: Patients with gallstone disease can present with elevated liver function tests (LFTs). It is often challenging to differentiate those with a common bile duct (CBD) stone from those without a CBD stone on the basis of the LFTs levels. In this study, we aim to evaluate the predictors of a CBD stones among patients presenting with symptomatic gallbladder disease and elevated LFTs. PATIENTS AND METHODS: We retrospectively examined all patients who had undergone a cholecystectomy between January 2010 and December 2015...
May 17, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28496540/recombinant-factor-viia-use-for-endoscopic-retrograde-cholangiopancreatography-with-sphincterotomy-in-a-patient-with-choledocholithiasis-and-unusual-coagulopathy
#5
Molham Abdulsamad, Pavithra Reddy, Suvarna Guvvala, Anil Dev
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that combines the use of endoscopy and fluoroscopy to diagnose and treat pancreaticobiliary disorders. The risks of ERCP include pancreatitis, infection, bleeding and perforation. Bleeding during ERCP typically develops after sphincterotomy, hence patients should be screened and tested for coagulopathy before undergoing ERCP. Coagulopathy is a major risk factor for ERCP-related bleeding. Inherited factor VII (FVII) deficiency is a rare autosomal recessive hemorrhagic disorder that can lead to significant coagulopathy and severe bleeding if not appropriately recognized and treated preoperatively...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28493164/the-model-for-end-stage-liver-disease-predicts%C3%A2-outcomes-in-patients-undergoing-cholecystectomy
#6
Scott C Dolejs, Joal D Beane, Joshua K Kays, Eugene P Ceppa, Ben L Zarzaur
BACKGROUND: The magnitude of risk for patients undergoing cholecystectomy with high model for end-stage liver disease (MELD) scores is poorly understood. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2013 was used to study patients undergoing cholecystectomy. Patients were excluded if they had choledocholithiasis or preoperative dialysis. Bivariate data analysis was performed and logistic regression modeling was conducted to calculate risk-adjusted 30-day outcomes...
May 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28493162/single-setting-endoscopic-retrograde-cholangiopancreatography-ercp-and-cholecystectomy-improve-the-rate-of-surgical-site-infection
#7
Michele M Loor, Jean Dominique Morancy, James K Glover, Gregory J Beilman, Catherine L Statz
INTRODUCTION: Cholecystectomy is a common surgical procedure. The presence of common bile duct stones complicates treatment, often requiring a second procedure for stone retrieval. For such patients, endoscopic retrograde cholangiopancreatography (ERCP) provides adequate therapy, and can be performed before, after, or at the same time as cholecystectomy. In 2013, duodenoscopes were implicated by the Centers for Disease Control and Prevention in transmission of carbapenem-resistant Enterobacteriaceae...
May 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28474701/-cholelithiasis-during-pregnancy-and-postpartum-prevalence-presentation-and-consequences-in-a-referral-hospital-in-baja-california-sur
#8
Andrea Socorro Álvarez-Villaseñor, Héctor Luis Mascareño-Franco, José Juan Agundez-Meza, Francisco Cardoza-Macías, Clotilde Fuentes-Orozco, Jorge Rendón-Félix, Mariana Chávez-Tostado, Leire Irusteta-Jiménez, Jesús García-Rentería, Alejandro González-Ojedaz
INTRODUCTION: Pregnancy and the postpartum period are risk factors for developing biliary sludge, gallstones, and any of their complications. OBJECTIVE: To determine the prevalence, presentation, and consequences of cholestasis during pregnancy and postpartum in a referral hospital of Baja California Sur. MATERIAL AND METHODS: This was a retrospective, observational study that enrolled pregnant or postpartum patients diagnosed with gallstones with any presentation...
March 2017: Gaceta Médica de México
https://www.readbyqxmd.com/read/28425658/endoscopic-management-of-acute-cholangitis-as-a-result-of-common-bile-duct-stones
#9
Mohan Ramchandani, Partha Pal, D Nageshwar Reddy
Acute cholangitis is infectious disease of the biliary system and potentially can cause significant morbidity and mortality. With advances in intensive care, antibiotic therapy advances and endoscopic and other modalities of biliary drainage, mortality rates have significantly come down of late. Although most cases respond to antibiotics alone, definitive therapy is required later in most of the patients. Increased biliary pressure leads to biliovenous reflux of bacteria and purulent bile into the circulation leading to systemic inflammation and sepsis with subsequent organ dysfunction...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28414680/a-rare-cause-of-abdominal-pain
#10
E M Dauchy, M Modica, N Masri
CASE: A 54 year old woman with hypothyroidism presented with right flank pain that began acutely one week prior to presentation. She was told initially she had a urinary tract infection and treatment resulted in mild symptomatic improvement. The pain returned and she presented to another Emergency Department (ED); and was told the pain was due to constipation. She returned to the ED the next day when her pain worsened and her labs were notable for WBC of 19,000/uL, BUN/Cr of 28/0.75 mg/dL, AST of 31 U/L, ALT of 92 U/L and total bilirubin of 0...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28409371/dynamic-analysis-of-commonly-used-biochemical-parameters-to-predict-common-bile-duct-stones-in-patients-undergoing-laparoscopic-cholecystectomy
#11
Stéphane Bourgouin, Xavier Truchet, Gatien Lamblin, Jérôme De Roulhac, Jean-Philippe Platel, Paul Balandraud
BACKGROUND: The prediction of persistent common bile duct stones (CBDS) in patients during choledocholithiasis crisis is challenging. We developed a model based on the course over time of commonly used biochemical parameters to reduce the rate of unnecessary endoscopic cholangiopancreatography (ERCP) and the risk of perioperative discovery of CBDS. METHODS: Medical charts of patients who presented between 2010 and 2015 for symptomatic gallstone disease with suspected choledocholithiasis were reviewed and compared according to the presence/absence of CBDS on preoperative ERCP or during cholecystectomy...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28409369/laparoscopic-surgery-for-choledocholithiasis-concomitant-with-calculus-of-the-left-intrahepatic-duct-or-abdominal-adhesions
#12
Yueqi Wang, Xiaobo Bo, Yaojie Wang, Min Li, Sheng Shen, Tao Suo, Hongtao Pan, Han Liu, Houbao Liu
BACKGROUND: Laparoscopic common bile duct exploration (LCBDE) has been widely promoted in recent years as a safe and effective treatment for choledocholithiasis. However, there are no standard guidelines for the treatment of patients who have concomitant hepatolithiasis of the left liver and abdominal adhesions. The aim of the current research was to compare the outcomes of open versus laparoscopic common bile duct exploration with left hepatectomy (OCBDH vs. LCBDH) in patients with choledocholithiasis concomitant with left-sided hepatolithiasis, and to evaluate the safety and feasibility of laparoscopic surgery for choledocholithiasis in patients with abdominal adhesions...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28402704/endoscopic-papillary-large-balloon-dilation-versus-endoscopic-sphincterotomy-for-retrieval-of-large-choledocholithiasis-a-prospective-randomized-trial
#13
Mohammed A Omar, Mohamed Abdelshafy, Mohamed Yousef Ahmed, Asmaa Gaber Rezk, Abdallah M Taha, Hamdy M Hussein
BACKGROUND: Endoscopic sphincterotomy (ES) is the standard technique for common bile duct (CBD) stone removal. Recently, endoscopic papillary large balloon dilation (EPLBD) has been shown to be a safe and effective technique for the removal of large CBD stone. The aim of this study was to determine the therapeutic outcomes and safety of EPLBD compared with ES for large CBD stone extraction. PATIENTS AND METHODS: One hundred twenty-four patients with large bile duct stones were randomized into two groups, the first group included 61 patients subjected to EPLBD and the second group included 63 patients who underwent ES...
April 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28360977/endoscopic-retrograde-cholangiopancretography-in-modified-double-tracks-anastomosis-with-anastomotic-stenosis
#14
Xiao-Song Wang, Fei Wang, Quan-Peng Li, Lin Miao, Xiu-Hua Zhang
A 63-year-old man presented at our hospital with right upper abdomen pain and fever for 4 d. The patient's magnetic resonance cholangiopancreatography revealed dilated common bile duct and choledocholithiasis. In his past history, he received proximal gastrectomy and modified double tracks anastomosis. Endoscopic retrograde cholangiopancretography in modified double tracks anastomosis, especially accompanied with anastomotic stenosis, has been rarely reported. In the present case, the duodenoscope was successfully introduced over the guidewire and the stone taken out using a basket...
March 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28359270/preliminary-experience-with-laparoscopic-common-bile-duct-exploration
#15
Asaad F Salama, Mohamed E Abd Ellatif, Hesham Abd Elaziz, Alaa Magdy, Hisham Rizk, Magdy Basheer, Wisam Jamal, Ibrahim Dawoud, Ayman El Nakeeb
BACKGROUND: Herein we present our experience with laparoscopic common bile duct exploration (LCBDE) in managing common bile duct stones. METHODS: Data of 129 consecutive patients who underwent laparoscopic cholecystectomy (LC) and LCBDE done at our institutes from April 2011 through June 2016 were prospectively recorded and retrospectively reviewed. RESULTS: Since 2011, 3012 laparoscopic cholecystectomy were performed at our institutes, intraoperative cholangiogram (IOC) was done in 295 (9...
March 31, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28350202/outcomes-of-laparoscopic-cholecystectomy-for-biliary-dyskinesia-in-children
#16
Sarah W Lai, Steven S Rothenberg, Saundra M Kay, Kristin E Shipman, Bethany J Slater
PURPOSE: To determine the outcomes of laparoscopic cholecystectomy as a treatment for biliary dyskinesia in children. METHODS: With ethics approval, a retrospective chart review was performed on children (<21 years) at a single center diagnosed with biliary dyskinesia (defined as gallbladder ejection fraction [EF] <35% and/or pain with cholecystokinin [CCK] on cholescintigraphy, in the absence of gallstones or cholecystitis on ultrasound) and treated with laparoscopic cholecystectomy between March 2010 and February 2016...
March 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28337833/acute-cholangitis-current-concepts
#17
REVIEW
David Lan Cheong Wah, Christopher Christophi, Vijayaragavan Muralidharan
BACKGROUND: Acute cholangitis, also known as ascending cholangitis, is a life-threatening systemic condition that results from a biliary tree infection and obstruction. Severe acute cholangitis was reported to have a mortality rate between 11 and 27% in the 1990s. This article is a literature review about acute cholangitis. Its aim is to review the latest literature about acute cholangitis and to discuss its pathogenesis, clinical presentation, diagnosis, prognosis, risk factors and treatment...
March 24, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28337485/safety-and-efficacy-of-minimal-biliary-sphincterotomy-with-papillary-balloon-dilation-m-ebs-epbd-in-patients-using-clopidogrel-or-anticoagulation
#18
Shaffer R S Mok, Murtaza Arif, David L Diehl, Harshit S Khara, Henry C Ho, Adam B Elfant
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (EBS) or endoscopic papillary balloon dilation (EPBD) are common techniques of biliary decompression. Potential risks include gastrointestinal hemorrhage, which can be increased by antiplatelet agents, anticoagulants (AC) and/or novel oral anticoagulants (NOACs) (ie. apixaban, dabigatran and rivaroxaban). The study aim is to evaluate the safety/efficacy of an alternative technique, minimal-EBS plus EPBD (m-EBS + EPBD), in individuals for whom clopidogrel, AC, and/or NOACs cannot be interrupted due to high cardiovascular or thromboembolic risk...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28317046/a-rare-case-of-choledochal-cyst-with-pancreas-divisum-case-presentation-and-literature-review
#19
Adrián Ransom-Rodríguez, Ruben Blachman-Braun, Emilio Sánchez-García Ramos, Jesús Varela-Prieto, Erick Rosas-Lezama, Miguel Ángel Mercado
Choledochal cysts are rare congenital malformations of the bile duct characterized by dilatations of the intrahepatic and/or extrahepatic portion of the biliary tree, they are associated to an anomalous arrangement of the pancreaticobiliary duct. Pancreas divisum results from a fusion failure of the pancreatic buds. The coexistence of pancreas divisum and choledochal cyst in adults has been reported in less than 10 well documented cases. This article presents a case of a 42-year-old Peruvian man with intermittent episodes of abdominal pain, initially diagnosed with choledocholithiasis, who underwent open cholecystectomy...
February 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28301778/risk-stratified-versus-non-risk-stratified-diagnostic-testing-for-management-of-suspected-acute-biliary-obstruction-comparative-effectiveness-costs-and-the-role-of-mr-cholangiopancreatography
#20
Stella K Kang, David Hoffman, Bart Ferket, Michelle I Kim, R Scott Braithwaite
Purpose To analyze the cost effectiveness of the American Society for Gastrointestinal Endoscopy (ASGE) risk stratification guidelines versus magnetic resonance (MR) cholangiopancreatography-based treatment of patients with possible choledocholithiasis. Materials and Methods A decision-analytic model was constructed to compare cost and effectiveness of three diagnostic strategies for gallstone disease with possible choledocholithiasis: noncontrast MR cholangiopancreatography, contrast material-enhanced MR imaging/MR cholangiopancreatography, and ASGE risk stratification guidelines for diagnostic evaluation recommending endoscopy (high risk), MR cholangiopancreatography (intermediate risk), or no test (low risk)...
March 16, 2017: Radiology
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