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Choledocholithiasis

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https://www.readbyqxmd.com/read/28425658/endoscopic-management-of-acute-cholangitis-as-a-result-of-common-bile-duct-stones
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28279776/outcomes-of-laparoscopic-vs-open-common-bile-duct-exploration-analysis-of-the-nsqip-database
#13
Hamzeh M Halawani, Hani Tamim, Farah Khalifeh, Aurélie Mailhac, Ali Taher, Jamal Hoballah, Faek R Jamali
BACKGROUND: Common bile duct exploration (CBDE) is one of the available options in the management of choledocholithiasis. We aim to analyze outcomes comparing the laparoscopic and open approach to CBDE using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. STUDY DESIGN: This is a retrospective cohort study of patients undergoing CBDE from year 2008 to 2013 using ACS NSQIP database. The cohort was split into 2 groups and compared based on the operative approach, laparoscopic versus open CBDE...
March 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28275221/magnetic-resonance-mr-cholangiopancreatography-demonstration-of-the-cystic-duct-entering-the-right-hepatic-duct
#14
Tommaso D'Angelo, Sergio Racchiusa, Silvio Mazziotti, Giuseppe Cicero
BACKGROUND MR cholangiopancreatography is widely performed before laparoscopic cholecystectomy to rule out choledocholithiasis and to avoid iatrogenic injuries that may be related to the high frequency of anatomical variations of the biliary tree. Although most of these variants have already been demonstrated surgically and by endoscopic retrograde cholangiopancreatography and CT cholangiography, there are no references in which MR cholangiopancreatography has shown a cystic duct draining into the right hepatic biliary duct...
March 9, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28273606/an-impressive-choledochal-cyst-and-its-surgical-resection
#15
Nhu Thao Nguyen Galván, Kayla Kumm, Dor Yoeli, Ellen Witte, Michael Kueht, Ronald Timothy Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
INTRODUCTION: Choledochal cysts are rare congenital dilations of the biliary tree that can present with non-specific symptoms such as abdominal pain, jaundice, cholelithiasis and pancreatitis. Although most commonly identified in children, they can be found in the adult population. However, because of the non-specific symptoms, this diagnosis may be difficult to make in the adult. A physician therefore must keep this diagnosis within their differential, as it may arise in an unexpected patient population who may present with a convoluted work up...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28262629/-results-of-cholecystectomies-2003-2010-in-a-small-hospital-in-iceland
#16
Marta Ros Berndsen, Fritz Hendrik Berndsen
AIM: Cholecystectomy is a common procedure in general surgery. The aim of this study was to retrospectivly assess the results of cholecystectomies performed in Akranes Hospital (AH), a small hospital in Iceland. MATERIAL AND METHODS: This retrospective study included all patients that underwent a cholecystectomy in AH from 1 January 2003 to 31 December 2010. Patient records were reviewed from AH, as well as from Landspitali University Hospital and Domus Medica. RESULTS: 378 operations were performed...
2017: Læknablađiđ
https://www.readbyqxmd.com/read/28261698/pediatric-cholecystectomy-for-symptomatic-gallstones-unrelated-to-hematologic-disorder
#17
Sang Gyun Suh, Yoo-Shin Choi, Kwi-Won Park, Seung Eun Lee
BACKGROUNDS/AIMS: Gallstones are being increasingly diagnosed in pediatric patients. The purpose of this study was to determine characteristics of pediatric patients who underwent cholecystectomy because of symptomatic gallstone disease unrelated to hemolytic disorder. METHODS: We reviewed cases of pediatric patients (under 18 years old) who underwent cholecystectomy between May 2005 and December 2015. RESULTS: A total 20 pediatric patients (under 18 years old) underwent cholecystectomy during the study period...
November 2016: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28241408/sensitivity-and-specificity-of-magnetic-resonance-cholangiopancreatography-versus-endoscopic-ultrasonography-against-endoscopic-retrograde-cholangiopancreatography-in-diagnosing-choledocholithiasis-the-indonesian-experience
#18
Dadang Makmun, Achmad Fauzi, Hamzah Shatri
Background/Aims: Biliary stone disease is one of the most common conditions leading to hospitalization. In addition to endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS) and magnetic resonance cholangiopancreatography (MRCP) are required in diagnosing choledocholithiasis. This study aimed to compare the sensitivity and specificity of EUS and MRCP against ERCP in diagnosing choledocholithiasis. Methods: This retrospective study was conducted after prospective collection of data involving 62 suspected choledocholithiasis patients who underwent ERCP from June 2013 to August 2014...
February 28, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28240505/gallbladder-duplication-masquerading-as-a-dilated-common-bile-duct-with-choledocholithiasis
#19
S Mewa Kinoo, R Naidoo, K Maharaj, B Singh
A duplicate gall bladder was diagnosed at laparoscopy, having been erroneously diagnosed on ultrasonography as a dilated common bile duct with choledocholithiasis. Gallbladder duplication is a congenital abnormality with a rare incidence, occuring in approximately 1 in 4 000 births and 0.020% in al large autopsy series. This report highlights its existence to improve awareness and lessen the potential for biliary injury.
June 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28240036/diagnosis-and-management-of-patients-with-an-intermediate-probability-of-choledocholithiasis
#20
José Alberto González González, Roberto Monreal Robles
We thank Dr. Dib for his interest in our prospective study, in which we assessed the accuracy of the American Society for Gastrointestinal Endoscopy guidelines for the prediction of choledocholithiasis (CL). The guidelines suggest the option of using a less-invasive initial test including endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) in patients with intermediate probability of CL. However, there is a paucity of published literature supporting this recommendation. Furthermore, in the study by Adams et al...
February 27, 2017: Revista Española de Enfermedades Digestivas
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