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Cheal Wung Huh, Sung Ill Jang, Beom Jin Lim, Hee Wook Kim, Jae Keun Kim, Jun Sung Park, Ja Kyung Kim, Se Joon Lee, Dong Ki Lee
Common bile duct (CBD) stones are generally associated with greater elevations of alkaline phosphatase and gamma-glutamyl transpeptidase levels than aspartate aminotransferase and alanine aminotransferase levels. However, some patients with CBD stones show markedly increased aminotransferase levels, sometimes leading to the misdiagnosis of liver disease. Therefore, the aim of this study was to investigate the clinicopathologic features of patients with CBD stones and high aminotransferase levels.This prospective cohort study included 882 patients diagnosed with CBD stones using endoscopic retrograde cholangiopancreatography (ERCP)...
October 2016: Medicine (Baltimore)
Ricardo U Macías-Rodríguez, Astrid Ruiz-Margáin, Jose L Rodriguez-Garcia, Sergio Zepeda-Gómez, Aldo Torre
OBJECTIVE: Endoscopic retrograde cholangio-pancreatography (ERCP) is useful for the management of biliary tract diseases; in patients with cirrhosis, portal hypertension may increase the risk for complications from ERCP. We evaluated the outcome and risk factors related to ERCP in patients with cirrhosis and portal hypertension. PATIENTS AND METHODS: In this case-control study, 37 patients (71 procedures) with cirrhosis and portal hypertension (group 1) and 37 controls (group 2) undergoing ERCP were included...
October 14, 2016: European Journal of Gastroenterology & Hepatology
Shumyla Jabeen, Irfan Robbani, Naseer A Choh, Obaid Ashraf, Feroze Shaheen, Tariq Gojwari, Sabeeha Gul
OBJECTIVE: To characterize biliary abnormalities seen in portal cavernoma cholangiopathy (PCC) on Magnetic Resonance Cholangiopancreaticography(MRCP) and elucidate certain salient features of the disease by collaborating our findings with those of previous studies. METHODS: We prospectively enrolled 52 patients with portal cavernoma secondary to idiopathic Extrahepatic portal vein obstruction(EHPVO) who underwent a standard MRCP protocol. Images were analysed for abnormalities involving the entire biliary tree...
October 12, 2016: British Journal of Radiology
Jesús A Bahena-Aponte, Guillermo Ramírez de Aguilar, Juan Carlos Torres Carrillo, Luis Espino Urbina, Jesús A Sánchez González
We present the case of a 34 years old female patient who presents with abdominal pain and elevated total and direct bilirrubins, so she underwent ERCP Reporting: a) successful sphincterotomy without complications, b) choledocholithias is endoscopically resolved, c) secondary cholangitis. She developed significant abdominal pain at 72 h, with hypovolemic shock and peritoneal irritation. She was taken to the surgery, finding a grade III liver laceration. This one was resolved with liver raffia and packing, during the same operative time cholecystectomy was performed...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Jorge Espinoza-Ríos, Miluska Aliaga Ramos, Jenny Rodríguez Borda, Eduardo Miraval Wong, Arturo Zegarra Chang, Eduar Bravo Paredes, Ricardo Prochazka Zárate
OBJECTIVE: We present a descriptive analysis of our cases of sphincterotomy followed by papillary large balloon dilation in a single session (ES-LBD) in the management of difficult to extract calculi, with the objective of assessing rates of therapeutic success and complications in local experience. MATERIAL AND METHODS: ERCP procedures with ES-LBD performed for choledocholithiasis between January 2009 and December 2014 in patients older than 18 years and without preexistent sphincterotomy were selected from records of the Gastroenterology Service at Cayetano Heredia National Hospital...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
H Jiang, S Y Wang, X L Jin, J C Jin, H B Gu, F M Zhang
The present study aimed to investigate the practicability and clinical value of applying laparotomy biliary lithotomy forceps to laparoscopic bile duct exploration (LCBDE) for the surgical treatment of incarcerated calculi. A total of 63 patients were diagnosed with cholecystolithiasis and choledocholithiasis. The present study performed a retrospective analysis of clinical samples from 16 of these patients who had incarcerated calculi at the terminus of the common bile duct, and who had been treated with laparoscopic cholecystectomy and LCBDE...
October 2016: Experimental and Therapeutic Medicine
Yakun Xu, Chengyong Dong, Kexin Ma, Fei Long, Keqiu Jiang, Ping Shao, Rui Liang, Liming Wang
Several studies have shown the safety and feasibility of laparoscopic common bile duct exploration (LCBDE) as a minimally invasive treatment options for choledocholithiasis. Use of T-tube or biliary stent drainage tube placement after laparoscopic choledochotomy for common bile duct (CBD) stones is still under debate. This study tried to confirm the safety of spontaneously removable biliary stent in the distal CBD after LCBDE to allow choledochus primary closure. A total of 47 patients with choledocholithiasis underwent LCBDE with primary closure and internal drainage using a spontaneously removable biliary stent drainage tube (stent group, N = 22) or T-tube (T-tube group, N = 25)...
September 2016: Medicine (Baltimore)
Jie-Gao Zhu, Wei Guo, Wei Han, Zhong-Tao Zhang
BACKGROUND: Choledocholithiasis represents a greater proportion of gallstone in the elderly. Elderly patients have more comorbidity, which could increase the operative risk and postoperative complications. However, no study has focused on the effect and safety of laparoscopic transcystic common bile duct exploration (LTCBDE) in elderly patients. The aim of this study was to investigate whether LTCBDE can be performed effectively and safely in elderly patients. METHODS: This is a retrospective study of patients who underwent LTCBDE for choledocholithiasis performed from January 2010 to December 2012...
September 27, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Qian Feng, Yong Huang, Kai Wang, Rongfa Yuan, Xiaoli Xiong, Linquan Wu
PURPOSE: The ideal treatment for choledocholithiasis should be simple, readily available, reliable, minimally invasive and cost-effective for patients. We performed this study to compare the benefits and drawbacks of different laparoscopic approaches (transcystic and choledochotomy) for removal of common bile duct stones. METHODS: A systematic search was implemented for relevant literature using Cochrane, PubMed, Ovid Medline, EMBASE and Wanfang databases. Both the fixed-effects and random-effects models were used to calculate the odds ratio (OR) or the mean difference (MD) with 95% confidence interval (CI) for this study...
2016: PloS One
Roberto Gómez, Yousef Allaoua, Rafael Colmenares, Sergio Gil, Pilar Roquero, José M Ramia
AIM: To evaluate all the references about primary gallbladder hidatidosis looking for best treatment evidence. METHODS: Search: 1966-2015 in MEDLINE, Cochrane Library, SciELO, and Tripdatabase. KEY WORDS: "gallabladder hydatid disease" and "gallbladder hydatid cyst". We found 124 papers in our searches but only 14 papers including 16 cases were about hydatid cyst of the gallbladder (GBHC). RESULTS: Eight cases of GBHC were women and seven men...
September 8, 2016: World Journal of Hepatology
Hyoung-Chul Oh
Bilioenteric anastomosis strictures are a serious complication of biliary surgery, and often result in recurrent cholangitis, choledocholithiasis, biliary cirrhosis, and hepatic failure. Bilioenteric reconstructive surgery is the standard treatment of choice for such complications. However, percutaneous transhepatic cholangioscopy (PTCS), also known as per-oral endoscopic-guided intervention, is a less invasive procedure that is becoming an increasingly popular alternative. This review describes the PTCS procedure (including the preparation process), as well as the diagnostic and therapeutic role of PTCS in bilioenteric anastomosis strictures...
September 19, 2016: Clinical Endoscopy
Jingu Kang, Kyu-Hyun Paik, Jong-Chan Lee, Hyoung Woo Kim, Jongchan Lee, Jin-Hyeok Hwang, Jaihwan Kim
BACKGROUND/AIMS: For the suspected choledocholithiasis, the American Society for Gastrointestinal Endoscopy has proposed guidelines to assign risk based on clinical predictors. The study aimed to assess the usefulness of clinical predictors of choledocholithiasis set forth by the guidelines in patients with intermediate risk of choledocholithiasis. METHODS: In 2014, 109 patients with intermediate risk of choledocholithiasis underwent endoscopic ultrasound. Their medical records were retrospectively reviewed...
September 17, 2016: Digestion
John Baillie, Pier-Alberto Testoni
No abstract text is available yet for this article.
October 2016: Gastrointestinal Endoscopy
Jian-Shan Cai, Sun Qiang, Yin Bao-Bing
Gallstone disease is a common and frequently occurring disease in human, and it is the main disease among the digestive system diseases. The incidence of gallstone disease in western countries is about 5%-22%, and common bile duct stones (CBDS) accounts for 8%-20%. CBDS easily lead to biliary obstruction, secondary cholangitis, pancreatitis, and obstructive jaundice, even endanger life. Therefore, it needs timely treatment once diagnosed. The recurrence of choledocholithiasis after bile duct stones clearance involves complicated factors and cannot be completely elaborated by a single factor...
September 9, 2016: Scandinavian Journal of Gastroenterology
Min Wang, Xu He, Chuan Tian, Jian Li, Feng Min, Hong-Yan Li
Background. In order to assess the diagnostic accuracy of linear EUS for evaluating clinically suggestive CBD stones in high-risk groups. Methods. 202 patients with clinically suggestive CBD stones in high-risk groups who underwent linear EUS examination between January 2012 and January 2015 were retrospectively reviewed. Endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction or surgical choledochoscopy was only performed when a CBD stone was detected by linear EUS. Cases that were negative for CBD stones were followed up for at least 6 months...
2016: Gastroenterology Research and Practice
Kishore Rajaguru, Siddharth Mehrotra, Shailendra Lalwani, Vivek Mangla, Naimish Mehta, Samiran Nundy
BACKGROUND: Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis, characterized by a focal or diffuse destructive inflammatory process. The importance of XGC is that it mimics gall bladder carcinoma (GBC) both preoperatively and intra-operatively, as it can present with pericholecystic infiltration, hepatic involvement and lymphadenopathy. As a result of a misdiagnosis, which is not infrequent, the patient may undergo an unnecessary radical cholecystectomy rather than only a cholecystectomy, which is associated with a greater morbidity and mortality...
September 6, 2016: ANZ Journal of Surgery
Antonio Navarro-Sánchez, Hutan Ashrafian, Juan José Segura-Sampedro, Alberto Martrinez-Isla
BACKGROUND: Laparoscopic bile duct exploration (LBDE) is recommended in current treatment guidelines for the management of choledocholithiasis with gallbladder in situ. Failure of this technique is common as a consequence of large or impacted common bile duct (CBD) stones. In this series, we present our experience in using holmium laser lithotripsy as an adjunct to LBDE for the treatment of choledocholithiasis. METHODS: Between 2014 and 2016, eighteen laparoscopic bile duct explorations utilising holmium laser lithotripsy were performed after failure of standard retrieval techniques...
August 29, 2016: Surgical Endoscopy
Michael W Wandling, Eric S Hungness, Emily S Pavey, Jonah J Stulberg, Ben Schwab, Anthony D Yang, Michael B Shapiro, Karl Y Bilimoria, Clifford Y Ko, Avery B Nathens
Importance: There are currently 2 widely accepted treatment strategies for patients presenting to the hospital with choledocholithiasis. However, the rate of use for each strategy in the United States has not been evaluated, and their trends over time have not been described. Furthermore, an optimal management strategy for choledocholithiasis has yet to be defined. Objective: To evaluate secular trends in the management of choledocholithiasis in the United States and to compare hospital length of stay between patients with choledocholithiasis treated with endoscopic retrograde cholangiopancreatography with laparoscopic cholecystectomy (ERCP+LC) vs laparoscopic common bile duct exploration with laparoscopic cholecystectomy (LCBDE+LC)...
August 24, 2016: JAMA Surgery
Rutger Quispel, Lydi M W J van Driel, Bart J Veldt, Paul M M van Haard, Marco J Bruno
BACKGROUND AND STUDY AIM: Endoscopic ultrasonography (EUS) is an established diagnostic modality for diagnosing common bile duct (CBD) stones. Its use has led to a reduction in the number of endoscopic retrograde cholangiopancreatography (ERCP) procedures performed for suspected choledocholithiasis. We aimed to explore the role of EUS in detecting CBD stones and/or sludge in common gastroenterology practice. PATIENTS AND METHODS: We reviewed case records of 268 consecutive patients who underwent (EUS) procedures performed to confirm or rule out the presence of CBD stones and/or sludge between November 2006 and January 2011 in the Reinier de Graaf Hospital, Delft, The Netherlands, which is a nonacademic community hospital...
August 23, 2016: European Journal of Gastroenterology & Hepatology
Feng Shen, Timothy M Pawlik
No abstract text is available yet for this article.
August 24, 2016: JAMA Surgery
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