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Choledocholithiasis

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https://www.readbyqxmd.com/read/27904246/noninvasive-imaging-of-the-biliary-system-relevant-to-percutaneous-interventions
#1
REVIEW
Stephen Thomas, Kayleen Jahangir
Clinical data such as history, physical examination, and laboratory tests are useful in identifying patients with biliary obstruction and biliary sources of infection. However, if intervention is planned, noninvasive imaging is needed to confirm the presence, location, and extent of the disease process. Currently, the most commonly available and used noninvasive modalities are ultrasound (US), computed tomography (CT), magnetic resonance (MR), and nuclear medicine hepatobiliary scintigraphy (HIDA). US is quick, portable, readily available, and is commonly the first imaging modality used when biliary pathology is suspected...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27904245/choledocholithiasis-evaluation-treatment-and-outcomes
#2
REVIEW
Christopher Molvar, Bryan Glaenzer
Choledocholithiasis occurs in up to approximately 20% of patients with cholelithiasis. A majority of stones form in the gallbladder and then pass into the common bile duct, where they generate symptoms, due to biliary obstruction. Confirmatory diagnosis of choledocholithiasis is made with advanced imaging, including magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Treatment varies locally; however, ERCP with sphincterotomy is most commonly employed with a high degree of success...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27902955/extrahepatic-biliary-obstrution-secondary-to-neuroendocrine-tumor-of-the-common-hepatic-duct
#3
Faraz A Khan, Anastasia Stevens-Chase, Rahman Chaudhry, Asra Hashmi, David Edelman, Donald Weaver
INTRODUCTION: Primary neuroendocrine tumors (NET) of the extrahepatic biliary tree are a rare entity with less than 100 reported cases in the literature. PRESENTATION OF CASE: Here, we report a case of NET of the extrahepatic bile duct in a 64-year-old male patient presenting with painless jaundice, direct hyperbilirubinemia, and mildly elevated transaminases. Diagnostic workup with an ultrasound revealed dilation of the intrahepatic biliary ducts, without cholelithiasis or choledocholithiasis...
November 23, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27871582/glucagon-induced-hypertensive-emergency-a-case-report
#4
Aron Legler, Richard K Kim, Nikhil Chawla
Glucagon is well acknowledged as a sphincter of Oddi relaxant for both diagnostic and therapeutic uses in choledocholithiasis, and an empiric treatment for β-blocker overdose. Although it has been implicated in inducing cardiovascular crises in patients with asymptomatic pheochromocytoma, adverse effects in other patient populations have not been characterized. This case report describes a patient with hypertension controlled on β blockers who, after glucagon administration during an intraoperative cholangiography, experienced hypertensive emergency despite adequate pain control...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27864721/intraoperative-endoscopic-nasobiliary-drainage-over-primary-closure-of-the-common-bile-duct-for-choledocholithiasis-combined-with-cholecystolithiasis-a-cohort-study-of-211-cases
#5
Pei Yin, Min Wang, Renyi Qin, Jian Zhang, Guangqin Xiao, Haifeng Yu, Zhiqiang Ding, Yahong Yu
BACKGROUND: Endoscopic nasobiliary drainage (ENBD) was often used for preoperative biliary drainage in cases like cholangiocarcinoma or acute obstructive suppurative cholangitis, reports on endoscopic nasobiliary drainage (ENBD) over primary closure of the common bile duct (CBD) are limited. This study compares outcomes of laparoscopic cholecystectomy (LC) + laparoscopic CBD exploration (LCBDE) + intraoperative ENBD + primary closure of CBD with equivalent patients who underwent preoperative endoscopic retrograde cholangiopancreatography (ERCP) and subsequent LC...
November 18, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27857966/endoscopic-versus-laparoscopic-treatment-for-choledocholithiasis-a-prospective-randomized-controlled-trial
#6
Javier Ernesto Barreras González, Rafael Torres Peña, Julián Ruiz Torres, Miguel Ángel Martínez Alfonso, Raúl Brizuela Quintanilla, Maricela Morera Pérez
Background and study aims: Overall, 5 % to 15 % of patients undergoing cholecystectomy for cholelithiasis have concomitant bile duct stones, and the incidence of choledocholithiasis increases with age. There is no clear consensus on the best therapeutic approach (endoscopic versus surgical). Patients and methods: A prospective randomized controlled clinical trial was performed to compare three treatment options for patients with choledocholithiasis at the National Center for Minimally Invasive Surgery in Havana, Cuba from November 2007 to November 2011...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27853743/a-novel-adjunctive-cleansing-method-to-reduce-colony-forming-units-on-duodenoscopes
#7
Karl Kwok, Joseph Chang, Simon Lo, Andrew Giap, Brian Lim, Bechien Wu
Background and study aims: Endoscopic retrograde cholangiopancreatography-related infections are of increasing global concern due to the emergence of multidrug-resistant bacteria such as carbapenem-resistant enterobacteriaceae (CRE), with bacterial biofilm production postulated as one cause of persistent infection from such virulent organisms. Because N-acetylcysteine (NAC) has been shown to possess antibacterial and biofilm-disruption properties, we aimed to evaluate if NAC would demonstrate clinical utility in reducing the colony forming units (CFU) at the elevator end of a duodenoscope, one of the hardest areas to clean...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27834026/timing-of-cholecystectomy-following-endoscopic-sphincterotomy-a-population-based-study
#8
Brett D Mador, Avery B Nathens, Wei Xiong, O Neely M Panton, S Morad Hameed
BACKGROUND: Choledocholithiasis is commonly treated initially with endoscopic sphincterotomy, followed by cholecystectomy to definitively address the underlying problem of cholelithiasis. While the benefits of early cholecystectomy have been realized in other populations, the preferred timing for this subset of patients is less well established. We performed a large, population-based analysis to determine the frequency, benefits, and practice variance in regard to early cholecystectomy on a provincial level...
November 11, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27803901/the-role-of-intraductal-ultrasonography-in-pancreatobiliary-diseases
#9
REVIEW
Bo Sun, Bing Hu
Intraductal ultrasonography (IDUS) provides real-time, cross-sectional imaging of pancreatobiliary ducts and surrounding structures during endoscopic retrograde cholangiopancreatography using a high-frequency ultrasound (US) transducer. Hence, IDUS has been considered a sensitive tool in the evaluation of suspicious choledocholithiasis and neoplasms, to help distinguish between benign and malignant bile duct strictures or wall thickness, and to assess tumor extension and invasion depth. With the rapid development and enriched choices of sensitive diagnostic modalities include but are not limited to endoscopic US, peroral cholangioscopy, and confocal laser endomicroscopy, it is needed to systematically assess the role of IDUS in the investigation of pancreatobiliary diseases...
September 2016: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/27796141/ultrathin-choledochoscope-improves-outcomes-in-the-treatment-of-gallstones-and-suspected-choledocholithiasis
#10
Hong-Tian Xia, Bin Liang, Yang Liu, Tao Yang, Jian-Ping Zeng, Jia-Hong Dong
BACKGROUND: We aimed to compare laparoscopic cholecystectomy (LC) and simultaneous laparoscopic transcystic common bile duct exploration (LTCBDE) using an ultrathin choledochoscope with LC followed by endoscopic retrograde cholangiopancreatography (ERC) and endoscopic sphincterotomy (ES) when indicated. METHODS: We retrospectively reviewed the records of patients seen between 2004 and 2014 and treated with LC+LTCBDE or LC for gallstones and suspected choledocholithiasis...
December 2016: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27795771/-role-of-biliary-mri-in-etiological-diagnosis-of-cholestatic-icteruses-in-dakar
#11
Nfally Badji, Geraud Akpo, Hamidou Deme, Mouhamadou Hamine Toure, Mamadou Ly, Boucar Ndong, El Hadji Niang
Biliary MRI is a relatively new diagnostic test in the arsenal of exploration techniques in biliopancreatic pathology. This is a reproducible and reliable non invasive technique for direct visualization of biliary and pancreatic ducts. This study aims to evaluate the morphological features of major abnormalities and the role of biliary MRI in the etiological diagnosis of cholestatic icteruses. This is a retrospective study of 17 patients conducted in the Imaging Unit of the University Hospital of Fann and of the Principal hospital of Dakar over a period of 4 years and six months (January 2008 at July 2012)...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27780944/the-usefulness-of-early-endoscopic-ultrasonography-in-acute-biliary-pancreatitis-with-undetectable-choledocholithiasis-on-multidetector-computed-tomography
#12
Jae Geun Park, Ki Bae Kim, Joung Ho Han, Soon Man Yoon, Hee Bok Chae, Sei Jin Youn, Seon Mee Park
Background/Aims: EUS can detect bile duct stones (BDS) that are undetectable on multidetector computed tomography (MDCT). BDS associated with acute biliary pancreatitis (ABP) are small and tend to be excreted spontaneously. This study evaluated the usefulness of early EUS in patients with ABP and undetectable BDS on MDCT. Methods: Forty-one patients with ABP and undetectable BDS on MDCT underwent EUS within 24 hours of admission and were diagnosed with BDS, sludge, dilated common bile duct (CBD), or normal CBD...
October 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27759652/clinicopathological-features-of-choledocholithiasis-patients-with-high-aminotransferase-levels-without-cholangitis-prospective-comparative-study
#13
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)
https://www.readbyqxmd.com/read/27755254/risk-factors-associated-with-complications-in-cirrhotic-patients-undergoing-endoscopic-retrograde-cholangio-pancreatography
#14
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
https://www.readbyqxmd.com/read/27730821/spectrum-of-biliary-abnormalities-in-portal-cavernoma-cholangiopathy-pcc-secondary-to-idiopathic-extrahepatic-portal-vein-obstruction-ehpvo-a-prospective-magnetic-resonance-cholangiopancreaticography-mrcp-based-study
#15
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
https://www.readbyqxmd.com/read/27716762/-spontaneous-liver-rupture-in-a-patient-with-choledocholithiasis-resolved-by-ercp
#16
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
https://www.readbyqxmd.com/read/27716756/-sphincterotomy-followed-by-papillary-large-balloon-in-the-management-of-cholecolithiasis-therapeutic-success-and-safety-in-a-lima-peru-hospital
#17
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
https://www.readbyqxmd.com/read/27698730/surgical-treatment-of-incarcerated-calculi-via-laparoscopic-bile-duct-exploration-using-laparotomy-biliary-lithotomy-forceps
#18
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
https://www.readbyqxmd.com/read/27684867/spontaneously-removed-biliary-stent-drainage-versus-t-tube-drainage-after-laparoscopic-common-bile-duct-exploration
#19
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)
https://www.readbyqxmd.com/read/27672728/laparoscopic-transcystic-common-bile-duct-exploration-in-the-elderly-is-as-effective-and-safe-as-in-the-younger-patients
#20
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
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