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Alberto Aiolfi, Emanuele Asti, Emanuele Rausa, Daniele Bernardi, Gianluca Bonitta, Luigi Bonavina
BACKGROUND: Trans-oral endoscopic access to the pancreaticobiliary system is challenging after Roux-en-Y gastric bypass (RYGB). Trans-gastric ERCP (TG-ERCP) has emerged as a viable option to manage patients with symptomatic post-RYBG choledocolithiasis. The aim of this systematic review and meta-analysis was to examine the outcomes of TG-ERCP to better define the risk-benefit ratio of this procedure and to guide clinical decision-making. METHODS: A literature search was conducted to identify all reports on ERCP after RYGB...
April 23, 2018: Obesity Surgery
Aldo Bove, Raffaella Maria Di Renzo, Gino Palone, Domenica Testa, Valentina Malerba, Giuseppe Bongarzoni
While laparoscopic cholecystectomy is generally accepted as the treatment of choice for simple gallbladder stones, in cases in which common bile duct stones are also present, clinical and diagnostic elements, along with intraoperative findings, define the optimal means of treatment. All available options must be accessible to the surgical team which must necessarily be multidisciplinary and include a surgeon, an endoscopist, and a radiologist in order to identify the best option for a truly personalized surgery...
2018: Therapeutics and Clinical Risk Management
Takao Itoi, Shomei Ryozawa, Akio Katanuma, Yoshinobu Okabe, Hironori Kato, Jun Horaguchi, Takayoshi Tsuchiya, Takuji Gotoda, Naotaka Fujita, Kenjiro Yasuda, Yoshinori Igarashi, Kazuma Fujimoto
The Japan Gastroenterological Endoscopy Society has developed the 'EPLBD Clinical Practice Guidelines' as fundamental guidelines based on new scientific techniques. EPLBD is a treatment method that has recently become widely used for choledocolithiasis. The evidence level in this field is usually low, and in many instances, the recommendation grading has to be determined on the basis of expert consensus. At this point, the guidelines are divided into the following six sections according to the 'EST Clinical Practice Guidelines': (i) Indications, (ii) procedures, (iii) special cases, (iv) procedure-related adverse events, (v) treatment outcomes, and (vi) postoperative follow up observation...
May 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Eda Albayrak, Fitnet Sonmezgoz, Zafer Ozmen, Fatma Aktas, Aysegul Altunkas
A 26-year-old female patient with Type 1 Gaucher's disease (GD) was admitted to our clinic with complaints of stomachache and signs of anemia. The patient underwent ultrasonography (US), computerised tomography (CT), and magnetic resonance imaging (MRI) scan. Imaging studies revealed massive hepatosplenomegaly, choledocolithiasis, and six nodules in the spleen with a mean size of 14 mm. The nodules appeared hyperechoic, hypoechoic, and of mixed echogenicity on the US and hypodense on the CT. While the nodules were observed to be iso-hypointense in T1-weighted (T1WI) images, they appeared to be hyperintense in the T2-weighted (T2WI) images...
October 2017: Malaysian Journal of Medical Sciences: MJMS
Oktay Karaköse, Mehmet Zafer Sabuncuoğlu, Mehmet Fatih Benzin, Girayhan Çelik, Mahmut Bülbül, Hüseyin Pülat
In cases where the dissection of Calot's triangle is difficult during laparoscopic cholecystectomy, laparoscopic partial cholecystectomy is an alternative to total cholecystectomy to prevent bile duct damage. However, recurrent symptoms and bile duct problems associated with the remaining gallbladder tissue may develop in patients over time. The case of a 45-year-old male who underwent laparoscopic partial cholecystectomy one year previously is presented here. In the postoperative period, as a result of tests for the continuing symptoms of cholecystitis, stones and surrounding abscess were detected in the remaining gallbladder tissue, so open completion cholecystectomy was applied...
2017: Turkish Journal of Surgery
Efstathios Karamanos, Kenji Inaba, Regan J Berg, Shelby Resnick, Obi Okoye, Sophoclis Alexopoulos, Konstantinos Chouliaras, Demetrios Demetriades
BACKGROUND: Aging has been associated with increasing common bile duct (CBD) diameter and reported as independently predictive of the likelihood of choledocolithiasis. These associations are controversial with uncertain diagnostic utility in patients presenting with symptomatic disease. The current study examined the relationship between age, CBD size, and the diagnostic probability of choledocolithiasis. METHODS: Symptomatic patients undergoing evaluation for suspected choledocolithiasis from January 2008 to February 2011 were reviewed...
2017: Digestive Surgery
Luis Barreda Cevasco, Javier Targarona Modena, Juan Carlos Marcos Enriquez, Carlos Arroyo Basto, Elizabeth Morón
OBJECTIVE: Describe the clinical and tomographic characteristics in relation to the extra peritoneal distribution of collections and air in patients with periampullary perforation after performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy. MATERIALS AND METHODS: Observational, descriptive study in patients with periampullary perforation after ERCP with or without sphincterotomy, treated in the Pancreas Surgery Service at Edgardo Rebagliati Martins Hospital, Lima, Peru between January 2013 and January 2015...
January 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Neha R Malhotra, Carlos Amir Esparza Monzavi, Jean-Sebastien Trepanier, Johan Nordenstam, Michael R Abern
Our patient presented with dysuria and pneumaturia without any prior urologic instrumentation. History included choledocolithiasis requiring endoscopic retrograde cholangiopancreatography and biliary stenting. Imaging showed a large bladder stone. The patient was taken to surgery and found to have diverticulitis. The sigmoid was resected and the bladder was found to have a small fistula tract. The bladder was opened and a large calculus was identified and extracted. The stone was opened and found to contain a biliary stent...
March 18, 2017: Urology
Esther Merino Rodríguez, Susana Rebolledo Olmedo, Joaquín Miquel Plaza
The bacterium Raoultella planticola (R planticola) is a rare pathogen in humans. We report a case of mild acute pancreatitis (MAP) of biliary origin with cholangitis and bacteremia with R planticola in association with pancreatic panniculitis (PP). We present the case report of a 55-year-old woman.
June 2017: Revista Española de Enfermedades Digestivas
Armando Rosales-Velderrain, Fuad Alkhoury
INTRODUCTION: Modifications to conventional laparoscopic cholecystectomy are aimed to decrease abdominal pain and improve cosmetic results. Single-port robotic cholecystectomy is a safe and feasible approach that has been reported in adults, though reports are limited in children. This study aims to report our experience with single-port robotic cholecystectomy in children, and to evaluate the safety, feasibility, and outcomes of this approach. METHODS: After single-port robotic approach was available at our institution, we prospectively followed our patients who underwent a single-port robotic cholecystectomy from March 2013 to May 2015 in our children's hospital...
April 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ben Schwab, Deborah M Rooney, Eric S Hungness, Katherine A Barsness
PURPOSE: Laparoscopic common bile duct exploration (LCBDE) decreases overall costs and length of stay in patients with choledocolithiasis. However, utilization of LCBDE remains low. We sought to evaluate a previously developed general surgery LCBDE simulator among a cohort of pediatric surgical trainees. The study purpose was to evaluate the content validity of an LCBDE simulator to support or refute its use in pediatric surgery education. MATERIALS AND METHODS: After IRB exempt determination, 30 participants performed a transcystic LCBDE using a previously developed simulator and evaluated the simulator using a self-reported 28-item instrument...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Mousalreza Hosseini, Payman Shalchiantabrizi, Khadijeh Yektaroudy, Maliheh Dadgarmoghaddam, Masoumeh Salari
BACKGROUND: Acute Post ERCP Pancreatitis (PEP) is the most common major complication of Endoscopic retrograde cholangiopancreatography (ERCP). The aim of the current study was to assess the utility of single dose rectal indomethacin with and without  intravenous perfusion of normal saline to prevent acute pancreatitis. METHODS: In this randomized clinical trial, 406 patients with choledocolithiasis underwent ERCP. Based on computer-generated  numbers, the patients were allocated into 4 groups, each group receiving a different intervention prior to the ERCP procedure...
August 2016: Archives of Iranian Medicine
Kemal Beksac, Nihan Turhan, Ergun Karaagaoglu, Osman Abbasoglu
INTRODUCTION: Although laparoscopic cholecystectomy is currently the standard treatment for benign gallbladder pathologies, some cases still require conversion to open cholecystectomy. Since open cholecystectomy has a significantly higher morbidity rate and a lengthier stay in the hospital compared with laparoscopic surgery, predicting this conversion would grant a great advantage in the management of cholecystitis. Therefore, in this study, we aimed to develop a predictive statistical model...
September 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Chadli Dziri, Imen Samaali, Samia Ben Osman, A Fingerhut, Riadh Bédoui, Youssef Chaker, Ibtissem Bouasker, Ramzi Nouira
BACKGROUND: The ideal way to show treatment effectiveness is through randomized controlled trials the 'gold standard' in evidence-based surgery. Indeed, not all surgical studies can be designed as randomized trials, sometimes for ethical and otherwise, for practical reasons. This article aimed to compare laparoscopic cholecystectomy to open cholecystectomy, according to data from an administrative database, managed by a propensity matched analysis. METHODS: Were included all patients with cholelithiasis admitted in Department B between June 1st, 2008 and December 31st, 2009...
August 2015: La Tunisie Médicale
Ali Riza Koksal, Salih Boga, Huseyin Alkim, Mehmet Bayram, Meltem Ergun, Canan Alkim
BACKGROUND AND AIMS: The relationship between insulin resistance and post-ERCP pancreatitis (PEP) is not known. We aimed to determine the relation between pre-ERCP insulin resistance and risk of PEP, and to evaluate the relationship of insulin resistance with well-established risk factors for PEP. METHODS: Consecutive patients who underwent ERCP with the diagnosis of choledocolithiasis between January and December 2013 were enrolled in this prospective study. Pre-procedural insulin resistance state and other risk factors were evaluated according to PEP development...
August 2016: Digestive Diseases and Sciences
Chadli Dziri, Imen Samaali, Samia Ben Osman, A Fingerhut, Riadh Bédoui, Youssef Chaker, Ibtissem Bouasker, Ramzi Nouira
BACKGROUND: The ideal way to show treatment effectiveness is through randomized controlled trials the 'gold standard' in evidence-based surgery. Indeed, not all surgical studies can be designed as randomized trials, sometimes for ethical and otherwise, for practical reasons. This article aimed to compare laparoscopic cholecystectomy to open cholecystectomy, according to data from an administrative database, managed by a propensity matched analysis. METHODS: Were included all patients with cholelithiasis admitted in Department B between June 1st, 2008 and December 31st, 2009...
August 2015: La Tunisie Médicale
R N Bălănescu, L Bălănescu, G Drăgan, A Moga, R Caragaţă
Although biliary lithiasis has been considered a less common pathology in the pediatric population than in adults, in recent years, it has increasingly been diagnosed in children, with a prevalence of between 0.13 to 0.22. The elective treatment of symptomatic biliary lithiasis is cholecystectomy, the laparoscopic approach being considered the œgold standard. We present 3 cases referred to our clinic with biliary lithiasis, in which we performed laparoscopic cholecystectomy. We performed intraoperative cholangiography with a 4 Fr transcystic catheter...
November 2015: Chirurgia
Hassan Taheri, Naser Ghemian, Yaser Taghavi, Javad Shokry-Shirani
BACKGROUND: Cholangiocarcinoma is an invasive biliary malignancy with poor prognosis. Diagnostic accuracy of conventional methods is low which is mainly due to the specific anatomy of the disease. The aim of this study was to evaluate the diagnostic value of biochemical profile and tumor marker of the bile in patients with malignant cholestasis compared to that of choledocholithiasis. METHODS: In this cross-sectional study, 46 patients with extrahepatic cholestasis were enrolled (20 patients with malignant cholestasis and 26 patients with choledocolithiasis) A definitive diagnosis of cholangiocarcinoma was made by imaging, cytology and biopsy...
2015: Caspian Journal of Internal Medicine
Joana Tozatti, André Luiz Parizi Mello, Orli Frazon
BACKGROUND: The choledocolithiasis has an incidence of 8-20% in patients with cholecystolithiasis. The preoperative diagnosis guides the interventional treatment on the bile duct AIM: To evaluate the sensitivity and specificity of the laboratory markers and imaging studies for choledocholithiasis preoperatively. METHODS: The study comprised 254 patients divided into two groups: the control group (207 patients), patients without choledocholithiasis intraoperatively and cases group (47 patients), that enrolled the patients with choledocholithiasis intra-operatively...
April 2015: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Martín Guidi, Hui Jer Hwang, Cecilia Curvale, Gonzalo Souto, Julio De María, Fernando Ragone, Esteban Promenzio, Raúl Matano
INTRODUCTION: The American Society of Gastroenterology (ASGE) and the American College of Gastroenterolog (ACG) have established indicators to recognize high-quality studies in endoscopic retrograde cholagiopancreatography (ERCP). The indicators were: a) Pre-procedure: adequate indication, informed consent, assessment of the degree of difficulty of the procedure and antibiotic prophylaxis. b) Intraprocedure: cannulation, choledocholithiasis extraction and stents placement rates. c) Postprocedure: full documentation and complications rates...
March 2015: Acta Gastroenterologica Latinoamericana
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