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Malignant biliary

A Laliotis, T Hettiarachchi, F Rashid, A Hindmarsh, V Sujendran
Surgical management of oesophageal and gastro-oesophageal junction malignancies is one of the most challenging situations confronting the surgeon. Attaining a complete circumferential resection margin of lower-third oesophageal and gastro-oesophageal junction locally advanced carcinomas requires en-bloc resection of the hiatus and all the peri-oesophageal tissue and pleura. This results in an increased risk of herniation of the abdominal organs through the enlarged hiatus, which carries significant risk of morbidity and mortality...
August 16, 2018: Annals of the Royal College of Surgeons of England
Sung Hyun Kim, Dai Hoon Han, Gi Hong Choi, Jin Sub Choi, Kyung Sik Kim
BACKGROUND: Intrahepatic cholangiocarcinoma is a malignancy of the intrahepatic biliary tree. Although surgical resection is the mainstay of treatment for this tumor, the impact of lymph node dissection during hepatectomy is controversial. In this study, we evaluated the impact of lymph node dissection during surgical resection for intrahepatic cholangiocarcinoma. METHODS: Records from 170 patients who underwent radical hepatectomy for intrahepatic cholangiocarcinoma from January 2000 to December 2014 were retrospectively reviewed...
August 15, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Wei Qin, Pengcheng Kang, Yi Xu, Kaiming Leng, Zhenglong Li, Lining Huang, Jianjun Gao, Yunfu Cui, Xiangyu Zhong
Cholangiocarcinoma (CCA) arising from the neoplastic transformation of cholangiocytes with increasing incidence in the worldwide. Unfortunately, a large amount of CCA patients lost their chance for surgery because it is hard to diagnose in the early stages. Long non-coding RNAs (lncRNAs) is closely associated with development and progression of various malignant tumors. Hox transcript antisense intergenic (HOTAIR), a negative prognostic factor for patients with gastric, liver and pancreatic carcinoma. Its transcription levels and functional roles in CCA is still unknown...
August 15, 2018: Scientific Reports
Xin Wu, Binglu Li, Chaoji Zheng, Xiaoyan Chang, Taiping Zhang, Xiaodong He, Yupei Zhao
Objective Intraductal papillary neoplasm of the bile duct (IPNB) has been increasingly recognized and reported. However, its clinical features are still controversial because of its low incidence. In the present study, we investigated the characteristics of IPNB. Methods In total, 28 patients with IPNB were treated at our institution from January 2000 to December 2016. Clinical data were collected and a retrospective accurate database was constructed. Demographic characteristics, perioperative management, and prognosis were retrospectively analyzed...
August 15, 2018: Journal of International Medical Research
Riccardo Inchingolo, Stavros Spiliopoulos, Massimiliano Nestola, Michele Nardella
Background Distinction between benign and malignant biliary obstruction is always challenging. Purpose To evaluate outcomes of percutaneous transluminal biopsy of biliary strictures using a dedicated forceps system. Material and Methods This prospective, single-center, single-arm study, included 29 consecutive patients (17 men [56.6%]; mean age = 60 ± 9 years), who underwent 30 transluminal biopsies during percutaneous transhepatic biliary drainage (PTBD) due to obstructive jaundice, between September 2014 and January 2017, using a transluminal biliary access and biopsy forceps set...
August 15, 2018: Acta Radiologica
Vladimir M Kushnir, Daniel K Mullady, Koushik Das, Gabriel Lang, Thomas G Hollander, Faris M Murad, Sara A Jackson, Nicole A Toney, Sydney D Finkelstein, Steven A Edmundowicz
BACKGROUND: Routine cytology of biliary stricture brushings obtained during endoscopic retrograde cholangiopancreatography (ERCP) has suboptimal sensitivity for malignancy. We compared the individual and combined ability of cytology, fluorescence in situ hybridization (FISH) analysis and PCR-based mutation profiling (MP) to detect malignancy in standard biliary brushings. METHODS: We performed a prospective study of patients undergoing ERCP using histology or 1 year follow-up to determine patient outcomes...
August 13, 2018: Journal of Clinical Gastroenterology
Jianan Chen, Yan Yu, Xiaolong Chen, Yuting He, Qiuyue Hu, Hongqiang Li, Qicai Han, Fang Ren, Juan Li, Chao Li, Jie Bao, Zhigang Ren, Zhenfeng Duan, Guangying Cui, Ranran Sun
OBJECTIVES: Gallbladder carcinoma (GBC) is the most highly aggressive cancer of biliary tract, but effective therapeutics are lacking. Emerging evidence has unveiled that miR-139-5p is aberrantly downregulated in cancers, including GBC. However, the functions and mechanisms of miR-139-5p in GBC remain unclear. MATERIALS AND METHODS: MiR-139-5p-overexpression was established in GBC cell lines, after which cell proliferation, migration, invasion, colony formation, and glucose metabolism were assayed in vitro...
August 13, 2018: Cell Proliferation
Oliver Beetz, Michael Klein, Harald Schrem, Jill Gwiasda, Florian W R Vondran, Felix Oldhafer, Sebastian Cammann, Jürgen Klempnauer, Karl J Oldhafer, Moritz Kleine
BACKGROUND: Distal cholangiocarcinoma (DCC) is a rare but over the last decade increasing malignancy and is associated with poor prognosis. According to the present knowledge curative surgery is the only chance for long term survival. This study was performed to evaluate prognostic factors for the outcome of patients undergoing curative surgery for distal cholangiocarcinoma. METHODS: 75 patients who underwent surgery between January 2000 and December 2014 for DCC in curative intention were analysed retrospectively...
August 13, 2018: BMC Surgery
Stephen P Pereira, Mark Jitlal, Marian Duggan, Emma Lawrie, Sandy Beare, Pam O'Donoghue, Harpreet S Wasan, Juan W Valle, John Bridgewater
Background: Endobiliary stenting is standard practice for palliation of obstructive jaundice due to biliary tract cancer (BTC). Photodynamic therapy (PDT) may also improve biliary drainage and previous small studies suggested survival benefit. Aims: To assess the difference in outcome between patients with BTC undergoing palliative stenting plus PDT versus stenting alone. Methods: 92 patients with confirmed locally advanced or metastatic BTC, ECOG performance status 0-3 and adequate biliary drainage were randomised (46 per group) to receive porfimer sodium PDT plus stenting or stenting alone...
2018: ESMO Open
Ja Yoon Heo, Hee Seung Lee, Jun Hyuk Son, Sang Hyub Lee, Seungmin Bang
PURPOSE: Endoscopic bile duct decompression using bilateral self-expandable metallic stents (SEMSs) deployed via a stent-in-stent (SIS) method is considered a preferred procedure for malignant hilar biliary obstruction (MHBO). However, occlusion thereof occurs frequently. Here, we investigated stent patency duration and risk factors related to stent obstruction with bilateral SIS placement for MHBO at two large centers. MATERIALS AND METHODS: The present study reviewed data on patients with MHBO who underwent endoscopic biliary drainage using the SIS method...
September 2018: Yonsei Medical Journal
Jean-Marc Dumonceau, Andrea Tringali, Ioannis S Papanikolaou, Daniel Blero, Benedetto Mangiavillano, Arthur Schmidt, Geoffroy Vanbiervliet, Guido Costamagna, Jacques Devière, Jesús García-Cano, Tibor Gyökeres, Cesare Hassan, Frédéric Prat, Peter D Siersema, Jeanin E van Hooft
ESGE recommends against routine preoperative biliary drainage in patients with malignant extrahepatic biliary obstruction; preoperative biliary drainage should be reserved for patients with cholangitis, severe symptomatic jaundice (e. g., intense pruritus), or delayed surgery, or for before neoadjuvant chemotherapy in jaundiced patients. Strong recommendation, moderate quality evidence. ESGE recommends the endoscopic placement of a 10-mm diameter self-expandable metal stent (SEMS) for preoperative biliary drainage of malignant extrahepatic biliary obstruction...
August 7, 2018: Endoscopy
Jun Hyuk Son, Hee Seung Lee, Sang Hyub Lee, Seungmin Bang, Jinwoo Kang, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim
BACKGROUND: Endoscopic biliary decompression using bilateral self-expandable metallic stent (SEMS) placed using the stent-in-stent (SIS) technique is considered favorable for unresectable malignant hilar biliary obstruction (MHBO). However, occlusion of the bilateral SIS placement is frequent and revision can be challenging. This study was performed to investigate the efficacy, the long-term patency and the appropriate approach for revision of occluded bilateral SIS placement in unresectable MHBO...
July 26, 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Iman Khaoudy, Olivier Farges, Emmanuel Boleslawski, Eric Vibert, Olivier Soubrane, Mustapha Adham, Jean Yves Mabrut, Laurent Christophe, Philippe Bachellier, Olivier Scatton, Yves-Patrice Le Treut, Jean Marc Regimbeau
OBJECTIVE: To perform a retrospective root-cause analysis of the causes of postoperative mortality after hepatectomy. BACKGROUND: Mortality after liver resection has not decreased over the past decade. METHODS: The study population was a prospective cohort of hepatectomies performed at hepatic, pancreatic, and biliary (HPB) centers between October 2012 and December 2014. Of the 1906 included patients, 90 (5%) died within 90 days of surgery...
August 3, 2018: Annals of Surgery
Sana Chams, Skye El Sayegh, Mulham Hamdon, Sarwan Kumar, Vesna Tegeltija
BACKGROUND: Acute pancreatitis is an acute inflammation of the pancreas that varies in severity from mild to life threatening usually requiring hospitalization. The true incidence of drug-induced pancreatitis (DIP) is indeterminate due to the inadequate documentation of case reports of DIP. Here we present the case of amoxicillin/clavulanic acid-induced pancreatitis in a previously healthy male after excluding all other causes of pancreatitis. CASE PRESENTATION: A 58-year-old Caucasian man presenting for acute sharp abdominal pain with associated nausea and heaves...
August 2, 2018: BMC Gastroenterology
Finnur Mellemgaard, Rune B Strandby, Julie Blockmann, Steen C Kofoed, Lars B Svendsen, Michael P Achiam
INTRODUCTION: Single-operator cholangioscopy (SOC) is increasingly used for evaluation of the biliary tree following endoscopic retrograde cholangiopancreaticography (ERCP). This study aimed to determine the visual and histological success rates of SOC at a single Danish tertiary referral centre. METHODS: All patients undergoing SOC between 2008 and 2015 were retrospectively included from a prospectively maintained database. Patient characteristics and proced-ure-related variables were obtained from medical records...
August 2018: Danish Medical Journal
Omar Abughanimeh, Ayman Qasrawi, Mohannad Abu Omar, Waled Bahaj, Mouhanna Abu Ghanimeh
Multiple myeloma (MM) is a common hematological malignancy that represents 1% of all cancers. MM is distinguished from other plasma cell disorders by prominent bone marrow involvement and systemic organ damage. Extramedullary plasmacytomas of the gall bladder (GB) or biliary ducts, whether solitary or in association with MM, are very rare. We report a case of a 66-year-old female with a history of refractory MM who presented with right upper quadrant abdominal pain. Her laboratory evaluation revealed an abnormal liver panel and lactic acidosis...
May 25, 2018: Curēus
Terumi Kamisawa, Yoh Zen, Takahiro Nakazawa, Kazuichi Okazaki
Autoimmune pancreatitis is an unusual form of pancreatitis that is histologically characterised by a massive infiltration of lymphocytes and IgG4-positive plasma cells and storiform fibrosis. The disease is recognised as a pancreatic manifestation of IgG4-related disease. IgG4-related sclerosing cholangitis is a biliary counterpart that is typically associated with autoimmune pancreatitis. Two parallel immunological responses are thought to underlie the pathophysiology of these diseases: a pro-inflammatory, tissue-destructive process and an anti-inflammatory feedback response, which probably relates to IgG4 production...
August 2018: Lancet. Gastroenterology & Hepatology
Wei Chen, Xiang-Ming Fang, Xuan Wang, Sanjeev Kumar Pitla Sudarshan, Xiao-Yun Hu, Hong-Wei Chen
PURPOSE: To evaluate the clinical efficacy of percutaneous trans-hepatic integrated 125I seed stents implantation for malignant lower biliary tract obstruction. METHODS: Thirty-two patients with malignant lower biliary obstruction were randomly divided into two groups. One group underwent the therapy with integrated 125I seed stents (Test group, n = 13), and another group received conventional metal stents implantation for treatment (Control group, n = 19). The pre- and post-operative changes in biochemical indices, white blood cell count, IgG level, stent patency, survival time, tumor size and complications were compared between the two groups...
July 19, 2018: Journal of X-ray Science and Technology
Kazunari Nakahara, Yosuke Michikawa, Ryo Morita, Keigo Suetani, Nozomi Morita, Junya Sato, Kensuke Tsuji, Hiroki Ikeda, Kotaro Matsunaga, Tsunamasa Watanabe, Nobuyuki Matsumoto, Shinjiro Kobayashi, Takehito Otsubo, Fumio Itoh
BACKGROUND: A new device with metallic wires for scrape cytology was developed. AIMS: To compare the diagnostic performance of scrape cytology and conventional cytology during endoscopic retrograde cholangiopancreatography for biliary strictures. METHODS: A total of 420 cases with biliary stricture underwent transpapillary bile cytology. Among them, there are 79 cases with scrape cytology using the new device (scrape group) and 341 cases with conventional cytology (control group)...
July 23, 2018: Digestive Diseases and Sciences
Anna Evdokimova, Stanislas Laurent, Laurent Dorthu
We present an atypical case of a 69-year-old woman with recurrent episodes of acute pancreatitis and a background history of mucinous colorectal adenocarcinoma. It is emphasized that in the framework of biliary malignant obstruction, modern non-invasive techniques like Magnetic Resonance Imaging (MRI) with hepatospecific contrast agent and Positron Emission Tomography (PET) may help establish the specific cause of the obstruction before any biliary decompression procedure is carried out. This strategy has the potential to prevent from more important tumour spread and provide a greater chance for curative surgery when applicable...
January 31, 2018: Journal of the Belgian Society of Radiology
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