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Common Bile Duct Exploration Or Choledocoscopy OR Gallbladder OR Pancreatitis

Masahiro Umemura, Takeshi Chida, Erika Matsunaga, Jun Ito, Kazuyoshi Ohta, Shin Shimoyama, Satoru Yamazaki, Kazuhito Kawata, Takaaki Ono, Yoshimasa Kobayashi
A 51-year-old Brazilian female who had IgD-lambda type multiple myeloma presented with epigastralgia and obstructive jaundice during her follow-up. Contrast-enhanced computed tomography (CT) showed an enhanced mass of 25mm in the pancreatic head, and endoscopic retrograde cholangiopancreatography revealed smooth stenoses in the lower bile duct and main pancreatic duct (MPD) of the head. We diagnosed the patient with extramedullary pancreatic metastasis of multiple myelomas. Plastic stents were endoscopically placed into both the common bile duct and MPD...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Ashraf M Abdelkader, Ahmed M Zidan, Mohamed T Younis
Objective: We are trying to investigate the possibility, safety, and benefits of replacing the role of T-tube by another more safe and effective procedure for biliary decompression in the case of common bile duct (CBD) exploration. Methods: Our present study includes fifty consecutive patients who underwent a traditional CBD exploration due to choledocholithiasis. Patients were divided into 2 equal groups. In the 1st group, a spontaneously expelled Nelaton tube is placed in the CBD to aid in bile drainage to the duodenum, while in the 2nd group, a conventional T-tube is placed to decompress the CBD in the early postoperative (PO) days to a drainage bag...
2018: HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery
L Fang, J Wang, W C Dai, B Liang, H M Chen, X W Fu, B B Zheng, J Lei, C W Huang, S B Zou
BACKGROUND: LTCBDE combined with or without modified techniques is safe and efficacious for the management of gallstones and concomitant, even large, common bile duct (CBD) stones. METHODS: To describe the surgical indications and procedure strategies of laparoscopic transcystic common bile duct exploration (LTCBDE), a retrospective analysis of 205 patients with concomitant gallstones and CBD stones treated using LTCBDE between June 2008 and June 2015 was performed...
October 8, 2018: Surgical Endoscopy
Nao Shimada, Shiro Miwa, Takuma Arai, Noriyuki Kitagawa, Shingo Akita, Nobuyoshi Iinuma, Keiko Ishii
INTRODUCTION: Pancreatic mixed adenoneuroendocrine carcinoma (MANEC) is a rare tumor. We report herein a case of pancreatic MANEC with cystic features. PRESENTATION OF CASE: A 67-year-old woman presented with jaundice. A CT scan revealed an 18-mm mass at the pancreatic head that obstructed the common bile duct and another 35-mm cystic lesion containing a mural nodule in the pancreatic body, which was suspected to be an intraductal papillary mucinous carcinoma. A biopsy of the head mass led to the diagnosis of adenocarcinoma...
September 23, 2018: International Journal of Surgery Case Reports
Gurjiwan Singh Virk, Nour A Parsa, Juan Tejada, Muhammad Sohail Mansoor, Sven Hida
For patients suffering from both biliary and duodenal obstruction, endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is the treatment of choice. ERCP through an already existing duodenal prosthesis is an uncommon procedure and furthermore no studies have reported installing a covered metal stent onto an already existing bare metal stent in the common bile duct (CBD). We describe a rare case of a stent-in-stent dilatation of the CBD through an already existing self-expanding metal stent in the second part of duodenum for the patient presenting with jaundice in setting of biliary and duodenal obstruction from pancreatic adenocarcinoma...
September 16, 2018: World Journal of Gastrointestinal Endoscopy
Xue-Min Liu, Yu Li, Jun-Xi Xiang, Feng Ma, Qiang Lu, Yan-Guang Guo, Xiao-Peng Yan, Bo Wang, Xu-Feng Zhang, Yi Lv
BACKGROUND: Magnetic anastomosis has been attempted in biliary and intestinal reconstruction. The objective of the current study was to introduce an initial clinical use of magnetic compression anastomosis for pancreaticojejunostomy and biliojejunostomy in Whipple's procedure. METHODS: Patients with peri-ampullary carcinoma and dilated bile and pancreatic ducts were prospectively enrolled from 2016 to 2017. After pancreaticoduodenectomy, an appropriate mother magnet and drainage tube was placed in the proximal bile duct and pancreatic duct...
October 2, 2018: Journal of Gastroenterology and Hepatology
Xuan Wang, Guang-Yang Yu, Mo Chen, Ran Wei, Jinhong Chen, Zheng Wang
Extrahepatic bile duct cancer (EBDC) is a combined type of malignancy mainly consisting of extrahepatic cholangiocarcinoma and gallbladder cancer. Clinically, it is featured with latent symptoms and early metastasis, leading to a poor prognosis. Therefore, this cohort study aimed to depict the possible metastatic patterns of EBDC of diverse sub-types and evaluate the prognostic significance of diverse metastatic destinations with data from the clinical database. Relevant data of total 4061 confirmed EBDC patients diagnosed between 2010 and 2013 from the Surveillance, Epidemiology and End Results (SEER) database was obtained...
September 12, 2018: Cancer Medicine
Milosz Wiktorowicz, Damian Mlynarski, Radoslaw Pach, Romana Tomaszewska, Jan Kulig, Piotr Richter, Marek Sierzega
BACKGROUND: Aberrantly expressed mucin glycoproteins (MUC) play important roles in pancreatic ductal adenocarcinoma (PDAC), yet their use as a diagnostic aid in fine-needle aspiration biopsy (FNAB) is poorly documented. The aim of this study was to investigate the rationale and feasibility of mucin (MUC1, MUC2, MUC3, MUC4, MUC5AC, and MUC6) expression profiling by RT-PCR for diagnostic applications in cytology. METHODS: Mucin expression was examined by RT-PCR and immunohistochemistry in specimens resected from patients with pancreatic (n = 101), ampullary (n = 23), and common bile duct (n = 10) cancers and 33 with chronic pancreatitis...
September 25, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Byung-Kwan Jeong, You Na Sung, Sung Joo Kim, Soyeon An, Hosub Park, Hee Sang Hwang, Hyo Jeong Kang, Jae Hoon Lee, Ki-Byung Song, Kyu-Pyo Kim, Dae Wook Hwang, Sang Soo Lee, Song Cheol Kim, Seung-Mo Hong
Identifying the accurate origin of periampullary cancers is important, because different origins may trigger different clinicopathologic behaviors. The presence of intraepithelial precursor lesions, including high-grade pancreatic intraepithelial neoplasias (PanINs) and/or high-grade biliary intraepithelial neoplasias (BilINs), may be suggestive of the origin of the periampullary carcinoma in challenging cases. To prove the usefulness of high-grade intraepithelial precursor lesions to identify the origin of ambiguous periampullary cancers, the status and grades of PanINs and BilINs were evaluated in 256 periampullary carcinomas with a well-defined cancer origin as a test set, including 114 pancreatic cancers, 82 distal bile duct cancers, 54 ampullary cancers, and 6 duodenal cancers, and 112 periampullary carcinomas with clinically equivocal epicenter either by radiologic imaging used as a validation set...
September 24, 2018: Human Pathology
Nilabja Sikdar, Gourab Saha, Ashmita Dutta, Shibajyoti Ghosh, Shailesh V Shrikhande, Sudeep Banerjee
Pancreatic Ductal AdenoCarcinoma (PDAC) is one of the most lethal malignancies of all solid cancers. Precancerous lesions for PDAC include PanIN, IPMNs and MCNs. PDAC has a poor prognosis with a 5-year survival of approximately 6%. Whereas Periampulary AdenoCarcinoma (PAC) having four anatomic subtypes, pancreatic, Common Bile Duct (CBD), ampullary and duodenum shows relative better prognosis. The highest incidence of PDAC has been reported with black with respect to white population. Similarly, incidence rate of PAC also differs with different ethnic populations...
September 2018: Current Genomics
Jiang Zhou, Rui Xiao, Jing-Rui Yang, Lu Wang, Jia-Xing Wang, Qian Zhang, Jian-Jun Ren
Background Mirizzi syndrome is a rare complication of chronic cholecystitis, usually caused by gallstones impacted in the cystic duct or the neck of the gallbladder. Mirizzi syndrome results in compression of the hepatic duct or fistula formation between the gallbladder and common bile duct (or hepatic duct, right hepatic duct, or even mutative right posterior hepatic duct). Clinical features include abdominal pain, fever, and obstructive jaundice. Severe inflammation and adhesion at Calot's triangle are potentially very dangerous for patients with Mirizzi syndrome undergoing cholecystectomy...
September 23, 2018: Journal of International Medical Research
Jae Hyuck Jun, Sung Koo Lee, So Yeon Kim, Dong Hui Cho, Tae Jun Song, Do Hyun Park, Sang Soo Lee, Dong-Wan Seo, Myung-Hwan Kim
BACKGROUND/OBJECTIVES: The pancreatoduodenal groove (anatomical groove) is a potential space bordered by the head of the pancreas, duodenum, and common bile duct. Discerning between groove carcinoma (GC) and groove pancreatitis (GP) is often difficult, but clinically important. We retrospectively analyzed and compared the findings of computed tomography (CT), laboratory tests, and endoscopic ultrasound-fine needle aspiration (EUS-FNA) for GC and GP. METHODS: GC (n = 36) and GP (n = 44) patients at Asan Medical Center from January 1, 2000, to May 31, 2017 were retrospectively reviewed...
October 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Yingjun Xie, Yien Xiang, Dan Zhang, Xiaoxiao Yao, Jiyao Sheng, Yongsheng Yang, Xuewen Zhang
Sarcomatoid carcinoma (SC) is an extremely rare and complicated malignant neoplasm that consists of both malignant epithelial components and atypical spindle cells that express an epithelial phenotype. The presents study reported a case of SC of the pancreas (SCP), along with a brief review of the literature. A 63‑year‑old man was admitted to The Second Hospital of Jilin University hospital with complaints of epigastralgia and jaundice of one month in duration. Based on preoperative laboratory blood tests and radiography, a mass at the distal common bile duct was suspected...
September 14, 2018: Molecular Medicine Reports
Dan-Qing Liu, Hang Zhang, Le Xiao, Bing-Yin Zhang, Wei-Hui Liu
BACKGROUND AND AIM: This study aims to assess the clinical validity and safety of single-operator cholangioscopy system (SOCS) for the treatment of concomitant gallbladder stones and secondary common bile duct (CBD) stones. METHODS: This retrospective study included 10 consecutive patients who had small-sized stones (< 1 cm) in both the gallbladder and CBD; the patients underwent SOCS treatment from June 2016 to December 2016. The clinical validity of this minimally invasive surgery was determined by the operation success rate, stone removal rate, postoperative hospital stay, hospitalization cost, and contrast images before and after the operation...
September 14, 2018: Journal of Gastroenterology and Hepatology
Toshikatsu Nitta, Jun Kataoka, Masato Ohta, Kensuke Fujii, Yuko Takashima, Yoshihiro Inoue, Takashi Ishibashi
Purpose: This paper presents an overview of the surgical strategy for patients with suspected gallbladder carcinoma (GBC), including incidental GBC cases, preoperatively or intraoperatively, as well as their outcomes. Methods: Between April 2009 and December 2017, 529 patients underwent cholecystectomy for gallbladder disease at our hospital. Both intraoperative and postoperative histological examinations of the excised gallbladder facilitated the diagnosis of GBC...
September 2018: Annals of Medicine and Surgery
Bin Liu, De-Shun Wu, Pi-Kun Cao, Yong-Zheng Wang, Wu-Jie Wang, Wei Wang, Hai-Yang Chang, Dong Li, Xiao Li, Yancu Hertzanu, Yu-Liang Li
AIM: To evaluate the clinical efficacy and safety of an innovative percutaneous transhepatic extraction and balloon dilation (PTEBD) technique for clearance of gallbladder stones in patients with concomitant stones in the common bile duct (CBD). METHODS: The data from 17 consecutive patients who underwent PTEBD for clearance of gallbladder stones were retrospectively analyzed. After removal of the CBD stones by percutaneous transhepatic balloon dilation (PTBD), the gallbladder stones were extracted to the CBD and pushed into the duodenum with a balloon after dilation of the sphincter of Oddi...
September 7, 2018: World Journal of Gastroenterology: WJG
Ying Luo, Tao Yang, Qiang Yu, Yu Zhang
BACKGROUND: There continues to be controversy regarding the optimal screening modality in patients with symptomatic cholelithiasis and suspected common bile duct (CBD) stones. The aim of this study was to assess the diagnostic accuracy of laparoscopic ultrasonography (LUS) compared to magnetic resonance cholangiopancreatography (MRCP). METHODS: Both LUS and MRCP were performed to evaluate the CBD stones and biliary anatomy in 200 patients undergoing laparoscopic surgery...
September 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Katri Saarela, Jaakko Tuomilehto, Reijo Sund, Ilmo Keskimäki, Sirpa Hartikainen, Eero Pukkala
Diabetes and cancer are common diseases both with enormous impact on health burden globally. The increased risk of several types of cancer among people with type 2 diabetes mellitus has been indicated repeatedly. This study aimed at exploring and describing the association between type 2 diabetes and cancer incidence. A cohort of 428,326 people with type 2 diabetes was identified from the Finnish National Diabetes Register and followed up through a register linkage with the Finnish Cancer Registry for cancer incidence during 1988-2014...
September 4, 2018: European Journal of Epidemiology
Yousuke Nakai, Hiroyuki Isayama, Hiroshi Kawakami, Hirotoshi Ishiwatari, Masayuki Kitano, Yukiko Ito, Ichiro Yasuda, Hironari Kato, Saburo Matsubara, Atsushi Irisawa, Takao Itoi
Background and Objectives: EUS-guided biliary drainage (EUS-BD) is increasingly reported as a salvage technique after failed endoscopic retrograde cholangiopancreatography, but it is still controversial whether EUS-BD can replace transpapillary biliary stenting. Therefore, we conducted this multicenter, prospective study of EUS-guided choledochoduodenostomy (EUS-CDS) using a covered metallic stent (CMS) as primary biliary drainage for unresectable distal malignant biliary obstruction (MBO)...
August 27, 2018: Endoscopic Ultrasound
Domna Fanidou, Nikolaos Filippou, Anastasia Katseli, Georgios Papadopoulos, Panagiotis Skandalakis, Dimitrios Filippou
Autoimmune pancreatitis (AIP) is a rare systematic autoimmune disease that causes chronic pancreatitis. Type 1-AIP (IgG4-related disease) may involve other organs as well. In this report we are presenting a case of a 74-year-old man with obstructive abdominal pain jaundice, mild and a history of retroperitoneal fibrosis and hydronephrosis. Labs were remarkable for hyperbilirubinemia, high serum IgG4 levels, mildly elevated CA 19-9, elevated rheumatoid factor and new onset diabetes. MRI revealed pancreatic enlargement, dilated intrahepatic bile ducts and stricture of the distal common bile duct concerning for cholangiocarcinoma...
September 2018: Oxford Medical Case Reports
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