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Common Bile Duct Exploration Or Choledocoscopy OR Gallbladder OR Pancreatitis

Paul Chandler, Jonathan Harris, Danny Sherwinter
Adenomyomatous hyperplasia (AH) is commonly found in the gallbladder and is considered a tumor-like inflammatory lesion arising from Rokitansky-Aschoff sinus. It is extremely rare in the extrahepatic bile duct and only 15 cases have been reported to date. We describe a 63-year-old male patient who presented with cholangitis, underwent an extensive diagnostic workup, and ultimately had a Whipple procedure. Final pathology showed a 2.0 × 1.5 × 0.5 cm3 granular lesion in the distal common bile duct. There was prominent biliary epithelial proliferation with tubular-papillary architecture and minimal nuclear atypia in association with chronic inflammation, stroma reaction and smooth muscle proliferation...
August 2018: Journal of Surgical Case Reports
Mingjie Zhang, Jianxin Zhang, Xu Sun, Jie Xu, Jing Zhu, Wenbin Yuan, Qiang Yan
BACKGROUND: Previous gastrectomy can lead to an increased incidence of cholecystocholedocholithiasis (CCL) and increased morbidity rate. However, the appropriate treatment strategy for patients with CCL and a history of gastrectomy remains unclear. METHODS: We performed a retrospective cohort study of patients with CCL and a history of gastrectomy who underwent either one-stage laparoscopic common bile duct (CBD) exploration with stone clearance and laparoscopic cholecystectomy (LCBDE+LC) or two-stage endoscopic retrograde cholangiopancreatography followed by LC (ERCP+LC) from May 2010 to March 2018...
August 9, 2018: BMC Surgery
Munita Bal, Swapnil Rane, Sanjay Talole, Mukta Ramadwar, Kedar Deodhar, Prachi Patil, Mahesh Goel, Shailesh Shrikhande
To evaluate differences in the R1 rates of ampullary (AC), pancreatic (PC), and distal bile duct (DBD) cancers in pancreatoduodenectomies (PD) using standardised pathology assessment. Data of PD (2010-2011) analysed in accordance with the Royal College of Pathologists (UK) protocol, were retrieved. Clinicopathologic features, including frequency, topography, and mode of margin involvement in AC (n = 87), PC (n = 18), and DBD (n = 5) cancers were evaluated. The R1 rate was 7%, 67%, and 20% in the AC, PC, and DBD cancers (p < 0...
August 8, 2018: Virchows Archiv: An International Journal of Pathology
Alberto Marcacuzco Quinto, Oana-Anisa Nutu, Ricardo San Román Manso, Iago Justo Alonso, Jorge Calvo Pulido, Alejandro Manrique Municio, Álvaro García-Sesma, Carmelo Loinaz Segurola, Javier Martínez Caballero, Luis Carlos Jiménez Romero
INTRODUCTION: Transarterial chemoembolization (TACE) is considered a therapeutic option. It is mostly used in hepatocellular carcinoma or liver colorectal, neuroendocrine or melanoma metastases. Although it is considered a safe procedure, TACE presents complications, such as acute cholecystitis, which is the most common. Other procedure-related complications include pulmonary embolism, hepatic abscess, bile duct injury, gastric mucosa injury and, less frequently, acute pancreatitis. The aim of this study is to review the complications following TACE for liver tumors...
August 3, 2018: Cirugía Española
Xiangdong Liu, De Luo, Hong Chen, Jiang Liu, Fangyi Peng, Cheng Fang, Bo Li, Song Su
Common bile duct (CBD) suturing is a difficult procedure in laparoscopic CBD exploration. We sought to develop a simpler CBD suture technique using running barbed sutures. We retrospectively compared 2 suture techniques for CBD closure after T-tube placement. The barbed group comprised of 46 patients who underwent CBD closure using running barbed sutures, whereas the standard group comprised of 39 patients who received interrupted sutures. Mean CBD suturing time (6.2±0.9 vs. 12.2±1.1 min; P<0.001), total operating time (79...
August 1, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Ping-Hua Tsai, Yueh-Chin Yen, Yi-Hong Chou, Chien-Hua Lin, Yu-Lin Bai, Shu-Chuan Kao, Yu-Meu Lin, Yu-Ling Wang, Ya-Chun Chou, Peter Tien-Ying Lee, Chui-Mei Tiu
Choledochal cysts rarely present with acute pancreatitis. We report a patient with type I choledochal cyst(s) who had concomitant acute frank hemorrhagic pancreatitis. A 14-year-old male noted with a history of recurrent abdominal pain, fever and jaundice. Ultrasonography (US) of abdomen at the Emergency Department depicted distended gall bladder with wall thickening. Apparently dilated intrahepatic ducts (IHDs) and fusiform dilatation of the common bile duct (CBD), and mild dilatation of the pancreatic duct were also noted, suggesting a type I choledochal cyst( )...
October 2017: Journal of Medical Ultrasound
Conor M Stack, Howard S Gold, Sharon B Wright, Linda M Baldini, Graham M Snyder
OBJECTIVE: To characterize the microbiology of hepatobiliary surgical site infections (SSIs) and to explore the relationship between specific antimicrobial prophylaxis regimens and the development of SSIs. DESIGN: Retrospective matched case-control study comparing patient, procedure, and antimicrobial prophylaxis characteristics among patients undergoing a hepatobiliary surgical procedure with and without an SSI. SETTING: A tertiary referral acute-care facility...
August 1, 2018: Infection Control and Hospital Epidemiology
Adnan Taş, Banu Kara, Sehmuz Ölmez, Mehmet Suat Yalçın, Nevin Akçaer Öztürk, Bunyamin Saritas
BACKGROUND: Ectopic opening of the common bile duct (EOCBD) is a very rare entity. It has been reported in the 3rd or 4th portion of the duodenum, pyloric canal, duodenal bulb, and the stomach. OBJECTIVES: The aim of this study was to evaluate the clinical characteristics, laboratory values and imaging studies of patients with EOCBD into the duodenal bulb retrospectively. MATERIAL AND METHODS: The files of patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) between January 2003 and November 2015 were reviewed...
July 31, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Lalin Navaratne, Jasim Al-Musawi, Asuncion Acosta Mérida, Jaime Vilaça, Alberto Martinez Isla
PURPOSE: During laparoscopic common bile duct exploration (LCBDE) where Calot's triangle cannot be safely dissected due to a 'frozen' hepatic hilum secondary to severe inflammation or fibrosis, the preferred transcystic approach to the common bile duct (CBD) is precluded. The aim of this paper is to describe a safe method of accessing the CBD via a trans-infundibular approach (TIA) in complex cases where conventional access to the cystic duct or CBD is denied. METHODS: A retrospective review of 154 consecutive patients who underwent LCBDE at a single centre between 2014 and 2018 was performed...
July 29, 2018: Langenbeck's Archives of Surgery
Guoxin Guan, Chenggong Sun, Yanying Ren, Zhengdong Zhao, Shili Ning
BACKGROUND: With the advent of minimally invasive surgery, the limits of surgery have been stretched by questioning the more usual, established 2-stage approach for choledocholithiasis with an initial endoscopic retrograde cholangiography and endoscopic biliary sphincterotomy followed by laparoscopic cholecystectomy in favor of the single-stage laparoscopic common bile duct exploration with laparoscopic cholecystectomy. The aim of this study was to compare the related benefits, difficulties, and outcomes of these 2 methods at a single institution...
July 24, 2018: Surgery
Kiyokazu Hiwatashi, Hiroshi Okumura, Tetsuro Setoyama, Kei Ando, Yoshito Ogura, Kuniaki Aridome, Shigeho Maenohara, Shoji Natsugoe
Intraoperative cholangiography involving the excretion of fluorescent indocyanine green (ICG) into the bile is used to determine biliary anatomy in laparoscopic cholecystectomy (LC). This study aimed to evaluate the features of intraoperative ICG cholangiography, in LC with cholecystitis, and compared the delineation of the cystic duct (CD) between ICG cholangiography and magnetic resonance cholangiopancreatography (MRCP).Participants comprised 65 patients undergoing LC using ICG cholangiography.Fifty-eight patients (89...
July 2018: Medicine (Baltimore)
W W Jin, C Lu, Y P Mou, X W Xu, R C Zhang, Y C Zhou, Z Y Qian, C J Huang
Objective: To evaluate the safety and feasible of adjacent organ resection during laparoscopic pancreaticoduodenectomy(LPD), and summary the surgical strategies. Methods: Clinical data of 15 adjacent organ resections combined with LPD from March 2013 to September 2017 were reviewed.There were 10 male and 5 female patients aging from 20 to 86 years, and the body mass index ranged from 19.6 to 34.5 kg/m(2).Two patients had previous abdominal surgical history.Two patients underwent preoperative chemotherapy. Results: The resected adjacent organs included liver( n =4), stomach( n =3), colon( n =6), right kidney with embolectomy and vasoplastic of inferior vena cava( n =1), and spleen artery aneurysms( n =1)...
July 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Simone Conci, Andrea Ruzzenente, Francesca Bertuzzo, Tommaso Campagnaro, Alfredo Guglielmi, Calogero Iacono
BACKGROUND: Total dorsal pancreatectomy (TDP) is a conservative pancreatic resection that should be considered in cases of benign or low malignant tumors confined to the dorsal pancreas to preserve the viability of both digestive and biliary tracts, and to avoid the endocrine and metabolic consequences of total pancreatectomy. We report a new case of TDP and provide a literature review of this procedure. METHODS: The case reported was a 35-year-old female patient with a solid pseudopapillary tumor...
July 13, 2018: Digestive Surgery
Volodymyr Pylypchuk
Introduction: The morbidity of chronic pancreatitis (CP) remains at a high level. In cases of CP, prepapillary stenosis of the common bile duct (CBD) complicates the course of disease in 30-60% of patients. Aim: To improve the detection of biliary hypertension (BH) in patients with complicated forms of CP by increasing the accuracy of preoperative and intraoperative diagnostics using modern diagnostic methods. Material and methods: We analysed the results of surgical treatment of 573 patients with complicated forms of CP...
2018: Przegla̜d Gastroenterologiczny
Wen-Song Liu, Yong Jiang, Dong Zhang, Long-Qing Shi, Dong-Lin Sun
PURPOSE: Laparoscopic common bile duct exploration (LCBDE) has been widely used to remove common bile duct (CBD) stones. However, surgery is not considered as the first treatment choice for elderly patients with CBD stones because of the potential risk of postoperative complications. This study aims to evaluate the safety and efficiency of LCBDE for elderly patients. METHODS: From April 2011 to October 2016, 265 consecutive patients underwent LCBDE. We performed a retrospective study and divided these patients into 2 groups...
July 1, 2018: Surgical Innovation
Roman O Kowalchuk, Roman M Kowalchuk, Katia Kaplan-List, Theodore K Oates, Sean C Smith
Gallbladder duplication is a rare anatomic variant of biliary anatomy, which can present diagnostic and treatment challenges. In this case, a 49-year-old male presented with classic symptoms of biliary colic to his primary care physician, and while computed tomography (CT) noted the presence of gallstones, neither CT nor ultrasound was able to locate a gallbladder within the gallbladder fossa. Initial surgery found and cauterized a rudimentary gallbladder, but symptoms persisted, requiring a second surgery and secondary analysis of CT, ultrasound, and magnetic resonance imaging with magnetic resonance cholangiopancreatography...
August 2018: Radiology Case Reports
Yen-Yi Juo, Usah Khrucharoen, Yas Sanaiha, Young-Ji Seo, Erik Dutson, Peyman Benharash
OBJECTIVE: To evaluate the cumulative hospitalization cost differences between routine cholecystectomy and an observational approach during index hospitalization for pregnant patients. METHODS: A retrospective cohort study of 1,245 pregnant women with biliary pancreatitis across the United States between 2010 and 2014 was performed using the Nationwide Readmissions Database. Cumulative costs and complications were compared between patients with and without cholecystectomy during both initial and subsequent hospitalizations...
August 2018: Obstetrics and Gynecology
Sheik Fazal Ur Rehman, Laura Ballance, Anthony Rate
BACKGROUND: Symptomatic gall stone disease requires early emergency treatment to prevent complications. This early treatment is often delayed due to difficulty in the diagnosis and management of concomitant choledocholithiasis. Intervention with preoperative endoscopic retrograde cholangiopancreatography (ERCP) is associated with complications and known to be unnecessary in most cases. We follow a strategy of providing early cholecystectomy with selective utility of antegrade stent in cases of choledocholithiasis...
July 11, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Bin Xu, Yu-Xiang Wang, Yong-Xin Qiu, Hong-Bo Meng, Jian Gong, Wei Sun, Bo Zhou, Jian He, Ti Zhang, Wen-Yan Zheng, Zhen-Shun Song
BACKGROUND: Although laparoscopic common bile duct exploration (LCBDE) has shown many obvious advantages compared with open surgery in the treatment of common bile duct (CBD) stones, it remains unclear regarding risk factors of conversion from LCBDE to open surgery and whether conversion will counteract the advantages of LCBDE. The purpose of this study was to explore risk factors and consequences of conversion from LCBDE to open surgery. METHODS: A retrospective study was conducted, using a database of 644 patients with LCBDE between 2011 and 2017...
July 9, 2018: Surgical Endoscopy
Fadil Sherifi, Sadi Bexheti, Zaim Gashi, Ismet Bajraktari, Jeton Shatri, Ali Lahu
AIM: This study was designated to evaluate the frequency of anatomic variations of the pancreaticobiliary union. MATERIALS AND METHODS: Our research was observational, comparative and analytical. The investigation was conducted from January 2016-May 2017. This study included 63 patients from Clinic of Gastroenterology and Hepatology - Prishtina, assessed pancreaticobiliary union with Magnetic Resonance cholangiopancreatography. RESULTS: Union of the common bile duct and the major pancreas was biliary-pancreatic type The angle between common bile duct and the major pancreas duct had different sizes average 35...
June 20, 2018: Open Access Macedonian Journal of Medical Sciences
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