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Bile duct alternative treatment

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https://www.readbyqxmd.com/read/29761151/endoscopic-ultrasound-guided-choledochoduodenostomy-as-palliative-treatment-a-challenging-case-report
#1
Helena Ribeiro, Richard Azevedo, Ana Caldeira, Rui Sousa, Eduardo Pereira, António Banhudo
We report the case of an 88-year-old female with obstructive jaundice due to a periampullary tumor. The patient developed acute cholangitis and consequent clinical deterioration, so it was decided to perform palliative biliary drainage. Due to duodenal tumor invasion, it was not possible to perform endoscopic retrograde cholangiopancreatography. A different approach was attempted and it was decided to carry out an endoscopic ultrasound-guided choledochoduodenostomy. This procedure was performed with a linear echoendoscope, and using a duodenal bulbar approach, a fistula was created between the bulb and the common bile duct...
April 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29729226/eus-guided-hepaticoenterostomy-as-a-portal-to-allow-definitive-antegrade-treatment-of-benign-biliary-diseases-in-patients-with-surgically-altered-anatomy
#2
Theodore W James, Y Claire Fan, Todd H Baron
BACKGROUND & AIMS: EUS-guided hepaticoenterostomy (EUS-HE) is usually reserved for palliation of malignant biliary obstruction after failed endoscopic retrograde cholangiography (ERC) or inaccessible biliary tree in surgically altered anatomy (SAA). We describe outcome of EUS-HE and antegrade therapy for benign biliary disease in patients with SAA. METHODS: Retrospective review of 20 consecutive patients with surgically altered anatomy and benign biliary obstruction who underwent EUS-HE performed by one endoscopist at a tertiary center over a three-year period...
May 2, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29720662/de-novo-formation-of-the-biliary-system-by-tgf%C3%AE-mediated-hepatocyte-transdifferentiation
#3
Johanna R Schaub, Kari A Huppert, Simone N T Kurial, Bernadette Y Hsu, Ashley E Cast, Bryan Donnelly, Rebekah A Karns, Feng Chen, Milad Rezvani, Hubert Y Luu, Aras N Mattis, Anne-Laure Rougemont, Philip Rosenthal, Stacey S Huppert, Holger Willenbring
Transdifferentiation is a complete and stable change in cell identity that serves as an alternative to stem-cell-mediated organ regeneration. In adult mammals, findings of transdifferentiation have been limited to the replenishment of cells lost from preexisting structures, in the presence of a fully developed scaffold and niche 1 . Here we show that transdifferentiation of hepatocytes in the mouse liver can build a structure that failed to form in development-the biliary system in a mouse model that mimics the hepatic phenotype of human Alagille syndrome (ALGS) 2 ...
May 2, 2018: Nature
https://www.readbyqxmd.com/read/29605722/efficacy-of-eus-and-ercp-guided-biliary-drainage-for-malignant-biliary-obstruction-prospective-randomized-controlled-study
#4
Joo Kyung Park, Young Sik Woo, Donghyo Noh, Ju-Il Yang, So Young Bae, Hwan Sic Yun, Jong Kyun Lee, Kyu Taek Lee, Kwang Hyuck Lee
BACKGROUND AND AIMS: ERCP-guided biliary drainage (ERCP-BD is a criterion standard treatment for malignant biliary obstruction when curative surgery is not an option. Alternative methods such as PTBD would significantly lower the quality of life. EUS-guided biliary drainage (EUS-BD) has been developed and performed by experienced endoscopists. Therefore, the aims of this study were to evaluate the efficacy and safety of EUS-BD compared with ERCP in malignant biliary obstruction. METHODS: The prospective randomized controlled study was conducted and 30 patients were enrolled; 15 for each EUS-BD and ERCP-BD arm...
March 29, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29605038/biliary-reconstruction-with-a-pedicled-gallbladder-flap-in-patients-during-pancreaticoduodenectomy
#5
Jiqiao Zhu, Jiantao Kou, Hongmeng Dong, Jun Ma, Huanye Liu, Chun Bai, Xianliang Li, Qiang He
BACKGROUND: Stricture formation at the biliary-enteric anastomosis can cause serious complications after pancreaticoduodenectomy while the anastomotic size is reported to significantly affect stricture formation. In this study, we aimed to determine the effect of a pedicled gallbladder flap used as an alternative to biliary reconstruction during pancreaticoduodenectomy in patients with a nondilated extrahepatic bile duct. METHODS: Data of patients with a nondilated extrahepatic bile duct, who underwent pancreaticoduodenectomy between October 2012 and July 2015 at the Department of Hepatobiliary and Pancreaticosplenic Surgery at Beijing Chaoyang Hospital, were collected...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29512768/anthocyanin-complex-exerts-anti-cholangiocarcinoma-activities-and-improves-the-efficacy-of-drug-treatment-in-a-gemcitabine-resistant-cell-line
#6
Kitti Intuyod, Aroonsri Priprem, Chawalit Pairojkul, Chariya Hahnvajanawong, Kulthida Vaeteewoottacharn, Porntip Pinlaor, Somchai Pinlaor
Cholangiocarcinoma (CCA) is a deleterious bile duct tumor with poor prognosis and is relatively resistant to chemotherapy. Therefore, alternative or supplementary agents with anticancer and chemosensitizing activities may be useful for the treatment of CCA. A novel anthocyanin complex (AC) nanoparticle, developed from extracts of cobs of purple waxy corn and petals of blue butterfly pea, has exhibited chemopreventive potential in vivo. In the present study, the anti-CCA activities of AC and their underlying molecular mechanisms were investigated further in vitro using a CCA cell line (KKU213)...
March 7, 2018: International Journal of Oncology
https://www.readbyqxmd.com/read/29428971/emergence-of-anti-mitochondrial-m2-antibody-in-patient-with-angioimmunoblastic-t-cell-lymphoma
#7
Shun-Ichi Wakabayashi, Takefumi Kimura, Naoki Tanaka, Satoru Joshita, Kazuhito Kawata, Takeji Umemura, Yuki Hiroshima, Hiromitsu Mori, Hikaru Kobayashi, Shuichi Wada, Eiji Tanaka
A 68-year-old woman was referred to our hospital due to fever and rash on the neck and extremities. Laboratory findings revealed hepatic dysfunction and positivity for anti-mitochondrial M2 antibody (AMA-M2). Hepatosplenomegaly and systemic lymphadenopathy were detected by enhanced computed tomography. One week after her first visit, hypoxemia, ascites, and Coomb test-positive autoimmune hemolytic anemia had newly appeared in addition to worsened fever, hepatosplenomegaly, and lymphadenopathy. Results of axillary lymph node, skin, and bone-marrow biopsies led to the diagnosis of angioimmunoblastic T-cell lymphoma (AITL), for which CEPP therapy (cyclophosphamide, etoposide, procarbazine, and prednisolone) was initiated...
February 10, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29408314/fibroblast-growth-factor-receptor-inhibition-induces-loss-of-matrix-mcl1-and-necrosis-in-cholangiocarcinoma
#8
Ayano Kabashima, Petra Hirsova, Steven F Bronk, Matthew C Hernandez, Mark J Truty, Sumera Rizvi, Scott H Kaufmann, Gregory J Gores
BACKGROUND & AIMS: Myeloid cell leukemia 1 (MCL1), a prosurvival member of the BCL2 protein family, has a pivotal role in human cholangiocarcinoma (CCA) cell survival. We previously reported that fibroblast growth factor receptor (FGFR) signalling mediates MCL1-dependent survival of CCA cells in vitro and in vivo. However, the mode and mechanisms of cell death in this model were not delineated. METHODS: Human CCA cell lines were treated with the pan-FGFR inhibitor LY2874455 and the mode of cell death examined by several complementary assays...
March 8, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29322853/laser-ablation-of-the-biliary-tree-in-vivo-proof-of-concept-as-potential-treatment-of-unresectable-cholangiocarcinoma
#9
Paola Saccomandi, Giuseppe Quero, Riccardo Gassino, Alfonso Lapergola, Ludovica Guerriero, Michele Diana, Alberto Vallan, Guido Perrone, Emiliano Schena, Guido Costamagna, Jaques Marescaux, Francesco M Di Matteo
OBJECTIVES: The palliative treatment of cholangiocarcinoma is based on stent placement with well-known procedure-related complications. Consequently, alternative energy-based techniques were put forward with controversial long-term results. This study aims to evaluate the safety and effectiveness of biliary tree laser ablation (LA) in terms of: (i) absence of perforation, (ii) temperature increase, (iii) induced thermal damage in in vivo models. MATERIALS AND METHODS: The common bile duct and cystic ducts of two pigs were ablated with a diode laser (circumferential irradiation pattern) for 6 and 3 min at 7 W...
January 24, 2018: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29302818/dissemination-of-minimally-invasive-liver-resection-for-primary-malignancy-reevaluating-effectiveness
#10
Patrick R Varley, Samer T Tohme, Alexis P Chidi, Julie Goswami, Dirk van der Windt, David A Geller, Allan Tsung
BACKGROUND: Experiences at specialized hepatobiliary centers have demonstrated efficacy of minimally invasive liver resection, but concerns exist regarding whether these procedures would remain effective once disseminated to a broad range of clinical practices. We sought to present the first comparison of MILR and open liver resection (OLR) for primary liver malignancy from a nationally representative cancer registry. METHODS: Cases of liver and intrahepatic bile duct cancer were identified from the National Cancer Data Base Participant Use File...
March 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29172216/the-economic-impact-of-using-single-operator-cholangioscopy-for-the-treatment-of-difficult-bile-duct-stones-and-diagnosis-of-indeterminate-bile-duct-strictures
#11
Pierre H Deprez, Rodrigo Garces Duran, Tom Moreels, Gianluca Furneri, Federica Demma, Len Verbeke, Schalk W Van der Merwe, Wim Laleman
BACKGROUND AND STUDY AIM:  Conventional endoscopic retrograde cholangiopancreatography (ERCP) combines endoscopy and radiography to diagnose and treat pathological conditions of the bile duct. The aim of the present analysis was to evaluate the clinical and economic impact of the use of single-operator intraductal cholangioscopy (IDC), which allows for direct visualization of the bile duct, as an alternative to ERCP for the treatment of difficult bile duct stones and the diagnosis of bile duct strictures...
February 2018: Endoscopy
https://www.readbyqxmd.com/read/29093736/what-is-the-value-of-the-learning-curve-in-endoscopic-balloon-dilatation-of-the-major-papilla
#12
Eduardo Tavio-Hernandez, Enrique Vazquez-Sequeiros, Enrique Rodriguez-Santiago, Juan Angel Gonzalez-Martin, Jose Ramón Foruny-Olcina, Vicente Benita-Leon, Victor Defarges-Pons, Daniel Boixeda-Miquel, Agustin Albillos-Martínez
Introduction: Endoscopic papillary large balloon dilatation (EPLBD) is an alternative for the treatment of common bile duct (CBD) stones. Existing evidence of factors associated with its outcomes is contradictory. Objective: To identify predictors (including the experience of an endoscopist) of success and adverse events in EPLBD. Methods: We reviewed the first 200 EPLBD with endoscopic sphincterotomy (EST) performed at our center. Demographic, clinical, and anatomic variables were studied, as well as the performance characteristics, correlating them with individual and group experience...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29093418/percutaneous-transhepatic-self-expanding-metallic-stent-placement-for-the-treatment-of-malignant-afferent-loop-obstruction
#13
Naruomi Jinno, Itaru Naitoh, Yoshihito Nagura, Kazutoshi Fujioka, Yusuke Mizuno, Junko Momose, Makoto Ooyama, Kazuki Hayashi, Tomokatsu Miyaki, Makoto Nakamura, Takashi Joh
We report the case of a 71-year-old man with afferent loop obstruction (ALO) after Roux-en-Y reconstruction due to gastric cancer. Computed tomography showed a distended afferent loop and a dilatated bile duct. We could not reach the stricture site in the afferent loop using a gastroscope. We performed percutaneous transhepatic biliary drainage (PTBD) and placed a self-expanding metallic stent (SEMS) in the duodenal stricture through the PTBD route. Although an endoscopic approach is preferable, when PTBD can be performed, percutaneous transhepatic SEMS placement might be an alternative option for treating ALO in cases in which it is not possible to reach the site of stenosis with an endoscope...
February 1, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29057174/concurrent-occurrence-of-primary-biliary-cirrhosis-and-rheumatoid-arthritis
#14
Stella Pak, Umar Darr, Zubair Khan, Andrew Kobalka, Zayd Safadi, Christine Dee
Primary biliary cirrhosis (PBC) is an autoimmune cholestatic disorder of the liver. A diagnostic serum marker for PBC is an anti-mitochondrial antibody. Most prominent histologic findings of PBC are portal inflammation and destruction of interlobular bile ducts. The PBC occurs only in 40 to 400 individuals per million in the general population. About 1.8 - 5.6% of individuals with this rare disorder have rheumatoid arthritis (RA). This case report describes a 56-year-old female with concurrent rheumatoid arthritis and primary biliary cirrhosis...
August 13, 2017: Curēus
https://www.readbyqxmd.com/read/28989012/in-vivo-transgene-expression-in-the-pancreas-by-the-intraductal-injection-of-naked-plasmid-dna
#15
Yuma Yamada, Mai Tabata, Jiro Abe, Masatoshi Nomura, Hideyoshi Harashima
Patients with type I diabetes, which is caused by the destruction of pancreatic islets, now require regular therapeutic injections of insulin. The use of transgene therapy represents an alternate and potent strategy for the treatment of type I diabetes. However, only a limited number of studies regarding in vivo gene delivery targeting the pancreas and islets have been reported. Here, we report on the possibility of in vivo transgene expression in the pancreas by the intraductal injection of naked plasmid DNA (pDNA)...
February 2018: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28912914/intraductal-ultrasonography-as-a-local-assessment-before-magnetic-compression-anastomosis-for-obstructed-choledochojejunostomy
#16
Hideaki Kawabata, Misuzu Hitomi, Naonori Inoue, Yukino Kawakatsu, Yuji Okazaki, Masatoshi Miyata
Magnetic compression anastomosis (MCA) has been developed as a non-surgical alternative treatment for biliary obstruction without serious complications. A 70-year-old woman who had undergone pancreaticoduodenectomy with modified Child reconstruction for pancreatic head cancer suffered from obstructed choledochojejunostomy with no recurrent findings 4 months after the operation. Cholangiography using the percutaneous transhepatic cholangiographic drainage (PTCD) and fluoroscopy revealed complete obstruction of the upper common bile duct, and the length of the obstruction was 7 mm...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28858128/percutaneous-transhepatic-papilla-balloon-dilatation-combined-with-a-percutaneous-transcystic-approach-for-removing-concurrent-gallbladder-stone-and-common-bile-duct-stone-in-a-patient-with-billroth-ii-gastrectomy-and-acute-cholecystitis-a-case-report
#17
Dong Li, Yu-Liang Li, Wu-Jie Wang, Bin Liu, Hai-Yang Chang, Wei Wang, Yong-Zheng Wang, Zheng Li
BACKGROUND: A 61-year-old man presented with upper abdominal pain and jaundice. Abdominal computed tomography imaging revealed stones in the gallbladder and the common bile duct, with a thickening of the gallbladder wall and an obvious increase in the volume of the gallbladder. Initial treatment using endoscopic retrograde cholangiopancreatography failed due to the presence of surgically altered gastrointestinal anatomy. Stones in the gallbladder and common bile duct were subsequently removed concurrently via percutaneous transhepatic papilla balloon dilatation combined with a percutaneous transcystic approach...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28839445/laparoscopic-ultrasonography-as-an-alternative-to-intraoperative-cholangiography-during-laparoscopic-cholecystectomy
#18
REVIEW
Alexandra Dili, Claude Bertrand
AIM: To assess the role of laparoscopic ultrasound (LUS) as a substitute for intraoperative cholangiography (IOC) during cholecystectomy. METHODS: We present a MEDLINE and PubMed literature search, having used the key-words "laparoscopic intraoperative ultrasound" and "laparoscopic cholecystectomy". All relevant English language publications from 2000 to 2016 were identified, with data extracted for the role of LUS in the anatomical delineation of the biliary tract, detection of common bile duct stones (CBDS), prevention or early detection of biliary duct injury (BDI), and incidental findings during laparoscopic cholecystectomy...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28835049/-preliminary-clinical-efficacy-of-percutaneous-transcystic-papilla-balloon-dilation-for-removing-common-bile-duct-stones
#19
D Li, J R Zhu, X Q Hou, F Du, B Liu, W J Wang, Y L Li
Objective: To evaluate the feasibility, safety, and preliminary efficacy of percutaneous transcystic papilla balloon dilation for the common bile duct stones. Methods: A total of 11 patients with the common bile duct stones without dilatation of the intrahepatic bile ducts treated with percutaneous transcystic papilla balloon dilation in multiple center from April 2013 to May 2015 were analyzed retrospectively.In these 11 patients, there were 3 males and 8 females.And the average age was 68(52-91) years old...
August 15, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28762058/advantages-of-laparoscopic-common-bile-duct-exploration-in-common-bile-duct-stones
#20
Ke-Yue Li, Cheng-Xian Shi, Ke-Li Tang, Jian-Zhao Huang, De-Lin Zhang
OBJECTIVE: To compare the efficacy, safety, and surgical outcomes of laparoscopic common bile duct exploration, endoscopic retrograde cholangiopancreatography, and open common bile duct exploration for treatment of common bile duct stones. METHODS: In total, 210 patients were prospectively randomized into 3 groups: laparoscopic common bile duct exploration, endoscopic retrograde cholangiopancreatography, and open common bile duct exploration. The primary outcome measures were the common bile duct stone clearance rate and the complication rate...
February 2018: Wiener Klinische Wochenschrift
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