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Bile duct alternative treatment

Jamal Mohammadi Ayenehdeh, Bahareh Niknam, Seyed Mahmoud Hashemi, Hossein Rahavi, Nima Rezaei, Masoud Soleimani, Nader Tajik
BACKGROUND: Islet transplantation could be an ideal alternative treatment to insulin therapy for type 1 diabetes Mellitus (T1DM). This clinical and experimental field requires a model that covers problems such as requiring a large number of functional and viable islets, the optimal transplantation site, and the prevention of islet dispersion. Hence, the methods of choice for isolation of functional islets and transplantation are crucial. METHODS: The present study has introduced an experimental model that overcomes some critical issues in islet transplantation, including in situ pancreas perfusion by digestive enzymes through common bile duct...
October 18, 2016: Iranian Biomedical Journal
Carmelo Luigiano, Giuseppe Iabichino, Benedetto Mangiavillano, Leonardo H Eusebi, Monica Arena, Pierluigi Consolo, Carmela Morace, Sharmila Fagoonee, Matteo Barabino, Enrico Opocher, Rinaldo Pellicano
Bile duct injuries are the most serious complications after hepatobiliary surgery and are associated with high morbidity and mortality. The incidence of iatrogenic injuries of bile ducts has increased after the advent of laparoscopic cholecystectomy. Bile duct injuries present with biliary leak or biliary obstruction or a combination of both. Successful treatment of these complications requires a multidisciplinary team that includes biliary endoscopists, interventional radiologists and hepatobiliary surgeons...
September 2, 2016: Minerva Chirurgica
Ahmad H Ali, Keith D Lindor
INTRODUCTION: Primary biliary cholangitis (PBC) is an autoimmune disease of the liver characterized by destruction and inflammation of the intrahepatic bile ducts. The disease affects mainly women. The disease is often discovered through abnormal alkaline phosphatase (ALP) activity, and is confirmed when anti-mitochondrial antibodies (AMA) are present. The etiology of PBC is poorly understood. Cigarette smoking, immune dysregulation, nail polish, urinary tract infections, and low socioeconomic status have been implicated but none have been confirmed...
September 2016: Expert Opinion on Pharmacotherapy
Suguru Yamashita, Evelyne Loyer, Yun Shin Chun, Milind Javle, Jeffrey E Lee, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: In the era of laparoscopic cholecystectomy, incidentally discovered gallbladder cancer (IGBC) has become a common clinical presentation.1 A consensus exists that radical resection should be performed for IGBC patients with T1b or more advanced tumors.2 Although the oncologic safety of laparoscopic treatment for selected patients with gallbladder cancer (GBC) has been demonstrated, a laparoscopic approach for IGBC remains uncommonly practiced due to the technical challenge of the frequently reoperative cases...
July 25, 2016: Annals of Surgical Oncology
Myong-Hwan Karm, Hyun-Seok Cho, Jae-Young Lee, Heon-Yong Bae, Ho-Soo Ahn, Yeon Ju Kim, Jeong-Gil Leem, Seong-Soo Choi
Although percutaneous transhepatic biliary drainage (PTBD) and tract dilatation (TD) are very painful procedures, almost all of those procedures have been conducted under local anesthesia and opioid injection due to the lack of manpower and time. Celiac plexus block (CPB) is an interventional technique used for diagnostic and therapeutic purposes in the treatment of abdominovisceral pain. CPB decreases the side effects of opioid medications and enhances analgesia from medications. We present the case of a patient who underwent PTBD and TD under CPB in order to reduce procedure-related abdominal pain...
July 2016: Medicine (Baltimore)
Markus W Löffler, P Anoop Chandran, Karoline Laske, Christopher Schroeder, Irina Bonzheim, Mathias Walzer, Franz J Hilke, Nico Trautwein, Daniel J Kowalewski, Heiko Schuster, Marc Günder, Viviana A Carcamo Yañez, Christopher Mohr, Marc Sturm, Huu-Phuc Nguyen, Olaf Riess, Peter Bauer, Sven Nahnsen, Silvio Nadalin, Derek Zieker, Jörg Glatzle, Karolin Thiel, Nicole Schneiderhan-Marra, Stephan Clasen, Hans Bösmüller, Falko Fend, Oliver Kohlbacher, Cécile Gouttefangeas, Stefan Stevanović, Alfred Königsrainer, Hans-Georg Rammensee
BACKGROUND & AIMS: We report a novel experimental immunotherapeutic approach in a patient with metastatic intrahepatic cholangiocarcinoma. In the 5year course of the disease, the initial tumor mass, two local recurrences and a lung metastasis were surgically removed. Lacking alternative treatment options, aiming at the induction of anti-tumor T cells responses, we initiated a personalized multi-peptide vaccination, based on in-depth analysis of tumor antigens (immunopeptidome) and sequencing...
October 2016: Journal of Hepatology
Cengiz Özdemir, Sinem Nedime Sökücü, Ayşegül Akbaş, Sezin Altay, Ahmet Levent Karasulu, Levent Dalar
Bronchobiliary fistula (BBF) is a rare condition in which an abnormal communication exists between the bile ducts and the bronchial tree. Malignancy is the most common etiology of BBF, although many others are possible. A 74-year-old male patient with an inoperable Klatskin tumor presented with a complaint of yellow-green sputum and cough; the patient underwent fiber-optic bronchoscopy based on a preliminary diagnosis of bronchobiliary fistula. Using fiber-optic rigid bronchoscopy, the laterobasal segment of the lower right lung lobe was occluded using three pieces of 5-mm Endobronchial Watanabe Spigot...
2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Sean Sassano-Higgins, Dave Baron, Grace Juarez, Neevon Esmaili, Mark Gold
Ketamine was discovered in the 1960s and released for public use in 1970. Originally developed as a safer alternative to phencyclidine, ketamine is primarily used in clinical settings for analgesia and sedation. In recent years, other uses have been developed, including pain management and treatment of asthma and depression. Clinical use of ketamine causes dissociation and emergence delirium. These effects have led to recreational abuse. Although death from direct pharmacologic effects appears rare, the disinhibition and altered sensory perceptions caused by ketamine puts users at risk of environmental harm...
August 2016: Depression and Anxiety
H Rudolph, F Neser, M Berger, J Boese-Landgraf
Background: Roux-Y hepaticojejunostomy is currently the standard surgical procedure for the reconstruction of the bile duct after iatrogenic transection in laparoscopic cholecystectomy. However, about 30 % of all hepaticojejunostomies develop a stenosis after some time and in 7 % a cholangiocellular carcinoma occurs. Therefore, alternative procedures have been investigated. Patients: Between September 2009 and October 2013 an iatrogenic bile duct lesion was treated in 6 consecutive patients by using the pedicled umbilical vein...
May 31, 2016: Zentralblatt Für Chirurgie
Mitsuhito Koizumi, Teru Kumagi, Taira Kuroda, Nobuaki Azemoto, Hirofumi Yamanishi, Yoshinori Ohno, Tomoyuki Yokota, Hironori Ochi, Kazuhiro Tange, Yoshiou Ikeda, Yoichi Hiasa
Pancreatobiliary fistulas associated with intraductal papillary mucinous neoplasms (IPMN) often develop obstructive jaundice and cholangitis; thus, early diagnosis is important. However, computed tomography and cholangiography, the current methods for detecting pancreatobiliary fistulas, are not always effective. We previously reported a case of IPMN-associated pancreatobiliary fistula and proposed a potential new diagnostic marker: the "pig-nose" appearance of the duodenal papilla, which results from dilated pancreatic and bile ducts and can be visualized via endoscopy...
April 2016: Endoscopy International Open
Anubha Sahay, Nishant Sahay, Ashok Kapoor, Jyoti Kapoor, Abhishek Chatterjee
INTRODUCTION: Percutaneous destruction of cancer cells using a radiofrequency energy source has become an accepted part of the modern armamentarium for managing malignancies. Radiofrequency ablation (RFA) is a relatively novel procedure for treating recurrent and metastatic tumors. It is used for debulking tumors and as adjuvant therapy for palliative care apart from its role as a pain management tool. Its use in the third world countries is limited by various factors such as cost and expertise...
January 2016: Indian Journal of Palliative Care
Kunihiro Shinjo, Hiroyuki Matsubayashi, Toru Matsui, Noboru Kawata, Sunao Uemura, Yusuke Yamamoto, Hiroyuki Ono
A 78-year-old woman was referred to our hospital for the examination and treatment of jaundice. A transpapillary forceps biopsy for a long distal bile duct stricture was performed using endoscopic retrograde cholangiopancreatography. Immediately after the biopsy, massive bleeding was observed from the orifice of the papilla. Although hemobilia was pulsatile, an endoscopic biliary plastic stent placement was very effective in achieving hemostasis. However, a nasal biliary catheter was required because a blood clot clogged the stent on the following day...
April 2016: Clinical Journal of Gastroenterology
Takuji Iwashita, Yousuke Nakai, Kazuo Hara, Hiroyuki Isayama, Takao Itoi, Do Hyun Park
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) for management of bile duct stone (BDS) in patients with surgically altered anatomy is challenging even when applying enteroscopy. Endoscopic ultrasound-guided antegrade treatments (EUS-AG) for BDS have been developed but have not been well studied yet. The aim of the present study was to evaluate the feasibility and safety of EUS-AG for BDS in patients with surgically altered anatomy as a multicenter retrospective cohort study...
April 2016: Journal of Hepato-biliary-pancreatic Sciences
Hajime Imai, Masayuki Kitano, Shunsuke Omoto, Kumpei Kadosaka, Ken Kamata, Takeshi Miyata, Kentaro Yamao, Hiroki Sakamoto, Yogesh Harwani, Masatoshi Kudo
BACKGROUND AND AIMS: EUS-guided bile duct drainage (EUS-BD) is a well-recognized rescue biliary drainage method after unsuccessful ERCP. EUS-guided gallbladder drainage (EUS-GBD) was recently used to treat acute cholecystitis. The aim of this study was to assess the efficacy and safety of EUS-GBD for malignant biliary stricture-induced obstructive jaundice after unsuccessful ERCP as well as unsuccessful or impractical EUS-BD. METHODS: Between January 2006 and October 2014, 12 patients with obstructive jaundice due to unresectable malignant distal biliary stricture underwent EUS-GBD after ERCP failed...
July 2016: Gastrointestinal Endoscopy
Shengyong Li, Yuliang Li, Jianli Geng, Bin Liu, Ruohui Gao, Zhongxiao Zhou, Sanyuan Hu
OBJECTIVE: To evaluate the clinical effectiveness and safety of percutaneous transhepatic papillary balloon dilatation (PPBD) combined with laparoscopic cholecystectomy (LC) for the treatment of gallstones with common bile duct stones. MATERIALS AND METHODS: From February 2012 to January 2013, 65 patients (31 males and 34 females) who had gallstones with common bile duct stones were divided into two groups: endoscopic papillary balloon dilatation (EPBD)+LC (n = 40 cases) and PPBD+LC (n = 25 cases)...
November 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Fabiana Benjaminov, Olga Barkay, Fred M Konikoff
Patients with symptomatic bile duct stones are at increased risk for complications, which can be life-threatening. In the last four decades, with the development of endoscopic retrograde cholangiopancreatography (ERCP) and biliary sphincterotomy, endoscopic treatment has almost totally replaced surgical treatment of bile duct stones. In addition, a variety of benign and malignant conditions such as iatrogenic strictures (post cholecystectomy/post liver transplant), PSC, papillary adenoma or malignant tumors of bile duct or pancreas, are now amenable to endoscopic treatment...
August 2015: Harefuah
Shuya Shimizu, Takahiro Nakazawa, Kazuki Hayashi, Itaru Naitoh, Katsuyuki Miyabe, Hiromu Kondo, Yuji Nishi, Shuichiro Umemura, Yasuki Hori, Akihisa Kato, Tomohito Morisaki, Atsushi Nanashima, Hirotaka Ohara, Takashi Joh
We herein report the case of a 72-year-old man who underwent photodynamic therapy (PDT) with talaporfin sodium for recurrent cholangiocarcinoma after surgical resection. Endoscopic retrograde cholangiography (ERC) showed severe stenosis with an irregular surface measuring approximately 1 cm in length from the anastomotic site, and a recurrent nodular lesion was observed at the anastomotic site of the right anterior intrahepatic bile duct on gastrointestinal endoscopy. ERC after PDT revealed a dramatic improvement in the bile duct stenosis, and the nodular lesion had disappeared...
2015: Internal Medicine
Juan Francisco Hasslacher-Arellano, Gregorio Arellano-Aguilar, Juan Francisco Funes-Rodríguez, Santiago López-Forcén, Fernando Torres-Zapiain, Luis Gerardo Domínguez-Carrillo
BACKGROUND: In the management of hydrocephalus, the ventriculo-gallbladder shunt is justified in situations where the ventriculo-peritoneal shunt is not useful due to peritoneal involvement and/or when the ventriculo-auricular and ventriculo-pleural shunts are contraindicated. CLINICAL CASE: A 27 year-old female with hydrocephalus at birth, managed with ventricle-peritoneal shunt, modified 3 times throughout her life due to repeated infections and other different reasons...
May 2016: Cirugia y Cirujanos
Zhaolian Bian, Qi Miao, Wei Zhong, Haiyan Zhang, Qixia Wang, Yanshen Peng, Xiaoyu Chen, Canjie Guo, Li Shen, Fan Yang, Jie Xu, Dekai Qiu, Jingyuan Fang, Scott Friedman, Ruqi Tang, M Eric Gershwin, Xiong Ma
Collagen triple helix repeat containing-1 (Cthrc1) is a documented specific inhibitor of TGF-β signaling. Based on this observation, we developed the hypothesis that knocking in/knocking out the Cthrc1 gene in murine models of cholestasis would alter the natural history of cholestatic fibrosis. To study this thesis, we studied two murine models of fibrosis, first, common bile duct ligation (CBDL) and second, feeding of 3, 5-diethoxy-carbonyl-1, 4-dihydrocollidine (DDC). In both models, we administered well-defined adenoviral vectors that expressed either Cthrc1 or, alternatively, a short hairpin RNA (shRNA)-targeting Cthrc1 either before or after establishment of fibrosis...
September 2015: Journal of Autoimmunity
Nuria Estellés Vidagany, Carlos Domingo Del Pozo, Nuria Peris Tomás, Jose Ángel Díez Ares, Antonio Vázquez Tarragón, Francisco Blanes Masson
BACKGROUND: The choice of surgical technique to extract stones from the common bile duct (CBD) depends on local experience, anatomical characteristics and also on the size, location and number of stones. Most authors consider choledochotomy an alternative to failed transcystic exploration, although some use it exclusively. Although the CBD is traditionally closed with T-tube drainage after choledochotomy, its use is associated with 11.3-27.5 % morbidity. This study examined the efficacy of laparoscopic CBD exploration (LCBDE) with primary closure for the treatment of CBD stones using intraoperative cholangiography (IOC)...
May 2016: Surgical Endoscopy
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