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Bile duct alternative treatment

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https://www.readbyqxmd.com/read/28512772/subspecialty-approach-for-the-management-of-acute-cholecystitis-an-alternative-to-acute-surgical-unit-model-of-care
#1
Sonia Tran, Vincent Choi, Kirsten Hepburn, Nathan Hewitt, Joel Zhou, Daniel L Chan, Michael L Talbot
BACKGROUND: Acute cholecystitis is a common condition. Recent studies have shown an association between creation of an acute surgical unit (ASU) and improved outcomes. This study aimed to evaluate the outcomes of a subspecialty based approach to the management of acute cholecystitis as an alternative to the traditional 'generalist' general surgery approach or the ASU model. METHOD: A 6-year retrospective analysis of outcomes in patients admitted under a dedicated upper gastrointestinal service for acute cholecystitis undergoing emergency laparoscopic cholecystectomy...
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28414680/a-rare-cause-of-abdominal-pain
#2
E M Dauchy, M Modica, N Masri
CASE: A 54 year old woman with hypothyroidism presented with right flank pain that began acutely one week prior to presentation. She was told initially she had a urinary tract infection and treatment resulted in mild symptomatic improvement. The pain returned and she presented to another Emergency Department (ED); and was told the pain was due to constipation. She returned to the ED the next day when her pain worsened and her labs were notable for WBC of 19,000/uL, BUN/Cr of 28/0.75 mg/dL, AST of 31 U/L, ALT of 92 U/L and total bilirubin of 0...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28350426/pharmacological-interventions-for-primary-biliary-cholangitis-an-attempted-network-meta-analysis
#3
REVIEW
Francesca Saffioti, Kurinchi Selvan Gurusamy, Leonardo Henry Eusebi, Emmanuel Tsochatzis, Brian R Davidson, Douglas Thorburn
BACKGROUND: Primary biliary cholangitis (previously primary biliary cirrhosis) is a chronic liver disease caused by the destruction of small intra-hepatic bile ducts resulting in stasis of bile (cholestasis), liver fibrosis, and liver cirrhosis. The optimal pharmacological treatment of primary biliary cholangitis remains uncertain. OBJECTIVES: To assess the comparative benefits and harms of different pharmacological interventions in the treatment of primary biliary cholangitis through a network meta-analysis and to generate rankings of the available pharmacological interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28331262/percutaneous-transhepatic-biliary-drainage-in-the-management-of-post-surgical-biliary-leaks
#4
Bhavesh Popat, Dev Thakkar, Hemant Deshmukh, Krantikumar Rathod
The aim of this study was to evaluate the efficacy of percutaneous transhepatic biliary drainage (PTBD) in the treatment of post-surgical biliary leaks and its efficacy in restoring the integrity of bile ducts. One hundred and fifty-seven patients with a post-surgical biliary leak were treated by means of percutaneous transhepatic biliary drainage. The biliary leak was due to laparoscopic procedures in 114 patients, while 43 patients had postoperative leak following open surgery. Percutaneous transhepatic biliary drainage was performed with an 8- to 10-F catheter, with the side holes positioned proximal to the site of extravasation to divert bile flow away from the leak site...
February 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28286559/a-comparative-evaluation-of-treatment-methods-for-bile-duct-stones-after-hepaticojejunostomy-between-percutaneous-transhepatic-cholangioscopy-and-peroral-short-double-balloon-enteroscopy
#5
Koichiro Tsutsumi, Hironari Kato, Shuntaro Yabe, Sho Mizukawa, Hiroyuki Seki, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Hirofumi Kawamoto, Hiroyuki Okada
BACKGROUND: Bile duct stones after hepaticojejunostomy are considered a troublesome adverse event. Although percutaneous transhepatic procedures using a cholangioscopy is performed to treat these bile duct stones, a peroral endoscopic procedure using a short, double-balloon enteroscope (sDBE) is an alternative. This study aimed to compare the immediate and long-term outcomes of both treatments for bile duct stones in patients who underwent prior hepaticojejunostomy. METHODS: Between October 2001 and May 2013, 40 consecutive patients were treated for bile duct stones after hepaticojejunostomy at a tertiary care hospital...
January 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28105582/-control-of-opisthorchis-viverrini-infection-for-cholangiocarcinoma-prevention
#6
Y Buisson
The International Agency for Research on Cancer (IARC) has classified two liver flukes as carcinogenic to humans (Group 1): Opisthorchis viverrini in 1994 and Clonorchis sinensis in 2009. This review is focused on O. viverrini, the most studied of these two trematodes, which infects nearly 10 million people in Southeast Asia. The life cycle involves two intermediate hosts living in fresh water: a snail of the genus Bithynia and a ciprinid fish. The definitive hosts (human, cat, dog) become infected by ingesting raw fish containing metacercariae, the infective stage of the parasite...
January 19, 2017: Bulletin de la Société de Pathologie Exotique
https://www.readbyqxmd.com/read/28081327/biliary-stenting-in-difficult-common-bile-duct-stones-a-single-tertiary-center-experience
#7
Mahmut Yüksel, Selçuk Dişibeyaz, Mustafa Kaplan, Erkan Parlak, Hakan Yıldız, İhsan Ates, Ertuğrul Kayaçetin
BACKGROUND/AIM: We aimed to examine the effect of plastic biliary stenting in the treatment of common bile duct (CBD) stones. MATERIALS AND METHODS: The data of 13,034 patients in our unit who had endoscopic retrograde cholangiopancreatography (ERCP) between 2008 and 2015 were scanned retrospectively. RESULTS: A biliary stent was placed in 61 of 74 patients. While the plastic biliary stent was placed in patients, the mean stone size after the 1st ERCP was 20 mm and the bile duct size was 13 mm...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28066983/endoscopic-ultrasound-guided-antegrade-biliary-stenting-for-unresectable-malignant-biliary-obstruction-in-patients-with-surgically-altered-anatomy-single-center-prospective-pilot-study
#8
Takuji Iwashita, Ichiro Yasuda, Tsuyoshi Mukai, Keisuke Iwata, Shinpei Doi, Shinya Uemura, Masatoshi Mabuchi, Mitsuru Okuno, Masahito Shimizu
BACKGROUND AND AIM: Endoscopic retrograde cholangiography (ERCP) with biliary stenting for the treatment of unresectable malignant biliary obstruction (MBO) is challenging among patients with surgically altered anatomy. Endoscopic ultrasound-guided antegrade biliary stenting (EUS-ABS) was introduced as an alternative biliary drainage method, although it has not yet been well studied. In this single-center prospective pilot study, we aimed to evaluate the feasibility and safety of EUS-ABS for MBO in patients with surgically altered anatomy...
May 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28058710/stereotactic-ablative-radiotherapy-for-patients-with-unresectable-or-medically-inoperable-cholangiocarcinoma
#9
Ming-Yueh Liu, Cheng-Hsiang Lo, Chun-Shu Lin, Hsing-Lung Chao, Jen-Fu Yang, Kuen-Tze Lin, Chao-Yueh Fan, Yu-Fu Su, Wen-Yen Huang
PURPOSE: The role of stereotactic ablative radiotherapy (SABR) in patients with unresectable or medically inoperable cholangiocarcinoma remains unclear. We examined the efficacy and safety of SABR in this group of patients. METHODS: From January 2008 to December 2014, 15 patients with 17 lesions were included in this study. The lesions included 14 intrahepatic, 1 hilar, and 2 distal bile duct tumors. Three patients were classified as medically inoperable because of old age or multiple comorbidities...
January 5, 2017: Tumori
https://www.readbyqxmd.com/read/28054294/treatment-of-common-bile-duct-stones-in-gastric-bypass-patients-with-laparoscopic-transgastric-endoscopic-retrograde-cholangiopancreatography
#10
Nina A Frederiksen, Louise Tveskov, Frederik Helgstrand, Lars Naver, Andrea Floyd
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass excludes the biliary tree from traditional evaluation and treatment with endoscopic retrograde cholangiopancreatography (ERCP). Due to the initial rapid weight loss, gastric bypass patients have an increased risk of developing gallstones in the gallbladder as well as in the common bile duct. Various techniques to access the biliary tree have been described. The techniques are characterised by complexity and varying results. The aim of the present study was to assess both feasibility and outcome of laparoscopic-assisted transgastric ERCP in patients with gastric bypass...
June 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27866907/radiofrequency-ablation-for-intraductal-extension-of-ampullary%C3%A2-neoplasms
#11
Tarun Rustagi, Shayan Irani, D Nageshwar Reddy, Barham K Abu Dayyeh, Todd H Baron, Christopher J Gostout, Michael J Levy, John Martin, Bret T Petersen, Andrew Ross, Mark D Topazian
BACKGROUND AND AIMS: Extension of ampullary adenomas into the common bile duct (CBD) or pancreatic duct (PD) may be difficult to treat endoscopically. We evaluated the feasibility, safety, and efficacy of endoscopic radiofrequency ablation (RFA) in the management of ampullary neoplasms with intraductal extension. METHODS: This was a multicenter, retrospective analysis of all patients with intraductal extension of ampullary neoplasms treated with endoscopic RFA between February 2012 and June 2015...
November 17, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27803771/efficacy-and-safety-of-endoscopic-papillary-balloon-dilation-for-the-removal-of-bile-duct-stones-data-from-a-real-life-multicenter-study-on-dilation-assisted-stone-extraction
#12
Roberto Di Mitri, Filippo Mocciaro, Socrate Pallio, Giulia Maria Pecoraro, Andrea Tortora, Claudio Zulli, Simona Attardo, Attilio Maurano
AIM: To report data on Dilation-Assisted Stone Extraction (DASE) use in clinical practice and its efficacy and safety trough three Italian referral centers for biliopancreatic diseases treatment. METHODS: From January 2011 to December 2015 we collected data on 120 patients treated with DASE. Technical success was obtained when the endoscopist was able to place the balloon trough the papilla inflating the balloon until the final diameter for an adequate time (at least 30 s)...
October 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27788612/a-european-survey-of-perendoscopic-treatment-of-biliary-complications-in-patients-with-alveolar-echinococcosis
#13
Sylvain Ambregna, Stéphane Koch, Michael C Sulz, Beate Grüner, Sümeyra Öztürk, Jean-Baptiste Chevaux, Małgorzata Sulima, Andrea de Gottardi, Bertrand Napoléon, Armand Abergel, Philippe Bichard, Isabelle Boytchev, Pierre Deprez, Jerome Dumortier, Jean-Louis Frossard, Eric Kull, Bernard Meny, Darius Moradpour, Fréderic Prat, Geoffroy Vanbiervliet, Thierry Thevenot, Dominique Angèle Vuitton, Solange Bresson-Hadni, Lucine Vuitton
BACKGROUND: Biliary complications represent a turning point in the course of Alveolar Echinococcosis (AE). We conducted a European survey to collect data on the current usage and results of perendoscopic interventions (PEIs) for their treatment. METHODS: Patient's characteristics and follow-up until January 31st, 2015 were recorded using an online questionnaire. RESULTS: From 18 centers 129 PEIs were analyzed in 38 patients; 139 plastic stents were inserted during 85 PEIs; median time between stent placements was significantly longer when 3 stents or more were placed...
January 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27752182/introducing-a-new-experimental-islet-transplantation-model-using-biomimetic-hydrogel-and-a-simple-high-yield-islet-isolation-technique
#14
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...
July 2017: Iranian Biomedical Journal
https://www.readbyqxmd.com/read/27589348/endoscopic-management-of-bile-duct-injury-after-hepatobiliary-tract-surgery-a-comprehensive-review
#15
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 (BDIs) 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. BDIs 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. Endoscopic treatment is the main option for biliary leak...
December 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27468093/obeticholic-acid-for-the-treatment-of-primary-biliary-cholangitis
#16
REVIEW
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
https://www.readbyqxmd.com/read/27456958/laparoscopic-management-of-gallbladder-cancer-a-stepwise-approach
#17
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...
December 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27399112/a-case-report-clinical-application-of-celiac-plexus-block-in-bile-duct-interventional-procedures
#18
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)
https://www.readbyqxmd.com/read/27397612/personalized-peptide-vaccine-induced-immune-response-associated-with-long-term-survival-of-a-metastatic-cholangiocarcinoma-patient
#19
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
https://www.readbyqxmd.com/read/27374219/endobronchial-watanabe-spigot-in-the-treatment-of-bronchobiliary-fistula
#20
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
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