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CBD stones

Cheal Wung Huh, Sung Ill Jang, Beom Jin Lim, Hee Wook Kim, Jae Keun Kim, Jun Sung Park, Ja Kyung Kim, Se Joon Lee, Dong Ki Lee
Common bile duct (CBD) stones are generally associated with greater elevations of alkaline phosphatase and gamma-glutamyl transpeptidase levels than aspartate aminotransferase and alanine aminotransferase levels. However, some patients with CBD stones show markedly increased aminotransferase levels, sometimes leading to the misdiagnosis of liver disease. Therefore, the aim of this study was to investigate the clinicopathologic features of patients with CBD stones and high aminotransferase levels.This prospective cohort study included 882 patients diagnosed with CBD stones using endoscopic retrograde cholangiopancreatography (ERCP)...
October 2016: Medicine (Baltimore)
Yakun Xu, Chengyong Dong, Kexin Ma, Fei Long, Keqiu Jiang, Ping Shao, Rui Liang, Liming Wang
Several studies have shown the safety and feasibility of laparoscopic common bile duct exploration (LCBDE) as a minimally invasive treatment options for choledocholithiasis. Use of T-tube or biliary stent drainage tube placement after laparoscopic choledochotomy for common bile duct (CBD) stones is still under debate. This study tried to confirm the safety of spontaneously removable biliary stent in the distal CBD after LCBDE to allow choledochus primary closure. A total of 47 patients with choledocholithiasis underwent LCBDE with primary closure and internal drainage using a spontaneously removable biliary stent drainage tube (stent group, N = 22) or T-tube (T-tube group, N = 25)...
September 2016: Medicine (Baltimore)
Kuang-Chun Hu, Cheng-Hsin Chu, Horng-Yuan Wang, Wen-Hsiung Chang, Shee-Chan Lin, Chuan-Chuan Liu, Wei-Chih Liao, Chun-Jen Liu, Ming-Shiang Wu, Shou-Chuan Shih
Common bile duct (CBD) stones are common in elderly adults, but the effect of aging on the presentation of CBD stones remains to be evaluated. Recent studies have demonstrated that the clinical presentation of CBD stones may vary with age. Younger adults may present with classical biliary colic symptoms, whereas elderly adults may have no unapparent clinical features. Younger adults with CBD stones were significantly more likely to have abnormal liver function tests than those without. The sensitivity and accuracy of transabdominal ultrasound scans in screening for CBD stones increases with age...
September 27, 2016: Journal of the American Geriatrics Society
Ricardo Mejía, Pablo Achurra, Mauricio Gabrielli, Eduardo Briceño, Rolando Rebolledo, Alberto Torres, Allan Sharp, Fernando Pimentel, Fernando Crovari
BACKGROUND: Common bile duct (CBD) stones in a Roux-en-Y gastric bypass (RYGB) represent a major challenge for ERCP due to long-limb anatomy. Trans-gastric approach has been proposed but entails high ERCP-related risks. Laparoscopy assisted trans-gastric rendez-vous (LATG-RV) is a one-step procedure that may lower the risks of these patients. METHODS: We describe our initial experience in four patients with past history of RYGB and CBD stones. RESULTS: All patients underwent LATG-RV and had successful CBD stone clearance...
September 10, 2016: Obesity Surgery
Min Wang, Xu He, Chuan Tian, Jian Li, Feng Min, Hong-Yan Li
Background. In order to assess the diagnostic accuracy of linear EUS for evaluating clinically suggestive CBD stones in high-risk groups. Methods. 202 patients with clinically suggestive CBD stones in high-risk groups who underwent linear EUS examination between January 2012 and January 2015 were retrospectively reviewed. Endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction or surgical choledochoscopy was only performed when a CBD stone was detected by linear EUS. Cases that were negative for CBD stones were followed up for at least 6 months...
2016: Gastroenterology Research and Practice
Antonio Navarro-Sánchez, Hutan Ashrafian, Juan José Segura-Sampedro, Alberto Martrinez-Isla
BACKGROUND: Laparoscopic bile duct exploration (LBDE) is recommended in current treatment guidelines for the management of choledocholithiasis with gallbladder in situ. Failure of this technique is common as a consequence of large or impacted common bile duct (CBD) stones. In this series, we present our experience in using holmium laser lithotripsy as an adjunct to LBDE for the treatment of choledocholithiasis. METHODS: Between 2014 and 2016, eighteen laparoscopic bile duct explorations utilising holmium laser lithotripsy were performed after failure of standard retrieval techniques...
August 29, 2016: Surgical Endoscopy
Pouya Iranmanesh, Olivier Tobler, Sandra De Sousa, Jean-Louis Frossard, Philippe Morel, Christian Toso
BACKGROUND AND AIMS: Initial cholecystectomy for patients at intermediate-risk of common bile duct (CBD) stone (including increased liver function tests but bilirubin <4 mg/dL and no cholangitis) showed decreased length of stay (LOS) and fewer common bile duct investigations without increased morbidity compared with sequential CBD endoscopic assessment and subsequent cholecystectomy in a randomized controlled trial. The objectives were to prospectively validate these results in daily clinical practice and discuss current guidelines...
August 24, 2016: Gastrointestinal Endoscopy
Rutger Quispel, Lydi M W J van Driel, Bart J Veldt, Paul M M van Haard, Marco J Bruno
BACKGROUND AND STUDY AIM: Endoscopic ultrasonography (EUS) is an established diagnostic modality for diagnosing common bile duct (CBD) stones. Its use has led to a reduction in the number of endoscopic retrograde cholangiopancreatography (ERCP) procedures performed for suspected choledocholithiasis. We aimed to explore the role of EUS in detecting CBD stones and/or sludge in common gastroenterology practice. PATIENTS AND METHODS: We reviewed case records of 268 consecutive patients who underwent (EUS) procedures performed to confirm or rule out the presence of CBD stones and/or sludge between November 2006 and January 2011 in the Reinier de Graaf Hospital, Delft, The Netherlands, which is a nonacademic community hospital...
August 23, 2016: European Journal of Gastroenterology & Hepatology
Yuka Masuda, Yoshiaki Mizuguchi, Tomohiro Kanda, Hiroyasu Furuki, Yasuhiro Mamada, Nobuhiko Taniai, Yoshiharu Nakamura, Masato Yoshioka, Akira Matsushita, Yoichi Kawano, Tetsuya Shimizu, Eiji Uchida
Limy bile syndrome extending to the common bile duct (CBD) is a rare condition that lacks a standardized treatment. Laparoscopic cholecystectomy with laparoscopic choledocholithotomy by CBD exploration is preferred because it preserves the function of the sphincter of the Vater's papilla and allows treatment of both lesions. A 37-year-old man who was receiving entecavir for chronic hepatitis B developed right upper quadrant pain. Abdominal ultrasonography revealed a calcified shadow in the gallbladder and CBD...
August 24, 2016: Asian Journal of Endoscopic Surgery
Marlein Miranda Cona, Ye-Wei Liu, Antoine Hubert, Ting Yin, Yuan-Bo Feng, Peter de Witte, Etienne Waelkens, Yan-Sheng Jiang, Jian Zhang, Stefaan Mulier, Qian Xia, Gang Huang, Raymond Oyen, Yi-Cheng Ni
AIM: To explore the feasibility of using hypericin as an optical imaging probe with affinity for cholesterol for differential fluorescent detection of human gallstones. METHODS: Cholesterol, mixed and pigment stones from cholecystectomy patients were incubated with hypericin or solvent. After 72 h, the stones were analysed for fluorescence (365 nm) and treated with 2-propanol/dimethyl sulfoxide for high performance liquid chromatography (HPLC) analysis. Rats with virtual gallbladder containing human cholesterol, mixed or pigment gallstones (VGHG) received 5 mg/kg hypericin or solvent and VGHG rats with cholesterol stones were given different hypericin doses (5-15 mg/kg)...
August 7, 2016: World Journal of Gastroenterology: WJG
Liang Gui, Ye Liu, Jun Qin, Lei Zheng, Yi-Jun Huang, Yue He, Wen-Sheng Deng, Bin-Bin Qian, Meng Luo
OBJECTIVE: To evaluate the safety and benefits of laparoscopic common bile duct exploration (LCBDE) compared with open approach (OCBDE) in cirrhotic patients. MATERIALS AND METHODS: Between January 2009 and December 2012, a total of 113 cirrhotic patients with choledocholithiasis underwent common bile duct (CBD) explorations in our department. There were two groups of patients: A:LCBDE (n = 61) and B:OCBDE (n = 52). Patients' demographic characteristics, surgical data, postoperative outcomes, and long-term results were retrospectively collected and analyzed...
August 10, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Yu Tian, Shuodong Wu, Chun-Chih Chen, Yongsheng Chen
BACKGROUND: Optimization of quality of life is an important goal in the advanced surgery. Herein we share our fifteen cases to demonstrate the feasibility of scarless laparoendoscopic single-site common bile duct (CBD) exploration using conventional instruments in the management of CBD stones. METHODS: Fifteen patients (4 male) underwent transumbilical laparoendoscopic single-site cholecystectomy and CBD exploration: the patients were diagnosed with CBD stones. The endoscopic nasobiliary drainage (ENBD), endoscopic retrograde biliary drainage (ERBD) or J-type tube was introduced into the CBD preoperatively or intraoperatively...
September 2016: International Journal of Surgery
Chan Sup Shim, Ji Wan Kim, Tae Yoon Lee, Young Koog Cheon
In recent years, endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) has been shown to be an effective technique for the removal of large or difficult common bile duct (CBD) stones, as an alternative to EST. Reviewing the literature published since 2003, it is understood that EPLBD has fewer associated overall complications than EST. Bleeding occurred less frequently with EPLBD than with EST. There was no significant difference in postendoscopic retrograde cholangiopancreatography pancreatitis or perforation...
July 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Duminda Subasinghe, Edippuli Arachchige Don Udayakumara, Upul Somathilaka, Milinda Huruggamuwa
Background. Spontaneous perforation of the extrahepatic biliary system is a rare presentation of gall stones. Very few cases of bile duct perforation have been reported in adults. It is rarely suspected or correctly diagnosed preoperatively. Case Presentation. A 66-year-old female presented at the surgical emergency with 3 days' history of severe upper abdominal pain with distension and repeated episodes of vomiting, as she had evidence of generalized peritonitis and underwent an exploratory laparotomy. A single 0...
2016: Case Reports in Gastrointestinal Medicine
N Ozcan, G Kahriman, O Karabiyik, H Donmez, E Emek
PURPOSE: The purpose of this study was to analyze the outcome of percutaneous management of residual common bile duct (CBD) stones in patients with surgically inserted T-tube in CBD after cholecystectomy. MATERIAL AND METHODS: Between April 2001 and August 2015, 89 patients (52 women, 37 men) with a mean age of 55.7 years±18 (SD) (range, 22-88 years) underwent percutaneous sphincteroplasty and stone expulsion into the duodenum with a Fogarty balloon catheter through the T-tube tract for residual CBD stones...
July 12, 2016: Diagnostic and Interventional Imaging
Jinfeng Zang, Yin Yuan, Chi Zhang, Junye Gao
BACKGROUND: Laparoscopic cholecystectomy (LC) is the standard treatment for gallbladder diseases. Intraoperative cholangiography (IOC) can reduce biliary complications of LC; however, with the emergence of magnetic resonance cholangiopancreatography (MRCP), IOC nowadays is faced with unprecedented challenge. The purpose of this study is to evaluate whether preoperative MRCP can safely replace IOC during elective LC in terms of retained common bile duct (CBD) stones and bile duct injury (BDI)...
2016: BMC Surgery
Chung-Mou Kuo, Yi-Chun Chiu, Chih-Ming Liang, Lung-Sheng Lu, Wei-Chen Tai, Yuan-Hung Kuo, Cheng-Kun Wu, Seng-Kee Chuah, Chi-Sin Changchien, Chung-Huang Kuo
BACKGROUND: Difficult biliary cannulation in endoscopic retrograde cholangiopancreatography (ERCP) can result in failure of common bile duct (CBD) stone removal and pancreatitis. The present study aimed to report the efficacy and safety of limited precut sphincterotomy (PS) combined with endoscopic papillary balloon dilation (EPBD) for CBD stone removal in patients with difficult biliary cannulation, and the complications associated with this combined procedure. METHODS: A total of 3305 patients underwent ERCP in our hospital between October 2009 and September 2014 and 258 were diagnosed with difficult biliary cannulation...
2016: BMC Gastroenterology
Vikas Singla, Anil Arora, Pankaj Tyagi, Praveen Sharma, Naresh Bansal, Ashish Kumar
Common bile duct (CBD) stones can lead to serious complications and require intervention with either endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic techniques for urgent relief. On an average 10%-20% of the patients with gall bladder stones can have associated CBD stones. CBD stones during pregnancy can be associated with hazardous complications for both the mother and the fetus. Failed cannulation while performing ERCP during pregnancy is a technically demanding situation, which requires immediate rescue with special techniques...
May 2016: Endoscopic Ultrasound
Nisa Netinatsunton, Siriboon Attasaranya, Jaksin Sottisuporn, Teepawit Witeerungrot, Theeratus Jongboonyanuparp, Teerha Piratvisuth, Bancha Ovartlarnporn
BACKGROUND AND OBJECTIVES: Endoscopic ultrasound (EUS) achieves results comparable to endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of common bile duct (CBD) stone, but studies from the western have shown EUS to be less expensive in patients with intermediate risk for CBD stones. The aim of this study was to compare the costs of EUS and ERCP in the diagnosis of CBD stones in a developing country. MATERIALS AND METHODS: A prospective study was done with 141 patients with suspected CBD stones, categorized as having high or intermediate risk for CBD stone...
May 2016: Endoscopic Ultrasound
Nooman Gilani, Muhammad Farooq Hanif, Veronika Karasek
We report the first case of Mirizzi syndrome in a patient who presented with biliary obstruction caused by pure calcium carbonate stones. A 61 years old male with history of portal vein thrombosis presented with rash, nausea and jaundice. An ultrasound of biliary tree showed gallstones with dilatation of hepatic duct and intrahepatic biliary tree. There was suspicion of a stone in proximal CBD. CT scan showed an opaque gallbladder with dense radio-opaque material in its lumen. An ERCP was then performed revealing external common hepatic duct obstruction at the neck of the gallbladder...
June 2016: JPMA. the Journal of the Pakistan Medical Association
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