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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
Zang Jinfeng, Yuan Yin, Zhang Chi, Gao Junye
INTRODUCTION: To explore the techniques for managing impacted common bile duct (CBD) stones during laparoscopic common bile duct exploration (LCBDE). METHODS: We retrospectively analyzed 377 consecutive patients undergoing LCBDE from January 2008 to June 2015. Group 1 was defined as patients with impacted CBD stones. Group 2 included patients without impacted CBD stones. The outcomes of LCBDE were compared between the two groups. RESULTS: There were 65 patients in Group 1 and 312 patients in Group 2...
August 2016: International Journal of Surgery
Sai-Bo Pan, Jian-Bin Zhang, Bai-Qin Zhao, Ying Chai
Postoperative iatrogenic diaphragmatic hernia after thoracoscopic lobectomy is extremely rare. We present a 55-year-old female patient who developed an iatrogenic diaphragmatic hernia with gastric perforation several months after VATS (video-assisted thoracic surgery) left upper lobectomy with systematic lymphadenectomy. During the readmission, urgent laparotomy was performed. Intraoperatively, the choledochoscopy was introduced into left thoracic cavity through the diaphragmatic defect for dissecting the secondary inflammatory adhesions and achieving satisfactory hemostasis...
June 2016: Journal of Thoracic Disease
Ming-Ming Xu, Michel Kahaleh
Peroral cholangioscopy has become an important tool in the diagnosis and treatment of a variety of biliary diseases, ranging from indeterminate biliary strictures to bile duct stones. Although the first cholangioscopy was performed in the 1970s, recent technological advances have provided us with cholangioscopes that yield high-resolution images, possess single-operator capability, and have ultrathin design to allow easier maneuverability and detailed imaging of the biliary tract. We review here the currently available devices for peroral cholangioscopy, their clinical applications, limitations, and complications...
2016: Clinical and Experimental Gastroenterology
Nikhil Gupta
Surgical fraternity has not yet arrived at any consensus for adequate treatment of choledocholithiasis. Sequential treatment in the form of pre-operative endoscopic retrograde cholangio-pancreatography followed by laparoscopic cholecystectomy (LC) is considered as optimal treatment till date. With refinements in technique and expertise in field of minimal access surgery, many centres in the world have started offering one stage management of choledocholithiasis by LC with laparoscopic common bile duct exploration (LCBDE)...
May 27, 2016: World Journal of Gastrointestinal Surgery
Kristaps Atstupens, Haralds Plaudis, Vladimirs Fokins, Maksims Mukans, Guntars Pupelis
BACKGROUNDS/AIMS: Laparoscopic treatment of patients with choledocholithiasis and cholangitis is challenging due to mandatory recovery of the biliary drainage and clearance of the common bile duct (CBD). The aim of our study was to assess postoperative course of cholangitis and biliary sepsis after laparoscopic clearance of the CBD in emergently admitted patients with choledocholithiasis and cholangitis. METHODS: Emergently admitted patients who underwent laparoscopic clearance of the CBD were included prospectively and stratified in 2 groups i...
May 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Biswajit Dey, Gourav Kaushal, Sajini Elizabeth Jacob, Adarsh Barwad, Biju Pottakkat
Hepatolithiasis or primary intrahepatic stones are prevalent in the Far-East countries such as Korea, Japan and Taiwan. It has been associated with helminthiasis, bacterial infections, environmental and dietary factors. Despite high prevalence of helminthiasis like ascariasis, poor environmental condition and low protein diet, India and Middle-East countries have a low incidence of hepatolithiasis. We report two cases of hepatolithiasis associated with bacterial infections and were surgically managed. The first case is a 45-year-old female presenting with upper abdominal pain and fever...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Fujing Lv, Shutian Zhang, Ming Ji, Yongjun Wang, Peng Li, Wei Han
OBJECTIVE: The aim of this study was to investigate the value of a single stage with combined tri-endoscopic (duodenoscopy, laparoscopy and choledochoscopy) approach for patients with concomitant cholecystolithiasis and choledocholithiasis. METHODS: Fifty-three patients with combined gallbladder stones and common bile duct stones from February 2014 to April 2015 were randomized assigned to two groups: 29 patients underwent single-stage surgery with combined duodenoscope, laparoscope and choledochoscope (combined tri-endoscopic group), and 29 patients underwent endoscopic sphincterotomy to remove common bile duct stones followed by laparoscopic cholecystectomy several days later (control group)...
April 28, 2016: Surgical Endoscopy
Esra Disci, Sabri Selcuk Atamanalp, Bunyami Ozogul, Mehmet Ilhan Yildirgan
OBJECTIVE: Advances in choledochoscopy technology lead to an improvement in the diagnosis and treatment of hepatopancreatobiliary diseases. The aim of this study is to reveal the role of choledochoscopy in hepatopancreatobiliary pathologies. MATERIALS AND METHODS: Choledochoscopy was used under general anesthesia in operation rooms. Flexible choledochoscope inserted via a vertical choledochotomy line, which was closed by primary closure, T-tube application, or choledochoduodenal anastomosis...
February 2016: Eurasian Journal of Medicine
Zhouqiao Wu, Lixin Wang
No abstract text is available yet for this article.
August 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Nirav Thosani, Richard S Zubarik, Rajan Kochar, Shivangi Kothari, Neeraj Sardana, Tu Nguyen, Subhas Banerjee
BACKGROUND AND STUDY AIMS: Choledochoscopy is increasingly performed during endoscopic retrograde cholangiopancreatography (ERCP) for direct bile duct visualization. Choledochoscopy necessitates irrigation of the bile duct with water or saline, which may increase intrabiliary pressure and consequently the risks of bacteremia and cholangitis. The aim of this study was to prospectively evaluate the risk of bacteremia and infectious complications in patients undergoing single-operator choledochoscopy (SOC)...
May 2016: Endoscopy
Juan José Núñez Ju, Eduardo Anchante Castillo, Victor Torres Cueva, Cecilia Yeren Paredes, Felix Carrasco Mascaro, Oscar Becerra, Ernesto Cordero Palomino, Julia Sumire
We report the case of a patient who had the initial diagnosis of tumor in the bile duct in the middle third. Patient presented with lost weight of 10 kilograms in two months and moderate epigastric pain, no jaundice. The patient underwent radical surgery of the bile duct with multiple freeze biopsy surgical margins, intraoperative choledochoscopy, intraoperative cholangiography and reconstruction bilioenteric anastomosis Y Roux transmesocolic, he had a great recovery and early discharge. The pathological results showed moderately differentiated tubular adenocarcinoma on the basis of an adenoma...
October 2015: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Ahmed ElGeidie, Ehab Atif, Yussef Naeem, Gamal ElEbidy
BACKGROUND: Laparoscopic common bile duct exploration (LCBDE) has been proven to be a safe, efficient, and cost-effective option for the management of common bile duct (CBD) stones. There are two guiding methods during LCBDE: fluoroscopic or choledochoscopic. Most surgeons prefer the use of flexible choledochoscopy at LCBDE, but it is a fragile, delicate, and expensive instrument. The aim of this work was to report our experience in fluoroscopically guided LCBDE. PATIENTS AND METHODS: A retrospective review of all patients who underwent LCBDE in the Mansoura Gastroenterology surgical center between March 2007 and September 2014 was performed...
October 2015: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
E Phillips, G Berci, K Barber, J Williams
BACKGROUND: Identifying and surgically removing bile duct calculi is challenging and critical in order to provide good patient outcomes. The history of this surgical pursuit since the introduction of anesthesia is both enlightening and fascinating. METHODS: A systematic review of the literature was conducted to identify the techniques and technology used to remove bile duct calculi. RESULTS: All bile duct surgical exploration advances have involved creation of tools to look within the bile duct and extract stones...
October 2015: Surgical Innovation
Eduardo E Montalvo-Javé, Germán E Mendoza Barrera, Alan I Valderrama Treviño, María C Piña Barba, César Montalvo-Arenas, Fernando Rojas Mendoza, Benjamin León Mancilla, Manuel A García Pineda, Álvaro Jaime Limón, Jorge Albores Saavedra, Jesús Tapia-Jurado
INTRODUCTION: Cholecystectomy is a common surgical procedure in which complications may occur, such as injury to the biliary tract, which are associated with high morbidity. The aim of this study was to demonstrate the efficacy of a polymer-based absorbable bioprosthesis with bone scaffold for the treatment of bile duct injury in an animal model. MATERIALS AND METHODS: An absorbable bioprosthesis was used to replace the common bile duct in 15 pigs which were divided into 3 groups with different follow-ups at 1, 3 and 6 months...
August 2015: International Journal of Surgery
Jian-Fei Zhang, Zhao-Qing Du, Qiang Lu, Xue-Min Liu, Yi Lv, Xu-Feng Zhang
Open surgery with common bile duct (CBD) exploration and T tube drainage are still traditionally performed in a large amount of selected patients with cholelithiasis and choledocholithiasis. Confirmation of CBD clearance via T tube cholangiography after surgery is a routine procedure before T tube removal. The present study aims at investigating potential risk factors associated with residual stones in CBD via T tube cholangiography.Patients undergoing open CBD exploration and T tube drainage for choledocholithiasis in the hospital were enrolled retrospectively from January 2011 to December 2013...
July 2015: Medicine (Baltimore)
Bin Zhu, Dan Li, Yu Ren, Ying Li, Yan Wang, Kai Li, Buhe Amin, Ke Gong, Yiping Lu, Ming Song, Nengwei Zhang
It is undetermined when and how laparoscopic common bile duct exploration (LCBDE) should be used in patients with common bile duct (CBD) stone-related nonsevere acute cholangitis. We aimed to evaluate the effect of LCBDE on the clinical outcome of those patients within (early) or beyond (delayed) 72 hours of emergent admission. Surgery-related complications, length of hospital stay (LOS), and total cost, as well as demographic and clinical parameters were compared between the two groups. Finally, 3 and 5 patients in early and delayed LCBDE group, respectively, had retained stones, which were removed by choledochoscopy before T-tube was removed...
2015: Scientific Reports
Xiaoming Ye, Kaiyuan Ni, Xiaoshuai Zhou, Kaigang Xie, Xiaoming Hong
INTRODUCTION: Hepatolithiasis is a prevalent disease in the southeastern coastal regions of China. Partial hepatectomy is the most definitive treatment for hepatolithiasis. This study evaluated the safety and efficacy of the laparoscopic left hemihepatectomy (LLH) for left-sided hepatolithiasis. METHODS: The clinical data of 37 consecutive patients who underwent pure LLH for left-sided hepatolithiasis at Yinzhou Second Hospital between March 2009 and December 2013 were reviewed retrospectively...
August 2015: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Soondoos Raashed, Manju D Chandrasegaram, Khaled Alsaleh, Glen Schlaphoff, Neil D Merrett
BACKGROUND: Right hepatic arterial injury (RHAI) is the most common vascular injury sustained during laparoscopic cholecystectomy, occurring in up to 7% of cholecystectomies. RHAI is also the most common vascular injury associated with a bile duct injury (BDI) and is reported to occur in up to 41 - 61% of cases when routine angiography is employed following a BDI. We present an unusual case of erosion of vascular coils from a previously embolised right hepatic artery into bilio-enteric anastomoses causing biliary obstruction...
2015: BMC Surgery
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