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https://www.readbyqxmd.com/read/28337485/safety-and-efficacy-of-minimal-biliary-sphincterotomy-with-papillary-balloon-dilation-m-ebs-epbd-in-patients-using-clopidogrel-or-anticoagulation
#1
Shaffer R S Mok, Murtaza Arif, David L Diehl, Harshit S Khara, Henry C Ho, Adam B Elfant
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (EBS) or endoscopic papillary balloon dilation (EPBD) are common techniques of biliary decompression. Potential risks include gastrointestinal hemorrhage, which can be increased by antiplatelet agents, anticoagulants (AC) and/or novel oral anticoagulants (NOACs) (ie. apixaban, dabigatran and rivaroxaban). The study aim is to evaluate the safety/efficacy of an alternative technique, minimal-EBS plus EPBD (m-EBS + EPBD), in individuals for whom clopidogrel, AC, and/or NOACs cannot be interrupted due to high cardiovascular or thromboembolic risk...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28337482/efficacy-and-safety-of-novel-digital-single-operator-peroral-cholangioscopy-guided-laser-lithotripsy-for-complicated-biliary-stones
#2
John Ct Wong, Raymond Sy Tang, Anthony Yb Teoh, Joseph Jy Sung, James Yw Lau
Background/study aims Laser lithotripsy can effectively fragment complicated biliary stones, but current cholangioscopes are limited by fragility, restricted mobility or moderate visual resolution. The efficacy and safety of a new digital single-operator peroral cholangioscope to guide laser lithotripsy were evaluated. Patients and methods In this prospective single-center series, consecutive patients with complicated biliary stones, defined as impacted stones > 1.5 cm in size and wider than the more distal common bile duct, or stones that failed extraction by basket mechanical lithotripsy, underwent ERCP and SpyGlass DS peroral cholangioscope (Boston Scientific, Marlborough, United States)-guided laser lithotripsy...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28336502/a-new-accurate-model-for-predicting-mortality-up-to-12-months-after-ercp
#3
Nalan Gülşen Ünal, Fatih Tekin
No abstract text is available yet for this article.
March 23, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28336200/systematic-review-of-transgastric-ercp-in-roux-en-y-gastric-bypass-patients
#4
Nikhil Banerjee, Mayur Parepally, T Karl Byrne, Rana C Pullatt, Gregory A Coté, B Joseph Elmunzer
Balloon-assisted endoscopic retrograde cholangiopancreatoscopy (ERCP) in Roux-en-Y gastric bypass (RYGB) patients is technically challenging due to anatomic and accessory constraints, thus success rates are modest. Transgastric ERCP (TG-ERCP) offers a viable alternative. We aimed to systematically review the literature on TG-ERCP in RYGB patients to better define the technical approaches, success rates, and adverse events of this procedure. A computer-assisted search of the Embase and PubMed databases was performed to identify studies that focused on the techniques and clinical outcomes of TG-ERCP...
February 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28330448/ascending-cholangitis-secondary-to-migrated-embolization-coil-of-gastroduodenal-artery-pseudo-aneurysm-a-case-report
#5
Haithem Zaafouri, Anis Hasnaoui, Sonia Essghaeir, Dhafer Haddad, Meriam Sabbah, Ahmed Bouhafa, Jamel Kharrat, Anis Ben Maamer
BACKGROUND: Gastroduodenalartery (GDA) pseudo-aneurysms are very rare. Their clinical importance lies in the eventuality of rupture, causing bleeding and ultimately exsanguination. CASE PRESENTATION: We report the case of a man, with prior history of biliary surgery, presenting with haemobilia secondary to a rupture of GDA pseudo-aneurysm eroding the main bile duct. The patient was treated with coil embolization. This technique is considered to be safe. However, on the long term, some complications may occur...
March 23, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28322898/biliary-stent-migration-a-rare-cause-of-a-bladder-stone
#6
Neha R Malhotra, Carlos Amir Esparza Monzavi, Jean-Sebastien Trepanier, Johan Nordenstam, Michael R Abern
Our patient presented with dysuria and pneumaturia without any prior urologic instrumentation. History included choledocolithiasis requiring ERCP and biliary stenting. Imaging showed a large bladder stone. She was taken to surgery and found to have diverticulitis. The sigmoid was resected and the bladder found to have a small fistula tract. The bladder was opened and a large calculus was identified and extracted. The stone was opened and found to contain a biliary stent. While biliary stenting is generally considered safe, migration can occur...
March 17, 2017: Urology
https://www.readbyqxmd.com/read/28321347/association-of-chronic-pancreatitis-and-malignant-main-duct-ipmn-a-rare-but-difficult-clinical-problem
#7
Zoltán Berger, Hernán De La Fuente, Manuel Meneses, Fernanda Matamala, Makarena Sepúlveda, Claudia Rojas
We report the case of a 70-year-old woman who consulted for recurrent short episodes of mild-to-moderate abdominal pain. Dilated main pancreatic duct was seen on CAT scan and magnetic resonance, with multiple calcifications and intraductal stones, typical in CP. However, for a more pronounced cystic dilatation in the pancreatic head, we could not exclude the coexistence of a main duct IPMN. ERCP was performed, with pancreatic sphincterotomy and extraction of pancreatic stones, but, at the same time, mucin extrusion was seen from the dilated duct through the papilla...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28321164/efficacy-and-safety-of-limited-endoscopic-sphincterotomy-before-self-expandable-metal-stent-insertion-for-malignant-biliary-obstruction
#8
Hyeong Seok Nam, Dae Hwan Kang, Hyung Wook Kim, Cheol Woong Choi, Su Bum Park, Su Jin Kim, Dae Gon Ryu
AIM: To evaluate the safety and efficacy of limited endoscopic sphincterotomy (ES) before placement of self-expandable metal stent (SEMS). METHODS: This was a retrospective analysis of 244 consecutive patients with unresectable malignant biliary obstruction, who underwent placement of SEMSs following limited ES from December 2008 to February 2015. The diagnosis of malignant biliary obstruction and assessment of patient eligibility for the study was established by a combination of clinical findings, laboratory investigations, imaging and pathological results...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28315036/diagnosing-chronic-pancreatitis
#9
REVIEW
Ahmad Anaizi, Phil A Hart, Darwin L Conwell
Diagnosing CP can range from routine in those with severe disease and obvious calcifications on CT imaging to elusive in those patients with early changes in CP. The workup of suspected CP should follow a progressively noninvasive to more invasive STEP-wise approach in a patient with a suspicious clinical presentation and risk factors that raise their pretest probability of disease. After a thorough history and physical examination, basic laboratories should be obtained such as lipase, amylase, metabolic panel, and indirect PFTs (fecal elastase-1, serum trypsin)...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28303610/new-rescue-technique-of-endoscopic-ultrasonography-guided-rendezvous-procedure-with-video
#10
Hiroshi Kawakami, Yoshimasa Kubota
The newly developed endoscopic ultrasonography-guided rendezvous procedure (EUS-RV) is used after failed endoscopic retrograde cholangiopancreatography (ERCP) [1,2]. Guidewire manipulation is one of the most challenging aspects of EUS-RV. A rescue technique that bounces back the guidewire from the perihilar bile duct in a long endoscopic position is commonly used. Herein, we describe a case using EUS-RV in a short endoscopic position. This article is protected by copyright. All rights reserved.
March 16, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28299352/a-simple-ergonomic-measure-reduces-fluoroscopy-time-during-ercp-a-multivariate-analysis
#11
Fahd Jowhari, Wilma M Hopman, Lawrence Hookey
Background and study aims Endoscopic retrograde cholangiopancreatgraphy (ERCP) carries a radiation risk to patients undergoing the procedure and the team performing it. Fluoroscopy time (FT) has been shown to have a linear relationship with radiation exposure during ERCP. Recent modifications to our ERCP suite design were felt to impact fluoroscopy time and ergonomics. This multivariate analysis was therefore undertaken to investigate these effects, and to identify and validate various clinical, procedural and ergonomic factors influencing the total fluoroscopy time during ERCP...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28298192/how-to-select-patients-and-timing-for-rectal-indomethacin-to-prevent-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis
#12
REVIEW
Jianhua Wan, Yuping Ren, Zhenhua Zhu, Liang Xia, Nonghua Lu
BACKGROUND: Acute pancreatitis is a severe complication of endoscopic retrograde cholangiopancreatography (ERCP). Previous meta-analyses have shown that indomethacin effectively prevents this complication; however, the data are limited. We performed a systematic review and meta-analysis to clarify the applications for rectal indomethacin. METHODS: A systematic search was performed in June 2016. Human prospective, randomized, placebo-controlled trials that compared rectally administered indomethacin with a placebo for the prevention of post-ERCP pancreatitis (PEP) were included...
March 15, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28294404/improved-classification-of-indeterminate-biliary-strictures-by-probe-based-confocal-laser-endomicroscopy-using-the-paris-criteria-following-biliary-stenting
#13
Pushpak Taunk, Satish Singh, David Lichtenstein, Virendra Joshi, Jason Gold, Ashish Sharma
BACKGROUND AND AIMS: Probe-based confocal laser endomicroscopy (pCLE) using the Miami Criteria has improved classification of indeterminate biliary strictures. However, previous biliary stenting may result in their misclassification as malignant strictures. Inflammatory criteria were added to form the Paris Classification to prevent this misclassification and reduce false positives. The aim of this study was to assess if the Paris Classification was more accurate than the Miami Classification in classifying indeterminate biliary strictures after biliary stenting...
March 11, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28289273/metastatic-colonic-adenocarcinoma-to-the-extrahepatic-common-bile-duct-the-critical-role-of-the-pathologist-and-immunohistochemistry-in-guiding-patient-care-decisions
#14
Kurt J Knowles, Shoujun Chen, Gillermo A Herrera
BACKGROUND Adenocarcinoma of the colon frequently invades adjacent organs, spreads intraperitoneal, and metastasizes to intestinal lymph nodes, lungs, and the liver. Metastasis solely to the extrahepatic bile duct is extremely rare and has only been previously reported on 15 occasions. The accurate determination that an extrahepatic common bile duct lesion is of colonic origin has critical therapeutic implications. CASE REPORT The patient was a 50-year-old male with a history of colon cancer S/P surgical resection in September 2014...
March 14, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28283322/asia-pacific-consensus-guidelines-for-endoscopic-management-of-benign-biliary-strictures
#15
REVIEW
Bing Hu, Bo Sun, Qiang Cai, James Yun Wong Lau, Shuren Ma, Takao Itoi, Jong Ho Moon, Ichiro Yasuda, Xiaofeng Zhang, Hsiu-Po Wang, Shomei Ryozawa, Rungsun Rerknimitr, Wen Li, Hiromu Kutsumi, Sundeep Lakhtakia, Hideyuki Shiomi, Ming Ji, Xun Li, Dongmei Qian, Zhuo Yang, Xiao Zheng
Benign biliary strictures (BBSs) are commonly caused by surgical injury, chronic pancreatitis, and inflammatory cholangiopathies. Although advanced imaging tests and tissue acquisition methods have been developed for evaluation of indeterminate biliary strictures, differentiation of BBSs from biliary malignancies remains a challenge to clinicians. The majority of BBSs have good response to nonsurgical treatment and surgical intervention mainly serves as a rescue when nonsurgical approaches fail. Endoscopic management is a safe, effective, and less-invasive treatment for BBSs compared with other approaches...
March 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28274206/the-h-o-u-s-e-classification-a-novel-endoscopic-retrograde-cholangiopancreatography-ercp-complexity-grading-scale
#16
Greger Olsson, Urban Arnelo, Fredrik Swahn, Björn Törnqvist, Lars Lundell, Lars Enochsson
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging endoscopic procedure, harboring a wide range of complexities within every single investigation. Classifications of the complexity of ERCP have been presented, but do not include modern endoscopic treatment modalities. In order to be able to target resources and compare the results of different endoscopic centers, a new complexity grading system for ERCP is warranted. This study launches a new complexity grading scale for ERCP-the H...
March 9, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28273653/unusual-migration-of-fractured-ercp-guidewire-a-case-report
#17
Christy B Pomeranz, Natasha E Wehrli, Amy Tyberg, Lily M Belfi
Endoscopic retrograde cholangiopancreatography (ERCP) routinely uses hydrophilic guidewires to cannulate ducts and traverse stenoses. Fracture of these guidewires have been reported, however, migration of these fractured fragments is an extremely rare occurrence that has yet to be reported in the literature. We present a case of a fractured ERCP guidewire with extensive migration in the retroperitoneal and lower extremity soft tissues and vasculature with radiologic correlation across multiple modalities-MRI, CT, and radiographs-as well as pathologic correlation...
February 22, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28273606/an-impressive-choledochal-cyst-and-its-surgical-resection
#18
Nhu Thao Nguyen Galván, Kayla Kumm, Dor Yoeli, Ellen Witte, Michael Kueht, Ronald Timothy Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
INTRODUCTION: Choledochal cysts are rare congenital dilations of the biliary tree that can present with non-specific symptoms such as abdominal pain, jaundice, cholelithiasis and pancreatitis. Although most commonly identified in children, they can be found in the adult population. However, because of the non-specific symptoms, this diagnosis may be difficult to make in the adult. A physician therefore must keep this diagnosis within their differential, as it may arise in an unexpected patient population who may present with a convoluted work up...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28266292/two-and-a-half-hours-of-cardiopulmonary-resuscitation-in-a-deceased-brain-dead-donor-before-liver-transplantation-a-good-idea-to-accept
#19
Dieter P Hoyer, Gernot M Kaiser, Andreas Paul, Nikolaos Machairas, Ernesto P Molmenti, Georgios C Sotiropoulos
The sequelae of cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) in organ donors potentially results in ischemic organ injury and graft dysfunction after transplantation. Thresholds of resuscitation times in brain dead liver donors have not been established so far. We report the case of a brain dead liver donor who experienced 2.5 hours of CPR whose liver was successfully transplanted. A 75-year-old male experienced CA and was treated by CPR with streptokinase application for 2.5 hours until stabilization of cardiac function...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28265825/diagnostic-accuracy-of-laboratory-tests-and-diagnostic-imaging-in-detecting-biliary-strictures-after-liver-transplantation
#20
Divyanshoo R Kohli, Ravi Vachhani, Tilak U Shah, Doumit S BouHaidar, M Shadab Siddiqui
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is often required to diagnose post-liver transplant (LT) biliary strictures. We evaluated the diagnostic accuracy of noninvasive laboratory and imaging tests in detecting post-LT biliary strictures. METHODS: Adult LT recipients who underwent ERCP between 2008 and 2015 were evaluated. Biliary strictures were diagnosed after blinded review of cholangiograms by three interventional endoscopists. The accuracy of liver enzymes, ultrasound, and MRI was determined using cholangiography as the reference standard...
March 6, 2017: Digestive Diseases and Sciences
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