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Antonia Rizzuto, Massimiliano Fabozzi, Anna Settembre, Stefano Reggio, Ernesto Tartaglia, Salomone Di Saverio, Piero Angelini, Vania Silvestri, Chiara Mignogna, Raffaele Serra, Stefano De Franciscis, Leonardo De Luca, Diego Cuccurullo, Francesco Corcione
BACKGROUND: Choledocholithiasis occurs in 10-15% of patients with cholecystolithiasis. Despite the existence of many therapeutic options for the treatment of cholecystocholedocholithiasis, a sequential treatment in which pre-operative ERCP is combined with intraoperative cholangiography (IOC) and laparoscopic cholecystectomy (LC), is the most commonly accepted strategy. However, use of IOC in the "splitting treatment" of cholecystocholedocholithiasis is controversial. The aim of the present study is to investigate the utility of IOC in detecting residual stones in patients undergoing LC in the sequential treatment of common biliary duct or gallbladder stones...
March 16, 2018: International Journal of Surgery
Vishal Sharma, Sarthak Malik, Harshal S Mandavdhare, Harjeet Singh
Endoscopic retrograde cholangio-pancreatography (ERCP) is an important tool for treatment of pancreaticobiliary diseases. However, ERCP may be difficult in patients who have altered gastrointestinal anatomy due to congenital or surgical reasons. A 40-year-old male with HIV infection presented with abdominal pain following abdominal trauma. The patient was diagnosed to have traumatic pancreatic injury and underlying situs inversus. The pancreatic fluid collection was drained using radiology guided pigtail placement done for the symptoms of abdominal pain and vomiting...
February 2018: Intractable & Rare Diseases Research
Guiliang Wang, Gui Xiao, Linfang Xu, Ping Qiu, Ting Li, Xiaoli Wang, Ping Wen, Jianbo Wen, Xianzhong Xiao
OBJECTIVE: To perform a meta-analysis of all available studies on the effect of prophylactic somatostatin administration on prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and post-ERCP hyperamylasemia (PEHA). METHODS: Electronic databases, including PubMed, EMBASE, the Cochrane library, and the Science Citation Index were searched to retrieve relevant trials. Randomized, placebo-controlled trials in adult patients that compared somatostatin versus placebo in prevention of PEP were included...
March 10, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Yuhan Wang, Craig Dorrell, Willscott E Naugler, Michael Heskett, Paul Spellman, Bin Li, Feorillo Galivo, Annelise Haft, Leslie Wakefield, Markus Grompe
Direct lineage reprogramming can convert readily available cells in the body into desired cell types for cell replacement therapy. This is usually achieved through forced activation or repression of lineage-defining factors or pathways. In particular, reprogramming toward the pancreatic β cell fate has been of great interest in the search for new diabetes therapies. It has been suggested that cells from various endodermal lineages can be converted to β-like cells. However, it is unclear how closely induced cells resemble endogenous pancreatic β cells and whether different cell types have the same reprogramming potential...
February 21, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
Keun Soo Ahn, Koo Jeong Kang, Yong Hoon Kim, Yoon Suk Lee, Gwang Bum Cho, Tae-Seok Kim, Jung Woo Lee
BACKGROUND: Ampulla of Vater (AOV) carcinoma is a rare malignancy but has a relatively good prognosis. The aims of this study were to determine the clinicopathologic factors associated with survival and disease recurrence in patients with AOV cancer, focusing on the impact of preoperative endoscopic retrograde cholangiopancreatography (ERCP) and type of biliary drainage (endoscopic retrograde biliary drainage [ERBD] or percutaneous transhepatic biliary drainage [PTBD]). METHODS: We retrospectively reviewed the medical records of 80 patients who underwent curative resection for AOV cancer at a single institution between 1995 and 2015...
March 2018: Surgical Oncology
Yan Yang, Zhongyin Zhou, Rong Liu, Lu Chen, Hongyu Xiang, Na Chen
Endoscopic retrograde cholangiopancreatography (ERCP) is an important treatment for inoperable hilar cholangiocarcinoma (HCC). The aim of the present study as to evaluate the clinical value of three-dimensional visualization (3DV) and 3D printing (3DP) technologies for ERCP in patients with HCC. The clinical data of 15 patients with HCC admitted for ERCP were analyzed retrospectively, including 9 males and 6 females. Thin-sliced data of computed tomography and magnetic resonance cholangiopancreatography (MRCP) were acquired and imported into Mimics Innovation Suite v17...
April 2018: Experimental and Therapeutic Medicine
Tatenda C Nzenza, Yahya Al-Habbal, Glen R Guerra, S Manolas, Tuck Yong, Trevor McQuillan
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) has become well established as a modality for the management of common bile duct stones (CBDS), especially in the setting of associated cholangitis. Our study aims to determine the rate of long term morbidity of recurrent CBDS post ES. METHODS: A retrospective analysis of patients who underwent ERCP and ES (ERCP+ES) was undertaken on a prospectively maintained database from 1998 to 2012 at the Northern Hospital, Melbourne...
March 15, 2018: BMC Gastroenterology
Ya-Dong Gao, Ya-Wei Qu, Hai-Feng Liu
OBJECTIVE: The accurate diagnosis of undetermined pancreaticobiliary strictures remains challenging. Current ERCP-guided tissue sampling methods are of low sensitivity. Confocal laser endomicroscopy (CLE) is a new procedure and allows real optical biopsies that may improve the diagnosis of undetermined pancreaticobiliary strictures. The aim of this meta-analysis was to determine the diagnostic yield of CLE, tissue sampling, and CLE combined with tissue sampling for undetermined pancreaticobiliary strictures...
March 15, 2018: Scandinavian Journal of Gastroenterology
Agazi Gebreselassie, Majidah Bukhari, Ahmad Awan, Mouen Khashab
Portal vein thrombosis with cavernous transformation is a rare cause of biliary obstruction. Portal biliopathy is a term that refers to abnormalities in the intrahepatic and extrahepatic biliary tract, gall bladder, and cystic duct secondary to portal hypertension. Patients may be asymptomatic, but they can also present with abdominal pain, jaundice, and fever. We present the case of a 61-year-old Caucasian female who presented with generalized weakness, dark urine, and yellow skin for three days' duration...
January 9, 2018: Curēus
Marianna Galeazzi, Paolo Mazzola, Breanna Valcarcel, Giuseppe Bellelli, Marco Dinelli, Giulio Maria Pasinetti, Giorgio Annoni
BACKGROUND: The incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard for treatment in these cases, but evidence about its safety in the elderly is still debated. METHODS: We retrospectively analyzed the clinical records of all patients aged ≥65 undergoing ERCP between July 2013 and July 2015. Of 387 ERCP cases, 363 (~ 94%) were completed entirely...
March 14, 2018: BMC Gastroenterology
María Victoria Alvarez-Sánchez, O B Luna, I Oria, K Marchut, F Fumex, G Singier, A Salgado, B Napoléon
BACKGROUND: It has been suggested that EUS-BD may be a feasible and safer alternative to percutaneous transhepatic biliary drainage (PTBD) after failed ERCP in patients with ascites. To date, no study has specifically evaluated the performance of EUS-BD in this context. METHODS: Retrospective analysis was done for patients with and without ascites who underwent EUS-BD for malignant biliary obstruction after failed ERCP between July 2010 and September 2014. Complications and technical and clinical successes between the two groups were compared...
March 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Ivana Zitinic, Ivana Plavsic, Goran Poropat, Goran Hauser
Acute pancreatitis (AP) is a common gastrointestinal disease of varied etiology; however, the most common causes of AP are gallstones and alcohol abuse. AP has emerged as the most frequent complication after endoscopic retrograde cholangiopancreatography (ERCP). Post-ERCP pancreatitis is generally a clinically irrelevant condition; however, it can be severe or even fatal in up to 0.8% of cases. Different clinical courses and outcomes have been observed between mild and severe AP of different etiologies (i.e...
April 2018: Medical Hypotheses
Yegor Tryliskyy, Gavin J Bryce
Acute pancreatitis is the most common and feared complication of endoscopic retrograde cholangiopancreatography (ERCP). The aim of the study was to review the current knowledge on the nomenclature, etiology, pathophysiology, clinical presentation, diagnostic workup, and risk stratification of post-ERCP pancreatitis (PEP). A structured search in PubMed and Scopus databases was performed using search terms related to the subject of diagnosis, pathophysiology, risk stratification of post-ERCP pancreatitis, including full text articles and abstracts in the English language...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Wei Liu, Lin-Ping Zhang, Mei Xu, Hong-Ze Zeng, Qi-Shan Zeng, Hong-Lin Chen, Qin Liu, Shou-Jiang Tang, Bing Hu
BACKGROUND AND STUDY AIMS: Ampullary impaction of an entrapped stone-basket complex is not an infrequent yet challenging event during endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study is to evaluate the feasibility, safety, and efficacy of "post-cut" for the management of such scenarios. PATIENTS AND METHODS: Patients with impacted biliary stone with an entrapped basket during ERCP at West China Hospital, Chengdu, China, from October 2004 to August 2014 were included in this retrospective study...
March 5, 2018: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Daniel Gilsdorf, Jake Henrichsen, Katie Liljestrand, Allison Staheli, Griffin Olsen, Prem Narayanan, Mark Ott, David S Morris, Raymond Price
BACKGROUND: The ideal management of common bile duct (CBD) stones remains controversial, whether with single-stage management using laparoscopic CBD exploration (LCBDE) during laparoscopic cholecystectomy, or with two-stage management using preoperative or postoperative endoscopic retrograde cholangiopancreatography (ERCP). We wished to elucidate the practice patterns within our health system, which includes both large urban referral centers and small rural critical access hospitals. STUDY DESIGN: Retrospective data analysis from our 22-hospital, not-for-profit, integrated healthcare system...
March 5, 2018: Journal of the American College of Surgeons
Emad Qayed, Rushikesh Shah, Yara K Haddad
OBJECTIVES: Cholecystectomy is the definitive management of gallstone pancreatitis (GSP). The benefit of endoscopic retrograde cholangiopancreatography (ERCP) in patients who do not undergo cholecystectomy remains unclear. This study aims to evaluate the effect of ERCP on all-cause and pancreatitis readmissions in GSP. METHODS: Adult hospitalizations for GSP in the 2010-2014 National Readmissions Database were divided into the following 3 groups: (1) no cholecystectomy nor ERCP, (2) no cholecystectomy with ERCP, and (3) cholecystectomy group...
April 2018: Pancreas
Lara M de A Coutinho, Wanderley M Bernardo, Rodrigo S Rocha, Fabio R Marinho, Aureo Delgado, Eduardo T H Moura, Sergio E Matuguma, Dalton Chaves, Tomazo A P Franzini, Paulo Sakai, Eduardo G H de Moura
OBJECTIVES: The aim of the study was to evaluate the role of early endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of acute biliary pancreatitis, in comparison with conservative treatment. METHODS: Systematic review via databases (MEDLINE [PubMed], Latin-American and Caribbean Health Sciences Literature database, Embase, Cochrane Central, and the [Brazilian] Regional Library of Medicine) is conducted. We analyzed 10 randomized controlled trials (1091 patients)...
April 2018: Pancreas
Mohammad Saud Khan, Faisal Jamal, Zubair Khan, Abhinav Tiwari, Hermann Simo, Himani Sharma
Duodenal perforation is a rare but life-threatening complication of endoscopic retrograde cholangiopancreatography (ERCP). Duodenal perforation can cause air leak into the extraperitoneal space. In rare instances, the air in the extraperitoneal space could dissect along the fascial planes of the abdomen to reach scrotum, leading to pneumoscrotum. We present the case of a 35-year-old male patient who developed scrotal pain and swelling following ERCP. He was found to have extensive pneumoscrotum, pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema...
January 2018: Case Reports in Gastroenterology
Hiroyuki Matsubayashi, Hirotoshi Ishiwatari, Toru Matsui, Kenichiro Imai, Kinichi Hotta, Hiroyuki Ono
In the present case with lower bile duct cancer, an endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) was placed because of repeated obstructions of biliary metallic stent. However, when the HGS was occluded, transpapillary duodenoscopic procedure was again required. During this transpapillary procedure, including biliary balloon cleaning and metallic stent deployment, the HGS stent was dislocated into the stomach. Fortunately, due to the complete fistulization, no bile peritonitis was recognized and an HGS stent could be replaced from the gastric wall three days later...
March 2, 2018: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Jessica Bernica, Sherif Alhanafi, Neeharika Kalkota, Yi Jia, Christopher Dodoo, Alok Dwivedi, Robert J Sealock, Kalpesh Patel, Isaac Raijman, Marc J Zuckerman, Mohamed Othman
BACKGROUND: Although cholangioscopy is a widespread technique used during Endoscopic Retrograde Cholangiopancreatiography (ERCP), its safety and feasibility in the elderly are not well established. This study aims to evaluate the safety and feasibility of ERCP in elderly patients. METHODS: A retrospective study of all ERCPs with single operator cholangioscopy (SOC) was conducted at three tertiary referral hospitals between March 2012 and October 2015 (specific dates varying by center)...
March 2, 2018: Clinical Gastroenterology and Hepatology
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