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Ana Karen Medina Lira, Argenis Jose Mayorga Soto, Pamela Frigerio
BACKGROUND: Choledochal cyst is a congenital dilatation of the biliary tree. It may affect only the extrahepatic bile duct (type I, II and III), intrahepatic (type V) or both (type IVa). Vater first described choledochal cyst in 1723. Open excision was the standard procedure made a great impact in the treatment but since 1995 Farello et al. first reported laparoscopic choledochal cyst excision and this has been used worldwide. CASE REPORT: Female, 17 years old, past medical history two years ago a laparoscopic cholecystectomy for gallbladders...
October 5, 2016: International Journal of Surgery Case Reports
Paul R Tarnasky
Post-cholecystectomy syndrome and the concept of a causal relationship to sphincter of Oddi dysfunction, despite the controversy, has presented a clinically relevant conflict for decades. Historically surgeons, and now gastroenterologists have expended tremendous efforts towards trying to better understand the dilemma that is confounded by unique patient phenotypes. Areas Covered: This review encompasses the literature from a century of experience on the topic of post-cholecystectomy syndrome. Relevant historical and anecdotal experiences are examined in the setting of insights from evaluation of recently available controlled data...
October 20, 2016: Expert Review of Gastroenterology & Hepatology
Priya D Farooq, Darryn R Potosky
We present the case of a patient who presented with signs and symptoms associated with a Klatskin tumor. After endoscopic retrograde cholangiopancreatography (ERCP) and biopsy, she was found instead to have granulomatous infiltration of the extrahepatic biliary tree consistent with biliary sarcoidosis. The patient was treated successfully with systemic corticosteroids and azathioprine. She later developed cutaneous, lymphatic, and pulmonary granulomatous disease. Isolated biliary disease is a rare initial presentation of systemic sarcoidosis...
August 2016: ACG Case Reports Journal
Toru Aoyama, Masaaki Murakawa, Yosuke Atsumi, Keisuke Kazama, Manabu Shiozawa, Satoshi Kobayashi, Makoto Ueno, Manabu Morimoto, Kouta Washimi, Norio Yukawa, Yasushi Rino, Munetaka Masuda, Soichiro Morinaga
A 74-year-old man with IgG4-related cholangitis had been treated with steroids for 1 year. In the outpatient clinic, elevated levels of the tumor marker CA19-9 and serum IgG4 were observed. Abdominal enhanced CT showed a 20mm hypovascular tumor in the pancreatic head. ERCP showed narrowingof the main pancreatic duct in the pancreatic head with slight caudal dilation and stricture of the lower common bile duct. We made a diagnosis of pancreatic cancer, and the patient underwent pancreaticoduodenectomy. Pathological examination of the resected tissue revealed a well-differentiated adenocarcinoma surrounded by autoimmune pancreatitis, characteristic of lymphoplasmacytic sclerosingpancreatitis...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kei Yane, Akio Katanuma, Hiroyuki Maguchi, Kuniyuki Takahashi, Toshifumi Kin, Satoshi Ikarashi, Itsuki Sano, Hajime Yamazaki, Koh Kitagawa, Kensuke Yokoyama, Hideaki Koga, Kazumasa Nagai, Masanori Nojima
Background and study aims: Short-type single-balloon enteroscope (short SBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is a promising alternative treatment in postsurgical altered anatomy. However, it is technically demanding, and factors affecting its technical difficulty have not yet been clarified. This study aimed to examine the procedural success rate of short SBE-assisted ERCP and the potential factors affecting procedural failure. Patients and methods: A total of 117 consecutive patients (203 procedures) with surgically altered anatomy underwent ERCP using prototype short SBEs...
October 19, 2016: Endoscopy
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)
Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Jun Horaguchi, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Miwa Uzuki, Fumiyoshi Fujishima
BACKGROUND AND AIMS: To elucidate the efficacy of pancreatic juice cytology with the cell block method (CB-PJC) for the determination of surgery in patients with branch duct intraductal papillary mucinous neoplasm (BD-IPMN). METHODS: In 138 patients with BD-IPMN from whom pancreatic juice was collected under ERCP for CB-PJC, we retrospectively evaluated the following: (1) the rate of the CB-PJC successfully evaluated, (2) the ability of CB-PJC for the diagnosis of malignant BD-IPMNs and for the identification of pathological subtypes in resected BD-IPMNs, (3) the rate of development into invasive cancer and progression of BD-IPMNs in patients with BD-IPMN diagnosed as benignancy by CB-PJC, and (4) post-ERCP adverse events...
October 15, 2016: Gastrointestinal Endoscopy
Ricardo U Macías-Rodríguez, Astrid Ruiz-Margáin, Jose L Rodriguez-Garcia, Sergio Zepeda-Gómez, Aldo Torre
OBJECTIVE: Endoscopic retrograde cholangio-pancreatography (ERCP) is useful for the management of biliary tract diseases; in patients with cirrhosis, portal hypertension may increase the risk for complications from ERCP. We evaluated the outcome and risk factors related to ERCP in patients with cirrhosis and portal hypertension. PATIENTS AND METHODS: In this case-control study, 37 patients (71 procedures) with cirrhosis and portal hypertension (group 1) and 37 controls (group 2) undergoing ERCP were included...
October 14, 2016: European Journal of Gastroenterology & Hepatology
Connie Huang, Jonathan Kung, Yong Liu, Audrey Tse, Anuj Datta, Inder Singh, Viktor E Eysselein, Sofiya Reicher
Background and aims: Post-ERCP complications increase with repeated attempts at cannulation. We evaluated several advanced biliary cannulation techniques applied when the standard approach fails. Methods: In total, 1873 consecutive patients underwent ERCP at our institution during the period 2010 - 2014. Guidewire-assisted (GA) cannulation with no contrast injection until deep biliary cannulation was considered the standard technique. Advanced techniques used were double wire-guided (DWG) cannulation, transpancreatic papillary septotomy (TPS), and needle-knife sphincterotomy (NKS)...
October 2016: Endoscopy International Open
Cecilia Strömberg, Camilla Böckelman, Huan Song, Weimin Ye, Eero Pukkala, Caj Haglund, Magnus Nilsson
Background and study aims: Elevated long-term risk of cholangiocarcinoma is reported after endoscopic sphincterotomy (ES), but in a previous study we found a trend towards a decreased risk. The aim of this study was to evaluate the association in a larger cohort with a longer follow-up. Patients and methods: Data concerning all patients having had an inpatient endoscopic retrograde cholangiopancreatography (ERCP) were collected from the hospital discharge registries of Finland and Sweden. Incident cases of malignancy were identified through linkage to the nationwide Cancer Registries...
October 2016: Endoscopy International Open
Yuji Fujita, Sho Hasegawa, Yuri Kato, Ken Ishii, Akito Iwasaki, Takamitsu Sato, Yusuke Sekino, Kunihiro Hosono, Atsushi Nakajima, Kensuke Kubota
Background and study aims: Several meta-analyses and randomized control trials have demonstrated the efficacy of rectal nonsteroidal anti-inflammatory drugs for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Diclofenac or indomethacin was administered at a dose of 100 mg in those studies, which may be too high for Asian population. In addition, rectal administration can be considered complicated. Patients and methods: This study was a prospective, randomized, placebo-controlled trial...
October 2016: Endoscopy International Open
Samih Nassif, Cecilia Ponchiardi, Teviah Sachs
Dorsal agenesis of the pancreas (DAP) is an uncommon embryological abnormality where there is absence of the distal pancreas. DAP is mostly asymptomatic, but common presenting symptoms include diabetes mellitus, abdominal pain, pancreatitis, enlarged pancreatic head, and, in a few cases, polysplenia. MRCP and ERCP are the gold standard imaging techniques to demonstrate the absence of the dorsal pancreatic duct. The literature on the association of pancreatic neoplasia and DAP is limited. We present the case of a pancreatic neuroendocrine tumor in a patient with dorsal agenesis of the pancreas, with a review of the related literature...
2016: Case Reports in Gastrointestinal Medicine
Gen Tohda, Masahiro Ohtani, Masaki Dochin
AIM: To investigate the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with acute cholangitis. METHODS: From June 2008 to May 2016, emergency ERCPs were performed in 207 cases of acute cholangitis at our institution. Patients were classified as elderly if they were aged 80 years and older (n = 102); controls were under the age of 80 years (n = 105). The patients' medical records were retrospectively reviewed for comorbidities, laboratory data, etiology of cholangitis (presence of biliary stones, biliary stricture and malignancy), details of the ERCP (therapeutic approaches, technical success rates, procedure duration), ERCP-related complications and mortality...
October 7, 2016: World Journal of Gastroenterology: WJG
Vincent Ganapini, Maryconi Jaurigue, Mitual Amin, Gehad Ghaith, Mitchell S Cappell
No abstract text is available yet for this article.
October 6, 2016: Gastrointestinal Endoscopy
Jesús A Bahena-Aponte, Guillermo Ramírez de Aguilar, Juan Carlos Torres Carrillo, Luis Espino Urbina, Jesús A Sánchez González
We present the case of a 34 years old female patient who presents with abdominal pain and elevated total and direct bilirrubins, so she underwent ERCP Reporting: a) successful sphincterotomy without complications, b) choledocholithias is endoscopically resolved, c) secondary cholangitis. She developed significant abdominal pain at 72 h, with hypovolemic shock and peritoneal irritation. She was taken to the surgery, finding a grade III liver laceration. This one was resolved with liver raffia and packing, during the same operative time cholecystectomy was performed...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Everson L A Artifon, Mauro E Ramirez, José C Ardengh, Maria Cristina Sartor, Gabriel M Favaro, Emilio Belmonte, Julio Lobo, Djalma Coelho, Julio Pereira-Lima, Cesar V Lopez, Sergio E Matuguma, Carlos K Furuya, Julio Pisani, Spencer Cheng, Marco A Buch, Tomazo Franzini, Tiago F Vilela, Ricardo Pessoa, Eduardo Bonin, Marcos Lera, Thaisa S Nakadomari, Leandro Y Kashiwagui, Marlus T Gerber, Ramiro Mascarenhas
Teaching models in endoscopy are important tools to minimize risks derived from endoscopic procedures, taking into account that therapeutic endoscopy, also known as surgical endoscopy, has greatly developed during the last decade. This results from the fact that minimally invasive procedures present relevant contributions and promote more comfort to patients. In this context, ex vivo teaching models and virtual simulators are important tools to the safe acquisition of abilities. In this article, the Brazilian Society of Digestive Endoscopy presents and describes its first course of therapeutic ERCP and EUS in models of laboratory teaching...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Jorge Espinoza-Ríos, Miluska Aliaga Ramos, Jenny Rodríguez Borda, Eduardo Miraval Wong, Arturo Zegarra Chang, Eduar Bravo Paredes, Ricardo Prochazka Zárate
OBJECTIVE: We present a descriptive analysis of our cases of sphincterotomy followed by papillary large balloon dilation in a single session (ES-LBD) in the management of difficult to extract calculi, with the objective of assessing rates of therapeutic success and complications in local experience. MATERIAL AND METHODS: ERCP procedures with ES-LBD performed for choledocholithiasis between January 2009 and December 2014 in patients older than 18 years and without preexistent sphincterotomy were selected from records of the Gastroenterology Service at Cayetano Heredia National Hospital...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Sheng Wang, Wen Liu, Siyu Sun, Guoxin Wang, Xiang Liu, Nan Ge, Jintao Guo
AIM: To evaluate the use of a double-channel gastroscope in patients with Billroth II gastrectomy to perform endoscopic retrograde cholangiopancreatography (ERCP) and interventions. MATERIAL AND METHODS: From January 2008 to December 2013, 18 patients with Billroth II gastrectomy were enrolled in this study. Endoscopic retrograde cholangiopancreatography was performed using a straight forward gastroscope with double working channel (4.2-mm diameter, 2.8-mm diameter)...
2016: Przegla̜d Gastroenterologiczny
Youssef Motiaa, Mustapha Bensghir, Abdelhamid Jaafari, Mohammed Meziane, Redouane Ahtil, Noureddine Drissi Kamili
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a technique used both for diagnosis and for the treatment of biliary and pancreatic diseases. ERCP has some anesthetic implications and specific complications. The primary outcome aim was to compare two protocols in terms of time of extubation. We also compared anesthetic protocols in terms of hemodynamic and respiratory instability, antispasmodics needs, endoscopist satisfaction, and recovery room stay. METHODS: Patients were randomized into two groups standard anesthesia group (Gr: SA) in whom induction was done by propofol, fentanyl and cisatracurium and maintenance was done by a mixture of oxygen, nitrousoxide (50%:50%) and sevoflurane; and intravenous anesthesia group to target concentration (Gr: TCI) in whom induction and maintenance of anesthesia were done with propofol with a target 0...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Jarno Jokelainen, Marianne Udd, Leena Kylänpää, Harri Mustonen, Jorma Halttunen, Outi Lindström, Reino Pöyhiä
OBJECTIVE: Patient controlled sedation (PCS) has been shown to be a valid choice for sedation during endoscopic retrograde cholangiopancreatography (ERCP) in randomized studies. However, large scale studies are lacking. MATERIAL AND METHODS: A single center, prospective observational study to determine how sedation for ERCP is administered in clinical setting. All 956 patients undergoing 1196 ERCPs in the endoscopy unit of Helsinki University Central Hospital 2012-2013, methods of sedation and adverse events associated with different sedations were recorded...
October 5, 2016: Scandinavian Journal of Gastroenterology
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