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https://www.readbyqxmd.com/read/27904249/benign-biliary-strictures
#1
REVIEW
Ashley Altman, Steven M Zangan
Differentiating benign and malignant biliary strictures is a challenging and important clinical scenario. The typical presentation is indolent and involves elevation of liver enzymes, constitutional symptoms, and obstructive jaundice with or without superimposed or recurrent cholangitis. While overall the most common causes of biliary strictures are malignant, including cholangiocarcinoma and pancreatic adenocarcinoma, benign strictures encompass a wide spectrum of etiologies including iatrogenic, autoimmune, infectious, inflammatory, and congenital...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27900203/combined-hepatocellular-cholangiocarcinoma-with-stem-cell-features-cholangiolocellular-subtype-after-inferior-vena-cava-stent-placement-for-a-patient-with-budd-chiari-syndrome
#2
Makoto Sakane, Keigo Osuga, Takahiro Matsui, Hidetoshi Eguchi, Masatoshi Hori, Noriyuki Tomiyama
We report a case of combined hepatocellular-cholangiocarcinoma with stem cell features, cholangiolocellular subtype arising about 15 years after placement of an inferior vena cava stent for primary Budd-Chiari syndrome. Pre-surgical differentiation of the tumor from hepatocellular carcinoma was difficult because of elevated levels of alpha-fetoprotein and hypervascularity in the arterial phase. Histopathological examination revealed atypical cells forming ductal and alveolar structures showing a vague border with the surrounding liver...
November 2016: Acta Radiologica Open
https://www.readbyqxmd.com/read/27866907/radiofrequency-ablation-for-intraductal-extension-of-ampullary-neoplasms
#3
Tarun Rustagi, Shayan Irani, D Nageshwar Reddy, Barham K Abu Dayyeh, Todd H Baron, Christopher J Gostout, Michael J Levy, John Martin, Bret T Petersen, Andrew Ross, Mark D Topazian
BACKGROUND AND AIMS: Extension of ampullary adenomas into the common bile duct (CBD) or pancreatic duct (PD) may be difficult to treat endoscopically. We evaluated the feasibility, safety, and efficacy of endoscopic radiofrequency ablation (RFA) in management of ampullary neoplasms with intraductal extension. METHODS: Multicenter, retrospective analysis of all patients with intraductal extension of ampullary neoplasms treated with endoscopic RFA between February 2012 and June 2015...
November 17, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27862912/stenting-of-the-ductus-arteriosus-in-infants-with-functionally-univentricular-heart-disease-and-ductal-dependent-pulmonary-blood-flow-a-single-center-experience
#4
Ahmet Celebi, Ilker Kemal Yucel, Mustafa Orhan Bulut, Mehmet Kucuk, Sevket Balli
OBJECTIVE: To determine the short- and medium-term outcomes of ductal stenting (DS) in patients with functionally univentricular hearts (FUHs) and ductal-dependent pulmonary blood flow. BACKGROUND: Several studies have evaluated the outcomes of DS in a limited number of patients with FUHs. Nonetheless, there is still no consensus regarding the indications for this procedure, and no appropriate patient selection criteria have been devised. METHODS: From 2005 to 2015, cardiac catheterization for DS was performed in 68 patients with FUHs...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27795815/arterial-complication-of-irreversible-electroporation-procedure-for-locally-advanced-pancreatic-cancer
#5
Yahya Ekici, Tugan Tezcaner, Hüseyin Onur Aydın, Fatih Boyvat, Gökhan Moray
Irreversible electroporation (IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable. We present the first case of acute superior mesenteric artery (SMA) occlusion secondary to pancreatic IRE procedure that has not been reported before in the literature. A 66-year-old man underwent neoadjuvant chemoradiotherapy for locally advanced pancreatic ductal adenocarcinoma. IRE procedure was applied to the patient during laparotomy under general anesthesia...
October 15, 2016: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27746039/ductus-arteriosus-stenting-a-promising-percutaneous-palliation-in-patients-with-duct-dependent-pulmonary-circulation
#6
Abhishek Raval, Bhavesh Thakkar, Tarun Madan, Nilesh Oswal, Rajiv Garg, Rhshikesh Umalkar, Komal Shah, Bhumika Maheriya
OBJECTIVES: We aimed to study the feasibility and outcomes of ductal stenting in patients with duct-dependent pulmonary blood flow (PBF). METHODS: Duct-dependent hypoxic patients with confluent pulmonary artery (PA) branches were enrolled for ductal stenting and followed regularly. RESULTS: Sixty patients, with a median age of 12 (1-1095) days and weight of 2.8 (2.2-8.9) kg, were enrolled. Median right PA (RPA) and left PA (LPA) Z-scores were -1...
October 13, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27731565/mediastinal-pseudocyst-in-acute-on-chronic-pancreatitis
#7
Sushil Kumar Mishra, Pawan Kumar Jain, Sukhdev Gupta
Pseudocyst is a common complication of Acute and chronic pancreatitis. However, its extension into the mediastinum is a rare entity. We present a case of 52 years male with acute on chronic pancreatitis (alcohol related) who presented with dysphagia and dyspnoea and was found to have a pancreatic pseudocyst extending upto the neck. Ultrasound fails to pick up mediastinal pseudocysts and requires additional imaging modalities - CT and MRI. Management of Mediastinal pseudocyst depends upon underlying etiology, ductal anatomy, size of the pseudocyst, and availability of expertise...
March 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27729733/review-of-endoscopic-radiofrequency-in-biliopancreatic-tumours-with-emphasis-on-clinical-benefits-controversies-and-safety
#8
REVIEW
María-Victoria Alvarez-Sánchez, Bertrand Napoléon
Most pancreatic cancers and extrahepatic cholangiocarcinomas are unresectable at the time of diagnosis, and even in case of a resectable cancer, for elderly or patients with coexistent comorbidities, surgery is not an option. Current treatment alternatives in these scenarios are very limited. Biliary stenting with self-expanding metal stents (SEMS) is the mainstay palliative treatment of biliary obstruction due to unresectable pancreatic cancer or cholangiocarcinoma. Nevertheless, more than 50% of SEMS become occluded after 6 mo due to tumour over- and ingrowth, leading to hospital readmissions and reinterventions that significantly impair quality of life...
October 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27709098/reverse-szabo-technique-for-stenting-a-single-major-aorto-pulmonary-collateral-vessel-in-pulmonary-atresia-with-ventricular-septal-defect
#9
Igor V Polivenok, John P Breinholt, Sri O Rao, Olga V Buchneva
Management of pulmonary atresia with ventricular septal defect (PA-VSD) in the neonatal period presents numerous challenges. Endovascular stenting of the ductus arteriosus or of a collateral vessel in ductal-dependent pulmonary circulation as an alternative to the Blalock-Taussig (BT) shunt has become increasingly popular in the last decades. The utilization of the reverse Szabo (anchor-wire) technique for single collateral vessel stenting in a case of PA-VSD is described.
July 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27681504/factors-and-outcomes-associated-with-pancreatic-duct-disruption-in-patients-with-acute-necrotizing-pancreatitis
#10
Ji Woong Jang, Myung-Hwan Kim, Dongwook Oh, Dong Hui Cho, Tae Jun Song, Do Hyun Park, Sang Soo Lee, Dong-Wan Seo, Sung Koo Lee, Sung-Hoon Moon
BACKGROUND AND AIMS: Acute necrotizing pancreatitis (ANP) can affect main pancreatic duct (MPD) as well as parenchyma. However, the incidence and outcomes of MPD disruption has not been well studied in the setting of ANP. METHODS: This retrospective study investigated 84 of 465 patients with ANP who underwent magnetic resonance cholangiopancreatography and/or endoscopic retrograde cholangiopancreatography. The MPD disruption group was subclassified into complete and partial disruption...
September 20, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27590845/nab-paclitaxel-and-gemcitabine-in-metastatic-pancreatic-ductal-adenocarcinoma-pdac-from-clinical-trials-to-clinical-practice
#11
Ferdinando De Vita, Jole Ventriglia, Antonio Febbraro, Maria Maddalena Laterza, Alessio Fabozzi, Beatrice Savastano, Angelica Petrillo, Anna Diana, Guido Giordano, Teresa Troiani, Giovanni Conzo, Gennaro Galizia, Fortunato Ciardiello, Michele Orditura
BACKGROUND: Pancreatic adenocarcinoma is an aggressive disease with poor prognosis. In a randomized phase III trial, combination of Nab-paclitaxel (Nab-P) plus gemcitabine showed superior activity and efficacy in first-line treatment compared with gemcitabine alone. METHODS: Nab-P is not dispensed in Italy; however, we obtained this drug from our Ethics Committee for compassionate use. The aim of this study was to evaluate the efficacy and safety profile of this Nab-P and gemcitabine combination in a cohort of patients treated outside clinical trials...
2016: BMC Cancer
https://www.readbyqxmd.com/read/27582885/placement-of-a-6-mm-fully-covered-metal-stent-for-main-pancreatic-head-duct-stricture-due-to-chronic-pancreatitis-a-pilot-study-with-video
#12
Takeshi Ogura, Saori Onda, Wataru Takagi, Masayuki Kitano, Tastsushi Sano, Atsushi Okuda, Akira Miyano, Daisuke Masuda, Toshihisa Takeuchi, Shinya Fukunishi, Kazuhide Higuchi
BACKGROUND: Temporary stent placement is widely performed for pancreatic duct stenosis due to chronic pancreatitis. A fully covered self-expandable metal stent (FCSEMS) has a larger diameter, and therefore longer stent patency, and the effect of expansion of the main pancreatic duct stricture may be obtained. However, if stent migration upstream occurs, stent removal is extremely difficult. In addition, because of the diameter gap between the FCSEMS and the main pancreatic duct, stent-induced ductal change may occur...
September 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27572066/success-and-complications-of-an-intra-ductal-fully-covered-self-expanding-metal-stent-id-fcsems-to-treat-anastomotic-biliary-strictures-as-after-orthotopic-liver-transplantation-olt
#13
Patrick Aepli, Andrew St John, Saurabh Gupta, Luke F Hourigan, Rhys Vaughan, Marios Efthymiou, Arthur Kaffes
BACKGROUND: Anastomotic biliary strictures (AS) after orthotopic liver transplantation (OLT) belong to the most common biliary complications and cause the biggest morbidity burden after OLT. Metal stents for benign biliary strictures are gaining acceptance with many published series. Traditional metal stent designs seem to have poor durability in AS after OLT. Novel intra-ductal stents are showing promise in these strictures. As a result, we designed a special stent with an antimigration waist and a short stent length with a long removal string that rests in the duodenum for easy removal...
August 29, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27516058/interventional-re-opening-of-a-pda-for-reverse-potts-shunt-circulation-after-ado-i-implantation-in-a-child
#14
Stephan Schubert, Björn Peters, Felix Berger
We report interventional re-opening of a PDA for reverse Potts shunt circulation 12 months after closure in a 3.8 year old child, suffering from right ventricular (RV) failure due to suprasystemic pulmonary artery hypertension (PAH) after ADO I implantation. After ex vivo simulation, perforation through the mesh of the ADO I with the use of transseptal needle, wire looping (AO-PA), balloon dilatation, stent implantation (Palmaz 6 mm) and post dilatation, a reverse Pott-shunt circulation was established. A follow-up period of 11 months was achieved with preserved RV function and reverse Pott shunt circulation maintained a post ductal saturation of 94-88%...
August 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27504816/specialized-imaging-and-procedures-in-pediatric-pancreatology-a-naspghan-clinical-report
#15
Tom K Lin, David M Troendle, Daniel B Wallihan, Bradley Barth, Victor L Fox, Douglas S Fishman, Veronique D Morinville
OBJECTIVES: An increasing number of children are being diagnosed with pancreatitis and other pancreatic abnormalities. Dissemination of the information regarding existing imaging techniques and endoscopic modalities to diagnose and manage pancreatic disorders in children is sorely needed. METHODS: We conducted a review of the medical literature on the use of the following imaging and procedural modalities in pediatric pancreatology: transabdominal ultrasonography (TUS), computed tomography (CT), magnetic resonance imaging (MRI)- magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), endoscopic retrograde cholangiopancreatography (ERCP)...
August 6, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27402320/management-of-splenic-and-pancreatic-trauma
#16
E Girard, J Abba, N Cristiano, M Siebert, S Barbois, C Létoublon, C Arvieux
The spleen and pancreas are at risk for injury during abdominal trauma. The spleen is more commonly injured because of its fragile structure and its position immediately beneath the ribs. Injury to the more deeply placed pancreas is classically characterized by discordance between the severity of pancreatic injury and its initial clinical expression. For the patient who presents with hemorrhagic shock and ultrasound evidence of major hemoperitoneum, urgent "damage control" laparotomy is essential; if splenic injury is the cause, prompt "hemostatic" splenectomy should be performed...
August 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27386476/characteristic-endoscopic-ultrasound-findings-of-ampullary-lesions-that-predict-the-need-for-surgical-excision-or-endoscopic-ampullectomy
#17
Jared J Rejeski, Sarba Kundu, Matthew Hauser, Jason D Conway, John A Evans, Rishi Pawa, Girish Mishra
BACKGROUND AND OBJECTIVES: The management of ampullary lesions has evolved to include endoscopic ampullectomy (EA) as a curative approach to cancers of the ampulla of Vater. With this change comes a need to risk-stratify patients at initial diagnosis. MATERIALS AND METHODS: Patients with verified ampullary lesions (N = 50) were analyzed in a case-control design. We evaluated endoscopic ultrasound (EUS) data to define characteristics that yield a high sensitivity in selecting candidates for EA...
May 2016: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/27366041/endoscopic-management-of-splenic-pseudocysts-associated-with-acute-and-chronic-pancreatitis
#18
Surinder Singh Rana, Ravi Sharma, Puneet Chhabra, Vishal Sharma, Rajesh Gupta, Deepak Kumar Bhasin
BACKGROUND: Splenic pseudocysts (SP) are a rare consequence of both acute and chronic pancreatitis. Surgery has been conventional treatment for SP and literature on role of endoscopic treatment is scant. In this study, we retrospectively evaluated SP clinical and radiological characteristics as well as the outcome following endoscopic drainage. METHODS: Retrospective analysis of SP patients seen at our unit from January 2002 to June 2015. All patients were treated with attempted endoscopic transpapillary drainage with a nasopancreatic drain or stent...
July 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/27364870/a-pilot-study-of-intraluminal-brachytherapy-using-125-i-seed-strand-for-locally-advanced-pancreatic-ductal-adenocarcinoma-with-obstructive-jaundice
#19
MinJie Yang, ZhiPing Yan, JianJun Luo, QingXin Liu, Wen Zhang, JinQing Ma, ZiHan Zhang, TianZhu Yu, Qian Zhao, LingXiao Liu
PURPOSE: To investigate the safety and feasibility of intraluminal brachytherapy using (125)I seed strand for locally advanced pancreatic ductal adenocarcinoma with obstructive jaundice. METHODS AND MATERIALS: From January 2010 to February 2015, 18 consecutive patients diagnosed with locally advanced, nonmetastatic, inoperable pancreatic ductal adenocarcinoma with obstructive jaundice were enrolled and underwent intraluminal brachytherapy using (125)I seed strand...
June 27, 2016: Brachytherapy
https://www.readbyqxmd.com/read/27354464/split-graft-technique-in-neonatal-heart-transplant-for-aortic-atresia
#20
Juan-Miguel Gil-Jaurena, María-Teresa González-López, Ana Pita-Fernández, Ramón Pérez-Caballero
We describe a neonate with aortic atresia and hypoplastic aorta, listed for heart transplant after extracorporeal membrane oxygenation resuscitation and ductal stenting. The donor aorta was detached from the graft, after an isolated arch reconstruction prior to the transplant itself in a routine fashion. To the best of our knowledge, this is the first reported case of neonatal arch reconstruction before transplantation performed with grafts from the same donor in a split-way strategy.
October 2016: Interactive Cardiovascular and Thoracic Surgery
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