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B Njei, T R McCarty, S Varadarajulu, U Navaneethan
BACKGROUND: The accuracy of current endoscopic modalities for diagnosing cholangiocarcinoma in primary sclerosing cholangitis (PSC) is suboptimal. AIM: To evaluate the comparative effectiveness of endoscopic retrograde cholangiopancreatography (ERCP)-based modalities, independently or in combination, for the diagnosis of cholangiocarcinoma in patients with PSC-induced biliary strictures. METHODS: Searches of PubMed, EMBASE, Web of Science and the Cochrane Library databases were performed through December 2015...
October 3, 2016: Alimentary Pharmacology & Therapeutics
Hyoung-Chul Oh
Bilioenteric anastomosis strictures are a serious complication of biliary surgery, and often result in recurrent cholangitis, choledocholithiasis, biliary cirrhosis, and hepatic failure. Bilioenteric reconstructive surgery is the standard treatment of choice for such complications. However, percutaneous transhepatic cholangioscopy (PTCS), also known as per-oral endoscopic-guided intervention, is a less invasive procedure that is becoming an increasingly popular alternative. This review describes the PTCS procedure (including the preparation process), as well as the diagnostic and therapeutic role of PTCS in bilioenteric anastomosis strictures...
September 19, 2016: Clinical Endoscopy
Hyoung-Chul Oh, Fatih Akisik, Stuart Sherman
No abstract text is available yet for this article.
September 14, 2016: Clinical Gastroenterology and Hepatology
Ihab I El Hajj, Raj J Shah
No abstract text is available yet for this article.
October 2016: Gastrointestinal Endoscopy
Jochen Weigt, Maciej Pech, Peter Malfertheiner
No abstract text is available yet for this article.
September 8, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Wim Laleman, Kristof Verraes, Werner Van Steenbergen, David Cassiman, Frederik Nevens, Schalk Van der Merwe, Chris Verslype
BACKGROUND AND STUDY AIM: Indeterminate biliary strictures and difficult bile duct stones remain clinically arduous and challenging situations. We aimed to evaluate the utility of the single-operator cholangioscopy (SOC)-system SpyGlass in both conditions in a single-center biliopancreatic interventional unit and in perspective of available aggregated literature. METHODS: Usefulness of SOC was assessed for the above-mentioned indications by means of the combination of successful procedural completion, clinical success and incidence of procedure-related adverse events in our own prospective cohort from 3/2010 to 7/2014 and all available literature till 6/2015...
September 7, 2016: Surgical Endoscopy
Basile Njei, Thomas R McCarty, Shyam Varadarajulu, Udayakumar Navaneethan
BACKGROUND AND AIMS: Cholangiocarcinoma (CCA) is a leading cause of morbidity and mortality in patients with primary sclerosing cholangitis (PSC). Although several ERCP-based diagnostic modalities are available for diagnosing CCA, it is unclear whether one modality is more cost-effective than the others. The primary aim of this study was to compare the cost-effectiveness of ERCP-based techniques for diagnosing CCA in patients with PSC-induced biliary strictures. METHODS: We performed a cost utility analysis to assess the net monetary benefit for accurately diagnosing CCA using 5 different diagnostic strategies: (1) ERCP with bile duct brushing for cytology; (2) ERCP with brushings for cytology and fluorescence in situ hybridization (FISH)-Trisomy; (3) ERCP with brushings for cytology and FISH-Polysomy; (4) ERCP with intraductal biopsies; and (5) single-operator cholangioscopy (SOC) with targeted biopsies...
August 30, 2016: Gastrointestinal Endoscopy
Takeshi Ogura, Wataru Takagi, Yoshitaka Kurisu, Kazuhide Higuchi
Endoscopic retrograde cholangiopancreatography (ERCP) is the gold-standard modality for diagnosis and therapy of bilio-pancreatic disease. In particular, peroral cholangiography (POCS) is a useful modality not only for diagnosing biliary disease, but also for therapeutic procedures such as electrohydraulic lithotripsy. The SPY-DS single-operator cholangioscope has recently become available, and offers favorable visualization, a wide view, suction function and a larger accessory working channel. However, if the duodenoscope cannot be advanced into the ampulla of Vater for reasons such as surgical anatomy, POCS cannot be performed...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Ernesto Quaresma Mendonça, Joel Fernandez de Oliveira, Elisa Ryoka Baba, André Roncon Dias, Fauze Maluf-Filho
No abstract text is available yet for this article.
August 1, 2016: Gastrointestinal Endoscopy
Rebecca Voaklander, Eileen Kim, William H Brown, Franklin E Kasmin, Jerome H Siegel
Direct examination of the biliary tree with endoscopes has been a challenge since endoscopists began performing endoscopic retrograde cholangiopancreatography (ERCP) in the late 1960s. Previously, surgeons had used rigid instruments intraoperatively, which made examination difficult. The first direct cholangioscopy performed by an endoscopist was likely unintentionally done in a patient with postsurgical anatomy. Indirect imaging, ERCP, and percutaneous transhepatic cholangiography are helpful modalities for examining the biliary tree, but they are limited procedures, particularly with regard to the evaluation and treatment of strictures and bile duct stones...
July 2016: Gastroenterology & Hepatology
Kwangwoo Nam, Sung Koo Lee, Tae Jun Song, Do Hyun Park, Sang Soo Lee, Dong-Wan Seo, Myung-Hwan Kim
BACKGROUND: Some biliary complications after liver transplantation (LT) are difficult to manage by endoscopic or radiologic intervention alone. In these cases, percutaneous transhepatic cholangioscopy (PTCS) can be used as an adjuvant option. METHODS: Patients who underwent PTCS for post-LT biliary complications between August 1992 and January 2016 were retrospectively reviewed. RESULTS: Fifteen patients underwent PTCS for post-LT biliary complications...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Milljae Shin, Jae-Won Joh
Apart from noticeable improvements in surgical techniques and immunosuppressive agents, biliary complications remain the major causes of morbidity and mortality after living donor liver transplantation (LDLT). Bile leakage and stricture are the predominant complications. The reported incidence of biliary complications is 15%-40%, and these are known to occur more frequently in living donors than in deceased donors. Despite the absence of a confirmed therapeutic algorithm, many approaches have been used for treatment, including surgical, endoscopic, and percutaneous transhepatic techniques...
July 21, 2016: World Journal of Gastroenterology: WJG
Saikiran Raghavapuram, Mohit Girotra, Jeffrey D Robertson, Tarun Pandey, Benjamin Tharian
No abstract text is available yet for this article.
July 20, 2016: Gastrointestinal Endoscopy
Prashant Kedia, Vincent Kuo, Paul Tarnasky
No abstract text is available yet for this article.
July 19, 2016: Gastrointestinal Endoscopy
Torsten Beyna, Harald Farnik, Christoph Sarrazin, Christian Gerges, Horst Neuhaus, Jörg G Albert
BACKGROUND AND STUDY AIMS: Direct retrograde cholangioscopy (DRC) enables high quality video imaging of the bile ducts and allows intraductal treatment with optical control. We evaluated the feasibility, success, and complications of a new third-generation prototype cholangioscope. PATIENTS AND METHODS: All consecutive patients from two tertiary endoscopy centers who had undergone DRC with the prototype were included. Indications for DRC were: evaluation of indeterminate strictures, filling defects, and complex bile duct stones...
October 2016: Endoscopy
Claudio Zulli, Mariano Sica, Angelo Caruso, Rita Luisa Conigliaro, Raffaele Manta
No abstract text is available yet for this article.
July 9, 2016: Gastrointestinal Endoscopy
Tomazo Antonio Prince Franzini, Renata Nobre Moura, Eduardo Guimarães Hourneaux de Moura
Nowadays, cholangioscopy is an established modality in diagnostic and treatment of pancreaticobiliary diseases. The more widespread use and the recent development of new technologies and accessories had renewed the interest of endoscopic visualization of the biliary tract, increasing the range of indications and therapeutic procedures, such as diagnostic of indeterminate biliary strictures, lithotripsy of difficult bile duct stones, ablative techniques for intraductal malignancies, removal of foreign bodies and gallbladder drainage...
2016: Gastroenterology Research and Practice
Guido Costamagna
New technological developments in endoscopic retrograde cholangiopancreatography and endoscopic ultrasound, both for diagnosis and treatment of biliary and pancreatic diseases, have opened up new scenarios in the recent years. For instance, removal of large bile duct stones with endoscopic sphincterotomy followed by large balloon dilation has been proven to be a safe and effective technique. Also cholangioscopy evolved in terms of better imaging, tissue acquisition and stones management. Self-expandable metal stents are used mostly for malignant diseases, but their role in benign diseases has also been deeply investigated in the last years...
June 2016: Recenti Progressi in Medicina
Saurabh Mukewar, Emmanuel C Gorospe, Mary A Knipschield, Juliane Bingener, Christopher Gostout
BACKGROUND AND AIM: Direct per oral cholangioscopy allows endoscopic visualization of the biliary tract. Insufflation with carbon dioxide (CO2) is an alternative to saline solution irrigation during direct cholangioscopy. There are no data on maximal CO2 insufflation in direct cholangioscopy without causing biliary barotrauma or fatal gas embolism. We aimed to evaluate the safety of increasing CO2 insufflation in direct cholangioscopy without causing biliary barotrauma or fatal gas embolism...
June 17, 2016: Gastrointestinal Endoscopy
Gabriel D Lang, Daniel K Mullady
No abstract text is available yet for this article.
June 17, 2016: Gastrointestinal Endoscopy
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