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biliary complications

Sainan Bian, Hua Chen, Li Wang, Yunyun Fei, Yunjiao Yang, Linyi Peng, Yongzhe Li, Fengchun Zhang
Patients with primary biliary cholangitis (PBC) can have extrahepatic manifestations. However, data about cardiac involvement of PBC is limited. We aimed in this study to analyze the clinical characteristics in patients with PBC complicated with and without cardiac involvement, and the risk factors of cardiac involvement in PBC. PBC patients admitted to Peking Union Medical College Hospital between January 2002 and February 2016 were consecutively enrolled. Structured interview, systemic rheumatologic examination, and laboratory tests were conducted for each patient, and risk factors of cardiac involvement were analyzed by comparing patients with and without cardiac involvement...
2018: PloS One
N Pinsker, M Papoulas, M Sodergren, P Harrison, N Heaton, K Menon
Introduction A bronchobiliary fistula (BBF) following liver directed therapy (resection/ablation) is a rare complication in which an abnormal communication between the biliary tract and bronchial tree is formed. This case report describes the successful management of a persistent BBF following multiple liver wedge resections and microwave ablation in a patient with a metastatic neuroendocrine tumour of the terminal ileum. Case history A 69-year-old man presented with unexplained weight loss and was subsequently diagnosed with a neuroendocrine tumour of the terminal ileum and liver metastasis...
March 15, 2018: Annals of the Royal College of Surgeons of England
Caoye Wang, Zhengqiang Yang, Jinguo Xia, Weiping Wang, Wenhua Chen, Qi Wang
Bronchobiliary fistula (BBF) is a rare condition, defined as an abnormal communication between the bronchial system and the biliary tree. Patients with this condition usually present with massive biliptysis, and the mortality rate is high. BBF has been reported to occur in patients with congenital conditions, complications of trauma, hepatic abscesses and biliary tract obstruction (surgical as well as non-surgical). However, to the best of our knowledge, BBF as a complication of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) has not been reported to date...
April 2018: Molecular and Clinical Oncology
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
Ashwin Rammohan, Sripriya Srinivas, Yahya Al Azri, Mettu Srinivas Reddy, Mohamed Rela
Roux-en-Y (RY) hepaticojejunostomy (HJ) is a critical component of complex hepatobiliary operations, and it is the treatment of choice for post-cholecystectomy biliary strictures (PCBS). Complications related to the Roux limb, particularly those leading to cholangitis, can severely compromise outcomes. We present a case of a 54-year-old lady who had previously undergone two HJ procedures for recurrent PCBS. The same Roux limb had been used in each of the operations. Short Roux/Roux reflux syndrome led to recurrent cholangitis in this patient, as proven by the reflux of oral contrast into the biliary tree on imaging...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Bader Hamza Shirah, Hamza Asaad Shirah, Syed Husham Zafar, Khalid B Albeladi
Backgrounds/Aims: Postcholecystectomy syndrome represents a heterogeneous group of symptoms and findings in patients who have previously undergone cholecystectomy. It is rare and under-reported in Saudi Arabia. It can be attributed to many complications such as bile duct injury, biliary leak, retained common bile duct stones, recurrent bile duct stones, and bile duct strictures. In this study, we aimed to analyze the causes and evaluate the approach to postcholecystectomy syndrome in our local Saudi Arabian community because of the vast number of cases encountered in our hospital for gallbladder clinical conditions and its related complications...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
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
Sjors Klompmaker, Jony van Hilst, Sarah L Gerritsen, Mustapha Adham, M Teresa Albiol Quer, Claudio Bassi, Frederik Berrevoet, Ugo Boggi, Olivier R Busch, Manuela Cesaretti, Raffaele Dalla Valle, Benjamin Darnis, Matteo De Pastena, Marco Del Chiaro, Robert Grützmann, Markus K Diener, Traian Dumitrascu, Helmut Friess, Arpad Ivanecz, Anastasios Karayiannakis, Giuseppe K Fusai, Knut J Labori, Carlo Lombardo, Santiago López-Ben, Jean-Yves Mabrut, Willem Niesen, Fernando Pardo, Julie Perinel, Irinel Popescu, Geert Roeyen, Alain Sauvanet, Raj Prasad, Christian Sturesson, Mickael Lesurtel, Jorg Kleeff, Roberto Salvia, Marc G Besselink
BACKGROUND: Western multicenter studies on distal pancreatectomy with celiac axis resection (DP-CAR), also known as the Appleby procedure, for locally advanced pancreatic cancer are lacking. We aimed to study overall survival, morbidity, mortality and the impact of preoperative hepatic artery embolization (PHAE). METHODS: Retrospective cohort study within the European-African Hepato-Pancreato-Biliary-Association, on DP-CAR between 1-1-2000 and 6-1-2016. Primary endpoint was overall survival...
March 12, 2018: Annals of Surgical Oncology
Yue Yang, Long Chen, Yuan Jia, Yang Liu, Lei Wen, Yaoxian Liang, Yuan An, Shi Chen, Yin Su, Zhanguo Li
To analyze the clinical spectrum, laboratory characteristics, and outcomes of monoclonal gammopathy (MG) in patients with rheumatic diseases. Screening for the presence of MG was performed in 872 inpatients with rheumatic diseases from January 2010 to July 2017. A total of 41 patients were enrolled. Their clinical and biological features in addition to outcomes were described. For each patient with primary Sjögren syndrome (pSS), 2 age- and sex-matched pSS patients without MG were selected as controls. Risk factors for the presence of MG and malignant hematological neoplasias were assessed...
March 13, 2018: Clinical Rheumatology
Felicia Turowski, Ulrich Hügle, Arno Dormann, Matthias Bechtler, Ralf Jakobs, Uwe Gottschalk, Ellen Nötzel, Dirk Hartmann, Albrecht Lorenz, Frank Kolligs, Wilfried Veltzke-Schlieker, Andreas Adler, Olaf Becker, Bertram Wiedenmann, Nataly Bürgel, Hanno Tröger, Michael Schumann, Severin Daum, Britta Siegmund, Christian Bojarski
BACKGROUND AND AIMS: The aim of the study was to evaluate the usefulness and diagnostic and therapeutic outcome of the single-operator cholangiopancreatoscopy (SOC) with SpyGlassDS™. METHODS: In a retrospective multicenter study between November 2015 and January 2017, SpyGlassDS™ procedures were analyzed in participating centers. Indications, accuracy of SOC-guided biopsies, management of large bile duct stones, and complications were analyzed. Follow-up was 4 months...
March 12, 2018: Surgical Endoscopy
Yang Xiao, Wei Li, Haifeng Wan, Yifei Tan, Hong Wu
BACKGROUND: Both central hepatectomy (CH) and major hepatectomy (MH) are suggested surgical treatments for patients with centrally located hepatocellular carcinoma (CL-HCC). However, no consensus has been reached regarding which method is superior for managing these patients. This meta-analysis was conducted to compare the short- and long-term outcomes of CH and MH in patients with CL-HCC. METHODS: An electronic search for studies published in all years up to July 2017 in PubMed (Medline), EMBASE, Cochrane Library and Web of Science was performed...
March 9, 2018: International Journal of Surgery
Hyun Young Woo, In Seok Lee, Jae Hyuck Chang, Seung Bae Youn, Si Hyun Bae, Jong Young Choi, Ho Jong Chun, Young Kyoung You, Dong Goo Kim, Seung Kew Yoon
Background/Aims: Biliary complications are the most common donor complication following living donor liver transplantation (LDLT). The aim of this study is to investigate the long-term outcomes of biliary complications in right lobe adult-to-adult LDLT donors, and to evaluate the efficacy of endoscopic treatment of these donors. Methods: The medical charts of right lobe donors who developed biliary complications between June 2000 and January 2008 were retrospectively reviewed...
March 14, 2018: Korean Journal of Internal Medicine
Bibigul Ilyassova, Yevgeny Yenin, Bolatbek Baymakhanov, Maksat Doskhanov
OBJECTIVES: At the National Scientific Center of Surgery named A. Syzganova, more than 100 liver transplants have been conducted from 2012 to November 2017. Survival and quality of life of patients in the posttransplant period largely depend on the compliance of patients, monitoring of complications, cause of liver disease, the severity of the condition of patients in the pretransplant period, and the technical features of the operation. The aims of the study were to analyze the results of liver biopsy in patients after liver transplant and to evaluate the value of morphologic studies of the liver for the diagnosis of complications in the posttransplant period...
March 2018: Experimental and Clinical Transplantation
Peter J Lee, Amareshwar Podugu, Dong Wu, Arier C Lee, Tyler Stevens, John A Windsor
BACKGROUND: Controversy remains about the best pre-operative management of jaundice in patients with resectable pancreatic head cancer (RPC) undergoing planned pancreaticoduodenectomy (PD). OBJECTIVE: The aim of this study was to compare rates of post-operative complications in patients undergoing four pre-operative approaches (POA): preoperative biliary drainage with plastic stent (PBD-PS), metal stent (PBD-MS), and percutaneous transhepatic drain (PBD-PT), or no pre-operative biliary drainage (NPBD)...
March 8, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Dong Il Gwon, Gi-Young Ko, Jong Woo Kim, Heung Kyu Ko, Hyun-Ki Yoon, Kyu-Bo Sung
Objective: To investigate the technical safety and clinical efficacy of a double-stent system with long duodenal extension in patients with malignant extrahepatic biliary obstruction. Materials and Methods: This prospective study enrolled 48 consecutive patients (31 men, 17 women; mean age, 61 years; age range, 31-77 years) with malignant extrahepatic biliary obstructions from May 2013 to December 2015. All patients were treated with a double-stent system with long duodenal covered extension (16 cm or 21 cm)...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
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
Vicky L Ng, Lisa G Sorensen, Estella M Alonso, Emily M Fredericks, Wen Ye, Jeff Moore, Saul J Karpen, Benjamin L Shneider, Jean P Molleston, Jorge A Bezerra, Karen F Murray, Kathleen M Loomes, Philip Rosenthal, Robert H Squires, Kasper Wang, Ronen Arnon, Kathleen B Schwarz, Yumirle P Turmelle, Barbara H Haber, Averell H Sherker, John C Magee, Ronald J Sokol
OBJECTIVES: To assess neurodevelopmental outcomes among participants with biliary atresia with their native liver at ages 12 months (group 1) and 24 months (group 2), and to evaluate variables predictive of neurodevelopmental impairment. STUDY DESIGN: Participants enrolled in a prospective, longitudinal, multicenter study underwent neurodevelopmental testing with either the Bayley Scales of Infant Development, 2nd edition, or Bayley Scales of Infant and Toddler Development, 3rd edition...
March 5, 2018: Journal of Pediatrics
Prabin Sharma, Rodrigo Aguilar, Mark Abi Nader, Shaheryar Siddiqui, Ramkaji Baniya, Sanjeeb Sudarshan Bhandari, Carmen Elena Cervantes, Ricardo Correa, Amir Masoud
OBJECTIVE: This study aimed to assess the difference in overall outcomes between weekend admissions for acute pancreatitis (AP) and weekday admissions. METHODS: Between 2005 and 2012, data were extracted from the Nationwide Inpatient Sample on adult patients with AP. Exclusion criteria were applied for chronic pancreatitis and other pancreatic and biliary malignancies. In-hospital mortality, length of stay, hospitalization costs, comorbidities, complications, and intervention rates were compared between the weekend and weekday admissions...
April 2018: Pancreas
Vivian M Ussui, Lavinia Goldstein, Enrico Souto, Cynthia Levy
Portal cavernoma colangiopathy (PCC) is an uncommon cause of portal hypertension, and it is an important differential diagnosis of pancreatic malignancy given the expanded network of collateral vessels. On imaging studies, portal cavernoma can be seen as a hypoechoic mass, possibly associated with distal common bile duct obstruction. Most cases occur in non-cirrhotic patients. During the symptomatic phase, these patients carry a high-risk of complications related to sustained biliary obstruction. We report a unique patient with obstructive jaundice and a presumed pancreatic mass that proved to be a portal cavernoma complicated by PCC in the setting of nodular regenerative hyperplasia of the liver...
2018: ACG Case Reports Journal
Gulraiz Chaudry, Anna P Lillis, Raja Shaikh, Horacio M Padua, Rush H Chewning, Ahmad I Alomari
PURPOSE: To characterize anatomy of congenital arterioportal fistulas (CAPF) and correlate this with technique and outcomes of transcatheter embolization (TCE). MATERIALS AND METHODS: Retrospective review was conducted of children with CAPF that underwent TCE in a 10-year period. Medical records, imaging and procedure details were reviewed. TCE was performed via transarterial (n = 5), portal (n = 5) or patent ductus venosus (n = 1) approach. Embolic agents used were coils (n = 10), Onyx (n = 1) and Amplatzer septal occluder (n = 1)...
March 6, 2018: Cardiovascular and Interventional Radiology
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