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Giuliano La Barba, Andrea Gardini, Elena Cavargini, Alessandro Casadei, Paolo Morgagni, Francesca Bazzocchi, Fabrizio D'Acapito, Davide Cavaliere, Roberta Curti, Domenico Tringali, Alessandro Cucchetti, Giorgio Ercolani
BACKGROUND AND AIM: Although the ideal management of cholecysto-choledocholitiasis is controversial, the two-stage approach, namely the common bile duct (CBD) clearance through endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy, remains the standard way of management. However, whenever feasible, the one-stage approach, using the so-called "laparoendoscopic rendezvous" (LERV) technique, offers some advantages, mainly reducing the hospital stay and the risk of post-ERCP pancreatitis...
February 27, 2018: Surgical Endoscopy
Julie Vaynshtein, Gilbert Sabbag, Ilya Pinsk, Ilan Rahmani, Avraham Reshef
AIM: Biliary lithiasis is common in most western countries. Symptomatic patients will also have choledocholithiasis in 10% of the cases. For patients with intermediate probability of CBD stones, the recommended imaging studies are endoscopic ultrasound (EUS) or MRCP. This study aims to identify early factors that can be used as predictors for the presence of CBD stones, and by that to find which patient should undergo ERCP without an early EUS. METHODS: This is a retrospective cohort study including all patients who underwent EUS for suspected choledocholithiasis at the Soroka University Medical Center (SUMC) in the years 2009-2014...
March 2018: Scandinavian Journal of Gastroenterology
Hamza Cinar, Gökhan S Ozbalci, Ismail A Tarim, Kagan Karabulut, Tugrul Kesicioglu, Ayfer K Polat, Kenan Erzurumlu, Murat Derebey
BACKGROUND: The rate of conversion to open surgery is high in laparoscopic cholecystectomy (LC) after Endoscopic Retrograde Cholangiopancreotocography (ERCP). The present study aimed to evaluate the risk factors associated with the conversion to open cholecystectomy and minimize the rate of conversion to open surgery. METHODS: A total of 157 patients admitted to the Ondokuz Mayıs University Medical Faculty Hospital due to cholelithiasis and choledocholithiasis between January 2002 and December 2012, and they receiving laparoscopic cholecystectomy were included in the study...
2017: Annali Italiani di Chirurgia
Adolfo Cuendis-Velázquez, Mario E Trejo-Ávila, Enrique Rosales-Castañeda, Eduardo Cárdenas-Lailson, Martin E Rojano-Rodríguez, Sujey Romero-Loera, Carlos A Sanjuan-Martínez, Mucio Moreno-Portillo
INTRODUCTION: Today's options for biliary bypass procedures, for difficult choledocholithiasis, range from open surgery to laparo-endoscopic hybrid procedures. The aim of this study was to analyze the outcomes of patients with difficult choledocholithiasis treated with laparoscopic choledochoduodenostomy. METHODS: We performed a prospective observational study from March 2011 to June 2016. We included patients with difficult common bile duct stones (recurrent or unresolved by ERCP) in which a biliary bypass procedure was required...
August 2017: Cirugía Española
L Ansaloni, M Pisano, F Coccolini, A B Peitzmann, A Fingerhut, F Catena, F Agresta, A Allegri, I Bailey, Z J Balogh, C Bendinelli, W Biffl, L Bonavina, G Borzellino, F Brunetti, C C Burlew, G Camapanelli, F C Campanile, M Ceresoli, O Chiara, I Civil, R Coimbra, M De Moya, S Di Saverio, G P Fraga, S Gupta, J Kashuk, M D Kelly, V Koka, H Jeekel, R Latifi, A Leppaniemi, R V Maier, I Marzi, F Moore, D Piazzalunga, B Sakakushev, M Sartelli, T Scalea, P F Stahel, K Taviloglu, G Tugnoli, S Uraneus, G C Velmahos, I Wani, D G Weber, P Viale, M Sugrue, R Ivatury, Y Kluger, K S Gurusamy, E E Moore
Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of "high risk" patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality...
2016: World Journal of Emergency Surgery: WJES
Grzegorz Ćwik, Michał Solecki, Grzegorz Wallner
UNLABELLED: Both acute and chronic inflammation of the pancreas often lead to complications that nowadays can be resolved using endoscopic and surgical procedures. In many cases, intraoperative ultrasound examination (IOUS) enables correct assessment of the extent of the lesion, and allows for safe surgery, while also shortening its length. AIM OF THE RESEARCH: At the authors' clinic, intraoperative ultrasound is performed in daily practice. In this paper, we try to share our experiences in the application of this particular imaging technique...
March 2015: Journal of Ultrasonography
Joana Magalhães, Bruno Rosa, José Cotter
AIM: To study the practical applicability of the American Society for Gastrointestinal Endoscopy guidelines in suspected cases of choledocholithiasis. METHODS: This was a retrospective single center study, covering a 4-year period, from January 2010 to December 2013. All patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis were included. Based on the presence or absence of predictors of choledocholithiasis (clinical ascending cholangitis, common bile duct (CBD) stones on ultrasonography (US), total bilirubin > 4 mg/dL, dilated CBD on US, total bilirubin 1...
February 16, 2015: World Journal of Gastrointestinal Endoscopy
Eduardo Guimarães Hourneaux de Moura, Tomazo Franzini, Renata Nobre Moura, Fred Olavo Aragão Andrade Carneiro, Everson Luiz de Almeida Artifon, Paulo Sakai
CONTEXT: Direct endoscopic visualization of biliopancreatic duct is certainly one of the greatest advances of therapeutic endoscopy. The use of a single-operator cholangioscopy platform (SpyGlass) is a promising technique in the evaluation of diseases such as indeterminate biliary stricture and giant choledocholitiasis. This is the first Brazilian case series using this technology. METHODS: We report a case series of 20 patients in whom SpyGlass was used with diagnostic and therapeutic intention...
July 2014: Arquivos de Gastroenterologia
Bohuslav Kianička, Jan Lata, Ivo Novotný, Petr Dítě, Jiří Vaníček
AIM: To evaluate single balloon enteroscopy in diagnostic and therapeutic endoscopic retrograde cholangiography (ERC) in patients with Roux-en-Y hepaticojejunoanastomosis (HJA). METHODS: The study took place from January 2009 to December 2011 and we retrospectively assessed 15 patients with Roux-en-Y HJA who had signs of biliary obstruction. In total, 23 ERC procedures were performed in these patients and a single balloon videoenteroscope (Olympus SIF Q 180) was used in all of the cases...
November 28, 2013: World Journal of Gastroenterology: WJG
Zoran Damnjanović, Milan Jovanović, Aleksandar Nagorni, Milan Radojković, Dusan Sokolović, Goran Damnjanović, Boris Djindjić, Igor Smiljković, Aleksandar Kamenov, Ivana Damnjanović
BACKGROUND/AIM: During choledocholitiasis inflammatory oxidant stress involves the promotion of mitochondrial dysfunction through an intracellular oxidant stress in hepatocytes leading mainly to necrosis and less to apoptosis. The product of oxidative stress, malondialdehyde (MDA), is extremely cytotoxic and damages cell membranes and intracellular macromolecules. The toxicity of MDA is based on its ability to act as a mutagenic agent in a cell. Therefore, the aim of this prospective study was to establish correlation of the parameters of inflammation and biochemical markers of cholestasis with the intensity of oxidative stress in pathogenesis of liver function disorders...
February 2013: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
C Boru, G Silecchia
BACKGROUND: bariatric surgery presented a dramatic increase due to the obesity epidemics and the laparoscopic approach. General surgeons might face acute or chronic complications of bariatric surgery, considering the increasing figures of obesity procedures performed every year in USA, as well as in Europe. AIM: to present the possible surgical emergencies after bariatric surgery. METHODS: laparoscopic adjustable gastric banding is the most widely performed bariatric procedure in Europe...
July 2010: Chirurgia
B Kianicka, P Díte, P Piskac
AIMS OF THE STUDY: The aim of this retrospective study was to analyse diagnostic and therapeutic success of endoscopic retrograde cholangiopancreatography (ERCP) in our sample of patients following Billroth II gastric resection, where, due to significantly modified anatomic ratios, this surgery represents a specific and often extremely difficult technical problem when performing ERCP. MATERIALS AND METHODOLOGY: The sample was followed up for 13 years (November 1994-December 2007)...
November 2009: Vnitr̆ní Lékar̆ství
C Athié-Gutíerrez
Cholelithiasis is considered as a major health problem in Mexico do to its high prevalence. The spectrum of gallstones ranges from sympatomatic to asymptomatic gallbladder stones. The most frequent complications are acute cholecystitis, choledocholithiasis, cholangitis and pancreatitis. The standard method for diagnosis is ultrasonography but for a better evaluation and in order to cover the ultrasonographic faults, the oral cholecystogram is recovering value. Computarized axial tomography, technetium marked radionucleids and ERCP are valuable tools to avoid unnecessary surgical exploratory choledochotomies...
July 1990: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
Shi Donev
The autor described his own clinical case with difficultes in the diagnoses of choledocholitiasis. He described the clinical, ultrasound and endoscopic difficultes in the verification of this very often meeted diseases.
2005: Khirurgiia
C Sciumè, G Geraci, F Pisello, F Li Volsi, T Facella, G Modica
BACKGROUND: The aim of this study was to evaluate the effectiveness of endoscopic sphincterotomy and positioning of naso-biliary drain or biliary endoprosthesis for preoperative and postoperative complications of hepatic hydatid disease (fistuias, compressioni cholestasis, rupture in biliary tree). METHODS: During the period 1994-2003, 22 patients (12 male and 10 female, mean age 55.4 years, range 16-65 yrs) underwent endoscopic treatment for complications of hepatic hydatid disease...
September 2004: Annali Italiani di Chirurgia
Miguel Angel Ramírez-Luna, Javier Elizondo-Rivera, Miguel F Herrera, Jorge Pedroza-Granados, Francisco Valdovinos-Andraca
BACKGROUND: With the popularity of laparoscopic cholecystectomy (LC), the algorithm of endoscopic retrograde cholangiography (ERC) with biliary sphincterotomy followed by laparoscopic cholecystectomy has proven to be an effective treatment in choledocholithiasis in symptomatic gallstone disease. However, its use as a standard approach remains controversial. OBJECTIVES: 1. To determine the diagnostic and therapeutic usefulness of ERC with biliary sphincterotomy in patients with LC...
October 2004: Revista de Gastroenterología de México
M Guidi, F Baldoni, E Goldin, D Wengrower, A Bologna, A Bernedo, H Martínez, N Chopita, N Landoni, A Jmelnitzky
INTRODUCTION: Endoscopic sphincterotomy (ES) is commonly used to remove bile-duct stones and to treat other problems. We prospectively investigated complications and mortality of endoscopic retrograde cholangiopancreatography (ERCP). PATIENTS AND METHODS: Between june 6, 1998 and june 6, 1999 553 ERCP were performed in our centers. Inclusion criteria for protocol were: ERCP indication, complete follow-up and informed consent. We prospectively studied complications of ECRP in consecutive patients treated at 2 institutions (San Martin Hospital, La Plata, Argentina and Hadassah University Hospital, Jerusalem, Israel)...
2003: Acta Gastroenterologica Latinoamericana
F Piacentini, S Perri, F Pietrangeli, M Nardi, A Dalla Torre, A Nicita, R Lotti, P Castaldo, F Gabbrielli, D Castiglia, G Citone
Since its presentation by Mirizzi in 1931, the role of intraoperative cholangiography (ICHO) has been controversial and has become an argument even more disputed with the introduction of laparoscopic cholecystectomy (VLC) in 1988. The Authors reviewed their experience to determine the most appropriate use of ICHO during VLC on the basis of a retrospective analysis of cases of selective ICHO. From December 1991 to January 2001, 597 patients, 552 elective procedure and 45 emergency procedure, were reviewed. Of 552 patients 62 presented with at least one diagnostic criterion for symptomatic gallstone disease and were treated by means of ERCP completed with endoscopic sphincterectomy (ES) when a stone of the common bile duct was found, while the remaining 490 patients underwent VLC; a total of 10 ICHO were performed, two of which in the ERCP group and 8 in the VLC group...
April 2003: Il Giornale di Chirurgia
J García-Cano Lizcano, J A González Martín, A Pérez Sola, M J Morillas Ariño
BACKGROUND AND AIM: ERCP with biliary sphincterotomy is the usual method to extract common bile duct stones. However, after sphincterotomy and by means of balloons and Dormia baskets not all stones may be extracted during the first endoscopy session. We present our experience regarding success rate after first ERCP. PATIENTS AND METHODS: 100 consecutive patients were included. All were diagnosed with choledocholitiasis by using ERCP. After biliary sphincterotomy, attempts to extract stones by means of balloons and Dormia baskets only were made...
June 2002: Revista Española de Enfermedades Digestivas
V Arsena, F Graziano, M Fontanili, P Viganò
BACKGROUND: The aim of this study is to show the utility of intraoperative cholangiography IOC in detecting unknown common bile duct calculosis during VLS cholecystectomy. METHODS: The General Surgery Unit of Carlo Poma Hospital in Mantova, carried out a retrospective study considering 288 VLS executed from January 1996 to May 1999. The study excluded the following categories of patients: those with an already known choledocholitiasis, those who underwent preoperative curative ERCP, and those with a preoperative cholangio RMN...
June 2001: Minerva Chirurgica
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