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Biliary pancreatitis

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https://www.readbyqxmd.com/read/28344051/massive-biliary-dilation-after-roux-en-y-gastric-bypass-is-it-ampullary-achalasia
#1
Jeffrey L Ponsky, Noble Jones, John H Rodriguez, Matthew D Kroh, Andrew T Strong
BACKGROUND: This series of patients with a history of roux-en-Y gastric bypass (RYGB) and cholecystectomy presented with symptoms consistent with obstructive biliary disease and massive biliary dilation of 15 mm or greater, suggesting a structural etiology. Findings from laparoscopic assisted transgastric endoscopic retrograde cholangiopancreatography (TGERCP) were a normal appearing ampulla without structural lesions or stones, suggesting a functional etiology, instead. STUDY DESIGN: Patients who underwent TGERCP from January 2008 to October 2016 and had a previous surgical history of RYGB and cholecystectomy were identified from an institutional database...
March 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28343588/preoperative-biliary-drainage-in-patients-with-resectable-perihilar-cholangiocarcinoma-is-percutaneous-transhepatic-biliary-drainage-safer-and-more-effective-than-endoscopic-biliary-drainage-a-meta-analysis
#2
Aimen Al Mahjoub, Benjamin Menahem, Audrey Fohlen, Benoit Dupont, Arnaud Alves, Guy Launoy, Jean Lubrano
PURPOSE: To determine the best initial procedure for performing preoperative biliary drainage in patients with resectable perihilar cholangiocarcinoma (PHCC). MATERIALS AND METHODS: MEDLINE/PubMed and the Cochrane database were searched for all studies published until June 2016 comparing endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD) for preoperative biliary drainage. Meta-analysis was performed by using Review Manager 5...
April 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28337739/intraductal-neoplasms-of-the-bile-duct-a-new-challenge-to-biliary-tract-tumor-pathology
#3
REVIEW
Yasuni Nakanuma, Katsuhiko Uesaka, Shiro Miyayama, Hiroshi Yamaguchi, Masayuki Ohtsuka
Invasive biliary tract carcinomas are usually tubular adenocaricnomas with abundant desmoplastic reactions and frequent ductal and periductal invasion at the time of the diagnosis. Recently, several intraductal neoplasms of the bile duct, particularly at a pre-invasive stage, have been recognized. They include intraductal papillary neoplasm of the bile duct (IPNB), biliary intraepithelial neoplasm (BilIN), and others, such as intraductal tubulopapillary neoplasm (ITPN) of the bile duct. IPNBs are grossly visible predominantly intraductal-growing papillary neoplasms covered by well-differentiated neoplastic epithelium with fine fibrovascular cores in the dilated bile ducts...
March 24, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/28337485/safety-and-efficacy-of-minimal-biliary-sphincterotomy-with-papillary-balloon-dilation-m-ebs-epbd-in-patients-using-clopidogrel-or-anticoagulation
#4
Shaffer R S Mok, Murtaza Arif, David L Diehl, Harshit S Khara, Henry C Ho, Adam B Elfant
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (EBS) or endoscopic papillary balloon dilation (EPBD) are common techniques of biliary decompression. Potential risks include gastrointestinal hemorrhage, which can be increased by antiplatelet agents, anticoagulants (AC) and/or novel oral anticoagulants (NOACs) (ie. apixaban, dabigatran and rivaroxaban). The study aim is to evaluate the safety/efficacy of an alternative technique, minimal-EBS plus EPBD (m-EBS + EPBD), in individuals for whom clopidogrel, AC, and/or NOACs cannot be interrupted due to high cardiovascular or thromboembolic risk...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28337482/efficacy-and-safety-of-novel-digital-single-operator-peroral-cholangioscopy-guided-laser-lithotripsy-for-complicated-biliary-stones
#5
John Ct Wong, Raymond Sy Tang, Anthony Yb Teoh, Joseph Jy Sung, James Yw Lau
Background/study aims Laser lithotripsy can effectively fragment complicated biliary stones, but current cholangioscopes are limited by fragility, restricted mobility or moderate visual resolution. The efficacy and safety of a new digital single-operator peroral cholangioscope to guide laser lithotripsy were evaluated. Patients and methods In this prospective single-center series, consecutive patients with complicated biliary stones, defined as impacted stones > 1.5 cm in size and wider than the more distal common bile duct, or stones that failed extraction by basket mechanical lithotripsy, underwent ERCP and SpyGlass DS peroral cholangioscope (Boston Scientific, Marlborough, United States)-guided laser lithotripsy...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28335780/considerable-interobserver-variation-in-delineation-of-pancreatic-cancer-on-3dct-and-4dct-a-multi-institutional-study
#6
Eva Versteijne, Oliver J Gurney-Champion, Astrid van der Horst, Eelco Lens, M Willemijn Kolff, Jeroen Buijsen, Gati Ebrahimi, Karen J Neelis, Coen R N Rasch, Jaap Stoker, Marcel van Herk, Arjan Bel, Geertjan van Tienhoven
BACKGROUND: The delineation of pancreatic tumors on CT is challenging. In this study, we quantified the interobserver variation for pancreatic tumor delineation on 3DCT as well as on 4DCT. METHODS: Eight observers (radiation oncologists) from six institutions delineated pancreatic tumors of four patients with (borderline) resectable pancreatic cancer. The study consisted of two stages. In the 3DCT-stage, the gross tumor volume (GTV) was delineated on a contrast-enhanced scan...
March 23, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28332175/endoscopic-ultrasound-of-lemmel-s-syndrome
#7
Piyush Somani, Malay Sharma
Periampullary duodenal diverticula are common and are usually asymptomatic. However, complications like biliary or pancreatic obstruction, duodenal obstruction, perforation, or hemorrhage can occur occasionally. Obstructive jaundice is usually due to biliary stones and periampullary tumors. Rarely, duodenal diverticula may present with obstructive jaundice in the absence of cholelithiasis or other detectable obstacle. This condition is called Lemmel's syndrome. There are only few case reports of this rare condition...
March 23, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28331537/combined-totally-mini-invasive-approach-in-necrotizing-pancreatitis-a-case-report-and-systematic-literature-review
#8
REVIEW
Luca Sorrentino, Osvaldo Chiara, Massimiliano Mutignani, Fabrizio Sammartano, Paolo Brioschi, Stefania Cimbanassi
BACKGROUND: Currently, both the step-up approach, combining percutaneous drainage (PD) and video-assisted retroperitoneal debridement (VARD), and endoscopic transgastric necrosectomy (ETN) are mini-invasive techniques for infected necrosis in severe acute pancreatitis. A combination of these approaches could maximize the management of necrotizing pancreatitis, conjugating the benefits from both the experiences. However, reporting of this combined strategy is anecdotal. This is the first reported case of severe necrotizing pancreatitis complicated by biliary fistula treated by a combination of ETN, PD, VARD, and endoscopic biliary stenting...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28321164/efficacy-and-safety-of-limited-endoscopic-sphincterotomy-before-self-expandable-metal-stent-insertion-for-malignant-biliary-obstruction
#9
Hyeong Seok Nam, Dae Hwan Kang, Hyung Wook Kim, Cheol Woong Choi, Su Bum Park, Su Jin Kim, Dae Gon Ryu
AIM: To evaluate the safety and efficacy of limited endoscopic sphincterotomy (ES) before placement of self-expandable metal stent (SEMS). METHODS: This was a retrospective analysis of 244 consecutive patients with unresectable malignant biliary obstruction, who underwent placement of SEMSs following limited ES from December 2008 to February 2015. The diagnosis of malignant biliary obstruction and assessment of patient eligibility for the study was established by a combination of clinical findings, laboratory investigations, imaging and pathological results...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28320629/is-acute-recurrent-pancreatitis-in-children-a-precursor-of-chronic-pancreatitis-a-long-term-follow-up-study-of-93-cases
#10
Ujjal Poddar, Surender K Yachha, Vibhor Borkar, Anshu Srivastava
BACKGROUND/AIMS: In view of paucity of literature we analyzed our experience of acute recurrent pancreatitis (ARP) to study clinical profile and long-term outcome. METHODS: Over 13 years, 93 consecutive children (≤18 years) diagnosed to have ARP were included in this study. Magnetic resonance cholangiopancreatography was done at baseline and on follow-up. Common mutations for serine-protease-inhibitor (SPINK1 N34S), protease inhibitor (PRSS1 R122S) and cystic fibrosis transmembrane conductance regulator (CFTR deltaF508, 5T) were studied in 22 idiopathic cases...
March 6, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28318494/the-role-of-the-irreversible-electroporation-in-the-hepato-pancreatico-biliary-surgery
#11
Patricia Sánchez-Velázquez, Pierre-Alain Clavien
Irreversible electroporation is a novel technique growing in popularity over the last years among the ablative modalities. Its unique action mechanism produces irreversible nanopores in the membrane of the cell leading to apoptosis; therefore irreversible electroporation can be used to ablate substantial volumes of tissue without the undesirable thermal effects as the "heat sink effect". Moreover the extracellular matrix is left unperturbed, thus sparing the structural architecture of surrounding structures such as bile ducts and blood vessels...
March 16, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28317208/current-status-of-interventional-endoscopic-ultrasound
#12
REVIEW
Shomei Ryozawa, Naotaka Fujita, Atsushi Irisawa, Yoshiki Hirooka, Tetsuya Mine
Endoscopic ultrasound (EUS) is being used increasingly in the management of pancreatic fluid collection, biliary and pancreatic duct drainage in cases of failed endoscopic retrograde cholangiopancreatography, drainage of the gallbladder, and other conditions. The role of interventional EUS is rapidly expanding and new interventions are continuously emerging. The development of devices could be a major breakthrough in the field of interventional EUS. New devices would enable the expansion of its role even further and prompt its widespread use in clinical practice...
March 20, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28317046/a-rare-case-of-choledochal-cyst-with-pancreas-divisum-case-presentation-and-literature-review
#13
Adrián Ransom-Rodríguez, Ruben Blachman-Braun, Emilio Sánchez-García Ramos, Jesús Varela-Prieto, Erick Rosas-Lezama, Miguel Ángel Mercado
Choledochal cysts are rare congenital malformations of the bile duct characterized by dilatations of the intrahepatic and/or extrahepatic portion of the biliary tree, they are associated to an anomalous arrangement of the pancreaticobiliary duct. Pancreas divisum results from a fusion failure of the pancreatic buds. The coexistence of pancreas divisum and choledochal cyst in adults has been reported in less than 10 well documented cases. This article presents a case of a 42-year-old Peruvian man with intermittent episodes of abdominal pain, initially diagnosed with choledocholithiasis, who underwent open cholecystectomy...
February 2017: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28317043/il-8-gene-polymorphism-in-acute-biliary-and-non-biliary-pancreatitis-probable-cause-of-high-level-parameters
#14
Ender Anilir, Filiz Ozen, Ibrahim Halil Yildirim, Ibrahim Ali Ozemir, Can Ozlu, Orhan Alimoglu
BACKGROUNDS/AIMS: Inflammatory mediators of the innate immune response play fundamental roles in the pathogenesis of acute pancreatitis. The correlation between interleukin-8 (IL-8) gene polymorphism with types of acute pancreatitis and severity of pancreatitis, was evaluated in this study. METHODS: According to the diagnostic criteria, 176 patients with acute pancreatitis were grouped into biliary (n=83) and nonbiliary pancreatitis (n=93). Healthy blood donors (n=100) served as controls...
February 2017: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#15
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28314312/surgical-resection-for-pulmonary-metastasis-from-pancreatic-and-biliary-tract-cancer
#16
Tetsuzo Tagawa, Kensaku Ito, Kengo Fukuzawa, Tatsuro Okamoto, Atsuro Yoshimura, Takahide Kawasaki, Takashi Masuda, Kentaro Iwaki, Takahiro Terashi, Masahiro Okamoto, Akio Shiromizu, Akira Motohiro, Yoshihiko Maehara
AIM: To determine the efficacy of pulmonary metastasectomy for pancreatic and biliary tract cancer. PATIENTS AND METHODS: Ten patients who underwent therapeutic pulmonary metastasectomy after resection for pancreatic and biliary tract cancer at our Institution from 2006 to 2016 were retrospectively evaluated. RESULTS: The primary site was the pancreas in four patients and biliary tract in six. Nine patients had single metastasis, and one patient had bilateral multiple metastases...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28293485/a-long-term-survivor-of-metastatic-pancreatic-adenocarcinoma-free-of-recurrence-12-years-after-treatment-of-oligometastatic-disease
#17
John M Stahl, Zenta Walther, Bryan W Chang, Howard S Hochster, Kimberly L Johung
Aggressive local therapy for patients with oligometastatic pancreatic ductal adenocarcinoma (PDAC) has traditionally not been pursued due to high rates of distant progression. We describe a 62-year-old male initially presenting with resectable PDAC who underwent the Whipple procedure but developed multiple liver metastases within two months of starting adjuvant gemcitabine. Oxaliplatin was added to the regimen and complete resolution of the liver lesions resulted. He remained disease-free for five years until re-staging revealed a small lung nodule...
February 2, 2017: Curēus
https://www.readbyqxmd.com/read/28289881/modified-biliary-enteric-anastomosis-for-congenital-choledochal-cyst-clinical-and-prognostic-analysis-of-91-cases
#18
Ji Chen, Bin Jiang, Jun Yi, Lei Huang, Xinmin Si
PURPOSE: To report our experience with a modified biliary-enteric anastomosis procedure for the surgical treatment of congenital choledochal cysts. METHODS: Between January 2009 and December 2013, 91 children (19 boys, 72 girls; ages, 6-145 months) with congenital choledochal cysts were treated with our modified surgical procedure in our hospital. Of these patients, 69 had type I cysts, and 22 had type IV B cysts. The main parameters analyzed mainly included the operative time, duration of bowel recovery, resumption of diet, postoperative hospital stay, liver-function tests, postoperative complications, and prognosis...
March 13, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28287940/diagnosis-and-management-of-complications-from-percutaneous-biliary-tract-interventions
#19
Nanda Venkatanarasimha, Karthik Damodharan, Apoorva Gogna, Sum Leong, Chow Wei Too, Ankur Patel, Kiang Hiong Tay, Bien Soo Tan, Richard Lo, Farah Irani
Complications related to percutaneous biliary tract interventions (PBTIs) can range from access site discomfort to life-threatening vascular complications. These complications are relatively uncommon, and most of them are self-limiting. However, major complications for which an increased level of patient care and/or a prolonged hospital stay are required and that may lead to death-albeit rarely-can occur. Some of the most common complications related to PBTI include pain, infection, bile leakage, and catheter blockage...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28287935/heterotopic-pancreas-histopathologic-features-imaging-findings-and-complications
#20
Maryam Rezvani, Christine Menias, Kumaresan Sandrasegaran, Jeffrey D Olpin, Khaled M Elsayes, Akram M Shaaban
Heterotopic pancreas is a congenital anomaly in which pancreatic tissue is anatomically separate from the main gland. The most common locations of this displacement include the upper gastrointestinal tract-specifically, the stomach, duodenum, and proximal jejunum. Less common sites are the esophagus, ileum, Meckel diverticulum, biliary tree, mesentery, and spleen. Uncomplicated heterotopic pancreas is typically asymptomatic, with the lesion being discovered incidentally during an unrelated surgery, during an imaging examination, or at autopsy...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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