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Biliary stricture

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https://www.readbyqxmd.com/read/28926836/percutaneous-biliary-balloon-dilation-impact-of-an-institutional-three-session-protocol-on-patients-with-benign-anastomotic-strictures-of-hepatojejunostomy
#1
Matias E Czerwonko, Pablo Huespe, Oscar Mazza, Martin de Santibanes, Rodrigo Sanchez-Claria, Juan Pekolj, Miguel Ciardullo, Eduardo de Santibanes, Sung Ho Hyon
BACKGROUND: Percutaneous biliary balloon dilation (PBBD) stands as a safe, useful, and inexpensive treatment procedure performed on patients with benign anastomotic stricture of Roux-en-Y hepatojejunostomy (BASH). However, the optimal mode of application is still under discussion. METHODS: A retrospective cohort study was conducted including patients admitted between 2008 and 2015 with diagnosis of BASH. Patients were divided into 2 groups: group I (n = 22), included patients treated after the implementation of an institutional protocol of 3 PBBD sessions within a fixed time interval and group II (n = 24) consisted of our historical control of patients who underwent one or 2 dilation sessions...
September 20, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28926171/biliary-reconstructive-techniques-and-associated-anatomic-variants-in-adult-living-donor-liver-transplants-the-a2all-experience
#2
Talia B Baker, Michael A Zimmerman, Nathan P Goodrich, Benjamin Samstein, Elizabeth A Pomfret, James J Pomposelli, Brenda W Gillespie, Carl L Berg, Jean C Emond, Robert M Merion
INTRODUCTION: Living donor liver transplantation (LDLT) is a technically demanding endeavor, requiring command of the complex anatomy of partial liver grafts. We examined the influence of anatomic variation and reconstruction technique on surgical outcomes and graft survival in the nine-center A2ALL Study. METHODS: Data from 272 adult LDLT recipients (2011-2015) included details on anatomic characteristics and types of intraoperative biliary reconstruction. Associations were tested between reconstruction technique and complications, which included first biliary complication ([BC]; leak, stricture, or biloma) and first vascular complication (hepatic artery thrombosis [HAT] or portal vein thrombosis [PVT])...
September 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28916322/intraductal-transanastomotic-stenting-in-duct-to-duct-biliary-reconstruction-after-living-donor-liver-transplantation-a-randomized-trial
#3
Ky Santosh Kumar, Johns Shaji Mathew, Dinesh Balakrishnan, Viju Kumar Bharathan, Binoj Sivasankara Pillai Thankamony Amma, Unnikrishnan Gopalakrishnan, Ramachandran Narayana Menon, Puneet Dhar, Sudheer Othiyil Vayoth, Sudhindran Surendran
BACKGROUND: Biliary complications continue to be the 'Achilles heel' of living donor liver transplantation (LDLT). The use of biliary stents in LDLT to reduce biliary complication is a controversial issue. We performed a randomized trial to study the impact of intraductal biliary stents on postoperative biliary complications following LDLT. STUDY DESIGN: Of the 94 LDLT's, that were performed during a period of 16 months, ABO incompatible transplants, left lobe grafts, ≥3 ducts on the graft and those requiring bilio-enteric drainage were excluded...
September 12, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28906357/ercp-related-complication-is-not-the-only-cause-of-gi-bleeding-in-post-liver-transplantation-patients-a-case-report
#4
Zhen Ding, Xue-Lian Tang, Rong Lin, Chaoqun Han, Jun Liu
RATIONALE: Endoscopic retrograde cholangiopancreatography (ERCP) is the treatment of choice for biliary complications in liver transplantation (LT) recipients as it is both diagnostic and therapeutic. The specific risks following ERCP among LT recipients have not been well studied. PATIENT CONCERNS: A 56-year-old man with a history of orthotopic LT underwent endoscopic retrograde cholangiopancreatography (ERCP) as a treatment of biliary strictures, whereby a plastic stent was implanted...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905807/buttressing-hepaticojejunostomy-apos-s-with-hepatic-round-ligament-flap-may-be-beneficial
#5
Jayant Kumar Banerjee, Ramanathan Saranga Bharathi, Pankaj Purushotam Rao
BACKGROUND: Bile leaks and anastomotic strictures are important complications of hepaticojejunostomy (HJ). Evidence suggests that the use of hepatic round ligament (HRL) to buttress HJ may be beneficial. This study evaluates the feasibility of this approach. METHODS: HJs performed over 2 years (Jun 2014- May 2016), with HRL reinforcement, were analyzed. Operative outcomes measured included technical difficulty, blood loss, time necessary for flap harvest, and reinforcement of HJ...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28905337/cholangioscopy-assisted-guidewire-placement-in-post-liver-transplant-anastomotic-biliary-stricture-efficient-and-potentially-also-cost-effective
#6
Fernanda P Martins, Angelo P Ferrari
No abstract text is available yet for this article.
September 13, 2017: Endoscopy
https://www.readbyqxmd.com/read/28875690/use-of-fully-covered-self-expanding-metal-stents-for-benign-biliary-etiologies-a-large-multi-center-experience
#7
Abdul Haseeb, Ali Siddiqui, Linda J Taylor, Alyssa Mills, Thomas E Kowalski, David E Loren, Jessica Dahmus, Silpa Yalamanchili, Christopher Cao, Andrew Canakis, Tayebah Mumtaz, Meet Parikh, Douglas G Adler
INTRODUCTION: Fully-covered self-expandable metal stents (FCSEMS) have been used in benign biliary diseases although reported data is limited. These devices are most commonly used to treat biliary leaks, strictures, or both. The aim of this study was to evaluate effectiveness of FCSEMS in treating benign biliary disease and recognize the associated complications. METHODS: We performed a multi-center longitudinal retrospective cohort study of patients with benign biliary disease needing FCSEMS between 2011 and 2016...
September 5, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28867074/association-of-covered-metallic-stents-with-cholecystitis-and-stent-migration-in-malignant-biliary-stricture
#8
Sunguk Jang, Tyler Stevens, Mansour Parsi, Rocio Lopez, Gregory Zuccaro, John Dumot, John J Vargo
BACKGROUND: ERCP with self-expandable metallic stent (SEMS) placement provides reliable and durable relief of malignant biliary obstruction. Our objective was to compare efficacy and adverse outcomes between uncovered SEMSs (USEMSs) and covered SEMSs (CSEMSs). METHODS: A retrospective cohort study was performed of all consecutive patients who underwent ERCP with SEMS placement for the management of a malignant bile duct stricture. Comparative analyses on clinical success, patency duration, stent dysfunction and adverse outcomes were performed...
August 31, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28866899/covered-biliary-stents-with-proximal-bare-stent-extension-for-the-palliation-of-malignant-biliary-disease-can-we-reduce-tumour-overgrowth-rate
#9
Miltiadis Krokidis, Adam Hatzidakis
BACKGROUND: Covered biliary stents have shown significant effectiveness in the palliative management of patients with malignant biliary disease due to prevention of tumour ingrowth. However, stent dysfunction may still occur due to growth of tumour at the borders of the covered stent (tumour overgrowth). The aim of this study is to assess the effectiveness of a bare extension in the prevention of tumour overgrowth when covered stents are used in the palliative treatment of malignant biliary strictures...
August 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28858292/endoscopic-drainage-of-50-of-liver-in-malignant-hilar-biliary-obstruction-using-metallic-or-fenestrated-plastic-stents
#10
Tossapol Kerdsirichairat, Mustafa A Arain, Rajeev Attam, Brooke Glessing, Yan Bakman, Stuart K Amateau, Martin L Freeman
OBJECTIVES: Endoscopic drainage of complex hilar tumors has generally resulted in poor outcomes. Drainage of >50% of liver volume has been proposed as optimal, but not evaluated using long multifenestrated plastic stents (MFPS) or self-expanding metal stents (SEMS). We evaluated outcomes of endoscopic drainage of malignant hilar strictures using optimal strategy and stents, and determined factors associated with stent patency, survival, and complications. METHODS: Cross-sectional study was conducted at an academic center over 5 years...
August 31, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28854772/usefulness-of-endoscopic-transpapillary-tissue-sampling-for-malignant-biliary-strictures-and-predictive-factors-of-diagnostic-accuracy
#11
Hiroki Tanaka, Shimpei Matsusaki, Youichirou Baba, Yoshiaki Isono, Tomohiro Sase, Hiroshi Okano, Tomonori Saito, Katsumi Mukai, Tetsuya Murata, Hiroki Taoka
Background/Aims: It is sometimes difficult to distinguish between malignant and benign biliary strictures using imaging studies alone, and pathological diagnosis is necessary. The aim of this study was to determine the usefulness of endoscopic transpapillary tissue sampling and factors predictive of diagnostic accuracy. Methods: From April 2008 to December 2014, 136 patients underwent endoscopic transpapillary tissue sampling for malignant biliary strictures. The cytological and histological findings were reported as negative, suspicious, or positive...
August 31, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28846154/-biopsy-forceps-fixation-novel-trick-of-the-trade-for-duodenal-guidewire-unlooping
#12
V Zimmer
Bile duct stenting remains the clinical mainstay for establishing biliary drainage in malignant or benign strictures with successful and stable deep guidewire passage as the sine qua non. Duodenal loop formation of an effectively inserted guidewire may occur occasionally and threatens the procedural success in day-to-day ERC practice, which may even be more troublesome after cumbersome guidewire passage in the first place. Attempts to rescue wire positioning often fail, since the wire is typically in a dead angle with a tendency to completely slip out of postion no matter how the scope or cannula is navigated...
August 28, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28840410/characterization-of-common-bile-duct-injury-after-laparoscopic-cholecystectomy-in-a-high-volume-hospital-system
#13
Julia F Kohn, Alexander Trenk, Kristine Kuchta, Brittany Lapin, Woody Denham, John G Linn, Stephen Haggerty, Ray Joehl, Michael B Ujiki
BACKGROUND: Despite the popularity of laparoscopic cholecystectomy, rates of common bile duct injury remain higher than previously observed in open cholecystectomy. This retrospective chart review sought to determine the prevalence of, and risk factors for, biliary injury during laparoscopic cholecystectomy within a high-volume healthcare system. METHODS: 800 of approximately 3000 cases between 2009 and 2015 were randomly selected and retrospectively reviewed. A single reviewer examined all operative notes, thereby including all cases of BDI regardless of ICD code or need for a second procedure...
August 24, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28839439/outcomes-of-preoperative-endoscopic-nasobiliary-drainage-and-endoscopic-retrograde-biliary-drainage-for-malignant-distal-biliary-obstruction-prior-to-pancreaticoduodenectomy
#14
Guo-Qiang Zhang, Yong Li, Yu-Ping Ren, Nan-Tao Fu, Hai-Bing Chen, Jun-Wu Yang, Wei-Dong Xiao
AIM: To compare the outcomes of preoperative endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) in patients with malignant distal biliary obstruction prior to pancreaticoduodenectomy (PD). METHODS: Data from 153 consecutive patients who underwent preoperative endoscopic biliary drainage prior to PD between January 2009 and July 2016 were analyzed. We compared the clinical data, procedure-related complications of endoscopic biliary drainage (EBD) and postoperative complications of PD between the ENBD and ERBD groups...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28838456/successful-treatment-of-stricture-of-duct-to-duct-biliary-anastomosis-after-living-donor-liver-transplantation-of-the-left-lobe-a%C3%A2-case%C3%A2-report
#15
Y Nakaseko, H Shiba, E Yamanouchi, Y Takano, T Sakamoto, H Imazu, H Ashida, K Yanaga
Biliary complications, such as stricture or obstruction, after living-donor liver transplantation (LDLT) remain major problems to be solved. Magnetic compression anastomosis (MCA) is a minimally invasive method of biliary anastomosis without surgery in patients with biliary stricture or obstruction. A 66-year-old woman had undergone LDLT for end-stage liver disease for primary biliary cholangitis 20 months previously at another hospital. Computerized tomography showed dilation of the intrahepatic bile duct (B2)...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28837510/use-of-fully-covered-self-expanding-metal-biliary-stents-in-pediatrics-a-case-series
#16
Jacob A Mark, Cara L Mack, Ahmed I Marwan, Robert E Kramer
OBJECTIVE: Endoscopic retrograde cholangiopancreatography (ERCP) is used to manage biliary pathology in pediatric patients. Plastic biliary stents have been utilized in this population for obstructive lesions and bile leaks, however they are sometimes not effective due to migration, occlusion, or ineffective sealing. Fully covered self-expanding metal stents (FCSEMS) have larger diameters making them more suitable for some situations. However, their use in pediatrics has not been defined...
August 23, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28831719/petersen-s-hernia-after-living-donor-liver-transplantation
#17
Sodai Sakamoto, Ryoichi Goto, Norio Kawamura, Yasuyuki Koshizuka, Masaaki Watanabe, Minoru Ota, Tomomi Suzuki, Daisuke Abo, Kenichiro Yamashita, Toshiya Kamiyama, Akinobu Taketomi, Tsuyoshi Shimamura
BACKGROUND: Hepaticojejunostomy may be used for biliary reconstruction in certain cases of liver transplantation. In this occasion, Roux-en-Y biliary reconstruction is predominantly performed. Petersen's hernia is an internal hernia that can occur after Roux-en-Y reconstruction, and it may lead to extensive ischemic changes affecting incarcerated portions of the small bowel or Roux limb resulting in severe complications with a poor prognosis. CASE PRESENTATION: The present case was a 44-year-old male who underwent living donor liver transplantation (LDLT) for familial amyloid polyneuropathy and in whom biliary reconstruction was performed with Roux-en-Y hepaticojejunostomy...
August 23, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28830294/heterotopic-gastric-mucosa-in-a-duplication-cyst-of-the-common-hepatic-duct-mimicking-cholangiocarcinoma
#18
Amedeo Sciarra, Roxane Hessler, Sébastien Godat, Montserrat Fraga, Clarisse Dromain, Rafael Duran, Nermin Halkic, Christine Sempoux
Heterotopic gastric mucosa in biliary tract is a congenital anomaly that can prove significant clinical dilemmas. Here we report the case of a 28-year-old female patient presenting with jaundice, pruritus, and altered liver tests, with predominant cholestasis. Liver biopsy revealed histological changes suggesting large bile duct obstruction with advanced fibrosis. At imaging, common hepatic duct stricture due to an intraluminal enhancing mass was observed. Endoscopic retrograde cholangiopancreatography and upper echoendoscopy revealed a firm mass of the common hepatic duct with a complete obstruction, suspicious for cholangiocarcinoma...
August 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28815030/a-combined-bile-and-urine-proteomic-test-for-cholangiocarcinoma-diagnosis-in-patients-with-biliary-strictures-of-unknown-origin
#19
Torsten Voigtländer, Jochen Metzger, Bastian Schönemeier, Mark Jäger, Harald Mischak, Michael P Manns, Tim O Lankisch
BACKGROUND: Detection of cholangiocarcinoma (CC) remains a diagnostic challenge particularly in patients with primary sclerosing cholangitis (PSC). We recently established diagnostic peptide marker models in bile and urine to detect CC. Our aim was to combine both models to reach a higher diagnostic accuracy of CC diagnosis. METHODS: Bile (BPA) and urine (UPA) proteome analysis by capillary electrophoresis mass spectrometry was performed in a case-control phase II study on 87 patients (36 CC including 13 with CC on top of PSC, 33 PSC and 18 other benign disorders)...
August 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28804514/is-eus-guided-drainage-a-suitable-alternative-technique-in-case-of-proximal-biliary-obstruction
#20
Frédérick Moryoussef, Adrien Sportes, Sarah Leblanc, Jean Baptiste Bachet, Stanislas Chaussade, Frédéric Prat
BACKGROUND: Results of endoscopic ultrasound-guided biliary drainage (EUBD) are unknown in case of proximal stricture. The aim is to assess clinical outcomes of EUBD in patients with malignant hilar obstruction. METHODS: Patients undergoing EUBD with hilar strictures were prospectively included. Primary outcome was clinical success at 7 and 30 days (defined by 50% bilirubin decrease). Secondary outcomes were technical success, procedure-related complications, length of hospital stay, reintervention rate, survival and chemotherapy administration...
July 2017: Therapeutic Advances in Gastroenterology
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