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Biliary stricture

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https://www.readbyqxmd.com/read/28331447/novel-biliary-reconstruction-techniques-during-liver-transplantation
#1
Ian C Carmody, John Romano, Humberto Bohorquez, Emily Bugeaud, David S Bruce, Ari J Cohen, John Seal, Trevor W Reichman, George E Loss
BACKGROUND: Biliary complications remain a significant problem following liver transplantation. Several surgical options can be used to deal with a significant size mismatch between the donor and recipient bile ducts during the biliary anastomosis. We compared biliary transposition to recipient biliary ductoplasty in cadaveric liver transplant. METHODS: A total of 33 reconstructions were performed from January 1, 2005 to December 31, 2013. In the biliary transposition group (n=23), 5 reconstructions were performed using an internal stent (5 or 8 French pediatric feeding tube), and 18 were performed without...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28328835/poor-response-of-initial-steroid-therapy-for-igg4-related-sclerosing-cholangitis-with-multiple-organs-affected
#2
Wei Liu, Weijie Chen, Xiaodong He, Qiang Qu, Tao Hong, Binglu Li
IgG4-related sclerosing cholangitis (IgG4-SC) is a rare biliary manifestation in which many other organs might be affected. The purpose of our study was to investigate the different clinical characteristics and initial steroid response between IgG4-SC patients with and without other organs affected.A series of patients with IgG4-SC in the period from January 2006 to December 2015 at our hospital were included. The pancreas and major salivary glands were screened, and the initial corticosteroid therapy was given...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28325053/-iatrogenic-biliary-tract-lesions-requiring-surgical-reconstruction-presentation-and-classification-of-the-lesions-their-reconstruction-and-evaluation-of-the-results
#3
M Straka, E Holášková, L Burda, M Vávrová, P Fojtík, M Škrovina
INTRODUCTION: The incidence of biliary duct injuries requiring surgical reconstruction has stabilised between 0.30.7%. Biliary reconstruction in the hands of a trained hepatobiliary surgeon may lead to better short- and long-term outcomes in patients with this infrequent, but serious complication. METHODS: This study presents a retrospective analysis of single surgeon experience with biliary injury repair during the period of 20072016. Extramucosal hepaticojejunostomy on the excluded segment of the jejunal loop was performed without the use of any transanastomotic drain...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28319567/treatment-of-biliary-stricture-after-live-donor-liver-transplantation-with-combined-metal-and-plastic-stent-%C3%A4-nsertion-a-feasibility-and-safety-study
#4
Erkan Parlak, Aydin Seref Koksal, Ahmet Tarik Eminler, Bilal Toka, Mustafa Ihsan Uslan
BACKGROUND: Fully covered-self expandable metal stents (Fc-SEMSs) have a challenging use in the treatment of anastomosis strictures (ASs) after live donor liver transplantation (LDLT) because they can occlude secondary branch biliary ducts when placed above the biliary bifurcation. In this study we evaluated the technical feasibility and safety of combining Fc-SEMSs with plastic stent(s) inserted to the secondary branch biliary ducts for the treatment of ASs after LDLT. METHODS: The study group included 22 patients (12 men, aged 51±11 years) with anastomotic biliary stricture after LDLT...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28316328/reoperation-after-cyst-excision-with-hepaticojejunostomy-for-choledochal-cysts-our-experience-in-18-cases
#5
Qingfeng Sheng, Zhibao Lv, Weijue Xu, Xianmin Xiao, Jiangbin Liu, Yibo Wu
BACKGROUND Complete cyst excision with biliary reconstruction is the treatment of choice for choledochal cyst (CC). The aim of this article is to review our experience in patients who underwent reoperation between January 1995 and December 2014. MATERIAL AND METHODS The records of 18 patients (female/male, 15/3) were retrospectively analyzed including age, sex, cyst type, initial procedure, lab and imaging findings, indications for reoperation, intraoperative findings, and results of reoperation. The median follow-up period was 6 years...
March 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28314602/endoscopic-rendez-vous-reconstruction-of-complete-biliary-obstruction
#6
B Neu, S Nennstiel, S von Delius, M Abdelhafez, M Bajbouj, R M Schmid, H Berger, H Feussner, A Meining
BACKGROUND AND STUDY AIMS: Complete biliary strictures normally require surgical intervention. We describe an alternative, minimally invasive endoscopic/percutaneous rendez-vous technique for the reconstruction of complete benign biliary strictures. PATIENTS AND METHODS: Complete biliary strictures were reconstructed in four patients using a rendez-vous percutaneous-endoscopic or percutaneous-percutaneous route guided by fluoroscopic and visual (transillumination) control...
February 27, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28302527/multiple-plastic-stents-versus-covered-metal-stent-for-treatment-of-anastomotic-biliary-strictures-after-liver-transplantation-a-prospective-randomized-multicenter-trial
#7
Andrea Oliver Tal, Fabian Finkelmeier, Natalie Filmann, Leena Kylänpää, Marianne Udd, Ilaria Parzanese, Paolo Cantù, Alexander Dechêne, Volker Penndorf, Andreas Schnitzbauer, Mireen Friedrich-Rust, Stefan Zeuzem, Jörg G Albert
BACKGROUND AND AIMS: Treatment of anastomotic biliary strictures (ABSs) after orthotopic liver transplantation (OLT) by endoscopic insertion of multiple plastic stents (MPSs) is well-established. The use of covered self-expandable metal stents (cSEMSs) for this indication is less investigated. METHODS: In an open-label, multicenter, randomized trial, patients with confirmed ABSs were randomly assigned 1:1 to receive either an MPS or a cSEMS. Primary endpoint was the number of endoscopic interventions until ABS resolution...
March 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28302441/percutaneous-transhepatic-cholangiographic-endobiliary-forceps-biopsy-versus-endoscopic-ultrasound-fine-needle-aspiration-for-proximal-biliary-strictures-a-single-centre-experience
#8
Kayvan Mohkam, Yaseen Malik, Carlos Derosas, John Isaac, Ravi Marudanayagam, Homoyoon Mehrzad, Darius F Mirza, Paolo Muiesan, Keith J Roberts, Robert P Sutcliffe
BACKGROUND: Endoscopic ultrasound fine needle aspiration (EUS-FNA) and percutaneous transhepatic cholangiographic endobiliary forceps biopsy (PTC-EFB) are valid procedures for histological assessment of proximal biliary strictures (PBS), but their performances have never been compared. This study aimed to compare the diagnostic performance of these two techniques. METHOD: The diagnostic performances of EUS-FNA and PTC-EFB were compared in a retrospective cohort of patients assessed for PBS from 2011 to 2015 at a single tertiary centre...
March 13, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28301778/risk-stratified-versus-non-risk-stratified-diagnostic-testing-for-management-of-suspected-acute-biliary-obstruction-comparative-effectiveness-costs-and-the-role-of-mr-cholangiopancreatography
#9
Stella K Kang, David Hoffman, Bart Ferket, Michelle I Kim, R Scott Braithwaite
Purpose To analyze the cost effectiveness of the American Society for Gastrointestinal Endoscopy (ASGE) risk stratification guidelines versus magnetic resonance (MR) cholangiopancreatography-based treatment of patients with possible choledocholithiasis. Materials and Methods A decision-analytic model was constructed to compare cost and effectiveness of three diagnostic strategies for gallstone disease with possible choledocholithiasis: noncontrast MR cholangiopancreatography, contrast material-enhanced MR imaging/MR cholangiopancreatography, and ASGE risk stratification guidelines for diagnostic evaluation recommending endoscopy (high risk), MR cholangiopancreatography (intermediate risk), or no test (low risk)...
March 16, 2017: Radiology
https://www.readbyqxmd.com/read/28294404/improved-classification-of-indeterminate-biliary-strictures-by-probe-based-confocal-laser-endomicroscopy-using-the-paris-criteria-following-biliary-stenting
#10
Pushpak Taunk, Satish Singh, David Lichtenstein, Virendra Joshi, Jason Gold, Ashish Sharma
BACKGROUND AND AIMS: Probe-based confocal laser endomicroscopy (pCLE) using the Miami Criteria has improved classification of indeterminate biliary strictures. However, previous biliary stenting may result in their misclassification as malignant strictures. Inflammatory criteria were added to form the Paris Classification to prevent this misclassification and reduce false positives. The aim of this study was to assess if the Paris Classification was more accurate than the Miami Classification in classifying indeterminate biliary strictures after biliary stenting...
March 11, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28293485/a-long-term-survivor-of-metastatic-pancreatic-adenocarcinoma-free-of-recurrence-12-years-after-treatment-of-oligometastatic-disease
#11
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/28283322/asia-pacific-consensus-guidelines-for-endoscopic-management-of-benign-biliary-strictures
#12
REVIEW
Bing Hu, Bo Sun, Qiang Cai, James Yun Wong Lau, Shuren Ma, Takao Itoi, Jong Ho Moon, Ichiro Yasuda, Xiaofeng Zhang, Hsiu-Po Wang, Shomei Ryozawa, Rungsun Rerknimitr, Wen Li, Hiromu Kutsumi, Sundeep Lakhtakia, Hideyuki Shiomi, Ming Ji, Xun Li, Dongmei Qian, Zhuo Yang, Xiao Zheng
Benign biliary strictures (BBSs) are commonly caused by surgical injury, chronic pancreatitis, and inflammatory cholangiopathies. Although advanced imaging tests and tissue acquisition methods have been developed for evaluation of indeterminate biliary strictures, differentiation of BBSs from biliary malignancies remains a challenge to clinicians. The majority of BBSs have good response to nonsurgical treatment and surgical intervention mainly serves as a rescue when nonsurgical approaches fail. Endoscopic management is a safe, effective, and less-invasive treatment for BBSs compared with other approaches...
March 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28275292/common-controversies-in-management-of-biliary-strictures
#13
EDITORIAL
Mansour A Parsi
Biliary strictures are caused by a heterogeneous group of benign and malignant conditions, each requiring a specific treatment approach. Management of biliary strictures often involves endoscopy either for definite treatment, as a bridge to surgery or for palliative purposes. Endoscopic treatment of various types of biliary strictures is not standardized and there are multiple areas of controversy regarding the best treatment options. These controversies are mainly due to lack of well-designed comparative studies to support a specific therapy...
February 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28271470/chronic-pancreatitis-in-eastern-india-experience%C3%A2-from-a-tertiary-care-center
#14
Ashish Kumar Jha, Mahesh Kumar Goenka, Usha Goenka
There is a wide variation in the clinical presentation of chronic pancreatitis (CP) in the different parts of India. Data regarding the clinical profile of CP from eastern India are scarce. We describe the clinical and demographic profiles of patients with CP in eastern India. Consecutive patients were evaluated for the clinical presentation, etiology and complication of CP. One hundred and thirty-nine patients with CP (mean age 39.57±14.88 years; M/F 3.48:1) were included. Idiopathic CP (50.35%) was the most common etiology followed by alcohol (33...
March 8, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28265825/diagnostic-accuracy-of-laboratory-tests-and-diagnostic-imaging-in-detecting-biliary-strictures-after-liver-transplantation
#15
Divyanshoo R Kohli, Ravi Vachhani, Tilak U Shah, Doumit S BouHaidar, M Shadab Siddiqui
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is often required to diagnose post-liver transplant (LT) biliary strictures. We evaluated the diagnostic accuracy of noninvasive laboratory and imaging tests in detecting post-LT biliary strictures. METHODS: Adult LT recipients who underwent ERCP between 2008 and 2015 were evaluated. Biliary strictures were diagnosed after blinded review of cholangiograms by three interventional endoscopists. The accuracy of liver enzymes, ultrasound, and MRI was determined using cholangiography as the reference standard...
March 6, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28262591/robotics-in-hepatobiliary-surgery-initial-experience-first-reported-case-series-from-india
#16
S Goja, M K Singh, A S Soin
INTRODUCTION: Robotic surgical system's ability to perform complex hepatobiliary surgeries is gaining momentum with outcomes similar to open surgery and advantages of minimal access surgery. The authors present their initial experience of a heterogenous spectrum of robotic hepatobiliary cases and the first reported case series from India. METHODS: Retrospective review of hepatobiliary cases done robotically from February 2015 to January 2016 was done. RESULTS: The series has ten patients; with median age of 45 years (range 15-72)...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28261696/incidence-of-underlying-biliary-neoplasm-in-patients-after-major-hepatectomy-for-preoperative-benign-hepatolithiasis
#17
Hyeong Min Park, Young Hoe Hur, Chol Kyoon Cho, Yang Seok Koh, Hee Joon Kim, Eun Kyu Park
BACKGROUNDS/AIMS: Despite hepatolithiasis being a risk factor for biliary neoplasm including cholangiocarcinoma, the incidence of underlying biliary neoplasm is unknown in patients with preoperative benign hepatolithiasis. The aim of this study was to evaluate the incidence of underlying biliary neoplasm in patients who underwent major hepatectomy for preoperative benign hepatolithiasis. METHODS: Between March 2005 and December 2015, 73 patients who underwent major hepatectomy for preoperative benign hepatolithiasis were enrolled in this study...
November 2016: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28261600/the-evolving-superiority-of-covered-metallic-stents-for-benign-biliary-strictures
#18
EDITORIAL
Ming-Ming Xu, Elizabeth Brown, Amy Tyberg, Michel Kahaleh
No abstract text is available yet for this article.
February 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/28261597/effectiveness-of-covered-metallic-stents-of-benign-biliary-stricture-resolution
#19
COMMENT
Enliang Li, Wenjun Liao, Linquan Wu
No abstract text is available yet for this article.
February 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/28261440/biliary-strictures-endoscopic-assessment-and-management
#20
REVIEW
Bharat Paranandi, Kofi W Oppong
The diagnosis of biliary strictures can be challenging. Endoscopy has an established role in the diagnosis and therapy of biliary strictures. However, the diagnostic yield from conventional endoscopic retrograde cholangiopancreatography tissue sampling is modest. Improvements in existing technologies as well as the implementation of novel technologies and techniques have the potential to improve the diagnostic performance of endoscopy and expand its therapeutic role. Recent studies have enabled greater clarity about the role of preoperative biliary drainage and the choice of stents in this setting as well as the utility of metal stents in benign and malignant disease...
April 2017: Frontline Gastroenterology
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