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Biliary stricture

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https://www.readbyqxmd.com/read/28804514/is-eus-guided-drainage-a-suitable-alternative-technique-in-case-of-proximal-biliary-obstruction
#1
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
https://www.readbyqxmd.com/read/28801436/effect-of-endoscopic-transpapillary-biliary-drainage-with-without-endoscopic-sphincterotomy-on-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-in-patients-with-biliary-stricture-e-best-a-protocol-for-a-multicentre-randomised-controlled-trial
#2
Shin Kato, Masaki Kuwatani, Ryo Sugiura, Itsuki Sano, Kazumichi Kawakubo, Kota Ono, Naoya Sakamoto
INTRODUCTION: The effect of endoscopic sphincterotomy prior to endoscopic biliary stenting to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis remains to be fully elucidated. The aim of this study is to prospectively evaluate the non-inferiority of non-endoscopic sphincterotomy prior to stenting for naïve major duodenal papilla compared with endoscopic sphincterotomy prior to stenting in patients with biliary stricture. METHODS AND ANALYSIS: We designed a multicentre randomised controlled trial, for which we will recruit 370 patients with biliary stricture requiring endoscopic biliary stenting from 26 high-volume institutions in Japan...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28791317/new-approach-to-decrease-post-ercp-adverse-events-in-patients-with-primary-sclerosing-cholangitis
#3
Udayakumar Navaneethan, Dennisdhilak Lourdusamy, Norma G Gutierrez, Xiang Zhu, John J Vargo, Mansour A Parsi
BACKGROUND AND STUDY AIMS : Endoscopic retrograde cholangiopancreatography (ERCP) is often performed in patients with primary sclerosing cholangitis (PSC). Our aim was to validate a treatment approach with the objective of decreasing ERCP related adverse events (AEs). PATIENTS AND METHODS : All patients who had undergone ERCP for PSC during the period from 2002 - 2012 were identified (group I). This group had traditional ERCP (no bile aspiration prior to contrast injection with balloon dilation and stent placement for treatment of dominant strictures)...
August 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28776138/a-new-fully-covered-self-expandable-metal-stent-for-the-treatment-of-postsurgical-benign-biliary-strictures
#4
Jun Wu, Dong-Xun Zhou, Tian-Tian Wang, Dao-Jian Gao, Bing Hu
BACKGROUND: Endotherapy with plastic stent (PS) placement is the main modality for treating benign biliary strictures (BBSs). Fully covered self-expandable metal stents (FCSEMSs) are being increasingly used for BBS management, with high stricture resolution. However, traditional metal tents are associated with high migration, causing treatment failure. METHODS: We investigated the efficacy and safety of a new FCSEMS for postsurgical BBS treatment and compared these parameters between the FCSEMS and PS treatment through retrospective analysis...
August 3, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28757315/liver-transplant-related-anastomotic-biliary-strictures-a-novel-rapid-safe-radiation-sparing-and-cost-effective-management-approach
#5
Monique T Barakat, Robert J Huang, Nirav C Thosani, Abhishek Choudhary, Mohit Girotra, Subhas Banerjee
BACKGROUND AND AIMS: Biliary strictures after orthotopic liver transplantation (OLT) are typically managed by sequential ERCP procedures, with incremental dilation of the stricture and stent exchange (IDSE) and placement of new stents. This approach resolves >80% of strictures after 12 months, but requires costly, lengthy ERCPs with significant patient radiation exposure. Increasing awareness of the harmful effects of radiation, escalating health care costs, and decreasing reimbursement for procedures mandate maximal efficiency in performing ERCP...
July 27, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28744748/biliary-complications-after-living-donor-liver-transplantation-a-retrospective-analysis-of-the-kyoto-experience-1999-2004
#6
Ayman Zaki Azzam, Koichi Tanaka
BACKGROUND AND AIM: In living donor liver transplantation (LDLT), biliary complications continue to be the most frequent cause of morbidity and may contribute to mortality of recipients although there are advances in surgical techniques. This study will evaluate retrospectively the short-term and long-term management of biliary complications. METHODS: During the period from May 1999, to May 2004, 505 patients underwent 518 LDLT in the Department of Liver Transplantation and Immunology, Kyoto University Hospital, Japan...
July 26, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28738976/proposal-of-a-diagnostic-algorithm-for-intraductal-ultrasonography-to-distinguish-between-benign-and-malignant-biliary-strictures
#7
Yao-Sheng Wang, Chiao-Hsiung Chuang, Jhong-Han Wu, Chiung-Yu Chen
To reexamine the recognizability of intraductal ultrasonography (IDUS) findings from an imaging database and propose a novel algorithm for clinical application. IDUS images of 102 patients who had undergone IDUS examinations for indeterminate causes of common bile duct dilation were independently reviewed by two endoscopists. The strength of the inter-rater agreement between the endoscopists was analyzed using Cohen's kappa (κ). An algorithm was implemented by arranging the IDUS characteristics according to their recognizability...
July 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/28736430/a-case-of-type-1-autoimmune-pancreatitis-aip-a-form-of-igg4-related-disease-igg4-rd
#8
Mounira El Euch, Souha Hddad, Madiha Mahfoudhi, Hela Maktouf, Fethi Ben Hamida, Fatima Jaziri, Khaoula Ben Abdelghani, Sami Turki, Taïeb Ben Abdallah
BACKGROUND Type 1 autoimmune pancreatitis (AIP), also known as lymphoplasmacytic sclerosing pancreatitis (LPSP), is a rare cause of chronic pancreatitis, characterized by a fibro-inflammatory process. However, patients with AIP may have a good response to corticosteroid therapy. We describe a Tunisian patient with AIP that was confirmed to be an IgG4-related disease (IgG4-RD). CASE REPORT We describe a case of a 70-year-old man who was admitted to hospital for obstructive jaundice and abdominal pain. Serum liver function tests were abnormal and upper abdominal computed tomography (CT) imaging showed diffuse pancreatic swelling and strictures of the main pancreatic duct without any focal lesion...
July 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28735936/combined-surgical-and-transhepatic-rendezvous-procedure-for-relieving-anastomotic-biliary-obstruction-in-children-with-liver-transplants
#9
John Crowley, Kyle Soltys, Rakesh Sindhi, Kevin Baskin, Sabri Yilmaz, Orrie Close, Avinash Medsinge
Four children (3 boys and 1 girl, age 1.4-9.4 y) presented 2-70 months after liver transplantation (mean 26 months) with high-grade narrowing at the surgical anastomosis that could not be crossed at percutaneous transhepatic cholangiography. Each patient was treated with a combined surgical and interventional radiology "rendezvous" procedure. Biliary drainage catheters were left in place for an average of 6 months after the procedure. At a mean 7.5 months after biliary drainage catheter removal, all children were catheter-free without clinical or biochemical evidence of biliary stricture recurrence...
August 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28728888/laparoscopic-choledochoduodenostomy-for-chronic-biliary-stricture-with-video
#10
S Permenter, L L Pereira, J A Stauffer
No abstract text is available yet for this article.
July 17, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28725941/endoscopic-stents-for-the-biliary-tree-and-pancreas
#11
REVIEW
Rajesh Krishnamoorthi, Mahendran Jayaraj, Richard Kozarek
OPINION STATEMENT: PURPOSE OF REVIEW: To review the recently published literature on biliary and pancreatic stents. RECENT FINDINGS: Covered self-expanding metal stents (SEMS) are increasingly being used in the endoscopic management of benign biliary strictures. Given the costs associated with SEMS, plastic stents are still the most commonly used stents. In this setting, SEMS are preferred over plastic stents for palliation of malignant biliary strictures due to superior patency and have a role in preoperative management of malignant biliary strictures...
July 20, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28720473/eus-guided-antegrade-stent-placement-for-unresectable-malignant-hilar-biliary-strictures-using-a-stent-in-stent-method
#12
Tatsuya Koshitani, Shuji Nakagawa, Yoshito Itoh
No abstract text is available yet for this article.
July 15, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28706774/are-dominant-strictures-in-primary-sclerosing-cholangitis-a-risk-factor-for-cholangiocarcinoma
#13
REVIEW
Roger W Chapman, Kate D Williamson
PURPOSE OF REVIEW: Cholangiocarcinoma is a devastating, unpredictable complication of large duct primary sclerosing cholangitis (PSC), which occurs in 5-15% of patients. The aim of this review is to discuss whether dominant strictures (DS) occurring in the larger bile ducts in PSC are a risk factor for the development of cholangiocarcinoma. RECENT FINDINGS: The development of DS is related to specific genetic polymorphisms affecting the innate immune system and the microbiome...
2017: Current Hepatology Reports
https://www.readbyqxmd.com/read/28694703/secondary-sclerosing-cholangitis-in-critically-ill-patients-current-perspectives
#14
REVIEW
Hafsteinn O Gudnason, Einar S Björnsson
Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28691046/a-randomized-trial-comparing-winged-versus-conventional-plastic-stents-for-malignant-bile-duct-strictures
#15
Lachlan Ayres, Danny Cheriyan, Ryan Scott, Edward Kim, Terry Lee, Joel Singer, Fergal Donnellan, Michael Byrne, Alan Weiss, Robert Enns, Jack Amar, Eric Lam, Jennifer Telford
BACKGROUND AND STUDY AIMS : Stent insertion at endoscopic retrograde cholangiopancreatography (ERCP) is an established therapy for managing malignant biliary obstruction. Conventional plastic stents with a tubular design are most commonly used despite limited patency. Plastic stents with a winged design may theoretically increase the duration of stent patency. The aim of this study was to compare stent patency of the winged versus conventional plastic stents in patients with malignant biliary obstruction...
July 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28690174/clinical-outcomes-of-donation-after-circulatory-death-liver-transplantation-in-primary-sclerosing-cholangitis
#16
Palak J Trivedi, Irene Scalera, Emma Slaney, Richard W Laing, Bridget Gunson, Gideon M Hirschfield, Andrea Schlegel, James Ferguson, Paolo Muiesan
BACKGROUND AND AIM: Primary sclerosing cholangitis (PSC) is a progressive fibro-inflammatory cholangiopathy for which liver transplantation is the only life-extending intervention. These patients may benefit from accepting liver donation after circulatory death (DCD), however their subsequent outcome is unknown. METHODS: Clinical outcomes were prospectively evaluated in PSC patients undergoing transplantation from 2006 to 2016 stratified by donor type (DCD, n=35 vs...
July 6, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28688649/better-long-term-outcomes-with-hilar-ductoplasty-and-a-side-to-side-roux-en-y-hepaticojejunostomy
#17
Hong-Tian Xia, Yang Liu, Tao Yang, Bin Liang, Jing Wang, Jia-Hong Dong
BACKGROUND: Whether a wide hilar hepaticojejunostomy after bile duct cyst (BDC) excision can prevent the development of postoperative complications remains an unanswered question. We compared our outcomes after a minimum of 2-y follow-up in patients with Todani type Ia choledochal cyst treated with hilar ductoplasty followed by a side-to-side Roux-en-Y hepaticojejunostomy (ductoplasty group) or radical cyst resection with an end-to-side Roux-en-Y hepaticojejunostomy (conventional group)...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28687243/biliary-reconstruction-options-for-bile-duct-stricture-in-patients-with-prior-roux-en-y-reconstruction
#18
Mihir M Shah, Benjamin M Martin, Jamil L Stetler, Ankit D Patel, S Scott Davis, Edward Lin, Juan M Sarmiento
Comprehensive description with illustrations of the 4 biliary reconstruction options for bile duct injury in patients with history of Roux-en-Y gastric bypass.
May 25, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28685637/endoscopic-biliary-stent-insertion-through-specialized-duodenal-stent-for-combined-malignant-biliary-and-duodenal-obstruction-facilitated-by-stent-or-ptbd-guidance
#19
Jong Jin Lee, Jong Jin Hyun, Jung Wan Choe, Dong-Won Lee, Seung Young Kim, Sung Woo Jung, Young Kul Jung, Ja Seol Koo, Hyung Joon Yim, Sang Woo Lee
OBJECTIVES: Endoscopic stenting for combined malignant biliary and duodenal obstruction is technically demanding. However, this procedure can be facilitated when there is guidance from previously inserted stent or PTBD tube. This study aimed to evaluate the feasibility and clinical success rate of endoscopic placement of biliary self-expandable metal stent (SEMS) through duodenal SEMS in patients with combined biliary and duodenal obstruction due to inoperable or metastatic periampullary malignancy...
July 7, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28685381/frequency-severity-and-risk-factors-for-acute-pancreatitis-after-percutaneous-transhepatic-biliary-stent-placement-across-the-papilla-of-vater
#20
Shunsuke Sugawara, Yasuaki Arai, Miyuki Sone, Hitoshi Katai
PURPOSE: To clarify the frequency, severity, and risk factors for acute pancreatitis after percutaneous biliary stent placement across the papilla of Vater for malignant biliary obstruction. MATERIALS AND METHODS: This retrospective study included 95 patients who underwent percutaneous biliary metallic stent placement (64 [67.4%] bare stents and 31 [32.6%] covered stents) across the papilla of Vater for malignant biliary obstruction between January 2010 and December 2012...
July 6, 2017: Cardiovascular and Interventional Radiology
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