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Endoscopic retrograde cholangiopancreatography

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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/28341284/prospective-microbiologic-evaluation-of-the-forceps-elevator-in-closed-channel-duodenoscopes-after-reprocessing
#2
Helga Paula, Barbara Tribl, Elisabeth Presterl, Magda Diab-El Schahawi
BACKGROUND: Endoscopes are well-known sources of bacterial transmission in health care facilities offering endoscopy services. The association between multidrug-resistant bacterial infections in patients who had undergone an endoscopic retrograde cholangiopancreatography procedure with reprocessed duodenoscopes has been much discussed. Bacterial contamination of duodenoscopes has been attributed to difficulties with reprocessing these devices, specifically the distal end of the scope, which features a movable forceps elevator...
February 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28337833/acute-cholangitis-current-concepts
#3
REVIEW
David Lan Cheong Wah, Christopher Christophi, Vijayaragavan Muralidharan
BACKGROUND: Acute cholangitis, also known as ascending cholangitis, is a life-threatening systemic condition that results from a biliary tree infection and obstruction. Severe acute cholangitis was reported to have a mortality rate between 11 and 27% in the 1990s. This article is a literature review about acute cholangitis. Its aim is to review the latest literature about acute cholangitis and to discuss its pathogenesis, clinical presentation, diagnosis, prognosis, risk factors and treatment...
March 24, 2017: ANZ Journal of Surgery
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/28331877/hemobilia-due-to-cystic-artery-pseudoaneurysm-a-rare-late-complication-of-laparoscopic-cholecystectomy
#5
Ricardo Badillo, Michael D Darcy, Vladimir M Kushnir
We discuss a patient with late presentation of hemobilia following cholecystectomy, which is unusual because pseudoaneurysm caused by vascular injury during surgery typically presents soon after surgery. Endoscopic retrograde cholangiopancreatography revealed a large blood clot arising from the biliary orifice with subsequent computed tomography angiography diagnosing a large pseudoaneurysm in the region of the cystic artery adjacent to the cholecystectomy clips. Embolization was performed via direct percutaneous puncture of the pseudoaneurysm...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28331537/combined-totally-mini-invasive-approach-in-necrotizing-pancreatitis-a-case-report-and-systematic-literature-review
#6
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/28330448/ascending-cholangitis-secondary-to-migrated-embolization-coil-of-gastroduodenal-artery-pseudo-aneurysm-a-case-report
#7
Haithem Zaafouri, Anis Hasnaoui, Sonia Essghaeir, Dhafer Haddad, Meriam Sabbah, Ahmed Bouhafa, Jamel Kharrat, Anis Ben Maamer
BACKGROUND: Gastroduodenalartery (GDA) pseudo-aneurysms are very rare. Their clinical importance lies in the eventuality of rupture, causing bleeding and ultimately exsanguination. CASE PRESENTATION: We report the case of a man, with prior history of biliary surgery, presenting with haemobilia secondary to a rupture of GDA pseudo-aneurysm eroding the main bile duct. The patient was treated with coil embolization. This technique is considered to be safe. However, on the long term, some complications may occur...
March 23, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28329918/-endoscopic-ultrasound-guided-biliary-drainage
#8
REVIEW
Hyeong Seok Nam, Dae Hwan Kang
The therapeutic role of endoscopic ultrasound (EUS) has continued to evolve in recent years. EUS-guided biliary drainage (EUS-BD) can be performed as an effective alternative to percutaneous drainage or surgical options when conventional Endoscopic retrograde cholangiopancreatography fails or is not possible. Depending on the access and exit routes of the stent, multiple approaches to EUS-BD have been proposed. Each patient should receive an individualized approach based on the patient's condition, anatomy, and endoscopist's experience, with an appropriate backup prepared...
March 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28317208/current-status-of-interventional-endoscopic-ultrasound
#9
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/28303610/new-rescue-technique-of-endoscopic-ultrasonography-guided-rendezvous-procedure-with-video
#10
Hiroshi Kawakami, Yoshimasa Kubota
The newly developed endoscopic ultrasonography-guided rendezvous procedure (EUS-RV) is used after failed endoscopic retrograde cholangiopancreatography (ERCP) [1,2]. Guidewire manipulation is one of the most challenging aspects of EUS-RV. A rescue technique that bounces back the guidewire from the perihilar bile duct in a long endoscopic position is commonly used. Herein, we describe a case using EUS-RV in a short endoscopic position. This article is protected by copyright. All rights reserved.
March 16, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28298192/how-to-select-patients-and-timing-for-rectal-indomethacin-to-prevent-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis
#11
REVIEW
Jianhua Wan, Yuping Ren, Zhenhua Zhu, Liang Xia, Nonghua Lu
BACKGROUND: Acute pancreatitis is a severe complication of endoscopic retrograde cholangiopancreatography (ERCP). Previous meta-analyses have shown that indomethacin effectively prevents this complication; however, the data are limited. We performed a systematic review and meta-analysis to clarify the applications for rectal indomethacin. METHODS: A systematic search was performed in June 2016. Human prospective, randomized, placebo-controlled trials that compared rectally administered indomethacin with a placebo for the prevention of post-ERCP pancreatitis (PEP) were included...
March 15, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28287204/-biliary-and-kidney-lithiasis-during-treatment-with-daclatasvir-sofosbuvir-ribavirin-and-atazanavir-ritonavir-abacavir-lamivudine-in-an-hiv-hcv-genotype-4-infected-patient-a-case-report
#12
Andrea Vavassori, Paola Lanza, Ilaria Izzo, Salvatore Casari, Silvia Odolini, Serena Zaltron, Elena Festa, Francesco Castelli
New Direct-acting Antiviral Agents (DAA)-based anti-HCV therapies currently provide extraordinary opportunities to cure patients. Drug-drug interactions are however a real challenge during treatment. In particular, in HIV-infected patients in cART, DAA choice is limited by such interactions, which can result both in reduced efficacy and toxicity. We report the case of a HIV-infected patient on cART with atazanavir/ritonavir/abacavir/lamivudine, who presented kidney and biliary lithiasis, the latter treated with endoscopic retrograde cholangiopancreatography and endoscopic biliary sphincterotomy, after beginning anti-HCV treatment with daclatasvir/sofosbuvir/ribavirin...
February 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28275221/magnetic-resonance-mr-cholangiopancreatography-demonstration-of-the-cystic-duct-entering-the-right-hepatic-duct
#13
Tommaso D'Angelo, Sergio Racchiusa, Silvio Mazziotti, Giuseppe Cicero
BACKGROUND MR cholangiopancreatography is widely performed before laparoscopic cholecystectomy to rule out choledocholithiasis and to avoid iatrogenic injuries that may be related to the high frequency of anatomical variations of the biliary tree. Although most of these variants have already been demonstrated surgically and by endoscopic retrograde cholangiopancreatography and CT cholangiography, there are no references in which MR cholangiopancreatography has shown a cystic duct draining into the right hepatic biliary duct...
March 9, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28274206/the-h-o-u-s-e-classification-a-novel-endoscopic-retrograde-cholangiopancreatography-ercp-complexity-grading-scale
#14
Greger Olsson, Urban Arnelo, Fredrik Swahn, Björn Törnqvist, Lars Lundell, Lars Enochsson
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging endoscopic procedure, harboring a wide range of complexities within every single investigation. Classifications of the complexity of ERCP have been presented, but do not include modern endoscopic treatment modalities. In order to be able to target resources and compare the results of different endoscopic centers, a new complexity grading system for ERCP is warranted. This study launches a new complexity grading scale for ERCP-the H...
March 9, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28273653/unusual-migration-of-fractured-ercp-guidewire-a-case-report
#15
Christy B Pomeranz, Natasha E Wehrli, Amy Tyberg, Lily M Belfi
Endoscopic retrograde cholangiopancreatography (ERCP) routinely uses hydrophilic guidewires to cannulate ducts and traverse stenoses. Fracture of these guidewires have been reported, however, migration of these fractured fragments is an extremely rare occurrence that has yet to be reported in the literature. We present a case of a fractured ERCP guidewire with extensive migration in the retroperitoneal and lower extremity soft tissues and vasculature with radiologic correlation across multiple modalities-MRI, CT, and radiographs-as well as pathologic correlation...
February 22, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28266293/emergency-pancreatico-duodenectomy-with-superior-mesenteric-and-portal-vein-resection-and-reconstruction-using-a-gore-tex-vascular-graft
#16
Mihai Adrian Eftimie, Vasile Lungu, Marian Tudoroiu, Genady Vatachki, Severina Batca, Leonard David
Emergency pancreatico-duodenectomy(EPD) is a very rare procedure and few reports are present in medical literature. It is an uncommon approach, usually used for emergency surgical treatment of abdominal trauma that involves the head of the pancreas or the duodenum, but it is also a surgical tool for the treatment of ruptured aneurysms, bleeding pseudocysts, duodenal perforations, uncontrollable hemorrhage from ulcers and tumors, severe infectious complications of acute pancreatitis or endoscopic retrograde cholangiopancreatography related complications (1,2)...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28265825/diagnostic-accuracy-of-laboratory-tests-and-diagnostic-imaging-in-detecting-biliary-strictures-after-liver-transplantation
#17
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/28262629/-results-of-cholecystectomies-2003-2010-in-a-small-hospital-in-iceland
#18
Marta Ros Berndsen, Fritz Hendrik Berndsen
AIM: Cholecystectomy is a common procedure in general surgery. The aim of this study was to retrospectivly assess the results of cholecystectomies performed in Akranes Hospital (AH), a small hospital in Iceland. MATERIAL AND METHODS: This retrospective study included all patients that underwent a cholecystectomy in AH from 1 January 2003 to 31 December 2010. Patient records were reviewed from AH, as well as from Landspitali University Hospital and Domus Medica. RESULTS: 378 operations were performed...
2017: Læknablađiđ
https://www.readbyqxmd.com/read/28262458/early-management-of-acute-pancreatitis-a-review-of-the-best-evidence
#19
REVIEW
Serena Stigliano, Hanna Sternby, Enrique de Madaria, Gabriele Capurso, Maxim S Petrov
In the 20th century early management of acute pancreatitis often included surgical intervention, despite overwhelming mortality. The emergence of high-quality evidence (randomized controlled trials and meta-analyses) over the past two decades has notably shifted the treatment paradigm towards predominantly non-surgical management early in the course of acute pancreatitis. The present evidence-based review focuses on contemporary aspects of early management (which include analgesia, fluid resuscitation, antibiotics, nutrition, and endoscopic retrograde cholangiopancreatography) with a view to providing clear and succinct guidelines on early management of patients with acute pancreatitis in 2017 and beyond...
February 7, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28261778/an-unusual-appearance-of-complicated-hydatid-cyst-necrotizing-pancreatitis
#20
Hasan Ediz Sıkar, Levent Kaptanoğlu, Metin Kement
Hydatid acute pancreatitis is a rare condition and always presents as consequence of acute edematous pancreatitis. Intrabiliary rupture of hepatic hydatid cysts and obstruction of papillary orifice with hydatid membrane is possible mechanism. A 49-year-old man was admitted with epigastric and right upper quadrant pain, nausea, and vomiting. Computed tomography scan showed 5 x 5 cm cyst in left hepatic lobe, which had ruptured into the biliary tract and caused necrotizing pancreatitis. Endoscopic retrograde cholangiopancreatography trial failed...
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
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