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https://www.readbyqxmd.com/read/28603054/comparable-long-term-outcomes-of-1-minute-vs-5-minute-endoscopic-papillary-balloon-dilation-for-bile-duct-stones
#1
Yu-Ting Kuo, Hsiu-Po Wang, Chi-Yang Chang, Joseph W Leung, Jiann-Hwa Chen, Ming-Chang Tsai, Wei-Chih Liao
BACKGROUND & AIMS: Endoscopic papillary balloon dilation (EPBD) is an alternative to endoscopic sphincterotomy (EST) for choledocholithiasis. Unlike EST, EPBD preserves biliary sphincter function, reducing long-term risk of recurrent choledocholithiasis by 50%. Guidelines recommend that duration of EPBD exceeds 2 minutes, to adequately loosen the sphincter and reduce risks of failed stone extraction and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, it is unclear whether this long duration of EPBD impairs sphincter function and negates the long-term benefit of EPBD...
June 8, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28574643/how-far-have-we-progressed-since-the-tokyo-guidelines-2013
#2
EDITORIAL
Tadahiro Takada
No abstract text is available yet for this article.
June 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28433613/association-between-early-ercp-and-mortality-in-patients-with-acute-cholangitis
#3
Ming Tan, Ove B Schaffalitzky de Muckadell, Stig B Laursen
BACKGROUND AND AIMS: Acute cholangitis (AC) is associated with high mortality of up to 10%. The association between timing of ERCP and mortality in patients with AC remains unclear. The aim of this study was to investigate whether early ERCP within 24 hours was associated with improved survival. METHODS: All patients who underwent ERCP at Odense University Hospital, Denmark, between March 2009 and September 2016 were identified using a prospective ERCP database...
April 20, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28427765/easl-clinical-practice-guidelines-the-diagnosis-and-management-of-patients-with-primary-biliary-cholangitis
#4
(no author information available yet)
Primary biliary cholangitis (PBC) is a chronic inflammatory autoimmune cholestatic liver disease, which when untreated will culminate in end-stage biliary cirrhosis. Diagnosis is usually based on the presence of serum liver tests indicative of a cholestatic hepatitis in association with circulating antimitochondrial antibodies. Patient presentation and course can be diverse and risk stratification is important to ensure all patients receive a personalised approach to their care. The goals of treatment and management are the prevention of end-stage liver disease, and the amelioration of associated symptoms...
April 18, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28427764/role-of-endoscopy-in-primary-sclerosing-cholangitis-european-society-of-gastrointestinal-endoscopy-esge-and-european-association-for-the-study-of-the-liver-easl-clinical-guideline
#5
(no author information available yet)
This guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE) and of the European Association for the Study of the Liver (EASL) on the role of endoscopy in primary sclerosing cholangitis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations.
June 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28425666/endoscopic-management-of-acute-cholangitis-according-to-the-tg13
#6
Takayoshi Tsuchiya, Atsushi Sofuni, Shujiro Tsuji, Shuntaro Mukai, Yukitoshi Matsunami, Yuichi Nagakawa, Takao Itoi
The Tokyo Guidelines 2013 (TG13) recommend that endoscopic drainage should be the first-choice treatment for biliary decompression in patients with acute cholangitis. Timing of biliary drainage for acute cholangitis should be based on the severity of the disease. For patients with severe acute cholangitis, appropriate organ support and urgent biliary drainage are needed. For patients with moderate acute cholangitis, early biliary drainage is needed. For patients with mild acute cholangitis, biliary drainage is needed when initial treatment such as antimicrobial therapy is ineffective...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28425663/management-of-acute-cholangitis-as-a-result-of-occlusion-from-a-self-expandable-metallic-stent-in-patients-with-malignant-distal-and-hilar-biliary-obstructions
#7
Hideyuki Shiomi, Kazuya Matsumoto, Hiroyuki Isayama
Acute cholangitis as a result of common bile duct stones can be managed; however, cholangitis caused by occlusion with a biliary self-expandable metallic stent (SEMS) in patients with an unresectable malignant biliary obstruction has not been fully discussed. The acute cholangitis clinical guidelines (Tokyo Guidelines 2013) recommend following the same procedure as that used for cholangitis; however, the patient's condition, including performance status, tumor extension or staging, and prognosis must be considered...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28425650/current-strategies-for-endoscopic-management-of-acute-cholangitis
#8
Hiroyuki Isayama, Ichiro Yasuda, Damien Tan
BACKGROUND AND AIM: At the pancreatobiliary session of Endoscopic Forum Japan (EFJ) 2016, current strategies for the endoscopic management of acute cholangitis were discussed. The topics consisted of two major parts, namely endoscopic management of acute cholangitis caused by common bile duct stones (CBDS) and biliary stent occlusion. METHODS: Endoscopists from nine Japanese high-volume centers along with two overseas centers participated in the questionnaires and discussion...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28420030/role-of-endoscopy-in-primary-sclerosing-cholangitis-european-society-of-gastrointestinal-endoscopy-esge-and-european-association-for-the-study-of-the-liver-easl-clinical-guideline
#9
Lars Aabakken, Tom H Karlsen, Jörg Albert, Marianna Arvanitakis, Olivier Chazouilleres, Jean-Marc Dumonceau, Martti Färkkilä, Peter Fickert, Gideon M Hirschfield, Andrea Laghi, Marco Marzioni, Michael Fernandez, Stephen P Pereira, Jürgen Pohl, Jan-Werner Poley, Cyriel Y Ponsioen, Christoph Schramm, Fredrik Swahn, Andrea Tringali, Cesare Hassan
1 ESGE/EASL recommend that, as the primary diagnostic modality for PSC, magnetic resonance cholangiography (MRC) should be preferred over endoscopic retrograde cholangiopancreatography (ERCP).Moderate quality evidence, strong recommendation. 2 ESGE/EASL suggest that ERCP can be considered if MRC plus liver biopsy is equivocal or contraindicated in patients with persisting clinical suspicion of PSC. The risks of ERCP have to be weighed against the potential benefit with regard to surveillance and treatment recommendations...
April 18, 2017: Endoscopy
https://www.readbyqxmd.com/read/28419764/clinical-application-and-verification-of-the-tg13-diagnostic-and-severity-grading-criteria-for-acute-cholangitis-an-international-multicenter-observational-study
#10
Seiki Kiriyama, Tadahiro Takada, Tsann-Long Hwang, Kohei Akazawa, Fumihiko Miura, Harumi Gomi, Rintaro Mori, Itaru Endo, Takao Itoi, Masamichi Yokoe, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto
BACKGROUND: The Tokyo Guidelines 2007 (TG07) first presented the diagnostic and severity grading criteria for acute cholangitis. Subsequently updated in 2013, the Tokyo Guidelines (TG13) have been widely adopted throughout the world as global standard guidelines. We set out to verify the efficacy of these TG13 criteria in an international multicenter study. METHODS: We reviewed 6,063 patients who were clinically diagnosed with acute cholangitis in Japan and Taiwan over a 2-year period...
April 17, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28375803/routine-use-of-prophylactic-antibiotics-during-laparoscopic-cholecystectomy-does-not-reduce-the-risk-of-surgical-site-infections
#11
Pinar Sarkut, Sadik Kilicturgay, Hikmet Aktas, Yilmaz Ozen, Ekrem Kaya
BACKGROUND: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallbladder stones. As infections are rare in uncomplicated LC, it is widely accepted that prophylactic antibiotics need not be administered, and guidelines do not support routine antibiotic prophylaxis during elective LC. However, routine antibiotic prophylaxis for elective LC is still popular in many clinical settings. We investigated this situation in our department. METHOD: This randomized double-blind controlled study included 570 patients who underwent LC between March 2007 and February 2010...
April 4, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28371094/updated-comprehensive-epidemiology-microbiology-and-outcomes-among-patients-with-acute-cholangitis
#12
Harumi Gomi, Tadahiro Takada, Tsann-Long Hwang, Kohei Akazawa, Rintaro Mori, Itaru Endo, Fumihiko Miura, Seiki Kiriyama, Naohisa Matsunaga, Takao Itoi, Masamichi Yokoe, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto
BACKGROUND: The international practice guidelines for patients with acute cholangitis and cholecystitis were released in 2007 (TG07) and revised in 2013 (TG13). This study investigated updated epidemiology and outcomes among patients with acute cholangitis on a larger scale for the first time. METHODS: This is an international multi-center retrospective observational study in Japan and Taiwan. All consecutive patients older than 18 years of age and given a clinical diagnosis of acute cholangitis by clinicians between 1 January 2011 and 31 December 2012 were enrolled...
March 29, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28337833/acute-cholangitis-current-concepts
#13
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/28290140/preoperative-cholangitis-affects-survival-outcome-in-patients-with-extrahepatic-bile-duct-cancer
#14
Masayuki Akita, Tetsuo Ajiki, Taku Matsumoto, Kenta Shinozaki, Tadahiro Goto, Sadaki Asari, Hirochika Toyama, Masahiro Kido, Takumi Fukumoto, Yonson Ku
BACKGROUND: It remains controversial whether preoperative cholangitis affects long-term outcomes after resection in patients with extrahepatic bile duct cancer. METHODS: A total of 107 patients with extrahepatic bile duct cancer who underwent resection with curative intent from 2008 to 2014 were retrospectively reviewed. Patients were categorized into two groups according to the presence or absence of preoperative cholangitis. Clinicopathological variables and long-term outcomes were compared in the two groups...
June 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28210765/refractory-long-term-cholangitis-after-pancreaticoduodenectomy-a-retrospective-study
#15
Hiroki Ueda, Daisuke Ban, Atsushi Kudo, Takanori Ochiai, Shinji Tanaka, Minoru Tanabe
BACKGROUND: Postoperative cholangitis is one of the major late complications after pancreaticoduodenectomy (PD), and recurrent cholangitis has a negative impact on patients' quality of life. However, detailed reports are scarce. The aim of this study was to investigate the clinical features of postoperative cholangitis after PD. METHODS: Between January 2007 and December 2013, 155 consecutive patients underwent PD. Of these, 113 patients were included in this study...
July 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28174126/accuracy-of-asge-high-risk-criteria-in-evaluation-of-patients-with-suspected-common-bile-duct-stones
#16
Huiqin He, Chenfei Tan, Jiaguo Wu, Ning Dai, Weiling Hu, Yawen Zhang, Loren Laine, James Scheiman, John J Kim
BACKGROUND AND AIMS: ERCP is recommended for patients considered high risk for choledocholithiasis after biochemical testing and abdominal US. Our aim was to determine whether the American Society for Gastrointestinal Endoscopy (ASGE) guidelines accurately select patients for whom the risk of ERCP is justified. METHODS: Consecutive patients hospitalized with suspected choledocholithiasis at Sir Run Run Shaw Hospital who received biochemical testing, abdominal US, and definitive testing for choledocholithiasis (MRCP, EUS, ERCP, intraoperative cholangiogram, and/or common bile duct [CBD] exploration) were identified...
February 4, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28074277/patient-reported-outcomes-for-acute-gallstone-pathology
#17
Ed Parkin, Martyn Stott, Joy Brockbank, Simon Galloway, Ian Welch, Andrew Macdonald
BACKGROUND: A number of prominent surgical trials and clinical guidelines regard length of hospital stay and rates of daycase surgery as being of upmost importance following cholecystectomy. However, it is unclear whether these outcomes also matter to patients. This study aimed to identify the factors patients regard as most important when admitted with acute gallstone pathology. METHODS: A 41-item survey was produced by combining outcomes assessed in recent clinical trials with results from a preliminary patient questionnaire...
May 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28028930/an-update-on-cancer-risk-and-surveillance-in-primary-sclerosing-cholangitis
#18
REVIEW
Jennifer L Horsley-Silva, Eduardo A Rodriguez, Diana L Franco, Keith D Lindor
Malignancy represents substantial morbidity and mortality in patients with primary sclerosing cholangitis (PSC). This subset of patients has been proven to be at increased risk for developing cholangiocarcinoma, gallbladder carcinoma and colorectal cancer in those with overlapping inflammatory bowel disease. Herein, we review the prevalence of these malignancies and recommend screening tools and current knowledge to reduce the disease burden in this population. Cholangiocarcinoma is the most dominant malignancy affecting PSC patients, with a lifetime risk ranging from 5% to 20%...
December 27, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28027992/short-course-antimicrobial-treatment-for-acute-cholangitis-with-gram-negative-bacillary-bacteremia
#19
Shunsuke Uno, Ryota Hase, Masayoshi Kobayashi, Toshiyasu Shiratori, So Nakaji, Nobuto Hirata, Naoto Hosokawa
OBJECTIVES: The optimal antimicrobial treatment duration for patients with acute cholangitis with bacteremia remains unknown. The updated Tokyo Guidelines 2013 recommend a minimum duration of 2 weeks only when bacteremia with Gram-positive cocci is present. Since May 2013, a shorter antimicrobial treatment duration of under 2 weeks has been implemented at the authors' institution for acute cholangitis with Gram-negative bacillary bacteremia. The aim of the present study was to validate this modified practice...
February 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28024739/pneumococcal-biliary-tract-infections-how-rare-are-they
#20
Hiroshi Morioka, Mitsutaka Iguchi, Mitsuru Oodate, Masaki Yoneda, Futoshi Ushijima, Aki Hirabayashi, Nobuyuki Tetsuka, Yuka Tomita, Daizo Kato, Tetsuya Yagi
Pneumococcal biliary tract infections (PBTIs) were reported as rare due to the bacterium's bile solubility. The purpose of this study was to determine the occurrence and clinical characteristics of PBTIs. A retrospective case series review was conducted from January 2006 to August 2014 at a tertiary referral university hospital in Japan. Patients with a blood or bile culture positive for Streptococcus pneumoniae diagnosed with definite cholangitis or cholecystitis according to Tokyo Guideline 2013 were enrolled in this study...
December 23, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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