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Acute cholangitis

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https://www.readbyqxmd.com/read/29912758/role-of-cholecystectomy-after-endoscopic-sphincterotomy-in-the-management-of-choledocholithiasis-in-high-risk-patients-a-systematic-review-and-meta-analysis
#1
Muhammad Ali Khan, Zubair Khan, Claudio R Tombazzi, Chiranjeevi Gadiparthi, Wade Lee, C Mel Wilcox
BACKGROUND: Endoscopic retrograde cholangiography and endoscopic sphincterotomy (ES) with subsequent cholecystectomy is the standard of care for the management of patients with choledocholithiasis. There is conflicting evidence in terms of mortality reduction, prevention of complications specifically biliary pancreatitis and cholangitis with the use of early cholecystectomy particularly in high-risk surgical and elderly patients. AIMS: We conducted this systematic review and meta-analysis of randomized controlled trials to compare the early cholecystectomy versus wait and watch strategy after ES...
June 16, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29912047/long-term-outcomes-and-risk-factors-after-adult-living-donor-liver-transplantation
#2
Daisuke Imai, Tomoharu Yoshizumi, Kazuhito Sakata, Toru Ikegami, Shinji Itoh, Noboru Harada, Takashi Motomura, Takeo Toshima, Yohei Mano, Yuji Soejima, Yoshihiko Maehara
BACKGROUND: Although risk factors for the long-term mortality of liver transplantation are well described, there is a lack of detailed study regarding these factors for adult living donor liver transplantation (LDLT). METHODS: We retrospectively analyzed 528 adult LDLT recipients in our hospital. The risk factors were analyzed for overall deaths >5 years post-LDLT. RESULTS: Over the 20-year follow-up, 137 patients died. Patient survival at 1, 3, 5, and 10 years post-LDLT was 87...
June 13, 2018: Transplantation
https://www.readbyqxmd.com/read/29907228/diagnostic-inflammatory-markers-in-acute-cholangitis
#3
Andrei M Beliaev, Michael Booth, David Rowbotham, Colleen Bergin
BACKGROUND: The 2018 Tokyo guidelines for acute cholangitis (AC) use white cell count (WCC) as one of the diagnostic criteria. However, the 2018 Tokyo guidelines grading does not provide guidance for AC patients with normal WCC. In this situation, other inflammatory biomarkers also can be used to diagnose AC and grade severity, but their diagnostic values are yet undetermined. The aims of this study were to evaluate the discriminative powers of common inflammatory markers compared with WCC for diagnosing AC and to determine their diagnostic cutoff levels...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29906691/intraductal-tubulopapillary-neoplasm-of-the-pancreas-presenting-as-recurrent-acute-pancreatitis-a-case-report
#4
Sodai Sakamoto, Yosuke Tsuruga, Yuki Fujii, Hiroki Shomura, Atsuo Hattori, Keizo Kazui
INTRODUCTION: The 2010 World Health Organization classification of intraductal neoplasms of the pancreas includes intraductal tubulopapillary neoplasms (ITPNs) and intraductal papillary mucinous neoplasms, the latter being a rare and new concept. ITPN sometimes cause acute pancreatitis; therefore, distinguishing ITPN from idiopathic acute pancreatitis is important but challenging. PRESENTATION OF CASE: We present the case of a 72-year-old male who had recurrent pancreatitis for the past 2 years, his diagnosis was idiopathic acute pancreatitis...
June 4, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29900747/a-study-of-a-pancreatic-mass-not-all-is-what-it-seems
#5
Irene Andaluz García, Cristina Suárez Ferrer, Pedro Mora Sanz
We report the case of a male with no medical history with acute cholangitis secondary to a pancreatic head´s mass suggestive of neoplasm. An EUS-FNA was performed where no atypical cells were identified but a granulomatous component did. The patient was finally diagnosed of disseminated tuberculosis with pancreatic involvement. Pancreatic tuberculosis is an infrequent entity that requires a high index of suspicion due to the variability of its forms of presentation and the high morbidity and mortality without targeted therapy...
June 14, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29898912/giant-choledochal-cyst-presenting-during-third-trimester-of-pregnancy
#6
Jesus Morales-Maza, Jorge Humberto Rodríguez-Quintero, Sonia Cortés-Vázquez, Luis Cruz-Benítez
Biliary cystic disease is a rare entity. Twenty-five per cent of cases are diagnosed during adulthood and only a few reports have described this condition during pregnancy, where it represents a therapeutic challenge for both obstetricians and surgeons with regard to the risks it entails for the patient and the fetus.Definitive management is surgical resection, as cysts may progress to malignancy if untreated. During pregnancy, resection is generally deferred to after delivery, especially in the context of suspected cholangitis...
June 13, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29895060/acute-cholangitis-complicating-a-chronic-alveolar-echinococcosis-an-unusual-therapeutic-cholangioscopy
#7
Jean-Phillip Le Mouel, Mathurin Fumery, Sami Hakim, Henri Thiebault, Franck Brazier, Eric Nguyen-Khac, Richard Delcenserie
No abstract text is available yet for this article.
June 12, 2018: Endoscopy
https://www.readbyqxmd.com/read/29850458/efficacy-and-safety-of-lumen-apposing-self-expandable-metal-stents-for-eus-guided-cholecystostomy-a-meta-analysis-and-systematic-review
#8
REVIEW
Nikhil R Kalva, Vishwas Vanar, David Forcione, Matthew L Bechtold, Srinivas Reddy Puli
Background: Patients with acute cholecystitis are treated with early cholecystectomy. A subset of patients are unfit for surgery due to comorbidities and late presentation. Prompt gall bladder drainage (GBD) with percutaneous or endoscopic approach remains a viable therapeutic option for nonoperative candidates. Endoscopic ultrasound (EUS) guided transluminal gall bladder drainage (EUS-GBD) continues to evolve as an alternative approach to percutaneous drainage. With continued refinement in stent technology, lumen apposing self-expandable metal stent (LAMS) offers several advantages...
2018: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29802947/macrophages-contribute-to-the-pathogenesis-of-sclerosing-cholangitis-in-mice
#9
Maria Eugenia Guicciardi, Christy E Trussoni, Anuradha Krishnan, Steven F Bronk, Maria J Lorenzo Pisarello, Steven P O'Hara, Patrick L Splinter, Yandong Gao, Pamela Vig, Alexander Revzin, Nicholas F LaRusso, Gregory J Gores
BACKGROUND & AIMS: Macrophages contribute to liver disease, but their role in cholestatic liver injury, including primary sclerosing cholangitis (PSC), is unclear. We tested the hypothesis that macrophages contribute to the pathogenesis of, and are therapeutic targets for, PSC. METHODS: Immune cell profile, hepatic macrophage number, localization and polarization, fibrosis, and serum markers of liver injury and cholestasis were measured in an acute (intrabiliary injection of the IAP antagonist BV6) and chronic (Mdr2-/- mice) mouse model of sclerosing cholangitis (SC)...
May 23, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29791984/-the-management-of-common-bile-duct-stones
#10
REVIEW
Chang Hwan Park
Common bile duct (CBD) stone is a relatively frequent disorder with a prevalence of 10-20% in patients with gallstones. This is also associated with serious complications, including obstructive jaundice, acute suppurative cholangitis, and acute pancreatitis. Early diagnosis and prompt treatment is the most important for managing CBD stones. According to a recent meta-analysis, endoscopic ultrasonography and magnetic resonance cholangiopancreatography have high sensitivity, specificity, and accuracy for the diagnosis of CBD stones...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29761151/endoscopic-ultrasound-guided-choledochoduodenostomy-as-palliative-treatment-a-challenging-case-report
#11
Helena Ribeiro, Richard Azevedo, Ana Caldeira, Rui Sousa, Eduardo Pereira, António Banhudo
We report the case of an 88-year-old female with obstructive jaundice due to a periampullary tumor. The patient developed acute cholangitis and consequent clinical deterioration, so it was decided to perform palliative biliary drainage. Due to duodenal tumor invasion, it was not possible to perform endoscopic retrograde cholangiopancreatography. A different approach was attempted and it was decided to carry out an endoscopic ultrasound-guided choledochoduodenostomy. This procedure was performed with a linear echoendoscope, and using a duodenal bulbar approach, a fistula was created between the bulb and the common bile duct...
April 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29761149/how-spyglass%C3%A2-may-impact-endoscopic-retrograde-cholangiopancreatography-practice-and-patient-management
#12
Pedro Pereira, Filipe Vilas-Boas, Armando Peixoto, Patrícia Andrade, Joanne Lopes, Guilherme Macedo
Introduction: Cholangiopancreatoscopy with SpyGlass™ Direct Visualization System (SGDVS) is being used in specialized centers for improving the sensitivity of endoscopic retrograde cholangiopancreatography (ERCP) in patients with indeterminate pancreatobiliary strictures (PBS). The aims of this study were to report our initial experience with SGDVS in the evaluation of indeterminate PBS, and discuss the improvements of ERCP brought by this technique in our center. Methods: The usefulness of SGDVS in patients with indeterminate PBS (defined after nondiagnostic previous ERCP with brush cytology) was evaluated in a prospective observational cohort study conducted at a single tertiary biliopancreatic unit...
April 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29751790/obliterative-cholangiopathy-in-acquired-cystic-biliary-atresia-type-iii-after-cyst-perforation-a-case-report
#13
Tsugumichi Koshinaga, Kensuke Ohashi, Kakou Ono, Hide Kaneda, Takeshi Furuya
BACKGROUND: In biliary atresia, the disease process of obliterative cholangiopathy may begin in the perinatal period; however, no chronological evidence exists on how the cholangiopathy progresses to biliary obliteration. This is the first acquired case with the final diagnosis of type III cystic biliary atresia with an extrahepatic biliary cyst which showed the progression of obliterative cholangiopathy in chronological order after birth. CASE PRESENTATION: An 81-day-old girl presented with acute abdominal distress due to bilious peritonitis caused by biliary cyst perforation, for which she underwent emergency biliary drainage...
May 11, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29744942/video-controlled-management-of-intrahepatic-stones-using-a-double-channel-scope-in-a-patient-with-surgically-altered-anatomy
#14
Shinya Kawaguchi, Tatsunori Satoh, Shinya Endo
We report a successful case of video-controlled management of intrahepatic stones using a double-channel scope in a patient with surgically altered anatomy.A 68-year-old man with a history of intraductal papillary mucinous neoplasia who had undergone pancreatoduodenectomy with reconstruction-II 10 years previously was admitted to our hospital for acute refractory cholangitis due to recurrent intrahepatic stones and stenosis in the choledochojejunal anastomosis.We performed endoscopic balloon dilatation of the anastomotic stricture (Fig...
May 9, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29742738/percutaneous-cholecystostomy-for-high-risk-patients-with-acute-cholangitis
#15
Yan-Lin Li, Kin-Hoi Wong, Keith Wan-Hang Chiu, Andrew Kai-Chun Cheng, Ronald Kin-On Cheung, Max Kai-Ho Yam, Angie Lok-Chi Chan, Victor Siang-Hua Chan, Martin Wai-Ming Law, Paul Sing-Fun Lee
Percutaneous cholecystostomy (PC) is a well-established treatment for acute cholecystitis. We investigate the performance and role of PC in managing acute cholangitis.Retrospective review on all patients who underwent PC for acute cholangitis between January 2012 and June 2017 at a major regional hospital in Hong Kong.Thirty-two patients were included. The median age was 84 years and median American Society of Anaesthesiologists (ASA) physical status was Class III (severe systemic disease). All fulfilled Tokyo Guidelines 2013 (TG13) diagnostic criteria for moderate or severe cholangitis...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29729042/transgastric-reintervention-for-self-expandable-metallic-stent-dysfunction-following-eus-guided-hepaticogastrostomy
#16
Tesshin Ban, Hiroshi Kawakami, Yoshimasa Kubota
EUS-guided hepaticogastrostomy (EUS-HGS) using a self-expandable metallic stent (SEMS) is recognized as an alternative to transpapillary access for performing biliary drainage.1,2 However, reintervention to mitigate stent dysfunction remains challenging.3-5 Here, we present a case of successful transgastric exchange of occluded SEMS. A 53-year-old woman with pancreatic cancer was admitted with acute cholangitis. Five months before, she underwent EUS-HGS using partially covered SEMS (6 mm×12 cm Niti-STM S Biliary Stent; Taewoong Medical Co...
May 5, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29699063/clinical-impact-of-recombinant-soluble-thrombomodulin-for-disseminated-intravascular-coagulation-associated-with-severe-acute-cholangitis
#17
Atsushi Okuda, Takeshi Ogura, Miyuki Imanishi, Akira Miyano, Nobu Nishioka, Kazuhide Higuchi
Background/Aims: Recently, recombinant human soluble thrombomodulin (rTM) has been developed as a new drug for disseminated intravascular coagulation (DIC). This study aims to evaluate the clinical benefit of rTM in patients with sepsis-induced DIC caused by acute cholangitis who underwent biliary drainage. Methods: Patients were divided into two groups: the rTM therapy group and the non-rTM therapy group. The primary outcome was the DIC resolution rate at 7 days, and the secondary outcome was 28-day mortality rate...
April 27, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29682365/bedside-endoscopic-retrograde-cholangiopancreatography-using-portable-x-ray-in-acute-severe-cholangitis
#18
Rushikesh Shah, Emad Qayed
Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29663264/no-association-of-timing-of-endoscopic-biliary-drainage-with-clinical-outcomes-in-patients-with-non-severe-acute-cholangitis
#19
Ryunosuke Hakuta, Tsuyoshi Hamada, Yousuke Nakai, Hirofumi Kogure, Rie Uchino, Naminatsu Takahara, Suguru Mizuno, Tatsunori Suzuki, Tatsuya Sato, Tsuyoshi Takeda, Kazunaga Ishigaki, Kei Saito, Tomotaka Saito, Minoru Tada, Hiroyuki Isayama, Kazuhiko Koike
BACKGROUND: Biliary drainage via endoscopic retrograde cholangiopancreatography (ERCP) is the first-line treatment for acute cholangitis. Despite the established effectiveness of urgent biliary drainage in patients with severe acute cholangitis, the indication of this procedure for non-severe acute cholangitis is controversial. AIMS: To assess the safety of elective drainage (≥ 12 h of admission) for non-severe acute cholangitis. METHODS: We retrospectively identified 461 patients with non-severe acute cholangitis who underwent endoscopic biliary drainage...
April 16, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29657606/early-biliary-drainage-is-associated-with-favourable-outcomes-in-critically-ill-patients-with-acute-cholangitis
#20
Mohammed Aboelsoud, Osama Siddique, Alexander Morales, Young Seol, Mazen Al-Qadi
Introduction: Acute cholangitis (AC) is a clinical condition that requires prompt medical management with IV fluids, antibiotics, and biliary drainage (BD). The optimal timing for BD remains unclear. Aim: To investigate the effect of biliary drainage timing on clinical outcomes in AC. Material and methods: We conducted a retrospective study of patients with AC admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database...
2018: Przegla̜d Gastroenterologiczny
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