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https://www.readbyqxmd.com/read/28097624/poorly-differentiated-adenocarcinoma-with-signet-ring-cells-in-duodenal-papilla-a-case-report
#1
Yuta Ushida, Kiyoshi Hiramatsu, Satomi Saeki, Takeshi Amemiya, Hidenari Goto, Toshiyuki Arai
An 82-year-old woman with common bile duct (CBD) dilatation observed during routine ultrasonography was referred to our hospital. Preliminary blood tests revealed elevated levels of hepatobiliary enzymes. Computed tomography (CT) scan showed lower bile duct wall thickening and enhancement. Esophagogastroduodenoscopy revealed mildly swollen papilla of Vater, without ulceration. Endoscopic retrograde cholangiography demonstrated that the CBD was grossly dilated with a constriction in the lower part. The final diagnosis indicated poorly differentiated adenocarcinoma of duodenal papilla with signet-ring cells; pT3N0M0, stage IIA (Unio Internationalis Contra Cancrum, 7th edition), for which subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) was performed...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28090506/cystic-duct-variation-detected-by-near-infrared-fluorescent-cholangiography-during-laparoscopic-cholecystectomy
#2
Nam Seok Kim, Hyeong Yong Jin, Eun Young Kim, Tae Ho Hong
Near-infrared fluorescent cholangiography (NIRFC) is an emerging technique for easy intraoperative recognition of biliary anatomy. We present a case of cystic duct variation detected by NIRFC which had a potential risk for biliary injury if not detected. A 32-year-old female was admitted to the Seoul St. Mary's Hospital for surgery for an incidental gallbladder polyp. We performed laparoscopic cholecystectomy with NIRFC. In fluorescence mode, a long cystic duct and an accessory short hepatic duct joining to the cystic duct were found and the operation was completed safely...
January 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28090475/use-of-omega-3-polyunsaturated-fatty-acids-to-treat-inspissated-bile-syndrome-a-case-report
#3
Woo Young Jun, Min Jeng Cho, Hye Seung Han, Sun Hwan Bae
Inspissated bile syndrome (IBS) is a rare condition in which thick intraluminal bile, including bile plugs, sludge, or stones, blocks the extrahepatic bile ducts in an infant. A 5-week-old female infant was admitted for evaluation of jaundice and acholic stool. Diagnostic tests, including ultrasound sonography, magnetic resonance cholangiopancreatography, and a hepatobiliary scan, were not conclusive. Although the diagnosis was unclear, the clinical and laboratory findings improved gradually on administration of urodeoxycholic acid and lipid emulsion containing omega-3 polyunsaturated fatty acids (PUFAs) for 3 weeks...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28086796/prophylaxis-of-post-erc-infectious-complications-in-patients-with-biliary-obstruction-by-adding-antimicrobial-agents-into-erc-contrast-media-a-single-center-retrospective-study
#4
Hella Wobser, Agnetha Gunesch, Frank Klebl
BACKGROUND: Patients with biliary obstruction are at high risk to develop septic complications after endoscopic retrograde cholangiography (ERC). We evaluated the benefits of local application of antimicrobial agents into ERC contrast media in preventing post-ERC infectious complications in a high-risk study population. METHODS: Patients undergoing ERC at our tertiary referral center were retrospectively included. Addition of vancomycin, gentamicin and fluconazol into ERC contrast media was evaluated in a case-control design...
January 13, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28071059/accuracy-of-asge-criteria-for-the-prediction-of-choledocholithiasis
#5
Jacobo Dib
I read with interest the article "Accuracy of ASGE criteria for the prediction of choledocholithiasis" by Nárvaez et al. Patients with suspicion of choledocholithiasis (CL) were categorized according to the American Society for Gastrointestinal Endoscopy (ASGE) recommendations. Those patients classified into high or intermediate-probability for CL underwent an endoscopic retrograde cholangiopancreatography (ERCP) without any further non-endoscopic biliary imaging modalities. In the ASGE recommendations for intermediate risk CL patients, they mention options for the evaluation of these patients including endoscopic ultrasound (EUS) and magnetic resonance cholangiography (MRC)...
January 10, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28066983/endoscopic-ultrasound-guided-antegrade-biliary-stenting-for-unresectable-malignant-biliary-obstruction-in-patients-with-surgically-altered-anatomy-a-single-center-prospective-pilot-study
#6
Takuji Iwashita, Ichiro Yasuda, Tsuyoshi Mukai, Keisuke Iwata, Shinpei Doi, Shinya Uemura, Masatoshi Mabuchi, Mitsuru Okuno, Masahito Shimizu
BACKGROUND AND AIMS: Endoscopic retrograde cholangiography (ERCP) with biliary stenting for the treatment of unresectable malignant biliary obstruction (MBO) is challenging among patients with surgically altered anatomy. Endoscopic ultrasound-guided antegrade biliary stenting (EUS-ABS) was introduced as an alternative biliary drainage method, although it has not been well studied yet. In this single-center prospective pilot study, we aimed to evaluate the feasibility and safety of EUS-ABS for MBO in patients with surgically altered anatomy...
January 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28062313/evolution-in-the-utilization-of-biliary-interventions-in-the-united-states-results-of-a-nationwide-longitudinal-study-from-1998-to-2013
#7
Robert J Huang, Nirav C Thosani, Monique T Barakat, Abhishek Choudhary, Alka Mithal, Gurkirpal Singh, Saurabh Sethi, Subhas Banerjee
BACKGROUND AND AIMS: Bile duct surgery (BDS), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP) are alternative interventions used to treat biliary disease. We aim to describe trends in ERCP, BDS, and PTC on a nationwide level in the United States. METHODS: We used the National Inpatient Sample to estimate age-standardized utilization trends of inpatient diagnostic ERCP, therapeutic ERCP, BDS, and PTC between 1998 and 2013...
January 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28054282/occult-mucin-producing-cholangiocarcinoma-in-situ-a-rare-clinical-case-with-difficult-tumour-staging
#8
Muneyasu Kiriyama, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
BACKGROUND: Mucin-producing cholangiocarcinoma (MPCC) is an uncommon tumour that is clinically characterized by mucin-hypersecretion. Because the initial symptoms of MPCC may be attributed to the viscus mucobilia, the primary tumour mass may potentially be unrecognizable. We report an interesting case of curatively resected occult MPCC in situ. CASE PRESENTATION: A 70-year-old man was referred to our hospital with increased levels of biliary enzymes. Multidetector row computed tomography (MDCT) demonstrated a diffuse dilatation of the entire biliary system without evidence of tumour mass...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28051047/evaluation-of-the-use-of-laparoscopic-guided-cholecystocholangiography-and-liver-biopsy-in-definitive-diagnosis-of-neonatal-cholestatic-jaundice
#9
Khalid Shreef, Abdullah Alhelal
BACKGROUND: Once it is established that a jaundiced infant has direct hyperbilirubinemia, the principal diagnostic concern is to differentiate hepatocellular from obstructive cholestasis. Traditional tests such as ultrasonography, percutaneous liver biopsy and technetium 99 m hepatobiliary iminodiacetic acid (HIDA) scan are often not sufficiently discriminating. Definitive exclusion of biliary atresia (BA) in the infant with cholestatic jaundice usually requires mini-laparotomy and intra-operative cholangiography...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28044956/retained-common-bile-duct-lithiasis-at-a-pacient-with-periampullary-duodenal-diverticulum
#10
Ionuţ Simion Coman, Elena-Violeta Radu, Vasile Șandru, Ionuţ Cristinel Bârsan, Cristinel Dumitru Badiu, Gabriel Constantinescu, Valentin Titus Grigorean
Periampullary duodenal diverticula are associated with the presence of common bile duct stones, being encountered more frequently with the increase of age. We present the case of a 76 years old female patient, who underwents emergency surgery for a perforated lithiasic gangrenous acute cholecystitis and for whom we perform a cholecystectomy and an external biliary drainage using a transcystic tube. Both preoperative and postoperative imaging and endoscopic examinations certify the presence of a periampullary duodenal diverticulum...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28044954/haemobilia-a-rare-cause-of-upper-gastro-intestinal-bleeding
#11
Daniel Ion, Carmen Iuliana Mavrodin, Mihai Bogdan Șerban, Tudor Marinescu, Dan Nicolae Păduraru
Haemobilia is a rare cause of upper gastrointestinal bleeding that consists of haemorrhage within the biliary tree. Most cases of haemobilia are due to iatrogenic cause, laparoscopic or open cholecystectomy, abdominal trauma, gallstones, hepatic tumours, vascular aneurism. We present the case of a male patient admitted in the surgery department for epigastric and right hypochondria pain, nausea and vomiting. Open cholecystectomy was performed with a trans-cystic tube drainage. Postoperative outcome was favourable but with a continuous decrease in haemoglobin level...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28026137/the-right-way-is-not-always-popular-comparison-of-surgeons-perceptions-during-laparoscopic-cholecystectomy-for-acute-cholecystitis-among-experts-from-japan-korea-and-taiwan
#12
T Hibi, Y Iwashita, T Ohyama, G Honda, M Yoshida, T Takada, H S Han, T L Hwang, S Shinya, K Suzuki, A Umezawa, Y S Yoon, I S Choi, W S W Huang, K H Chen, F Miura, M Watanabe, Y Abe, T Misawa, Y Nagakawa, D S Yoon, J Y Jang, H C Yu, K S Ahn, S C Kim, I S Song, J H Kim, S S Yunv, S H Choi, Y Y Jan, S M Sheen-Chen, Y S Shan, C G Ker, D C Chan, C C Wu, N Toyota, R Higuchi, Y Nakamura, Y Mizuguchi, Y Takeda, M Ito, S Norimizu, S Yamada, N Matsumura, J Shindoh, H Sunagawa, T Gocho, H Hasegawav, T Rikiyama, N Sata, N Kano, S Kitano, H Tokumura, Y Yamashita, G Watanabe, K Nakagawa, T Kimura, T Yamakawa, G Wakabayashi, I Endo, M Miyazakiv, M Yamamoto
BACKGROUND: Generally, surgeons' perceptions of surgical safety are based on experience and institutional policy. Our recent pilot survey demonstrated that the acceptable duration of surgery and criteria for open conversion during laparoscopic cholecystectomy (LC) vary among workplaces. METHODS: A web-based survey was distributed to 554 expert LC surgeons in Japan, Korea, and Taiwan. The questionnaire covered LC experience, safety measures and recognition of landmarks, decision-making regarding conversion to open/partial cholecystectomy and the implications of this decision...
December 26, 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28026048/consideration-of-different-heating-lengths-of-needles-with-induction-heating-and-resistance-system-a-novel-design-of-needle-module-for-thermal-ablation
#13
Huy-Tien Bui, Sheng-Jye Hwang, Huei-Huang Lee, Durn-Yuan Huang
Thermal ablation using alternating electromagnetic fields is a promising method to treat tissues including tumors. With this approach, an electromagnetic field is generated around an induction coil, which is supplied with high frequency current from a power source. Any electrically conducting object, which is placed in the electromagnetic field, is then heated due to eddy currents. Basic principles underlying this novel thermotherapy needle system are internal induction and resistance heating. This presents a new design of a standard gauge 18 percutaneous trans-hepatic cholangiography needle module combined with a compact power source...
December 27, 2016: Bioelectromagnetics
https://www.readbyqxmd.com/read/28019036/utility-of-newly-developed-short-type-double-balloon-endoscopy-for-endoscopic-retrograde-cholangiography-in-postoperative-patients
#14
Masaaki Shimatani, Mitsuo Tokuhara, Kota Kato, Sachi Miyamoto, Masataka Masuda, Masayuki Sakao, Norimasa Fukata, Hideaki Miyoshi, Tsukasa Ikeura, Makoto Takaoka, Kazuichi Okazaki
BACKGROUND AND AIMS: The utility of conventional short-type DBE (C-short DBE) for pancreatobiliary disease in patients with postoperative anatomy had been widely acknowledged and accepted. However, some technical difficulties yet remained. In an attempt to solve these problems, the new short-type DBE (N-short DBE) was uniquely designed for therapeutic endoscopic retrograde cholangiography (ERC) in postoperative patients. The aim of this study was to evaluate the usefulness of N-short DBE for ERC in postoperative patients...
December 26, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28017834/indocyanine-green-fluorescence-imaging-in-hepatobiliary-surgery
#15
REVIEW
Ali Majlesara, Mohammad Golriz, Mohammadreza Hafezi, Arash Saffari, Esther Wild, Lena Maier-Hein, Beat P Müller-Stich, Arianeb Mehrabi
Indocyanine green (ICG) is a fluorescent dye that has been widely used for fluorescence imaging during hepatobiliary surgery. ICG is injected intravenously, selectively taken up by the liver, and then secreted into the bile. The catabolism and fluorescence properties of ICG permit a wide range of visualization methods in hepatobiliary surgery. We have characterized the applications of ICG during hepatobiliary surgery into: 1) liver mapping, 2) cholangiography, 3) tumor visualization, and 4) partial liver graft evaluation...
December 22, 2016: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/28008403/endoscopic-ultrasound-as-a-diagnostic-tool-in-a-case-of-obscure-hemobilia
#16
Monica A Konerman, Zishu Zhang, Cyrus Piraka
Hemobilia represents an uncommon cause of gastrointestinal bleeding that can present both diagnostic and therapeutic challenges. The evaluation of hemobilia typically involves cross-sectional imaging and endoscopic retrograde cholangiopancreatography (ERCP). There is limited data regarding the diagnostic utility of endoscopic ultrasound (EUS) in the evaluation of hemobilia. We present a case of a hepatic artery pseudoaneurysm as the etiology of hemobilia that was detected via EUS only. We conclude that EUS can serve as an important diagnostic tool in the evaluation of obscure hemobilia, especially in cases where imaging, ERCP, and percutaneous transhepatic cholangiography have been unsuccessful or inconclusive...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27995197/eus-guided-biliary-drainage-or-enteroscopy-assisted-ercp-in-patients-with-surgical-anatomy-and-biliary-obstruction-an-international-comparative-study
#17
Mouen A Khashab, Mohamad H El Zein, Kaveh Sharzehi, Fernando P Marson, Oleh Haluszka, Aaron J Small, Yousuke Nakai, Do Hyun Park, Rastislav Kunda, Anthony Y Teoh, Irene Peñas, Manuel Perez-Miranda, Vivek Kumbhari, Schalk Van der Merwe, Everson L Artifon, Andrew S Ross
Background and study aims: How enteroscopy-assisted ERCP (e-ERCP) and endoscopic ultrasound-guided biliary drainage (EUS-BD) compare in patients with surgically altered upper gastrointestinal anatomy is currently unknown. The aims of this study were to compare efficacy and safety of both techniques and study predictors of these outcomes. Patients and methods: This was an international, multicenter comparative cohort study at 10 tertiary centers. Outcomes data included technical success (biliary access with cholangiography and stent placement [when indicated]), clinical success (resolution of biliary obstruction) and adverse events (AEs) (graded according to the ASGE lexicon)...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27994344/percutaneous-placement-of-pancreatico-biliary-drainage-catheter-for-the-treatment-of-complicated-pancreatic-anastomotic-leakage-an-alternative-treatment-option
#18
Enes Duman, Erkan Yıldırım
A 58-year-old female patient who had anastomotic leakage after a Whipple operation was treated with a percutaneously placed pancreatico-biliary drainage catheter. Complete secondary healing of the anastomotic defect and leakage was seen on control cholangiography examination on the 35th postoperative day, and the pancreatico-biliary drainage catheter was removed. She was discharged on the 39th postoperative day uneventfully. Percutaneous pancreatico-biliary drainage should be kept in mind as an alternative treatment option of complicated pancreatic anastomotic leakage after a Whipple operation...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27986173/liver-function-assessment-by-magnetic-resonance-imaging
#19
Emre Ünal, Deniz Akata, Musturay Karcaaltincaba
Liver function assessment by hepatocyte-specific contrast-enhanced magnetic resonance imaging is becoming a new biomarker. Liver function can be assessed by T1 mapping (reduction rate) and signal intensity measurement (relative enhancement ratio) before and after GD-EOB-DTPA (gadoxetic acid) administration, as alternative to Tc-99m galactosyl serum albumin scintigraphy, 99m Tc-labeled mebrofenin scintigraphy, and indocyanine green clearance test. Magnetic resonance imaging assessment of liver function can enable diagnosis of cirrhosis, nonalcoholic fatty liver disease associated fibrosis and steatohepatitis, primary sclerosing cholangitis, toxic hepatitis, and chemotherapy and radiotherapy-related changes, which may be only visible on hepatobiliary phase images...
December 2016: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/27981308/primary-biliary-cirrhosis-and-primary-sclerosing-cholangitis-an-update-on-mr-imaging-findings-with-recent-developments
#20
REVIEW
Jelena Djokić Kovač, Marc-André Weber
Primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC) are the most common immune-mediated chronic cholestatic liver diseases leading to cirrhosis and liver failure. Although magnetic resonance imaging (MRI) is not a necessary procedure for the diagnosis of PBC, MRI is recommended for monitoring disease progression and early detection of complications. Even though liver cirrhosis subtypes have similar MR imaging features, there are some findings which could indicate PBC, such as the periportal halo sign...
December 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
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