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https://www.readbyqxmd.com/read/27904860/interventional-therapy-for-pancreatic-cancer
#1
REVIEW
Jianwei Zhu, Zhendong Jin
BACKGROUND: Palliative therapy and primarily chemoradiotherapy are the mainstream treatments in patients with locally advanced or metastatic pancreatic cancer (PC). Conventional endoscopy and endoscopic ultrasound (EUS)-guided interventional therapy has emerged as an important procedure for PC management. In this review, the progress in conventional endoscopy and EUS for PC management is discussed. SUMMARY: For local palliative therapy against PC, EUS-guided fine needle injection (FNI) could deliver different kinds of agents, such as radioactive seeds and fiducials...
October 2016: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/27904244/management-of-malignant-biliary-obstruction
#2
REVIEW
Jonathan M Lorenz
The diagnosis of malignant biliary obstruction combines the use of clinical evaluation, diagnostic imaging, tissue sampling, and minimally invasive options with the initial goal of identifying candidates for curative resection. The most common causes of obstruction are pancreatic adenocarcinoma and cholangiocarcinoma, and most cases are too advanced for surgical options. Interventional radiologists and gastroenterologists offer palliative options for biliary drainage such as plastic stents and catheters, bare metal stents, and covered stents...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27845340/plastic-vs-self-expandable-metal-stents-for-palliation-in-malignant-biliary-obstruction-a-series-of-meta-analyses
#3
Majid A Almadi, Alan Barkun, Myriam Martel
OBJECTIVES: Self-expandable metal stents (SEMS) are thought to have an advantage over plastic stents in achieving biliary drainage. METHODS: We performed a systematic search of MEDLINE, EMBASE, Scopus, CENTRAL, and ISI Web of knowledge databases, from January 1980 to September 2015, for randomized-controlled trials (RCTs) comparing SEMS vs. plastic stents in the palliation of malignant biliary obstruction. Primary outcomes were durations of stent patency, patient survival, and 30-day mortality...
November 15, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27788612/a-european-survey-of-perendoscopic-treatment-of-biliary-complications-in-patients-with-alveolar-echinococcosis
#4
Sylvain Ambregna, Stéphane Koch, Michael C Sulz, Beate Grüner, Sümeyra Öztürk, Jean-Baptiste Chevaux, Małgorzata Sulima, Andrea de Gottardi, Bertrand Napoléon, Armand Abergel, Philippe Bichard, Isabelle Boytchev, Pierre Deprez, Jerome Dumortier, Jean-Louis Frossard, Eric Kull, Bernard Meny, Darius Moradpour, Fréderic Prat, Geoffroy Vanbiervliet, Thierry Thevenot, Dominique Angèle Vuitton, Solange Bresson-Hadni, Lucine Vuitton
BACKGROUND: Biliary complications represent a turning point in the course of Alveolar Echinococcosis (AE). We conducted a European survey to collect data on the current usage and results of perendoscopic interventions (PEIs) for their treatment. METHODS: Patient's characteristics and follow-up until January 31st, 2015 were recorded using an online questionnaire. RESULTS: From 18 centers 129 PEIs were analyzed in 38 patients; 139 plastic stents were inserted during 85 PEIs; median time between stent placements was significantly longer when 3 stents or more were placed...
October 28, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27775958/predicting-efficacy-of-plastic-stents-for-posttransplantation-biliary-strictures
#5
Erwin Santo, Anna Itshak, Liat Mlynarsky, Moshe Leshno, Nathan Gluck
BACKGROUND: Biliary strictures (BS) are a common complication of liver transplantation. The standard treatment is sequential insertion of increasing numbers of plastic stents by endoscopic retrograde cholangiopancreatography (ERCP). Despite high success rates, some strictures fail to resolve and require surgery as definitive treatment. GOALS: To identify predictors of response or failure of standard endoscopic treatment, allowing earlier referral to alternative modalities when needed and avoiding unnecessary procedures...
October 21, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27765727/aspirin-use-is-associated-with-reduced-risk-of-occlusion-of%C3%A2-metallic-biliary-stents
#6
Sunguk Jang, Tyler Stevens, Mansour A Parsi, Rocio Lopez, John J Vargo
BACKGROUND & AIMS: Biliary self-expandable metallic stents (SEMSs) are widely used to treat malignant and benign conditions of bile duct. Despite their lower rate of occlusion and longer patency than plastic stents, SEMSs still have significant rates of occlusion. We aimed to identify factors associated with occlusion of biliary SEMS. METHODS: We performed a retrospective study of consecutive patients who underwent endoscopic retrograde cholangiopancreatography with biliary SEMS placement at the Cleveland Clinic Foundation from March 2011 to April 2016...
October 17, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27758723/-new-developments-in-the-treatment-of-pancreatic-cancer
#7
H A Marsman, M G Besselink
- The incidence of pancreatic cancer is increasing due to the ageing population among other things, while 5-year survival has improved in the past two decades from 3 to 7%.- In case of biliary obstruction due to pancreatic cancer, biliary drainage before surgery or ablative therapy using a covered metal stent instead of plastic reduces the rate of complications.- In patients with metastasized pancreatic cancer a combination of folinic acid, fluorouracil, irinotecan and oxaliplatin (FOLFIRINOX) results in improved survival...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27754790/antireflux-versus-conventional-plastic-stent-in-malignant-biliary-obstruction-a-prospective-randomized-study
#8
Hanna Vihervaara, Juha M Grönroos, Saija Hurme, Risto Gullichsen, Paulina Salminen
OBJECTIVE: Endoscopic stents are used to relieve obstructive jaundice. The purpose of this prospective randomized study was to compare the patency of antireflux and conventional plastic biliary stent in relieving distal malignant biliary obstruction. MATERIALS AND METHODS: All jaundiced patients admitted to hospital with suspected unresectable malignant distal biliary stricture between October 2009 and September 2010 were evaluated for the study. Eligible patients were randomized either to antireflux or conventional plastic stent arms...
October 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27747284/application-of-a-silver-coating-on-plastic-biliary-stents-to-prevent-biofilm-formation-an-experimental-study-using-electron-microscopy
#9
Akane Yamabe, Atsushi Irisawa, Ikuo Wada, Goro Shibukawa, Mariko Fujisawa, Ai Sato, Ryo Igarashi, Takumi Maki, Koki Hoshi
Background and study aims: Biliary stent dysfunction is mainly caused by biliary sludge that forms as a result of bacterial adherence and subsequent biofilm formation on the inner surface of the stent. Silver ions arewell known to have excellent antimicrobial activity against a wide range of microorganisms. In this study, we designed and constructed silver-coated plastic stent (PS) and investigated whether the silver coating prevented bacterial adherence and biofilm formation through the use of electron microscopy...
October 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27744664/endoscopic-management-of-anastomotic-strictures-after-liver-transplantation
#10
Dong Wook Lee, Hyeong Ho Jo, Juveria Abdullah, Michel Kahaleh
Endoscopic treatment of biliary strictures involving plastic stent placement has been used widely. The use of self-expandable metal stents (SEMSs) has been described for anastomotic strictures following liver transplantation (LT). This review aimed to assess and compare the efficacy of plastic stents with SEMS in LT patients. Information was retrieved regarding technical success, stricture resolution, the number of endoscopic retrograde cholangiography procedures, follow-up, immediate, and late complications...
September 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27744539/side-by-side-placement-of-bilateral-endoscopic-metal-stents-for-the-treatment-of-postoperative-biliary-stricture
#11
Seiji Kaino, Manabu Sen-Yo, Shuhei Shinoda, Michitaka Kawano, Hirofumi Harima, Shigeyuki Suenaga, Isao Sakaida
Postoperative biliary strictures are usually complications of cholecystectomy. Endoscopic plastic stent prosthesis is generally undertaken for treating benign biliary strictures. Recently, fully covered metal stents have been shown to be effective for treating benign distal biliary strictures. We present the case of a 53-year-old woman with liver injury in which imaging studies showed a common hepatic duct stricture. Endoscopic retrograde cholangiopancreatography also confirmed the presence of a common hepatic duct stricture...
October 15, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27742337/endoscopic-management-of-post-liver-transplantation-biliary-strictures-with-the-use-of-fully-covered-metallic-stents
#12
M Jiménez-Pérez, J M Melgar Simón, A Durán Campos, R González Grande, J M Rodrigo López, R Manteca González
OBJECTIVE: The aim of this work was to evaluate the safety and efficacy of a fully covered self-expandable metal stent (FCSEMS) in the treatment of post-liver transplantation biliary strictures. METHODS: From October 2009 to October 2014, 44 patients with post-liver transplantation biliary stenosis were treated with the use of endoscopic retrograde cholangiography and placement of FCSEMS after informed consent. The FCSEMS was scheduled to remain in situ for 3-6 months...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27716861/radiofrequency-ablation-for-the-management-of-occluded-biliary-metal-stents
#13
Abdurrahman Kadayifci, Mustafa Atar, David G Forcione, Brenna W Casey, Peter B Kelsey, William R Brugge
Background and study aim: Obstruction of biliary self-expandable metal stents (SEMSs) is seen frequently. Radiofrequency ablation (RFA) causes tissue necrosis. This study aimed to assess the efficacy of RFA for management of occluded SEMS. Patients and methods: Patients with biliary malignancy and treated for an occluded SEMS were retrospectively reviewed. The study group comprised patients treated with RFA using an Habib endoprobe inside the SEMS. The control group comprised patients treated only with insertion of a plastic stent into an occluded SEMS...
December 2016: Endoscopy
https://www.readbyqxmd.com/read/27679466/spontaneous-biliary-peritonitis-with-common-bile-duct-stones-report-of-a-case
#14
Ryoga Hamura, Koichiro Haruki, Jun Tsutsumi, Sumio Takayama, Hiroaki Shiba, Katsuhiko Yanaga
Spontaneous biliary peritonitis is rare in adults. We herein report a case of spontaneous biliary peritonitis. An 84-year-old man was admitted to our hospital for abdominal pain for 5 days. He developed fever, jaundice, and abdominal rigidity. Computed tomography (CT) revealed massive ascites in the omental bursa and around the liver. The ascites obtained by diagnostic paracentesis was dark yellow-green in color, which implied bile leakage. With a diagnosis of bile peritonitis, the patient underwent emergency exploratory laparotomy...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27606045/endoscopic-multiple-metal-stenting-for-the-treatment-of-enteral-leaks-near-the-biliary-orifice-a-novel-effective-rescue-procedure
#15
Massimiliano Mutignani, Lorenzo Dioscoridi, Stefanos Dokas, Paolo Aseni, Pietro Carnevali, Edoardo Forti, Raffaele Manta, Mariano Sica, Alberto Tringali, Francesco Pugliese
Between April 2013 and October 2015, 6 patients developed periampullary duodenal or jejunal/biliary leaks after major abdominal surgery. In all patients, percutaneous drainage of the collection or re-operation with primary surgical repair was attempted at first but failed. A fully covered enteral metal stent was placed in all patients to seal the leak. Subsequently, we cannulated the common bile duct and, in some cases, and the main pancreatic duct inserting hydrophilic guidewires through the stent after dilating the stent mesh with a dilatation balloon or breaking the meshes with Argon Plasma Beam...
August 10, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27589348/endoscopic-management-of-bile-duct-injury-after-hepatobiliary-tract-surgery-a-comprehensive-review
#16
Carmelo Luigiano, Giuseppe Iabichino, Benedetto Mangiavillano, Leonardo H Eusebi, Monica Arena, Pierluigi Consolo, Carmela Morace, Sharmila Fagoonee, Matteo Barabino, Enrico Opocher, Rinaldo Pellicano
Bile duct injuries are the most serious complications after hepatobiliary surgery and are associated with high morbidity and mortality. The incidence of iatrogenic injuries of bile ducts has increased after the advent of laparoscopic cholecystectomy. Bile duct injuries present with biliary leak or biliary obstruction or a combination of both. Successful treatment of these complications requires a multidisciplinary team that includes biliary endoscopists, interventional radiologists and hepatobiliary surgeons...
September 2, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27572066/success-and-complications-of-an-intra-ductal-fully-covered-self-expanding-metal-stent-id-fcsems-to-treat-anastomotic-biliary-strictures-as-after-orthotopic-liver-transplantation-olt
#17
Patrick Aepli, Andrew St John, Saurabh Gupta, Luke F Hourigan, Rhys Vaughan, Marios Efthymiou, Arthur Kaffes
BACKGROUND: Anastomotic biliary strictures (AS) after orthotopic liver transplantation (OLT) belong to the most common biliary complications and cause the biggest morbidity burden after OLT. Metal stents for benign biliary strictures are gaining acceptance with many published series. Traditional metal stent designs seem to have poor durability in AS after OLT. Novel intra-ductal stents are showing promise in these strictures. As a result, we designed a special stent with an antimigration waist and a short stent length with a long removal string that rests in the duodenum for easy removal...
August 29, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27566054/a-novel-technique-for-the-endoscopic-treatment-of-complete-biliary-anastomosis-obstructions-after-liver-transplantation-through-the-scope-magnetic-compression-anastomosis
#18
Erkan Parlak, Aydın Seref Koksal, Fahrettin Kucukay, Ahmet Tarık Eminler, Bilal Toka, Mustafa Ihsan Uslan
BACKGROUND AND AIMS: Magnetic compression anastomosis is a rescue technique for recanalization of complete biliary strictures. Here, we present magnetic compression anastomosis with novel through-the-scope magnets in patients with complete duct-to-duct anastomosis obstruction after liver transplantation. METHODS: The magnets were 2 and 2.4 mm in diameter, with a hole at the center for inserting a guidewire. One of the magnets was advanced through the scope up to the distal site of the stricture by using a 7F pusher...
August 24, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27556089/adjunctive-radiofrequency-ablation-for-the-endoscopic-treatment-of-ampullary-lesions-with-intraductal-extension-with-video
#19
Alejandro L Suarez, Gregory A Coté, B Joseph Elmunzer
Catheter-based radiofrequency ablation (RFA) delivered during endoscopic retrograde cholangiopancreatography (ERCP) may represent a viable treatment option for intraductal extension of ampullary neoplasms, however, clinical experience with this modality is limited. After ampullary resection, 4 patients with intraductal extension underwent adjunctive RFA of the distal bile duct. All patients received a temporary pancreatic stent to reduce the risk of pancreatitis, as well as a plastic biliary stent to prevent biliary obstruction...
July 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27540583/therapeutic-enteroscopy-using-a-new-single-balloon-enteroscope-a-case-series
#20
Tom G Moreels, Nathalie Kouinche Madenko, Alaa Taha, Hubert Piessevaux, Pierre H Deprez
BACKGROUND AND STUDY AIMS: Balloon-assisted enteroscopy allows therapeutic intervention in the small bowel, and even of the biliopancreatic system in patients with altered anatomy. However, the conventional single-balloon enteroscope (SBE) has limited therapeutic use because of its small-caliber working channel and the lack of an additional water jet channel. The new single-balloon enteroscope prototype XSIF-180JY has been developed to overcome these problems. We present experience with use of the new SBE prototype during 14 therapeutic endoscopy procedures, which illustrates its advantages...
August 2016: Endoscopy International Open
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