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https://www.readbyqxmd.com/read/28527615/a-multicenter-randomized-trial-comparing-the-use-of-touch-versus-no-touch-guidewire-technique-for-deep-biliary-cannulation-the-tnt-study
#1
Marco Bassi, Carmelo Luigiano, Stefania Ghersi, Carlo Fabbri, Giulia Gibiino, Lucio Balzani, Giuseppe Iabichino, Alberto Tringali, Raffaele Manta, Massimiliano Mutignani, Vincenzo Cennamo
BACKGROUND AND AIMS: There are 2 techniques described for selective bile duct guidewire cannulation, the touch (T) technique (engaging the papilla with a sphincterotome and then advancing the guidewire) and the no-touch (NT) technique (engaging the papilla only with the guidewire). The aim of this prospective, multicenter randomized study was to compare the outcomes of the 2 guidewire cannulation techniques. METHODS: 300 consecutive patients with naive papillae were enrolled in 2 groups (150 to T group and 150 to NT group)...
May 17, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28522915/ninety-day-readmissions-after-inpatient-cholecystectomy-a-5-year-analysis
#2
Alba Manuel-Vázquez, Raquel Latorre-Fragua, Carmen Ramiro-Pérez, Aylhin López-Marcano, Farah Al-Shwely, Roberto De la Plaza-Llamas, José Manuel Ramia
AIM: To determine the incidence of readmission after cholecystectomy using 90 d as a time limit. METHODS: We retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomy-related complications...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28520575/predictors-of-bile-tree-pathology-in-patients-presenting-with-gallbladder-disease
#3
Mahmoud A Rahal, Mohammad O Rammal, Walid Karaoui, Ali Hallal, Hani Tamim, Yasser Shaib
BACKGROUND: Patients with gallstone disease can present with elevated liver function tests (LFTs). It is often challenging to differentiate those with a common bile duct (CBD) stone from those without a CBD stone on the basis of the LFTs levels. In this study, we aim to evaluate the predictors of a CBD stones among patients presenting with symptomatic gallbladder disease and elevated LFTs. PATIENTS AND METHODS: We retrospectively examined all patients who had undergone a cholecystectomy between January 2010 and December 2015...
May 17, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28516570/proposal-of-size-based-surgical-indication-criteria-for-liver-hemangioma-based-on-a-nationwide-survey-in-japan
#4
Yoshihiro Sakamoto, Norihiro Kokudo, Takeyuki Watadani, Junji Shibahara, Masakazu Yamamoto, Hiroki Yamaue
BACKGROUND: Surgical indications for liver hemangioma remain unclear. METHODS: Of 510 patients undergoing surgical resection for liver hemangioma in 118 Japanese centers between 1998 and 2012, abdominal symptoms, diagnostic accuracy, and surgical outcomes were analyzed to propose size-based surgical indications. Patients were classified into four groups based on tumor size: Group A) ≤5 cm (n = 122, 24%), B) 5-10 cm (n = 164, 32%), C) 10-15 cm (n = 124, 24%), and D) >15 cm (n = 100, 20%)...
May 17, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#5
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28512648/revision-of-biliary-sphincterotomy-by-re-cut-balloon-dilation-or-temporary-stenting-comparison-of-clinical-outcome-and-complication-rate-with-video
#6
Gianfranco Donatelli, Jean-Loup Dumont, Fabrizio Cereatti, Thierry Tuszynski, Bertrand Marie Vergeau, Bruno Meduri
Background and study aims Revision of endoscopic retrograde cholangiopancreatography (ERCP) may be necessary following previous biliary endoscopic sphincterotomy for recurrent biliary symptoms related to biliary stone recurrence, cholangitis or post-biliary endoscopic sphincterotomy (bEST) papillary stenosis and cholestasis. The aim of this retrospective study was to evaluate the clinical outcome and complication rate associated with re-cut, balloon dilation and biliary metal stenting in revision ERCP. Patients and methods From January 2010 to January 2015, 139 subjects with stigma of a previous sphincterotomy required a revision ERCP (64 Men/75 Women; mean age 71 years; range 32 - 101 years)...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28511162/improvement-of-the-complex-medical-treatment-for-the-patients-w%C3%B1-th-chronic-biliary-pancreatitis
#7
L S Babinets, K Yu Kytsai, Yu Ya Kotsaba, I M Halabitska, N A Melnyk, I V Semenova, O S Zemlyak
INTRODUCTION: The most common reason of chronic pancreatitis is liver and bile ducts disease: functional disorders, chronic cholecystitis, cholelithiasis and cholecystectomy in medical history. All these changes are associated with the colloidal structure of bile, increased lithogenicity, gallstones formation, Oddi's sphincter dysfunction, dysmotility and inflammation in the bile ducts. THE AIM: to study the effectiveness of using medicine Liveria IC (metadoxine) in standard therapy as well as effect on spectrum of blood serum lipids and structural condition of liver (stiffness) and pancreas in patients with chronic biliary pancreatitis combined with obesity...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28509786/igg4-related-disease-of-the-biliary-tract-and-pancreas-clinical-and-experimental-advances
#8
Lowiek M Hubers, Ulrich Beuers
PURPOSE OF REVIEW: IgG4-related disease (IgG4-RD) is an immune-mediated disease of unknown cause. It predominantly affects the biliary tract [IgG4-associated cholangitis (IAC)] and pancreas [autoimmune pancreatitis (AIP)] of mostly elderly men. Accurate diagnostic tests are lacking. Patients benefit from predniso(lo)ne treatment. However, disease relapse is often seen. This review will address pathophysiological aspects and advances in diagnostic and therapeutic strategies. RECENT FINDINGS: The role of IgG1 and IgG4 in the pathophysiology of IgG4-RD was studied in mice which showed more intense organ damage of pancreas and salivary glands when IgG1 rather than IgG4 of patients with IgG4-RD was injected...
May 13, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28507752/effective-treatment-of-benign-biliary-strictures-with-a-removable-fully-covered-self-expandable-metal-stent-a-prospective-multicenter-european-study
#9
Arthur Schmidt, Tilman Pickartz, Markus M Lerch, Fabrizio Fanelli, Fausto Fiocca, Pierleone Lucatelli, Fabrizio Cereatti, Albrecht Hoffmeister, Werner van Steenbergen, Matthias Kraft, Benjamin Meier, Karel Caca
BACKGROUND: Temporary placement of removable, fully covered, self-expandable metal stents (fcSEMS) for treatment of benign biliary strictures (BBS) has been reported to be effective. However, the optimal extraction time point remains unclear and stent migration has been a major concern. OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of this treatment modality using an fcSEMS with a special antimigration design and prolonged stent indwell time...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28502372/early-onset-acute-recurrent-and-chronic-pancreatitis-is-associated-with-prss1-or-ctrc-gene-mutations
#10
Matthew J Giefer, Mark E Lowe, Steven L Werlin, Bridget Zimmerman, Michael Wilschanski, David Troendle, Sarah Jane Schwarzenberg, John F Pohl, Joseph Palermo, Chee Y Ooi, Veronique D Morinville, Tom K Lin, Sohail Z Husain, Ryan Himes, Melvin B Heyman, Tanja Gonska, Cheryl E Gariepy, Steven D Freedman, Douglas S Fishman, Melena D Bellin, Bradley Barth, Maisam Abu-El-Haija, Aliye Uc
OBJECTIVES: To assess whether the age of onset was associated with unique features or disease course in pediatric acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP). STUDY DESIGN: Demographic and clinical information on children with ARP or CP was collected at INSPPIRE (INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE) centers. The Cochran-Armitage trend test and Jonckheere-Terpstra test were used to examine for differences between pediatric age groups (<6, 6-11, and ≥12 years)...
May 9, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28488091/outcomes-of-endoscopic-retrograde-cholangiopancreatography-ercp-and-sphincterotomy-for-suspected-sphincter-of-oddi-dysfunction-sod-post-roux-en-y-gastric-bypass
#11
Chin Hong Lim, Cyrus Jahansouz, Martin L Freeman, Daniel B Leslie, Sayeed Ikramuddin, Stuart K Amateau
BACKGROUND: Sphincter of Oddi dysfunction (SOD) is thought to be a cause of chronic abdominal pain post Roux-en-Y gastric bypass, and current practice of performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy is not supported by evidence. In addition to the complexity and risks of the procedure in patients with Roux-en-Y anatomy, the outcomes are uncertain and debatable. We performed a retrospective review and analysis of post-gastric bypass patients who had undergone ERCP with sphincterotomy to determine the effectiveness in patients with suspected SOD...
May 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28487727/number-of-endoscopic-retrograde-cholangiopancreatography-procedures-required-for-short-biliary-cannulation-time
#12
Koichiro Mandai, Koji Uno, Yasutoshi Fujii, Takuji Kawamura, Kenjiro Yasuda
Background. Several previous studies assessed the competence in endoscopic retrograde cholangiopancreatography (ERCP) using the bile duct cannulation success rate. However, the cannulation time is also important, because a long cannulation time was reported to be a risk factor for post-ERCP pancreatitis. Aim. To determine the number of ERCP procedures required for short cannulation time of the bile duct. Methods. We retrospectively analyzed 605 ERCP procedures performed for bile duct cannulation in patients with native papilla at our institution between March 2012 and December 2015...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28485270/a-review-of-the-scaffold-protein-menin-and-its-role-in-hepatobiliary-pathology
#13
Laurent Ehrlich, Chad Hall, Fanyin Meng, Terry Lairmore, Gianfranco Alpini, Shannon Glaser
Multiple endocrine neoplasia type I (MEN1) is a familial cancer syndrome with neuroendocrine tumorigenesis of the parathyroid glands, pituitary gland, and pancreatic islet cells. The MEN1 gene codes for the canonical tumor suppressor protein, menin. Its protein structure has recently been crystallized, and it has been investigated in a multitude of other tissues. In this review, we summarize recent advancements in understanding the structure of the menin protein and its function as a scaffold protein in histone modification and epigenetic gene regulation...
April 28, 2017: Gene Expression
https://www.readbyqxmd.com/read/28480730/choledochocele-as-an-atypical-cause-of-relapsing-acute-pancreatitis-diagnosis-and-endoscopic-treatment
#14
Cristina Saldaña Dueñas, Juan José Vila Costa, Ignacio Fernández-Urién
The choledochocele is a cystic dilatation of the intraduodenal portion of the bile duct and corresponds to the type III biliary cysts in the Todani ´s classification. Eventhough the majority of patients remain asymptomatic they can be an atypical cause of abdominal pain or relapsing acute pancreatitis events. The risk of malignancy is lower than other choledochal cyst (<2,5%). The treatment is based on surgical or new endoscopic techniques of resection. In some of the cases an endoscopic sphincterotomy is the first approach...
May 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28479376/extracellular-vesicles-in-bile-as-markers-of-malignant-biliary-stenoses
#15
Valeria Severino, Jean-Marc Dumonceau, Myriam Delhaye, Solange Moll, Isabelle Annessi-Ramseyer, Xavier Robin, Jean-Louis Frossard, Annarita Farina
BACKGROUND & AIMS: Algorithms for diagnosis of malignant common bile duct (CBD) stenoses are complex and lack accuracy. Malignant tumors secrete large numbers of extracellular vesicles (EVs) into surrounding fluids; EVs might therefore serve as biomarkers for diagnosis. We investigated whether concentrations of EVs in bile could discriminate malignant from nonmalignant CBD stenoses. METHODS: We collected bile and blood samples from 50 patients undergoing therapeutic endoscopic retrograde cholangiopancreatography at university hospitals in Europe for CBD stenosis of malignant (pancreatic cancer, n=20 or cholangiocarcinoma, n=5) or nonmalignant (chronic pancreatitis [CP], n=15) origin...
May 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28476903/endoscopic-nasobiliary-drainage-an-effective-treatment-option-for-benign-recurrent-intrahepatic-cholestasis-bric
#16
Ashok Choudhury, Anand V Kulkarni, Bishnupriya Sahoo, Chhagan Bihari
Benign recurrent intrahepatic cholestasis (BRIC) is characterised by recurrent episodes of jaundice, severe pruritus and low or normal serum γ-glutamyltransferase activity lasting from several weeks to months. BRIC is an autosomal recessive disorder caused by the mutation in either of the two hepatic transporter genes-ATP8B1 or ABCB11 gene. The disease is very well known for episodic flare of jaundice with cholestatic symptoms that are spontaneous or perpetuated by acute insults, followed by self-recovery...
May 5, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28475277/a-stepwise-procedure-for-removal-of-an-embedded-self-expandable-metallic-stent-by-dual-knife
#17
Ya-Wei Bi, Zhao-Shen Li, Liang-Hao Hu
Benign biliary stricture (BBS) occurs in 7.3%-30.0% patients with chronic pancreatitis(1, 2) . In the management of BBS, fully covered self-expandable metallic stent (FCSEMS) is currently well used(3-5) . However, proximal migration of FCSEMS occurs in 10.0% recipients and is much more difficult to manage(5) . A 44-year-old man was admitted with abdominal pain and recurred obstructive jaundice a month after removal of last biliary plastic stents. This article is protected by copyright. All rights reserved.
May 5, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28475221/influence-of-cholangitis-after-preoperative-endoscopic-biliary-drainage-on-postoperative-pancreatic-fistula-in-patients-with-middle-and-lower-malignant-biliary-strictures
#18
Toru Kaneko, Hiroshi Imaizumi, Mitsuhiro Kida, Eiji Miyata, Hiroshi Yamauchi, Kosuke Okuwaki, Tomohisa Iwai, Wasaburo Koizumi
BACKGROUND: Preoperative cholangitis after preoperative drainage has been reported to increase postoperative complications, particularly pancreatic fistula. We therefore examined the effects of cholangitis after preoperative endoscopic biliary drainage (EBD) on postoperative pancreatic fistula in patients with middle and lower malignant biliary strictures. METHODS: The study group comprised 102 patients who underwent EBD among patients who underwent surgery. RESULTS: Of the 102 patients, 33 (32%) had postoperative pancreatic fistulas, and 56 (55%) had preoperative cholangitis after preoperative drainage...
May 5, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28474701/-cholelithiasis-during-pregnancy-and-postpartum-prevalence-presentation-and-consequences-in-a-referral-hospital-in-baja-california-sur
#19
Andrea Socorro Álvarez-Villaseñor, Héctor Luis Mascareño-Franco, José Juan Agundez-Meza, Francisco Cardoza-Macías, Clotilde Fuentes-Orozco, Jorge Rendón-Félix, Mariana Chávez-Tostado, Leire Irusteta-Jiménez, Jesús García-Rentería, Alejandro González-Ojedaz
INTRODUCTION: Pregnancy and the postpartum period are risk factors for developing biliary sludge, gallstones, and any of their complications. OBJECTIVE: To determine the prevalence, presentation, and consequences of cholestasis during pregnancy and postpartum in a referral hospital of Baja California Sur. MATERIAL AND METHODS: This was a retrospective, observational study that enrolled pregnant or postpartum patients diagnosed with gallstones with any presentation...
March 2017: Gaceta Médica de México
https://www.readbyqxmd.com/read/28469406/review-of-current-applications-of-immunohistochemistry-in-pediatric-nonneoplastic-gastrointestinal-hepatobiliary-and-pancreatic-lesions
#20
REVIEW
Joseph de Nanassy, Dina El Demellawy
Immunohistochemical (IHC) stains are widely used by pathologists for a variety of considerations in the diagnostic workup of pediatric nonneoplastic lesions in gastrointestinal (GI), hepatic, biliary, and pancreatic lesions. The pathologic changes cover a wide range and types of presentations, including inflammatory (bacterial and viral), metaplastic, posttransplant lymphoproliferative, autoimmune, metabolic, degenerative, developmental, and genetic conditions, among others. The everyday practical value of IHC stains covers primary identification, confirmation, differential, and/or exclusionary roles in the hands and eyes and minds of the practitioners...
2017: Analytical Chemistry Insights
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