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Endoscopic stenting biliary tract

Atsushi Takano, Hiroshi Nakagomi, Kou Ikegame, Atsushi Yamamoto, Hideki Watanabe, Haruka Nakada, Masayuki Inoue, Hidemitsu Sugai, Michiya Yasutome, Kazushige Furuya, Masao Hada, Yoshiaki Miyasaka, Toshio Oyama, Masao Omata
INTRODUCTION: The over-expression of P53 protein in gallbladder carcinoma is a biomarker correlating with a poor survival. However, the significance of P53 expression in peritumor tissues is unknown. We experienced a case of gallbladder carcinoma where the operative specimen showed over-expression of P53 on the peritumor epithelium, and early recurrence developed at the biliary tract. PRESENTATION OF CASE: A 74-year-old female patient was referred to our hospital due to wall thickening of the gallbladder on ultrasonography...
October 18, 2016: International Journal of Surgery Case Reports
Takashi Obana, Shuuji Yamasaki
Here, we present a case of malignant biliary tract obstruction with severe obesity, which was successfully treated by endoscopic ultrasonography-guided biliary drainage (EUS-BD). A female patient in her sixties who had been undergoing chemotherapy for unresectable pancreatic head cancer was admitted to our institution for obstructive jaundice. She had diabetes mellitus, and her body mass index was 35.1 kg/m(2). Initially, endoscopic retrograde cholangiopancreatography (ERCP) was performed, but bile duct cannulation was unsuccessful...
2016: Case Reports in Medicine
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
Guido Costamagna
New technological developments in endoscopic retrograde cholangiopancreatography and endoscopic ultrasound, both for diagnosis and treatment of biliary and pancreatic diseases, have opened up new scenarios in the recent years. For instance, removal of large bile duct stones with endoscopic sphincterotomy followed by large balloon dilation has been proven to be a safe and effective technique. Also cholangioscopy evolved in terms of better imaging, tissue acquisition and stones management. Self-expandable metal stents are used mostly for malignant diseases, but their role in benign diseases has also been deeply investigated in the last years...
June 2016: Recenti Progressi in Medicina
Chuanguo Zhou, Baojie Wei, Kun Gao, Renyou Zhai
Endobiliary radiofrequency ablation (RFA) has recently been recognized as a beneficial treatment option for malignant biliary obstruction using percutaneous or endoscopic approaches. The feasibility and safety of this method has been demonstrated in clinical studies, with pain, cholangitis and asymptomatic biochemical pancreatitis reported as relatively common complications. By contrast, hepatic coma, newly diagnosed left bundle branch block and partial liver infarction have been reported as uncommon complications...
June 2016: Oncology Letters
Hyeong Seok Nam, Dae Hwan Kang
Many advances have been achieved in biliary stenting over the past 30 years. Endoscopic stent placement has become the primary management therapy to relieve obstruction in patients with benign or malignant biliary tract diseases. Compared with plastic stents, a self-expandable metallic stent (SEMS) has been used for management in patients with malignant strictures because of a larger lumen and longer stent patency. Recently, SEMS has been used for various benign biliary strictures and leaks. In this article, we briefly review the characteristics of SEMS as well as complications of stent placement...
March 2016: Clinical Endoscopy
M Crespi, G Montecamozzo, D Foschi
Biliary fistulas are rare complications of gallstone. They can affect either the biliary or the gastrointestinal tract and are usually classified as primary or secondary. The primary fistulas are related to the biliary lithiasis, while the secondary ones are related to surgical complications. Laparoscopic surgery is a therapeutic option for the treatment of primary biliary fistulas. However, it could be the first responsible for the development of secondary biliary fistulas. An accurate preoperative diagnosis together with an experienced surgeon on the hepatobiliary surgery is necessary to deal with biliary fistulas...
2016: Gastroenterology Research and Practice
Nan Ge, Siyu Sun, Shiwei Sun, Sheng Wang, Xiang Liu, Guoxin Wang
BACKGROUND: Laparoscopic cholecystectomy (LC) has become the 'gold standard' for the treatment of symptomatic gallstones. Innovative methods are being introduced, and these procedures include transgastric or transcolonic endoscopic cholecystectomy. However, before clinical implementation, instruments still need modification, and a more convenient treatment is still needed. Moreover, some gallbladders still have good functionality and cholecystectomy may be associated with various complications...
2016: BMC Gastroenterology
Tae Hoon Lee, Jun-Ho Choi, Do Hyun Park, Tae Jun Song, Dong Uk Kim, Woo Hyun Paik, Young Hwangbo, Sang Soo Lee, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim
BACKGROUND & AIMS: Although percutaneous transhepatic biliary drainage (PTBD) is the standard method for draining a malignant biliary obstruction after failed endoscopic retrograde cholangiopancreatographies (ERCPs), use of endoscopic ultrasound-guided transmural biliary drainage (EUS-BD) is increasing. We performed a multicenter, open-label, randomized trial to compare EUS-BD vs PTBD for malignant distal biliary obstruction after a failed ERCP. METHODS: Patients with unresectable malignant distal biliary obstructions and failed primary ERCP, caused by inaccessible papilla, were assigned to groups that underwent EUS-BD with an all-in-one device for direct deployment of a partially covered metal stent (without further fistula tract dilation, n = 34) or PTBD (n = 32)...
July 2016: Clinical Gastroenterology and Hepatology
Hugo Gonçalo Guedes, Roberto Iglesias Lopes, Joel Fernandez de Oliveira, Everson Luiz de Almeida Artifon
Endoscopic ultrasound (EUS) is used for diagnosis and evaluation of many diseases of the gastrointestinal (GI) tract. In the past, it was used to guide a cholangiography, but nowadays it emerges as a powerful therapeutic tool in biliary drainage. The aims of this review are: outline the rationale for endoscopic ultrasound-guided biliary drainage (EGBD); detail the procedural technique; evaluate the clinical outcomes and limitations of the method; and provide recommendations for the practicing clinician. In cases of failed endoscopic retrograde cholangiopancreatography (ERCP), patients are usually referred for either percutaneous transhepatic biliary drainage (PTBD) or surgical bypass...
October 25, 2015: World Journal of Gastrointestinal Endoscopy
Jürgen Feisthammel, Joachim Mössner, Albrecht Hoffmeister
In most of the cases, pancreatic cancer and malignancies of the bile tract can only be treated palliatively. Endoscopy offers several methods for effective control of the symptoms in those situations. In pancreatic cancer, stenting of bile ducts enables a control of jaundice most of the time. Stenting of an obstructed duodenum can relieve symptoms of gastric outlet obstruction without the need for major surgery. In biliary tract cancer, stenting of the bile ducts can provide effective drainage of the biliary system...
August 2014: Viszeralmedizin
Özkan Yilmaz, Remzi Kiziltan, Oktay Aydin, Vedat Bayrak, Çetin Kotan
Endoscopic biliary stents have been recently applied with increasing frequency as a palliative and curable method in several benign and malignant diseases. As a reminder, although most of the migrated stents pass through the intestinal tract without symptoms, a small portion can lead to complications. Herein, we present a case of intestinal perforation caused by a biliary stent in the hernia of a patient with a rarely encountered incarcerated incisional hernia.
2015: Case Reports in Surgery
Siddharth Yadav, Animesh Singh, Prabhjot Singh
Percutaneous nephrolithotomy (PCNL) is a standard procedure for large renal calculi but has potential for complications. Rarely, biliary tract injury can occur during PCNL that can lead to biliary peritonitis with sepsis. Such cases are usually managed by emergent cholecystectomy. We present a case of biliary peritonitis resulting from gall bladder injury during PCNL, managed minimally invasively with an abdominal drain and endoscopic retrograde cholangiography with common bile duct stenting.
July 2015: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Masakuni Fujii, Shuhei Ishiyama, Hiroaki Saito, Mamoru Ito, Akiko Fujiwara, Takefumi Niguma, Masao Yoshioka, Junji Shiode
Progress in double-balloon endoscopy (DBE) has allowed for the diagnosis and treatment of disease in the postoperative bowel. For example, a short DBE, which has a 2.8 mm working channel and 152 cm working length, is useful for endoscopic retrograde cholangiopancreatography in bowel disease patients. However, afferent loop and Roux-limb obstruction, though rare, is caused by postoperative recurrence of biliary tract cancer with intractable complications. Most of the clinical findings involving these complications are relatively nonspecific and include abdominal pain, nausea, vomiting, fever, and obstructive jaundice...
June 10, 2015: World Journal of Gastrointestinal Endoscopy
Vishal Sharma, Surinder S Rana, Deepak K Bhasin
Endoscopic ultrasound (EUS) has emerged as an important diagnostic and therapeutic modality in the field of gastrointestinal endoscopy. EUS provides access to many organs and lesions which are in proximity to the gastrointestinal tract and thus giving an opportunity to target them for therapeutic and diagnostic purposes. This modality also provides a real time opportunity to target the required area while avoiding adjacent vascular and other structures. Therapeutic EUS has found role in management of pancreatic fluid collections, biliary and pancreatic duct drainage in cases of failed endoscopic retrograde cholangiopancreatography, drainage of gallbladder, celiac plexus neurolysis/blockage, drainage of mediastinal and intra-abdominal abscesses and collections and in targeted cancer chemotherapy and radiotherapy...
June 10, 2015: World Journal of Gastrointestinal Endoscopy
Carlos Macías-Gómez, Jean-Marc Dumonceau
Biliary tract diseases are the most common complications following liver transplantation (LT) and usually include biliary leaks, strictures, and stone disease. Compared to deceased donor liver transplantation in adults, living donor liver transplantation is plagued by a higher rate of biliary complications. These may be promoted by multiple risk factors related to recipient, graft, operative factors and post-operative course. Magnetic resonance cholangiopancreatography is the first-choice examination when a biliary complication is suspected following LT, in order to diagnose and to plan the optimal therapy; its limitations include a low sensitivity for the detection of biliary sludge...
June 10, 2015: World Journal of Gastrointestinal Endoscopy
Abuzer Dirican, Cengiz Ara, Koray Kutluturk, Mustafa Ozsoy, Mustafa Ates, Adil Baskiran, Burak Isik, Sezai Yilmaz
OBJECTIVES: Although the main factors responsible for donor deaths after living-donor liver transplant are liver failure and sepsis, the most common donor complications are associated with the biliary tract. MATERIALS AND METHODS: Between April 2006 and May 2012, five hundred ninety-three donors underwent living-donor hepatectomy procedures for living-donor liver transplants. The mean age of donors was 31.0 ± 9.9 years and the ratio of men to women was 341:252...
December 2015: Experimental and Clinical Transplantation
Stefan Brückner, Alexander Arlt, Jochen Hampe
Endoscopic ultrasound-guided biliary drainage (EUS-BD) might be an alternative to percutaneous or transpapillary biliary drainage in unresectable pancreatic or biliary cancer. A lumen-apposing, fully covered, self-expanding metal stent, which creates a sealed transluminal conduit between the biliary and gastrointestinal tract may offer advantages over conventional plastic and metal stents. In this retrospective, observational, open-label case study, five patients underwent EUS-BD for obstructive jaundice in pancreatic cancer (n = 4) or distal cholangiocarcinoma (n = 1)...
September 2015: Endoscopy
Luca Barresi, Ilaria Tarantino, Dario Ligresti, Gabriele Curcio, Antonino Granata, Mario Traina
No abstract text is available yet for this article.
2015: Endoscopy
Rong Fan, Buyun Wu, Ling Kong, Dehua Gong
Coupled plasma filtration adsorption (CPFA) usually adopts membrane to separate plasma from blood. Here, we reported a case with erythrocytosis experienced severe hemolysis and membrane rupture during CPFA, which was avoided by changing from membrane-based technique to a centrifuge-based one. A 66-year-old man was to receive CPFA for severe hyperbilirubinemia (total bilirubin 922 μmol/L, direct bilirubin 638 μmol/L) caused by obstruction of biliary tract. He had erythrocytosis (hemoglobin 230 g/L, hematocrit 0...
July 2016: American Journal of Therapeutics
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