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Endoscopic stenting biliary tract

Ramkaji Baniya, Sunil Upadhaya, Seetharamprasad Madala, Subash Chandra Subedi, Tabrez Shaik Mohammed, Ghassan Bachuwa
The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%-7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD...
2017: Clinical and Experimental Gastroenterology
Aysen Terzi, Mahir Kirnap, Cigdem Sercan, Gokce Ozdemir, Binnaz Handan Ozdemir, Mehmet Haberal
Traumatic neuromas of the biliary tract have occasionally been reported to cause strictures at the cystic duct stump as a late complication of cholecystectomy with common bile duct exploration. The incidence of symptomatic traumatic biliary neuroma appears to be low after orthotopic liver transplant, as only 25 patients have been described previously in the English-language literature. Traumatic (amputation) neuroma is a reactive proliferation of pericholangial nerve fibers induced by injury, but it is not a true neoplasm...
February 2017: Experimental and Clinical Transplantation
Takeshi Ogura, Saori Onda, Tastsushi Sano, Wataru Takagi, Astushi Okuda, Akira Miyano, Nobu Nishioka, Miyuki Imanishi, Mio Amano, Daisuke Masuda, Kazuhide Higuchi
OBJECTIVES: The clinical impact of catheter based radiofrequency ablation (RFA) under ERCP guidance has been recently reported, however severe adverse events have also been noted. If tumor is not present in the biliary tract, severe adverse events such as perforation or bleeding due to vessel injury around the biliary tract may occur. In addition, the effectiveness of RFA may not be sufficient based solely on radiographic guidance. The aim of this study was to evaluate the actual feasibility of intraductal RFA by peroral cholangioscope (POCS) evaluation before/after RFA...
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
George A Rapp, Kari J Nelson, David K Imagawa, Jason Y Huang, John G Lee
Biliary leaks are uncommon but morbid complications of pancreaticoduodenectomies, which have historically been managed with percutaneous drainage, reoperation, or a combination of both. We report a de novo percutaneous-endoscopic hepaticojejunostomy from an anomalous right hepatic duct injured during pancreaticoduodenectomy to the afferent bowel limb. The percutaneous-endoscopic hepaticojejunostomy was stented to allow for tract formation with successful stent removal after 5.5 months. One year after the creation of the percutaneous-endoscopic hepaticojejunostomy, the patient remains clinically well without evidence of biliary leak or obstruction...
2017: ACG Case Reports Journal
J Ma, S C Lü, J T Kou, X L Li, J Q Zhu, H M Dong, Q He
Objective: To analysis of the possible cause and surgical diagnosis and treatment strategies of acute gangrenous cholecystitis (AGC) after biliary stent drainage. Methods: The clinical data of 273 patients who received biliary stent drainage in Beijing Chaoyang Hospital from January 2015 to March 2016 were analyzed retrospectively. Among them, 22 patients who underwent surgical treatment were divided into two groups: 9 cases of AGC group and 13 cases of non-AGC group. The risk factors of AGC and surgical approach were analyzed...
December 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Chih-Wei Tseng, Yu-Tso Chen, Cheng-Li Lin, Ji-An Liang
BACKGROUND: The relationship between chronic pancreatitis (CP) and subsequent pyogenic liver abscess (PLA) is not well understood. METHODS: We investigated the risk of PLA in patients with CP using inpatient claims data from the Taiwan National Health Insurance Program for the period 2000-2010. We identified 17,810 patients with chronic pancreatitis (CP group) and 71,240 patients without CP (non-CP group). Both cohorts were followed until a diagnosis of PLA, until they were censored from the study because of loss to follow-up, death, or termination of insurance, or until the study cut-off date of 31 December 2011...
January 4, 2017: Current Medical Research and Opinion
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 (BDIs) 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. BDIs 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. Endoscopic treatment is the main option for biliary leak...
December 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...
January 19, 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
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