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https://www.readbyqxmd.com/read/29751790/obliterative-cholangiopathy-in-acquired-cystic-biliary-atresia-type-iii-after-cyst-perforation-a-case-report
#1
Tsugumichi Koshinaga, Kensuke Ohashi, Kakou Ono, Hide Kaneda, Takeshi Furuya
BACKGROUND: In biliary atresia, the disease process of obliterative cholangiopathy may begin in the perinatal period; however, no chronological evidence exists on how the cholangiopathy progresses to biliary obliteration. This is the first acquired case with the final diagnosis of type III cystic biliary atresia with an extrahepatic biliary cyst which showed the progression of obliterative cholangiopathy in chronological order after birth. CASE PRESENTATION: An 81-day-old girl presented with acute abdominal distress due to bilious peritonitis caused by biliary cyst perforation, for which she underwent emergency biliary drainage...
May 11, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29727803/synchronous-double-primary-cancers-of-the-extrahepatic-bile-duct-a-case-report-and-literature-review
#2
Takeshi Nishi, Yoshitoshi Sato, Takuya Hanaoka, Takuya Takahashi, Hiroshi Miura, Kenji Takubo
BACKGROUND: Double cancers of the biliary tract system are rare. Most of these cancers are synchronous double cancers of the gall bladder and bile duct, associated with pancreaticobiliary maljunction (PBM). Synchronous double cancers of the extrahepatic bile duct without PBM are especially rare, and only 4 cases have been reported. CASE PRESENTATION: A 78-year-old woman was admitted to our hospital for examination of hyperbilirubinemia and liver dysfunction. Contrast-enhanced abdominal computed tomography, Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography revealed 2 stenotic regions in the common bile duct: at its junction with the cystic duct and in the distal bile duct...
April 27, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29713676/novel-temperature-controlled-rfa-probe-for-treatment-of-blocked-metal-biliary-stents-in-patients-with-pancreaticobiliary-cancers-initial-experience
#3
Manu K Nayar, Kofi W Oppong, Noor L H Bekkali, John S Leeds
Background and study aims:  Radiofrequency ablation (RFA) is used to treat blocked biliary stents in patients with pancreaticobiliary (PB) tumors with varying results. We report our experience with a novel temperature-controlled probe for treatment of blocked metal stents. Patients and methods:  Patients with histologically proven PB cancers and a blocked biliary stents were treated using ELRATM electrode (Taewoong Medical) under fluoroscopic guidance. Demographics, clinical outcome, stricture diameter improvements, complications and mortality at 30 days were prospectively recorded...
May 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29687343/trans-gastric-ercp-after-roux-en-y-gastric-bypass-systematic-review-and-meta-analysis
#4
Alberto Aiolfi, Emanuele Asti, Emanuele Rausa, Daniele Bernardi, Gianluca Bonitta, Luigi Bonavina
BACKGROUND: Trans-oral endoscopic access to the pancreaticobiliary system is challenging after Roux-en-Y gastric bypass (RYGB). Trans-gastric ERCP (TG-ERCP) has emerged as a viable option to manage patients with symptomatic post-RYBG choledocolithiasis. The aim of this systematic review and meta-analysis was to examine the outcomes of TG-ERCP to better define the risk-benefit ratio of this procedure and to guide clinical decision-making. METHODS: A literature search was conducted to identify all reports on ERCP after RYGB...
April 23, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29668560/eus-directed-transgastric-ercp-edge-versus-laparoscopy-assisted-ercp-la-ercp-for-roux-en-y-gastric-bypass-rygb-anatomy-a-multicenter-early-comparative-experience-of-clinical-outcomes
#5
Prashant Kedia, Paul R Tarnasky, Jose Nieto, Stephen L Steele, Ali Siddiqui, Ming-Ming Xu, Amy Tyberg, Monica Gaidhane, Michel Kahaleh
BACKGROUND AND AIMS: The standard of care for managing pancreaticobiliary disease in altered Roux-en-Y gastric bypass patients is laparoscopy-assisted endoscopic retrograde cholangiopancreatography (LA-ERCP), but is limited by cost and adverse events. Recently a minimally invasive, completely endoscopic approach using endoscopic ultrasound (EUS) directed transgastric ERCP (EDGE) has been described. We aim to compare EDGE to LA-ERCP in this study. METHODS: Patients from May 2005 to June 2017 with Roux-en-Y gastric bypass anatomy having undergone LA-ERCP or EDGE at 4 tertiary centers were captured in a registry...
April 17, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29656611/modified-breath-hold-compressed-sensing-3d-mr-cholangiopancreatography-with-a-small-field-of-view-and-high-resolution-acquisition-clinical-feasibility-in-biliary-and-pancreatic-disorders
#6
Liang Zhu, Huadan Xue, Zhaoyong Sun, Tianyi Qian, Elisabeth Weiland, Bernd Kuehn, Patrick Asbach, Bernd Hamm, Zhengyu Jin
BACKGROUND: Compressed-sensing (CS) accelerated 3D MR cholangiopancreatography (MRCP) could be acquired in both navigator-triggered (NT) and breath-hold (BH) mode, but the latter has been considered inferior in depicting pancreatic duct and diagnosing pancreatic duct-related diseases. PURPOSE: To prospectively evaluate the clinical feasibility of a modified 3D BH-CS-MRCP prototype protocol with small field-of-view (FOV) and higher spatial resolution, and to compare its performance to the original BH-CS-MRCP and NT-CS-MRCP...
April 14, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29629807/clinical-feasibility-of-mr-elastography-in-patients-with-biliary-obstruction
#7
Dong Kyu Kim, Jin Young Choi, Mi-Suk Park, Myeong-Jin Kim, Yong Eun Chung
OBJECTIVE: The purpose of this study is to evaluate the clinical effect of liver stiffness measured using MR elastography (MRE) in patients with cholestasis due to biliary obstruction. MATERIALS AND METHODS: In this retrospective study, 69 consecutive patients with no history of diffuse liver disease who underwent pancreaticobiliary imaging with MRE were included. Quantitative MRI parameters (i.e., liver stiffness, apparent diffusion coefficient, R2*, and proton density fat fraction) and laboratory results (i...
April 9, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29623665/laparoscopic-gastric-bypass-with-fundectomy-and-gastric-remnant-exploration-lrygbfse-results-at-5-year-follow-up
#8
Giovanni Lesti, Alberto Aiolfi, Enrico Mozzi, Fabrizio Altorio, Ezio Lattuada, Francesco Lesti, Gianluca Bonitta, Marco Antonio Zappa
BACKGROUND: The laparoscopic Roux-en-Y gastric bypass (LRYGB) is the gold standard treatment for morbid obesity. After LRYGB, the endoscopic access to the gastric remnant and pancreaticobiliary system is challenging. The laparoscopic gastric bypass with fundectomy and exploration of the gastric remnant (LRYGBfse) was introduced in an attempt to overcome this limitation. The purpose of this study was to analyze the medium-term outcomes and safety of LRYGBfse. METHODS: Observational prospective single-arm multicenter cohort study...
April 5, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29622700/hybrid-capture-based-tumor-sequencing-and-copy-number-analysis-to-confirm-origin-of-metachronous-metastases-in-brca1-mutant-cholangiocarcinoma-harboring-a-novel-ywhaz-braf-fusion
#9
Huat C Lim, Meagan Montesion, Thomas Botton, Eric A Collisson, Sarah E Umetsu, Spencer C Behr, John D Gordan, Phil J Stephens, Robin K Kelley
Biliary tract cancers such as cholangiocarcinoma represent a heterogeneous group of cancers that can be difficult to diagnose. Recent comprehensive genomic analyses in large cholangiocarcinoma cohorts have defined important molecular subgroups within cholangiocarcinoma that may relate to anatomic location and etiology [1-4] and may predict responsiveness to targeted therapies in development [5-7]. These emerging data highlight the potential for tumor genomics to inform diagnosis and treatment options in this challenging tumor type...
April 5, 2018: Oncologist
https://www.readbyqxmd.com/read/29619402/rare-metastasis-of-primary-pancreatic-adenocarcinoma-to-the-bladder
#10
Anup Shah, Praneet Korrapati, Jerome Siegel, Franklin Kasmin
Pancreatic cancer commonly metastasizes to the liver, lungs, stomach, bone, and bowel, but rarely does it spread to the bladder. We describe a case of a 66-year-old woman with diabetes mellitus who presented with abnormal liver function laboratory tests, abdominal discomfort, unintentional weight loss, and no urinary symptoms. Abdominal CT revealed a pancreatic and bladder mass. Pathology of the bladder mass confirmed metastatic adenocarcinoma of pancreaticobiliary origin. To our knowledge, this is only the third case of metastatic pancreatic cancer spreading to the bladder since 1953...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29564165/a-kras-wild-type-mutational-status-confers-a-survival-advantage-in-pancreatic-ductal-adenocarcinoma
#11
Annika L Windon, Arturo Loaiza-Bonilla, Christopher E Jensen, Michael Randall, Jennifer J D Morrissette, Stuti G Shroff
Background: The KRAS oncogene is a driver mutation and is present in greater than 90% of pancreatic ductal adenocarcinomas (PDAC). A subset of these tumors, however, do not harbor mutations in KRAS (wild type KRAS ). Studies have shown that patients with mutated KRAS have a poorer survival on first-line gemcitabine-based chemotherapy compared to wild type KRAS . In this study, we examined a cohort of patients with PDAC at our institution who were either wild type or mutant for the KRAS gene and assessed for differences in survival and response to different chemotherapeutic regimens...
February 2018: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29552451/successful-ercp-for-management-of-traumatic-pancreatic-disruption-in-a-patient-with-situs-inversus
#12
Vishal Sharma, Sarthak Malik, Harshal S Mandavdhare, Harjeet Singh
Endoscopic retrograde cholangio-pancreatography (ERCP) is an important tool for treatment of pancreaticobiliary diseases. However, ERCP may be difficult in patients who have altered gastrointestinal anatomy due to congenital or surgical reasons. A 40-year-old male with HIV infection presented with abdominal pain following abdominal trauma. The patient was diagnosed to have traumatic pancreatic injury and underlying situs inversus. The pancreatic fluid collection was drained using radiology guided pigtail placement done for the symptoms of abdominal pain and vomiting...
February 2018: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/29550797/the-effect-of-estrogen-receptor-agonists-on-pancreaticobiliary-duct-ligation-induced-experimental-acute-pancreatitis
#13
Z Guleken, D Ozbeyli, M Acikel-Elmas, S Oktay, B Alev, S Sirvanci, A Velioglu Ogunc, O Kasimay Cakir
The 17β-estradiol plays a role in physiology of pancreas and may protect it from inflammation. To examine the possible anti-inflammatory effects of 17β-estadiol in pancreaticobiliary duct ligated (PBDL) acute pancreatitis (AP) model, and the underlying mechanism that 17β-estradiol acts on, via evaluating the direct and the receptor related effects by using 17β-estradiol, ER-α and -β agonists. In the study both sexes of rats (n = 88) were used. Animals were divided into two groups as PBDL and PBDL + ovariectomized...
December 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/29543078/comparison-of-diagnostic-efficacy-between-cle-tissue-sampling-and-cle-combined-with-tissue-sampling-for-undetermined-pancreaticobiliary-strictures-a-meta-analysis
#14
Ya-Dong Gao, Ya-Wei Qu, Hai-Feng Liu
OBJECTIVE: The accurate diagnosis of undetermined pancreaticobiliary strictures remains challenging. Current ERCP-guided tissue sampling methods are of low sensitivity. Confocal laser endomicroscopy (CLE) is a new procedure and allows real optical biopsies that may improve the diagnosis of undetermined pancreaticobiliary strictures. The aim of this meta-analysis was to determine the diagnostic yield of CLE, tissue sampling, and CLE combined with tissue sampling for undetermined pancreaticobiliary strictures...
April 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29526692/rituximab-maintenance-therapy-reduces-rate-of-relapse-of-pancreaticobiliary-immunoglobulin-g4-related-disease
#15
Shounak Majumder, Sonmoon Mohapatra, Ryan J Lennon, Guilherme Piovezani Ramos, Neil Postier, Ferga C Gleeson, Michael J Levy, Randall K Pearson, Bret T Petersen, Santhi Swaroop Vege, Suresh T Chari, Mark D Topazian, Thomas E Witzig
BACKGROUND & AIMS: IgG4-related disease (IgG4-RD), a multi-organ fibroinflammatory syndrome, typically responds to steroids. However, some cases are steroid resistant, and pancreaticobiliary IgG4-RD commonly relapses after steroid withdrawal. Rituximab induces remission of IgG4-RD, but the need for and safety of maintenance rituximab treatment are unknown. We compared outcomes of patients with pancreaticobiliary IgG4-RD treated with or without maintenance rituximab therapy. METHODS: We performed a retrospective study of patients with pancreaticobiliary IgG4-RD treated with rituximab at the Mayo Clinic in Rochester, Minnesota, from January 2005 through December 2015...
March 8, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29517713/digital-pancreaticocholangioscopy-for-mapping-of-pancreaticobiliary-neoplasia-can-we-alter-the-surgical-resection-margin
#16
Amy Tyberg, Isaac Raijman, Ali Siddiqui, Urban Arnelo, Douglas G Adler, Ming-Ming Xu, Najib Nassani, Divyesh V Sejpal, Prashant Kedia, Yun Nah Lee, Frank G Gress, Sammy Ho, Monica Gaidhane, Michel Kahaleh
INTRODUCTION: In patients with pancreaticobiliary lesions anticipating surgical resection, digital pancreaticocholangioscopy can be used to identify the extent of disease. This presurgical"mapping" could change the surgical plan and optimize patient care. MATERIALS AND METHODS: Patients with pancreaticobiliary lesions anticipating surgery who underwent endoscopic retrograde cholangiopancreatography with digital pancreaticocholangioscopy from 9 international centers were included...
March 6, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29504349/choledochal-cyst-and-biliary-stone
#17
Anjum Saeed, Asaad Assiri
Choledochal cyst is not an uncommonly seen entity in children. Presentation may be varied and at different age groups. Abnormal pancreaticobiliary junction is usually a phenomenon in acquired type of choledochal cyst. A four years old child presented with symptoms of acute viral hepatitis A but persistence of symptoms beyond the usual time necessitated other conditions to be considered. Choledochal cyst was the final diagnosis complicating with biliary stone which was managed by surgical excision.
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29484072/percutaneous-transgastric-interventional-radiology-operated-duodenoscopy-for-the-identification-of-duodenal-perforation-and-graham-patch-dehiscence
#18
Ravi Nara Srinivasa, Matthew L Osher, Douglas A Murrey, Jordan Bruce Fenlon, Charles Brewerton, Wael E Saad, Jeffrey Forris Beecham Chick
Patients with a Roux-en-Y gastric bypass may be challenging diagnostic and therapeutic dilemmas for gastroenterologists and endoscopists due to anatomic considerations. Pancreaticobiliary limb pathology is particularly difficult to diagnose from standard endoscopic approaches as it often requires double balloon enteroscopy. Percutaneous access and gastrostomy placement into the gastric remnant, however, is a commonly performed procedure by interventional radiology. This report describes the identification of duodenal perforation and Graham patch dehiscence in the pancreaticobiliary limb of a patient with a prior Roux-en-Y gastric bypass who had failed traditional endoscopic measures, using transgastric remnant interventional duodenoscopy and confirmed with methylene blue injection into a periduodenal abscess...
December 2017: Radiology Case Reports
https://www.readbyqxmd.com/read/29459178/the-challenge-of-treating-older-patients-with-pancreaticobiliary-malignancies
#19
REVIEW
Lynda R Corrigan, Dara M Bracken-Clarke, Anne M Horgan
Pancreatic and biliary tract cancers are aggressive malignancies. They commonly present with metastatic or unresectable disease. Those that do present with resectable cancer have high rates of recurrence. Despite recent advances in surgical technique, chemotherapy, and radiotherapy regimens, they are associated with poor survival outcomes. These cancers represent an exception to the trend of improved overall survival evident in most malignancies in recent decades. Depending on the goal of treatment, active management of pancreatic and biliary cancers involves surgery, chemotherapy, and radiation therapy, either alone or in combination...
January 2018: Current Problems in Cancer
https://www.readbyqxmd.com/read/29451166/molecular-analysis-of-pancreatic-cyst-fluid-changes-clinical-management
#20
David M Arner, Brooke E Corning, Ali M Ahmed, Henry C Ho, Bradley J Weinbaum, Uzma Siddiqui, Harry Aslanian, Reid B Adams, Todd W Bauer, Andrew Y Wang, Vanessa M Shami, Bryan G Sauer
Background and Objectives: DNA molecular analysis has been suggested as a tool to evaluate pancreatic cysts. This study assesses whether the addition of DNA molecular analysis alters clinical management. Methods: This is a retrospective review of 46 consecutive patients who underwent EUS-FNA of pancreatic cysts with DNA molecular analysis at two major academic institutions. Cases were presented to two pancreaticobiliary surgeons first without and then with DNA molecular analysis data...
January 2018: Endoscopic Ultrasound
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