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https://www.readbyqxmd.com/read/28229343/a-case-of-pancreaticobiliary-maljunction-with-a-connecting-duct-without-a-long-common-channel
#1
Masataka Kikuyama, Terumi Kamisawa, Sawako Kuruma, Kazuro Chiba, Satomi Koizumi, Taku Tabata, Goro Honda
Pancreaticobiliary maljunction (PBM) is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall, usually forming an abnormally long common channel. In PBM, since the long common channel defeats the effect of the sphincter of Oddi, pancreatobiliary reflux frequently occurs, resulting in high rates of biliary tract cancers. We present the case of a 68-year-old female with advanced gallbladder cancer concomitant with bile duct cancer associated with PBM without biliary dilatation that had an extremely rare configuration showing a connecting duct without a long common channel...
February 22, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28229077/surgical-therapy-of-cholangiocarcinoma
#2
REVIEW
Arnold Radtke, Alfred Königsrainer
BACKGROUND: The majority of patients with cholangiocarcinoma present with advanced disease that is often challenging to diagnose and to treat. The optimal preoperative evaluation requires a coordinated multidisciplinary approach. Surgical resection is the mainstay of therapy. METHODS: This systematic review delineates surgical treatment strategies for cholangiocarcinoma in general as well as special considerations concerning the particular tumor localization. A literature search (see keywords) was conducted using PubMed and publications between 1990 and 2016 regarding resectable and advanced cholangiocarcinoma were reviewed...
December 2016: Visceral Medicine
https://www.readbyqxmd.com/read/28226350/-value-of-endoscopy-application-in-the-management-of-complications-after-radical-gastrectomy-for-gastric-cancer
#3
Yiqun Zhang, Pinghong Zhou
Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28220035/case-report-modified-laparoscopic-subtotal-cholecystectomy-an-alternative-approach-to-the-difficult-gallbladder
#4
Michael S Segal, Richard H Huynh, George O Wright
BACKGROUND Laparoscopic cholecystectomy is a commonly performed surgical procedure. In certain situations visualization of the Callot triangle can become difficult due to inflammation, adhesions, and sclerosing of the anatomy. Without being able to obtain the "critical view of safety" (CVS), there is increased risk of damage to vital structures. An alternative approach to the conventional conversion to an open cholecystectomy (OC) would be a laparoscopic subtotal cholecystectomy (LSC). CASE REPORT We present a case of a 56-year-old male patient with acute cholecystitis with a "difficult gallbladder" managed with LSC...
February 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28216981/real-case-of-primitive-embryonal-duodenal-carcinoma-in-a-young-man
#5
Julien Barbieux, Riccardo Memeo, Vito De Blasi, Sebastian Suciu, Vanina Faucher, Gerlinde Averous, Catherine Roy, Jacques Marescaux, Didier Mutter, Patrick Pessaux
We report here the case of a young man suffering from a rare germ cell tumour. The patient was a 25-year-old man who was referred to our centre for asthenia, stinging epigastric pain, and an iron deficiency anaemia. Gastroscopy revealed a circumferential vegetating lesion on the second portion of the duodenum. The lesion was indurated at the third portion of the duodenum, responsible for a tight stenosis. A computerized tomography-scan of the chest, abdomen and pelvis, and a pancreatic MRI showed a circumferential lesion with a bi-ductal dilatation (i...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28216968/complications-and-management-of-forgotten-long-term-biliary-stents
#6
Se Hoon Sohn, Jae Hyun Park, Kook Hyun Kim, Tae Nyeun Kim
AIM: To evaluate complications and management outcomes of retained long-term plastic biliary stents. METHODS: Endoscopic plastic biliary stent placement was performed in 802 patients at Yeungnam University Hospital between January 2000 and December 2014. Follow-up loss with a subsequently forgotten stent for more than 12 mo occurred in 38 patients. We retrospectively examined the cause of biliary stent insertion, status of stents, complications associated with biliary stents and management outcomes of long-term plastic biliary stents...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28213744/intraductal-papillary-neoplasm-originating-from-an-anomalous-bile-duct
#7
Harufumi Maki, Taku Aoki, Takeaki Ishizawa, Mariko Tanaka, Takashi Sakatani, Yoshifumi Beck, Kiyoshi Hasegawa, Yoshihiro Sakamoto, Norihiro Kokudo
An 82-year-old woman who had been suffering from repeated obstructive jaundice for 7 years was referred to our hospital. Although endoscopic aspiration of the mucin in the common bile duct had been temporally effective, origin of the mucin production had not been detectable. The patient thus had been forced to be on long-term follow-up without curative resection. Endoscopic retrograde cholangioscopy on admission revealed massive mucin in the common bile duct. In addition, an anomalous bile duct located proximal to the gallbladder was identified...
February 17, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28212261/passage-of-gallstones-into-common-bile-duct-during-laparoscopic-cholecystectomy-is-it-surgeon-s-responsibility
#8
Mohammed Bani Hani, Abdel Rahman Al Manasra, Haitham Qandeel
PURPOSE: Gallstones patients without preoperative history of jaundice, deranged liver function tests, or dilated bile ducts (BD) are unlikely to have BD stones. However, some of these patients in our series underwent endoscopic stone(s) removal after laparoscopic cholecystectomy (LC). We aim to find the incidence, possible intraoperative risk factors, and if the Surgeon can be blamed for this event. MATERIALS AND METHODS: We studied LC cases over 12-year period at our university hospital and identified patients who did not have preoperative risk factors for BD stones but developed postoperative jaundice and/or persistent abdominal pain...
February 16, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28211310/morphologic-and-doppler-findings-from-hepatic-ultrasonography-of-normal-cynomolgus-monkeys-macaca-fascicularis
#9
Kyo Won Lee Chan Woo Cho Ji Eun Lee Hyojun Park Gyu-Seong Choi Woo Kyoung Jeong Jae Berm Park And Sungjoo Kim
The present study evaluated the anatomic and ultrasonographic features of the liver in normal cynomolgus monkeys (Macacafascicularis). Healthy, male, cynomolgus monkeys from Cambodia (n = 25; mean age, 58.1 mo) were sedated with ketamine (7mg/kg) and examined by using 2D and Doppler ultrasonography. We measured the diameters of the vascular structures and bile duct, determined the velocities of the hepatic artery and portal vein, and calculated the resistance index of the hepatic artery. Vessel diameters were: proper hepatic artery, 1...
February 16, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28207553/laparoscopic-living-donor-right-hemihepatectomy-with-venous-outflow-reconstruction-using-cadaveric-common-iliac-artery-allograft-case-report-and-literature-review
#10
Jiaxin Li, Jiwei Huang, Hong Wu, Yong Zeng
RATIONALE: With the development of laparoscopic technique, the total laparoscopic living donor right hemihepatectomy (LLDRH) procurement surgery has been successfully performed in many liver transplant centers all over the world, and the number of cases is continuing to increase. We report our case of laparoscopic right graft resection with venous outflow reconstruction using cadaveric common iliac artery allograft in our center and review literatures about total LLDRH surgery. PATIENT CONCERNS AND DIAGNOSES: A 40-year-old male living donor for right hepatectomy was selected after pretransplant evaluation including laboratory tests, liver volume, anatomy of hepatic vein, artery, portal vein, and bile duct...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205184/extrahepatic-bile-duct-hepatocellular-carcinoma-due-to-recurrence-of-hematogenous-metastasis-50%C3%A2-months-after-hepatectomy
#11
Hiroyuki Kumata, Shigehito Miyagi, Keigo Murakami, Atsushi Fujio, Yasuyuki Hara, Chikashi Nakanishi, Naoki Kawagishi, Hironobu Sasano, Takashi Kamei, Noriaki Ouchi
BACKGROUND: Recurrent hepatocellular carcinoma (HCC) in the extrahepatic bile duct is rare with most cases diagnosed after manifesting sudden obstructive jaundice. Here, we report an extremely rare case of recurrent HCC in the common bile duct due to hematogenous metastasis. CASE PRESENTATION: A 66-year-old man underwent an extended left hepatectomy for HCC in the medial segment of the liver. Fifty months later, he presented with sudden obstructive jaundice. Endoscopic retrograde cholangiography showed a space-occupying lesion in the common bile duct, which was suspected as cholangiocarcinoma...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28205123/isolated-pancreatic-uncinate-duct-ipmn
#12
Ajay V Maker, Vijay K Maker
The ventral pancreas originally forms as an evagination of the common bile duct at 32 days gestation and its duct, the uncinate duct, eventually rotates with the ventral anlage to join the dorsal pancreas and fuse with the main pancreatic duct. Thus, though often considered a "branch" duct of the pancreas, embryologically, the uncinate duct is the "main" pancreatic duct of the ventral pancreas. This concept is not fully addressed in the current definitions of intraductal papillary mucinous neoplasms of the pancreas (IPMN) where international consensus guidelines consider the main-duct IPMN as high risk for malignancy and most small branch-duct IPMN as low risk for malignancy...
February 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28203125/migration-of-surgical-clips-into-the-common-bile-duct-after-laparoscopic-cholecystectomy
#13
Krishn Kant Rawal
Laparoscopic cholecystectomy (LC) is currently the treatment of choice for symptomatic gallstones. Associated complications include bile duct injury, retained common bile duct (CBD) stones, and migration of surgical clips. Clip migration into the CBD can present with recurrent cholangitis over a period of time. Retained CBD stones can be another cause of recurrent cholangitis. A case of two surgical clips migrating into the common bile duct with few retained stones following LC is reported here. The patient had repeated episodes of fever, pain at epigastrium, jaundice, and pruritus 3 months after LC...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28202062/isolated-igg4-related-sclerosing-cholangitis-misdiagnosed-as-malignancy-in-an-area-with-endemic-cholangiocarcinoma-a-case-report
#14
Narongsak Rungsakulkij, Pattana Sornmayura, Penampai Tannaphai
BACKGROUND: The most common cause of perihilar obstruction is cholangiocarcinoma, especially in Thailand. Benign perihilar stricture represents less than 20% of cases. IgG4-related disease and IgG4-related sclerosing cholangitis, however, have been receiving increased recognition. Isolated IgG4-related sclerosing cholangitis is less common. The preoperative diagnosis of IgG4-related sclerosing cholangitis without pancreatic involvement is very difficult because the clinical presentation and preoperative evaluation are extremely difficult to distinguish from perihilar cholangiocarcinoma...
February 15, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28197333/a-case-of-primary-biliary-cirrhosis-mimicking-acute-hepatitis-b-in-the-clinic-republic-of-korea
#15
Woo Hyuk Kwon, Hong Min Park, Jeong Jun Park, Sung Hoon Lee, Yong Kyu Lee
Primary biliary cirrhosis (PBC) is a slowly progressive cholestatic autoimmune liver disease characterized by progressive bile duct injury. The most common symptoms of this disease include fatigue and pruritus. The diagnosis of PBC is based on cholestatic biochemical liver tests, presence of antimitochondrial antibodies, and characteristic histological biopsy findings. We report a case of a patient with PBS, who was initially suspected to be in the window period of hepatitis B by a private doctor in a local clinic based on the detection of isolated immunoglobulin M antibody against hepatitis B core antigen...
January 2017: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/28190819/cholecystectomy-in-a-heifer
#16
Takeshi Tsuka, Hinako Tanaka, Shinji Kono, Takehito Morita, Yusuke Murahata, Kazuo Azuma, Tomohiro Osaki, Norihiko Ito, Yoshiharu Okamoto, Tomohiro Imagawa
A 10-month-old female Japanese black heifer presenting with sudden loss of appetite was diagnosed with extreme extension of the gallbladder. Laparotomy reaching from the right part of the 10th rib to the right flank showed an extended gallbladder greater than 50 cm in diameter. Cholecystectomy was performed as follows: 1) complete removal of the gallbladder distally from the base; 2) flushing via a catheter inserted into the common bile duct; and 3) covering of the hole opened in the common bile duct with a double-suturing method using the mucous membrane and muscular layers of the remaining gallbladder structures...
February 10, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28188033/success-and-safety-of-endoscopic-retrograde-cholangiopancreatography-in-children
#17
Jordan D Rosen, Rebecca S Lane, Jose M Martinez, Eduardo A Perez, Jun Tashiro, Amy E Wagenaar, Robert M Van Haren, Ashwini Kumar, Juan E Sola
PURPOSE: Despite its diagnostic and therapeutic utility, endoscopic retrograde cholangiopancreatography (ERCP) is underutilized in children. METHODS: Patients younger than 18years undergoing ERCP from 2000 to 2014 at a children's hospital were identified. Patient characteristics and outcomes were evaluated. RESULTS: Overall, 215 ERCPs (78% therapeutic) were performed in 184 patients. Our cohort was 67% female, with a median age (IQR) of 14 (8) years...
February 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28182359/fluorescence-in-situ-hybridization-with-the-urovysion-kit-for-the-detection-of-biliary-cancer-in-chinese-patients
#18
Xi Wu, Xuan Zeng, Aiming Yang, Fang Yao, Tao Guo, Dongsheng Wu, Shafei Wu, Hongmei Qiu, Weixun Zhou, Zhen Huo, Xinghua Lu, Jiaming Qian
BACKGROUND: Conventional biliary brush via ERCP has low clinical detection for biliary malignancy. Therefore, new approaches are needed to facilitate diagnosis. We therefore explored the application of fluorescent in situ hybrization (FISH) using a UroVysion kit for the detection of malignancy in the bile duct. METHODS: Genetic alterations of target chromosomes such as aneuploidy in Chinese biliary cancer cell lines and tissues were measured using a UroVysion kit...
February 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28179089/a-snare-assisted-peroral-direct-choledochoscopy-and-pancreatoscopy-using-an-ultra-slim-upper-endoscope-a-case-series-study
#19
Yong-Hui Huang, Hong Chang, Wei Yao, Yao-Peng Zhang, Ke Li, Ye Wang
OBJECTIVE: To evaluate the feasibility, effectiveness and safety of a new snare-assisted peroral direct choledochoscopy/pancreatoscopy (PDCPS) technique. METHODS: From November 2014 through December 2016, 20 consecutive patients with indications for PDCPS were enrolled in this observational study. Endoscopic retrograde cholangiography was initially performed using a conventional duodenoscope, and endoscopic papillary balloon dilation was performed. Next, an ultra-slim endoscope was inserted to perform the PDCPS; a snare tightened around the end of the scope's bending section facilitated its entry into the common bile duct (CBD)...
January 20, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28178882/fluorescent-imaging-with-indocyanine-green-during-laparoscopic-cholecystectomy-in-patients-at-increased-risk-of-bile-duct-injury
#20
Marjolein Ankersmit, Dieuwertje A van Dam, Anne-Sophie van Rijswijk, Baukje van den Heuvel, Jurriaan B Tuynman, Wilhelmus J H J Meijerink
BACKGROUND: Although rare, injury to the common bile duct (CBD) during laparoscopic cholecystectomy (LC) can be reduced by better intraoperative visualization of the cystic duct (CD) and CBD. The aim of this study was to establish the efficacy of early visualization of the CD and the added value of CBD identification, using near-infrared (NIR) light and the fluorescent agent indocyanine green (ICG), in patients at increased risk of bile duct injury. MATERIALS AND METHODS: Patients diagnosed with complicated cholecystitis and scheduled for LC were included...
January 1, 2017: Surgical Innovation
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