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Benign biliary stricture

Sunguk Jang, Tyler Stevens, Mansour A Parsi, Rocio Lopez, John J Vargo
BACKGROUND & AIMS: Biliary self-expandable metallic stents (SEMSs) are widely used to treat malignant and benign conditions of bile duct. Despite their lower rate of occlusion and longer patency than plastic stents, SEMSs still have significant rates of occlusion. We aimed to identify factors associated with occlusion of biliary SEMS. METHODS: We performed a retrospective study of consecutive patients who underwent endoscopic retrograde cholangiopancreatography with biliary SEMS placement at the Cleveland Clinic Foundation from March 2011 to April 2016...
October 17, 2016: Clinical Gastroenterology and Hepatology
Seiji Kaino, Manabu Sen-Yo, Shuhei Shinoda, Michitaka Kawano, Hirofumi Harima, Shigeyuki Suenaga, Isao Sakaida
Postoperative biliary strictures are usually complications of cholecystectomy. Endoscopic plastic stent prosthesis is generally undertaken for treating benign biliary strictures. Recently, fully covered metal stents have been shown to be effective for treating benign distal biliary strictures. We present the case of a 53-year-old woman with liver injury in which imaging studies showed a common hepatic duct stricture. Endoscopic retrograde cholangiopancreatography also confirmed the presence of a common hepatic duct stricture...
October 15, 2016: Clinical Journal of Gastroenterology
María-Victoria Alvarez-Sánchez, Bertrand Napoléon
Most pancreatic cancers and extrahepatic cholangiocarcinomas are unresectable at the time of diagnosis, and even in case of a resectable cancer, for elderly or patients with coexistent comorbidities, surgery is not an option. Current treatment alternatives in these scenarios are very limited. Biliary stenting with self-expanding metal stents (SEMS) is the mainstay palliative treatment of biliary obstruction due to unresectable pancreatic cancer or cholangiocarcinoma. Nevertheless, more than 50% of SEMS become occluded after 6 mo due to tumour over- and ingrowth, leading to hospital readmissions and reinterventions that significantly impair quality of life...
October 7, 2016: World Journal of Gastroenterology: WJG
Abdolmajid Taheri, Ayoob Rostamzadeh, Alireza Gharib, Daryoush Fatehi
INTRODUCTION: Recently, multidetector computed tomography (MDCT) has been introduced into clinical practice. MDCT has become the noninvasive diagnostic test of choice for detailed evaluation of biliary obstruction. AIM: the main objective of the present study was to evaluate the diagnostic value of MDCT compared to invasive procedures for detecting biliary obstruction causes. MATERIAL AND METHODS: Since February 2009 until May 2011 fifty biliary obstruction patients based on clinical, laboratory or ultrasonographic findings, were evaluated by Multidetector-row computed tomography...
July 16, 2016: Acta Informatica Medica: AIM
Xiao Zheng, Bo Sun, Ye-Chen Wu, Zhi-Yuan Bo, Wei Wan, Dao-Jian Gao, Bing Hu
OBJECTIVES: The management of benign biliary stricture is challenging. Endoscopic therapy has evolved as the first-line treatment for various benign biliary strictures. However, covered self-expandable metal stents have not been approved by the United States Food and Drug Administration for the treatment of benign biliary stricture. With this goal, we conducted this systemic review and meta-analysis to evaluate the efficacy and safety of endoscopic stenting with covered self-expandable metal stent in the treatment of benign biliary stricture...
September 28, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Orrie N Close, Olaguoke Akinwande, Rakesh K Varma, Ernesto Santos, Hyun S Kim
Postoperative biliary complications following extensive hepatic resections are complex, often requiring a multidisciplinary team approach. We describe a case of a free bile duct leak following extended right hepatectomy and surgical hepaticojejunostomy treated with percutaneous transhepatic hepaticojejunostomy in which a radiofrequency guidewire was used to gain enteral access. A modified internal/external biliary catheter was left in place. The patient was enrolled in a benign biliary stricture protocol, and 8 months later, the catheter was removed following a normal cholangiogram and biliary manometric perfusion testing...
September 27, 2016: Cardiovascular and Interventional Radiology
Gael S Roth, Philippe Bichard, Michele Fior-Gozlan, Hubert Roth, Jean Auroux, Olivier Risse, Christian Letoublon, Marie Hélène Laverrière, Ivan Bricault, Vincent Leroy, Thomas Decaens
BACKGROUND AND STUDY AIMS: Endobiliary brushing during endoscopic retrograde cholangiopancreatography (ERCP) is the main technique used to diagnose a malignant stricture, but has a poor sensitivity. This study evaluated the diagnostic performance of bile aspiration associated with biliary brushing during ERCP to diagnose a malignant stricture, compared to brushing alone. PATIENTS AND METHODS: Between January 2007 and December 2012, all consecutive patients undergoing ERCP to treat a biliary stricture were included...
September 2016: Endoscopy International Open
Varayu Prachayakul, Phataraphong Thearavathanasingha, Chanitra Thuwajit, Sittiruk Roytrakul, Janthima Jaresitthikunchai, Peti Thuwajit
Biliary obstruction is a common clinical manifestation of various conditions, including extrahepatic cholangiocarcinoma. However, a screening test for diagnosis of extrahepatic cholangiocarcinoma in patients with biliary obstruction is not yet available. According to the rationale that the biliary system plays a major role in lipid metabolism, biliary obstruction may interfere with lipid profiles in the body. Therefore, plasma lipidomics may help indicate the presence or status of disease in biliary obstruction suspected extrahepatic cholangiocarcinoma...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Sung Ill Jang, Kwang-Hun Lee, Hong Jin Yoon, Dong Ki Lee
BACKGROUND & AIMS: Although non-surgical methods produce high clinical success rates in the treatment of benign biliary stricture (BBS), conventional methods are not always successful in cases of severe biliary stricture or complete obstruction. Therefore, the efficacy of magnetic compression anastomosis (MCA) for treatment of refractory BBS was evaluated in a single-center, nonrandomized study. METHODS: MCA was performed in patients with BBS that was not resolved by conventional endoscopic or percutaneous treatments...
September 9, 2016: Gastrointestinal Endoscopy
Patrick Aepli, Andrew St John, Saurabh Gupta, Luke F Hourigan, Rhys Vaughan, Marios Efthymiou, Arthur Kaffes
BACKGROUND: Anastomotic biliary strictures (AS) after orthotopic liver transplantation (OLT) belong to the most common biliary complications and cause the biggest morbidity burden after OLT. Metal stents for benign biliary strictures are gaining acceptance with many published series. Traditional metal stent designs seem to have poor durability in AS after OLT. Novel intra-ductal stents are showing promise in these strictures. As a result, we designed a special stent with an antimigration waist and a short stent length with a long removal string that rests in the duodenum for easy removal...
August 29, 2016: Surgical Endoscopy
Antti Siiki, Irina Rinta-Kiikka, Juhani Sand, Johanna Laukkarinen
The first clinical experience of endoscopically inserted polydioxanone biodegradable biliary stents (BDBS) in the treatment of benign biliary strictures is reported. Two patients with a benign common bile duct stricture were endoscopically treated with 8 mm bore BDBS in ERC (endoscopic retrograde cholangiography). Both BDBS insertions were technically successful and without adverse events. At six months, the stricture resolution was excellent and BDBS degradation was predicted in repeated magnetic resonance imaging...
August 11, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Jin Seok Park, Seok Jeong, Joon Mee Kim, Sang Soon Park, Don Haeng Lee
The large animal model with benign biliary stricture (BBS) is essential to undergo experiment on developing new devices and endoscopic treatment. This study conducted to establish a clinically relevant porcine BBS model by means of endobiliary radiofrequency ablation (RFA). Endoscopic retrograde cholangiography (ERC) was performed on 12 swine. The animals were allocated to three groups (60, 80, and 100 W) according to the electrical power level of RFA electrode. Endobiliary RFA was applied to the common bile duct for 60 seconds using an RFA catheter that was endoscopically inserted...
September 2016: Journal of Korean Medical Science
Dirk Walter, Eva Herrmann, Ria Winkelmann, Jörg G Albert, Juliane Liese, Andreas Schnitzbauer, Stefan Zeuzem, Martin Leo Hansmann, Jan Peveling-Oberhag, Sylvia Hartmann
BACKGROUND AND AIM: CD15 is expressed by various cancer types, among these intrahepatic and perihilar cholangiocarcinoma (CCA). Aim of this study was to elucidate CD15 expression in distal CCA as well as in dysplastic biliary tissue and to determine its prognostic significance. METHODS: Tissue samples from patients with intrahepatic (iCCA, n=22), perihilar (pCCA, n=7) and distal CCA (dCCA, n=15), who underwent surgical resection in the period from 2010 to 2015 were evaluated for CD15 expression...
July 21, 2016: Histopathology
(no author information available yet)
The Food and Drug Administration (FDA) is classifying the metallic biliary stent system for benign strictures into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the metallic biliary stent system for benign strictures' classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.
July 13, 2016: Federal Register
Ulriikka Chaput, Ariane Vienne, Etienne Audureau, Paul Bauret, Philippe Bichard, Dimitri Coumaros, Bertrand Napoléon, Thierry Ponchon, Jean-Christophe Duchmann, René Laugier, Hervé Lamouliatte, Bruno Védrenne, Marianne Gaudric, Stanislas Chaussade, Françoise Robin, Sarah Leblanc, Frédéric Prat
BACKGROUND: Endoscopic treatment of benign biliary strictures (BBS) can be challenging. OBJECTIVE: To evaluate the efficacy of fully covered self-expandable metal stents (FCSEMS) in BBS. METHODS: Ninety-two consecutive patients with BBS (chronic pancreatitis (n = 42), anastomotic after liver transplantation (n = 36), and post biliary surgical procedure (n = 14)) were included. FCSEMS were placed across strictures for 6 months before endoscopic extraction...
June 2016: United European Gastroenterology Journal
Tae Ho Kim, Jae Hyuck Chang, Hee Jin Lee, Jean A Kim, Yeon Soo Lim, Chang Whan Kim, Sok Won Han
Although advances have been made in diagnostic tools, the distinction between malignant and benign biliary strictures still remains challenging. Intraductal brush cytology is a convenient and safe method that is used for the diagnosis of biliary stricture, but, low sensitivity limits its usefulness. This study aimed to demonstrate the usefulness of mRNA expression levels of target genes in brush cytology specimens combined with cytology for the diagnosis of malignant biliary stricture. Immunohistochemistry for cadherin 3 (CDH3), p53, insulin-like growth factor II mRNA-binding protein 3 (IGF2BP3), homeobox B7 (HOXB7), and baculoviral inhibitor of apoptosis repeat containing 5 (BIRC5) was performed in 4 benign and 4 malignant bile duct tissues...
July 2016: Medicine (Baltimore)
Hiep Nguyen Canh, Kenichi Harada
Biliary epithelial cells preferentially respond to various insults under chronic pathological conditions leading to reactively atypical changes, hyperplasia, or the development of biliary neoplasms (such as biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct, and cholangiocarcinoma). Moreover, benign biliary strictures can be caused by a variety of disorders (such as IgG4-related sclerosing cholangitis, eosinophilic cholangitis, and follicular cholangitis) and often mimic malignancies, despite their benign nature...
June 27, 2016: Medical Molecular Morphology
Yong Keun Park, Jee Eun Choi, Woon Yong Jung, Sung Kyu Song, Jong In Lee, Chul-Woon Chung
BACKGROUND: Biliary strictures at the hilum of the liver arise from heterogeneous etiologies. The majority is malignant entities, but some may have benign etiologies. It is difficult to distinguish between malignant and benign biliary strictures preoperatively. It has been reported that 5~15 % of preoperative diagnoses of hilar cholangiocarcinoma turn out to be benign lesions or even other types of malignancies. Primary non-Hodgkin's lymphoma of the extrahepatic bile duct is very rare, with only a few cases reported as mucosa-associated lymphoid tissue (MALT) lymphoma arising from the hepatic duct bifurcation...
2016: World Journal of Surgical Oncology
Jin Ho Choi, Sang Hyub Lee, Joo Seong Kim, Jung Kim, Bang Sup Shin, Dong Kee Jang, Ji Kon Ryu, Yong Tae Kim
Adenomyomatous hyperplasia is a reactive malformation or non-neoplastic tumor-like lesion frequently observed in the gallbladder, stomach, duodenum and jejunum, but rare in the extrahepatic bile duct. A 42-year-old man with epigastric discomfort had a stricture in the common bile duct on initial CT scans. Initially, it was regarded as a malignant lesion with some evidence, but histopathologic examinations of multiple biopsies obtained by multiple sessions of endoscopic retrograde cholangiopancrea-tography showed no evidence of malignancy...
June 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Juliana F Yang, Reem Z Sharaiha, Gloria Francis, Kunal Karia, C A Kistler, Sobia N Laique, Raza Hasan, Monica Gaidhane, Amy Tyberg, Michel Kahaleh, Thomas E Kowalski, David E Loren, Ali Siddiqui
BACKGROUND: The aim of this study was to assess the operating characteristics of using the confocal endomicroscopy miniprobe (pCLE) compared to cholangioscopic targeted biopsies for the detection of malignancy in biliary tract strictures. METHODS: We conducted a retrospective analysis of data of patients who underwent evaluation of indeterminate biliary strictures after inconclusive brush cytology. Only those patients with a final pathologic diagnosis or a conclusive >12 months follow-up were included...
September 2016: Minerva Gastroenterologica e Dietologica
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