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Biliary drainage

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https://www.readbyqxmd.com/read/28523061/duel-stage-treatment-for-biliary-cysts-with-cholangitis-during-pregnancy
#1
Baoxing Jia, Ludong Tan, Zhe Jin, Yahui Liu
BACKGROUND & OBJECTIVE: Biliary cysts in pregnant women are a complex medical issue, especially when complicated with cholangitis. It is a serious and life-threatening diagnosis that can seriously endanger both the expectant mother and the fetus. However, during pregnancy, surgical treatment would lead to further complications and higher fetal mortality. Here, we propose a novel therapeutic approach that would be safe for both mother and child during pregnancy, with a definitive treatment postponed until after delivery...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28520651/laparoscopic-management-of-hepatocellular-carcinoma-a-critical-reappraisal
#2
David Fuks, Luca Aldrighetti, Long R Jiao, Go Wakabayashi, Paolo Limongelli
Following the introduction of the first laparoscopic liver resection, after ∼25 years, a critical reappraisal seems to be warranted. Liver resection represents the first choice for curing early hepatocellular carcinoma (HCC) allowing a curative chance also in selected patients with intermediate stage tumors. The criteria for liver resectability by laparoscopy remains the same for open surgery, which is oncological criteria (absence of extrahepatic tumor location; completely resectable R0 resection), anatomic (resectability of involved segment with its own blood surely and biliary drainage; absence of vascular invasion of portal or hepatic veins) and technical (possibility to leave in place a residual volume ≥40%)...
May 17, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28516371/perforated-emphysematous-cholecystitis-managed-by-endoscopic-transpapillary-gallbladder-drainage
#3
Chikara Iino, Tadashi Shimoyama, Takasato Igarashi, Tomoyuki Aihara, Kentaro Ishii, Juichi Sakamoto, Hiroshi Tono, Shinsaku Fukuda
An 88-year-old woman with dementia was diagnosed as having perforated emphysematous cholecystitis with localized peritonitis. Because she was at high risk for surgery, gallbladder drainage was required before surgery. Endoscopic transpapillary gallbladder drainage instead of percutaneous transhepatic biliary drainage was performed because bile could leak from the puncture site to free space around the perforated gallbladder. After the insertion of a nasobiliary drainage tube, the gallbladder was drained and cleaned with saline solution...
May 17, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#4
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28508251/occlusion-of-a-long-term-transpleural-biliary-drainage-tract-using-a-gelatin-pledget-hep-plug-%C3%A2
#5
Nikolas Kortes, Daniel Gnutzmann, Philip Konietzke, Philipp Mayer, Migle Sumkauskaite, Hans-Ulrich Kauczor, Boris A Radeleff
This case describes a technique used to close a long-term 14F transpleural biliary drainage catheter tract to prevent biliopleural fistula and further complications. We deployed a compressed gelatin foam pledget provided in a pre-loaded delivery device (Hep-Plug™) along the intrahepatic tissue tract for sealing it against the pleural cavity. The device used is easy to handle and gives the Interventional Radiologist the possibility to safely manage and prevent complications after percutaneous transhepatic interventions...
May 15, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28506055/clinical-features-and-outcomes-of-patients-with-hepatocellular-carcinoma-complicated-with-bile-duct-invasion
#6
Jihyun An, Kwang Sun Lee, Kang Mo Kim, Do Hyun Park, Sang Soo Lee, Danbi Lee, Ju Hyun Shim, Young-Suk Lim, Han Chu Lee, Young-Hwa Chung, Yung Sang Lee
Background/Aims: Little is known about the treatment or outcomes of hepatocellular carcinoma (HCC) complicated with bile duct invasion. Methods: A total of 247 consecutive HCC patients with bile duct invasion at initial diagnosis were retrospectively included. Results: The majority of patients had Barcelona Clinic Liver Cancer (BCLC) stage C HCC (66.8%). Portal vein tumor thrombosis was present in 166 (67.2%) patients. Median survival was 4...
May 16, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28503061/use-of-4-fr-versus-6-fr-nasobiliary-catheter-for-biliary-drainage-a-prospective-multicenter-randomized-controlled-study
#7
Tomofumi Tsuboi, Masahiro Serikawa, Tamito Sasaki, Yasutaka Ishii, Yoshifumi Fujimoto, Atsushi Yamaguchi, Takashi Ishigaki, Akinori Shimizu, Keisuke Kurihara, Yumiko Tatsukawa, Eisuke Miyaki, Kazuaki Chayama
Background and Aim. Endoscopic nasobiliary drainage (NBD) effects according to diameter remain unclear. We aimed to assess the drainage effects of the 4-Fr and 6-Fr NBD catheters. Methods. This prospective, multicenter, randomized, controlled study was conducted at Hiroshima University Hospital and related facilities within Hiroshima Prefecture. Endoscopic retrograde cholangiopancreatography (ERCP) in 246 patients revealed acute cholangitis, obstructive jaundice, and/or extrahepatic cholestasis; 4-Fr or 6-Fr NBD catheters were randomly allocated and placed in these patients...
2017: Diagnostic and Therapeutic Endoscopy
https://www.readbyqxmd.com/read/28500686/factors-predicting-the-overall-response-and-overall-survival-in-hepatocellular-carcinoma-patients-undergoing-balloon-occluded-transcatheter-arterial-chemoembolization-b-tace-a-retrospective-cohort-study
#8
Takeshi Hatanaka, Hirotaka Arai, Mitsuhiko Shibasaki, Hiroki Tojima, Daichi Takizawa, Mitsuo Toyoda, Hisashi Takayama, Takehiko Abe, Ken Sato, Satoru Kakizaki, Masanobu Yamada
AIM: This study aimed to investigate the factors predicting the overall response and overall survival in hepatocellular carcinoma (HCC) patients undergoing balloon-occluded transcatheter arterial chemoembolization (B-TACE). METHODS: Sixty-six patients treated with B-TACE at a tertiary referral hospital between January 2011 and August 2015 were included in this retrospective cohort study. RESULTS: The overall response was classified as complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) in 35 (53...
May 12, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28500461/predicting-success-in-percutaneous-transhepatic-biliary-drainage
#9
Ankaj Khosla, Yin Xi, Seth Toomay
PURPOSE: To develop a model to predict successful bilirubin decrease following percutaneous biliary drain placement. METHODS: A total of 257 patients who were identified having undergone percutaneous transhepatic biliary drain placement (PTBD) at our institution between 2002 and 2013 had their medical records and imaging reviewed. Of those, 190 of these patients met criteria and were used in the analysis. A regression model was performed on logarithm-transformed collected variables to predict post-drainage logarithmic transformed total bilirubin levels...
May 12, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28497648/intrahepatic-cholangiojejunostomy-for-complex-biliary-stenosis-after-pediatric-living-donor-liver-transplantation
#10
Fernando A Alvarez, Rodrigo Sanchez Claria, Juan Glinka, Martin de Santibañes, Juan Pekolj, Eduardo de Santibañes, Miguel A Ciardullo
The treatment of biliary stenosis after pediatric LDLT is challenging. We describe an innovative technique of peripheral IHCJ for the treatment of patients with complex biliary stenosis after pediatric LDLT in whom percutaneous treatment failed. During surgery, the percutaneous biliary drainage is removed and a flexible metal stylet is introduced trough the tract. Subsequently, the most superficial aspect of the biliary tree is recognized by palpation of the stylet's round tip in the liver surface. The liver parenchyma is then transected until the bile duct is reached...
May 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28497252/gallbladder-cancer-presenting-with-jaundice-uniformly-fatal-or-still-potentially-curable
#11
Thuy B Tran, Jeffrey A Norton, Cecilia G Ethun, Timothy M Pawlik, Stefan Buettner, Carl Schmidt, Eliza W Beal, William G Hawkins, Ryan C Fields, Bradley A Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Kamran Idrees, Chelsea A Isom, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, George A Poultsides
BACKGROUND: Jaundice as a presenting symptom of gallbladder cancer has traditionally been considered to be a sign of advanced disease, inoperability, and poor outcome. However, recent studies have demonstrated that a small subset of these patients can undergo resection with curative intent. METHODS: Patients with gallbladder cancer managed surgically from 2000 to 2014 in 10 US academic institutions were stratified based on the presence of jaundice at presentation (defined as bilirubin ≥4 mg/ml or requiring preoperative biliary drainage)...
May 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28489218/percutaneous-transbiliary-biopsy
#12
Gustavo Vieira Andrade, Miguel Arcanjo Santos, Marconi Roberto Meira, Mateus Duarte Meira
Percutaneous drainage of the bile ducts is an established procedure for malignant obstructions, in which a histological diagnosis is often not obtained. We describe the biopsy technique of obstructive lesions through biliary drainage access, using a 7F endoscopic biopsy forceps, widely available; some are even reusable. This technique applies to lesions of the hepatic ducts, of the common hepatic duct and of all extension of the common bile duct. RESUMO A drenagem percutânea das vias biliares é um procedimento estabelecido para obstruções malignas, nos quais, muitas vezes, não se consegue um diagnóstico histológico...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28488733/surgical-resection-for-bismuth-type-iv-perihilar-cholangiocarcinoma
#13
T Ebata, T Mizuno, Y Yokoyama, T Igami, G Sugawara, M Nagino
BACKGROUND: Bismuth type IV perihilar cholangiocarcinoma has traditionally been categorized as unresectable disease. The aim of this study was to review experience with a resection-based strategy in patients who have type IV perihilar cholangiocarcinoma. METHODS: Medical records of consecutive patients with a diagnosis of type IV perihilar cholangiocarcinoma between 2006 and 2015 were reviewed retrospectively. Primary outcomes assessed were surgical results and long-term survival...
May 10, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28479493/bilateral-versus-unilateral-placement-of-metal-stents-for-inoperable-high-grade-malignant-hilar-biliary-strictures-a-multicenter-prospective-randomized-study-with-video
#14
Tae Hoon Lee, Tae Hyeon Kim, Jong Ho Moon, Sang Hyub Lee, Hyun Jong Choi, Young Hwangbo, Jong Jin Hyun, Jun-Ho Choi, Seok Jeong, Jong Hyeok Kim, Do Hyun Park, Joung-Ho Han, Sang-Heum Park
BACKGROUND AND AIMS: The efficacy of palliative biliary drainage using bilateral or unilateral self-expandable metal stents (SEMSs) for a malignant hilar biliary stricture (MHS) remains controversial. This prospective, randomized, multicenter study investigated whether bilateral drainage using SEMSs is superior to unilateral drainage in patients with inoperable MHS. METHODS: Patients with inoperable high-grade MHS who underwent palliative endoscopic insertion of bilateral or unilateral SEMSs were enrolled...
May 4, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28476903/endoscopic-nasobiliary-drainage-an-effective-treatment-option-for-benign-recurrent-intrahepatic-cholestasis-bric
#15
Ashok Choudhury, Anand V Kulkarni, Bishnupriya Sahoo, Chhagan Bihari
Benign recurrent intrahepatic cholestasis (BRIC) is characterised by recurrent episodes of jaundice, severe pruritus and low or normal serum γ-glutamyltransferase activity lasting from several weeks to months. BRIC is an autosomal recessive disorder caused by the mutation in either of the two hepatic transporter genes-ATP8B1 or ABCB11 gene. The disease is very well known for episodic flare of jaundice with cholestatic symptoms that are spontaneous or perpetuated by acute insults, followed by self-recovery...
May 5, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28475221/influence-of-cholangitis-after-preoperative-endoscopic-biliary-drainage-on-postoperative-pancreatic-fistula-in-patients-with-middle-and-lower-malignant-biliary-strictures
#16
Toru Kaneko, Hiroshi Imaizumi, Mitsuhiro Kida, Eiji Miyata, Hiroshi Yamauchi, Kosuke Okuwaki, Tomohisa Iwai, Wasaburo Koizumi
BACKGROUND: Preoperative cholangitis after preoperative drainage has been reported to increase postoperative complications, particularly pancreatic fistula. We therefore examined the effects of cholangitis after preoperative endoscopic biliary drainage (EBD) on postoperative pancreatic fistula in patients with middle and lower malignant biliary strictures. METHODS: The study group comprised 102 patients who underwent EBD among patients who underwent surgery. RESULTS: Of the 102 patients, 33 (32%) had postoperative pancreatic fistulas, and 56 (55%) had preoperative cholangitis after preoperative drainage...
May 5, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28473850/endoscopic-ultrasound-guided-biliary-drainage-using-self-expandable-metal-stent-for-malignant-biliary-obstruction
#17
Lei Lu, Xiaowei Tang, Hangbin Jin, Jianfeng Yang, Xiaofeng Zhang
Purpose. Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been increasingly reported worldwide. However, studies concerning EUS-BD from Mainland China are sporadic. This study aims to investigate the feasibility, efficacy, and safety of EUS-BD using SEMS in a single center from Mainland China. Methods. Between November 2011 and August 2015, 24 patients underwent EUS-BD using a standardized algorithm. Results. Three patients underwent rendezvous technique (RV), 4 underwent hepaticogastrostomy (HGS), and 17 underwent choledochoduodenostomy (CDS)...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28461144/disease-free-survival-following-resection-in-non-ductal-periampullary-cancers-a-retrospective-multicenter-analysis
#18
Stéphane Bourgouin, Jacques Ewald, Julien Mancini, Vincent Moutardier, Jean-Robert Delpero, Yves-Patrice Le Treut
BACKGROUND: Predictors of recurrence following pancreaticoduodenectomy are well described for ductal periampullary cancers but lack reliability for non-ductal tumors. The purpose of this study is to analyze the disease-free survival (DFS) and to define the predictors of recurrence following resection for ampullary (AC), bile duct (BDC) and duodenal cancers (DC). MATERIALS AND METHODS: Clinico-pathological data of patients operated on between 2001 and 2011 were retrospectively reviewed...
April 28, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28461005/the-complication-of-hepatic-artery-injuries-of-1-304-percutaneous-transhepatic-biliary-drainage-in-a-single-institute
#19
En-Li Shiau, Huei-Lung Liang, Yih-Huie Lin, Ming-Feng Li, Chia-Ling Chiang, Matt Chiung-Yu Chen, Jer-Shyung Huang, Huay-Ben Pan
PURPOSE: To determine frequency of and assess risk factors for hepatic artery (HA) injury during percutaneous transhepatic biliary drainage (PTBD) and to discuss the technique and report the clinical outcome of embolization for HA injury. MATERIALS AND METHODS: Over a 14-year period (2002-2016), 1,304 PTBD procedures in 920 patients were recorded. The incidence of HA injury was determined, and possible associated risk factors were analyzed. When injury occurred, HA embolization was performed at the site as close to the bleeding point as possible...
April 28, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28460245/3rd-st-gallen-eortc-gastrointestinal-cancer-conference-consensus-recommendations-on-controversial-issues-in-the-primary-treatment-of-pancreatic-cancer
#20
REVIEW
Manfred P Lutz, John R Zalcberg, Michel Ducreux, Daniela Aust, Marco J Bruno, Markus W Büchler, Jean-Robert Delpero, Beat Gloor, Rob Glynne-Jones, Werner Hartwig, Florence Huguet, Pierre Laurent-Puig, Florian Lordick, Patrick Maisonneuve, Julia Mayerle, Marc Martignoni, John Neoptolemos, Andrew D Rhim, Bruno M Schmied, Thomas Seufferlein, Jens Werner, Jean-Luc van Laethem, Florian Otto
The primary treatment of pancreatic cancer was the topic of the 3rd St. Gallen Conference 2016. A multidisciplinary panel reviewed the current evidence and discussed controversial issues in a moderated consensus session. Here we report on the key expert recommendations. It was generally accepted that radical surgical resection followed by adjuvant chemotherapy offers the only evidence-based treatment with a chance for cure. Initial staging should classify localised tumours as resectable or unresectable (i.e...
April 28, 2017: European Journal of Cancer
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