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Biliary stent

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https://www.readbyqxmd.com/read/28223737/pancreaticoduodenectomy-secondary-stenting-of-the-celiac-trunk-after-inefficient-median-arcuate-ligament-release-and-reoperation-as-an-alternative-to-simultaneous-hepatic-artery-reconstruction
#1
Théophile Guilbaud, Jacques Ewald, Olivier Turrini, Jean Robert Delpero
In patients undergoing pancreaticoduodenectomy (PD), unrecognized hemodynamically significant celiac axis (CA) stenosis impairs hepatic arterial flow by suppressing the collateral pathways supplying arterial flow from the superior mesenteric artery and leads to serious hepatobiliary complications due to liver and biliary ischemia, with a high rate of mortality. CA stenosis is usually due to an extrinsic compression by a previously asymptomatic median arcuate ligament (MAL). MAL is diagnosed by computerized tomography in about 10% of the candidates for PD, but only half are found to be hemodynamically significant during the gastroduodenal artery clamping test with Doppler assessment, which is mandatory before any resection...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28223041/is-routine-hepaticojejunostomy-at-the-time-of-unplanned-surgical-bypass-required-in-the-era-of-self-expanding-metal-stents
#2
Roberta Angelico, Shakeeb Khan, Bobby Dasari, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, John Isaac, Darius Mirza, Keith J Roberts
BACKGROUND: Hepaticojejunostomy is routinely performed in patients when inoperable disease is found at planned pancreatoduodenectomy; however, in the presence of self-expanding metal stent (SEMS) hepaticojejunostomy may not be required. The aim of this study was to assess biliary complications and outcomes in patients with unresectable disease at time of planned pancreaticoduodenectomy stratified by the management of the biliary tract. MATERIAL AND METHODS: Retrospective analysis of patients undergoing surgery in January 2010-December 2015...
February 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28216982/late-onset-severe-biliary-bleeding-after-endoscopic-pigtail-plastic-stent-insertion
#3
Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Takaaki Ito, Hiroyuki Morishita, Norimasa Yoshida
Here, we report our experience with a case of severe biliary bleeding due to a hepatic arterial pseudoaneurysm that had developed 1 year after endoscopic biliary plastic stent insertion. The patient, a 78-year-old woman, presented with hematemesis and obstructive jaundice. Ruptured hepatic arterial pseudoaneurysm was diagnosed, which was suspected to have been caused by long-term placement of an endoscopic retrograde biliary drainage (ERBD) stent. This episode of biliary bleeding was successfully treated by transarterial embolization (TAE)...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28216968/complications-and-management-of-forgotten-long-term-biliary-stents
#4
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/28209556/palliation-of-malignant-gastroduodenal-obstruction-fluoroscopic-metallic-stent-placement-with-different-approaches
#5
Elif Bulut, Türkmen Çiftçi, Okan Akhan, Devrim Akıncı
PURPOSE: We aimed to evaluate the safety and effectiveness of fluoroscopy-guided gastroduodenal metallic stent placement with different approaches in malignant obstruction. METHODS: We retrospectively assessed 53 patients (33 men and 20 women; mean age, 58.7±15 years) who underwent stent placement between February 2004 and April 2014. All patients had unresectable tumors. The most common causes of obstruction were gastric (38%) and pancreatic cancers (36%). Uncovered self-expandable metallic stents (SEMS) were placed under fluoroscopic guidance...
February 17, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28208009/impact-of-a-newly-developed-short-double-balloon-enteroscope-on-stent-placement-in-patients-with-surgically-altered-anatomies
#6
Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada
A newly developed short double-balloon enteroscope with a working channel enlarged to a diameter of 3.2 mm is a novel innovation in stent placement for patients with surgically altered anatomies. Herein, we report three patients in whom this new scope contributed to an efficient technique and ideal treatment. In the first case, the double guidewire technique was efficient and effective for multiple stent placements. In the second case, covered self-expandable metal stent (SEMS) placement, which is the standard treatment for malignant biliary obstruction, could be performed in a technologically sound and safe manner...
February 17, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28208003/partially-covered-metal-stents-may-not-prolong-stent-patency-compared-to-uncovered-stents-in-unresectable-malignant-distal-biliary-obstruction
#7
Jae Yun Kim, Gyu Bong Ko, Tae Hoon Lee, Sang-Heum Park, Yun Nah Lee, Young Sin Cho, Yunho Jung, Il-Kwun Chung, Hyun Jong Choi, Sang-Woo Cha, Jong Ho Moon, Young Deok Cho, Sun-Joo Kim
Background/Aims: Controversy still exists regarding the benefits of covered self-expandable metal stents (SEMSs) compared to uncovered SEMSs. We aimed to compare the patency and stent-related adverse events of partially covered SEMSs (PC-SEMSs) and uncovered SEMSs in unresectable malignant distal biliary obstruction. Methods: A total of 134 patients who received a PC-SEMS or uncovered SEMS for palliation of unresectable malignant distal biliary obstruction were reviewed retrospectively...
February 17, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28203092/nab-paclitaxel-plus-gemcitabine-for-metastatic-pancreatic-cancer-a-subgroup-analysis-of-the-western-european-cohort-of-the-mpact-trial
#8
Josep Tabernero, Volker Kunzmann, Werner Scheithauer, Michele Reni, Jack Shiansong Li, Stefano Ferrara, Kamel Djazouli
PURPOSE: The global Phase III MPACT trial demonstrated superior efficacy of nab-paclitaxel plus gemcitabine over gemcitabine alone as first-line treatment for metastatic pancreatic cancer. Region was a randomization stratification factor in the MPACT trial. This subgroup analysis of MPACT examined efficacy and safety of patients treated in Western Europe. PATIENTS AND METHODS: Patients received nab-paclitaxel plus gemcitabine or gemcitabine alone as first-line treatment for metastatic pancreatic cancer as previously described...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28196389/conversion-of-external-percutaneous-transhepatic-biliary-drainage-to-endoscopic-ultrasound-guided-hepaticogastrostomy-after-failed-standard-internal-stenting-for-malignant-biliary-obstruction
#9
Woo Hyun Paik, Nah Kyum Lee, Yousuke Nakai, Hiroyuki Isayama, Dongwook Oh, Tae Jun Song, Sang Soo Lee, Dong-Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Do Hyun Park
Background and study aim Percutaneous transhepatic biliary drainage (PTBD) is a rescue procedure after a failed endoscopic retrograde cholangiopancreatography. As PTBD causes patient discomfort, conversion of the PTBD to internal biliary stenting (PTBDS) may be required; however, PTBDS is sometimes difficult because of the tight stricture. We evaluated the efficacy and safety of conversion of external PTBD to endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) after failed PTBDS. Patients and methods A total of 16 patients with malignant distal biliary obstruction who underwent conversion of external PTBD to EUS-HGS after failed PTBDS were enrolled from two institutions in Korea and Japan...
February 14, 2017: Endoscopy
https://www.readbyqxmd.com/read/28192807/endoscopic-removal-of-a-proximally-migrated-biliary-metallic-stent
#10
Chuncheng Wu, Juliana F Yang, Mei Xu, Wei Liu, Bing Hu
No abstract text is available yet for this article.
February 2017: Endoscopy
https://www.readbyqxmd.com/read/28185468/post-ercp-pancreatitis-early-precut-or-pancreatic-duct-stent-a-multicenter-randomized-controlled-trial-and-cost-effectiveness-analysis
#11
Hui Jer Hwang, Martín Alejandro Guidi, Cecilia Curvale, Juan Lasa, Raúl Matano
BACKGROUND: Pancreatitis is the most frequent complication due to ERCP. Pancreatic duct stent placement has been described as a preventive measure. There is also evidence pointing towards the preventive effect that early precut may provide. AIM: To determine and compare the cost-effectiveness of an early precut approach versus pancreatic duct stent placement for the prevention of post-ERCP pancreatitis. METHODS: This was a multicenter, randomized-controlled pilot study with a cost-effectiveness analysis performed between early precut (group A) and pancreatic duct stent (group B) for the prevention of pancreatitis in high-risk patients...
February 10, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28182300/endoscopic-double-stenting-for-gastrojejunostomy-anastomotic-and-biliary-obstruction-in-a-patient-with-roux-en-y-reconstruction
#12
Tadahisa Inoue, Kiyoaki Ito, Masashi Yoneda
Although it has been reported that endoscopic double stenting using a self-expandable metallic stent (SEMS) for gastroduodenal and biliary obstruction is useful [1-2], the efficacy and safety of performing double stenting using balloon enteroscopy is uncertain in patients with surgically altered anatomy. We describe a patient who had undergone gastrectomy and then underwent endoscopic double stenting for gastrojejunostomy anastomotic and biliary obstruction. A man in his 50s with a history of having undergone distal gastrectomy with Roux-en-Y reconstruction because of gastric cancer developed gastrojejunostomy anastomotic obstruction due to local anastomotic recurrence and peritoneal dissemination (Fig...
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28181704/evaluation-of-the-safety-of-endoscopic-radiofrequency-ablation-for-malignant-biliary-stricture-using-a-digital-peroral-cholangioscope-with-videos
#13
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
https://www.readbyqxmd.com/read/28181137/portoenterostomy-as-a-salvage-procedure-for-major-biliary-complications-following-hepaticojejunostomy
#14
Amit Sharma, John S Hammond, Emmanouil Psaltis, W Keith Dunn, Dileep N Lobo
Major biliary complications that require surgical intervention after hepaticojejunostomy are rare and technically challenging. While the hepaticojejunostomy can be refashioned in most patients requiring surgical reexploration after anastomotic dehiscence, a selected few may require a portoenterostomy, which involves anastomosis of the jejunum to a decapsulated area of the liver to establish a conduit from the intrahepatic bile ducts to the intestine. Herein, we describe the technique where a portoenterostomy has been used to restore bilioenteric continuity in three patients where reconstruction with a hepaticojejunostomy was not feasible...
February 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28175974/resolution-of-metallic-biliary-stent-allergic-reaction-after-partial-stent-removal-in-a-patient-with-nickel-sensitivity
#15
Anthony M Esparaz, Muneeb Ahmed
Local and systemic reactions to implanted metallic devices, particularly to those containing nickel, are well documented. Metal ions are released due to exposure of the metal to blood, proteins, other body fluids, and sheer mechanical stress. Metal ions then complex with native proteins and become antigens, which can elicit hypersensitivity reactions. Another case report depicts a specific allergic complication (early stent occlusion) related to metallic biliary stent implantation. We present a case of allergic symptoms, associated with eating, in a patient who developed nickel sensitivity after biliary metal stent placement confirmed by allergic skin testing to the same metallic biliary stent placed one year earlier...
February 7, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28169138/outcomes-of-salvage-percutaneous-biliary-drainage-after-occlusion-of-endoscopic-stents
#16
Jonathan Kessler, Aram Lee, Paul Frankel, Andrew Dagis, John J Park, James Lin
PURPOSE: To describe outcomes of patients with malignant biliary obstruction who undergo salvage percutaneous biliary drainage after occlusion of endoscopic biliary stents. MATERIALS AND METHODS: A single-center retrospective review was performed of 47 patients (25 men, 22 women) who underwent percutaneous biliary drainage for recurrent obstruction after endoscopic stent placement between 2005 and 2015. Primary malignancies were bile duct (n = 13), colorectal (n = 11), gallbladder (n = 7), pancreas (n = 5), hepatocellular (n = 4), and other (n = 7)...
February 3, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28162906/comparative-study-of-percutaneous-transhepatic-biliary-stent-placement-with-or-without-iodine-125-seeds-for-treating-patients-with-malignant-biliary-obstruction
#17
Asihaer Hasimu, Jun-Peng Gu, Wei-Zheng Ji, Hai-Xiao Zhang, Di-Wen Zhu, Wei-Xin Ren
PURPOSE: To prospectively evaluate safety and efficacy of biliary stent placement with iodine-125 ((125)I) seeds in patients with malignant obstructive jaundice (MOJ). MATERIALS AND METHODS: From July 2011 to June 2014, 55 patients were enrolled (group A, 11 men and 17 women, mean age 70.93 y ± 8.58; group B, 14 men and 13 women, mean age 70.26 y ± 9.71). All patients were randomly assigned to placement of a biliary stent with (125)I seeds (group A) or biliary stent only (group B)...
February 2, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28160331/long-term-outcomes-and-risk-factors-of-biliary-stent-dysfunction-after-endoscopic-double-stenting-for-malignant-biliary-and-duodenal-obstructions
#18
Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Sho Mizukawa, Syuntaro Yabe, Hiroyuki Seki, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Kenji Kuwaki, Hiroyuki Okada
BACKGROUND AND AIMS: Few reports describe the endoscopic double stenting procedure for malignant biliary and duodenal obstructions. We evaluated the clinical outcomes from double stenting, and analyzed the risk factors for biliary stent dysfunction following double stenting. METHODS: Eighty-one patients who underwent endoscopic double stenting for malignant biliary and duodenal obstructions were retrospectively analyzed. We determined the stent dysfunction rate and the biliary stent dysfunction risk factors, and analyzed the endoscopic reintervention results...
February 3, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28160269/infections-in-cancer-patients-with-solid-tumors-a-review
#19
REVIEW
Kenneth V I Rolston
Solid tumors are much more common than hematologic malignancies. Although severe and prolonged neutropenia is uncommon, several factors increase the risk of infection in patients with solid tumors, and the presence of multiple risk factors in the same patient is not uncommon. These include obstruction (most often caused by progression of the tumor), disruption of natural anatomic barriers such as the skin and mucosal surfaces, and treatment-related factors such as chemotherapy, radiation, diagnostic and/or therapeutic surgical procedures, and the increasing use of medical devices such as various catheters, stents, and prostheses...
February 3, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28142156/balloon-enteroscopy-assisted-biliary-drainage-using-a-diathermic-dilator-followed-by-placement-of-a-novel-ultra-slim-metallic-stent
#20
Hiroshi Kawakami, Yoshimasa Kubota, Shinya Ashizuka, Masaru Haraguchi, Ichiro Sannomiya
No abstract text is available yet for this article.
February 2017: Endoscopy
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