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https://www.readbyqxmd.com/read/29449266/fungal-liver-abscess-in-an-immunocompetent-patient-who-underwent-repeated-ercps-and-subtotal-cholecystectomy
#1
Sundas Hasan, Robert Fearn
We report a case of a previously healthy female patient who initially presented with fever, jaundice and right upper quadrant pain three days after dilatation and stenting of a stricture of the common bile duct (CBD). During an earlier admission, the patient had undergone endoscopic retrograde cholangiopancreatography (ERCP) having presented with fevers and biliary dilatation on ultrasound. The ERCP features were more consistent with Mirizzi's Syndrome. The patient subsequently underwent subtotal cholecystectomy and later developed a CBD stricture, requiring repeat ERCP and stent insertion...
February 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29444709/mucinous-cystic-neoplasm-of-the-liver-with-extrahepatic-growth-presenting-with-ascending-cholangitis-diagnosed-by-endoscopic-ultrasound-features-a-case-report
#2
Tanawat Pattarapuntakul, Bancha Ovartlarnporn, Jaksin Sottisuporn
BACKGROUND: Mucinous cystic neoplasm of the liver with extrahepatic growth is a rare benign epithelial neoplasm of the biliary system that presents with a mass effect or is incidentally found on imaging. The tumor affects mostly the common hepatic duct, which is difficult to diagnose preoperatively by radiology, endoscopy, or cystic fluid analysis. Endoscopic ultrasound is a noninvasive tool for the evaluation of features of a cystic lesion and the extent of disease. Optimal treatment is complete tumor resection...
February 15, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29444707/percutaneous-transhepatic-vs-endoscopic-retrograde-biliary-drainage-for-suspected-malignant-hilar-obstruction-study-protocol-for-a-randomized-controlled-trial
#3
Firas Al-Kawas, Harry Aslanian, John Baillie, Filip Banovac, Jonathan M Buscaglia, James Buxbaum, Amitabh Chak, Bradford Chong, Gregory A Coté, Peter V Draganov, Kulwinder Dua, Valerie Durkalski, B Joseph Elmunzer, Lydia D Foster, Timothy B Gardner, Brian S Geller, Priya Jamidar, Laith H Jamil, Rajesh N Keswani, Mouen A Khashab, Gabriel D Lang, Ryan Law, David Lichtenstein, Simon K Lo, Sean McCarthy, Silvio Melo, Daniel Mullady, Jose Nieto, J Bayne Selby, Vikesh K Singh, Rebecca L Spitzer, Brian Strife, Paul Tarnaksy, Jason R Taylor, Jeffrey Tokar, Andrew Y Wang, April Williams, Field Willingham, Patrick Yachimski
BACKGROUND: The optimal approach to the drainage of malignant obstruction at the liver hilum remains uncertain. We aim to compare percutaneous transhepatic biliary drainage (PTBD) to endoscopic retrograde cholangiography (ERC) as the first intervention in patients with cholestasis due to suspected malignant hilar obstruction (MHO). METHODS: The INTERCPT trial is a multi-center, comparative effectiveness, randomized, superiority trial of PTBD vs. ERC for decompression of suspected MHO...
February 14, 2018: Trials
https://www.readbyqxmd.com/read/29442062/gallstone-ileus-in-a-ninety-two-years-old-colecistectomized-patient-after-endoscopic-biliary-sphincterotomy-a-case-report
#4
S Fedele, P Lobascio, G Carbotta, G Balducci, R Laforgia, M G Sederino, M Minafra, A Delvecchio, N Palasciano
INTRODUCTION: Gallstone ileus is an uncommon condition of mechanical bowel obstruction caused by the passage of a gallstone into the bowel. It occurs more frequently in female patients older than 65 years and often for a biliary-enteric fistula. The pathognomonic features of gallstone ileus - the Rigler's triad - are pneumobilia, ectopic gallstone and bowel obstruction. Less commonly, a gallstone may enter the intestinal lumen through the common bile duct, after endoscopic retrograde cholangiopancreatography, and very rarely in colecistectomized patient...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29441227/pancreaticoportal-fistula-formation-as-a-consequence-of-recurrent-acute-pancreatitis-clinical-and-imaging-considerations
#5
Mina S Makary, Edward L Gayou, Douglas Kyrouac, Zarine K Shah
A pancreatic-portal vein fistula (PPVF) is an extremely rare complication of pancreatitis. In this report, we present a patient with a PPVF in the setting of recurrent pancreatitis and portal vein thrombosis diagnosed by cross-sectional imaging and endoscopic retrograde cholangio-pancreatography, who responded to medical management and anticoagulation. A critical review of this disease process is explored to highlight pathology, imaging characteristics, and essential alternative diagnostic considerations. We also discuss potential complications and current treatment strategies...
2018: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/29439461/early-diagnosis-to-improve-the-poor-prognosis-of-pancreatic-cancer
#6
REVIEW
Masataka Kikuyama, Terumi Kamisawa, Sawako Kuruma, Kazuro Chiba, Shinya Kawaguchi, Shuzo Terada, Tatsunori Satoh
Pancreatic cancer (PC) has a poor prognosis due to delayed diagnosis. Early diagnosis is the most important factor for improving prognosis. For early diagnosis of PC, patients with clinical manifestations suggestive of PC and high risk for developing PC need to be selected for examinations for PC. Signs suggestive of PC (e.g., symptoms, diabetes mellitus, acute pancreatitis, or abnormal results of blood examinations) should not be missed, and the details of risks for PC (e.g., familial history of PC, intraductal mucin producing neoplasm, chronic pancreatitis, hereditary pancreatitis, or life habit) should be understood...
February 11, 2018: Cancers
https://www.readbyqxmd.com/read/29437771/hepatotoxicity-associated-with-vismodegib
#7
Prabhjot S Bedi, Manoj P Rai, Nishant Tageja, Heather Laird-Fick
An 82-year-old Caucasian woman with a history of basal cell carcinoma on vismodegib presented with nausea, vomiting and intermittent abdominal pain. Laboratory results were remarkable for the elevation of liver enzymes. Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiogram (PTC) did not show evidence of intrahepatic or extrahepatic obstruction of the biliary tract. During PTC external biliary catheter was placed; however, bilirubin continued to rise. Further, laboratory work-up and imaging studies ruled out other possible aetiologies for hepatotoxicity such as infections, autoimmune hepatitis and other drugs known to be hepatotoxic thus leaving vismodegib the most likely cause of hepatotoxicity...
February 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29435318/endoscopic-management-of-bile-leaks-after-liver-transplantation-an-analysis-of-two-high-volume-transplant-centers
#8
Oriol Sendino, Alejandro Fernández-Simon, Ryan Law, Barham Abu Dayyeh, Michael Leise, Karina Chavez-Rivera, Henry Cordova, Jordi Colmenero, Gonzalo Crespo, Cristina Rodriguez de Miguel, Constantino Fondevila, Josep Llach, Miquel Navasa, Todd Baron, Andrés Cárdenas
Background: Bile leak after liver transplantation (LT) is commonly treated with endoscopic retrograde cholangiopancreatography (ERCP); however, there are limited data regarding the optimal treatment strategy. Objective: We aimed to examine the role of ERCP in LT recipients with bile leaks at two large institutions. Methods: We reviewed all ERCPs performed in LT recipients with bile leak and duct-to-duct biliary anastomosis at two high-volume transplant centers...
February 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29434167/history-of-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-and-acute-pancreatitis-as-risk-factors-for-post-ercp-pancreatitis
#9
Eiji Funatsu, Atsuhiro Masuda, Mamoru Takenaka, Takashi Nakagawa, Hideyuki Shiomi, Hayato Yoshinaka, Takashi Kobayashi, Arata Sakai, Yosuke Yagi, Masaru Yoshida, Yoshifumi Arisaka, Yoshihiro Okabe, Hiromu Kutsumi, Takeshi Azuma
BACKGROUND: Previous pancreatitis is a definite patient-related risk factor for pancreatitis after endoscopic retrograde cholangiopancreatography (post-ERCP pancreatitis: PEP). However, the effects of differences in the history of PEP and acute pancreatitis on the occurrence of PEP have not been fully investigated. We examined the relationship between previous PEP or previous acute pancreatitis and procedural factors associated with PEP. METHODS: Clinical data on 1,334 consecutive patients undergoing ERCP between April 2006 and June 2010 were collected...
May 15, 2017: Kobe Journal of Medical Sciences
https://www.readbyqxmd.com/read/29434158/can-trainees-safely-perform-endoscopic-treatments-for-common-bile-duct-stones-a-single-center-retrospective-study
#10
Tomoya Iida, Hiroyuki Kaneto, Kouhei Wagatsuma, Hajime Sasaki, Yumiko Naganawa, Suguru Nakagaki, Shuji Satoh, Haruo Shimizu, Hiroshi Nakase
Objective There are no reports on whether or not trainees can safely carry out endoscopic procedures for the removal of common bile duct (CBD) stones. The aim of this study was to investigate the efficacy and safety of endoscopic treatments for CBD stones by trainees. Methods Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 1,016 consecutive patients at our institution during the 6-year study period. The endoscopically treated patients with CBD stones were included in this study. Physicians who had experienced ≥300 ERCP procedures were defined as experts, while those who had experienced <300 procedures were defined as trainees...
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29430229/pancreatic-pseudocyst-ruptured-due-to-acute-intracystic-hemorrhage
#11
Kunishige Okamura, Masanori Ohara, Tsukasa Kaneko, Tomohide Shirosaki, Aki Fujiwara, Takumi Yamabuki, Ryo Takahashi, Kazuteru Komuro, Nozomu Iwashiro, Noriko Kimura
Rupture of pancreatic pseudocyst is one of the rare complications and usually results in high mortality. The present case was a rupture of pancreatic pseudocyst that could be treated by surgical intervention. A 74-year-old man developed abdominal pain, vomiting, and diarrhea, and he was diagnosed with cholecystitis and pneumonia. Three days later, acute pancreatitis occurred and computed tomography (CT) showed slight hemorrhage in the cyst of the pancreatic tail. After another 10 days, CT showed pancreatic cyst ruptured due to intracystic hemorrhage...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29428940/analysis-of-wire-guided-hemostasis-introducer-for-percutaneous-therapy-of-bile-duct-stones
#12
Marcus Hollenbach, Jürgen Feisthammel, Joachim Mössner, Albrecht Hoffmeister
BACKGROUND: Bile duct stones (BDS) are usually removed via endoscopic retrograde cholangiopancreatography (ERCP) or, if ERCP remains unsuccessful, percutaneous transhepatic cholangiodrainage (PTCD). However, PTCD provides limited access to large BDSs. We analyzed a modified approach of PTCD for percutaneous therapy of BDS. METHODS: We used a modified approach of PTCD with a 13-french (Fr) hemostasis introducer for transhepatic access to BDS. Short-wired balloon or basket catheter were applied for safe removal of BDS...
February 9, 2018: Digestion
https://www.readbyqxmd.com/read/29428105/risk-factor-analysis-of-post-ercp-cholangitis-a-single-center-experience
#13
Min Chen, Lei Wang, Yun Wang, Wei Wei, Yu-Ling Yao, Ting-Sheng Ling, Yong-Hua Shen, Xiao-Ping Zou
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) may have complications. Our study aimed to investigate the risk factors and prevention of post-ERCP cholangitis. METHODS: We retrospectively analyzed 4234 cases undergone ERCP in the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2008 to December 2013. Patient-related factors and procedure-related factors were analyzed to find the risk factors of post-ERCP cholangitis...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29425886/ercp-performed-through-previously-placed-duodenal-stents-a-multicenter-retrospective-study-of-outcomes-and-adverse-events
#14
Judith Staub, Ali Siddiqui, Linda Jo Taylor, David Loren, Tom Kowalski, Douglas G Adler
BACKGROUND AND AIMS: ERCP (endoscopic retrograde cholangiopancreatography) performed through previously placed enteral stents is an uncommon procedure without a significant amount of supporting literature, and with a wide reported range of technical success. The purpose of this study was to evaluate and better define the technical feasibility and safety of performing ERCP through enteral stents in patients with combined malignant biliary and gastric outlet obstruction (GOO). METHODS: We conducted a multicenter, retrospective study on 71 patients with combined gastric outlet and biliary obstruction who underwent ERCP through a previously placed enteral stent at 2 tertiary care centers...
February 6, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29423876/ureteroscopic-holmium-laser-assisted-retrograde-nephrostomy-access-a-novel-approach-to-percutaneous-stone-removal
#15
Kamaljot S Kaler, Egor Parkhomenko, Zhamshid Okunohov, Roshan M Patel, Jaime Landman, Ralph V Clayman, Carlos A Uribe
INTRODUCTION AND OBJECTIVES: Percutaneous nephrolithotomy remains a challenging procedure primarily due to difficulties obtaining access. Indeed, few urologists obtain their own access due to difficulties using a fluoroscopic or ultrasonic based antegrade puncture technique. Herein we report the first experience using holmium laser energy to obtain access in a retrograde fashion. METHODS: After a pretreatment week of tamsulosin 0.4 mg/day (one center only) and following a documented sterile urine, a total of ten patients underwent retrograde holmium laser-assisted endoscopic-guided nephrostomy access in a prone split leg position...
February 8, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29421914/the-safety-of-deep-sedation-with-propofol-controlled-by-the-endoscopist-in-endoscopic-retrograde-cholangiopancreatography-ercp-a-prospective-study-in-a-tertiary-hospital
#16
Lara Luzón Solanas, Leticia Ollero Domenche, Eva María Sierra Moros, José Val Pérez, María Teresa Soria San Teodoro, Teresa Giménez Júlvez, Rafael Uribarrena Amezaga
INTRODUCTION: propofol administered by an endoscopist with a trained nurse has evolved as an alternative to anesthesia monitoring and is increasingly common in the routine clinical practice, even in advanced endoscopy. OBJECTIVE: to evaluate the safety of deep sedation with endoscopist-controlled propofol in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). MATERIAL AND METHODS: this was a prospective study in patients undergoing ERCP under deep sedation with propofol...
February 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29420854/transgastric-endoscopic-submucosal-dissection-of-esophageal-cancer-with-cervical-stricture
#17
Yuichi Shimodate, Yoshio Nagahisa, Motowo Mizuno
A 60-year-old man with a severe cervical stricture and pharyngocutaneous fistula caused by total laryngopharyngectomy and radiochemotherapy (70 Gy) for laryngeal cancer underwent esophagogastroduodenoscopy using a small-caliber endoscope (Olympus GIF-XP290N). A 15-mm superficially depressed lesion in the irradiated area of the cervical esophagus and a 30-mm superficially depressed lesion in the mid esophagus were identified (Fig. 1A-C). Esophagectomy or endoscopic dilation of the cervical stricture was not possible because of the pharyngocutaneous fistula...
February 8, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29417182/simultaneous-common-bile-duct-clearance-and-laparoscopic-cholecystectomy-experience-of%C3%A2-a-one-stage-approach
#18
Shahin Mohseni, John Ivarsson, Rebecka Ahl, Sinan Dogan, Sten Saar, Arvo Reinsoo, Teesi Sepp, Karl-Gunnar Isand, Edvard Garder, Ilmar Kaur, Heiti Ruus, Peep Talving
INTRODUCTION: The timing and optimal method for common bile duct (CBD) clearance and laparoscopic cholecystectomy remains controversial. Several different approaches are available in clinical practice. The current study presents the experience of two European hospitals of simultaneous laparoscopic cholecystectomy (LC) and intra-operative endoscopic retrograde cholangiopacreatography (IO-ERCP) done by surgeons. METHODS: Retrospective analysis of all consecutive patients subjected to LC + IO-ERCP during their index admission between 4/2014 and 9/2016...
February 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29416281/comparative-efficacy-of-tamsulosin-versus-tadalafil-as-medical-expulsive-therapy-for-distal-ureteric-stones
#19
Suresh Kumar Goyal, Vikash Singh, Himanshu Pandey, Mahaveer Kumar Chhabra, Satinder Pal Aggarwal, Amilal Bhat
Objective: The objective of this study was to compare the relative efficacy of tamsulosin and tadalafil as medical expulsive therapy for distal ureteric stones. Patients and Methods: This was a prospective study performed between December 2014 and February 2016. A total of 123 adult patients (>18 years of age) presenting with distal ureteric stones sized 6-10 mm were randomized to treatment with tamsulosin 0.4 mg once daily (Group A) or tadalafil10 mg once daily (Group B)...
January 2018: Urology Annals
https://www.readbyqxmd.com/read/29411681/assessment-of-sedation-level-for-endoscopic-retrograde-cholangiopancreatography-a-prospective-validation-study
#20
Jarno Jokelainen, Harri Mustonen, Leena Kylänpää, Marianne Udd, Outi Lindström, Reino Pöyhiä
BACKGROUND AND AIMS: There is no consensus on how to assess the depth of sedation for endoscopic retrograde cholangiopancreatography (ERCP). This study was carried out in order to evaluate different methods of assessment of depth of sedation: bispectral index (BiS), modified Richmond Agitation/Sedation Scale (mRASS), modified Ramsay Sedation Scale (mRSS) and modified Observer Assessment of Alertness and Sedation (mOAAS) and their applicability to clinical practice. METHODS: Two hundred patients were recruited...
February 7, 2018: Scandinavian Journal of Gastroenterology
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