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Biliary stenosis

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https://www.readbyqxmd.com/read/28804514/is-eus-guided-drainage-a-suitable-alternative-technique-in-case-of-proximal-biliary-obstruction
#1
Frédérick Moryoussef, Adrien Sportes, Sarah Leblanc, Jean Baptiste Bachet, Stanislas Chaussade, Frédéric Prat
BACKGROUND: Results of endoscopic ultrasound-guided biliary drainage (EUBD) are unknown in case of proximal stricture. The aim is to assess clinical outcomes of EUBD in patients with malignant hilar obstruction. METHODS: Patients undergoing EUBD with hilar strictures were prospectively included. Primary outcome was clinical success at 7 and 30 days (defined by 50% bilirubin decrease). Secondary outcomes were technical success, procedure-related complications, length of hospital stay, reintervention rate, survival and chemotherapy administration...
July 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28758243/enteroscopy-overtube-assisted-over-the-wire-stent-placement-to-treat-an-enteral-stenosis
#2
Antonino Granata, Michele Amata, Mario Traina
A 77-year-old man underwent duodeno-cephalo-pancreatectomy with Roux-en-Y reconstruction for pancreatic head cancer. After two years developed recurrent cholangitis with obstructive jaundice. In suspicion of obstruction of biliary tree, a percutaneous transhepatic cholangiography (PTC) was attempted. Contrast dye injected troughs the catheter shower an intestinal stenosis about 10 centimeters above the bilio-enteric anastomosis. Following PET-CT scan showed no cancer recurrence. This article is protected by copyright...
July 31, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28668523/how-to-deal-with-hepatic-artery-injury-during-pancreaticoduodenectomy-a-systematic-review
#3
S Landen, D Ursaru, V Delugeau, C Landen
BACKGROUND: Operative injury to the hepatic artery is a serious complication of pancreaticoduodenectomy and guidelines to manage this complication are lacking. METHODS: A systematic search performed in PubMed database identified eleven studies overall including 20 patients having sustained injury to the hepatic artery during pancreaticoduodenectomy (n=18) or total pancreatectomy (n=2). One further unpublished personal observation following pancreaticoduodenectomy was also included...
June 28, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28657946/reconstruction-repair-of-iatrogenic-biliary-injuries-is-the-robot-offering-a-new-option-short-clinical-report
#4
Pier Cristoforo Giulianotti, Pablo Quadri, Samarth Durgam, Francesco Maria Bianco
OBJECTIVE: The aim of this study is to analyze perioperative outcomes of robotic reconstruction of iatrogenic biliary injuries and describe the surgical technique in detail. BACKGROUND: Iatrogenic bile duct injuries (BDIs) continue to be a major concern in open and laparoscopic cholecystectomy. In the past decade, robotic surgery has been applied to many different procedures showing technical advantages, especially in microsurgical fields. Few cases of robotic BDI reconstructions have been described in the literature so far...
June 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28651522/the-role-of-enterococcus-spp-and-multidrug-resistant-bacteria-causing-pyogenic-liver-abscesses
#5
Marcus M Mücke, Johanna Kessel, Victoria T Mücke, Katharina Schwarzkopf, Michael Hogardt, Christoph Stephan, Stefan Zeuzem, Volkhard A J Kempf, Christian M Lange
BACKGROUND: Pyogenic liver abscesses (PLA) remain a significant clinical problem. Unfortunately, little is known about current bacterial susceptibility profiles and the incidence of multidrug resistant organisms (MDROs) causing PLA in Western countries. Yet, this crucial information is pivotal to guide empirical antibiotic therapy. Aim of this study was to provide detailed characteristics of PLA with a special focus on underlying bacterial pathogens and their susceptibility to antibiotics...
June 26, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28644566/clinical-characteristics-and-outcome-of-liver-transplantation-for-alagille-syndrome-in-children
#6
Tao Zhou, Jianjun Zhang, Yi Luo, Yuan Liu, Sy Zhuang, Feng Xue, Longzhi Han, Qiang Xia
AIM: The aim of this study was to analyze clinical characteristics and outcome of liver transplantation for Alagille syndrome in children. METHOD: By retrospectively reviewing the medical records of 9 Alagille syndrome patients(AGS) with liver transplantation(LT) in Renji Hospital between 2006 and 2015,After operative,the height and weight Z score were compared with preoperative. RESULT: There were 9 patients included in the study; cholestasis and peculiar faces were seen in all of the patients (100%), heart defect in 8 patients (88...
June 23, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28621295/efficacy-and-safety-in-case-of-technical-success-of-endoscopic-ultrasound-guided-transhepatic-antegrade-biliary-drainage-a-report-of-a-monocentric-study
#7
Sébastien Godat, Erwan Bories, Fabrice Caillol, Christian Pesenti, Jean Philippe Ratone, Chiara de Cassan, Marc Giovannini
BACKGROUND AND OBJECTIVES: Endoscopic ultrasound (EUS)-guided biliary drainage techniques are alternative procedures in cases of obstructive jaundice with altered anatomy or failed ERCP. Complications related to EUS-guided antegrade drainage (EUS-AD) are still present in up to 10% of cases, and combination of procedures is sometimes suggested to avoid adverse events. The purpose of our study is to evaluate the efficacy and safety of EUS-AD with transhepatic access in case of technical success...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28606484/short-and-long-term-outcomes-after-a-reconstituting-and-fenestrating-subtotal-cholecystectomy
#8
Aafke H van Dijk, Sandra C Donkervoort, Wytze Lameris, Eefje de Vries, Quirijn Aj Eijsbouts, Bart C Vrouenraets, Olivier R Busch, Marja A Boermeester, Philip R de Reuver
BACKGROUND: Multiple surgical techniques are advised to safely perform cholecystectomy in difficult cases, such as conversion to open surgery or subtotal cholecystectomy (STC). A reconstituting and a fenestrating STC are techniques for STC. The aim of this study was to investigate short and long-term morbidity and quality of life associated with STC and to compare the outcomes after fenestrating and reconstituting STC. STUDY DESIGN: Patients who underwent STC were identified...
June 9, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28598458/multidisciplinary-cooperation-in-a-simultaneous-combined-liver-and-kidney-transplantation-patient-of-primary-hyperoxaluria-1
#9
Q Ren, W Ju, D Wang, Z Guo, M Chen, X He
Primary hyperoxaluria type 1 is an autosomal recessive hereditary glyoxylate metabolism disorder characterized by excessive production of oxalate, caused by the deficiency of liver specific peroxisomal enzyme: alanineglyoxylate aminotransferase. For patients with end-stage renal disease, combined liver and kidney transplantation was needed. This report describes one patient, with a diagnosis of end-stage renal disease and primary hyperoxaluria 1 confirmed by PCR and direct sequencing with genomic DNA, received the simultaneous combined liver and kidney transplantation after seven months' waiting...
January 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28567456/surgery-for-intractable-pain-in-a-patient-with-chronic-pancreatitis-complicated-with-biliary-obstruction-portal-vein-stenosis-and-mesenteric-venous-collaterals
#10
Cuneyt Kayaalp, Murat Sait Dogan, Veysel Ersan
Pancreatic head resection for chronic pancreatitis is a challenging procedure, in the presence of venous collaterals, cavernous transformation, extensive fibrosis or porto-mesenteric stenosis or thrombosis. We present a surgically treated patient for the intractable pain of chronic pancreatitis. Complications with biliary obstruction and portal vein stenosis/thrombosis resulted in cavernous transformation. A pancreaticoduodenectomy combined with portal vein resection was intended in a 51 year-old male, but the procedure was terminated due to the high risk associated with intraoperative bleeding...
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28547740/biliary-duodenal-anastomosis-using-magnetic-compression-following-massive-resection-of-small-intestine-due-to-strangulated-ileus-after-living-donor-liver-transplantation-a-case-report
#11
Ryusuke Saito, Hiroyuki Tahara, Seiichi Shimizu, Masahiro Ohira, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Hideki Ohdan
BACKGROUND: Despite the improvements of surgical techniques and postoperative management of patients with liver transplantation, biliary complications are one of the most common and important adverse events. We present a first case of choledochoduodenostomy using magnetic compression following a massive resection of the small intestine due to strangulated ileus after living donor liver transplantation. CASE PRESENTATION: The 54-year-old female patient had end-stage liver disease, secondary to liver cirrhosis, due to primary sclerosing cholangitis with ulcerative colitis...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28527479/-biliary-anastomosis-in-liver-transplantation-with-or-without-t-tube
#12
Janine Carmelino, Susana Rodrigues, Hugo Pinto Marques, Vasco Ribeiro, Daniel Virella, Marta Alves, Américo Martins, Eduardo Barroso
INTRODUCTION: Biliary complications occur in 10-30% of liver transplants. The aim of this study was to compare the incidence of these complications in liver transplants when the T-tube was or was not used during the biliary anastomosis. MATERIAL AND METHODS: Analysis of 2 groups of patients undergoing liver transplantation between 2008 and 2012. Patients were divided considering if the T-tube was used (G1) or if it was not (G2). We sought explanatory models of the occurrence of biliary complications by logistic regression, including the variables identified in the univariate analysis...
February 27, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28512648/revision-of-biliary-sphincterotomy-by-re-cut-balloon-dilation-or-temporary-stenting-comparison-of-clinical-outcome-and-complication-rate-with-video
#13
Gianfranco Donatelli, Jean-Loup Dumont, Fabrizio Cereatti, Thierry Tuszynski, Bertrand Marie Vergeau, Bruno Meduri
Background and study aims Revision of endoscopic retrograde cholangiopancreatography (ERCP) may be necessary following previous biliary endoscopic sphincterotomy for recurrent biliary symptoms related to biliary stone recurrence, cholangitis or post-biliary endoscopic sphincterotomy (bEST) papillary stenosis and cholestasis. The aim of this retrospective study was to evaluate the clinical outcome and complication rate associated with re-cut, balloon dilation and biliary metal stenting in revision ERCP. Patients and methods From January 2010 to January 2015, 139 subjects with stigma of a previous sphincterotomy required a revision ERCP (64 Men/75 Women; mean age 71 years; range 32 - 101 years)...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28497648/intrahepatic-cholangiojejunostomy-for-complex-biliary-stenosis-after-pediatric-living-donor-liver-transplantation
#14
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...
August 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28489291/long-term-outcomes-of-early-compared-to-late-onset-choledochocholedochal-anastomotic-strictures-after-orthotopic-liver-transplantation
#15
Sanjaya K Satapathy, Imran Sheikh, Bilal Ali, Fazal Yahya, Mehmet Kocak, Laxmi Babu Parsa, James D Eason, Jason M Vanatta, Satheesh P Nair
BACKGROUND: Endoscopic treatment of anastomotic biliary stricture (ABS) after liver transplantation (LT) has been proven to be effective and safe, but long-term outcomes of early compared to late onset ABS have not been studied. The aim of this study is to compare the long-term outcome of early ABS to late ABS. METHODS: Of the 806 adult LT recipients (04/2006-12/2012), 93 patients met the criteria for inclusion, and were grouped into non-ABS (no stenosis on ERCP, n=41), early ABS (stenosis <90 days after LT, 18 [19...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28479376/extracellular-vesicles-in-bile-as-markers-of-malignant-biliary%C3%A2-stenoses
#16
Valeria Severino, Jean-Marc Dumonceau, Myriam Delhaye, Solange Moll, Isabelle Annessi-Ramseyer, Xavier Robin, Jean-Louis Frossard, Annarita Farina
BACKGROUND & AIMS: Algorithms for diagnosis of malignant common bile duct (CBD) stenoses are complex and lack accuracy. Malignant tumors secrete large numbers of extracellular vesicles (EVs) into surrounding fluids; EVs might therefore serve as biomarkers for diagnosis. We investigated whether concentrations of EVs in bile could discriminate malignant from nonmalignant CBD stenoses. METHODS: We collected bile and blood samples from 50 patients undergoing therapeutic endoscopic retrograde cholangiopancreatography at university hospitals in Europe for CBD stenosis of malignant (pancreatic cancer, n = 20 or cholangiocarcinoma, n = 5) or nonmalignant (chronic pancreatitis [CP], n = 15) origin...
August 2017: Gastroenterology
https://www.readbyqxmd.com/read/28476200/analysis-of-the-long-term-results-of-living-donor-liver-transplantation-in-adults
#17
Santiago Sánchez Cabús, Laia Estalella, Mihai Pavel, David Calatayud, Víctor Molina, Joana Ferrer, Constantino Fondevila, Josep Fuster, Juan Carlos García-Valdecasas
INTRODUCTION: Living donor liver transplantation (LDLT) is an alternative to conventional transplantation given its excellent results. The aim of this study is to evaluate long-term outcomes in LDLT recipients. METHODS: 100 consecutive THDV recipients from the Hospital Clínic of Barcelona from March 2000 to October 2015 were included. The main indication for transplantation was end-stage liver disease (58%) followed by hepatocellular carcinoma (41%). 95% of grafts consisted of the right liver of the donor and the 5% of the left liver...
May 2, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28457413/hepatic-artery-thrombosis-after-liver-transplantation-five-year-experience-at-the-state-university-of-campinas
#18
C H Puliti Reigada, E C de Ataide, T de Almeida Prado Mattosinho, I F S F Boin
BACKGROUND: Hepatic artery thrombosis (HAT) is reported in 4%-15% of orthotopic liver transplants. Risk factors include technical error in the anastomosis, vascular anatomic variation, and high microvascular resistance. The aim of this study was to verify the incidence of HAT, early or late, and possible risk factors. METHODS: This was a retrospective study from January 2007 to December 2012 at the State University of Campinas. Variables analyzed were age, sex, cold and warm ischemia times, underlying disease, presence of hepatocellular carcinoma, Model for End-Stage Liver Disease (MELD) score, arterial anatomic variation in the graft, cytomegalovirus (CMV) infection, rejection, biliary complications, retransplantation rate, and survival...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457406/comparison-of-the-results-of-living-donor-liver-transplantation-due-to-acute-liver-failure-and-biliary-atresia-in-a-quaternary-center
#19
L Éboli, A C Tannuri, N Gibelli, T Silva, P Braga, U Tannuri
OBJECTIVE: The objective of this study was to compare the complications, outcomes, and survival prevalence in patients undergoing living donor liver transplantation due to biliary atresia (BA) or acute liver failure (ALF). RESULTS: In the period of June 1998-July 2016, 199 children underwent living transplantation due to BA or ALF. Of these 199, 184 were included in the analysis. The average age, weight, and body mass index of BA patients were lower than those of ALF (P < ...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28429278/-trans-hepatico-cystic-coledochostomy-for-the-opening-hydatid-cyst-in-the-biliary-tract-indications-and-outcome-evaluation-of-25-cases
#20
S Daldoul, G H El Kebir, I Messoudi, A Mabrouk, M Tahar Bouzidi, M Ben Moussa
The treatment of hydatid cysts of the liver opened in the bile ducts is sometimes difficult and complex. The trans-hepaticocystic coledochostomy (CTHK) is one of these processes. We conducted a review of the indications for this surgical procedure and its perioperative outcomes through a series of 25 patients and then we analyzed predictor factors of complications. During the period's study, 909 patients with liver hydatid cyst went under the surgery. Ninety two (92, i.e. 10.1%) of them had an opening in the bile ducts through a large fistula...
April 20, 2017: Bulletin de la Société de Pathologie Exotique
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