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https://www.readbyqxmd.com/read/28104994/cutting-balloon-treatment-of-anastomotic-biliary-stenosis-after-liver-transplantation-report-of-two-cases
#1
Fan Ding, Hui Tang, Chi Xu, Zai-Bo Jiang, Shu-Hong Yi, Hua Li, Nan Jiang, Wen-Jie Chen, Qing Yang, Yang Yang, Gui-Hua Chen
Biliary stenosis is a common complication after liver transplantation, and has an incidence rate ranging from 4.7% to 12.5% based on our previous study. Three types of biliary stenosis (anastomotic stenosis, non-anastomotic peripheral stenosis and non-anastomotic central hilar stenosis) have been identified. We report the outcome of two patients with anastomotic stricture after liver transplantation who underwent successful cutting balloon treatment. Case 1 was a 40-year-old male transplanted due to subacute fulminant hepatitis C...
January 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28100991/sphincter-of-oddi-dysfunction-a-perplexing-presentation
#2
Sana Ahmad Din, Iman Naimi, Mirza Beg
Sphincter of Oddi dysfunction is caused by stenosis or dyskinesia of the sphincter of Oddi, leading to blockage of bile drainage from the common bile duct. We present the case of a 16-year-old female with chronic abdominal pain who underwent laparoscopic cholecystectomy for cholelithiasis but continued to experience abdominal pain, nausea, and vomiting along with persistently elevated ALT and AST levels. Postoperative abdominal ultrasound was nondiagnostic. Esophagogastroduodenoscopy showed mild reflux esophagitis and mild chronic Helicobacter pylori-negative gastritis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28086796/prophylaxis-of-post-erc-infectious-complications-in-patients-with-biliary-obstruction-by-adding-antimicrobial-agents-into-erc-contrast-media-a-single-center-retrospective-study
#3
Hella Wobser, Agnetha Gunesch, Frank Klebl
BACKGROUND: Patients with biliary obstruction are at high risk to develop septic complications after endoscopic retrograde cholangiography (ERC). We evaluated the benefits of local application of antimicrobial agents into ERC contrast media in preventing post-ERC infectious complications in a high-risk study population. METHODS: Patients undergoing ERC at our tertiary referral center were retrospectively included. Addition of vancomycin, gentamicin and fluconazol into ERC contrast media was evaluated in a case-control design...
January 13, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28042247/a-fully-covered-self-expandable-metal-stent-anchored-by-a-10-fr-double-pigtail-plastic-stent-an-effective-anti-migration-technique
#4
Panagiotis Katsinelos, Georgia Lazaraki, Stergios Gkagkalis, Grigoris Chatzimavroudis, Kiriaki Anastasiadou, Nikos Georgakis, Olga Giouleme, Christos Zavos, Jannis Kountouras
BACKGROUND: Fully covered self-expandable metal stents (FCSEMS) have been used successfully in the treatment of malignant and benign biliary strictures. However, stent migration is a major complication. We investigated the efficacy of anchoring FCSEMS with a 10-Fr double-pigtail plastic stent to prevent migration in patients with biliary strictures. METHODS: Between January 2012 and May 2013, 10 patients with malignant biliary strictures and one patient with a suprapapillary benign biliary stenosis were enrolled in the study...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28018098/therapeutic-approaches-for-portal-biliopathy-a-systematic-review
#5
REVIEW
Irene Franceschet, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Marco Senzolo
Portal biliopathy (PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma (PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC (77%-100%), only a part of these (5%-38%) are symptomatic...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27997964/treatment-of-biliary-strictures-with-fully-covered-self-expandable-metal-stents-after-pancreaticoduodenectomy
#6
Hitoshi Shibuya, Kazuo Hara, Nobumasa Mizuno, Susumu Hijioka, Hiroshi Imaoka, Masahiro Tajika, Tsutomu Tanaka, Makoto Ishihara, Yutaka Hirayama, Tsukasa Yoshida, Nozomi Okuno, Nobuhiro Hieda, Patommatat Bhanthumkomol, Yasuhiro Shimizu, Yoshiki Senda, Seiji Natsume, Yasumasa Niwa, Kenji Yamao
Background and study aims Anastomotic stricture is a late complication after biliary reconstructive surgery, but standard treatments are currently lacking. We selected patients who had undergone pancreaticoduodenectomy and Child's procedure, and aimed to evaluate the safety and efficacy of temporary placement of fully covered self-expandable metal stents (FCSEMSs) to treat postoperative anastomotic stricture. Patients and methods This study retrospectively analyzed 13 patients who underwent treatment with FCSEMSs for anastomotic stricture between June 2011 and March 2016...
January 2017: Endoscopy
https://www.readbyqxmd.com/read/27932131/t-tube-systematic-use-in-the-biliary-anastomosis-comparison-of-two-consecutive-series-of-liver-transplantation
#7
C M García Bernardo, I González-Pinto Arrillaga, A Miyar de León, V Cadahia Rodrigo, L González Dieguez, L Barneo Serra, L Vázquez Velasco
OBJECTIVES: The authors sought to check the frequency of biliary complications with the use of a T-tube. In 2012, throughout the year, it was carried out systematically in all liver transplantations regardless of the characteristics of the bile duct. Despite the long experience, biliary complications remain a common cause of postoperative morbidity and mortality. MATERIAL AND METHODS: In this study we compared complications in 23 consecutive transplantation cases using T-tube biliary anastomosis during the year 2012 with 23 consecutive transplantation cases without T-tube during the year 2013...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27928446/gastrostomy-with-peritoneal-collar-versus-percutaneous-endoscopic-gastrostomy
#8
Tudor C, Branescu C, Savlovschi C, El-Khatib A, Pantu H, Nica A, Dascalu Am, Masoumeh B, Tudor As, Oprescu Sm, Serban D
Aim. The present study aimed to perform a medico-surgical comparative analysis of the 2 most widely used techniques: gastrostomy with peritoneal collar versus percutaneous endoscopic gastrostomy, based on the vast clinical experience in an Upper Digestive Surgery Clinic. Materials and method. A retrospective study was carried out between January 2010 and January 2015 on the patients admitted for a surgical solution for feeding. The indications, preoperative preparation, surgical techniques, and postoperative outcomes were analyzed...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27925689/prognostic-significance-of-hepatic-arterial-collaterals-in-liver-transplant-recipients-with-biliary-strictures
#9
André Viveiros, Rafael Rehwald, Erich Vettori, Armin Finkenstedt, Maria Effenberger, Benedikt Schaefer, Livia Dorn, Herbert Tilg, Stefan Schneeberger, Bernhard Glodny, Heinz Zoller, Martin C Freund
BACKGROUND: The aim of the present study was to determine the prevalence of hepatic artery stenosis (HAS) and the prognostic implications of hepatic arterial collaterals in liver transplant (LT) recipients with biliary strictures. METHODS: 105 LT recipients transplanted between 2004 and 2015 at our center had documented biliary strictures. HAS and collaterals were assessed in high quality imaging of the hepatic artery available from 66 recipients. Clinical, demographic and biochemical recipient and donor data were retrospectively analyzed and tested for their association with biliary of arterial complications after LT...
December 7, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27921168/the-2016-diagnostic-criteria-for-primary-sclerosing-cholangitis
#10
Takahiro Nakazawa, Kenji Notohara, Susumu Tazuma, Atsushi Tanaka, Hiroyuki Isayama, Toshio Tsuyuguchi, Toshiyuki Mori, Hajime Takikawa
BACKGROUND: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown cause that is characterized pathologically by an inflammatory and fibrotic process centered on the epithelium, leading to diffuse biliary stenosis and increased wall thickness throughout the intra- and extra-hepatic biliary trees. A nationwide survey in Japan revealed several differences in the clinical aspects of PSC between Japan and Western countries. PSC was recently designated an intractable hepatobiliary disease in Japan...
December 5, 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27904308/laparoscopic-transcystic-treatment-biliary-calculi-by-laser-lithotripsy
#11
Jun Liu, Lan Jin, Zhongtao Zhang
BACKGROUND AND OBJECTIVES: Laparoscopic transcystic common bile duct exploration (LTCBDE) is a complex procedure requiring expertise in laparoscopic and choledochoscopic skills. The purpose of this study was to investigate the safety and feasibility of treating biliary calculi through laparoscopic transcystic exploration of the CBD via an ultrathin choledochoscope combined with dual-frequency laser lithotripsy. METHODS: From August 2011 through September 2014, 89 patients at our hospital were treated for cholecystolithiasis with biliary calculi...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27762149/post-cholecystectomy-syndrome-and-sphincter-of-oddi-dysfunction-past-present-and-future
#12
Paul R Tarnasky
Post-cholecystectomy syndrome and the concept of a causal relationship to sphincter of Oddi dysfunction, despite the controversy, has presented a clinically relevant conflict for decades. Historically surgeons, and now gastroenterologists have expended tremendous efforts towards trying to better understand the dilemma that is confounded by unique patient phenotypes. Areas covered: This review encompasses the literature from a century of experience on the topic of post-cholecystectomy syndrome. Relevant historical and anecdotal experiences are examined in the setting of insights from evaluation of recently available controlled data...
December 2016: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27752181/-total-laparoscopy-to-treat-hepatolithiasis-using-gallbladder-hepatic-duct-subcutaneous-tunnel
#13
T Li, L Cui, G Wang, X F Ling, C S Hou, L X Wang, Z Xu
To investigate the effect and feasibility of total laparoscopy to treat hepatolithiasis using gallbladder-hepatic duct subcutaneous tunnel. Retrospective analysis was conducted of the case data of 11 patients with hepatolithiasis who underwent total laparoscopic treatment using gallbladder-hepatic duct subcutaneous tunnel from January 2010 to October 2014. The operation time, blood loss, postoperative complications and recurrence of stones were recorded.All the cases completed the operation.The average hospital-stay was 9...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/27742337/endoscopic-management-of-post-liver-transplantation-biliary-strictures-with-the-use-of-fully-covered-metallic-stents
#14
M Jiménez-Pérez, J M Melgar Simón, A Durán Campos, R González Grande, J M Rodrigo López, R Manteca González
OBJECTIVE: The aim of this work was to evaluate the safety and efficacy of a fully covered self-expandable metal stent (FCSEMS) in the treatment of post-liver transplantation biliary strictures. METHODS: From October 2009 to October 2014, 44 patients with post-liver transplantation biliary stenosis were treated with the use of endoscopic retrograde cholangiography and placement of FCSEMS after informed consent. The FCSEMS was scheduled to remain in situ for 3-6 months...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27721721/incomplete-annular-pancreas-with-ectopic-opening-of-the-pancreatic-and-bile-ducts-into-the-pyloric-ring-first-report-of-a-rare-anomaly
#15
Shinjiro Kobayashi, Horoyuki Hoshino, Kouhei Segami, Satoshi Koizumi, Nobuyuki Ooike, Takehito Otsubo
The patient was a 56-year-old woman who had experienced epigastralgia and dorsal pain several times over the last 20 years. She was admitted for a diagnosis of acute cholecystitis, and severe intra- and extrahepatic bile duct dilatation with inner air density was noted. No papilla of Vater was present in the descending duodenum, and 2 small holes were present in the pyloric ring. Bile excretion from one of the small holes was observed under forward-viewing endoscope. It was considered that the pancreatic and bile ducts separately opened into the pyloric ring...
May 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27716861/radiofrequency-ablation-for-the-management-of-occluded-biliary-metal-stents
#16
Abdurrahman Kadayifci, Mustafa Atar, David G Forcione, Brenna W Casey, Peter B Kelsey, William R Brugge
Background and study aim: Obstruction of biliary self-expandable metal stents (SEMSs) is seen frequently. Radiofrequency ablation (RFA) causes tissue necrosis. This study aimed to assess the efficacy of RFA for management of occluded SEMS. Patients and methods: Patients with biliary malignancy and treated for an occluded SEMS were retrospectively reviewed. The study group comprised patients treated with RFA using an Habib endoprobe inside the SEMS. The control group comprised patients treated only with insertion of a plastic stent into an occluded SEMS...
December 2016: Endoscopy
https://www.readbyqxmd.com/read/27678368/immunohistochemical-evaluation-for-outflow-reconstruction-using-opened-round-ligament-in-living-donor-right-posterior-sector-graft-liver-transplantation-a-case-report
#17
Yukihiro Sanada, Yasunaru Sakuma, Hideki Sasanuma, Atsushi Miki, Takumi Katano, Yuta Hirata, Noriki Okada, Naoya Yamada, Yoshiyuki Ihara, Taizen Urahashi, Naohiro Sata, Yoshikazu Yasuda, Koichi Mizuta
Utilizing the opened round ligament as venous grafts during liver transplantation is useful but controversial, and there are no pathological analyses of this procedure. Herein, we describe the first reported case of a pathological analysis of an opened round ligament used as a venous patch graft in a living donor liver transplantation (LDLT). A 13-year-old female patient with biliary atresia underwent LDLT using a posterior segment graft from her mother. The graft had two hepatic veins (HVs), which included the right HV (RHV; 15 mm) and the inferior RHV (IRHV; 20 mm)...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27626003/temporary-trans-jejunal-hepatic-duct-stenting-in-roux-en-y-hepaticojejunostomy-for-reconstruction-of-iatrogenic-bile-duct-injuries
#18
Mohammad Sadegh Fazeli, Ali Reza Kazemeini, Ali Jafarian, Mohammad Bashashati, Mohammad Reza Keramati
BACKGROUND: Bile Duct Injuries (BDI) during cholecystectomy are now being recognized as major health problems. OBJECTIVES: Herein, we present our experience with handling major BDIs and report long-term outcome of hepaticojejunostomies followed by trans-jejunal hepatic duct stenting performed to reconstruct extra-hepatic biliary tracts. MATERIALS AND METHODS: In this case series, we prospectively collected data of 22 patients, who underwent first time biliary reconstruction through Roux-en-y hepaticojejunostomy followed by hepatic duct stenting using a trans-jejunal bifurcated 6F tube drain...
May 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27619787/treatment-of-completely-obstructed-benign-biliary-strictures-with-magnetic-compression-anastomosis-follow-up-results-after-recanalization
#19
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
https://www.readbyqxmd.com/read/27616153/role-of-mdct-in-the-detection-of-early-abdominal-complications-after-orthotopic-liver-transplantation
#20
Piero Boraschi, Francescamaria Donati, Massimiliano Rossi, Davide Ghinolfi, Franco Filipponi, Fabio Falaschi
PURPOSE: This study aims to assess the role of multidetector computed tomography (MDCT) for detecting early abdominal complications after orthotopic liver transplantation. MATERIALS AND METHODS: We retrospectively enrolled 170 subjects with clinical laboratory and/or echo-color Doppler abnormalities who underwent MDCT within the first 90 days after transplantation. All images were reviewed by two radiologists in conference and imaging results were correlated with digital subtraction angiography, conventional cholangiography, surgery, clinical laboratory, and/or imaging follow-up...
November 2016: Clinical Imaging
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