4,228 results match your criteria Bile Duct Strictures


[A Case of Pancreaticoduodenectomy for Vater Papillary Cancer with Celiac Axis Stricture].

Gan To Kagaku Ryoho 2021 Apr;48(4):572-574

Dept. of Surgery, Ikeda City Hospital.

During the follow‒up of Vater papillary adenoma, a 74‒year‒old man was admitted to our hospital with a chief complaint of upper abdominal pain and diagnosed as cholangitis with obstructive jaundice. Cholestasis had been considered to be caused by papillary adenoma, however, EUS exam showed continuous bile duct wall irregularity from papilla of Vater. So we diagnosed as papillary carcinoma with extension to the distal bile duct. Read More

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Optimal tissue sampling during ERCP and emerging molecular techniques for the differentiation of benign and malignant biliary strictures.

Therap Adv Gastroenterol 2021 15;14:17562848211002023. Epub 2021 Apr 15.

Department of Gastroenterology & Hepatology, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, Room Na-609, Rotterdam, 3015 GD, The Netherlands.

Patients with cholangiocarcinoma have poor survival since the majority of patients are diagnosed at a stage precluding surgical resection, due to locally irresectable tumors and/or metastases. Optimization of diagnostic strategies, with a principal role for tissue diagnosis, is essential to detect cancers at an earlier stage amenable to curative treatment. Current barriers for a tissue diagnosis include both insufficient tissue sampling and a difficult cyto- or histopathological assessment. Read More

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Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study.

J Clin Med 2021 Apr 12;10(8). Epub 2021 Apr 12.

Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan.

Although Spy DS (SpyGlass DS Direct Visualization System) is considered to be useful for the diagnosis of bile duct strictures and the treatment of bile duct stones, there is limited data to date validating its efficacy. We hence retrospectively evaluated the clinical outcomes of the use of Spy DS in a large number of patients. A total of 183 patients who underwent Spy DS-guided procedures for indeterminate bile duct strictures ( = 93) and bile duct stones ( = 90) were analyzed retrospectively. Read More

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Laparoscopic hepaticojejunostomy for benign biliary stricture: A case series of 16 patients at a tertiary care centre in India.

J Minim Access Surg 2021 Mar 8. Epub 2021 Mar 8.

Department of General Surgery, SCBMCH, Cuttack, Odisha, India.

Background: Gallstone disease is common in India, and since primary management involves surgery, it is one of the most commonly performed surgeries by a general surgeon either laparoscopically or open. There are various factors which are responsible for intra- and post-operative complications. These factors result in significant injuries which cause serious post-operative complications. Read More

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The role of portoenterostomy in the treatment of patients with multiple bile duct trauma: Case series and review of the literature.

Ulus Travma Acil Cerrahi Derg 2021 May;27(3):362-368

Department of General Surgery, İzmir Katip Çelebi Üniversity, Atatürk Training and Research Hospital, İzmir-Turkey.

Background: Hepaticojejunostomy is a challenging and complex procedure to be administered with the confidence, in conditions which contain a large number of bile duct damaged by benign pathologies or major bile duct trauma.

Methods: Here, our clinical series of portoenterostomy (PE), in which we applied in patients who had aggressive hilar dissection for hilar benign biliary pathologies and major bile duct traumas during laparoscopic cholecystectomies were discussed in the light of the literature. The PE procedure was performed in the presence of three or more bile ducts that could not be merged. Read More

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Prolonged endoscopic retrograde cholangiopancreatography results in higher rates of pancreatitis and unplanned hospitalisation.

Surg Endosc 2021 Apr 19. Epub 2021 Apr 19.

Gastroenterology and Hepatology Unit, Canberra Hospital, Garran, 2605, Australia.

Background And Aim: Although complications from endoscopic retrograde cholangiopancreatography (ERCP) are well described, procedure duration has received scant attention. The relationship between ERCP duration and patient demographics, indications, results and complications were examined.

Methods: A contemporaneously recorded database of 2572 consecutive ERCPs performed between 2008 and 2018 by a single endoscopist was analysed. Read More

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Digital Cholangioscopy-guided Cold Snare Resection of an Inflammatory Intraductal Pseudopolyp.

Dig Endosc 2021 Apr 12. Epub 2021 Apr 12.

Department of Gastroenterology and Hepatology, University Hospitals Leuven, Belgium.

Digital single-operator cholangioscopy (DSOC) has revolutionized the endoscopic diagnosis and treatment of various hepato-pancreaticobiliary diseases, such as indeterminate biliary strictures and large balloon dilation-refractory common bile duct (CBD) stones, using either a retrograde or antegrade approach. Direct visualization provided by DSOC has furthermore paved the road towards minimally invasive treatment of intraductal neoplasms, although little evidence is available in this specific context. A 70-year-old patient was admitted following several episodes of colicky abdominal discomfort, mixed liver function abnormalities and non-intentional weight loss. Read More

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Single-operator cholangioscopy-guided biopsy of indeterminate bile duct strictures - Work in progress.

Dig Endosc 2021 Apr 7. Epub 2021 Apr 7.

Digestive Health Institute, Orlando Health, Florida, USA.

Determining an accurate diagnosis in indeterminate biliary strictures is challenging with historically low sensitivity of 50-60% as all presently available diagnostic modalities possess some degree of inherent limitations. However, the development of the second-generation single-operator cholangioscopy system (SpyGlassDS, Boston Scientific Corp.) has resulted in a significant improvement in the diagnostic sensitivity to 75-85%, and we have recently shown in a randomized trial that an accurate diagnosis can be established in 90% of patients with indeterminate biliary strictures. Read More

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Primary sclerosing cholangitis.

Transl Gastroenterol Hepatol 2021 5;6:29. Epub 2021 Apr 5.

Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.

Primary sclerosing cholangitis (PSC) is a rare chronic cholestatic liver disease characterized by inflammatory destruction of the intrahepatic and/or extrahepatic bile ducts, leading to bile stasis, fibrosis, and ultimately to cirrhosis, and often requires liver transplantation (LT). PSC occurs more commonly in men, and is typically diagnosed between the ages of 30 and 40. Most cases occur in association with inflammatory bowel disease (IBD), which often precedes the development of PSC. Read More

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Probe-based confocal laser endomicroscopy in the evaluation of dominant strictures in patients with primary sclerosing cholangitis: results of a U.S. multicenter prospective trial.

Gastrointest Endosc 2021 Mar 30. Epub 2021 Mar 30.

Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, CO. Electronic address:

Background And Aims: Patients with primary sclerosing cholangitis (PSC) and dominant biliary strictures carry increased risk for the development of cholangiocarcinoma. Although ERCP-based techniques including brush cytology and intraductal biopsies represent first-line tissue sampling methods for dominant strictures, sensitivity is low. Probe-based confocal laser endomicroscopy (pCLE) offers microscopic level imaging of subepithelial biliary mucosa. Read More

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IgG4-Related Sclerosing Cholangitis Mimicking Cholangiocarcinoma.

Case Rep Oncol 2021 Jan-Apr;14(1):39-46. Epub 2021 Feb 18.

Department of Radiology, Ha Noi Medical University, Hanoi, Vietnam.

IgG4-related sclerosing cholangitis (IgG4-SC) is a relatively newly identified disease that is frequently associated with autoimmune pancreatitis. The differential diagnosis between cholangiocarcinoma, primary sclerosing cholangitis, and IgG4-SC can be challenging due to significant overlap among the clinical and imaging characteristics. We report the case of a 71-year-old woman who was diagnosed with IgG4-related disease based on increased serum IgG4 levels, imaging, and clinical presentation, which showed systemic involvement, including sclerosing cholangitis and kidneys. Read More

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February 2021

Aspiration fluid cytology during single operator cholangioscopy with targeted biopsy to improves the diagnostic yield in indeterminate biliary strictures.

Diagn Cytopathol 2021 Jun 23;49(6):768-772. Epub 2021 Mar 23.

Gastroenterology Section, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

Introduction: Sensitivities of various sampling methods to detect malignant biliary strictures remain suboptimal. Irrigation during digital single operator cholangioscopy (dSOC) is done routinely for visualization of the duct. The aim of this study was to evaluate improvement of the sensitivity for detecting malignant biliary strictures when adding aspiration fluid cytology (AFC) from the irrigated fluid during cholangioscopy to cholangioscopic biopsy (CBx). Read More

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Double rarity: malignant masquerade biliary stricture in a situs inversus totalis patient.

BMC Surg 2021 Mar 21;21(1):153. Epub 2021 Mar 21.

Department of Transplantation and Surgery, Semmelweis University, VIII. Baross u.23, Budapest, 1082, Hungary.

Background: Situs inversus totalis is a rare anatomical variation of both the thoracic and the abdominal organs. Common bile duct strictures can be caused by malignant and benign diseases as well. 7-18% of the latter ones are 'malignant masquerade' cases, as pre-operative differentiation is difficult. Read More

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Bile duct reconstruction using scaffold-free tubular constructs created by Bio-3D printer.

Regen Ther 2021 Mar 24;16:81-89. Epub 2021 Feb 24.

Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan.

Introduction: Biliary strictures after bile duct injury or duct-to-duct biliary reconstruction are serious complications that markedly reduce patients' quality of life because their treatment involves periodic stent replacements. This study aimed to create a scaffold-free tubular construct as an interposition graft to treat biliary complications.

Methods: Scaffold-free tubular constructs of allogeneic pig fibroblasts, that is, fibroblast tubes, were created using a Bio-3D Printer and implanted into pigs as interposition grafts for duct-to-duct biliary reconstruction. Read More

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Factors affecting the diagnostic yield of endoscopic transpapillary forceps biopsy in patients with malignant biliary strictures.

J Gastroenterol Hepatol 2021 Mar 17. Epub 2021 Mar 17.

Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.

Background And Aim: Transpapillary biliary forceps biopsy (TBFB) is a common method to obtain histological evidence for the differential diagnosis of biliary stricture. This study aimed to evaluate the factors associated with a positive cancer diagnosis from TBFB and the number of tissue samples required to increase the diagnostic yield in patients with malignant biliary strictures.

Methods: A total of 376 patients who underwent TBFB for investigation of biliary stricture were included. Read More

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The Classification of Biliary Strictures ın Patients With Right Lobe Liver Transplant Recipients and Its Relation to Traversing the Stricture With a Guidewire.

Transplantation 2021 Mar 8. Epub 2021 Mar 8.

Hacettepe University Faculty of Medicine Department of Gastroenterology, Ankara, Turkey. Sakarya University Faculty of Medicine Department of Gastroenterology, Sakarya, Turkey Hacettepe University Faculty of Medicine Department of Radyology, Ankara, Turkey. Inonu University Faculty of Medicine Department of Surgery and Liver Transplant Institute, Malatya, Turkey.

Background: Traversing the stricture with a guidewire is a prerequisite for the endoscopic treatment of biliary strictures after living donor liver transplantation (LDLT). We aimed to evaluate the effect of variations in the biliary anastomosis and strictures on the success of endoscopic treatment and suggest a cholangiographic classification.

Methods: The 125 strictures among the 104 patients with right lobe LDLT were reviewed. Read More

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Diagnostic Approach to Suspected Perihilar Malignancy.

Visc Med 2021 Feb 19;37(1):3-9. Epub 2021 Jan 19.

Department of Gastroenterology, Hepatology and Endocrinology, University Hospital, Paracelsus Medical University Nuremberg, Nuremberg, Germany.

Background: Cholangiocarcinomas are relatively rare tumors most frequently arising from the epithelium of the hilar bile ducts. The diagnosis is often made in advanced (symptomatic) stages, which accounts for the infavorable prognosis with a 5-year survival of less than 10%. Identification of perihilar cholangiocarcinoma (pCCA) is often challenging because there is no single method offering sufficient diagnostic accuracy. Read More

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February 2021

Intramural Biliary Stricture From Metastatic Breast Cancer.

Am J Gastroenterol 2021 03;116(3):447

Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

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Diagnostic Accuracy and Therapeutic Efficacy of Digital Single-Operator Cholangioscopy for Biliary Lesions and Stenosis.

Digestion 2021 Feb 25:1-7. Epub 2021 Feb 25.

Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany.

Background/aims: Digital single-operator cholangioscopy (dSOC) has revolutionized bile duct visualization. Interventions like electrohydraulic or laser lithotripsy, inspection of suspicious areas, and targeted biopsies have become possible quick and easy. One main indication for dSOC remains the evaluation of indeterminate biliary strictures. Read More

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February 2021

Post-liver transplant biliary complications: Current knowledge and therapeutic advances.

World J Hepatol 2021 Jan;13(1):66-79

Department of Interventional Gastroenterology, Acibadem City Clinic Tokuda Hospital, Sofia 1407, Bulgaria.

Liver transplantation is the current standard of care for end-stage liver disease and an accepted therapeutic option for acute liver failure and primary liver tumors. Despite the remarkable advances in the surgical techniques and immunosuppressive therapy, the postoperative morbidity and mortality still remain high and the leading causes are biliary complications, which affect up to one quarter of recipients. The most common biliary complications are anastomotic and non-anastomotic biliary strictures, leaks, bile duct stones, sludge and casts. Read More

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January 2021

[Bilary anastomotic strictures after right lobe living donor liver transplantation: a single-center experience].

Khirurgiia (Mosk) 2021 (2):5-13

Burnazyan Federal Medical Biophysical Center, Moscow, Russia.

Objective: To determine the incidence of AS after right lobe living donor liver transplantation with various biliary reconstructions and to identify the predictors of this complication.

Material And Methods: A retrospective and prospective analysis included 245 RLLDLTs for the period 2011-2018 at the Burnazjan Federal Medical Biophysical Center. The results of transplantations in 207 patients aged 19-68 years (median 43 years) were assessed. Read More

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February 2021

Accuracy of brush cytology in biliopancreatic strictures: a single-center cohort study.

J Int Med Res 2021 Feb;49(2):300060520987771

Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University, Shulan International Medical College, Hangzhou, Zhejiang, P.R. China.

Objective: False positive and negative results are associated with biliary tract cell brushing cytology during endoscopic retrograde cholangiopancreatography (ERCP). The causes are uncertain. The purpose of this study was to evaluate the accuracy of diagnoses made via cell brushing in our center, and to explore the factors influencing diagnosis. Read More

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February 2021

Utility of palliative EUS-guided biliary drainage using lumen-apposing metal stents: a prospective multicenter feasibility study (with video).

Gastrointest Endosc 2021 Feb 3. Epub 2021 Feb 3.

NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom; Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom.

Background And Aims: Biliary drainage with ERCP is successful in only 80% to 90% of cases of extrahepatic cholangiocarcinoma and pancreatic cancer. We present the results of a multicenter prospective study assessing the safety, feasibility, and quality of life of patients after EUS-guided biliary drainage (EUS-BD) with lumen-apposing metal stents after failed ERCP.

Methods: All consecutive adults with a dilated common bile duct (CBD) ≥14 mm secondary to inoperable malignant distal CBD stricture and failed ERCP biliary drainage were screened and recruited from 3 tertiary UK centers. Read More

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February 2021

Multicenter experience with digital single-operator cholangioscopy in pregnant patients.

Endosc Int Open 2021 Feb 25;9(2):E116-E121. Epub 2021 Jan 25.

Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States.

 The use of fluoroscopy during pregnancy should be minimized given that a clear-cut safe radiation dose in pregnancy is unknown. The role of digital single-operator cholangioscopy (D-SOC) as an alternative to standard enodoscopic retrograde cholangiopancreatography (ERCP) in pregnant patients has not been comprehensively studied. This study assessed 1 Technical success defined as performance of ERCP with D-SOC without the use of fluoroscopy in pregnant patients; 2 safety of D-SOC in pregnancy; and 3 maternal and neonatal outcomes after D-SOC during/after pregnancy. Read More

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February 2021

EUS-guided hepaticogastrostomy for hepaticojejunostomy stricture using a 22G needle and a mechanical dilator (with video).

J Hepatobiliary Pancreat Sci 2021 Feb 2. Epub 2021 Feb 2.

2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

EUS-guided biliary drainage (EUS-BD) has been indicated for benign biliary strictures. However, the intrahepatic bile duct is sometimes much narrower in benign biliary strictures. In this situation, puncture of the intrahepatic bile duct using a 19-G needle is sometimes challenging. Read More

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February 2021

Three-dimensional visualization technique compared with magnetic resonance cholangiopancreatography for evaluation of anatomic variants of pediatric congenital choledochal cysts.

Pediatr Surg Int 2021 Jun 28;37(6):705-713. Epub 2021 Jan 28.

Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1665 of Kongjiang Road, Yangpu District, Shanghai, 200092, China.

Objective: The aim of this study was to compare the application of a three-dimensional (3D) visualization technique and magnetic resonance cholangiopancreatography (MRCP) for diagnosis of pediatric congenital choledochal cysts.

Methods: Thin slices of coronal heavily T2-weighted pulse sequences of MRI pertaining to 35 patients were retrospectively used to reconstruct 3D models. Diagnoses and variants of the biliary system were evaluated based on the 3D models and MRCP imaging. Read More

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Long-term Morbidity of Choledochal Malformations in Children.

J Pediatr Gastroenterol Nutr 2021 Jun;72(6):820-825

Department of Pediatric Surgery, Pediatric Liver and Gut Research Group, Pediatric Research Center.

Objective: The aim of the study was to assess long-term morbidity in children operated for choledochal malformation (CM) by relating clinical complications to liver histopathology, follow-up imaging, liver stiffness, and biochemistry.

Methods: A single-center retrospective follow-up study including all CM patients (n = 55, 71% girls) treated during 1976 to 2018 was performed. Mann-Whitney U test and Spearman rank correlation were used for statistical analyses. Read More

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Title: Endoscopic retrograde cholangiopancreatography and carbohydrate antigen 19-9 in the differential diagnosis of biliary strictures.

Rev Esp Enferm Dig 2021 Jan 13. Epub 2021 Jan 13.

Gastroenterología, CIMEQ, Cuba.

Introduction: Bile duct strictures include a wide spectrum of benign or malignant diseases.

Objective: To determine the usefulness of endoscopic retrograde cholangiopancreatography (ERCP) and circulating carbohydrate antigen19-9 (CA 19-9) in the differential diagnosis of biliary strictures.

Method: We used an observational, prospective and cross-sectional study in 75 patients with biliary stricture diagnosed by ERCP between October 2018-January 2020. Read More

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January 2021

Biodegradable JDBM coating stent has potential to be used in the treatment of benign biliary strictures.

Biomed Mater 2021 Feb 18;16(2):025010. Epub 2021 Feb 18.

Shanghai Key Laboratory of Pancreatic Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, People's Republic of China. Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, New Songjiang Road No. 650, Shanghai 201620, People's Republic of China.

In our previous study, to find out the optimal alloy suitable for biliary surgery, magnesium alloy Jiao Da Bio-magnesium (denoted as JDBM) alloy, Zn-3Cu alloys, and their respective coating (MgF-PDLLA) products were produced for our research. We found that JDBM seems to be a potential material for clinical biliary stent application due to its uniform degradation and good compatibility. In order to apply the JDBM alloy to treat benign bile duct stricture, our group prepared the bare JDBM and its coating product into finished stents by mesh weaving carving technology and conducted the mechanical property tests, degradation tests and biocompatibility tests. Read More

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February 2021