9,824 results match your criteria Biliary Obstruction


Best period to replace or change plastic stents with self-expandable metallic stents using multivariate competing risk regression analysis.

Sci Rep 2020 Aug 4;10(1):13080. Epub 2020 Aug 4.

Department of Endoscopy, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.

In endoscopic biliary drainage (EBD) for various benign and malignant biliary disorders, the appropriate timing to replace or change a plastic stent (PS) with a self-expandable metallic stent (SEMS) remains unclear. This study aimed to define the best period to replace or change a PS with a SEMS. Between January 1, 2012, and December 31, 2018, 1,887 consecutive EBD procedures, including 170 SEMS placements, were retrospectively identified. Read More

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http://dx.doi.org/10.1038/s41598-020-70081-3DOI Listing

Endoscopic ultrasound-guided hepaticogastrostomy or hepaticojejunostomy without dilation using a stent with a thinner delivery system.

Endosc Int Open 2020 Aug 21;8(8):E1034-E1038. Epub 2020 Jul 21.

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.

Use of endoscopic ultrasound-guided biliary drainage (EUS-BD) has recently increased. In EUS-BD, after puncturing the bile duct, dilation is performed and the stent is deployed. Due to adverse events (AEs) such as unexpected displacement of the guidewire, simplified procedures are required. Read More

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http://dx.doi.org/10.1055/a-1169-3749DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373653PMC

An Uncommon Presentation of Extrahepatic Cholestasis due to Single Biliary Stricture From Kaposi Sarcoma.

Cureus 2020 Jun 29;12(6):e8913. Epub 2020 Jun 29.

Gastroenterology and Hepatology, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.

Kaposi sarcoma is one of the acquired immunodeficiency syndrome (AIDS) defining diseases. AIDS-associated Kaposi sarcoma affects primarily the skin and the lungs. Although gastrointestinal involvement is relatively common, biliary tract involvement has rarely been reported. Read More

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http://dx.doi.org/10.7759/cureus.8913DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7389956PMC

Cholestasis of Sepsis: A Case Report.

Cureus 2020 Jun 29;12(6):e8897. Epub 2020 Jun 29.

Gastroenterology and Hepatology, Gujarat Superspeciality Clinic, Ahmedabad, IND.

A 46-year-old man presented with fever, general lethargy, and weight loss over the last few months. He started to develop jaundice and his condition worsened. Blood tests confirmed rising levels of conjugated bilirubin with near-normal alanine aminotransferase, alkaline phosphatase, and prothrombin time. Read More

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http://dx.doi.org/10.7759/cureus.8897DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7389144PMC

Elastography improves accuracy of early hepato-biliary complications diagnosis after allogeneic stem cell transplantation.

Haematologica 2020 Jul 30. Epub 2020 Jul 30.

Hematology and transplantation unit, Saint Louis Hospital, APHP, Paris, France;

Significant morbidity and mortality have been associated with liver complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Causes and consequences of these hepato-biliary complications are various and might be life-threatening. A high misdiagnosis rate has been reported because of a weak correlation between clinical, laboratory and imaging data. Read More

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http://dx.doi.org/10.3324/haematol.2019.245407DOI Listing

Comparison study between double bare covered and fully covered metal stent during endoscopic ultrasound-guided choledochoduodenostomy (with video).

Dig Dis 2020 Jul 30. Epub 2020 Jul 30.

Background: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) is a common technique for biliary drainage. However, EUS-CDS is associated with adverse events such as cystic duct obstruction, stent dislocation, and stent kinking caused by powerful axial force. A novel double-bare, covered self-expandable metal stent (DBSEMS) has recently become available in Japan. Read More

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http://dx.doi.org/10.1159/000510560DOI Listing

Rapid enlargement of a hepatic hilar cyst leading to bile duct obstruction after acute exacerbation of chronic hepatitis B.

Clin J Gastroenterol 2020 Jul 29. Epub 2020 Jul 29.

Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.

A hepatic cyst is usually asymptomatic but, in some cases, can be associated with various complications. Here we report a rare case with rapid enlargement of a hepatic hilar cyst that induced bile duct obstruction after an acute exacerbation of chronic hepatitis B. The case is a 60-year old female who discontinued entecavir by herself. Read More

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http://dx.doi.org/10.1007/s12328-020-01189-2DOI Listing

Relief of biliary obstruction: choosing between endoscopic ultrasound and endoscopic retrograde cholangiopancreatography.

BMJ Open Gastroenterol 2020 Jul;7(1)

Division of Gastroenterology and Hepatology, Director of Advanced Therapeutic Endoscopy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Endoscopic ultrasound (EUS) was originally devised as a novel diagnostic technique to enable endoscopists to stage malignancies and acquire tissue. However, it rapidly advanced toward therapeutic applications and has provided gastroenterologists with the ability to effectively treat and manage advanced diseases in a minimally invasive manner. EUS-guided biliary drainage (EUS-BD) has gained considerable attention as an approach to provide relief in malignant and benign biliary obstruction for patients when endoscopic retrograde cholangiopancreatography (ERCP) fails or is not feasible. Read More

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http://dx.doi.org/10.1136/bmjgast-2020-000428DOI Listing

[Indications for Surgical Therapy in Chronic Pancreatitis].

Zentralbl Chir 2020 Jul 29. Epub 2020 Jul 29.

Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland.

Chronic pancreatitis is a recurrent disease with repeating exacerbations of inflammation of the pancreatic gland - associated with belt-like back pain. Without treatment, recurrent chronic pancreatitis leads to development of opioid-dependent pain. The chronic pancreatitis leads to recurrent hospital stays for the affected patient and socioeconomic challenges. Read More

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http://dx.doi.org/10.1055/a-1168-7314DOI Listing

A Rare Case of Pancreatic Tuberculosis Diagnosed via Endoscopic Ultrasound-Guided Fine Needle Aspiration and Polymerase Chain Reaction.

Cureus 2020 Jun 24;12(6):e8795. Epub 2020 Jun 24.

Gastroenterology, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

Pancreatic tuberculosis (TB) is a very rare condition even in endemic areas of the world where the disease is considered to be highly prevalent. The presenting features are usually vague and its radiological features mimic pancreatitis and pancreatic malignancy. We present a case of a 26-year-old active military male, originally from Virginia with no past medical history who presented to the ED with a two-week history of abdominal pain, increased nausea and vomiting, decreased appetite, increased darkening of his urine, and pale-colored stools. Read More

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http://dx.doi.org/10.7759/cureus.8795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381879PMC

Gastric outlet obstruction in the setting of acute cholecystitis.

Radiol Case Rep 2020 Sep 20;15(9):1673-1675. Epub 2020 Jul 20.

Department of Radiology, Feinberg School of Medicine, Northwestern University, Institution: Northwestern Memorial Hospital, 251 E Huron St, Chicago, IL 60611 USA.

Acute cholecystitis is a rare cause of gastric outlet obstruction (GOO) and may manifest with nonspecific symptoms which may preclude or delay diagnosis. During the latter part of the 20th century, benign disease was responsible for most cases of GOO in adults with peptic ulcer disease accounting for up to 90% of these cases. Although precise estimates on GOO incidence and prevalence are lacking, as many as 2000 surgical operations were reportedly performed annually for GOO in the United States in the 1990s. Read More

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http://dx.doi.org/10.1016/j.radcr.2020.07.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371980PMC
September 2020

A Multicenter Prospective Randomized Controlled Trial for Preoperative Biliary Drainage with Uncovered Metal versus Plastic Stents for Resectable Periampullary Cancer.

J Hepatobiliary Pancreat Sci 2020 Jul 26. Epub 2020 Jul 26.

Department of Internal Medicine, Seoul National University Bundang Hosptial, Seoul National University College of Medicine, Seongnam, Korea.

Background And Study Aims: Although routine preoperative biliary drainage (PBD) in patients with distal malignant biliary obstruction is generally not recommended, there are still various situations where it may be necessary. The current study aims to compare between the uncovered self-expandable metal stent (uSEMS) and plastic stent (PS), where PBD may be necessary.

Patients And Methods: In this multicenter prospective randomized study, patients with resectable periampullary cancer with cholangitis, deep jaundice, or expected long waiting time for surgery were included. Read More

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http://dx.doi.org/10.1002/jhbp.811DOI Listing

Long-term multidisciplinary treatment including proton therapy for a recurrent low-grade endometrial stromal sarcoma and pathologically prominent epithelial differentiation: an autopsy case report.

BMC Womens Health 2020 Jul 25;20(1):154. Epub 2020 Jul 25.

Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City West Medical Center, Nagoya, Japan.

Background: Long-term follow-up reports of low-grade endometrial stromal sarcoma (LGESS) including its clinical course and pathological data are rare. We previously reported the case of a Japanese woman diagnosed with LGESS, who was treated with multidisciplinary therapy. She had been suffering from uterine cervical tumor diagnosed as cervical polyps, or fibroid in statu nascendi, since 24 years old. Read More

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http://dx.doi.org/10.1186/s12905-020-01019-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382065PMC

Right-sided versus left-sided percutaneous transhepatic biliary drainage in the management of malignant biliary obstruction: a randomized controlled study.

Abdom Radiol (NY) 2020 Jul 22. Epub 2020 Jul 22.

Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Aim: To compare the technical difficulty, safety, radiation exposure and success rates between right-sided and left-sided percutaneous transhepatic biliary drainage (RPTBD and LPTBD) in patients with malignant biliary obstruction (MBO).

Materials And Methods: Fifty patients (28 males, 22 females; mean age 51.78 years) with MBO were randomized to undergo either RPTBD or LPTBD during the study period between June 2016 and May 2018. Read More

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http://dx.doi.org/10.1007/s00261-020-02651-yDOI Listing

The efficacy of the combination of percutaneous transhepatic biliary drainage and I stranded seeds for malignant bile duct obstruction treatment.

J Contemp Brachytherapy 2020 Jun 30;12(3):225-232. Epub 2020 Jun 30.

Interventional Department, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.

Purpose: To investigate the efficacy of percutaneous transhepatic biliary drainage (PTBD) combined with iodine-125 (I) stranded seeds for the treatment of malignant bile duct obstruction (MBO).

Material And Methods: A retrospective study was performed on 58 consecutive MBO patients. Twenty patients underwent PTBD combined with I stranded seeds (group A). Read More

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http://dx.doi.org/10.5114/jcb.2020.96862DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366027PMC

Endoscopic Ultrasound-Guided Hepaticogastrostomy: Technical Review and Tips to Prevent Adverse Events.

Gut Liver 2020 Jul 23. Epub 2020 Jul 23.

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

Most patients who require biliary drainage can be treated by endoscopic retrograde cholangiopancreatography (ERCP)- guided procedures. However, ERCP can be challenging in patients with complications, such as malignant duodenal obstruction, or a surgically-altered anatomy, such as a Rouxen- Y anastomosis, which prevent advancement of the duodenoscope into the ampulla of Vater. Recently, endoscopic ultrasound (EUS)-guided biliary drainage via transhepatic or transduodenal approaches has emerged as an alternative means of biliary drainage. Read More

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http://dx.doi.org/10.5009/gnl20096DOI Listing

Relationship between Cancer Diagnosis and Complications Following Pancreatoduodenectomy for Duodenal Adenoma.

Ann Surg Oncol 2020 Jul 20. Epub 2020 Jul 20.

Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.

Background: Pancreatoduodenectomy (PD) for duodenal adenoma (DA) resection may be associated with excessive surgical risk for patients with potentially benign lesions, given the absence of pancreatic duct obstruction. We examined factors associated with final malignant pathology and evaluated the postoperative course of patients with DA versus pancreatic ductal adenocarcinoma (PDAC).

Methods: We retrospectively analyzed patients with DA who underwent PD from 2008 to 2018 and assessed the accuracy rate of preoperative biopsy and factors associated with final malignant pathology. Read More

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http://dx.doi.org/10.1245/s10434-020-08767-1DOI Listing

Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer.

HPB (Oxford) 2020 Jul 16. Epub 2020 Jul 16.

Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address:

Background: Guidelines advise self-expanding metal stents (SEMS) over plastic stents in preoperative endoscopic biliary drainage (EBD) for malignant extrahepatic biliary obstruction. This study aims to assess nationwide practice and outcomes.

Methods: Patients with pancreatic head and periampullary cancer who underwent EBD before pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2017-2018). Read More

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http://dx.doi.org/10.1016/j.hpb.2020.06.009DOI Listing

Single-Session Endoscopic Ultrasound-Directed Transgastric ERCP ("EDGE") in a Bariatric Patient with Pancreatic Mass and Biliary Obstruction.

Obes Surg 2020 Jul 17. Epub 2020 Jul 17.

Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, 420 Delaware Street SE, MMC 36, Minneapolis, MN, 55455, USA.

This video case report presents a patient with an invasive pancreatic mass and a history of Roux-en-Y gastric bypass surgery who underwent single-session endoscopic ultrasound-directed transgastric ERCP for tissue sampling and biliary stenting with subsequent maintenance of the newly established gastrogastrostomy. The demonstrated technique enables spectrum of endoscopic interventions in gastric bypass patients by facilitating a direct endoscopic passage through the reconnected stomach. Importantly, the method carries a risk of weight regain by essentially reversing the bypass. Read More

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http://dx.doi.org/10.1007/s11695-020-04839-zDOI Listing

The synthetic toxin biliatresone causes biliary atresia in mice.

Lab Invest 2020 Jul 17. Epub 2020 Jul 17.

Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, and Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai, 201102, China.

Exposure to environmental toxins may be responsible for biliary atresia. The focus of this study was to investigate the effect of biliatresone on the development of the hepatobiliary system in mice. We successfully synthesized biliatresone with a purity of 98% and confirmed its biliary toxicity. Read More

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http://dx.doi.org/10.1038/s41374-020-0467-7DOI Listing

Hepatic Langerhans Cell Histiocytosis (LCH) Presenting as a Harbinger of Multisystem LCH.

Cureus 2020 Jun 13;12(6):e8591. Epub 2020 Jun 13.

Pathology and Laboratory Medicine, Albany Medical Center, Albany, USA.

Langerhans cell histiocytosis (LCH) is a rare systemic disorder characterized by an infiltration of CD1a+/langerin+ histiocytes, commonly involving bone, skin, and lymph nodes in children. Hepatic involvement is rarely observed in multisystem LCH. We describe an exceptional case of hepatic LCH in an adult preceding the diagnosis of multisystem LCH, mimicking anti-mitochondrial antibody (AMA)-negative primary biliary cholangitis (PBC). Read More

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http://dx.doi.org/10.7759/cureus.8591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359969PMC

Percutaneous metal stenting for malignant hilar biliary obstruction: a systematic review and meta-analysis of unilateral versus bilateral stenting.

Abdom Radiol (NY) 2020 Jul 15. Epub 2020 Jul 15.

Department of Medical Imaging, Xuzhou Central Hospital, 199 South Jiefang Road, Xuzhou, China.

The purpose of this study is to assess the relative clinical efficacy of treating malignant hilar biliary obstruction (MHBO) via percutaneous unilateral or bilateral metal stenting. Relevant articles up to December 2019 were identified within the Web of science, Pubmed, Embase, and Cochrane Library databases. Stent dysfunction served as the primary endpoint, while we assessed technical success, clinical success, early and late complication incidence, and overall survival as secondary outcomes. Read More

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http://dx.doi.org/10.1007/s00261-020-02643-yDOI Listing

Acute Obstructive Choledocholithiasis: A Case of Elusive Gallstones on Imaging.

Cureus 2020 Jun 7;12(6):e8489. Epub 2020 Jun 7.

Gastroenterology, University of Miami, John F. Kennedy Regional Campus, Atlantis, USA.

Acute choledocholithiasis results when stones form in the gallbladder and then pass into the common bile duct, where they may become lodged and cause obstruction. To our knowledge, very few cases are reported in which multiple imaging techniques had failed to detect the presence of gallstones, as per current literature review. We report a case of a 73-year-old woman with nausea, vomiting, and jaundice who was found to have choledocholithiasis with negative imaging on abdominal ultrasound (US), CT, and magnetic resonance cholangiopancreatography (MRCP). Read More

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http://dx.doi.org/10.7759/cureus.8489DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343315PMC

Indian National Association for the Study of the Liver Consensus Statement on Acute Liver Failure (Part 1): Epidemiology, Pathogenesis, Presentation and Prognosis.

J Clin Exp Hepatol 2020 Jul-Aug;10(4):339-376. Epub 2020 Apr 28.

Institute of Liver & Digestive Diseases and Head of Hepatology & Liver Transplant (Medicine), BLK Super Speciality Hospital, Delhi, India.

Acute liver failure (ALF) is an infrequent, unpredictable, potentially fatal complication of acute liver injury (ALI) consequent to varied etiologies. Etiologies of ALF as reported in the literature have regional differences, which affects the clinical presentation and natural course. In this part of the consensus article designed to reflect the clinical practices in India, disease burden, epidemiology, clinical presentation, monitoring, and prognostication have been discussed. Read More

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http://dx.doi.org/10.1016/j.jceh.2020.04.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335721PMC

[A case of Lemmel syndrome caused by food residue in giant juxtapapillary diverticulum].

Nihon Shokakibyo Gakkai Zasshi 2020 ;117(7):646-650

Third Department of Internal Medicine, University of Toyama.

A woman in her 70s was admitted to our hospital because of epigastric pain and anorexia. Laboratory evaluations revealed elevated levels of liver transaminases, biliary enzymes, and amylase. CT and MRCP showed dilatation of the bile and pancreatic ducts and a large juxtapapillary diverticulum filled with contents. Read More

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http://dx.doi.org/10.11405/nisshoshi.117.646DOI Listing

Primary EUS-guided biliary drainage ERCP drainage for the management of malignant biliary obstruction: A systematic review and meta-analysis.

Endosc Ultrasound 2020 Jul 9. Epub 2020 Jul 9.

Dr. Henry D. Janowitz Division of Gastroenterology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, USA.

EUS-guided biliary drainage (EUS-BD) has been used as a salvage modality for relief of malignant biliary obstruction (MBO) after a failed ERCP. Multiple recent randomized controlled trials (RCTs) and observational studies have been published to assess the suitability of EUS-BD as a first-line modality for achieving palliative BD. We aimed to perform a systematic review and meta-analysis comparing primary EUS-BD versus ERCP for MBO. Read More

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http://dx.doi.org/10.4103/eus.eus_10_20DOI Listing

Unilateral Versus Side-By-Side Metal Stenting for Malignant Hilar Biliary Obstruction: A Meta-analysis.

J Laparoendosc Adv Surg Tech A 2020 Jul 9. Epub 2020 Jul 9.

Department of Radiology, Xuzhou Central Hospital, Xuzhou, China.

The present meta-analysis was designed to compare the relative clinical efficacy of unilateral and side-by-side metal stenting for the treatment of malignant hilar biliary obstruction (MHBO). The PubMed, Embase, and Cochrane Library databases were searched to identify all relevant studies published as of May 2020. This meta-analysis was conducted using RevMan v5. Read More

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http://dx.doi.org/10.1089/lap.2020.0400DOI Listing
July 2020
1.187 Impact Factor

Retrieval anchor-assisted endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction.

Scand J Gastroenterol 2020 Jul 9;55(7):865-868. Epub 2020 Jul 9.

Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China.

Objectives: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is an emerging procedure for gastric outlet obstruction (GOO) as an alternative to endoscopic stent placement in the duodenum or surgery; however, it is technically challenging. This study aimed to evaluate the safety, success rate, and adverse events rate associated with retrieval anchor-assisted EUS-GE.

Methods: Data from patients who underwent retrieval anchor-assisted EUS-GE for malignant and benign GOO were retrospectively analyzed. Read More

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http://dx.doi.org/10.1080/00365521.2020.1778077DOI Listing
July 2020
2.329 Impact Factor

Correction to: No evidence of improved efficacy of covered stents over uncovered stents in percutaneous palliation of malignant hilar biliary obstruction: results of a prospective randomized trial.

Eur Radiol 2020 Jul 6. Epub 2020 Jul 6.

Department of Vascular and Interventional Radiology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.

On request from the Editors, the authors would like to clarify the following: the patient cohorts in the publications "No evidence of improved efficacy of covered stents over uncovered stents in percutaneous palliation of malignant hilar biliary obstruction: results of a prospective randomized trial". Read More

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http://dx.doi.org/10.1007/s00330-020-07029-8DOI Listing

Methotrexate-loaded tumour-cell-derived microvesicles can relieve biliary obstruction in patients with extrahepatic cholangiocarcinoma.

Nat Biomed Eng 2020 Jul 6;4(7):743-753. Epub 2020 Jul 6.

Department of Immunology and National Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Most patients with cholangiocarcinoma (CCA) develop extrahepatic malignant biliary obstructions, which require palliative drainage to normalize bilirubin levels and to improve the patients' overall survival. Here, we report that the infusion of methotrexate-containing plasma-membrane microvesicles derived from apoptotic human tumour cells into the bile-duct lumen of patients with extrahepatic CCA mobilized and activated neutrophils and relieved biliary obstruction in 25% of the patients. Neutrophil recruitment by the microvesicles was associated with an increase in uridine diphosphate glucose and complement C5, and led to the degradation of the stromal barrier of CCA. Read More

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http://dx.doi.org/10.1038/s41551-020-0583-0DOI Listing

Human Ascariasis: An Updated Review.

Recent Pat Inflamm Allergy Drug Discov 2020 Jul 5. Epub 2020 Jul 5.

Department of Paediatrics, The Chinese University of Hong Kong, and Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital. Hong Kong.

Background: Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide. Read More

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http://dx.doi.org/10.2174/1872213X14666200705235757DOI Listing

Advances in the endoscopic management of malignant biliary obstruction.

Ann Gastroenterol 2020 Jul-Aug;33(4):338-347. Epub 2020 May 25.

Johannes Gutenberg University, Mainz, Germany (Thomas Thomaidis, Visvakanth Sivanathan, Markus Moehler).

Biliary obstruction is common in pancreatobiliary malignancies and has a negative impact on the patient's quality of life, postoperative complications, and survival rates. Particularly in the last decade, there has been enormous progress regarding the diagnostic and therapeutic options in patients with malignant biliary obstruction. Endoscopy has given a new insight in this direction and novel techniques have been developed for the better characterization and treatment of malignant strictures. Read More

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http://dx.doi.org/10.20524/aog.2020.0497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315700PMC

Outcomes assessment in intrahepatic cholangiocarcinoma using qualitative and quantitative imaging features.

Cancer Imaging 2020 Jul 3;20(1):43. Epub 2020 Jul 3.

Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.

Background: To assess the performance of imaging features, including radiomics texture features, in predicting histopathologic tumor grade, AJCC stage, and outcomes [time to recurrence (TTR) and overall survival (OS)] in patients with intrahepatic cholangiocarcinoma (ICC).

Methods: Seventy-three patients (26 M/47F, mean age 63y) with pre-operative imaging (CT, n = 37; MRI, n = 21; CT and MRI, n = 15] within 6 months of resection were included in this retrospective study. Qualitative imaging traits were assessed by 2 observers. Read More

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http://dx.doi.org/10.1186/s40644-020-00323-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333305PMC

EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles.

Endosc Int Open 2020 Jul 16;8(7):E938-E943. Epub 2020 Jun 16.

University of Utah School of Medicine Huntsman Cancer Center - Gastroenterology and Hepatology, Salt Lake City, Utah, United States.

We compared the diagnostic yield and specimen adequacy in EUS-guided parenchymal biopsies between two types of EUS 19 G core needles. This is a retrospective study of 420 patients at two tertiary medical centers in Florida with unexplained abnormal liver associated tests were referred for EUS evaluation of biliary obstruction and pancreatic pathology. EUS-guided liver biopsy (EUS-LB) was performed at the same session after biliary obstruction was excluded. Read More

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http://dx.doi.org/10.1055/a-1165-1767DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297611PMC

Outcomes of EUS-guided choledochoduodenostomy as primary drainage for distal biliary obstruction with covered self-expandable metallic stents.

Endosc Int Open 2020 Jul 16;8(7):E861-E868. Epub 2020 Jun 16.

Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University.

Endoscopic ultrasonography-guided choledochoduodenostomy (EUS-CDS) is an alternative therapy for percutaneous transhepatic biliary drainage. Outcomes of EUS-CDS for distal biliary tract obstruction with a covered self-expandable metallic stent (SEMS) as a primary drainage technique are unclear because there are few relevant reports. This study aimed to determine outcomes in patients undergoing EUS-CDS using SEMS as the primary drainage technique for malignant distal biliary duct obstruction. Read More

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http://dx.doi.org/10.1055/a-1161-8488DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297614PMC

Side-by-side placement of 4 fully covered self-expandable metal stents for malignant hilar biliary obstruction.

Dig Endosc 2020 Jul 2. Epub 2020 Jul 2.

Department of Gastroenterology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.

The best approach to endoscopic stenting for hilar malignant biliary obstruction (HMBO) is subject to debate. Multiple stent deployments are often needed, and plastic stents (PS) or uncovered self-expandable metal stents (SEMS) are commonly used. However, a recent study showed that the efficiency of the use of PS for HMBO was inferior to that of SEMS. Read More

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http://dx.doi.org/10.1111/den.13785DOI Listing

Pharmacological Characterization of a Novel Mouse Model of Cholestatic Pruritus.

Biol Pharm Bull 2020 ;43(7):1111-1117

Department of Applied Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama.

Patients with cholestatic liver diseases, such as primary biliary cirrhosis, usually suffer from pruritus. However, the pathogenesis of cholestatic pruritus is unclear, and there is no current effective treatment for it. In order to find a treatment for the condition, an appropriate mouse model should be developed. Read More

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http://dx.doi.org/10.1248/bpb.b20-00097DOI Listing
January 2020

[Clinical diagnosis and treatment characteristics of pancreatic cystic neoplasms in pediatric patients: a report of 13 cases].

Zhonghua Wai Ke Za Zhi 2020 Jul;58(7):525-529

Department of General Surgery, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430014, China.

To investigate the clinical characteristics of pancreatic cystic neoplasms in pediatric patients. The clinical data of 13 patients with pancreatic cystic neoplasm at Wuhan Children's Hospital from July 2007 to November 2019 were collected.There were 5 males and 8 females, with a mean age of 133 months(range: 9 to 170 months). Read More

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http://dx.doi.org/10.3760/cma.j.cn112139-20191122-00574DOI Listing

Hemobilia as a Complication of Transhepatic Percutaneous Biliary Drainage: a Rare Indication for Laparoscopic Common Bile Duct Exploration.

J Gastrointest Surg 2020 Jun 30. Epub 2020 Jun 30.

General Surgery Division, NYU Langone Health - Bellevue Hospital, 550 1st Avenue, New York, NY, |10016, USA.

Background: Hemobilia is the presence of blood in the biliary tree and is a frequent complication after percutaneous transhepatic biliary drainage (PTBD). Most of these episodes are self-limited; nevertheless, in less than 5% of cases, hemobilia is clinically significant, requiring an intervention (hepatic artery embolization, stenting, or percutaneous thrombin injection). Adequate treatment requires control of hemorrhage and restoration of bile flow. Read More

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http://dx.doi.org/10.1007/s11605-020-04664-wDOI Listing

Percutaneous transhepatic placement of plastic biliary stents: technical description and preliminary results.

Abdom Radiol (NY) 2020 Jun 30. Epub 2020 Jun 30.

Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 740, Vila Clementino, 04023-062, São Paulo, SP, Brazil.

Purpose: To describe a novel technique of percutaneous transhepatic (PTH) placement of a plastic biliary stent (PBS), report the feasibility and safety of the technique, and present the preliminary results of a pilot study that included 32 patients with symptomatic obstructive jaundice (SOJ) treated with the technique.

Materials And Methods: This was a prospective, single-arm, single-center, pilot study of a cohort of patients with the diagnosis of benign or malignant obstructive jaundice that underwent PTH placement of a PBS to relieve the obstruction.

Results: Thirty-two patients were included, 16 men and 16 women (age range, 35-88 years). Read More

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http://dx.doi.org/10.1007/s00261-020-02626-zDOI Listing

Percutaneous Fluoroscopic-Guided Creation of Neoanastomosis for the Treatment of Biliary Occlusions.

Cardiovasc Intervent Radiol 2020 Jun 29. Epub 2020 Jun 29.

Division of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.

Purpose: Complete biliary occlusions at different anatomic locations that are not amenable to surgical, endoscopic, or routine percutaneous methods pose a challenge to physicians. Biliary ductal neoanastomosis technique can play a very important role in solving such clinical problems.

Materials: Between October 2004 and January 2018, six patients were treated in our institution for biliary drainage using biliary ductal neoanastomosis technique via sharp recanalization and a staged approach to achieve internal/external biliary drainage. Read More

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http://dx.doi.org/10.1007/s00270-020-02544-zDOI Listing

Collateral intrahepatic circulation in presence of hepatic veins obstruction: The "half-moon".

Dig Liver Dis 2020 Jun 26. Epub 2020 Jun 26.

Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.

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http://dx.doi.org/10.1016/j.dld.2020.06.026DOI Listing

A Patient with Primary Sclerosing Cholangitis and Diffuse Biliary Dilation.

Gastroenterology 2020 Jun 26. Epub 2020 Jun 26.

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

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http://dx.doi.org/10.1053/j.gastro.2020.06.053DOI Listing

Challenging biliary strictures: pathophysiological features, differential diagnosis, diagnostic algorithms, and new clinically relevant biomarkers - part 1.

Therap Adv Gastroenterol 2020 16;13:1756284820927292. Epub 2020 Jun 16.

Department of Medicine, Geneva University, Geneva, Switzerland.

It is frequently challenging to make the correct diagnosis in patients with biliary strictures. This is particularly important as errors may have disastrous consequences. Benign-appearing strictures treated with stents may later be revealed to be malignant and unnecessary surgery for benign strictures carries a high morbidity rate. Read More

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http://dx.doi.org/10.1177/1756284820927292DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298429PMC

Percutaneous endobiliary forceps biopsy of biliary strictures for histopathologic examination.

Diagn Interv Radiol 2020 Jul;26(4):339-344

Department of Diagnostic and Interventional Radiology, University-Hospital of Würzburg, Würzburg, Germany.

Purpose: We aimed to investigate the feasibility, accuracy and safety of percutaneous endobiliary cholangio-forceps biopsy of biliary strictures in our institution.

Methods: A total of 13 percutaneous transhepatic endobiliary biopsies (7 men and 6 women, mean age 66.85±16. Read More

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http://dx.doi.org/10.5152/dir.2020.19329DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360072PMC

Duodenal Crohn's disease, gastro-jejunal bypass vs. duodenal-jejunal bypass - A Video Vignette.

Colorectal Dis 2020 Jun 18. Epub 2020 Jun 18.

Colorectal Surgery Unit, Donostia University Hospital, Donostia, Spain.

In this video S1, we describe two different approaches for the surgical treatment of duodenal Crohn´s disease (CD): the gastro-jejunal by-pass and the duodenal-jejunal by pass. The first patient, a 67-year-old male patient, had developed a stricture in the 4 part of the duodenum which was causing obstructive symptoms. A gastro-jejunal by-pass was performed but postoperatively the patient's symptoms persisted. Read More

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http://dx.doi.org/10.1111/codi.15202DOI Listing

Identification of risk factors for obstructive cholecystitis following placement of biliary stent in unresectable malignant biliary obstruction: a 5-year retrospective analysis in single center.

Surg Endosc 2020 Jun 15. Epub 2020 Jun 15.

Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, 18450, Gyeonggi-do, Korea.

Background: The risk factors for acute cholecystitis following biliary stent placement in patients with malignant biliary obstruction (MBO) have not been identified. We determined these risk factors and the efficacy of endoscopic ultrasound (EUS)-guided gallbladder drainage (GBD) as treatment.

Methods: We retrospectively analyzed patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for MBO from October 2013 to September 2018, and those with unresectable MBO with intact gallbladder (GB) were enrolled. Read More

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http://dx.doi.org/10.1007/s00464-020-07694-2DOI Listing