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JAMA Surg 2019 Feb 13. Epub 2019 Feb 13.

Dumont-UCLA (University of California, Los Angeles) Transplant and Liver Cancer Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, UCLA.

Importance: Anastomotic biliary complications (ABCs) constitute the most common technical complications in liver transplant (LT). Given the ever-increasing acuity of LT, identification of factors contributing to ABCs is essential to minimize morbidity and optimize outcomes. A detailed analysis in a patient population undergoing high-acuity LT is lacking. Read More

Curr Opin Crit Care 2019 Feb 5. Epub 2019 Feb 5.

Purpose Of Review: To review recent literature on the management of patients with severe acute pancreatitis (SAP) admitted to an ICU.

Recent Findings: SAP is a devastating disease associated with a high morbidity and mortality. Recent evidence advocates adequate risk assessment and severity prediction (including intra-abdominal pressure monitoring), tailored fluid administration favoring balanced crystalloids, withholding prophylactic antibiotic therapy, and early detection and treatment of extra-pancreatic and fungal infections. Read More

Abdom Radiol (NY) 2019 Feb 6. Epub 2019 Feb 6.

Department of Interventional Radiology, The Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA.

Background: Ascites is a relative contraindication to percutaneous biliary drainage (PBD), but patients with biliary obstruction presenting with ascites may still undergo PBD insertion. We hypothesized that ascites increases the major complication rate of PBD.

Materials: PBDs placed between January 2005 and August 2016 were identified (n = 491). Read More

Transplantation 2019 Jan 30. Epub 2019 Jan 30.

Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD.

Background: An 11-year old girl with DOCK8 deficiency was proposed for potentially curative hematopoietic stem cell transplantation (HSCT), the donor being her haploidentical mother. However, end-stage liver disease, caused by chronic Cryptosporidium infection required liver transplantation before HSCT.

Methods: Consequently, a staged approach of a sequential liver transplant followed by a HSCT was planned, with her mother as the donor for both liver and HSCT. Read More

Saudi J Gastroenterol 2019 Feb 1. Epub 2019 Feb 1.

The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University; Liver Diseases Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.

Background/aim: For resectable extrahepatic cholangiocarcinoma with biliary obstruction, it remains a controversy whether to choose percutaneous transhepatic biliary drainage (PTBD) or endoscopic biliary drainage (EBD). A systematic review was conducted to compare the long-term efficacy between the two techniques.

Materials And Methods: Eligible studies were searched from January 1990 to May 2018, comparing the long-term efficacy between EBD and PTBD for extrahepatic cholangiocarcinoma. Read More

Endosc Ultrasound 2019 Feb 4. Epub 2019 Feb 4.

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Background And Objectives: EUS-guided biliary drainage (EUS-BD) is increasingly utilized to manage unresectable malignant biliary obstruction after a failed ERCP. However, there is no data on how endoscopists perceive EUS-BD. The aim of this study was to investigate the perception of endoscopists on EUS-BD. Read More

Clin Med Insights Oncol 2019 22;13:1179554918825450. Epub 2019 Jan 22.

Digestive Tumours Unit, Institut Bergonié, Bordeaux, France.

Background: Pre-operative chemotherapy for colorectal liver metastasis (CRLM) is thought to be the cause of hepatotoxicity of non-tumoural parenchyma. Studies on hepatotoxicity are contradictory. We investigated the impact of a single-line pre-operative chemotherapy on non-tumoural liver analysed by an expert hepatico-pancreatico-biliary pathologist, and the consequences on surgical outcomes. Read More

Dig Endosc 2019 Feb 3. Epub 2019 Feb 3.

Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.

Objectives: The time to recurrent biliary obstruction (TRBO) of unresectable distal malignant biliary obstruction is generally thought to be longer when a self-expandable metal stent (SEMS) with a thicker inner diameter is used for drainage, but the dependence on the inner diameter using a fully covered SEMS (FCSEMS) is uncertain. The objective of this multicenter prospective study was to compare TRBO and adverse events, such as cholecystitis and pancreatitis, in treatment of patients with unresectable malignant biliary obstruction using 8-mm and 10-mm diameter FCSEMS.

Methods: Eighteen tertiary-care centers participated in the study. Read More

Surg Case Rep 2019 Feb 1;5(1):16. Epub 2019 Feb 1.

Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Fukushima Medical University, Hikarigaoka-1, Fukushima-shi, Fukushima, 960-1295, Japan.

Background: Although annular pancreas concurrent with pancreaticobiliary maljunction has rarely been reported, some reports have pointed out a possibility that both anomalies have a common pathogenesis in pancreatic development. We herein report a case with pancreaticobiliary maljunction diagnosed long after surgical treatment for annular pancreas.

Case Presentation: A 34-year-old female, with a surgical history of duodenal obstruction due to annular pancreas in the neonatal period, was referred to our hospital for further examination of chronic pancreatitis. Read More

World J Hepatol 2019 Jan;11(1):19-36

Department of Pediatrics, University of Utah, Salt Lake City, UT 84113, United States.

Primary sclerosing cholangitis (PSC) is a rare disease of stricturing and destruction of the biliary tree with a complex genetic and environmental etiology. Most patients have co-occurring inflammatory bowel disease. Children generally present with uncomplicated disease, but undergo a variable progression to end-stage liver disease. Read More

World J Gastroenterol 2019 Jan;25(4):485-497

Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.

Background: Endoscopic sphincterotomy (EST) for the management of common bile duct stones (CBDS) is used increasingly widely because it is a minimally invasive procedure. However, some clinical practitioners argued that EST may be complicated by post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and accompanied by a higher recurrence of CBDS than open choledochotomy (OCT). Whether any differences in outcomes exist between these two approaches for treating CBDS has not been thoroughly elucidated to date. Read More

Korean J Gastroenterol 2019 Jan;73(1):39-44

Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

Intramural hematoma of the duodenum is a relatively unusual complication associated with the endoscopic treatment of bleeding peptic ulcers. Intramural hematomas are typically resolved spontaneously with conservative treatment alone. We report a case of an intramural duodenal hematoma following endoscopic hemostasis with epinephrine injection therapy, which was associated with transient obstructive jaundice in a patient undergoing hemodialysis. Read More

GE Port J Gastroenterol 2018 Dec 10;26(1):70-72. Epub 2018 Apr 10.

Department of Gastroenterology, Portuguese Institute of Oncology Francisco Gentil, Porto, Portugal.

Clin Endosc 2019 Jan 22. Epub 2019 Jan 22.

Asian Institute of Gastroenterology, Hyderabad, India.

Malignancies of the pancreatobiliary system are usually unresectable at the time of diagnosis. As a consequence, a majority of these cases are candidates for palliative care. With advances in chemotherapeutic agents and multidisciplinary care, the survival rate in pancreatobiliary malignancies has improved. Read More

J Comput Assist Tomogr 2019 Jan 17. Epub 2019 Jan 17.

Objective: The aim of this study was to investigate the potential of intravoxel incoherent motion diffusion-weighted imaging in diagnosing hilar obstructive jaundice.

Methods: Fifty-nine patients diagnosed with hilar obstructive jaundice were enrolled in our hospital form January 2017 to January 2018. All the patients received scanning by a 3. Read More

Cureus 2018 Nov 12;10(11):e3577. Epub 2018 Nov 12.

Interventional Radiology, University of Florida College of Medicine, Jacksonville, USA.

Percutaneous cholangiography is typically performed via a transhepatic approach and is reserved for patients with contraindications to traditional cholangiogram imaging modalities. For those with suspected cholelithiasis or choledocholithiasis who cannot undergo magnetic resonance imaging for diagnosis, percutaneous cholecystostomy with cholangiogram is a viable option. Endoscopic retrograde cholangiopancreatography may also be precluded due to anatomic or obstructive limitations, in which case, percutaneous transhepatic cholangiography (PTC) may be indicated for diagnosis. Read More

Mol Clin Oncol 2019 Jan 26;10(1):168-172. Epub 2018 Oct 26.

Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan.

The aim of the present study was to clarify the clinical significance of a novel fibrotic marker, serum Mac-2 binding protein glycosylation isomer (M2BPGi), in non-cirrhotic patients with biliary diseases. Associations between the serum levels of M2BPGi and clinical features (including background disease and laboratory data) were analyzed. A total of 78 patients with biliary disease (32 with biliary cancer and 46 with benign disease) were evaluated, and their clinical features (age, sex and biliary stricture status), serum level of M2BPGi and other serum laboratory data [aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyltranspeptidase (γ-GTP), alkaline phosphatase (ALP), total bilirubin (TB), direct bilirubin (DB), c-reactive protein (CRP), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9)] were compared. Read More

Mol Clin Oncol 2019 Jan 1;10(1):144-146. Epub 2018 Nov 1.

Third Department of Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.

Secondary pancreatic lesions are very uncommon. Resection of these metastatic lesions with a curative intent has been reported in selected patients; however, the survival benefit from these procedures has yet to be clearly determined. A 78-year-old male patient presented to our department with obstructive jaundice. Read More

Endoscopy 2019 Jan 17. Epub 2019 Jan 17.

HPB Medicine, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom.

Background:  Stents are frequently placed in patients with biliary obstruction due to a mass in the head of the pancreas. The impact of plastic or self-expandable metal stents (SEMSs) on endoscopic ultrasound (EUS)-guided tissue sampling is unclear. This study aimed to assess, using strict pathological criteria, whether stents impair fine-needle aspiration (FNA) or fine-needle biopsy (FNB). Read More

CVIR Endovasc 2018 28;1(1). Epub 2018 Jun 28.

2University College London Hospital, Euston Road, London, NW1 2BU UK.

Background: Haemobilia, defined as bleeding from the biliary tree, is a rare entity. The most common cause of haemobilia is iatrogenic trauma, which accounts for 70% of cases. Pseudoaneurysms of the portal vein are an extremely rare cause of haemobilia with only four reported cases to date. Read More

Endosc Int Open 2019 Jan 15;7(1):E87-E89. Epub 2019 Jan 15.

Department of Surgery, University Hospital "Saint Marina", Pleven, Bulgaria.

An intraluminal duodenal diverticulum (IDD) is a rare congenital anomaly, which is a result of incomplete recanalization of the foregut lumen during embryonic development. Most patients are asymptomatic. Symptoms usually occur after the third decade of life and mainly include epigastric pain, nausea, vomiting, or bloating. Read More

Endosc Int Open 2019 Jan 3;7(1):E26-E35. Epub 2019 Jan 3.

Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, Bologna, Italy.

 To assess the rate of adverse events and the technical success rate of biliary stenting with or without EBS.   A literature search up to February 2017 was performed. Studies assessing adverse events (AEs) and technical success rates of stenting with or without EBS were considered. Read More

Cureus 2018 Oct 26;10(10):e3499. Epub 2018 Oct 26.

Radiation Oncology, Stanford University Medical Center, Stanford, USA.

Here we describe the case of a 10-year-old boy with a history of chronic hepatitis B who was diagnosed with hepatocellular carcinoma (HCC) with a large central hepatic mass and metastatic disease in a celiac lymph node. His tumor was unresectable, due to location and lack of clear margins, and he could not receive chemotherapy due to elevated bilirubin. He was treated with stereotactic body radiotherapy (SBRT) to the primary site and involved nodal region. Read More

Internist (Berl) 2019 Jan 11. Epub 2019 Jan 11.

Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 München, Deutschland.

With an increasing number of hospital admissions, an average of 16-to 20 days in hospital per year, 34% of patients constantly taking pain medication, 57% in need of enzyme supplementation, and 29% with diabetes mellitus, chronic pancreatitis is a debilitating disease of high socio-economic relevance. In total, 33% of all patients suffering from chronic pancreatitis can no longer practice their original profession. The number of unemployed chronic pancreatitis patients due to prolonged stays in hospital or continued alcohol abuse is known to be as high as 40%. Read More

Cancer Med 2019 Jan 10. Epub 2019 Jan 10.

Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.

Pancreatic ductal adenocarcinoma (PDAC) is a devastating malignancy with poor prognosis. Many preoperative biomarkers can predict postoperative survival of PDAC patients. In this study, we created a novel ratio index based on preoperative liver function test, γ-glutamyltransferase-to-albumin ratio (GAR), and evaluated its prognostic value in predicting clinical outcomes of PDAC patients following radical surgery. Read More

Case Rep Gastroenterol 2018 Sep-Dec;12(3):722-728. Epub 2018 Nov 28.

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has been utilized as an alternative endoscopic technique for patients with acute cholecystitis. In addition to EUS-guided hepaticogastrostomy and EUS-guided cystogastrostomy, EUS-GBD has been reported as being useful for biliary drainage in cases with distal malignant biliary obstruction instead of conventional endoscopic retrograde cholangiopancreatography. We present a case of successful EUS-GBD for malignant obstruction of an aberrant hepatic duct draining directly into the cystic duct. Read More

Case Rep Gastroenterol 2018 Sep-Dec;12(3):686-691. Epub 2018 Nov 28.

Department of Gastroenterology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Clips inserted during laparoscopic cholecystectomy (LC) may migrate into the biliary system and function as a nidus for the formation of gallstones. Here, we present a series of 4 patients who presented with this rare complication 5-17 years after LC. All 4 patients presented with symptomatic choledocholithiasis with biochemical and radiological signs of biliary obstruction. Read More

Acta Radiol 2019 Jan 10:284185118820049. Epub 2019 Jan 10.

Julius-Maximilians-University of Würzburg, Institute of Diagnostic and Interventional Radiology, Würzburg, Germany.

Background: Percutaneous biliary drainage (PTBD) is a necessary procedure in several benign and malignant conditions. After PTBD removal biliocutaneous fistula is a rare but potential complication. Different embolization agents have been used for transhepatic catheter tract embolization in the past, while there is only little experience using gelatin sponge for this procedure. Read More

Intern Med 2019 Jan 10. Epub 2019 Jan 10.

Pathology Division, University of Miyazaki Hospital, Japan.

Even in the era of Helicobacter pylori eradication and proton pump inhibitors, peptic ulcer remains an important disease. Stricture due to a duodenal ulcer in the healing stage is a well-known etiology of benign gastric outlet obstruction. However, a duodenal ulcer-induced submucosal tumor-like change with gastric outlet obstruction is a very rare manifestation. Read More

Clin Endosc 2019 Jan 10;52(1):40-46. Epub 2019 Jan 10.

Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.

Combined obstruction of the bile duct and duodenum is a common occurrence in periampullary malignancies. The obstruction of gastric outlet or duodenum can follow, occur simultaneously, or precede biliary obstruction. The prognosis in patients with combined obstruction is particularly poor. Read More

World J Gastrointest Pathophysiol 2019 Jan;10(1):1-10

Department of Medicine, The University of Melbourne, Melbourne, VIC 3084, Australia.

Chronic liver diseases that inevitably lead to hepatic fibrosis, cirrhosis and/or hepatocellular carcinoma have become a major cause of illness and death worldwide. Among them, cholangiopathies or cholestatic liver diseases comprise a large group of conditions in which injury is primarily focused on the biliary system. These include congenital diseases (such as biliary atresia and cystic fibrosis), acquired diseases (such as primary sclerosing cholangitis and primary biliary cirrhosis), and those that arise from secondary damage to the biliary tree from obstruction, cholangitis or ischaemia. Read More

J Gastroenterol Hepatol 2019 Jan 7. Epub 2019 Jan 7.

Digestive Disease Center and Research Institute, Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon, Cheonan and Seoul, Korea.

Background: Fully covered self-expandable metal stents (FCSEMS) may be better than plastic stents (PS) for preoperative biliary drainage (PBD) to relieve cholangitis or jaundice for resectable malignant biliary obstruction (MBO). However, modification of current FCSEMS designed originally for nonresectable MBO is needed to be a proper stent for PBD. The aim of this study was to evaluate the possible superiority of non-flared modified FCSEMS (M-FCSEMS) with 12 mm diameter and waist of central portion over PS in patients with resectable MBO. Read More

Nutrition 2018 Oct 10;60:206-211. Epub 2018 Oct 10.

Hepato-Pancreatico-Biliary Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. Electronic address:

Objectives: Providing home enteral nutrition (HEN) might prevent further deterioration of nutritional status and reduce complication risk after very invasive abdominal surgery. The aim of this study was to assess the effect of HEN after pancreaticoduodenectomy (PD).

Methods: Between January 2013 and July 2016, 150 consecutive patients underwent PD. Read More

Radiology 2019 Jan 1:180279. Epub 2019 Jan 1.

From the Division of Vascular and Interventional Radiology, Department of Radiology (A.S., C.A.H., J.L.W., G.K., N.C., Y.P., O.R.B., M.A.), and Center for Healthcare Delivery Sciences (V.N.), Beth Israel Deaconess Medical Center, 1 Deaconess Rd, Boston, MA 02215; and Clinical Research Center, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (V.N.).

Purpose To investigate rates and causes of 30-day readmission for patients who undergo percutaneous transhepatic biliary drainage (PTBD) procedures. Materials and Methods In this retrospective study, PTBD procedures performed at a tertiary care institution (June 2008 to May 2013) were reviewed. For each patient, the first 30-day readmission was used to determine cause of readmission. Read More

Dig Endosc 2018 Dec 27. Epub 2018 Dec 27.

Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan.

J Cancer Res Ther 2018 ;14(7):1503-1508

Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China.

Background: The symptoms of patients with malignant biliary obstruction (MBO) could be effectively alleviated with percutaneous transhepatic biliary drainage (PTBD). Postoperative infections were considered as challenging issues for clinicians. In this study, the risk factors of biliary infection in patients after PTBD were analyzed. Read More

Clin Med Res 2018 Dec;16(3-4):73-75

Department of Urology, Gundersen Health System, La Crosse, Wisconsin USA

Bouveret Syndrome is a rare complication of gallstone disease that occurs when a gallstone enters the stomach or bowel through a biliary enteric fistula and becomes impacted, resulting in gastric outlet obstruction. It is frequently seen in elderly chronically ill patients with neglected biliary disease. We describe a multidisciplinary approach to management of Bouveret Syndrome that could be adopted by healthcare systems with resources commonly found in facilities with a general urologist and gastroenterologist or general surgeon. Read More

JFMS Open Rep 2018 Jul-Dec;4(2):2055116918817631. Epub 2018 Dec 16.

Foundation Hospital Veterinary Clinic, Autonomous Foundation Hospital of Barcelona, Barcelona, Spain.

Case Summary: Congenital or acquired hepatic cystic lesions in cats are a rare condition. Congenital hepatic cysts are often present as part of a systemic polycystic disease involving several organs. Most cats with hepatic cysts remain clinically normal for their lives, although some patients may show abdominal distension, vomiting, abdominal pain and jaundice. Read More

United European Gastroenterol J 2018 Dec 19;6(10):1448-1460. Epub 2018 Oct 19.

Northern Institute for Cancer Research, Newcastle University, Newcastle, UK.

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a short list of key performance measures for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). We recommend that endoscopy services across Europe adopt the following seven key and one minor performance measures for EUS and ERCP, for measurement and evaluation in daily practice at centre and endoscopist level: Adequate antibiotic prophylaxis before ERCP (key performance measure, at least 90%); antibiotic prophylaxis before EUS-guided puncture of cystic lesions (key performance measure, at least 95%); bile duct cannulation rate (key performance measure, at least 90%); tissue sampling during EUS (key performance measure, at least 85%); appropriate stent placement in patients with biliary obstruction below the hilum (key performance measure, at least 95%); bile duct stone extraction (key performance measure, at least 90%); post-ERCP pancreatitis (key performance measure, less than 10%); and adequate documentation of EUS landmarks (minor performance measure, at least 90%). This present list of quality performance measures for ERCP and EUS recommended by the ESGE should not be considered to be exhaustive; it might be extended in future to address further clinical and scientific issues. Read More

Khirurgiia (Mosk) 2018 (12):50-56

Research Institute - Ochapovsky Regional Clinical Hospital #1 of Healthcare Ministry of the Krasnodar region, Krasnodar, Russia.

Aim: To study postoperative complications and mortality after minimally invasive biliary decompression in patients with mechanical jaundice.

Material And Methods: Prospective analysis included 2.072 patients with mechanical jaundice who underwent differential biliary decompression depending on the cause, level of obstruction, severity of jaundice and patient's condition. Read More

Medicine (Baltimore) 2018 Dec;97(50):e13072

Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju.

Rationale: Self-expanding metal stent placement is a useful procedure for intestinal obstruction. Afferent loop syndrome after gastrectomy is an uncommon complication of gastroenterostomy reconstruction. Ascending cholangitis caused by afferent loop syndrome is a potential, but rare, complication. Read More

Khirurgiia (Mosk) 2018 (11):20-23

Botkin Municipal Clinical Hospital, Moscow, Russia.

In the time period from 2009 to 2017 in Botkin Hospital (Moscow) bilateral biliary stenting was performed in 43 patients with malignant common hepatic duct stricture. Patients were divided into 2 statistically homogeneous groups: 'side-by-side' stenting in 28 patients and percutaneous 'Y'-biliary stent placement in 15 patients. The causes of malignant obstruction were as follows: in the 1 group 13 (46. Read More

Endosc Ultrasound 2018 Nov-Dec;7(6):404-412

Third Department of Surgery, Tokyo Medical University, Tokyo, Japan.

Background And Objectives: Recently, a novel EUS-guided biliary drainage (EUS-BD) technique consisting of EUS-guided antegrade stenting and EUS-guided hepaticoenterostomy (EUS-AS+HES) using two conventional metal stents (MS) has been reported to decrease adverse events and maintain longer stent patency for malignant biliary obstruction (MBO). However, only a few limited reports have evaluated this technique. Finally, dedicated plastic stents (PSs) have been developed to perform EUS-HES safely. Read More

Endosc Ultrasound 2018 Nov-Dec;7(6):356-365

Endoscopy Center, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.

Background And Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed.

Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2018 Nov;21(11):1201-1205

Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China.Email: zhangxiaotianmed@ 163.com.

Acute abdomen in patients with malignant tumors is called malignant acute abdomen, often seen in the digestive system tumor or abdominal pelvic metastasis of the other primary tumors. Bleeding, perforation, gastrointestinal obstruction, biliary obstruction with infection, acute peritonitis are acute and severe, however, prevention is more important than treatment. For high-risk patients, even if acute abdomen does not occur when the disease is diagnosed, we should make precautions, including actively local treatment of local lymph nodes or primary lesions and careful choice of drugs. Read More

Cardiovasc Intervent Radiol 2019 Feb 30;42(2):268-275. Epub 2018 Nov 30.

Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, China.

Purpose: To evaluate the effectiveness and safety of simultaneous placement of a self-expandable metallic stents (SEMS) and iodine-125 seed strand in the management of malignant obstructive jaundice (MOJ).

Materials And Methods: This study included 132 patients with MOJ treated from November 2015 to October 2017. Forty-five patients underwent insertion of SEMS with iodine-125 seed strands (Seeds group); the remaining 87 patients underwent SEMS placement alone (Control group). Read More

Int J Mol Sci 2018 Nov 29;19(12). Epub 2018 Nov 29.

Department of Internal Medicine I, Ulm University, 89081 Ulm, Germany.

Liver cholestasis is a chronic liver disease and a major health problem worldwide. Cholestasis is characterised by a decrease in bile flow due to impaired secretion by hepatocytes or by obstruction of bile flow through intra- or extrahepatic bile ducts. Thereby cholestasis can induce ductal proliferation, hepatocyte injury and liver fibrosis. Read More

Curr Probl Diagn Radiol 2018 Aug 29. Epub 2018 Aug 29.

Department of Interventional Radiology, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095. Electronic address:

Purpose: To create a three-dimensional endoscopic model of the biliary tract from magnetic-resonance cholangiopancreatography imaging and to evaluate its effectiveness as a tool for training in endoscopic biliary interventions.

Materials And Methods: A magnetic-resonance cholangiopancreatography study was performed on a patient with biliary obstruction secondary to a distal bile duct cholangiocarcinoma. Using Vitrea, a three-dimensional volume-rendered image was created, and exported as a standard tessellated language file. Read More

Physiol Meas 2018 Nov 26;39(11):114008. Epub 2018 Nov 26.

Faculty of Medical Sciences, Department of Physiology, Tarbiat Modares University, Tehran, Iran. These authors are joint first authors.

Objective: The network of interactions between different organs is impaired in liver cirrhosis. Liver cirrhosis is associated with multi-system involvement, which eventually leads to multiple organ failure. This process is accelerated by a precipitating factor such as bacterial infection, which leads to respiratory distress, circulatory shock, neural dysfunction and very high mortality. Read More

Clin Endosc 2018 Nov 29. Epub 2018 Nov 29.

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Endoscopic transpapillary biliary drainage is the current standard of care for unresectable hilar malignant biliary obstruction (MBO) and bilateral metal stent placement is shown to have longer patency. However, technical and clinical failure is possible and percutaneous transhepatic biliary drainage (PTBD) is sometimes necessary. Endoscopic ultrasound-guided biliary drainage (EUS-BD) is increasingly being reported as an alternative rescue procedure to PTBD. Read More