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J West Afr Coll Surg 2020 Jul-Sep;10(3):36-39. Epub 2022 May 4.

Department of Surgery, Korle-Bu Teaching Hospital, Accra, Ghana.

Background: Obstructive jaundice is a term that describes the clinical entity of yellowness of the skin and mucous membranes due to the inability of bile to flow freely into the duodenum. This is commonly due to mechanical or physiological blockage of either the intrahepatic or extrahepatic bile ducts. Malignancies are responsible for the most cases of obstructive jaundice in our locality. Read More

Clin Exp Gastroenterol 2022 11;15:79-90. Epub 2022 Jun 11.

Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.

Background: The diagnosis of extrahepatic obstructive jaundice (EHOJ) remains a challenge and is often made late in low-resource settings. Systematic data are limited on the etiology and prognosis of patients with obstructive jaundice in Uganda. The objective of this study was to determine the etiology, clinical presentations, and short-term treatment outcomes of patients managed for EHOJ at Mbarara Regional Referral Hospital (MRRH) in south-western Uganda. Read More

J Minim Access Surg 2022 Jul-Sep;18(3):327-337

Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.

Objective: To systematically evaluate the application effect of endoscopic papillary balloon dilatation (EPBD) with different balloon dilatation duration for biliary duct calculi, and find the most appropriate dilatation duration for EPBD using a network meta-analysis.

Materials And Methods: PubMed, Embase and Cochrane Library databases were searched for relevant randomised controlled trials (RCTs) published up to August 2020. Node split, consistency and inconsistency models analysis were all conducted in network meta-analysis. Read More

J Laparoendosc Adv Surg Tech A 2022 Jun 14. Epub 2022 Jun 14.

Gwent Center for Digestive Diseases, Royal Gwent Hospital, Newport, Wales, United Kingdom, General district hospital experience, Case series and review of literature.

Concomitant gallstones and common bile duct (CBD) stones is a common problem, and there is still no consensus on the best approach in the management. Options include preoperative endoscopic retrograde cholangiopancreatography (ERCP), Laparoscopic cholecystectomy (LC) with CBD exploration, and LC with postoperative ERCP. Each option has its own limitations and complications. Read More

GE Port J Gastroenterol 2022 May 12;29(3):172-177. Epub 2021 Aug 12.

Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, India.

Background And Aim: Endoscopic retrograde cholangiopancreatography (ERCP) is considered a safe therapeutic modality even in pregnant women; however, adequate care needs to be taken. The utility of the SpyGlass DS II system in choledocholithiasis among pregnant women is unexplored.

Methods: We retrospectively analyzed patients who underwent ERCP for choledocholithiasis in the absence of fluoroscopy using the SpyGlass DS II system from October 2019 to November 2020. Read More

Am Surg 2022 Jun 12:31348221091950. Epub 2022 Jun 12.

Department of Surgery, 24520Novant Health New Hanover Regional Medical Center, Wilmington, NC, USA.

Intraoperative cholangiogram (IOC) is a useful tool for surgeons to assess anatomy of the biliary tree and diagnose biliary pathology. Many surgeons utilize cholangiography in most cases in hopes of preventing ductal injuries and are deemed routine cholangiographers. There is little data on the success rate and reasons why IOC is not performed. Read More

Comput Math Methods Med 2022 3;2022:9110676. Epub 2022 Jun 3.

Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui 230000, China.

Objective: Evaluate the influence of laparoscopy combined with choledochoscopy on operation-related indexes, serum total bilirubin (TBIL) level, and abdominal drainage tube extraction time within cases carrying cholecystolithiasis/choledocholithiasis.

Methods: 86 cases of cholecystolithiasis together with choledocholithiasis were chosen for this investigation, and cases were randomly segregated within the control cohort (43 cases, open surgery) and observation cohort (43 cases, laparoscopy combined with choledochoscopy).The operation-related indexes, complete stone clearance rate, postoperative visual analogue scale (VAS) scoring, serum TBIL level, and postsurgical complications/recovery incidence were observed and comparatively analyzed across cohorts. Read More

Endosc Int Open 2022 Jun 10;10(6):E898-E904. Epub 2022 Jun 10.

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

The utility of digital single- operator cholangiopancreatoscopy (D-SOCP) in surgically altered anatomy (SAA) is limited. We aimed to evaluate the technical success and safety of D-SOCP in patients SAA. Patients with SAA who underwent D-SOCP between February 2015 and June 2020 were retrospectively evaluated. Read More

ANZ J Surg 2022 06;92(6):1304-1305

Division of Surgery, Northern Health, Epping, Victoria, Australia.

Langenbecks Arch Surg 2022 Jun 7. Epub 2022 Jun 7.

Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Av/ Gaspar Aguilar 90, 46017, Valencia, Spain.

Background: Recurrence after common bile duct stone (CBDS) clearance is the major long-term drawback of their management. Its prevalence is significant, and it occurs after all primary therapeutic alternatives. The aim of this study was to determine the predictive factors associated with stone recurrence after surgical common bile duct exploration (CBDE). Read More

J Can Assoc Gastroenterol 2022 Jun 16;5(3):116-120. Epub 2021 Sep 16.

Department of Internal Medicine, Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada.

Introduction: Roux-en-Y gastric bypass (RYGB) surgery imposes anatomic barriers to endoscopic retrograde cholangiopancreatography (ERCP). Potential options for biliary access in these patients include laparoscopic-assisted ERCP or balloon enteroscopy. However, these approaches require specialized equipment and/or operating room personnel and are associated with high rates of failure and adverse events compared to conventional ERCP. Read More

World J Gastrointest Surg 2022 Apr;14(4):341-351

Emergency Department/Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.

Background: Despite being a benign disease, hepatolithiasis has a poor prognosis because of its intractable nature and frequent recurrence. Nonsurgical treatment is associated with high incidences of residual and recurrent stones. Consequently, surgery hepatic lobectomy or segmental hepatectomy has become the main treatment modality. Read More

Int J Surg Case Rep 2022 May 1;94:107127. Epub 2022 May 1.

Department of Surgery, RIMS, Ranchi.

Introduction: Among a plethora of causes of acute abdomen, spontaneous common bile duct perforation (SCBDP) resulting in biliary peritonitis is almost never envisaged. Since the term SCBDP is often misconstrued as absence of an identifiable cause of perforation, 'nontraumatic perforation of CBD' is also in parlance to exclude relatively common causes such as trauma and iatrogenic injuries. In adults, choledochal cyst, cholangitis, infection, pancreatitis, pancreatobiliary maljunction have been identified as causes of perforation, however, choledocholithiasis remains the most common cause associated with spontaneous perforation of extra hepatic bile duct. Read More

J Clin Gastroenterol 2022 May 25. Epub 2022 May 25.

Division of Gastroenterology, Department of Internal Medicine, University of South Carolina School of Medicine, Columbia.

Background And Aim: We aimed to determine the rate of 30-day hospital readmissions of uncomplicated choledocholithiasis and its impact on mortality and health care use in the United States.

Methods: Nonelective admissions for adults with uncomplicated choledocholithiasis were selected from the Nationwide Readmission Database 2016-2018. The primary outcome was the all-cause 30-day readmission rate. Read More

Surg Laparosc Endosc Percutan Tech 2022 Apr 20. Epub 2022 Apr 20.

Department of Gastroenterology, Fuyang People's Hospital, Fuyang, China.

Background And Objectives: Endoscopic nasobiliary drainage (ENBD) is usually retained for several days after choledocholithiasis is removed by endoscopic retrograde cholangiopancreatography (ERCP). ENBD placement provides reliable biliary drainage and perfusion, prevents pancreatitis, and allows for cholangiography. However, it has not been established whether retention time of ENBD is associated with symptomatic choledocholithiasis recurrence after ERCP. Read More

Surg Laparosc Endosc Percutan Tech 2022 Jun 1;32(3):368-372. Epub 2022 Jun 1.

Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China.

Background: Suture under the laparoscopy was considered as one of the most difficult and time-consuming tasks in laparoscopic common bile duct (CBD) exploration. Difficult suturing can lead to prolonged suturing time and decreased suturing quality. The aim of this study was to identify preoperative factors associated with the difficulty of T-tube suture following laparoscopic bile duct exploration. Read More

World J Gastroenterol 2022 Apr;28(16):1692-1704

Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States.

Background: Acute gallstone pancreatitis (AGP) is the most common cause of acute pancreatitis (AP) in the United States. Patients with AGP may also present with choledocholithiasis. In 2010, the American Society for Gastrointestinal Endoscopy (ASGE) suggested a management algorithm based on probability for choledocholithiasis, recommending additional imaging for patients at intermediate risk and endoscopic retrograde cholangiopancreatography (ERCP) for patients at high risk of choledocholithiasis. Read More

Cureus 2022 Apr 13;14(4):e24101. Epub 2022 Apr 13.

Trauma and Acute Care Surgery, Methodist Health System, Dallas, USA.

Cholecystocolonic fistula (CCF) is a rare complication of biliary tract disease. Increased use of imaging has aided in diagnosing these fistulae preoperatively and has established laparoscopy as a safe alternative to laparotomy. Here, we present a 79-year-old male who presented to the emergency room with abdominal pain and was diagnosed with choledocholithiasis. Read More

Langenbecks Arch Surg 2022 May 13. Epub 2022 May 13.

Department of General Surgery, Hefei Second People's Hospital, Anhui Medical University, Hefei, 230011, Anhui Province, People's Republic of China.

Background: The safety and feasibility of primary closure after laparoscopic common bile duct exploration (LCBDE) have been confirmed in elective settings. However, the suitability of primary closure after LCBDE in the treatment of patients with non-severe acute cholangitis in emergency settings remains unclear. The aim of the present study was to explore the safety and feasibility of LCBDE with primary closure in patients with non-severe acute cholangitis. Read More

Evid Based Complement Alternat Med 2022 2;2022:2662435. Epub 2022 May 2.

Department of Gastroenterology, Yuyao People's Hospital, Yuyao, Zhejiang, China.

Objective: The treatment of choledocholithiasis with duodenal stenosis is a clinical difficult problem. This study aimed to investigate the efficacy and safety of ERCP via gastroscopy in the treatment of choledocholithiasis and duodenal stenosis.

Methods: From January 2015 to December 2020, 21 patients with choledocholithiasis with duodenal stenosis who underwent ERCP treatment under gastroscopy in our hospital were enrolled. Read More

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2022 Apr;44(2):286-289

Department of General Surgery,the Number One Hospital of Zhangjiakou,Zhangjiakou,Hebei 075000,China.

Objective To evaluate the safety and effectiveness of laparoscopic common bile duct exploration in the treatment of common bile duct stones. Methods A retrospective analysis was conducted for 158 patients with cholecystolithiasis and choledocholithiasis admitted to the Number One Hospital of Zhangjiakou from January 2015 to December 2019.The patients were assigned into three groups according to the diameters of cystic duct and common bile duct,degrees of abdominal infection and tissue edema,and operation method. Read More

Dig Dis Sci 2022 May 9. Epub 2022 May 9.

Department of Upper GI Surgery, Northwick Park Hospital & St Marks Hospitals, London, HA1 3UJ, UK.

Pharmacotherapy 2022 Jun 17;42(6):483-494. Epub 2022 May 17.

Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.

Study Objective: Clinical trials have suggested that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may be associated with a higher risk of biliary-related diseases in patients with type 2 diabetes. Limited real-world studies have examined the comparative biliary safety of GLP-1RAs versus other antihyperglycemic drugs. We aimed to estimate the comparative risk of biliary-related diseases between GLP-1RAs and sodium glucose cotransporter 2 inhibitors (SGLT2is), which are indicated for patients with similar diabetes severity in Taiwan. Read More

Surg Endosc 2022 May 4. Epub 2022 May 4.

Laparoscopic Biliary Service, University Hospital Monklands, Monkscourt Avenue, Airdrie, Lanarkshire, ML6 0JS, Scotland, UK.

Background: The timing of laparoscopic cholecystectomy (LC) for emergency biliary admissions remains inconsistent with national and international guidelines. The perception that LC is difficult in acute cholecystitis and the popularity of the two-session approach to pancreatitis and suspected choledocholithiasis result in delayed management.

Methods: Analysis of prospectively maintained data in a unit adopting a policy of "intention to treat" during the index admission. Read More

Medicine (Baltimore) 2022 Mar 11;101(10):e29002. Epub 2022 Mar 11.

Department of Hepatobiliary Surgery, Zigong First People's Hospital, Zigong, Sichuan, China.

Objectives: The optimal treatment strategy for cholecystocholedocholithiasis is still controversial. We conducted an up-to-date meta-analysis to compare the efficacy and safety of the intra- endoscopic retrograde cholangiopancreatography (ERCP) + LC procedure with the traditional pre-ERCP +  laparoscopic cholecystectomy (LC) procedure in the management of cholecystocholedocholithiasis.

Methods: We searched the PubMed, Embase, Cochrane Library, and Web of Science databases up to September 2020. Read More

Pol Merkur Lekarski 2022 Apr;50(296):102-108

Ternopil V. Hnatiuk National Pedagogical University, Ternopil, Ukraine.

Adverse reactions after intravascular administration of iodine-based contrast media are well-known. Nevertheless the same type of contrast media is also used for endoscopic retrograde cholangiopancreatography and systemic absorption of contrast media after mentioned procedure routinely occurs, not much is known about effects of widely used diatrizoates (Triombrast) on the hepato-pancreato-biliary system in case of cholelithiasis treatment.

Aim: The aim of the present study was to determine the effectiveness and biosafety of diatrizoate contrast media in terms of complicated cholelithiasis healing using conventional and improved surgery treatment protocols based on set of biochemical markers. Read More

Am Surg 2022 Apr 17:31348221087442. Epub 2022 Apr 17.

Department of Surgery, 116057Henry Ford Macomb, Clinton Twp, MI, USA.

This report presents a case of aberrant gallbladder anatomy. A 75-year-old female presented to the hospital with choledocholithiasis was admitted and underwent an endoscopic retrograde cholangiopancreatography (ERCP) to clear the common bile duct stones; no aberrant anatomy was noted at this time. The following day she was taken to the operating room for cholecystectomy prior to discharge. Read More

Front Surg 2022 31;9:782357. Epub 2022 Mar 31.

Faculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.

Objective: The aim of the present study is to summarize the experience of using a 2. 7 mm choledochoscope for laparoscopic cholecystectomy combined with an ultrathin choledochoscope for common bile duct exploration and choledocholithotomy in the treatment of cholecystolithiasis associated with choledocholithiasis after the implementation of strict inclusion and exclusion criteria.

Methods: A retrospective analysis of 47 patients with cholecystolithiasis complicated with choledocholithiasis who were treated in the hepatopancreatobiliary surgery department of the Chinese People's Liberated Army General Hospital between January 2015 and December 2019 was performed in the present study. Read More

Radiol Case Rep 2022 Jun 8;17(6):2001-2005. Epub 2022 Apr 8.

MedStar Health, Department of Internal Medicine, Baltimore, MD, USA.

Dropped gallstones are a known complication of laparoscopic cholecystectomy. Rarely, dropped stones may be embedded within the potential intraperitoneal spaces or abdominal wall, mimicking metastatic implants, tuberculosis, peritoneal loose body, actinomyces, and primary tumors, which when coupled with the fact that most bile stones are radiolucent, leads to diagnostic challenges. Here, we report a case of abdominal wall abscess due to a dropped stone that presented over 15 years after laparoscopic cholecystectomy. Read More

World J Gastroenterol 2022 Mar;28(12):1257-1271

Guangdong Provincial Key Laboratory of Microbial Safety and Health, Key Laboratory of Agricultural Microbiomics and Precision Application, Ministry of Agriculture and Rural Affairs, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, Guangdong Province, China.

Background: Choledocholithiasis is a severe disorder that affects a significant portion of the world's population. Treatment using endoscopic sphincterotomy (EST) has become widespread; however, recurrence post-EST is relatively common. The bile microbiome has a profound influence on the recurrence of choledocholithiasis in patients after EST; however, the key pathogens and their functions in the biliary tract remain unclear. Read More