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Endosc Int Open 2019 Apr 12;7(4):E608-E614. Epub 2019 Apr 12.

Long Island Jewish Medical Center, New Hyde Park, New York, United States.

After stone removal in endoscopic retrograde cholangiopancreatography (ERCP), an occlusion cholangiogram (OC) is performed to confirm bile duct clearance. OC can miss residual stones that can lead to recurrent biliary symptoms. The aim of this study was to assess if digital peroral cholangioscopy (POC) increased the diagnostic yield of residual biliary stones that are missed with OC. Read More

Int J Surg Case Rep 2019 Apr 8;58:14-17. Epub 2019 Apr 8.

Department of Surgery, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.

Introduction: Choledocholithiasis during pregnancy is relatively uncommon but it can be life-threatening. Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) poses the risk of ionizing radiation exposure to the developing fetus. Other strategies are thus needed to tackle this problem. Read More

Adv Clin Exp Med 2019 Apr 13. Epub 2019 Apr 13.

General Surgery Department, Atatürk Research and Education Hospital, Ankara, Turkey.

Background: Laparoscopic cholecystectomy (LC) is nowadays the gold standard in the surgical treatment of cholelithiasis and gallbladder diseases. But sometimes it may be inevitable to convert it to open surgery to safely end the procedure.

Objectives: In this study, we aimed to investigate the risk factors for conversion to open surgery from LC. Read More

J Laparoendosc Adv Surg Tech A 2019 Apr 13. Epub 2019 Apr 13.

1 Department of Pediatric Surgery, Medical Faculty Mannheim, Heidelberg University, University Medical Center, Mannheim, Germany.

Purpose: There is a lack of experience with stenting for benign pancreaticobiliary disorders in children.

Materials And Methods: Fifteen children (9 male and 6 female) with a median age of 7.1 years (range 0. Read More

Gastrointest Endosc 2019 Apr 9. Epub 2019 Apr 9.

Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA. Electronic address:

Each year choledocholithiasis results in biliary obstruction, cholangitis, and pancreatitis in a significant number of patients. The primary treatment, ERCP, is minimally invasive but associated with adverse events in 6% to 15%. This American Society for Gastrointestinal Endoscopy (ASGE) Standard of Practice (SOP) Guideline provides evidence-based recommendations for the endoscopic evaluation and treatment of choledocholithiasis. Read More

Obes Surg 2019 Apr 10. Epub 2019 Apr 10.

Unit of Clinical Surgery, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy.

Introduction: In Roux-en-Y reconstructions, choledocholithiasis could represent a really challenging condition to treat which can be treated by a surgical-assisted ERCP. Only six cases of transjejunal laparoscopic-assisted ERCP (LAERCP) can be found in literature to date and no large series are present.

Methods: A young woman who had undergone a laparoscopic Roux-en-Y gastric bypass 2 years earlier came complaining recurrent abdominal pain. Read More

Indian Pediatr 2019 Mar;56(3):196-198

Department of Gastroenterology, GB Pant Hospital, New Delhi, India.

Objective: To evaluate spectrum, efficacy and safety of Endoscopic retrograde cholangiopancreatography (ERCP) in pediatric population.

Methods: Retrospective case record review of pediatric patients (age ≤15 y) undergoing ERCP between January 2011 to June 2015 at a tertiary care referral hospital in New Delhi, India. The Indications for ERCP, cannulation success rate, procedure success rate and complications were recorded. Read More

Proc (Bayl Univ Med Cent) 2018 Oct 26;31(4):467-469. Epub 2018 Oct 26.

Department of Gastroenterology, Scott & White Medical CenterTempleTexas.

Endoscopic retrograde cholangiopancreatography in the setting of altered upper gastrointestinal anatomy presents several procedural challenges. Use of a standard side-viewing duodenoscope is often precluded by the patient's anatomy, thus rendering a limited examination of the ampulla and difficult cannulation of the bile duct. The authors present a case of single-balloon enteroscopy with successful endoscopic retrograde cholangiopancreatography, direct cholangioscopy, and cystic duct stone extraction using only an enteroscope. Read More

Hum Pathol 2019 Apr 1. Epub 2019 Apr 1.

Department of Pathology and Immunology, School of Medicine, Washington University in St. Louis, 425 S Euclid Ave, Campus Box 8118, St. Louis, MO, USA 63110.. Electronic address:

Follicular cholecystitis (FC) is a relatively rare entity with uncertain causal associations. In this study, we aimed to explore different clinicopathologic associations of FC, and to better characterize the entity. A retrospective review of archival H&E slides and pertinent clinical information was undertaken for all cholecystectomy cases with a rendered diagnosis of "follicular cholecystitis", from 1991 to 2017. Read More

Turk J Gastroenterol 2019 Apr;30(4):336-344

Department of Gastroenterology, Hacettepe University School of Medicine Ankara, Turkey.

Background/aims: Several studies recommend prompt laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. However, histopathological alterations in the gallbladder during this time interval and the role played by ERCP in causing these changes have not been sufficiently elucidated. To compare early period LCs with delayed LCs following common bile duct stone extraction via ERCP with regard to operation time, hospitalization period, conversion to open cholecystectomy rate, morbidity, mortality, and histopathological alterations in the gallbladder wall. Read More

Curr Treat Options Gastroenterol 2019 Apr 3. Epub 2019 Apr 3.

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

Purpose Of Review: To review the current literature focusing on the indications, efficacy, and safety of endoscopic papillary balloon dilation (EPBD) and endoscopic papillary large balloon dilation (EPLBD) with or without endoscopic sphincterotomy (EST) in the treatment of bile duct stones. • EPBD without EST is associated with a higher risk of post-procedural pancreatitis and lower rate of stone clearance than EST alone. • EPBD without EST should be at least 2 min in duration, and placement of a pancreatic stent and other measures to reduce pancreatitis risk should be considered. Read More

Endoscopy 2019 Apr 3. Epub 2019 Apr 3.

Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

ESGE recommends offering stone extraction to all patients with common bile duct stones, symptomatic or not, who are fit enough to tolerate the intervention.Strong recommendation, low quality evidence.ESGE recommends liver function tests and abdominal ultrasonography as the initial diagnostic steps for suspected common bile duct stones. Read More

Can J Gastroenterol Hepatol 2019 3;2019:5382708. Epub 2019 Mar 3.

Department of Surgery, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.

Background: Common bile duct (CBD) stones are common. However, they are known to pass spontaneously, which obviates the need for ERCP.

Aim: The aim of this study is to identify specific predictors for spontaneous passage of CBD stones. Read More

Am J Surg 2019 Mar 26. Epub 2019 Mar 26.

Oregon Health and Science University, Portland, OR.

Introduction: Laparoscopic common bile duct exploration (LCBDE-LC) or ERCP plus laparoscopic cholecystectomy (ERCP-LC) represent minimally invasive choledocholithiasis treatments. We hypothesized that LCBDE-LC has a shorter length of stay (LOS) and lower charges than ERCP-LC.

Methods: Charts were reviewed for all LCBDE-LC or ERCP-LC for choledocholithiasis from 2007 to 2017. Read More

J Assoc Physicians India 2019 Jan;67(1):81-82

Director, Institute of Digestive Disease and Hepatobiliary Sciences, Medanta-The Medicity Gurgaon, Haryana.

Zhonghua Wai Ke Za Zhi 2019 Apr;57(4):282-287

Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

To explore the selection method and technology of laparoscopic surgery for gallbladder stones and common bile duct stones(GCBDS). Data was collected from 318 in-patients of GCBDS at Department of General Surgery,Xuanwu Hospital of Capital Medical University from January 2013 to December 2017, and 298 in-patients acceptedlaparoscopic cholecystectomy(LC) and choledocholithotomy were recruited into final analysis.There were 138 males and 160 females,aged (60. Read More

J Pediatr Surg 2019 Mar 1. Epub 2019 Mar 1.

Division of Pediatric General, Thoracic and Minimally Invasive Surgery, St. Christopher's Hospital for Children, Philadelphia, PA. Electronic address:

Background/purpose: The incidence of choledocholithiasis is increasing. The diagnosis of common bile duct (CBD) obstruction is based on abnormal CBD size. Establishing norms for CBD size in children would improve diagnostic accuracy. Read More

Surg Endosc 2019 Mar 25. Epub 2019 Mar 25.

Department of Medicine, Keck School of Medicine, University of Southern California, D & T Building Room B4H100, 1983 Marengo St, Los Angeles, CA, 90033-1370, USA.

Background: Numerous models have been developed to predict choledocholithiasis. Recent work has shown that these algorithms perform suboptimally. Identification of clinical predictors with high positive and negative predictive value would minimize adverse events associated with unnecessary diagnostic endoscopic retrograde cholangiopancreatography (ERCP) while limiting the use of expensive tests including magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) for indeterminate cases. Read More

ANZ J Surg 2019 Apr 18;89(4):E142-E146. Epub 2019 Mar 18.

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.

Background: Presently, experience with robotic biliary surgery (RBS) is increasing worldwide although widespread adoption remains limited. In this study, we report our initial experience with RBS.

Methods: Retrospective review of a single institution prospective database of 95 consecutive robotic hepatopancreatobiliary surgeries performed between 2013 and 2018. Read More

Surg Laparosc Endosc Percutan Tech 2019 Mar 11. Epub 2019 Mar 11.

Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University.

It is currently unclear whether endoscopic papillary balloon dilation (EPBD) is associated with increased severe postendoscopic retrograde cholangiopancreatography pancreatitis (PEP)-related morbidity owing to conflicting reports. This study aimed to investigate whether EPBD increases the risk of PEP and hyperamylasemia. Clinical data of patients with choledocholithiasis, treated at the Second Affiliated Hospital of Harbin Medical University from January 2015 to December 2016 were analyzed. Read More

Ann Hepatobiliary Pancreat Surg 2019 Feb 28;23(1):41-45. Epub 2019 Feb 28.

Department of Surgery, Faculty of Medical Sciences, University of Sri Jayewardenepura, Colombo, Sri Lanka.

Backgrounds/aims: Published data on choledocholithiasis in Sri Lanka is scarce. This study was conducted to determine epidemiological, clinical and endoscopic characteristics of choledocholithiasis in Sri Lanka.

Methods: This was a retrospective study of consecutive patients for a period of three years until April 2016. Read More

AJR Am J Roentgenol 2019 Mar 12:1-6. Epub 2019 Mar 12.

1 Department of Radiology, Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305.

Objective: In patients with acute cholecystitis (AC), accurate identification of a common bile duct (CBD) stone before cholecystectomy is of concern for surgeons, gastroenterologists, and radiologists. This study evaluates the utility of preoperative MRCP taking into consideration both sonographic findings and biochemical predictors for choledocholithiasis.

Materials And Methods: Fifty-seven patients (58% women; mean age, 54 years old) with signs of AC on right upper quadrant (RUQ) ultrasound (US) who underwent subsequent MRCP from 2007 to 2017 were identified using a text-based search and retrospectively analyzed, using ERCP as the reference standard. Read More

Rev Gastroenterol Peru 2018 Oct-Dec;38(4):384-387

Departmentof Surgery, University of Sao Paulo. Sao Paulo, Brazil.

Endoscopic retrograde cholangiopancreatography (ERCP) is the treatment of choice in patients with choledocholithiasis. However,despite its high success rate, in some cases it is not successful, requiring alternative therapy. Billroth II partial gastrectomy is a condition associated with an important failure rate of ERCP. Read More

J Gastrointestin Liver Dis 2019 Mar;28(1):89-94

Humanitas University, Rozzano, Milan, Italy.

Background And Aims: Endoscopic sphincterotomy (ES) with stone extraction is the standard treatment for choledocholithiasis. After stone retrieval, balloon-occluded cholangiography is generally performed to confirm bile duct clearance but can miss residual stones particularly in patients with residual small-sized stones, a large bile duct or pneumobilia. In addition, difficult common bile duct (CBD) stones requiring advanced endoscopic techniques for retrieval are a potential risk factor for choledocholithiasis recurrence. Read More

Gastrointest Endosc Clin N Am 2019 Apr 2;29(2):257-275. Epub 2019 Feb 2.

Division of Gastroenterology, Department of Medicine, Methodist Dallas Medical Center, 221 West Colorado Boulevard, Pavillion II, Suite 630, Dallas, TX 75208, USA.

Choledocholithiasis is a common disorder that is managed universally by endoscopic retrograde cholangiopancreatography (ERCP). For difficult or complex stones, ERCP with conventional techniques may fail to achieve biliary clearance in 10% to 15% of cases. This review summarizes the literature regarding the current available endoscopic techniques for complex stone disease, including mechanical lithotripsy, endoscopic papillary large balloon dilation, cholangioscopy-guided lithotripsy, and endoscopic ultrasound-guided biliary access. Read More

Surg Clin North Am 2019 Apr 10;99(2):259-282. Epub 2019 Feb 10.

Rutgers, New Jersey Medical School, 185 South Orange Avenue, MSB G586, Newark, NJ 07103, USA. Electronic address:

Consensus guidelines recommend patients with symptomatic cholelithiasis and suspected choledocholithiasis have common bile duct exploration (CBDE) at the time of cholecystectomy to prevent downstream problems. Despite superiority of single-stage cholecystectomy with CBDE, 2-stage precholecystectomy/postcholecystectomy with endoscopic clearance of the duct is commonly practiced. This is related to inadequate training in minimally invasive techniques, lack of technical support for efficient and safe CBDE, and surgeons' inexperience with complex biliary pathologic condition. Read More

Surg Clin North Am 2019 Apr 10;99(2):175-184. Epub 2019 Feb 10.

Division of Hepatopancreatobiliary Surgery, Department of Surgery, Atrium Health/Carolinas Medical Center, Charlotte, NC, USA; Division of Hepatopancreatobiliary Surgery, Atrium Health/Carolinas Medical Center - Northeast, 200 Medical Park Drive, Suite 430, Concord, NC 28025, USA. Electronic address:

Acute cholangitis remains a potentially lethal disease if not appropriately diagnosed in a timely fashion. Modern diagnostic and therapeutic modalities have greatly decreased mortality from acute cholangitis. This article aims to provide an up-to-date synopsis of empirically tested diagnostic criteria as well as an overview of the expanding interventions available. Read More

World J Gastroenterol 2019 Feb;25(8):1002-1011

Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China.

Background: A clinical pathway (CP) is a standardized approach for disease management. However, big data-based evidence is rarely involved in CP for related common bile duct (CBD) stones, let alone outcome comparisons before and after CP implementation.

Aim: To investigate the value of CP implementation in patients with CBD stones undergoing endoscopic retrograde cholangiopancreatography (ERCP). Read More

J Gastrointest Surg 2019 May 28;23(5):1055-1068. Epub 2019 Feb 28.

Division of Minimally Invasive and Bariatric Surgery, Department of General Surgery, Penn State Milton S. Hershey Medical Center, 500 University Drive, H149, Hershey, PA, 17033, USA.

Purpose: Endoscopy is playing an ever-increasing role in the management of acute biliopancreatic disorders. With the management paradigm shifting away from more invasive surgical approaches, surgeons need to be aware of the treatment options available to improve patient care. Our manuscript serves to improve surgeons' knowledge and understanding of these emerging treatment modalities to expand their algorithmic approach to biliopancreatic disorders. Read More

Am Surg 2019 Feb;85(2):e100-e103

Medicine (Baltimore) 2019 Feb;98(8):e14585

Department of General Surgery.

Sarcomatous carcinoma in biliary system, including sarcomatous intrahepatic cholangiocarcinoma (SIC) and sarcomatous choledochal carcinoma (SCC), is extremely rare and malignant.This retrospective study included 5 patients with SIC and 4 patients with SCC. Their basic characteristics, preoperative lab tests, preoperative imaging features, perioperative status, and follow-up information have been collected and analyzed. Read More

Rev Esp Enferm Dig 2019 Apr;111(4):331-333

Cirugía General y Digestiva, Hospital General Reina Sofía. Murcia, España.

Objective: To describe our experience regarding post-endoscopic retrograde cholangio-pancreatography (ERCP) perforations and its conservative management.

Material And Methods: Retrospective study of the therapeutic management of post-ERCP perforations occurred over the period 2012-2017 in our hospital.

Results: There were 12 perforations after ERCP, with choledocholithiasis being the main indication for the test (66. Read More

Pediatr Surg Int 2019 May 26;35(5):569-574. Epub 2019 Feb 26.

Department of Paediatric Surgery, John Hunter Children's Hospital, 2 Lookout Road, New Lambton Heights, Newcastle, NSW, 2305, Australia.

Background And Aim: Currently, there is a paucity of the literature describing the natural history of cholelithiasis (CL) and choledocholithiasis (CDL) in adolescent children. This study aims to analyse the changing demographics of paediatric and adolescent gallstones.

Methodology: Retrospective review of all children (Age 0-18 years) presenting with symptomatic gallstones over the last 15 years (2002-2017) at a single tertiary institution. Read More

Radiologe 2019 Apr;59(4):293-299

Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Clinical Issue: Biliary diseases require fast and rational use of diagnostic tests by both gastroenterologists and radiologists.

Standard Treatment: Standard diagnostic workup includes transabdominal ultrasound, endoscopic retrograde cholangiography (ERC), endoscopic ultrasound, direct cholangioscopy, magnetic resonance cholangiopancreatography (MRI/MRCP), and computed tomography (CT).

Treatment Innovations: Modular cholangioscopy is a novel diagnostic method. Read More

Dig Endosc 2019 Feb 25. Epub 2019 Feb 25.

Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan.

Radiologe 2019 Apr;59(4):338-341

Medizinische Klinik I, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.

Endoscopic interventions in the biliary system are defined by the elimination of an outflow obstruction such as in choledocholithiasis or the optimization of bile flow by means of stent drainage. Exclusive use of diagnostic endoscopic retrograde cholangiography (ERC) is now obsolete, but due to its minimally invasive approach, therapeutic ERC is the method of choice for intervention in appropriate indications. If access to the biliary system via the papilla is not possible, approaches as guided by endoscopic ultrasound appear to be a valid option for the experienced endoscopist. Read More

Endoscopy 2019 Feb 20. Epub 2019 Feb 20.

Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China.

Background:  Endoscopic sphincterotomy plus balloon dilation (ESBD) is considered to be a promising method for the removal of large common bile duct (CBD) stones. However, when compared with endoscopic sphincterotomy (EST) alone, the efficacy and safety of ESBD remain controversial. This meta-analysis aimed to compare the efficacy and safety of ESBD vs. Read More

Rozhl Chir Winter 2019;98(1):10-13

Despite several studies, the role and timing of endoscopic retrograde cholangiopancreatography (ERCP) in the case of acute biliary pancreatitis (ABP) remains a subject of discussion.There is a clear indication of early ERCP within 72 hours in patients with ABP andcholedochal obstruction, moreover the ERCP within 24 hours in cases of cholangitis. However, the role of ERCP in patients with ABP without symptoms of cholangitis or concrements obstructing the bile duct is controversial. Read More

Sci Rep 2019 Feb 18;9(1):2168. Epub 2019 Feb 18.

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

There are no clinical guidelines for the timing of cholecystectomy (CCY) after performing therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. We tried to analyze the clinical practice patterns, medical expenses, and subsequent outcomes between the early CCY, delayed CCY, and no CCY groups of patients. 1827 choledocholithiasis patients who underwent therapeutic ERCP were selected from the nationwide population databases of two million random samples. Read More

Cir Cir 2019 ;87(2):146-150

Servicio de Medicina del Enfermo en Estado Crítico. Hospital San José TecSalud, Monterrey, Nuevo León, México.

Background: Cholecystectomy is one of the most performed procedures worldwide. Many surgeons defend the use of routine intraoperative cholangiography (IOC), but this action is getting less practiced because other preoperative tools that can omit IOC.

Objective: Evaluate the utility of performing intraoperative cholangiography in patients whom got a preoperative imaging or endoscopy study. Read More

J Crit Care Med (Targu Mures) 2019 Jan 4;5(1):6-18. Epub 2019 Feb 4.

Department of Medicine, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, "Albert Einstein" College of Medicine, Bronx, NY 10461, USA.

Approximately twenty per cent of adults have gallstones making it one of the most prevalent gastrointestinal diseases in Western countries. About twenty per cent of gallstone patients requires medical, endoscopic, or surgical therapies such as cholecystectomy due to the onset of gallstone-related symptoms or gallstone-related complications. Thus, patients with symptomatic, uncomplicated or complicated gallstones, regardless of the type of stones, represent one of the largest patient categories admitted to European hospitals. Read More

Medicine (Baltimore) 2019 Feb;98(7):e14272

Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Rationale: Although endoscopic and laparoscopic techniques in situs inversus totalis (SIT) have been reported respectively, endo-laparoscopic combination therapy due to biliary lithiasis remains infrequent. We shared the experience regarding the operations with a video report and discussed the similarities and differences with the usual procedures, which proved to be challenging to some extent for SIT.

Patient Concerns: Herein we present a 72-year-old man with SIT who underwent endo-laparscopic combination therapy due to choledocholithiasis and gallbladder stone. Read More

J Gastroenterol Hepatol 2019 Feb 27. Epub 2019 Feb 27.

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

Background And Aim: Recurrences after endoscopic treatment of common bile duct stones (CBDS) are common. The aims of this study were to identify risk factors for recurrences of CBDS and to evaluate the effect of interventions for prevention of further recurrences.

Methods: A total of 976 patients who underwent endoscopic treatment of CBDS were retrospectively studied. Read More

Am Surg 2018 Oct;84(10):1679-1683

Kaiser Permanente Fontana Medical Center, Fontana, California, USA.

Same-day endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy (LC) could potentially reduce hospital length of stay (HLOS). Patients undergoing same-day procedures (N = 164) between 2012 and 2014 were compared with different-day procedures performed in the second half of 2014 (N = 276), in the Kaiser Permanente Southern California database. Both groups had comparable baseline characteristics. Read More

World J Clin Cases 2019 Feb;7(3):300-310

Gastroenterology, "Grigore T. Popa" University of Medicine and Pharmacy, Iași 700115, România.

Background: Despite significant technical and training improvements, the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) has not significantly dropped. Although many studies have evaluated the efficacy of various agents, . nonsteroidal anti-inflammatory drugs, octreotide, antioxidants, administered various dosages, routes (oral, intrarectal or parenteral), and schedules (before or after the procedure), the results have been conflicting. Read More

Dig Dis 2019 7;37(4):303-308. Epub 2019 Feb 7.

Department of Gastroenterology, Yamanashi Prefectural Central Hospital, Yamanashi, Japan.

Background: The Tokyo Guidelines (TG; 2013) indicated that emergency cholecystectomy is an important early treatment option for acute cholecystitis; however, surgical intervention is not necessarily indicated in patients with advanced age. We evaluated percutaneous transhepatic gallbladder aspiration (PTGBA), percutaneous transhepatic gallbladder drainage (PTGBD), and the administration of antibiotics alone as treatment options for acute -cholecystitis.

Methods: From January 2010 to December 2017, 159 patients with acute cholecystitis were treated at our institution. Read More

Surg Laparosc Endosc Percutan Tech 2019 Feb 1. Epub 2019 Feb 1.

Department of General Surgery, Konak Hospital, Gebze, Kocaeli, Turkey.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) has been commonly used for biliopancreatic diseases of patients with normal gastrointestinal (GI) anatomy with a success rate of >90%. However, this procedure may also be necessary in patients with altered GI anatomy such as Billroth II or Roux-en-Y reconstructions. Performing ERCP in these patients may pose extreme technical challenges, and increase the risk of complications. 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 Clin Cases 2019 Jan;7(2):137-144

Department of Hepatopancreatobiliary Surgery, the Third Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China.

Background: Gamma-glutamyltransferase (GGT) is one of the most important laboratory tests for the evaluation of liver damage. Through a long-term clinical observation of patients with secondary asymptomatic choledocholithiasis, we found that most patients had abnormal GGT serum levels.

Aim: To investigate the combination of serum GGT and alkaline phosphatase (ALP) in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis. Read More

Surgeon 2019 Jan 28. Epub 2019 Jan 28.

Hepatobiliary and Pancreatic Surgery Unit, General Surgery Department, Joan XXIII University Hospital, Tarragona, Spain.

Background: Current evidence shows that single-stage treatment of concomitant choledocholithiasis and cholelithiasis is as effective and safe as two-stage treatment. However, several studies suggest that single-stage approach requires shorter hospitalization time and is more cost-effective than the two-stage approach, even though it requires considerable training. This study aimed to evaluate the implementation of a protocol for managing concomitant choledocholithiasis and cholelithiasis using single-stage treatment. Read More