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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 13. Epub 2019 Feb 13.

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

Background And Aims: 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

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 Feb 7:1-6. 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

JSLS 2019 Jan-Mar;23(1)

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

Background And Objectives: Laparoscopic common bile duct exploration (LCBDE) has been verified to be an effective technique in treating choledocholithiasis, and T-tube insertion has been widely performed after LCBDE. With growing doubts regarding the effectiveness and safety of T-tube drainage (TTD), it has been suggested to replace such with primary duct closure (PDC). This meta-analysis aimed to evaluate the short- and long-term effectiveness and safety of PDC compared with TTD after LCBDE. Read More

J Gastrointest Surg 2019 Jan 22. Epub 2019 Jan 22.

Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.

Backgrounds: A two-stage procedure involving endoscopic retrograde cholangiopancreatography (ERCP), followed by cholecystectomy, is one of the primary treatments of concomitant gallstones and choledocholithiasis. However, negative findings on ERCP and migrating gallstones after cholecystectomy are major concerns. This study aimed to identify the prevalence of unnecessary ERCP and to develop and validate a predictive nomogram using preoperative factors in patients who underwent a two-stage procedure. 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

Am J Surg 2019 Jan 2. Epub 2019 Jan 2.

Baylor College of Medicine, USA.

Background: Choledocholithiasis is present in up to 15% of cholecystectomy patients. Treatment can be surgical, endoscopic, or via interventional radiology. We hypothesized significant heterogeneity between hospitals exists in the approach to suspected common duct stones. Read More

PLoS One 2019 17;14(1):e0210805. Epub 2019 Jan 17.

Department of Internal Medicine, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is seldom used in children, and published series have limited numbers of pediatric patients. The aim of this retrospective observational study was to assess the efficacy and safety of pediatric ERCP in a large group of children.

Methods: Data were evaluated from 626 children with biliopancreatic disorders admitted to University Hospital Motol, Prague, between January 1999 and January 2018. Read More

J Gastroenterol Hepatol 2019 Jan 16. Epub 2019 Jan 16.

Department of Gastroenterology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Minami-ku, Kumamoto City, Kumamoto, 862-0965, Japan.

Background And Aim: For asymptomatic common bile duct (CBD) stones, removal by endoscopic retrograde cholangiopancreatography (ERCP) is recommended in available guidelines. However, few studies have reported the risk of post-ERCP pancreatitis (PEP), which is the most common and serious ERCP-related complication for asymptomatic CBD stones. We performed a propensity-score-matching analysis to examine the risk of PEP in therapeutic ERCP for asymptomatic CBD stones. Read More

Updates Surg 2019 Jan 14. Epub 2019 Jan 14.

Department of General and Endoscopic Surgery, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, Mexico City, 14090, Mexico.

Patients with combined choledocholithiasis and cholecystitis require treatment of both diseases. The aim of our study was to analyze perioperative results of next-day (< 24 h) vs. early (> 24 h) laparoscopic cholecystectomy (LC) after endoscopic clearance of common bile duct stones. Read More

Dig Surg 2019 Jan 11:1-9. Epub 2019 Jan 11.

Department of Surgery, School of Medicine and Surgery, Milano-Bicocca University, San Gerardo Hospital, Monza,

Aim Of The Study: The diagnosis of choledocholithiasis is challenging. Previously published scoring systems designed to calculate the risk of choledocholithiasis were evaluated to appraise the diagnostic performance.

Patients And Methods: Data of patients who were admitted between 2013 and 2015 with the following characteristics were retrieved: bile stone-related symptoms and signs, and indication to laparoscopic cholecystectomy. 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

Clin Endosc 2019 Jan 8;52(1):5-6. Epub 2019 Jan 8.

Division of Gastroenterology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

Arq Bras Cir Dig 2019 Jan 7;32(1):e1416. Epub 2019 Jan 7.

Discipline of Digestive System Surgery.

Background: Cholelithiasis is a highly prevalent condition, and choledocholitiasis is a high morbidity complication and requires accurate methods for its diagnosis.

Aim: To evaluate the population of patients with suspected choledocholitiasis and check the statistical value of magnetic resonance cholangiopancreatography, ultrasonography, the laboratory and the clinic of these patients comparing them to the results obtained by perioperative cholangiography.

Methods: This is a retrospective cohort study, which were evaluated 76 patients with cholelithiasis and suspected choledocholithiasis. Read More

JGH Open 2018 Dec 15;2(6):329-332. Epub 2018 Oct 15.

Department of Gastrointestinal Surgery Indira Gandhi Institute of Medical Sciences Patna India.

Pneumothorax is a very rare complication of endoscopic retrograde cholangiopancreatography. Here, we report two cases of pneumothorax following ERCP and sphincterotomy for choledocholithiasis. Patient was treated successfully with laprotomy and repair of a rent in the posterolateral wall of the second portion of duodenum. Read More

J Int Med Res 2019 Feb 7;47(2):1052-1058. Epub 2019 Jan 7.

1 Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China.

Endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction is a common and preferred choice for gallstone disease. Laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) are being increasingly used for managing choledocholithiasis and cholecystolithiasis. We report a case of a Hem-o-lok clip that was dropped into the common bile duct (CBD) after LC and surgical common bile duct exploration (CBDE). Read More

Dig Endosc 2018 Dec 26. Epub 2018 Dec 26.

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

Background And Aim: With an aging population, an increasing number of individuals on antithrombotic agents are diagnosed with large bile duct stones. Studies have shown the effectiveness of endoscopic papillary large balloon dilation (EPLBD) for removal of large bile duct stones. EPLBD without endoscopic sphincterotomy (EST) may reduce the risk of procedure-related bleeding, but the safety of this procedure for users of antithrombotic agents remains unclear. Read More

Case Rep Gastrointest Med 2018 21;2018:2390213. Epub 2018 Nov 21.

Hasrat Sidhu, M.B.B.S, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

Levonorgestrel uterine implants are accepted as a safe and efficacious method of contraception. One of the two major health side effects in a large controlled study of subcutaneous hormonal implants with levonorgestrel was a significant increase in gallbladder disease. Gallbladder hypomotility is recognized as a side effect of the levonorgestrel (progesterone). Read More

Eur J Gastroenterol Hepatol 2019 02;31(2):192-196

Department of Internal Medicine, Division of Gastroenterology and Hepatology, Yeungnam University College of Medicine, Daegu, Republic of Korea.

Background: Acute gallstone pancreatitis occurs when a gallstone is impacted at the ampulla of Vater. The role of endoscopic retrograde cholangiopancreatography in the treatment of small choledocholithiasis in these patients is uncertain. The aim of this study was to compare outcomes of expectant management with endoscopic sphincterotomy for the treatment of small choledocholithiasis (≤5 mm) in patients with acute gallstone pancreatitis. Read More

Rev Assoc Med Bras (1992) 2018 Nov;64(11):1012-1016

Department of the second lesion of general surgery, Jiangjin central hospital of Chongqing, Jiangjin district, Chongqing, China.

Objective: We conducted this study to investigate the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) on elder choledocholithiasis and its effects on the levels of TNF-α, IL-1, and IL-6.

Methods: Elder patients with choledocholithiasis were enrolled in this study, and according to the surgical methods, they were divided into the ERCP group and the surgical group. After treatment, we compared the efficacy of these two methods on patients, inflammatory responses indicated by the levels of TNF-α, IL-1, and IL-6, and the complications. 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):e13564

Rationale: Endoscopic ultrasound (EUS)-guided treatment has been recently described for internalizing refractory pancreaticocutaneous fistulas (PCFs). However, the existing techniques are limited because of the difficulty in accessing nondilated pancreatic ducts or fistulas. In an attempt to overcome this limitation, we present a case where a EUS-guided intervention utilizing a balloon-target technique was employed to internalize a PCF into the stomach. Read More

Ann Med Surg (Lond) 2018 Dec 5;36:173-177. Epub 2018 Nov 5.

Consultant Upper GI Surgeon, South Devon NHS Foundation Trust, United Kingdom.

Background: Laparoscopic common bile duct exploration (LCBDE) is gaining popularity over endoscopic retrograde cholangiopancreatography (ERCP) for the management of common bile duct stones. However, its application has been almost exclusively following preoperative stone confirmation via magnetic retrograde cholangiopancreatography (MRCP), endoscopic ultrasound (EUS) or ERCP. We present our series of LCBDE following detection of common bile duct stones with intraoperative imaging (IOI) alone, in consecutive elective and emergency patients with suspected choledocholithiasis. Read More

J Surg Res 2019 Jan 26;233:8-19. Epub 2018 Jul 26.

Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Background: Transferred emergency general surgery (EGS) patients have increased morbidity, mortality, and costs, yet little is known about the characteristics of such transfers. Increasing specialization and a decreasing general surgery workforce have led to concerns about access to care, which may lead to increased transfers. We sought to evaluate the reasons for and timing of transfers for EGS diagnoses. Read More

Pancreatology 2019 Jan 22;19(1):39-43. Epub 2018 Nov 22.

Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany.

Objectives: The risk of post-ERCP pancreatitis (PEP) can be reduced effectively by the placement of a self dislodging pancreatic stent. The present study analyzed whether a prolonged interval until stent passage evaluation and removal of retained stents is associated with an increased risk for clinically relevant complications.

Methods: In the retrospective study 182 patients receiving a pancreatic stent for PEP prophylaxis were included and clinical data and complications until documented spontaneous stent dislodgement or removal were analyzed. Read More

Scand J Gastroenterol 2018 Oct - Nov;53(10-11):1381-1387. Epub 2018 Dec 5.

a Department of Medicine , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.

Objectives: The American Society for Gastrointestinal Endoscopy (ASGE) guidelines offered the risk-stratified approach in suspected choledocholithiasis. Previous studies have raised concern about the insufficient accuracy of the guideline, especially in high probability group. The purposes of this study were to authenticate the stratification and clinical predictors of the guidelines for suspected choledocholithiasis with no visible choledocholithiasis on computed tomography (CT) and to make clear the clinical strategy of endoscopic ultrasonography (EUS). Read More

Rev Esp Enferm Dig 2018 Dec 3;111. Epub 2018 Dec 3.

Yancheng City No. 1 People's Hospital.

Background: there is an increasing incidence rate of cholecysto-choledocholithiasis associated with the increasing proportion of senile individuals.

Methods: a total of 100 elderly patients (over 80 years of age) suffering both from cholelithiasis and choledocholithiasis were retrospectively studied from January 2010 to December 2016. Patients were scheduled for either a single-stage or two-stage procedure. Read More

World J Gastrointest Endosc 2018 Nov;10(11):354-366

Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Huntsman Cancer Center, Salt Lake City, UT 84132, United States.

Aim: To investigate indications and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhotics, especially adverse events. Patients with cirrhosis undergoing ERCP are believed to have increased risk. However, there is a paucity of literature describing the indications and outcomes of ERCP procedures in patients with cirrhosis, especially focusing on adverse events. Read More

Am J Surg 2018 Sep 29. Epub 2018 Sep 29.

Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. Electronic address:

Background: We sought to examine whether preoperative endoscopic retrograde cholangio-pancreatography (ERCP) increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy.

Methods: Patients admitted to an academic hospital from 2010 to 2016, who were older than 18 and had a laparoscopic or a laparoscopic converted to open cholecystectomy for complicated biliary tract disease were included. We compared those who had a preoperative ERCP to those who did not. Read More

Gastrointest Endosc 2018 Nov 19. Epub 2018 Nov 19.

University of Michigan Health Care System, Ann Arbor, Michigan; VA Healthcare System, Ann Arbor, Michigan.

Background And Aims: Markedly increased liver chemistries in patients presenting with acute calculous cholecystitis (AC) often prompt an evaluation for concomitant choledocholithiasis (CDL). However, current guidelines directing the workup for CDL fail to address this unique population. The aims of this study are to define the range of presenting laboratory values and imaging findings in AC, develop a model to predict the presence of concurrent CDL, and develop a management algorithm that can be easily applied on presentation. Read More

Turk J Gastroenterol 2018 Nov 19. Epub 2018 Nov 19.

Hepatopancreatobiliary Surgery Unit, Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey.

Background/aims: To investigate the safety and long-term results of endoscopic retrograde cholangiopancreatography (ERCP) in children with a literature review.

Materials And Methods: All patients within the age range of 6-17 years who underwent ERCP between 1994 and 2014 at our institution were retrospectively evaluated.

Result: Twenty-four patients with a median age of 15 years underwent ERCP. Read More

Surg Res Pract 2018 22;2018:5216089. Epub 2018 Oct 22.

Department of General Surgery, Beilinson Hospital, Rabin Medical Center, Petach-Tikva, Israel.

Background: All patients with mild acute biliary pancreatitis should undergo early cholecystectomy. Whether routine common bile duct (CBD) imaging should be employed before the surgical procedure in these patients is a matter of current controversy. The aim of this study was to investigate the rate of detection of CBD stones using magnetic resonance cholangiopancreatography (MRCP) at different time intervals from admission. Read More

J Gastrointest Surg 2018 Nov 12. Epub 2018 Nov 12.

Department of General Surgery, Division of HPB Surgery, Hospital Italiano de Buenos Aires, Juan D. Peron 4190, C1181ACH, Buenos Aires, Argentina.

Background: Emergent laparoscopic transcystic common bile duct exploration (LTCBDE) has been reported to be on the increase in some institutions, reflecting the growing confidence with the technique. However, no study has focused on the outcomes of LTCBDE in the non-elective setting. The aim of this study is to investigate whether LTCBDE can be performed effectively and safely in the emergency. Read More

VideoGIE 2018 Nov 26;3(11):351-353. Epub 2018 Aug 26.

Department of Visceral and Transplantation Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Zhonghua Nei Ke Za Zhi 2018 Nov;57(11):772-801

Endoscopic retrograde cholangiopancreatography (ERCP) was reported for the first time in 1970s. Since then, ERCP has become an indispensable procedure in the diagnosis and management of a variety of biliary and pancreatic disorders. The main purpose of Chinese ERCP guideline is to precisely define the clinical indications of ERCP. Read More

Insights Imaging 2018 Dec 2;9(6):925-941. Epub 2018 Nov 2.

Diagnostic and Interventional Radiology Department, ASST Santi Paolo e Carlo, Via A di Rudinì 8, 20142, Milan, Italy.

Performed on either an elective or urgent basis, cholecystectomy currently represents the most common abdominal operation due to the widespread use of laparoscopy and the progressively expanded indications. Compared to traditional open surgery, laparoscopic cholecystectomy minimised the duration of hospitalisation and perioperative mortality. Albeit generally considered safe, cholecystectomy may result in adverse outcomes with non-negligible morbidity. Read More

Medicine (Baltimore) 2018 Nov;97(44):e12976

Department of General Surgery, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico.

Cholecystectomy is the only definitive management of pancreatitis secondary to gallstone disease. Approximately 20% to 30% of patients with acute biliary pancreatitis (ABP) will have persistent common bile duct (CBD) stones. Therefore, choosing a method for the early diagnosis of choledocholithiasis is essential to reduce waiting days for surgery and hospital stay in these patients. Read More

Cir Pediatr 2018 Oct 17;31(4):166-170. Epub 2018 Oct 17.

Servicio de Cirugía Pediátrica. Hospital Universitario y Politécnico La Fe. Valencia.

Introduction: In patients with hemolytic disorders (HD) splenectomy is recommended between 6-12 years. A higher risk of biliary complications (BC) has been described in those with associated Gilbert's disease (GD), but the ideal surgical age has not been stablished yet. Our aim is to quantify the risk of BC in patients with HD and GD to assess the benefit of early splenectomy. Read More

Dig Liver Dis 2019 Jan 6;51(1):75-78. Epub 2018 Oct 6.

Centro Hospitalar de Vila Nova de Gaia e Espinho, Gastrenterology Department, Vila Nova de Gaia, Portugal.

Background And Aims: The guidelines by the American Society for Gastrointestinal Endoscopy (ASGE) suggest that in patients with gallbladder in situ, endoscopic retrograde cholangiopancreatography (ERCP) should be performed in the presence of high-risk criteria for choledocholithiasis, after biochemical tests and abdominal ultrasound. There are no specific recommendations for cholecystectomized patients. The aim of this study was to evaluate the applicability of ASGE criteria for ERCP in cholecystectomized patients with suspected choledocholithiasis. Read More

World J Gastrointest Endosc 2018 Oct;10(10):308-321

Division of Gastroenterology, New York University Winthrop Medical Center, Mineola, NY 11501, United States.

Aim: To systematically review safety/efficacy of therapeutic endoscopic-retrograde-cholangiopancreatography (ERCP) performed during pregnancy, considering fetal viability, fetal teratogenicity, premature delivery, and future postpartum development of the infant.

Methods: Systematic computerized literature search performed using PubMed with the key words "ERCP" and "pregnancy". Two clinicians independently reviewed the literature, and decided on which articles to incorporate in this review based on consensus and preassigned priorities. Read More

World J Gastroenterol 2018 Oct;24(39):4489-4498

Department of Intervention Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong Province, China.

Aim: To evaluate the effectiveness and safety of combined ursodeoxycholic acid and percutaneous transhepatic balloon dilation for management of gallstones after expulsion of common bile duct (CBD) stones.

Methods: From April 2014 to May 2016, 15 consecutive patients (6 men and 9 women) aged 45-86 (mean, 69.07 ± 9. Read More

Ann R Coll Surg Engl 2019 Feb 24;101(2):e45-e47. Epub 2018 Oct 24.

Clinica Chirurgica Generale, Università di Parma , Parma , Italy.

The incidence of biliary lithiasis after gastric surgery seems to be higher than in the general population. Endoscopic retrograde cholangiopancreatography (ERCP) allows several biliary and pancreatic pathologies to be dealt with; however, in patients with an altered anatomy of the upper and mid gastrointestinal tract, this endoscopic manoeuvre can be extremely challenging. We report a case of a 79-year-old woman with previous subtotal gastrectomy and Roux-en-Y reconstruction, admitted with a diagnosis of cholecystitis and choledocolithiasis. Read More

GE Port J Gastroenterol 2018 Sep 16;25(5):271-273. Epub 2018 Jan 16.

Gastroenterology Department, Centro Hospitalar de São João, Porto Medical School, Porto, Portugal.