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World J Hepatol 2022 May;14(5):1038-1046

Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague 14021, Czech Republic.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a method used to decrease portal hypertension. Biliary stricture is the rarest of the complications associated with this procedure with only 12 cases previously reported in the literature. None of these cases have documented the resolution of biliary stenosis induced by a stent graft. Read More

World J Gastrointest Endosc 2022 May;14(5):335-341

Department of Gastroenterology, Hopital Charles-Lemoyne, Greenfield Park J4V 2H1, Québec, Canada.

Background: Endoscopic ultrasonography (EUS) has evolved in the last years making it not only a diagnostic modality but a therapeutic procedure. EUS is now used as an alternative technique to percutaneous and surgical drainage. Even though EUS is a challenging procedure and not always suitable compared to percutaneous drainage, there is a need for developing new therapeutic approaches to the liver for when percutaneous drainage is not feasible. Read More

Gastrointest Endosc Clin N Am 2022 Jul 11;32(3):493-505. Epub 2022 May 11.

Division of Vascular and Interventional Radiology, Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street, Sheik Zayed Tower, Suite 7203, Baltimore, MD 21287, USA. Electronic address:

Percutaneous biliary interventions (PBIs) are commonly performed by interventional radiologists for a variety of clinical indications including biliary infections, strictures, leaks, and postoperative complications. PBIs have high technical and clinical success rates and are relatively safe when compared with more invasive surgical techniques. Percutaneous transhepatic cholangiography and percutaneous biliary drainage play an essential role in the management of common posthepatobiliary complications including biliary strictures and leaks. Read More

BMC Surg 2022 Jun 11;22(1):224. Epub 2022 Jun 11.

Department of Surgery, Kensei Hospital, 2 Ogimachi, Hirosaki, Aomori, 036-8511, Japan.

Background: Early cholecystectomy is recommended for patients with acute cholecystitis. However, emergency surgery may not be indicated due to complications and disease severity. Patients requiring drainage are usually treated with percutaneous transhepatic gallbladder drainage (PTGBD), whereas patients with biliary duct stones undergo endoscopic stones removal followed by endoscopic gallbladder drainage (EGBD). Read More

Intern Med 2022 Jun 7. Epub 2022 Jun 7.

First Department of Internal Medicine, Gifu University Hospital, Japan.

A 76-year-old woman with advanced pancreatic cancer developed recurrent cholecystitis after covered self-expandable metal stent (CSEMS) placement. The cholecystitis was refractory to repeated percutaneous transhepatic gallbladder drainage (PTGBD). Cholecystography showed a patent cystic duct with right and cranial side bifurcation, which is indicative of an increased likelihood of success of endoscopic transpapillary gallbladder drainage (ETGBD). Read More

Life (Basel) 2022 May 6;12(5). Epub 2022 May 6.

General, Emergency and Transplant Surgery Department, ASST-Settelaghi and University of Insubria, 21100 Varese, Italy.

Liver involvement after abdominal blunt trauma must be expected, and in up to 30% of cases, spleen, kidney, and pancreas injuries may coexist. Whenever hemodynamics conditions do not contraindicate the overcoming of the ancient dogma according to which exploratory laparotomy should be performed after every major abdominal trauma, a CT scan has to clarify the liver lesions so as to determine the optimal management strategy. Except for complete vascular avulsion, no liver trauma grade precludes nonoperative management. Read More

Ann R Coll Surg Engl 2022 May 26. Epub 2022 May 26.

Salford Royal NHS Foundation Trust, Northern Care Alliance, UK.

Introduction: The prevalence and complications of biliary disease increase with age. Frailty has been associated with adverse outcomes in the hospital setting. We describe the prevalence of frailty in older patients hospitalised with benign biliary disease and its association with duration of hospital stay, and 90-day and 1-year mortality. Read More

Ann Surg Treat Res 2022 May 3;102(5):257-262. Epub 2022 May 3.

Division of Hepato-Biliary-Pancreatic and Transplantation Surgery, Department of Surgery, Chosun University Hospital, Gwangju, Korea.

Purpose: This study aimed to evaluate the feasibility of surgeon-performed percutaneous transhepatic gallbladder drainage (PTGBD).

Methods: Patients treated with PTGBD for acute cholecystitis (AC), performed by surgeons at Chosun University Hospital for 12 months between March 2017 and February 2018, were enrolled retrospectively, into the S-PTGBD group (n = 134). Patients with PTGBD performed by interventional radiologists for 12 months, 6 months before March 2017, and after February 2018, were included in the X-PTGBD group (n = 107). Read More

J Gastrointest Cancer 2022 May 24. Epub 2022 May 24.

Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.

Background And Aim: Malignant biliary obstruction is an ominous complication of metastatic colorectal cancer (mCRC) that is challenging to solve. Biliary drainage can be performed to relieve symptoms of jaundice, treat cholangitis, or enable palliative systemic therapy. The aim of this study is to evaluate clinical outcomes of biliary drainage of malignant biliary obstruction in mCRC patients. Read More

Front Surg 2022 27;9:908909. Epub 2022 Apr 27.

Department of Interventional Vascular Surgery, Hunan Provincial People's Hospital (The first-affiliated hospital of Hunan normal university), Changsha, China.

Jaundice is a detection index in many disease conditions commonly characterized by yellowish staining of the skin and mucous membranes. This work studies the postoperative care outcome in 1,246 patients (669 males and 577 females) with obstructive jaundice who underwent percutaneous transhepatic biliary drainage (PTBD). These patients were admitted to the interventional vascular surgery department of our hospital from February 2017 to February 2022. Read More

Cancers (Basel) 2022 Apr 24;14(9). Epub 2022 Apr 24.

Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.

Perihilar cholangiocarcinoma is a rare hepatobiliary malignancy that requires thoughtful, multidisciplinary evaluation in the preoperative setting to ensure optimal patient outcomes. Comprehensive preoperative imaging, including multiphase CT angiography and some form of cholangiographic assessment, is key to assessing resectability. While many staging systems exist, the Blumgart staging system provides the most useful combination of resectability assessment and prognostic information for use in the preoperative setting. Read More

Cancers (Basel) 2022 Apr 21;14(9). Epub 2022 Apr 21.

Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.

Background: One of the cornerstones of palliative treatment for unresectable perihilar cholangiocarcinoma is biliary stent placement in order to restore biliary drainage. In this review, the potential added value of RFA with stent placement in comparison to stent placement alone in patients with unresectable perihilar cholangiocarcinoma is analyzed.

Methods: We performed a comprehensive online search for relevant articles in November 2021 (PROSPERO ID: CRD42021288180). Read More

Endoscopy 2022 May 13. Epub 2022 May 13.

Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Hokkaido, Japan.

Transl Gastroenterol Hepatol 2022 25;7:20. Epub 2022 Apr 25.

Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

Endoscopic ultrasound (EUS) has been continuously evolving for the past three decades and has become widely used for both diagnostic and therapeutic purposes. The efficacy of therapeutic EUS (TEUS) has proven to be superior and better tolerated than conventional percutaneous or surgical techniques. TEUS has allowed the performance of multiple procedures including gallbladder, pancreatic duct and biliary drainage as well as gastrointestinal anastomoses. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):287-292. Epub 2021 Sep 10.

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Background: There is limited literature on the role of percutaneous transhepatic biliary drainage (PTBD) as an adjunct to endoscopic retrograde cholangiopancreatography (ERCP). This study evaluates the role of PTBD in patients with failed ERCP or post-ERCP cholangitis.

Methods: Retrospective evaluation of clinical and intervention records of patients with biliary obstruction referred for PTBD following failed ERCP or post-ERCP cholangitis was performed. Read More

Ann Transl Med 2022 Apr;10(7):411

Hepatobiliary Pancreatic Center Department, Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University, Beijing, China.

Background: Hyperbilirubinemia is a major barrier to anti-tumor treatment in patients with end-stage primary liver cancer. However, no research has demonstrated the efficacy and safety of hepatic artery infusion chemotherapy (HAIC) in primary liver cancer patients with hyperbilirubinemia. This study investigated HAIC with a modified oxaliplatin, fluorouracil, and leucovorin (mFOLFOX) regimen. Read More

Transpl Int 2022 22;35:10044. Epub 2022 Apr 22.

Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.

This study evaluated endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTBD) as interventions for patients with anastomotic biliary complications (ABC) after living donor liver transplantation (LDLT). Prospectively collected data of patients who were diagnosed with ABC after LDLT between January 2013 and June 2017 were retrospectively reviewed. There were 57 patients who underwent LDLT with a right liver graft using duct-to-duct biliary reconstruction and experienced ABC. Read More

Case Rep Gastroenterol 2022 Jan-Apr;16(1):154-158. Epub 2022 Mar 28.

Department of Radiology, Mohammed V Military Hospital, Faculty of medicine and pharmacy, Mohammed V University, Rabat, Morocco.

Biloma is a severe complication that can result from bile duct disruption or hepatic trauma. It can occur after biliary surgery such as cholecystectomy or an endoscopic retrograde cholangiopancreatography manipulation and endoscopic biliary sphincterotomy. We present the case of a 59-year-old man admitted for jaundice, with pain in his right flank and fever, 10 days after an endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for an ill-defined pancreatic lesion, associated with an infected biloma. Read More

Am J Case Rep 2022 May 8;23:e936329. Epub 2022 May 8.

Department of General Surgery, Shanghai Gongli Hospital, The Second Military Medical University, Shanghai, China (mainland).

BACKGROUND Clostridium perfringens (CP), one of several clostridial species gram-positive bacteria, is a major cause of animal necrosis enteritis and traumatic gangrene. In some reports, CP can cause acute emphysematous cholecystitis in patients with biliary tract infections. However, C. Read More

Endoscopy 2022 May 6. Epub 2022 May 6.

Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Hokkaido, Japan.

J Vasc Interv Radiol 2022 Apr 30. Epub 2022 Apr 30.

Division of Surgery, DAICIM Foundation, Buenos Aires, Argentina; Division of Surgery, University of Buenos Aires, Buenos Aires, Argentina; Division of Surgery, Percutaneous Surgery, IHU IRCAD, University of Strasbourg, France.

Purpose: To determine risk factors (RFs) for hemorrhagic adverse events (AEs) associated with percutaneous transhepatic biliary drainage (PTBD) and to develop a risk assessment model.

Materials And Methods: This was a multicenter, prospective, observational study between 2015 and 2020. Adults with an indication for PTBD were included. Read More

Intern Med 2022 Apr 30. Epub 2022 Apr 30.

Department of Gastroenterology, Juntendo University Graduate School of Medicine, Japan.

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an effective biliary drainage procedure in adult cases with difficult biliary access. However, there have been no reports on this procedure being used in pediatric cases. We successfully performed EUS-HGS in a pediatric case with a surgically altered anatomy. Read More

Evid Based Complement Alternat Med 2022 13;2022:9255444. Epub 2022 Apr 13.

Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150000, China.

Aim: This study aimed to provide profiles of microorganisms isolated from bile and antibiotic susceptibility patterns of biliary tract infections (BTIs) in our center.

Methods: A total of 277 patients diagnosed with BTIs at the Second Affiliated Hospital of Harbin Medical University from 2011 to 2018 were included in this study. Medical records were reviewed to obtain clinical and demographic data. Read More

Medicine (Baltimore) 2022 Mar 11;101(10):e29048. Epub 2022 Mar 11.

Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.

Abstract: Percutaneous drainage catheters (PDCs) are required for the management of benign biliary strictures refractory to first-line endoscopic treatment. While biliary patency after PDC placement exceeds 75%, long-term catheterization is occasionally necessary. In this article, we assess the outcomes of patients at our institution who required long-term PDC placement. Read More

Cureus 2022 Mar 16;14(3):e23209. Epub 2022 Mar 16.

Gastroenterology, Atrium Health Wake Forest Baptist, Winston-Salem, USA.

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HG) is increasingly being used as an alternative to percutaneous transhepatic biliary drainage (PTBD) after unsuccessful endoscopic retrograde pancreatography (ERCP). This technique has also been utilized for diagnosis of malignant biliary obstruction by providing biliary access for antegrade cholangioscopy with biopsies and brushings for cytology and fluorescent in situ hybridization (FISH). However, the potential impact of EUS-HG on surgical candidacy in cases with resectable disease remains unknown. Read More

Cureus 2022 Mar 15;14(3):e23167. Epub 2022 Mar 15.

Division of Visceral Surgery, Department of Surgery, Sion Cantonal Hospital, Sion, CHE.

Perforated diverticulitis is a rare but serious complication associated with a significant mortality rate. Although many cases of conservative treatment have been reported, surgery remains the mainstay for perforated duodenal diverticulitis. We report a rare case of a 55-year-old female who presented with epigastric pain without fever. Read More

J Surg Case Rep 2022 Apr 11;2022(4):rjac132. Epub 2022 Apr 11.

Division of General and Hepato-Pancreato-Biliary Surgery, Department of Surgery, University of Verona, Verona, Italy.

Ductal biliary recurrence of cancers arising in other anatomical districts is a rare event, usually observed in the setting of disseminated disease; hence surgery is rarely a viable option. We present the case of a 56-year-old male who underwent subtotal gastric resection 7 years earlier for a poorly cohesive gastric cancer, presenting with obstructive jaundice. Magnetic resonance imaging and computed tomography scan suggested primary malignant obstruction of the main bile duct. Read More

Clin Exp Hepatol 2022 Mar 23;8(1):70-77. Epub 2022 Mar 23.

Department of Internal Medicine, Cantonal Hospital "Safet Mujić", University of Mostar, Mostar, Bosnia and Herzegovina.

Aim Of The Study: Most of the malignancies leading to obstructive jaundice are diagnosed too late when they are already advanced and inoperable, with palliation being the only treatment option left. Due to progressing hyperbilirubinaemia with its consequent adverse effects, biliary drainage must be established even in advanced malignancies. This study aims to investigate and analyse factors that affect clinical outcomes of percutaneous trans-hepatic biliary drainage (PTBD) in patients with obstructive jaundice due to advanced inoperable malignancy, and identify potential predictors of patient survival. Read More

BMJ Case Rep 2022 Apr 12;15(4). Epub 2022 Apr 12.

Internal Medicine, Infectious Diseases, Boston University School of Medicine, Harvard Medical School, and VA Boston Healthcare System, West Roxbury, Massachusetts, USA.

We describe a case of a man in his 70s who presented with tachycardia and several weeks of right lower quadrant pain 3 months after partial right hepatectomy for hepatocellular carcinoma. Initial laboratory findings were significant for elevated C reactive protein and normal white cell count. CT revealed right pleural effusion and 5. Read More

J Clin Med 2022 Mar 28;11(7). Epub 2022 Mar 28.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan.

Severe acute cholangitis is a life-threatening medical emergency. Endoscopic biliary drainage (EBD) or percutaneous transhepatic biliary drainage (PTBD) is usually used for biliary decompression. However, it can be risky to transport a critical patient to the radiology unit. Read More