Search Our Scientific Publications & Authors

Front Surg 2021 15;8:616320. Epub 2021 Apr 15.

Division of General Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Percutaneous cholecystostomy (PC) has become an important procedure for the treatment of acute cholecystitis (AC). PC is currently applied for patients who cannot undergo immediate laparoscopic cholecystectomy. However, the management following PC has not been well-reviewed. Read More

Eur J Intern Med 2021 Apr 27. Epub 2021 Apr 27.

Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, CX 3584, the Netherlands. Electronic address:

Background And Aims: Malignant biliary obstruction is an ominous complication of metastatic colorectal cancer (mCRC). Biliary drainage is frequently performed to relieve symptoms of jaundice or enable palliative systemic therapy, but effective drainage can be difficult to accomplish. The aim of this study is to summarize literature on clinical outcomes of biliary drainage in mCRC patients with malignant biliary obstruction. Read More

Cardiovasc Intervent Radiol 2021 Apr 29. Epub 2021 Apr 29.

Humanitas Clinical and Research Center - IRCCS, Via Manzoni, 56, Rozzano, 20089, Milan, Italy.

Bronchobiliary fistula is a rare condition characterized by bile leaking into the bronchial tree causing biliptysis. It may arise from liver infection or as a consequence of resection and thermal ablation of cancer. Currently, there is no consensus about the treatment strategy. Read More

Surg Endosc 2021 Apr 28. Epub 2021 Apr 28.

Department of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Herestraat 49, 3000, Leuven, Belgium.

Objectives: Where palliative surgery or percutaneous drainage used to be the only option in patients with afferent loop syndrome, endoscopic management by EUS-guided gastroenterostomy has been gaining ground. However, EUS-guided hepaticogastrostomy might also provide sufficient biliary drainage. Our aim was to evaluate the feasibility of EUS-guided hepaticogastrostomy for the management of afferent loop syndrome and provide comparative data on the different approaches. Read More

Int J Clin Oncol 2021 Apr 26. Epub 2021 Apr 26.

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Background: The efficacy of different types of preoperative biliary drainage for cholangiocarcinoma has been debated over the past two decades. Controversy concerning the use of percutaneous transhepatic biliary drainage (PTBD) versus endoscopic biliary drainage (EBD) still exists. This study aimed to compare the long-term outcomes between PTBD and EBD in patients with distal cholangiocarcinoma. Read More

Radiol Case Rep 2021 Jun 1;16(6):1315-1319. Epub 2021 Apr 1.

Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico "G. Martino'', University of Messina, Via Consolare Valeria 1, 98100 Messina, Italy.

Biliary fistula and bile leakage are complications that can occur during hepato-biliary or intestinal surgery and percutaneous biliary intervention. In some cases, spontaneous resolution is possible but more often re-intervention (surgical or percutaneous) is necessary. We present the case of a 45 y-o male patient who underwent duodenocefalopanreasectomy (Whipple procedure) with bilio-digestive anastomosis for adenoma of the duodenal papilla of Vater, complicated by the formation of a fistula through the bilio-digestive anastomosis. Read More

Clin J Gastroenterol 2021 Apr 24. Epub 2021 Apr 24.

Division of Hepatobiliary, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, JL. Diponegoro 71, Jakarta, DKI Jakarta, 10430, Indonesia.

Biliary obstruction is one of challenging biliary disorders in gastroenterology field, where this long-standing condition can also lead to portal hypertension and multi-disciplinary teamwork is usually needed to manage this problem. Biliary drainage is the primary management to prevent prolonged cholestasis. Biliary system with its thin-walled and tubular structure sometimes makes the diagnosis and therapeutic not easy to approach. Read More

Int J Surg Case Rep 2021 Apr 16;82:105886. Epub 2021 Apr 16.

Department of Neonatal and Paediatric Intensive Care, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India.

Introduction: Minimally-invasive techniques offered by interventional radiology (IR) are really helpful in the management of challenging surgical cases. The current report highlights a series of four complex pediatric surgical cases which were successfully managed by specific image-guided techniques.

Case Presentation: The first two cases in the present report were infants. Read More

Cardiovasc Intervent Radiol 2021 Apr 22. Epub 2021 Apr 22.

Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.

Purpose: To investigate clinical outcomes and safety of extraluminal recanalization for duct-to-duct anastomotic obstruction after living donor liver transplantation (LDLT).

Materials And Methods: Extraluminal recanalization was performed as a salvage procedure after failure of intraluminal cannulation in eight patients who underwent percutaneous transhepatic treatment of duct-to-duct anastomotic obstruction 11.0 ± 5. Read More

VideoGIE 2021 Feb 14;6(2):90-92. Epub 2020 Dec 14.

Director, Endoscopy and EUS, Department of Medical Gastroenterology, AIG Hospitals, Hyderabad, Telangana, India.

Curr Med Sci 2021 Apr 20;41(2):375-380. Epub 2021 Apr 20.

Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

Preoperative biliary drainage may increase the morbidity and mortality of pancreaticoduodenectomy. Studies on percutaneous transhepatic biliary drainage (PTBD) before laparoscopic pancreaticoduodenectomy (LPD), however, are scarce. The aim of this study was to examine the impact of PTBD on clinical outcomes of patients with malignant obstructive jaundice undergoing LPD. Read More

J Am Coll Radiol 2021 Apr 10. Epub 2021 Apr 10.

Vascular and Interventional Radiology, The Russell H. Morgan Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland. Electronic address:

Objective: To explore baseline characteristics, comorbidities, and clinical diagnoses in the prediction of outcomes for inpatient percutaneous biliary interventions in the United States.

Methods: Hospitalizations for percutaneous transhepatic cholangiography and percutaneous biliary drainage were studied using the National Inpatient Sample 2012 to 2015. Associations between baseline characteristics, comorbidities, clinical diagnoses, and outcomes were analyzed using multivariable regression modeling. Read More

BMJ Case Rep 2021 Apr 12;14(4). Epub 2021 Apr 12.

Department of Surgery, Albany Medical Center, Albany, New York, USA.

The current management of persistent biliary fistula includes biliary stenting and peritoneal drainage. Endoscopic retrograde cholangiopancreatography (ERCP) is preferred over percutaneous techniques and surgery. However, in patients with modified gastric anatomy, ERCP may not be feasible without added morbidity. Read More

Acta Radiol 2021 Apr 12:2841851211006915. Epub 2021 Apr 12.

Department of Upper GI Surgery, 6634University Hospitals Plymouth NHS Trust, Plymouth, UK.

The incidence of gallstone-related complications is rising, thus leading to increases in waiting list times for elective laparoscopic cholecystectomy (LC). Percutaneous cholecystostomy (PC) provides immediate biliary drainage and may be used as an emergency option in a critically unwell patient as a bridge to surgery, or as the management option of a patient who is not fit for surgery. However, a significant number of these patients may be readmitted after PC with recurrent acute cholecystitis or pancreatitis, leading to significant morbidity and mortality. Read More

J Hepatobiliary Pancreat Sci 2021 Apr 12. Epub 2021 Apr 12.

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

Background: Endoscopic transpapillary gallbladder drainage (EGBD) has been reported as an effective gallbladder drainage treatment option for acute cholecystitis in high-risk surgical patients. However, the long-term outcomes such as cholecystitis' recurrence rate after placement of EGB stenting (EGBS) have not been well studied yet.

Aims: The aim of the present study was to compare the long-term outcome of EGBS and removal of gallbladder drainage after percutaneous transhepatic gallbladder drainage (PTGBD) or endoscopic nasogallbladder drainage (ENGBD) for acute cholecystitis in high-risk surgical patients and clarify the usefulness of long-term placement of EGBS. Read More

Am J Transl Res 2021 15;13(3):1817-1824. Epub 2021 Mar 15.

Department of Hepatobiliary and Pancreatic Surgery, Hengshui People's Hospital Hengshui, Hebei Province, China.

Objective: To investigate the effect of percutaneous transhepatic cholangial drainage (PTCD) + radiofrequency ablation (RFA) combined with biliary stent implantation on the liver function of patients with cholangiocarcinoma complicated with malignant obstructive jaundice.

Methods: Retrospective analysis of 120 patients with cholangiocarcinoma complicated with malignant obstructive jaundice were divided into the research group (n=60) and the control group (n=60) according to different treatments. The research group received PTCD + RFA combined with biliary stent implantation, while the control group received only PTCD combined with biliary stent implantation. Read More

HPB (Oxford) 2021 Mar 19. Epub 2021 Mar 19.

Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138, Bologna, Italy.

Background: Bile leak (BL) after hepato-pancreato-biliary (HPB) surgery is associated with significant morbidity and mortality. Aim of this study was to evaluate effectiveness and safety of percutaneous transhepatic approach (PTA) to drainage BL after HPB surgery.

Methods: Between 2006 and 2018, consecutive patients who were referred to interventional radiology units of three tertiary referral hospitals were retrospectively identified. Read More

Medicine (Baltimore) 2021 Apr;100(14):e24486

Department of Radiology, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

Abstract: To evaluate the effectiveness of percutaneous removal of common bile duct (CBD) stones using a modified balloon technique (balloon catheter sphincteroplasty and expulsion of the stones using half-captured balloons within the sheath) in patients difficult to treat with endoscopy.Fifty patients underwent a modified balloon technique (balloon group), and 53 patients underwent CBD stone removal by the basket method (stone basket group) between 2016 and 2019. We compared the balloon and stone basket groups to evaluate the effectiveness of the modified balloon technique. Read More

BMC Surg 2021 Apr 6;21(1):180. Epub 2021 Apr 6.

Unit of HepatoBilioPancreatic and Digestive Surgery, Department of Health Science, San Paolo Hospital, University of Milan, Via Di Rudinì 8, 20142, Milan, Italy.

Background: COVID-19 pandemic has impacted the Italian National Health Care system at many different levels, causing a complete reorganization of surgical wards. In this context, our study retrospectively analysed the management strategy for patients with acute cholecystitis.

Methods: We analysed all patients admitted to our Emergency Department for acute cholecystitis between February and April 2020 and we graded each case according to 2018 Tokyo Guidelines. Read More

Ann Transplant 2021 Apr 6;26:e928907. Epub 2021 Apr 6.

Department of Surgery, University Hospital Bonn, Bonn, Germany.

BACKGROUND Biliary complications are common causes of morbidity and mortality after liver transplantation. MATERIAL AND METHODS From 2013 to 2018, 102 whole-organ liver transplantations were conducted in our department. Patients were closely monitored for biliary complication development. Read More

Endosc Ultrasound 2021 Mar-Apr;10(2):124-133

Endoscopy Unit, Paoli Calmette Institute, Marseille, France.

Background And Objectives: Concomitant biliary and duodenal malignant obstruction are a severe condition mainly managed by duodenal and biliary stenting, which can be performed simultaneously (SAMETIME) or in two distinct procedures (TWO-TIMES). We conducted a single-center retrospective study to evaluate the feasibility of a SAMETIME procedure and the impact of endoscopic ultrasound (EUS)-hepaticogastrostomy in double malignant obstructions.

Patients And Methods: From January 1, 2011, to January 1, 2018, patients with concomitant malignant bilioduodenal obstruction treated endoscopically were included. Read More

Surg Endosc 2021 Apr 1. Epub 2021 Apr 1.

Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

Background: Endoscopic biliary stenting (EBS) with a fully covered, self-expandable metallic stent (FC-SEMS) and plastic stent (PS) is safe and efficient for biliary anastomotic strictures (ASs) after a deceased donor liver transplantation. Limited studies have investigated the use of FC-SEMSs for biliary strictures post-living donor liver transplantation (LDLT). We compared the resolution rate of biliary ASs post-LDLT and the 12-month recurrence rates post-stent removal between EBS with an FC-SEMS, PS, and percutaneous transhepatic biliary drainage (PTBD). Read More

Minerva Gastroenterol (Torino) 2021 Apr 1. Epub 2021 Apr 1.

Gastroenterology Unit, Department of Medical and Surgical Sciences, Hospital of Imola, University of Bologna, Bologna, Italy.

Acute cholecystitis (AC) is the most common biliary stone disease complication. While there is consensus regarding cholecystectomy for AC, gallbladder drainage is indicated in elderly or high-risk surgical patients. We systematically reviewed available evidence in the field of EUS-guided gallbladder drainage (EUS-GBD) for AC in high-risk surgical patients. Read More

Case Rep Gastroenterol 2021 Jan-Apr;15(1):210-217. Epub 2021 Feb 18.

Digestive Disease and GI Oncology Center, Medistra Hospital, Jakarta, Indonesia.

Pancreatobiliary disorder is a challenging clinical condition, especially when this condition is causing severe infection or biliary sepsis, and sometimes it requires intensive care unit (ICU) treatment. Biliary drainage is the mainstay of therapy; however, the choice of the drainage method is dependent on the patient's clinical condition and the disease itself. A 79-year-old female was transferred on a ventilator to our ICU from another hospital due to biliary sepsis, a large common bile duct stone, and an infected pancreatic pseudocyst. Read More

BMJ Case Rep 2021 Mar 30;14(3). Epub 2021 Mar 30.

Department of Gastroenterology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan.

A 78 year-old female status post subarachnoid haemorrhage developed abdominal pain and obstructive jaundice. CT scan showed acute cholecystitis and dilation of the intrahepatic ducts. Endoscopic retrograde cholangiography revealed hepatic duct stenosis due to compression by an enlarged gallbladder. Read More

J Clin Gastroenterol 2021 Mar 12. Epub 2021 Mar 12.

*Department of Medicine †Department of Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, AR ‡Evidence-Based Practice Center, Mayo Clinic, Rochester, MN.

Background And Aims: Endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic biliary drainage, and endoscopic ultrasound (EUS)-guided biliary drainage are all established techniques for drainage of malignant biliary obstruction. This network meta-analysis (NMA) was aimed at comparing all 3 modalities to each other.

Materials And Methods: Multiple databases were searched from inception to October 2019 to identify relevant studies. Read More

Khirurgiia (Mosk) 2021 (4):34-38

Kazan City Hospital No. 7, Kazan, Russia.

Objective: To reduce the incidence of complications in acute destructive pancreatitis via stenting of the main pancreatic duct in complex treatment of these patients.

Material And Methods: There were 182 patients aged 31-76 (mean 42.8±11) years with acute destructive pancreatitis. Read More

Korean J Gastroenterol 2021 03;77(3):136-140

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.

Although ERCP is a therapeutic endoscopic procedure in pacreatico-biliary diseases, its rare complications, including pancreatitis, duodenal perforation, and bleeding, can be fatal. An 87-year-old woman with a history of gallbladder cancer presented with jaundice and general weakness. Her skin color was yellowish and epigastric tenderness was confirmed on a physical examination. Read More

J Clin Exp Hepatol 2021 Mar-Apr;11(2):254-259. Epub 2020 Jul 19.

Department of Gastrointestinal Surgery and Liver Transplantation, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Percutaneous liver biopsy is a relatively safe procedure with low complication rates. Infections following liver biopsy are uncommon and can lead to a poor outcome. There are limited data on liver biopsy-related infections among liver transplant (LT) recipients. Read More

BMC Surg 2021 Mar 21;21(1):153. Epub 2021 Mar 21.

Department of Transplantation and Surgery, Semmelweis University, VIII. Baross u.23, Budapest, 1082, Hungary.

Background: Situs inversus totalis is a rare anatomical variation of both the thoracic and the abdominal organs. Common bile duct strictures can be caused by malignant and benign diseases as well. 7-18% of the latter ones are 'malignant masquerade' cases, as pre-operative differentiation is difficult. Read More