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Respir Med Case Rep 2020 20;30:101075. Epub 2020 May 20.

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, People's Republic of China.

Background: The biliary bronchial fistula is rare and difficult to treat. Here we report a 49-year-old woman diagnosed with biliary bronchial fistula due to cough with yellow-green sputum.

Case Presentation: this is a typical case of the biliary bronchial fistula with typical symptoms. Read More

Surg Laparosc Endosc Percutan Tech 2020 Jun 1. Epub 2020 Jun 1.

Department of Gastroenterology, Affiliated HangZhou First People's Hospital, Zhejiang University School of Medicine.

Aim: The aim of this study was to evaluate the efficacy and safety of endoscopic ultrasound-guided biliary drainage (EUS-BD) in patients with biliary obstruction and surgically altered anatomy.

Patients And Methods: This was a retrospective study. We collected data from 60 patients with biliary obstruction and surgically altered anatomies who undergone EUS-BD (group A, 33 cases) and percutaneous transhepatic biliary drainage (PTBD) (group B, 27 cases) after unsuccessful endoscopic retrograde cholangiopancreatography from January 2016 to January 2018. Read More

Surg Case Rep 2020 May 24;6(1):111. Epub 2020 May 24.

Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan.

Background: Subtotal cholecystectomy is an effective surgical method to decrease the risk of complications for gallbladders that are difficult to remove. However, there is a risk for postoperative refractory bile leakage through the gallbladder stump. Here, we report a new management technique involving the use of argon plasma coagulation (APC) to stop bile leakage after a subtotal cholecystectomy. Read More

Transplant Proc 2020 May 17. Epub 2020 May 17.

Department of Radiology, Kaohsiung Medical University, Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (R.O.C.); Department of Radiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan (R.O.C.). Electronic address:

A bronchobiliary fistula (BBF), which is defined by abnormal communication between the biliary system and the bronchial tree, is usually regarded as a consequence of local infection, such as hydatid or amebic disease of the liver, hepatic abscess, trauma, neoplasm, and other causes of biliary obstruction. We present a 40-year-old female patient who received a living donor liver transplantation for autoimmune hepatitis and who suffered from biliary stricture at the anastomosis, bile leakage in the right subphrenic region, and development of a BBF 1 year later. Magnetic resonance cholangiography (MRC) and fistulography showed a fistula between the subphrenic biloma and right lower bronchus. Read More

Turk J Gastroenterol 2020 Apr;31(4):318-323

Department of Gastroenterology, Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey.

Background/aims: The aim of this study was to investigate the indications, technical and clinical success, and complications of the endoscopic retrograde cholangiography (ERC) via a permanent access loop (PAL).

Materials And Methods: Twenty patients who underwent ERC through PAL between 2009 and 2017 were included in this study. The technical success was described as achieving access to the bile ducts through PAL and the clinical success was described as the clinical and laboratory improvement of the patients after the procedure. Read More

BMC Cancer 2020 May 14;20(1):422. Epub 2020 May 14.

Division of Haematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, Taiwan.

Background: Chemotherapy with gemcitabine and cisplatin has been the standard of care in first-line chemotherapy for advanced biliary tract cancer (BTC) since the trial ABC-02 was published in 2010. We aimed to investigate the prognostic and predictive factors of this regimen in a cohort of Taiwanese patients with advanced BTC.

Methods: A total of 118 patients with histologically confirmed BTC treated at Chang Gung Memorial Hospital at Linkou from 2012 to 2017 were retrospectively reviewed. Read More

J Hepatobiliary Pancreat Sci 2020 Apr 13. Epub 2020 Apr 13.

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

Background: Percutaneous cholecystostomy (PC) followed by definitive cholecystectomy is an alternative treatment for acute cholecystitis (AC). We retrospectively investigated the impact of PC tube removal before definitive cholecystectomy on surgical outcomes.

Methods: From 2012 to 2017, 942 AC patients underwent PC at a single institute. Read More

Med Oncol 2020 Apr 9;37(5):45. Epub 2020 Apr 9.

Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via Francesco De Sanctis 1, Campobasso, Italy.

Cholangiocarcinoma (CC) accounts for about 3% of the gastrointestinal and 10-25% of all hepatobiliary malignancies. It arises from the epithelium of the bile duct and it can be classified in intrahaepatic (ICC), perihilar (PCC) and distal (DCC) cholangiocarcinoma, depending on the anatomical location. About 50-60% of the cases are PCC. Read More

Acta Radiol 2020 Mar 25:284185120911187. Epub 2020 Mar 25.

Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany.

Medicine (Baltimore) 2020 Mar;99(11):e19545

Department of Intervention Medicine, the Second Hospital of Shandong University.

To compare the diagnostic performance of percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography for the pathological assessment of suspected malignant bile duct stricture, using brush cytology and forceps biopsy.The study group comprised 79 consecutive patients who underwent pathological assessment for suspected malignant biliary stricture, 38 of whom underwent percutaneous transhepatic cholangiography (group A) and the other 41 underwent endoscopic retrograde cholangiography (group B). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Read More

Int J Surg Case Rep 2020 28;68:193-197. Epub 2020 Feb 28.

IRCAD/AITS-Asian Institute of TeleSurgery, Chang Bing Show Chwan Hospital, Changhua, Taiwan.

Introduction: The utility of intracystic administration of indocyanine green for near-infrared fluorescent cholangiography in acute calculous cholecystitis initially treated with percutaneous transhepatic gallbladder drainage (PTGBD) was described in this report.

Presentation Of Case: Two cases who underwent near-infrared fluorescent cholangiography guided interval laparoscopic cholecystectomy two weeks post-PTGBD were studied retrospectively. Both patients were diagnosed with moderate acute calculous cholecystitis based on diagnostic criteria of the Tokyo guidelines. Read More

J Clin Med 2020 Mar 11;9(3). Epub 2020 Mar 11.

Carol Davila University of Medicine and Pharmacy, 7000 Bucharest, Romania.

Primary sclerosing cholangitis is a progressive liver disease characterized by chronic inflammation leading to liver fibrosis and cirrhosis. Even though the exact pathogenesis is still unclear, a combination of autoimmune, environmental, and ischemic factors could explain certain aspects of the disease. The most important diagnostic step is cholangiography, which can be obtained either by endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiography (MRCP as the gold standard), or percutaneous transhepatic cholangiography. Read More

AJR Am J Roentgenol 2020 Jun 11;214(6):1377-1383. Epub 2020 Mar 11.

Department of Medical Ultrasound, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Rd 2, Guangzhou, 510080 China.

The purpose of this study was to evaluate the feasibility of ultrasound (US)-guided percutaneous transhepatic cholangial drainage (PTCD) and consequent percutaneous US cholangiography in managing the dilated biliary tracts of children who have undergone hepatobiliary surgery. Sixteen children (11 boys, five girls; age range, 3-144 months) who underwent hepatobiliary surgery from December 2016 to October 2018 and had US evidence of biliary dilatation were included. All patients had undergone US-guided PTCD because of elevated postoperative serum bilirubin levels or bile duct infection. Read More

Zhonghua Wai Ke Za Zhi 2020 May;58(5):326-330

Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

To explore the proper protective measures for pancreatic diseases treatment during the outbreak of 2019 coronavirus disease(COVID-19). Clinical data of four cases of patients that suffered COVID-19 from February 2(nd) to February 9(th), 2020 at Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were reviewed induding 4 males and 1 female, aging of 50, 51, 46, 87 years old, respectively. After the first patients cuffed nosocomial infection of COVID-19, the general protective measures were updated. Read More

Pediatr Radiol 2020 May 18;50(6):827-832. Epub 2020 Feb 18.

Diagnostic Radiology Department, Bicetre University Hospital, 78 Rue Général Leclerc, 94270, Le Kremlin-Bicêtre, France.

Background: Liver-transplanted, immunosuppressed pediatric patients undergoing repeated percutaneous transhepatic cholangiography (PTC) require optimized exposure to ionizing radiation.

Objective: To establish local diagnostic reference levels (DRL) for pediatric PTC and investigate the routine use of X-ray equipment.

Materials And Methods: The study retrospectively analyzed data collected between October 2016 and June 2018 from a single center performing PTC. Read More

CVIR Endovasc 2019 Jan 4;2(1). Epub 2019 Jan 4.

Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.

Background: Hepatic arterial injury is an uncommon complication of percutaneous transhepatic biliary drainage interventions that commonly presents with hemobilia and peri catheter hemorrhage. It is classically managed with antegrade trans arterial embolization. However, this approach may not be possible due to altered anatomy and alternative techniques need to be considered. Read More

Medicine (Baltimore) 2020 Jan;99(3):e18855

Department of Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

Rationale: Prolonged cholestasis is a rare complication associated with endoscopic retrograde cholangiopancreatography (ERCP).

Patient Concerns: A 68-year-old man who presented with worsening cholestasis after ERCP for the removal of a common bile duct stone.

Diagnosis: Total bilirubin increased up to 35. Read More

Surg Endosc 2020 Jan 28. Epub 2020 Jan 28.

Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, 3010, Bern, Switzerland.

Background: In bariatric surgery patients, pancreaticobiliary access via endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging and the optimal approach for the evaluation and treatment of biliary tree-related pathologies has been debated. Besides laparoscopy-assisted ERCP (LA-ERCP) as standard of care, EUS-directed transgastric ERCP (EDGE) and hepaticogastrostomy (HGS) with placement of a fully covered metal stent have emerged as novel techniques. The objective of this study was to evaluate safety and efficacy of three different endoscopic approaches (LA-ERCP, EDGE, and HGS) in bariatric patients. Read More

BMJ Open 2020 Jan 23;10(1):e033576. Epub 2020 Jan 23.

Department of Gastroenterology, Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, UK

Introduction: Relieving obstructive jaundice in inoperable pancreato-biliary cancers improves quality of life and permits chemotherapy. Percutaneous transhepatic cholangiography with drainage and/or stenting relieves jaundice but can be associated with significant morbidity and mortality. Percutaneous transhepatic biliary drainage (PTBD) in malignant biliary obstruction was therefore examined in a national cohort to establish risk factors for poor outcomes. Read More

Br J Radiol 2020 Apr 30;93(1108):20191046. Epub 2020 Jan 30.

Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, India.

Objective: To study the outcome of salvage percutaneous transhepatic biliary drainage (PTBD) in complex and technically challenging post-liver transplant (LT) biliary complications and analyse the reason for failure of endoscopic retrograde cholangiopancreatography (ERCP).

Methods And Materials: Hospital data were searched for all LT patients with biliary complications requiring salvage PTBD (upon failure of ERCP) from January 2010 to May 2017. Patients who underwent primary PTBD were excluded. Read More

EClinicalMedicine 2020 Jan 3;18:100212. Epub 2020 Jan 3.

Department of Gastroenterology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

Background: Relieving malignant biliary obstruction improves quality of life and permits chemotherapy. Outcomes of endoscopic retrograde cholangio-pancratography(ERCP) in inoperable malignant biliary obstruction have been examined in a national cohort to establish factors associated with poor outcomes.

Methods: Hospital Episode Statistics include diagnostic and procedural data for all NHS hospital attendances in England. Read More

Endosc Ultrasound 2019 Nov 28;8(Suppl 1):S28-S34. Epub 2019 Nov 28.

Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA.

EUS-guided gallbladder drainage (EUS-GBD) is utilized for the treatment of acute cholecystitis and symptomatic cholelithiasis in patients who are poor operative candidates. Over the last several years, improved techniques and accessories have facilitated GBD. Recent literature demonstrated effectiveness and safety of EUS-guided GBD. Read More

J Clin Exp Hepatol 2019 Nov-Dec;9(6):684-689. Epub 2019 Mar 25.

Center for Liver and Biliary Sciences, Indraprastha Apollo Hospital, Delhi-Mathura Road, Sarita Vihar, New Delhi 110076, India.

Background: In the living donor liver transplant (LDLT) population, postoperative biliary stricture is a common problem. Endoscopic retrograde cholangiography (ERCP) and stenting failures usually occur because of odd angulation of the ducts, particularly in right lobe grafts. Percutaneous transhepatic biliary drainage (PTBD) is helpful in patients where endoscopic intervention is unsuccessful. Read More

BMJ Case Rep 2019 Dec 29;12(12). Epub 2019 Dec 29.

Clinical Radiology, Aberdeen Royal Infirmary, Aberdeen, UK.

A 63-year-old patient was admitted to intensive treatment unit with biliary sepsis due to a small distal common bile duct stone. Endoscopic retrograde cholangiopancreatography was initially attempted for insertion of a biliary stent but failed due to the presence of a periampullary diverticulum. Referral to interventional radiology for percutaneous drainage was considered the next alternative even though there was no dilatation of intrahepatic ducts. Read More

Surg Endosc 2019 Nov 25. Epub 2019 Nov 25.

Sunderby Research Unit, Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.

Background: Rendezvous endoscopic retrograde cholangiopancreaticography (ERCP) is a well-established method for treatment of choledocholithiasis. The primary aim of this study was to determine how different techniques for management of common bile duct stone (CBDS) clearance in patients undergoing cholecystectomy have changed over time at tertiary referral hospitals (TRH) and county/community hospitals (CH). The secondary aim was to see if postoperative rendezvous ERCP is a safe, effective and feasible alternative to intraoperative rendezvous ERCP in the management of CBDS. Read More

Cardiovasc Intervent Radiol 2020 Feb 20;43(2):302-310. Epub 2019 Nov 20.

Department of Radiology, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy.

Purpose: To investigate the effectiveness of percutaneous approaches to treat bile leak and to propose an anatomical classification of biliary fistula to guide the most appropriate percutaneous approach.

Materials And Methods: Fifty-six patients with bile leakage after hepatobiliary surgery were included. Based on preoperative images and postoperative fistulogram images, three categories of bile leakage were defined. Read More

Indian J Radiol Imaging 2019 Jul-Sep;29(3):310-312. Epub 2019 Oct 30.

Department of Diagnostic Imaging and Radiotherapy, University Hospital "G. Martino", Messina, Italy.

Biliary fistula and bile leakage are complications that can occur during hepato-biliary surgery (both open and laparoscopic) and percutaneous biliary intervention. In some cases, spontaneous resolution is documented but more often re-intervention (surgical or percutaneous) is necessary. We present the case of a male patient who underwent right hepatectomy with bilio-digestive anastomosis for a cholangiocarcinoma which developed a bilo-cutaneous fistula through the path of a previously inserted percutaneous transhepatic drainage. Read More

Chirurg 2020 Jan;91(1):29-36

Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Uniklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.

Bile leakage and postoperative bile duct strictures or anastomotic stenosis after bilioenteric anastomosis are complex surgical complications, which are associated with increased morbidity and mortality. Detailed diagnostics and sophisticated decision-making is always requiered. Complex liver surgery (redo procedures, nonanatomic resections, etc. Read More

Dig Dis Sci 2019 12 23;64(12):3672-3673. Epub 2019 Oct 23.

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.

Tech Vasc Interv Radiol 2019 Sep 2;22(3):139-148. Epub 2019 May 2.

Department of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University St. Louis School of Medicine, St Louis, MO.

The morbidity and mortality of cholecystectomy can increase to 10% in high surgical risk patients. The technique for percutaneous cholecystolithotomy consists of 3 steps: (1) percutaneous cholecystostomy, (2) tract dilation and cholecystolithotomy, and (3) tract evaluation and catheter removal. Cholecystoscopy is critical in guiding the lithotripsy probe for fragmentation of large stones and is useful for locating small stone fragments not seen in cholangiography. Read More

Endosc Int Open 2019 Oct 1;7(10):E1262-E1275. Epub 2019 Oct 1.

Department of Gastroenterology and Hepatology, Erasmus MC, The Netherlands.

 Transabdominal ultrasound (US), computed tomographic scanning (CT) and magnetic resonance imaging (MRI) are established diagnostic tools for liver diseases. Percutaneous transhepatic cholangiography is used to perform hepatic interventional procedures including biopsy, biliary drainage procedures, and radiofrequency ablation. Despite their widespread use, these techniques have limitations. Read More

J Med Imaging Radiat Oncol 2019 Dec 23;63(6):758-764. Epub 2019 Sep 23.

Interventional Radiology Service - Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia.

Advances in interventional radiology have seen the adaptation of urological endoscopic laser techniques to treat biliary tract calculi. Percutaneous transhepatic biliary laser lithotripsy provides an effective alternative procedure for the management of intrahepatic or conventionally refractory choledocholithiasis which would otherwise require invasive and high-risk surgical intervention. Several small studies have validated the procedure for management in this subset of patients, with most achieving 100% calculi clearance with minimal complications. Read More

J Int Med Res 2019 Oct 17;47(10):5337-5342. Epub 2019 Sep 17.

Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China.

VideoGIE 2019 Sep 8;4(9):423-425. Epub 2019 Jun 8.

Division of Gastroenterology & Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.

Cardiovasc Intervent Radiol 2019 Dec 6;42(12):1745-1750. Epub 2019 Sep 6.

Department of Interventional Radiology, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, FL, USA.

Introduction: Biliary duct injuries pose a significant management challenge due to the propensity for recurrent biliary strictures. Development of a modified Roux-en-Y hepaticojejunostomy known as a Hutson-Russell Pouch (HRP) provides a point of entry for repetitive access to the biliary tree. We aim to highlight the effectiveness of using the HRP as an access point for the long-term management of anastomotic and distal biliary strictures, thereby showcasing the value in potential widespread adoption of this modification to a standard surgical procedure. Read More

Korean J Gastroenterol 2019 Aug;74(2):69-80

Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Pancreatic cancer is a major cause of cancer-related mortality and morbidity, and its incidence is increasing as the population is aging. On the other hand, significant improvement in the prognosis has not occurred. The absence of early diagnosis means that many patients are diagnosed only when they develop symptoms, such as jaundice, due to a biliary obstruction. Read More

Radiol Bras 2019 Jul-Aug;52(4):222-228

Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil.

Objective: To evaluate the accuracy of percutaneous transhepatic biliary biopsy (PTBB) in patients with suspected biliary obstruction.

Materials And Methods: This was a retrospective analysis of 18 patients with obstructive jaundice who underwent PTBB. In each patient, three to ten fragments were collected from the lesion. Read More

World J Gastroenterol 2019 Aug;25(29):3857-3869

Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Milan 20089, Italy.

In the last years, endoscopic ultrasonography (EUS) has evolved from a purely diagnostic technique to a more and more complex interventional procedure, with the possibility to perform several type of therapeutic interventions. Among these, EUS-guided biliary drainage (BD) is gaining popularity as a therapeutic approach after failed endoscopic retrograde cholangiopancreatography in distal malignant biliary obstruction (MBO), due to the avoidance of external drainage, a lower rate of adverse events and re-interventions, and lower costs compared to percutaneous trans-hepatic BD. Initially, devices created for luminal procedures (. Read More

Gastrointest Endosc 2020 01 10;91(1):178-184. Epub 2019 Aug 10.

Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

Background And Aims: EUS-guided biliary drainage (EUS-BD) has been used as a rescue procedure after failed endoscopic retrograde cholangiography (ERC), and there is growing interest in EUS-BD as a primary therapy for distal malignant biliary obstruction. After EUS-guided needle puncture of an obstructed bile duct, directional control of wire advancement remains an area of need, potentially addressed by a new steerable EUS access system. The aim of this study was to evaluate the safety and efficacy of this novel steerable access system in patients undergoing EUS-BD after failed ERC. Read More

Surg Endosc 2020 Jun 10;34(6):2541-2550. Epub 2019 Aug 10.

Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.

Background: Magnetic compression anastomosis (MCA) is a revolutionary minimally invasive method to perform choledochocholedochostomy in patients with benign biliary stricture (BBS). We conducted MCA for the treatment of severe BBS that could not be treated by conventional methods.

Patients And Methods: Patients with BBSs that could not be treated using conventional treatments were included. Read More

S Afr J Surg 2019 Sep;57(3):24-29

Surgical Gastroenterology Unit, Division of General Surgery, Department of Surgery, Faculty of Health Sciences, Groote Schuur Hospital, University of Cape Town, South Africa.

Background: The South African healthcare system has an under-financed public sector serving most of the population and a better resourced private sector serving a small fraction of the population. This study evaluated management and outcome in patients with complex bile duct injuries (BDIs) after laparoscopic cholecystectomy referred from either private or public hospitals.

Method: The data of patients who underwent hepaticojejunostomy repair were retrieved from a prospectively maintained central departmental BDI database. Read More

Surg Endosc 2019 11 26;33(11):3567-3577. Epub 2019 Jul 26.

Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.

Background: Endoscopic gallbladder drainage (GBD) is an alternative to percutaneous GBD (PGBD) to treat acute cholecystitis, yielding similar success rates and fewer adverse events. To our knowledge, no cost-effectiveness analysis has compared these procedures. We performed an economic analysis to identify clinical and cost determinants of three treatment options for acute cholecystitis in poor surgical candidates. Read More

BMJ Case Rep 2019 Jul 12;12(7). Epub 2019 Jul 12.

Department of Internal Medicine, Unity Hospital, Rochester, New York, USA.

A 72-year-old female patient who was admitted for ischaemic stroke had developed ascending cholangitis. Percutaneous transhepatic cholangiogram was performed to drain the infected bile, but this was complicated by haemorrhagic shock and hepatic haematoma. Mesenteric angiogram showed right hepatic artery (RHA) pseudoaneurysm which was embolised, there by stopping her bleeding. Read More

Int J Surg Case Rep 2019 28;60:340-344. Epub 2019 Jun 28.

Surgical Gastroenterology Unit, Division of General Surgery, University of Cape Town Health Sciences Faculty and Groote Schuur Hospital, Cape Town, South Africa. Electronic address:

Introduction: Treatment of major iatrogenic and non-iatrogenic bile duct injury (BDI) often requires delayed surgery with interim external biliary drainage. Percutaneous transhepatic cholangiography (PTC) with biliary catheter placement and endoscopic retrograde cholangiography (ERC) with stent placement have been used to bridge defects. In some patients, bridging the defect cannot be achieved through ERC or PTC alone. Read More

J Gastrointest Surg 2019 Jun 21. Epub 2019 Jun 21.

Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.

Background: Biliary complications are common following liver transplantation (LT) and traditionally managed with Roux-en-Y hepaticojejunostomy. However, endoscopic management has largely supplanted surgical revision in the modern era. Herein, we evaluate our experience with the management of biliary complications following LT. Read More

Surg Laparosc Endosc Percutan Tech 2019 Aug;29(4):261-266

Departments of Surgery.

This study aimed to evaluate the safety and efficacy of endoscopic transpapillary pancreatic duct stent placement (ETPS) for symptomatic peripancreatic fluid collection caused by postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP). ETPS was also compared with percutaneous drainage (PTD). Retrospectively 38 patients were studied who developed clinically relevant POPF. Read More

World J Clin Cases 2019 May;7(10):1149-1154

Department of Endoscopy and Endoscopic Surgery, Fukuoka Dental College, Fukuoka 814-0175, Japan.

Background: In patients with large stones in the common bile duct (CBD), advanced treatment modalities are generally needed. Here, we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy (EHL) by the percutaneous approach and rendezvous endoscopic retrograde cholangiography (ERC) using a nasal endoscope.

Case Summary: A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 mm. Read More

Gland Surg 2019 Apr;8(2):141-149

Diagnostic and Interventional Radiology Department, ASST Santi Paolo e Carlo, San Paolo Hospital, University of Milan, Milan, Italy.

Bile duct injuries are among the most feared complications after pancreatic surgery. Most of these surgical complications are related to iatrogenic injuries and include bile leakage, biliary duct obstruction or stricture and infection. A wide range of Interventional Radiology treatment options are currently available. Read More

Zhonghua Nei Ke Za Zhi 2019 Jun;58(6):415-418

Department of Gastroenterology, the Second Medical Center, the PLA General Hospital, Beijing 100853, China.

To analyze the clinical characteristics and explore the risk predictors on mortality in elderly patients with acute cholecystitis and cholangitis. We conducted a retrospective analysis of elderly patients hospitalized in the Second Medical Center of General Liberation Army Hospital for acute cholecystitis and cholangitis during 2000 to 2018. Clinical data and risk predictors on mortality were assessed. Read More