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Pediatr Radiol 2021 May 11. Epub 2021 May 11.

APHM, Equipe d'Accueil 3279 - IFR 125, Service d'Imagerie Pédiatrique et Prénatale, Hôpital Timone Enfants, Aix Marseille Univ, Marseille, France.

We aim to present a practical approach to imaging in suspected biliary atresia, an inflammatory cholangiopathy of infancy resulting in progressive fibrosis and obliteration of extrahepatic and intrahepatic bile ducts. Left untreated or with failure of the Kasai procedure, biliary atresia progresses to biliary cirrhosis, end-stage liver failure and death within the first years of life. Differentiating biliary atresia from other nonsurgical causes of neonatal cholestasis is difficult as there is no single method for diagnosing biliary atresia and clinical, laboratory and imaging features of this disease overlap with those of other causes of neonatal cholestasis. Read More

Clin Exp Gastroenterol 2021 30;14:145-154. Epub 2021 Apr 30.

Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan.

Purpose: Bile duct injury is one of the most serious complications of laparoscopic cholecystectomy. Intraoperative indocyanine green (ICG) cholangiography is a safe and useful navigation modality for confirming the biliary anatomy. ICG cholangiography is expected to be a routine method for helping avoid bile duct injuries. Read More

Cardiovasc Intervent Radiol 2021 May 4. Epub 2021 May 4.

Division of Image Guided Minimally Invasive Surgery, Juan D. Perón 4190 (C1181ACH), Ciudad autónoma de Buenos Aires, Argentina.

Purpose: The aim of this study was to determine the effect of hyperbilirubinemia in the sensitivity of percutaneous transluminal forceps biopsy (PTFB) in patients with suspected malignant biliary stricture.

Materials And Methods: Ninety-three patients with suspicion of malignant biliary stricture underwent percutaneous transhepatic cholangiography followed by PTFB. Sensitivity, specificity and predictive values were analysed based on the presence or absence of hyperbilirubinemia, defined as total bilirubin equal to, or higher than 5 mg/dL. Read More

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

Surg Laparosc Endosc Percutan Tech 2021 May 3. Epub 2021 May 3.

Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Background: Endoscopic management is the mainstay for biliary strictures after liver transplantation. However, this method is often failed in cases associated with hepatolithiasis or refractory strictures. The aim of this study is to investigate whether 1-step percutaneous transhepatic biliary cholangiography (PTC) combined with high-frequency needle-knife electrotomy can be an alternative method in biliary strictures after liver transplantation that could not be treated by endoscopic management. Read More

Int J Surg Case Rep 2021 Apr 1;82:105854. Epub 2021 Apr 1.

Department of General Surgery, Visceral, Thoracic and Vascular Surgery, Universitätsmedizin Greifswald, Greifswald, Germany.

Introduction And Importance: The endoscopic retrograde cholangiography (ERC) represents the standard treatment for choledocholithiasis. However, ERC in patients with previous gastrectomy and anastomosis is difficult due to altered access.

Case Presentation: In our case, we report on a patient with previous gastrectomy and Y-Roux-anastomosis suffering from choledocholithiasis. 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

Surg Endosc 2021 Apr 6. Epub 2021 Apr 6.

Surgical Post-Graduate Program, Universidade Federal do Rio Grande do Sul, 2400 Ramiro Barcelos Street, Porto Alegre, 90035-002, Brazil.

Background: Choledocholithiasis is a common complication of cholelithiasis, occurring in up to 18% of patients. Multiple treatments are often performed during the course of the management of choledocholithiasis, sometimes without success. Our study was performed identify the factors predictive of the success of treatment with retrograde endoscopic cholangiopancreatography (ERCP). Read More

J Clin Med 2021 Mar 29;10(7). Epub 2021 Mar 29.

Radiology Department, Fondation IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122 Milan, Italy.

Objectives: To evaluate the efficacy and safety of percutaneous transhepatic lithotripsy (PTL) using an electro-hydraulic (EH) system for difficult bile stones.

Methods: We retrospectively evaluated two patients with recurrent cholangitis, jaundice and fever for the presence of difficult bile stones, inaccessible by an endoscopic approach, treated with PTL. Both procedures were conducted using the same protocol, with two different accesses. Read More

Antibiotics (Basel) 2021 Mar 10;10(3). Epub 2021 Mar 10.

Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy.

Percutaneous transhepatic cholangiography (PTC) is an established treatment in the management of biliary strictures. The aim of our study was to determine the incidence of PTC-related infectious complications in transplanted children, and identify their precise aetiol-ogy. We retrospectively reviewed all PTC performed from January 2017 to October 2020 in our center. Read More

Surg Endosc 2021 Mar 31. Epub 2021 Mar 31.

Department of Hepatobiliary Surgery, Chinese PLA Air Force Medical Center Affiliated To Air Force Military Medical University, 30 Fucheng Rd, Beijing, 100142, China.

Background: Although self-expandable mental stents (SEMS) placement is the standard care for relieving obstructive jaundice caused by unresectable malignant biliary stricture, how to maintain stent potency remains an intractable problem. This study was to evaluate the efficacy and safety of endobiliary radiofrequency ablation (RFA) through percutaneous transhepatic cholangiography (PTC) pathway in treating such patients.

Methods: Consecutive patients who were performed endobiliary RFA as well as SEMS placement because of unresectable malignant obstructive jaundice in single institution in recent 8 years were retrospectively reviewed. 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

Case Rep Radiol 2021 9;2021:6677500. Epub 2021 Mar 9.

Integrated IR/DR Residency, PGY-4, Saint Louis University School of Medicine, 3635 Vista Ave., St. Louis, MO 63110, USA.

The development of inoperable biliary obstruction in patients with liver, biliary, and pancreatic neoplasia is commonplace particularly in the advanced stages of these diseases. Under these circumstances, restoring bile flow to the gut is paramount in reestablishing homeostasis. Hitherto, this has been achieved by utilizing passive, gravity-dependent bilioenteric conduits with the use of perforated plastic catheters or metallic stents inserted either in a percutaneous transhepatic fashion or via endoscopic techniques. Read More

Dig Endosc 2021 May 22;33(4):e65-e66. Epub 2021 Mar 22.

Department of Gastroenterology & Hepatology, Université catholique de Louvain, Cliniques universitaires Saint-Luc, Brussels, Belgium.

Surgery 2021 Mar 18. Epub 2021 Mar 18.

HPB Surgery, Hepatology and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori di Milano, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy. Electronic address:

Background: Bile leaks occurring after complex liver resection and lasting >1 week (grade B) usually are managed by means of invasive cholangiography either endoscopic or percutaneous, with a substantial risk of procedure-related complications. The aim of this study was to investigate the ability of gadoxetic acid disodium-enhanced magnetic resonance cholangiography to detect postoperative biliary leaks and avoid invasive cholangiography in case of peripheral location of the fistula.

Methods: Patients with grade B biliary leak after complex liver resection from January 2018 to March 2020 underwent magnetic resonance cholangiography to guide the management of the leak (study group). Read More

Dig Dis 2021 Mar 8. Epub 2021 Mar 8.

Background: In the setting of a naïve papilla, biliary cannulation is a key step in successfully performing endoscopic retrograde cholangiography (ERC). Difficult biliary cannulation (DBC) is associated with an increased risk of post-ERCP-pancreatitis and failure of the whole procedure.

Summary: Recommendations for biliary cannulation can be divided in (a) measures to reduce the likelihood of a difficult papilla-situation a priori and (b) rescue techniques in case the endoscopist is actually facing DBC. Read More

Ann Hepatobiliary Pancreat Surg 2021 Feb;25(1):39-45

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

Backgrounds/aims: Biliary complications continue to be the major morbidity and mortality causes following living donor liver transplantation (LT). Endoscopic retrograde cholangiopancreatography (ERCP) has been performed to identify the biliary leakage source. However, this can lead to retrograde cholangitis and pancreatitis, and is not sufficient to diagnose bile leakage from cuts' surface. Read More

J Int Med Res 2021 Feb;49(2):300060520970741

Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China.

Objective: To study changes in T lymphocyte subsets, cytokines, and liver enzymes in patients with malignant obstructive jaundice (MOJ) before and after external biliary drainage (percutaneous transhepatic cholangiography drainage, PTCD) and internal biliary drainage (percutaneous transhepatic insertion of biliary stents, PTIBS).

Methods: MOJ patients undergoing PTCD (n = 44) and PTIBS (n = 38) at our hospital were enrolled in the study from January 2017 until December 2019. Peripheral blood total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), CD3%, CD4%, CD4/CD8 ratio, interleukin (IL)-2, IL-6, and tumor necrosis factor (TNF)-α were measured before and 1 week after biliary drainage. Read More

Diagn Interv Radiol 2021 Feb 18. Epub 2021 Feb 18.

Department of General Surgery, Inonu University Faculty of Medicine, Malatya, Turkey.

Purpose: Biliary complications develop at a higher rate in living donor liver transplantation (LDLT) compared with cadaveric liver transplantation. Almost all studies about biliary complications after LDLT were made with the right lobe. The aim of this study was to determine the frequency of biliary complications developing after adult left lobe LDLT and to evaluate the efficacy of the algorithm followed in diagnosis and treatment, particularly percutaneous radiological treatment. Read More

World J Hepatol 2021 Jan;13(1):66-79

Department of Interventional Gastroenterology, Acibadem City Clinic Tokuda Hospital, Sofia 1407, Bulgaria.

Liver transplantation is the current standard of care for end-stage liver disease and an accepted therapeutic option for acute liver failure and primary liver tumors. Despite the remarkable advances in the surgical techniques and immunosuppressive therapy, the postoperative morbidity and mortality still remain high and the leading causes are biliary complications, which affect up to one quarter of recipients. The most common biliary complications are anastomotic and non-anastomotic biliary strictures, leaks, bile duct stones, sludge and casts. Read More

J Surg Case Rep 2021 Jan 25;2021(1):rjaa591. Epub 2021 Jan 25.

Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia.

Renal cell carcinoma (RCC) can be an aggressive malignancy that has a propensity to spread to atypical locations, most commonly to lung, bone, lymph node. RCC presenting as obstructive jaundice with gastric outlet obstruction has rarely been cited in literature. This study presents a case of advanced RCC in a patient with obstructive jaundice and associated gastric outlet obstruction from a large right renal RCC with malignant retrocaval lymphadenopathy invading the duodenum and distal common bile duct. Read More

Br J Radiol 2021 Apr 2;94(1120):20200879. Epub 2021 Feb 2.

Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.

Hemorrhagic complications are uncommon after percutaneous transhepatic biliary drainage. The presenting features include bleeding through or around the drainage catheter, hematemesis or melena. Diagnosis requires cholangiography, CT angiography or conventional angiography. Read More

Endosc Ultrasound 2021 Jan-Feb;10(1):51-56

Department of Endoscopy, Institut Paoli-Calmette, Marseille, France.

Background And Objectives: EUS-guided biliary drainage (EUS-BD) has emerged as a complementary technique for primary drainage or as a rescue technique after failed endoscopic retrograde cholangiography. The objective of this study was to demonstrate the feasibility of EUS-BD for malignant hilar stenosis (MHS), both as an initial and rescue procedure.

Patients And Methods: This study was a retrospective work based on a prospective registry of patients with malignant drainage stenosis of the hilum. Read More

Surg Endosc 2021 Jan 4. Epub 2021 Jan 4.

Medizinische Klinik II, Krankenhaus Landshut-Achdorf, Akademisches Lehrkrankenhaus der TU München, Achdorferweg 3, 84036, Landshut, Germany.

Background: In patients with altered upper gastrointestinal anatomy, conventional endoscopic retrograde cholangiography is often not possible and different techniques, like enteroscopy-assisted or percutaneous approaches are required. Aim of this study was to analyze success and complication rates of these techniques in a large collective of patients in the daily clinical practice in a pre-endosonographic biliary drainage era.

Patients And Methods: Patients with altered upper gastrointestinal anatomy with biliary interventions between March 1st, 2006, and June 30th, 2014 in four tertiary endoscopic centers in Munich, Germany were retrospectively analyzed. Read More

Medicine (Baltimore) 2020 Oct;99(44):e22741

Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University.

Percutaneous balloon dilatation for benign biliary-enteric anastomosis stricture has been the most widely used alternative to endoscopic treatment. However, patency results from the precedent literature are inconsistent.The objective of this study was to evaluate the safety and feasibility of repeated balloon dilatation with long-term biliary drainage for the treatment of benign biliary-enteric anastomosis strictures. Read More

Rev Esp Enferm Dig 2020 Dec;112(12):893-897

Gastroenterology, the Second Affiliated Hospital of Soochow University.

Introduction: both percutaneous transhepatic cholangiography and drainage (PTCD) and endoscopic retrograde cholangiopancreatography (ERCP) with SEMS implantation have been used for unresectable hilar cholangiocarcinoma (HC) in the clinic for many years. However, which one is preferred is still unknown.

Objective: to study the effects of biliary drainage of self-expanding metal stents (SEMS) implantation under PTCD or ERCP to treat HC. Read More

Turk J Gastroenterol 2020 09;31(9):614-619

Department of Gastroenterology, İnönü University School of Medicine, Malatya, Turkey.

Background/aims: Although living donor liver transplantation (LDLT) has been accepted as a primary treatment for adults with end-stage liver disease, concerns about donor health have been emerged. As LDLT is technically complex, it creates perioperative morbidity and mortality risk in donors. Biliary complications such as stricture and leakage are seen most frequently in donors after liver transplantation. Read More

Eur Radiol 2021 May 13;31(5):3035-3041. Epub 2020 Oct 13.

Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.

Objectives: The aim of this study was to compare success, technical complexity, and complication rates of percutaneous transhepatic biliary drainage (PTBD) in patients with dilated vs. nondilated bile ducts.

Methods: In a retrospective analysis, we evaluated all consecutive PTBD performed in our department over a period of 5 years. Read More

PLoS One 2020 9;15(10):e0240219. Epub 2020 Oct 9.

Department of Internal Medicine, Wonkwang University College of Medicine and Hospital, Iksan, Republic of Korea.

Objectives: Endoscopic transpapillary gallbladder drainage (ETGBD) has been proposed as an alternative to surgery or percutaneous cholecystostomy in patients with acute calculus cholecystitis (ACC). We aimed to evaluate the safety and efficacy of ETGBD via endoscopic transpapillary gallbladder stenting (ETGBS) or endoscopic naso-gallbladder drainage (ENGBD) as either a bridging or a definitive treatment option for patients with ACC when a cholecystectomy is delayed or cannot be performed.

Methods: From July 2014 to December 2018, 171 patients with ACC in whom ETGBD were attempted were retrospectively reviewed. Read More