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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

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

2Memorial 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

Transplant Proc 2018 Dec 10;50(10):3673-3680. Epub 2018 Sep 10.

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

Background: Multidetector computerized tomography (MDCT) is considered to be a fast noninvasive diagnostic technique for the evaluation of postoperative complications in patients with liver transplantation (LT). However, its role has not been fully established in the diagnosis for detecting complications after liver transplantation. The aim of this work was to evaluate the diagnostic performance of MDCT for detecting abdominal complications in the early and late periods after LT. Read More

Radiology 2019 Jan;290(1):262-263

1 From the Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608.

History A 70-year-old man presented to the emergency department with fever, chills, rigors, and upper abdominal discomfort. Physical examination revealed jaundice and mild right upper quadrant tenderness. Laboratory tests revealed an increased C-reactive protein level of 133 mg/L (normal range, 0. Read More

Rofo 2018 Dec 18. Epub 2018 Dec 18.

Purpose:  Percutaneous treatment of biliary leaks is frequently required, yet technically challenging and limited to smaller fistulas. This study sought to evaluate the off-the-shelf use of the ArtVentive EOS device for the occlusion of biliary or cystic stump leaks.

Materials And Methods:  ePTFE-covered ArtVentive EOS devices were used to perform biliary leak embolization in 5 explanted porcine livers and in 3 explanted bovine livers. Read More

Endoscopy 2018 Dec 14. Epub 2018 Dec 14.

Radiologische Universitätsklinik, Universitätsklinikum Tübingen, Tübingen, Germany.

Tech Vasc Interv Radiol 2018 Dec 30;21(4):249-254. Epub 2018 Jul 30.

Department of Interventional Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC.

Percutaneous biliary interventions have a well-established role in the management of hepatobiliary diseases. Good outcomes include recognizing and avoiding complications. This section will cover the "standard" technique of percutaneous biliary drainage, pearls to decrease the risk of problems, and approaches to treat those complications in patients undergoing percutaneous transhepatic cholangiography and percutaneous transhepatic biliary drainage. Read More

Obes Surg 2018 Dec 11. Epub 2018 Dec 11.

Service de Chirurgie Générale et Endocrinienne, CHU Lille, Hôpital Huriez, Rue Michel Polonowski, 59000, Lille, France.

Background: The incidence of biliary lithiasis is increased after bariatric surgery due to rapid weight loss [1]. Trans-oral endoscopic management in cases of common bile duct gallstone complication is not possible in patients with Roux-en-Y gastric bypass (RYGB) due to the modified anatomy. Access to the biliary tree after RYGB with a classical direct surgical approach of common bile duct and choledocoscopy can be used, but may be complicated in situations of acute cholangitis because of the fragility of common duct, or in cases of previous cholecystectomy. Read More

Clin J Gastroenterol 2018 Nov 29. Epub 2018 Nov 29.

Department of Surgery, School of Medicine, İzmir Katip Çelebi University, İzmir, Turkey.

Heterotopic tissue in the bile duct is a very rare condition. There are a few case reports of heterotopic tissue including gastric and pancreatic cells. However, we could not find any data regarding heterotopic chondroid tissue obstructing the common bile duct in the literature. Read More

Radiologe 2018 Dec;58(12):1099-1114

Kinderradiologie im Dr. von Haunerschen Kinderspital der Radiologischen Klinik und Poliklinik, Ludwig-Maximilian-Universität München, München, Deutschland.

Upper abdominal pain, icterus and cholestasis are the symptoms leading to evaluation of the biliary tract. Together with its complications biliary stone disease is the main reason for inflammation of the biliary system. A distinction is made between acute and chronic variants. Read More

Respirol Case Rep 2018 Dec 25;6(9):e00376. Epub 2018 Oct 25.

Department of Hepatogastroenterology Shin Kong Wu Ho-Su Memorial Hospital Taipei Taiwan.

For hepatocellular carcinomas, radiofrequency ablation is extensively used to alleviate primary and metastatic hepatic tumours. Common complications of this procedure include bleeding, infection, and hollow organ perforation. We present the case of a patient with hepatoma who underwent radiofrequency ablation. Read More

J Med Case Rep 2018 Oct 27;12(1):314. Epub 2018 Oct 27.

Department of Medical Laboratory, National Hospital Organization Kanazawa Medical Center, 1-1 Shimoishibiki, Kanazawa, 920-8650, Japan.

Background: Most colorectal cancer liver metastases form nodules within the hepatic parenchyma, and hepatectomy is the only radical treatment for synchronous metastases. There is concern about intrabiliary tumor growth which may affect the surgical margin, resulting in local recurrence after hepatectomy for colorectal cancer liver metastasis; however, there has been no report of the dissemination in the bile duct after hepatectomy. Here, we report an unusual case of biliary dissemination of colorectal cancer that caused recurrent intrabiliary growth after hepatectomy, and discuss the management of intrabiliary metastasis of colorectal cancer. Read More

Liver Int 2018 Oct 26. Epub 2018 Oct 26.

Department for Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf.

Background & Aims: Biliary strictures are common complications after orthotopic liver transplantation (OLT). Endoscopic retrograde cholangiography (ERC) evolved as standard and percutaneous transhepatic cholangiodrainage (PTCD) as alternative therapy. This study analysed predictors of long-term success of biliary strictures after ERC and/or PTCD and its impact on patient survival. 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

Cureus 2018 Jul 24;10(7):e3037. Epub 2018 Jul 24.

General Surgery, Hacettepe University, Ankara, TUR.

An undifferentiated embryonal sarcoma of the liver (UESL) is a rare and highly malignant mesenchymal neoplasm that is uncommonly observed in adults. We report a case of UESL found in a 26-year-old female. Our case was initially regarded as a type II hydatid cyst and then a malignant mass in radiological studies. Read More

J Laparoendosc Adv Surg Tech A 2018 Sep 25. Epub 2018 Sep 25.

1 Department of General Surgery and Surgical Specialties "Paride Stefanini," Sapienza University of Rome , Rome, Italy .

Purpose: Bile duct injuries (BDIs) are more frequent during laparoscopic cholecystectomy (LC). Several BDI classifications are reported, but none encompasses anatomy of damage and vascular injury (A), timing of detection (To), and mechanism of damage (M). Aim was to apply the ATOM classification to a series of patients referred for BDI management after LC. Read More

BMC Surg 2018 Sep 24;18(1):76. Epub 2018 Sep 24.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan.

Background: We experienced a rare case of benign arterial stricture of the right posterior hepatic artery (RPHA) caused by atherosclerosis in a patient with hilar cholangiocarcinoma.

Case Presentation: A 75-year-old man was referred to our hospital for the detailed investigation of serum hepatobiliary enzyme elevation. The patient had a history of hypertension, type 2 diabetes mellitus, and an operative history of coronary artery bypass grafting 10 years before. Read More

World J Gastroenterol 2018 Sep;24(33):3799-3805

Department of Interventional Medicine, The Second Hospital of Shandong University, Jinan 250033, Shandong Province, China.

Aim: To evaluate the clinical efficacy and safety of an innovative percutaneous transhepatic extraction and balloon dilation (PTEBD) technique for clearance of gallbladder stones in patients with concomitant stones in the common bile duct (CBD).

Methods: The data from 17 consecutive patients who underwent PTEBD for clearance of gallbladder stones were retrospectively analyzed. After removal of the CBD stones by percutaneous transhepatic balloon dilation (PTBD), the gallbladder stones were extracted to the CBD and pushed into the duodenum with a balloon after dilation of the sphincter of Oddi. Read More

Niger J Clin Pract 2018 Sep;21(9):1121-1126

Division of Hematology and Medical Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea.

Background: Despite many attempts to improve the patency rate of biliary stents in patients with inoperable perihilar cholangiocarcinomas, the longevity of these stents has not been satisfactory. The purpose of the present study is to report technical outcomes and clinical efficacy of the placement of compound tri-metal stent in patients with malignant perihilar biliary obstruction.

Materials And Methods: Retrospective analysis was performed of the medical records of 26 consecutive patients with inoperable malignant perihilar biliary obstruction who underwent compound tri-metal stent placement through a percutaneous transhepatic biliary drainage tube from January 2012 to April 2017. Read More

Rev Med Suisse 2018 Aug;14(615):1443-1447

Service de gastroentérologie, CHU Sart-Tilman, 4000 Liège, Belgique.

The incidence of pancreatic cancer is increasing, but proportion of resectable cases and survival do not increase. Then, our care strategies have to be optimized. Chemotherapy is the principal treatment of locally advanced pancreatic cancer. Read More

Yonsei Med J 2018 Sep;59(7):904-907

Department of Pediatrics, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.

Inspissated bile syndrome (IBS) is a relatively rare condition. Many treatment options are available, including medication, surgery, and surgical interventions, such as insertion of cholecystostomy drain, endoscopic retrograde cholangiopancreatography, internal biliary drainage, and percutaneous transhepatic biliary drainage (PTBD). We herein report the first case of IBS that was successfully treated with PTBD in a two-month-old infant in Korea. Read More

Curr Med Sci 2018 Feb 15;38(1):137-143. Epub 2018 Mar 15.

Department of Pediatrics, Wuhan, 430030, China.

The different methods in differentiating biliary atresia (BA) from non-BA-related cholestasis were evaluated in order to provide a practical basis for a rapid, early and accurate differential diagnosis of the diseases. 396 infants with cholestatic jaundice were studied prospectively during the period of May 2007 to June 2011. The liver function in all subjects was tested. Read More

Acta Gastroenterol Belg 2018 Apr-Jun;81(2):283-287

Inonu University Medical Faculty, Department of General Surgery, Liver Transplantation Institute, Malatya, Turkey.

Background And Aim: Biliary complications are an important cause of mortality and morbidity after living donor liver transplantation (LDLT). We present our endoscopic treatment results after LDLT as a single center with high volume.

Methods: Patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) after LDLT between 2005 and 2015 were included. Read More

Chirurgia (Bucur) 2018 May-Jun;113(3):291-299

The management of infected pancreatic necrosis has historically been based on early, open necrosectomy, associated with significant mortality. In recent years, an evidence based transformation has occurred towards the step-up approach consisting of percutaneous catheter drainage, if necessary, followed by minimally invasive necrosectomy. More recently the endoscopic step-up approach has gained popularity. Read More

Medicine (Baltimore) 2018 Jun;97(26):e11234

Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

Bile is aseptic; under conditions of no external influx, there is a less than 30% chance of isolating bacteria even in acute cholecystitis. This study was conducted to evaluate the incidence of biliary microflora and most common biliary microflora and resistance to antibiotics in patients with cholecystitis, as well as predict situations that do not require the use of prophylactic antibiotics.Bile samples were collected for culture using standard methods during all cholecystectomies performed from January 2015 to December 2015 in the Department of Surgery, Pusan National University Hospital. Read More

Clin J Gastroenterol 2018 Dec 8;11(6):493-496. Epub 2018 Jun 8.

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

An 87-year-old man was admitted to our hospital due to fever and elevated liver enzymes. Computed tomography (CT) scan revealed bile duct stones with a dilated biliary system, which confirmed the diagnosis of cholangitis. A 12-cm simple hepatic cyst was also seen in the right liver, which had been detected on CT scan 5 years before, and did not change in size. Read More

Surg Case Rep 2018 Jun 19;4(1):61. Epub 2018 Jun 19.

Department of Hepatobiliary and Pancreatic Surgery, Gunma University, Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.

Background: Bile leakage after hepatectomy still causes relatively serious problems, and some types of bile leakage are intractable.

Case Presentation: We report a case of postoperative isolated bile duct leakage managed successfully by combination therapy of percutaneous transhepatic portal vein embolization (PTPE) and bile duct ablation with ethanol. A 61-year-old man diagnosed with hepatocellular carcinoma underwent partial hepatectomy. Read More

Cardiovasc Intervent Radiol 2018 Jun 5. Epub 2018 Jun 5.

Department of Radiology, Lyon Faculty of Medecine-UCLB1, Centre Hospitalier de la Croix-Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France.

Purpose: To assess the effectiveness of percutaneous radiological treatment for complex biliary leaks compared to simple biliary leaks.

Materials And Methods: We retrospectively analyzed 101 percutaneous treatments for bile leak performed from January 1994 to January 2012. Sixty (59%) bile leaks were classified as simple and 41 (41%) as complex based on a morphological classification that considered eight types of biliary wound on cholangiography images. Read More

Pediatr Surg Int 2018 Aug 5;34(8):897-901. Epub 2018 Jun 5.

Department of Gastroenterology, Nanjing Drum Tower Hospital, Nanjing, 210008, China.

Congenital biliary dilatation (CBD) is usually associated with complications such as recurrent cholangitis, manifested as abdominal pain, vomiting, and jaundice. If cholangitis cannot be controlled by conservative treatment, a good therapeutic effect can be obtained through percutaneous biliary drainage or open T-tube drainage. We aimed to evaluate our experiences in biliary drainage through endoscopic retrograde cholangiopancreatography in children with cholangitis caused by CBD. Read More

Transplant Direct 2018 May 23;4(5):e347. Epub 2018 Apr 23.

Division of Transplant Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Science Center, Memphis, TN.

Background: Biliary strictures (BS) are common complication after liver transplantation. We aimed to determine the accuracy of magnetic resonance cholagiopancreatography (MRCP) in diagnosing BS in liver transplant recipients (LTRs) when compared to direct cholangiographic methods (endoscopic resonance cholagiopancreatography [ERCP] and/or percutaneous transhepatic cholangiography [PTC]).

Methods: Retrospective chart review of 910 LTRs (July 2008 to April 2015) was performed, and a total of 39 patients with duct-to-duct anastomosis (22 males; 56. Read More

Korean J Gastroenterol 2018 05;71(5):247-252

Division of Gastroenterology, Department of Internal Medicine, Soon Chun Hyang University Seoul Hospital, Soon Chun Hyang University College of Medicine, Seoul, Korea.

Intrahepatic duct (IHD) stone is the presence of calculi within the intrahepatic bile duct specifically located proximal to the confluence of the left and right hepatic ducts. This stone is characterized by its intractable nature and frequent recurrence, requiring multiple therapeutic interventions. Without proper treatment, biliary strictures and retained stones can lead to repeated episodes of cholangitis, liver abscesses, secondary biliary cirrhosis, portal hypertension, and death from sepsis or hepatic failure. Read More

Khirurgiia (Mosk) 2018(4):41-45

N.V. Sklifosovskii Research Institute for Emergency Medicine of Moscow Healthcare Department, Moscow, Russia.

Purpose Of The Study: Comparison of the methods of surgical treatment of cholelithiasis.

Material And Methods: The work is based on the experience of treating 139 patients with acute cholecystitis complicated by choledocholithiasis from 2008 to 2016, who were on treatment of the department of acute surgical diseases of the liver and pancreas, N.V. Read More

Clin Res Hepatol Gastroenterol 2018 Apr 20. Epub 2018 Apr 20.

Department of Medicine, Marienhausklinik St. Josef Kohlhof, 66539 Neunkirchen, Germany; Department of Medicine II, Saarland University Medical Center, Saarland University, 66421 Homburg, Germany. Electronic address:

There is an increasing rivalry between percutaneous transhepatic (PTBD) vs. endoscopic ultrasound-guided biliary drainage (EUS-BD) as rescue techniques after failed endoscopic retrograde cholangiography (ERC) access. While EUS-BD procedures hold a bright future, innovations in PTBD technique are still possible and clinically meaningful, at least so, under the a conceptual framework understanding PTBD as a bridging, anatomy-respecting technology for definitive biliary metal stenting. Read More

Surg Laparosc Endosc Percutan Tech 2018 Jun;28(3):183-187

Departments of Gastrointestinal Endoscopy.

Aim: The goal of the study is to compare the efficacy and safety of bile duct drains guided by endoscopic ultrasound-guided biliary drainage (EGBD) versus percutaneous transhepatic biliary drainage (PTBD).

Materials And Methods: Retrospective comparative study. Patients with obstruction of the bile duct who underwent the EGBD or PTBD procedure and had at least 1 previous endoscopic retrograde cholangiopancreatography that failed or was inaccessible to the second duodenal portion were included. Read More

Saudi J Gastroenterol 2018 Mar-Apr;24(2):82-86

Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.

Background/aims: Metal stent insertion is a common palliative treatment for distal malignant biliary obstruction (MBO) but whether placement across the sphincter of Oddi (SO) causes more complications or shorter survival is in question. The aim of this study was to compare the clinical outcomes of percutaneous uncovered self-expandable metal stent placement above and across the SO in patients with distal MBO.

Patients And Methods: We retrospectively studied 59 patients who underwent uncovered metal stent placement for distal MBO between January 2012 and March 2016. Read More

Gastrointest Endosc 2018 08 30;88(2):277-282. Epub 2018 Mar 30.

Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.

Background And Aims: ERCP-guided biliary drainage (ERCP-BD) is a criterion standard treatment for malignant biliary obstruction when curative surgery is not an option. Alternative methods such as percutaneous transhepatic biliary drainage would significantly lower the quality of life. EUS-guided biliary drainage (EUS-BD) has been developed and performed by experienced endoscopists. Read More

Acta Gastroenterol Belg 2017 Apr-Jun;80(2):249-255

University Hospital of Ghent, Department of Interventional Radiology, De Pintelaan 185, 9000 Ghent, Belgium.

Background And Study Aims: Obstructive jaundice caused by metastatic disease leads to deterioration of general condition and short survival time. Successful decompression can offer symptom control and enable further treatment with chemotherapy, which can improve survival.

Patients And Methods: Ninety-nine percutaneous transhepatic cholangiography (PTC) procedures with metallic stent placement were performed in 93 patients between 2007 and 2013. Read More

Surg Oncol 2018 Mar 30;27(1):82-87. Epub 2017 Dec 30.

Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Keimyung University School of Medicine, Dongsan Medical Center, 56 Dalsungro, Junggu, Daegu City, Republic of Korea.

Background: Ampulla of Vater (AOV) carcinoma is a rare malignancy but has a relatively good prognosis. The aims of this study were to determine the clinicopathologic factors associated with survival and disease recurrence in patients with AOV cancer, focusing on the impact of preoperative endoscopic retrograde cholangiopancreatography (ERCP) and type of biliary drainage (endoscopic retrograde biliary drainage [ERBD] or percutaneous transhepatic biliary drainage [PTBD]).

Methods: We retrospectively reviewed the medical records of 80 patients who underwent curative resection for AOV cancer at a single institution between 1995 and 2015. Read More

J Vasc Interv Radiol 2018 05 13;29(5):676-687. Epub 2018 Mar 13.

Hepatobiliary and Pancreatic Unit, General and Digestive Surgery Department, Hospital Clõnico Universitario de Valencia, Valencia, Spain.

Purpose: To compare postoperative complications in patients who underwent pancreatoduodenectomy after either endoscopic or percutaneous biliary drain (BD).

Material And Methods: Data from studies comparing the rate of postoperative complications in patients who underwent endoscopic BD or percutaneous BD before pancreatoduodenectomy were extracted independently by 2 investigators. The primary outcome compared in the meta-analysis was the risk of postoperative complications. Read More

Korean J Intern Med 2018 07 14;33(4):705-715. Epub 2018 Mar 14.

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Background/aims: Biliary complications are the most common donor complication following living donor liver transplantation (LDLT). The aim of this study is to investigate the long-term outcomes of biliary complications in right lobe adult-to-adult LDLT donors, and to evaluate the efficacy of endoscopic treatment of these donors.

Methods: The medical charts of right lobe donors who developed biliary complications between June 2000 and January 2008 were retrospectively reviewed. Read More

Rev Gastroenterol Peru 2017 Oct-Dec;37(4):350-356

Universidad Privada del Norte. Lima, Perú.

Iatrogenic bile duct injuries (IBDI) represent a serious surgical complication of laparoscopic cholecystectomy (LC). Often it occurs when the bile duct merges with the cystic duct; and they have been ranked by Strasberg and Bismuth, depending on the degree and level of injury. About third of IBDI recognized during LC, to detect bile leakage. Read More

GE Port J Gastroenterol 2018 Jan 11;25(1):10-17. Epub 2017 Oct 11.

Serviço de Gastrenterologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Background And Aims: Biliary tract complications following liver transplant remain an important source of morbidity and mortality. Endoscopic retrograde cholangiopancreatography (ERCP) has become a common therapeutic option before other invasive procedures. The aim of this study was to evaluate ERCP efficacy in managing this type of complications. Read More

Trials 2018 Feb 14;19(1):108. Epub 2018 Feb 14.

Division of Gastroenterology, Vanderbilt University, Nashville, TN, USA.

Background: The optimal approach to the drainage of malignant obstruction at the liver hilum remains uncertain. We aim to compare percutaneous transhepatic biliary drainage (PTBD) to endoscopic retrograde cholangiography (ERC) as the first intervention in patients with cholestasis due to suspected malignant hilar obstruction (MHO).

Methods: The INTERCPT trial is a multi-center, comparative effectiveness, randomized, superiority trial of PTBD vs. Read More

BMJ Case Rep 2018 Feb 8;2018. Epub 2018 Feb 8.

Department of Internal Medicine, Michigan State University, Lansing, Michigan, USA.

An 82-year-old Caucasian woman with a history of basal cell carcinoma on vismodegib presented with nausea, vomiting and intermittent abdominal pain. Laboratory results were remarkable for the elevation of liver enzymes. Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiogram (PTC) did not show evidence of intrahepatic or extrahepatic obstruction of the biliary tract. Read More

Digestion 2018 9;97(3):267-274. Epub 2018 Feb 9.

Background: Bile duct stones (BDS) are usually removed via endoscopic retrograde cholangiopancreatography (ERCP) or, if ERCP remains unsuccessful, percutaneous transhepatic cholangiodrainage (PTCD). However, PTCD provides limited access to large BDSs. We analyzed a modified approach of PTCD for percutaneous therapy of BDS. Read More

Hepatobiliary Pancreat Dis Int 2018 Feb 31;17(1):49-54. Epub 2018 Jan 31.

Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, Munich 81675, Germany. Electronic address:

Background: Occlusion of self-expanding metal stents (SEMS) in malignant biliary obstruction occurs in up to 40% of patients. This study aimed to compare the different techniques to resolve stent occlusion in our collective of patients.

Methods: Patients with malignant biliary obstruction and occlusion of biliary metal stent at a tertiary referral endoscopic center were retrospectively identified between April 1, 1994 and May 31, 2014. Read More

J Gastroenterol Hepatol 2018 Jul 30;33(7):1413-1421. Epub 2018 Mar 30.

Aichi Cancer Center Hospital, Nagoya, Japan.

Background And Aim: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is performed as an alternative to the percutaneous or surgical approach. Despite high success rates, the adverse events rate is high. Recently, we used 6-mm fully covered self-expandable metal stents to prevent adverse events and allow easy re-intervention. Read More

Dig Endosc 2018 Jul 26;30(4):501-507. Epub 2018 Feb 26.

Department of Surgery, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.

Background And Aim: Percutaneous transhepatic drainage is the most common method for non-operative gallbladder drainage, but the technique does have several disadvantages because of its invasive nature and requirement for continuous drainage. To overcome these disadvantages, we developed a novel procedure, endoscopic gallbladder lavage followed by stent placement, carried out in a single endoscopic session. Our aim was to prospectively evaluate the efficacy and safety of this procedure in patients with acute cholecystitis. Read More

Turk J Gastroenterol 2018 01;29(1):123-125

Department of Gastroenterology, SUNY Downstate Medical Center, New York, USA.