Intrabiliary radiofrequency-enhanced local chemotherapeutic deposit in bile duct walls using a needle-integrated balloon catheter: A feasibility study on survival pigs

2017 ◽  
Vol 28 (2) ◽  
pp. S105-S106
Author(s):  
F Zhang ◽  
J Gao ◽  
Y JIN ◽  
S Jingjing ◽  
F Xiong ◽  
...  
Keyword(s):  
Bile Duct ◽  
Feasibility Study ◽  
Balloon Catheter

scholarly journals P11: NEAR INFRARED FLUORESCENT CHOLANGIOGRAPHY IN LAPAROSCOPIC CHOLECYSTECTOMY: A SINGLE CENTRE FEASIBILITY STUDY. THE OPTIMUM DOSING REGIME, LIMITATIONS AND WHERE NEXT?

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
G Armstrong ◽  
G Toogood ◽  
DG Jayne ◽  
AM Smith
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Indocyanine Green ◽  
Feasibility Study ◽  
Near Infrared ◽  
Intravenous Dose ◽  
Structure Identification ◽  
Dosing Regimen ◽  
Single Centre ◽  
Fluorescent Cholangiography

Abstract Introduction This study explored near-infrared fluorescent cholangiography (NIRFC) with Indocyanine Green (ICG) during laparoscopic cholecystectomy (LC) surgery in a tertiary referral hepatobiliary unit. ICG binds to albumin and is excreted in bile. NIRFC utilises the fluorescent and excretory properties of ICG to provide dynamic extrahepatic bile duct mapping during LC. Method Non-randomised single centre feasibility study. Twenty-two participants were sequentially allocated to four dosing subgroups prior to NIRFC assisted LC. Each received a single intravenous dose of ICG prior to LC with the Stryker Novadaq NIR laparoscope. The biliary anatomy was assessed with NIRFC at three time-points, detection was compared to radiological cholangiogram where available and surgeon satisfaction was assessed. Result Eight participants received 2.5mg ICG 20-40min before surgery, four 0.25mg/kg 20-40min, five 90min – 180min and five 12 – 36 hour pre-operatively. Average age 50 years (S.D±15), BMI 27.5m2 (S.D±3.6), 6/22 were acute LC procedures. The prolonged dosing interval produced increased extrahepatic biliary structure identification (p = 0.016), reduced noise to signal ratio and was consistently preferred by the operating surgeon. NIRFC was inferior to radiological cholangiogram (n = 10) (p = 0.014) for bile duct mapping. We observed iatrogenic bile spillage saturating the field and obscuring structure differentiation and peri-hilar inflammation impeding fluorescent detection in acute LC. Conclusion The dosing regimen 0.25mg/kg ICG 12 to 36 hours prior to surgery provides optimum NIRFC structure visualisation. Fluorescent tissue penetrance is limited in acute peri-hilar inflammation. More research in to the efficiency of NIRFC in emergency LC is required. Take-home message An intravenous dose of 0.25mg/kg of Indocyanine Green 12 to 36 hours before surgery is the optimum dosing regimen for increased extra-hepatic bile duct structures with near infrared fluorescent cholangiography. The role of NIRFC in acute laparoscopic cholecystectomy surgery remains ill-defined.

scholarly journals Gallstone Ileus following Endoscopic Stone Extraction

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yoshiya Yamauchi ◽  
Noritaka Wakui ◽  
Yasutsugu Asai ◽  
Nobuhiro Dan ◽  
Yuki Takeda ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Gallstone Ileus ◽  
Balloon Catheter ◽  
Common Bile Duct Stones ◽  
Abdominal Distension ◽  
Abdominal Ultrasonography ◽  
Stent Occlusion ◽  
Plastic Stent ◽  
Rosai Hospital

An 85-year-old woman was an outpatient treated at Tokyo Rosai Hospital for cirrhosis caused by hepatitis B. She had previously been diagnosed as having common bile duct stones, for which she underwent endoscopic retrograde cholangiopancreatography (ERCP). However, as stone removal was unsuccessful, a plastic stent was placed after endoscopic sphincterotomy. In October 2012, the stent was replaced endoscopically because she developed cholangitis due to stent occlusion. Seven days later, we performed ERCP to treat recurring cholangitis. During the procedure, the stone was successfully removed by a balloon catheter when cleaning the common bile duct. The next day, the patient developed abdominal pain, abdominal distension, and nausea and was diagnosed as having gallstone ileus based on abdominal computed tomography (CT) and abdominal ultrasonography findings of an incarcerated stone in the terminal ileum. Although colonoscopy was performed after inserting an ileus tube, no stone was visible. Subsequent CT imaging verified the disappearance of the incarcerated stone from the ileum, suggesting that the stone had been evacuated naturally via the transanal route. Although it is extremely rare for gallstone ileus to develop as a complication of ERCP, physicians should be aware of gallstone ileus and follow patients carefully, especially after removing huge stones.

scholarly journals Differentiated approach of using extraction balloon catheters in endoscopic biliary surgery

2021 ◽  
Vol 26 (3) ◽  
pp. 123-134
Author(s):  
A. E. Kotovskiy ◽  
B. M. Magomedova ◽  
K. G. Glebov ◽  
A. A. Martyntsov ◽  
A. K. Mahmudova ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
Balloon Catheter ◽  
Main Function ◽  
Biliary Surgery ◽  
Benign Diseases ◽  
Balloon Catheters ◽  
Tumor Lesion ◽  
Endoscopic Extraction ◽  
Design Characteristics

Aim. Expand and determinate indications for using of extraction balloon catheters in endoscopic biliary surgery, as an additional and auxiliary endoscopic technique, which optimizes the technical conditions for performing medical and diagnostic tasks.Material and methods. We used disposable two- and three-lumen extraction balloon catheters with a diameter of 7.5 Fr. The catheters assumed delivery of an extractor balloon along a conductor with a diameter of 0.35 in into the bile duct, and also made it possible to inject a radiopaque substance. 136 retrograde endoscopic interventions were performed on the bile ducts using extraction balloon catheters.Research results. Indications for the use of an extractor balloon have been determined and proposed as a conventional standard. Interventions on the bile ducts were carried out using only a balloon catheter and in combination with a Dormia basket (n = 61). An extraction balloon catheter was used during retrograde endoscopic intervention on the bile ducts as an additional diagnostic endoscopic manipulation to facilitate the performance of the diagnostic task (n = 38). The device was also used to optimize the technical conditions of medical and diagnostic tasks (n = 37). 116 patients had benign diseases, 20 patients had tumor lesion.Сonclusion. The main function of an extraction balloon catheter is to move or displace the contents from the proximal to the distal parts of the bile duct, followed by its extraction into the duodenum. The design characteristics of the instrument make it possible to significantly expand the indications for its use, including not for its intended purpose, but as an additional method, optimizes the technical conditions for performing medical and diagnostic tasks. The endoscopic extraction balloon catheter is a multipurpose instrument that can be used to solve both diagnostic and therapeutic tasks of retrograde interventions on the bile ducts.

scholarly journals Common bile duct stone development due to a Hem-o-lok clip migration: a rare complication of laparoscopic cholecystectomy

2019 ◽  
Vol 12 (7) ◽  
pp. e230178
Author(s):  
Yong Jun Roh ◽  
Jong Whan Kim ◽  
Tae Joo Jeon ◽  
Ji Young Park
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Stone Formation ◽  
Rare Complication ◽  
Acute Cholangitis ◽  
Balloon Catheter ◽  
Wall Thickening ◽  
Surgical Clip ◽  
Upper Abdominal

Surgical clip migration is a rare complication of laparoscopic cholecystectomy (LC). Surgical clips migrating into the common bile duct (CBD) can lead to stone formation and obstruction. Here, we report a case of acute cholangitis caused by surgical Hem-o-lok clip migration into the bile duct with stone formation 13 months after LC. A 65-year-old man who underwent LC presented with upper abdominal pain and fever for 3 days. Abdominal CT scan showed a radiopaque material in the CBD, diffuse wall thickening and dilatation of intrahepatic and extrahepatic duct. Emergency percutaneous transhepatic biliary drainage was performed. Twodays later, an endoscopic retrograde cholangio-pancreatography was implemented, and muddy stones and one surgical clip were successfully removed by extraction balloon catheter.

Percutaneous Transhepatic External Biliary Drainage Utilizing a Pig Tail Balloon Catheter

1994 ◽  
Vol 35 (5) ◽  
pp. 509-511
Author(s):  
S. Karstrup ◽  
T. Mygind ◽  
V. Hennild
Keyword(s):  
Bile Duct ◽  
Internal Fixation ◽  
Biliary Drainage ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Balloon Catheter ◽  
External Drainage ◽  
Catheter Dislodgement ◽  
External Biliary Drainage ◽  
Transhepatic Biliary Drainage

A 2.3-mm soft pig tail balloon catheter was developed to be used for percutaneous transhepatic biliary drainage. A small balloon (OD 10 mm) secures an optimal internal fixation and side holes behind the balloon secure drainage of the cannulated bile duct peripheral to the balloon. Successful transhepatic biliary drainage with the pig tail balloon catheter was achieved in 11 of 12 patients for a period of 3 to 67 days (median 6 days). In one patient the catheter clogged after 55 days of drainage. No case of catheter dislodgement or other complications related to the external drainage was seen.

scholarly journals Balloon Catheter Dilatation of Stenotic Common Bile Duct Anastomoses in the Pig

1987 ◽  
Vol 28 (1) ◽  
pp. 115-120
Author(s):  
Ulf Nilsson ◽  
L. Ekelund ◽  
L.-E. Hammarström ◽  
T. Holmin ◽  
N. Jonsson
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Catheter ◽  
Catheter Dilatation

scholarly journals Choledochoplasty by Vein Grafts in Iatrogenic Bile Duct Injuries

HPB Surgery ◽  
1992 ◽  
Vol 5 (3) ◽  
pp. 195-202 ◽  
Author(s):  
Aws S. Salim
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Balloon Catheter ◽  
Tissue Loss ◽  
Stricture Formation ◽  
Vein Grafts ◽  
Bile Duct Injuries ◽  
Considerable Morbidity

The quality of immediate repair of common bile duct injuries with or without tissue loss occurring during elective cholecystectomy is crucial and maybe the sole factor behind future stricture formation with its considerable morbidity and mortality. Successful repair of iatrogenic common bile duct injuries has been achieved by immediate saphenous vein grafts in two patients with cystic duct avulsion, in one patient whose duct was split by a balloon catheter, and in one patient where a segment of the duct was resected. Follow-up for 5 years demonstrated that the grafting remained sound and produced no complications. Consequently, the immediate repair of iatrogenic bile duct injuries using vein grafts deserves consideration.

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