scholarly journals Flushable Exo-Endodrainage: A Modified Palliative Approach to Non-Resectable Malignant Biliary Obstruction

HPB Surgery ◽  
1993 ◽  
Vol 7 (1) ◽  
pp. 25-32
Author(s):  
M. Stierer ◽  
H. Wasl ◽  
H. R. Rosen ◽  
A. P. Marczell ◽  
H. Spoula
Keyword(s):  
Bile Duct ◽  
Biliary Obstruction ◽  
Extrahepatic Bile Duct ◽  
Imaging Techniques ◽  
Necrotizing Pancreatitis ◽  
Malignant Biliary Obstruction ◽  
Palliative Resection ◽  
The Other ◽  
High Complication Rate ◽  
Acute Necrotizing

The introduction of new imaging techniques has markedly improved the diagnosis of hepatobiliary disorders. Due to their anatomic situation, a substantial percentage of malignancies located near the hilus is not suitable for surgical management. We discuss an effective palliative intervention to relieve jaundice. In many instances drainage is a superior choice when biliodigestive anastomoses are not technically feasible and palliative resection carries a high complication rate.We present an irrigatable exo-endodrainage method employing a modified port-a-cath system as a new alternative. In four patients, all older than 75 years, this system was implanted because of jaundice due to unresectable malignant stenosis of the extrahepatic bile duct. One patient (80 years old) died of pre-existing acute necrotizing pancreatitis, although hyperbilirubinemia was found to decrease on the 7th postoperative day. The other three patients showed complete normalization of their bilirubin levels and their port-a-cath systems remained open until their death (at 3 weeks, 6 months and 7 months respectively).

Extrahepatic Bile Duct Carcinoid Tumors: Malignant Biliary Obstruction with a Good Prognosis

2007 ◽  
Vol 205 (2) ◽  
pp. 357-361 ◽  
Author(s):  
Cristina R. Ferrone ◽  
Laura H. Tang ◽  
Michael D’Angelica ◽  
Ronald P. DeMatteo ◽  
Leslie H. Blumgart ◽  
...  
Keyword(s):  
Bile Duct ◽  
Biliary Obstruction ◽  
Extrahepatic Bile Duct ◽  
Good Prognosis ◽  
Malignant Biliary Obstruction ◽  
Carcinoid Tumors

scholarly journals Metastatic melanoma presenting as malignant biliary obstruction of the common bile duct demonstrated with single-operator digital cholangioscopy

VideoGIE ◽  
2017 ◽  
Vol 2 (10) ◽  
pp. 266-267
Author(s):  
Prapimphan Aumpansub ◽  
Phonthep Angsuwatcharakon ◽  
Naruemon Wisedopas ◽  
Wiriyaporn Ridtitid ◽  
Rungsun Rerknimitr
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Metastatic Melanoma ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Single Operator ◽  
The Common

Bile Duct: Analysis of Percutaneous Transluminal Forceps Biopsy in 130 Patients Suspected of Having Malignant Biliary Obstruction

Radiology ◽  
2002 ◽  
Vol 224 (3) ◽  
pp. 725-730 ◽  
Author(s):  
Gyoo-Sik Jung ◽  
Jin-Do Huh ◽  
Sang Uk Lee ◽  
Byung Hoon Han ◽  
Hee-Kyung Chang ◽  
...  
Keyword(s):  
Bile Duct ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Forceps Biopsy ◽  
Percutaneous Transluminal

1066 Metastatic Melanoma Presenting as Malignant Biliary Obstruction of the Common Bile Duct Demonstrated With Digital Spyglass Cholangioscopy

2017 ◽  
Vol 85 (5) ◽  
pp. AB132
Author(s):  
Prapimphan Aumpansub ◽  
Phonthep Angsuwatcharakon ◽  
Nareumon Wisedopas ◽  
Wiriyaporn Ridtitid ◽  
Rungsun Rerknimitr
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Metastatic Melanoma ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
The Common

scholarly journals White bile in patients with malignant biliary obstruction is an independent factor of poor survival

2021 ◽  
Vol 09 (02) ◽  
pp. E203-E209
Author(s):  
Rosario Dʼalmeida ◽  
Coralie Barbe ◽  
Valérie Untereiner ◽  
Fidy Ramaholimihaso ◽  
Pascal Renard ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bilirubin Level ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Stent Insertion ◽  
Serum Total Bilirubin ◽  
Independent Factor ◽  
Poor Survival ◽  
Malignant Obstructive Jaundice ◽  
White Bile

Abstract Background and study aims White bile is defined as a colorless fluid occasionally found in the biliary tract of patients with bile duct obstruction. Its significance is not clearly established. Our objective was to analyze the prognostic value of white bile in a series of patients with biliary obstruction due to biliary or pancreatic cancer. Patients and methods The study was conducted on a series of consecutive patients with malignant obstructive jaundice. They all underwent endoscopic retrograde cholangiopancreatography with collection of bile and biliary stent insertion. White bile was defined as bile duct fluid with bilirubin level < 20 µmol/L. Univariate and multivariate analyses were performed to identify variables associated with overall survival (OS). Results Seventy-three patients were included (32 pancreatic cancers, 41 bile duct cancers). Thirty-nine (53.4 %) had white bile. The mean bile duct bilirubin level in this group was 4.2 ± 5.9 µmol/L vs 991 ± 1039 µmol/L in patients with colored bile (P < 0.0001). In the group of 54 patients not eligible for surgery, the multivariate analysis demonstrated an association between the presence of white bile and reduced OS (HR 2.3, 95 %CI 1.1–4.7; P = 0.02). Other factors independently associated with OS were metastatic extension (HR 2.8, 95 %CI 1.4–5.7) and serum total bilirubin (HR 1.003, 95 %CI 1.001–1.006). There was a significant inverse correlation between serum and bile duct bilirubin levels (r = –0.43, P = 0.0001). Conclusion White bile in patients with inoperable malignant biliary obstruction is an independent factor of poor survival.

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