Retrograde stenting of the bile ducts for benign hepatopancreatoduodenal diseases

Aim.To evaluate the immediate results of endoscopic retrograde stenting of bile ducts in benign hepatopancreatoduodenal diseases and to justify enlargement of indications for surgery.Material and methods.There were 341 patients with various benign hepatopancreatoduodenal diseases for the period 2007–2017. Plastic stents were installed in 326 (95.6%) patients, metal self-expanding stents – in 15 (4.4%) patients.Results.There was a tendency to increase of the number of stenting procedures in patients with benign hepatopancreatoduodenal diseases that was primarily due to expansion of indications for this intervention. Therapeutic and prophylactic purposes of biliary stenting were determined. The main objectives of therapeutic stenting were bile drainage restoration in obstructive jaundice, reduction of extra- and intrahepatic biliary pressure, as well as drainage of cavities in liver communicating with biliary system. The main prophylactic goal was to prevent violation of bile outflow after endoscopic manipulations on the major duodenal papilla at high risk of migration of stones from gallbladder and reflux cholangitis. Severe complications of endoscopic transpapillary procedures were not observed.Conclusion.The indications for endoscopic transpapillary stenting of the bile ducts in case of benign hepatopancreatoduodenal diseases were systematized and reasonably expanded. Immediate results of biliary stenting confirm high efficacy of the method.

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Short-Term Biliary Stent Placement Contributing Common Bile Duct Stone Disappearance with Preservation of Duodenal Papilla Function

Gastroenterology Research and Practice ◽

10.1155/2016/6153893 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Tatsuki Ueda ◽

Masataka Kikuyama ◽

Yuzo Kodama ◽

Takafumi Kurokami

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Stent Placement ◽

Bile Ducts ◽

Common Bile Duct Stones ◽

Biliary Stent ◽

Duodenal Papilla ◽

Short Term ◽

Endoscopic Retrograde ◽

Obstructive Cholangitis

Aims. To investigate the effect of biliary stent placement without endoscopic sphincterotomy (EST) on common bile duct stones (CBDS) disappearance and the contribution of preserving the duodenal papilla function to reduce recurrence of CBDS.Methods. Sixty-six patients admitted for acute obstructive cholangitis due to CBDS who underwent biliary stent placement without EST for 2 years from March 2011 were evaluated retrospectively. The second endoscopic retrograde cholangiopancreatography (ERCP) was performed for treatment of CBDS 3 to 4 months after the first ERCP. We estimated the rate of stone disappearance at the time of second ERCP.Results. CBDS disappearance was observed in 32 (48.5%) of 66 patients. The diameter of the bile ducts and the diameter of CBDS in patients with CBDS disappearance were significantly smaller than in those with CBDS requiring extraction (p=0.007andp<0.001, resp.). Stone disappearance was evident when the diameter of bile ducts and that of CBDS were <10 and 7 mm, respectively (p=0.002).Conclusions. Short-term stent placement without EST eliminates CBDS while preserving duodenal papilla function and may be suitable for treating CBDS in patients with nondilated bile ducts and small CBDS.

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Photodynamic therapy of cancer of large duodenal papilla and extrahepatic bile ducts

Biomedical Photonics ◽

10.24931/2413-9432-2020-9-2-18-28 ◽

2020 ◽

Vol 9 (2) ◽

pp. 18-28

Author(s):

E. F. Stranadko ◽

A. V. Baranov ◽

V. A. Duvansky ◽

A. I. Lobakov ◽

V. A. Morokhotov ◽

...

Keyword(s):

Photodynamic Therapy ◽

Bile Ducts ◽

Malignant Tumors ◽

Control Group ◽

Malignant Neoplasms ◽

Duodenal Papilla ◽

Risk Of Death ◽

Photodynamic Therapy Of Cancer ◽

Bile Drainage ◽

Extrahepatic Bile Ducts

The problem of treating patients with malignant neoplasms of the extrahepatic bile ducts and the large duodenal papilla remains relevant due to the growing incidence, high mortality, and a pronounced decrease in the quality of life of patients, despite the radical surgery. The purpose of this study was to evaluate the effectiveness of photodynamic therapy (PDT) in inoperable patients with malignant tumors of these localizations.The study is based on the treatment of 79 patients with adenocarcinoma of large duodenal papilla and extrahepatic bile ducts. 29 patients received palliative bile drainage operations with PDT. 50 patients in the control group only had palliative bile drainage operations. Patients in the study group received from 1 to 3 PDT courses in a year. In total, 29 patients received 52 PDT courses. The tolerance to the method and the life expectancy of patients were evaluated. The median survival of patients who underwent PDT was 18 months (11–60 months); in the control group – 11.5 months. PDT, in combination with bile drainage operation, is an effective method for the treatment of inoperable patients with malignant neoplasms of the extrahepatic bile ducts and the large duodenal papilla in the absence of severe complications and with easy tolerance to therapy by patients. For the treatment and prolongation of life of patients whose radical surgical treatment is associated with a high risk of death, PDT seems to be the best treatment option. Results of PDT treatment for cancer of this localization are comparable with the results of radical surgeries and exceed those for palliative surgeries.

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Improved Visualization of Intrahepatic Bile Ducts by Endoscopic Retrograde Balloon Catheter Cholangiography

Annals of Surgery ◽

10.1097/00000658-198108000-00010 ◽

1981 ◽

Vol 194 (2) ◽

pp. 171-175 ◽

Cited By ~ 19

Author(s):

SEIYO IKEDA ◽

MASAO TANAKA ◽

HIDEO YOSHIMOTO ◽

HIDEAKI ITOH ◽

FUMIO NAKAYAMA

Keyword(s):

Bile Ducts ◽

Balloon Catheter ◽

Endoscopic Retrograde ◽

Intrahepatic Bile Ducts

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Surgical management of cystic dilatation bile ducts in adults

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202015000100005 ◽

2015 ◽

Vol 28 (1) ◽

pp. 17-19

Author(s):

Olival Cirilo Lucena da FONSECA-NETO ◽

Moacir Cavalcante de ALBUQUERQUE-NETO ◽

Antonio Lopes de MIRANDA

Keyword(s):

Magnetic Resonance Imaging ◽

Rare Disease ◽

Biliary Tract ◽

Bile Ducts ◽

Adult Population ◽

Ultrasound Scanning ◽

Resonance Imaging ◽

Cystic Dilatation ◽

Initial Examination ◽

Endoscopic Retrograde

BACKGROUND: The cystic dilatation of the biliary tract is a rare disease and uncertain origin. It is recognized more frequently in children; however, its incidence comes increasing in adults, representing 20% of the cases. AIM: To evaluate morbimortality rates, evolution and handing of patients with cystic dilatation bile ducts in adults. METHODS: Were evaluated, retrospectively, five adults who had the diagnosis of choledochal cyst and that had been submitted to some surgical procedure. RESULTS: Abdominal pain was the commonest complain to all patients. Jaundice was present in 80%. Ultrasound scanning was done in all the cases as initial examination. CT scan, magnetic resonance imaging and endoscopic retrograde cholangiopancreatography were also done in some patients; however, the diagnosis was established intra-operatively in all cases. The cyst resection with reconstruction of the biliary tract was done in 60%; the cystojejunostomy in 20%; and in 20% biliary tract drainage. CONCLUSIONS: Biliary tract cystic dilatation is a rare disease. However, its incidence is increasing in the adult population, so, it must be thought as differential diagnosis when facing obstructive jaundice.

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Clinical Aspects of Nonsurgical Percutaneous Transhepatic Bile Drainage in Obstructive Lesions of the Extrahepatic Bile Ducts

Annals of Surgery ◽

10.1097/00000658-197901000-00012 ◽

1979 ◽

Vol 189 (1) ◽

pp. 58-61 ◽

Cited By ~ 69

Author(s):

JAN ANDERS HANSSON ◽

JÜRGEN HOEVELS ◽

GÖRAN SIMERT ◽

ULF TYLÉN ◽

JOHANNES VANG

Keyword(s):

Bile Ducts ◽

Clinical Aspects ◽

Bile Drainage ◽

Extrahepatic Bile Ducts

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LAPAROSCOPIC CHOLEDOCH REVISION FOR THE TREATMENT OF CHOLEDOCHOLITHIASIS IN AN INFANT

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2019-23-4-220-223 ◽

2019 ◽

Vol 23 (4) ◽

pp. 220-223

Author(s):

M. Yu. Kozlov ◽

Anton S. Malashenko ◽

A. A. Shchebeteev

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Bile Ducts ◽

Open Abdomen ◽

Unified Approach ◽

Endoscopic Retrograde ◽

Surgical Practice ◽

Percutaneous Puncture ◽

The Common

Choledocholithiasis is a rare pathology in children. Various techniques have been proposed for removing calculi from the common bile duct: percutaneous puncture drainage of bile ducts, endoscopic retrograde cholangiopancreatography with papillosphincterotomy as well as revision of the common bile duct which can be done laparoscopically or in the open abdomen. However at present, there is no any unified approach to managing this pahtology in children. The article describes authors’ experience of laparoscopic revision of the common bile duct in an infant with choledocholithiasis. The authors consider that this technique can be applied in pediatric surgical practice.

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The Efficacy and Safety of Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiography in Pediatric Patients with Surgically Altered Gastrointestinal Anatomy

Journal of Clinical Medicine ◽

10.3390/jcm10173936 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3936

Author(s):

Kensuke Yokoyama ◽

Tomonori Yano ◽

Atsushi Kanno ◽

Eriko Ikeda ◽

Kozue Ando ◽

...

Keyword(s):

Success Rate ◽

Pediatric Patients ◽

Clinical Success ◽

Clinical Success Rate ◽

Endoscopic Retrograde Cholangiography ◽

Adult Patients ◽

Efficacy And Safety ◽

Duodenal Papilla ◽

Endoscopic Retrograde ◽

Balloon Enteroscopy

Balloon enteroscopy-assisted endoscopic retrograde cholangiography (BEA-ERC) is useful and feasible in adults with pancreatobiliary diseases, but its efficacy and safety have not been established in pediatric patients. We compared the success rate and safety of BEA-ERC between adults and pediatric patients. This single-center retrospective study reviewed 348 patients (pediatric: 57, adult: 291) with surgically altered gastrointestinal anatomies who underwent BEA-ERC for biliary disorders from January 2007 to December 2019. The success rate of reaching the anastomosis or duodenal papilla was significantly lower in pediatric patients than in adult patients (66.7% vs. 88.0%, p < 0.01). The clinical success rate was also significantly lower in pediatric patients (64.9% vs. 80.4%, p = 0.014). The rate of adverse events was significantly higher in pediatric patients than in adults (14.2% vs. 7.7%, p = 0.037). However, if the anastomotic sites were reached in pediatric patients, the treatment was highly successful (97.3%). The time of reaching target site was significantly longer in pediatric patients than in adult patients. This study shows that BEA-ERC in pediatric patients is more difficult than that in adult patients. However, in patients where the balloon enteroscope was advanced to the anastomosis, clinical outcomes comparable to those in adults can be achieved.

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Endoscopic Treatment of Post-Cholecystectomy Biliary Leaks

GE Portuguese Journal of Gastroenterology ◽

10.1159/000511527 ◽

2020 ◽

pp. 1-9

Author(s):

Ricardo Rio-Tinto ◽

Jorge Canena

Keyword(s):

Endoscopic Treatment ◽

Open Cholecystectomy ◽

Plastic Stents ◽

Optimal Time ◽

Endoscopic Retrograde ◽

Procedural Approach ◽

Technological Developments ◽

Optimal Time Point ◽

Bile Leaks

Postcholecystectomy leaks may occur in 0.3–2.7% of patients. Bile leaks associated with laparoscopy are often more complex and difficult to treat than those occurring after open cholecystectomy. Furthermore, their incidence has remained unchanged despite improvements in laparoscopic training and technological developments. The management of biliary leaks has evolved from surgery into a minimally invasive endoscopic procedural approach, namely, endoscopic retrograde cholangiopancreatography (ERCP), which decreases or eliminates the pressure gradient between the bile duct and the duodenum, thus creating a preferential transpapillary bile flow and allowing the leak to seal. For simple leaks, the success rate of endotherapy is remarkably high. However, there are more severe and complex leaks that require multiple endoscopic interventions, and clear strategies for endoscopic treatment have not emerged. Therefore, there is still some debate regarding the optimal time point at which to intervene, which technique to use (sphincterotomy alone or in association with the placement of stents, whether metallic or plastic stents should be used, and, if plastic stents are used, whether they should be single or multiple), how long the stents should remain in place, and when to consider treatment failure. Here, we review the types and classification of postoperative biliary injuries, particularly leaks, as well as the evidence for endoscopic treatment of the latter.

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Location of Major Duodenal Papilla in Human Duodenum

Bangladesh Journal of Anatomy ◽

10.3329/bja.v12i1.22614 ◽

2015 ◽

Vol 12 (1) ◽

pp. 22-24 ◽

Cited By ~ 1

Author(s):

Sharmina Sayeed ◽

Shamim Ara ◽

Mesbahul Hoque ◽

Zannatul Ferdous ◽

Kanetarin Kashem

Keyword(s):

Observational Study ◽

Forensic Medicine ◽

Diagnosis And Treatment ◽

Medial Wall ◽

Duodenal Papilla ◽

Endoscopic Retrograde ◽

Cross Sectional ◽

Medical College ◽

Major Duodenal Papilla ◽

Dead Bodies

Context: The major duodenal papilla is one of the most fascinating papilla present at the duodenum attracting many gastroenterologists as they do endoscopic retrograde cholangiopancreatiography (ERCP) for diagnosis and treatment purpose of many diseases. Most of the textbooks of Anatomy describe that the summit of major duodenal papilla is situated posteromedially in the descending part of duodenum. Henceforth the present study was undertaken in 70 human duodenums to observe the location of major duodenal papilla. Materials & Methods: A cross-sectional observational study was conducted in the department of Anatomy, Dhaka Medical College, Dhaka from July 2010 to June 2011. Seventy postmortem human duodenums were collected from unclaimed dead bodies that were under examination in the morgue of department of Forensic Medicine and the department of Anatomy of Dhaka Medical College, Dhaka. Location of major duodenal papilla was observed and recorded. Results: The location of major duodenal papilla was observed in the medial wall of second part of duodenum in 78.6% specimens, in the posteromedial wall of second part in 15.7% cases and in the posteromedial wall of the junction between second and third part in 4.3% and absent in 1.4% duodenum. Conclusion: The location of major duodenal papilla varies in position. DOI: http://dx.doi.org/10.3329/bja.v12i1.22614 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 22-24

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