scholarly journals Radiation study techniques in diagnosing the causes of opisthorchiasis-induced obstructive jaundice

2020 ◽  
Vol 101 (1) ◽  
pp. 39-46
Author(s):  
N. V. Klimova ◽  
A. Ya. Ilkanich ◽  
V. V. Darvin ◽  
A. L. Koctrubin ◽  
T. S. Vardanyan ◽  
...  
Keyword(s):  
Bile Duct ◽  
Obstructive Jaundice ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Diagnostic Value ◽  
Diagnostic Methods ◽  
Endoscopic Retrograde ◽  
Radiation Study ◽  
Study Techniques ◽  
Sensitivity Specificity ◽  
Instrumental Methods

Objective: to analyze the diagnostic value of radiation techniques in patients with opisthorchiasis-induced obstructive jaundice and to determine the types of bile duct (BD) changes characteristic of this disease.Subjects and methods. The investigation enrolled 103 patients with chronic opisthorchiasis complicated by obstructive jaundice. For BD visualization, the investigators used radiation diagnostic methods, such as ultrasonography (USG), magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP); their efficiency was evaluated.Results. ERCP and MRCP could identify 5 types of BD architectonics in opisthorchiasis-induced obstructive jaundice. The sensitivity, specificity, and overall accuracy of MRCP in diagnosing opisthorchiasis-induced sclerotic changes were 98.1, 87.5, and 96.8%, respectively.Conclusion. Among instrumental methods for diagnosing sclerotic BD changes in prolonged opisthorchiasis invasion, it is preferable to use MRCP, which is determined by its high informative value. Five types of cholangioarchitectonics are detectable in chronic opisthorchiasis complicated by obstructive jaundice.

scholarly journals Accuracy of MRCP compared to ERCP in the diagnosis of bile duct disorders

2008 ◽  
Vol 12 (1) ◽  
pp. 14 ◽  
Author(s):  
Delmé Hurter ◽  
Coert De Vries ◽  
Pierre Potgieter ◽  
Renald Barry ◽  
Frikkie Botha ◽  
...  
Keyword(s):  
Bile Duct ◽  
Prospective Observational Study ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Endoscopic Retrograde ◽  
Predictive Values ◽  
Biliary Pathology ◽  
Study Population ◽  
Small Study Population ◽  
Bile Duct Calculi ◽  
Sensitivity Specificity

AIM: To determine the accuracy of Magnetic Resonance Cholangiopancreatography compared to the gold standard Endoscopic Retrograde Cholangiopancreatography in the diagnosis of bile duct disorders at our institution. PATIENTS AND METHODS: 52 patients with suspected pancreatobiliary pathology were included in this prospective observational study. MRCP was performed in the 24-hour period prior to the ERCP. RESULTS: MRCP had sensitivity, specificity, positive and negative predictive values of 87%, 80%, 83.3% and 84.2% respectively for choledocholitiasis which correlates well with results obtained in other parts of the world. CONCLUSION: At our institution, MRCP has high diagnostic accuracy for bile duct calculi. Due to a small study population, results for other biliary pathology were inconclusive

The Value of Cholangiography through Jackson-Pratt Drains in the Management of Postoperative Biliary Injuries

2014 ◽  
Vol 80 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Francisco Igor B. Macedo ◽  
Victor J. Casillas ◽  
James S. Davis ◽  
Joe U. Levi ◽  
Danny Sleeman
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Common Hepatic Duct ◽  
Biliary Reconstruction ◽  
Biliary Injury ◽  
Endoscopic Retrograde ◽  
Distal Common Bile Duct ◽  
Potential Benefits

Iatrogenic biliary injury is the most significant complication after laparoscopic cholecystectomy. We present our experience with an alternative diagnostic approach using transcatheter cholangiography (TCC) through a Jackson-Pratt (JP) drain and discuss potential benefits and limitations of the technique. From March 2002 to February 2012, 40 patients with major postoperative biliary injury underwent biliary reconstruction at our institution. Mean age was 51.7 ± 18.1 years (range, 19 to 86 years) with 30 (75%) females. Seventeen (42.5%) injuries were detected intraoperatively and in 13 (32.5%) cases, JP drains were placed for biliary drainage. Lesions were classified according to Bismuth grade: I (10 patients [25%]), II (10 patients [25%]), III (six patients [15%]), IV (10 patients [25%]), and V (four patients [10%]). TCC was performed in seven patients with JP drains (53.8%). It fully defined the injury site in three cases of limited magnetic resonance cholangiopancreatography (MRCP) such as common hepatic duct and common bile duct leaks and in four cases (57.1%) that endoscopic retrograde cholangiopancreatography (ERCP) was limited as a result of clipping of the distal common bile duct. TCC showed promising results in cases of limited MRCP and ERCP such as fistulous orifices or leakage. It may represent an alternative adjunct in the diagnostic armamentarium of complex biliary injuries.

Initial Cholecystectomy with Cholangiography Decreases Length of Stay Compared to Preoperative MRCP or ERCP in the Management of Choledocholithiasis

2015 ◽  
Vol 81 (7) ◽  
pp. 726-731 ◽  
Author(s):  
Christine Lin ◽  
Jay N. Collins ◽  
Rebecca C. Britt ◽  
Lunzy D. Britt
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Length Of Stay ◽  
Common Bile Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Common Bile Duct Exploration ◽  
Optimal Treatment ◽  
Endoscopic Retrograde ◽  
Elevated Bilirubin ◽  
Preoperative Magnetic Resonance

There are several treatments available for choledocholithiasis, but the optimal treatment is highly debated. Some advocate preoperative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) with cholangiography (IOC). Others advocate initial LC + IOC followed by common bile duct exploration or ERCP. The purpose of this study was to determine whether initial LC + IOC had a shorter length of stay (LOS) compared with preoperative magnetic resonance cholangiopancreatography (MRCP) or ERCP. Patients who underwent cholecystectomy between 2012 and 2013 at two institutions were reviewed. Patients were selected if they had suspected choledocholithiasis, indicated by dilated CBD and/or elevated bilirubin, or confirmed choledocholithiasis. They were excluded if they had pancreatitis or cholangitis. There were 126 patients with suspected choledocholithiasis in this study. Of these, 97 patients underwent initial LC ± IOC with an average LOS of 3.9 days. IOC was negative in 47.4 per cent patients, and they had a shorter LOS compared with positive IOC patients (2.93 vs 4.82, P < 0.001). Laparoscopic common bile duct exploration was successful in 64.7 per cent and had a shorter LOS compared with postoperative ERCP patients ( P = 0.01). Preoperative MRCP was performed in 21 patients with an average LOS of 6.48 days. Preoperative ERCP was performed in eight patients with an average LOS of seven days. Initial LC+IOC is associated with a shorter LOS compared to preoperative MRCP or ERCP. It is recommended as the optimal treatment choice for suspected choledocholithiasis.

scholarly journals Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell Patient

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Vikas D. Reddy ◽  
Anas Al-Khateeb ◽  
Muhammad Hussain ◽  
Varun Patel ◽  
Muqueet Kadri ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Pleural Fluid ◽  
Sickle Cell ◽  
Serum Bilirubin ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Endoscopic Retrograde ◽  
Distal Common Bile Duct ◽  
Intrahepatic Bile Ducts ◽  
Sickle Cell Crisis

Bilothorax is a rare cause of an exudative pleural effusion. The diagnosis is confirmed by a pleural fluid to serum bilirubin ratio of greater than 1. Typically, bilothorax presents as a right-sided effusion due to its proximity to the liver and biliary system. Herein, we present a case of isolated left-sided bilothorax in a 43-year-old female admitted with sickle cell crisis. Only one other case of isolated spontaneous left-sided bilothorax has been described in the literature. A thoracentesis performed on admission demonstrated greenish fluid and bilothorax was suspected, with a pleural fluid to serum bilirubin ratio greater than 1 confirming the diagnosis. A magnetic resonance cholangiopancreatography (MRCP) showed an abnormal 90-degree acute angulation in the mid-to-distal common bile duct with proximal common bile duct and intrahepatic bile ducts dilation. This was further confirmed with an endoscopic retrograde cholangiopancreatography (ERCP), which did not reveal any extravasation of contrast into the left pleural space. Ultimately, despite the use of various modalities, no definitive cause of bilothorax was identified. Postthoracentesis imaging revealed evidence of fibrothorax, a direct and permanent complication of bilothorax. The presence of an isolated left-sided bilothorax, along with the lack of a confirmed etiology, makes this case unique.

scholarly journals Diagnostic Accuracy of Magnetic Resonance Cholangiopancreatography (MRCP) In-Patients Undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP) for Pancreaticobiliary Disorders

2021 ◽  
pp. 119-124
Author(s):  
M. Vignesh Kumar
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Diagnostic Accuracy ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Periampullary Carcinoma ◽  
Endoscopic Retrograde ◽  
Common Cause ◽  
The Common ◽  
Study Participants

This is a prospective study done to compare the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography (MRCP) in patients undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP) for pancreaticobiliary disorders.Majority of the study participants were males (63.3%), while the rest 36.78% of them were females and periampullary carcinoma (11.7%) and common bile duct calculus (11.7%) are the common cause of obstruction found on MRCP followed by malignant stricture (10%). The extent of obstruction was determined in most of the study participants (91.7%) by MRCP while the rest 8.3% were not determined by MRCP. The Common bile duct calculus (11.7%) is the common cause of obstruction on ERCP followed by malignant stricture (10%) and Periampullary carcinoma (10%) and 20% of the patients were found to be normal in ERCP. Among them, 71.4 % did not show MRCP and the association was found to be significant. (p- Value < 0.00).

scholarly journals Litiasis del hepatocolédoco

2020 ◽  
Vol 112 (4) ◽  
pp. 398-405
Author(s):  
José De Vinatea de Cárdenas ◽  
◽  
Fernando Revoredo Rego
Keyword(s):  
Bile Duct ◽  
Clinical Judgment ◽  
Intraoperative Ultrasound ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Individual Case ◽  
Conclusive Evidence ◽  
Endoscopic Retrograde ◽  
Decision Making Processes ◽  
The Common ◽  
Therapeutic Tools

Previously, when a surgeon diagnosed bile duct lithiasis, he/she performed cholecystectomy, choledocotomy, stone removal and placement of a Kehr’s “T” tube. Some cases might require sphincteroplasty or bilio-digestive bypass. Nowadays, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, endoscopic ultrasound and intraoperative ultrasound have emerged as diagnostic and therapeutic tools. Decision-making processes are complex and there is no conclusive evidence supporting them. Many studies have focused on the matter with a non-comprehensive approach so that each surgeon will use his/her common sense for each individual case. The optimal management of the common bile duct is still controversial. Deciding on endoscopic, laparoscopic or conventional management requires adequate training and clinical judgment. Conventional surgery is still in valid option.

scholarly journals Magnetic resonance cholangiopancreatography: Diagnostic significance in malignant diseases of bile and pancreatic ducts

2009 ◽  
Vol 56 (4) ◽  
pp. 127-134
Author(s):  
R.M. Maksimovic ◽  
R.D. Milenkovic ◽  
M.S. Kratovac-Dunjic ◽  
G.B. Lilic ◽  
D.M. Masulovic ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Diagnostic Value ◽  
Pancreatic Ducts ◽  
Noninvasive Method ◽  
Endoscopic Retrograde ◽  
Diagnostic Significance ◽  
Optimal Method ◽  
Imaging Protocol ◽  
Malignant Obstruction

Magnetic resonance cholangiopancreatography (MR CP) is a relatively new, noninvasive method in patients with pancreaticobiliary diseases, which is comparable to invasive endoscopic retrograde cholangiopancreatography (ERCP). One of the most common indications for MRCP is malignant obstruction of the bile and pancreatic ducts. Standard imaging protocol includes routine abdominal study followed by a sequence for MRCP adapted to each of the patients and site of the malignant process. MRCP is a simple to perform, does not exposure the patients to radiation, requires no anesthesia, is less operator dependent and allows better visualization of ducts proximal to an obstruction. Thus, during one examination only, it is possible to assess not only pancreaticobiliary system but also abdominal structures, which increases diagnostic value of MR and is therefore, optimal method in evaluation of these patients. .

scholarly journals Performance of the Xpert® MTB/RIF assay in the rapid diagnosis of tracheobronchial tuberculosis using bronchial washing fluid

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052092164
Author(s):  
Yan-Hua Song ◽  
Qiang Li ◽  
Li-Ping Ma ◽  
Rong-Mei Liu ◽  
Guang-Lu Jiang ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
Culture Method ◽  
Diagnostic Value ◽  
Acid Fast Bacillus ◽  
Diagnostic Methods ◽  
Bronchial Washing ◽  
Sensitivity Specificity ◽  
Higher Sensitivity

Objective To assess the diagnostic value of the Xpert® MTB/RIF (GeneXpert) assay for tracheobronchial tuberculosis (TBTB) using bronchial washing fluid (BWF). Methods This retrospective study enrolled patients suspected of having TBTB and patients with non-TB pulmonary disease as controls. BWF were used to undertake acid-fast bacillus (AFB) smears, the GeneXpert assay and the Lӧwenstein–Jensen (LJ) culture method. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were compared among BWF AFB smears, BWF GeneXpert and the BWF LJ culture method. Results A total of 130 patients with TBTB and 102 patients with non-TB pulmonary disease were enrolled in the study. Sputum AFB smears were positive in 62 of 130 patients (47.7%) with TBTB. Using the clinical diagnosis of TBTB as the gold standard, the sensitivity, specificity, PPV and NPV of the three methods using BWF were as follows: 93.1%, 99.0%, 99.2% and 91.8% for BWF GeneXpert; 73.1%, 100.0%, 100.0% and 74.5% for BWF LJ cultures; 53.8%, 99.0%, 98.6% and 62.7% for BWF AFB smears. The diagnostic yield of BWF GeneXpert was significantly higher compared with BWF cultures for type III and IV TBTB. Conclusion The Xpert® MTB/RIF assay using BWF exhibited higher sensitivity than bacteriological diagnostic methods and was particularly useful for the early diagnosis of smear-negative TBTB.

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