scholarly journals Endoscopic ultrasonography-guided cholecystogastrostomy in a patient with pancreatic cancer: the first case in Colombia (with video)

2020 ◽  
Vol 35 (4) ◽  
pp. 527-532
Author(s):  
Renzo Pinto-Carta ◽  
Jaime Solano Mariño ◽  
Luis Felipe Cabrera Vargas ◽  
Erika Johana Benito Flórez
Keyword(s):  
Pancreatic Cancer ◽  
Bile Duct ◽  
Third World ◽  
Extrahepatic Bile Duct ◽  
Bile Leakage ◽  
Current Treatment ◽  
Curative Intent ◽  
Palliative Intent ◽  
First Case ◽  
Duodenal Invasion

The current treatment of malignant biliary obstruction is non-surgical biliary diversion with palliative intent, the surgery having specific indications in patients with malignant pathology with curative intent. However, duodenal obstruction and non-dilated intra- or extrahepatic bile duct make these surgical and endoscopic procedures guided by EUS difficult. We present our experience with the first case in Colombia a third-world country in Latin America of a cholecystogastrostomy guided by EUS in a patient with unresectable pancreatic cancer and duodenal invasion with dilated common bile duct using a luminal stent (LAMS) (HOT stent AXIOS; Xlumena Inc., Mountain View, CA, USA) 15mm x 10mm.EUS-guided cholecystogastrostomy should be considered as an option for biliary decompression of greater importance than percutaneous drainage since it is superior in terms of technical feasibility, safety and efficacy in specific cases of ampullary stenosis and duodenal invasion. In addition, it can be done in third world countries when it has the appropriate training and implements. The fully covered metal stent applied to light (HOT AXIOS stent, Xlumena Inc., Mountain View, CA, USA) is ideal for EUS guided cholecystogastrostomy to minimize complications such as bile leakage. Additional comparative studies are needed to validate the benefits of this technique.

scholarly journals Biliary Peritonitis Due to Spontaneous Perforation of the Left Intrahepatic Bile Duct in an Adult: A Case Report and Review of Literature

2018 ◽  
Vol 103 (7-8) ◽  
pp. 339-343
Author(s):  
Wenwu Cai ◽  
Ke Pan ◽  
Qinglong Li ◽  
Xiongying Miao ◽  
Chang Shu
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Bile Leakage ◽  
Common Bile Duct Exploration ◽  
Good Prognosis ◽  
Spontaneous Perforation ◽  
Repair Operation

Spontaneous perforation of the left intrahepatic bile duct is extremely rare, especially in adults. Here, we report on a case of a 64-year-old woman who had a complaint of right upper abdominal pain for 10 days, which gradually progressed to entire abdominal pain for 3 days, and was admitted to our hospital. Relevant examinations revealed she had a normal cardiac and lung workup, but an obvious abnormal abdominal computed tomography examination, which revealed an enlarged gallbladder, choledocholithiasis with dilatation of the common bile duct (1.8 cm) and intrahepatic bile duct, and a lot of encapsulated ascites. After being given adequate fluid resuscitation and active preoperative preparation, cholecystectomy and common bile duct exploration and perforation repair operation were then performed. The postoperative course was uneventful, and she was discharged with the T-tube in situ. A choledochoscopy examination at week 6 showed the conditions of the intrahepatic and extrahepatic bile duct were good. For these patients, early diagnosis and surgical treatment are essential for good prognosis. The goal of our surgery is to stop bile leakage, resolve choledocholithiasis and cholangitis, and reconstruct the bile duct.

scholarly journals Mixed Large Cell Neuroendocrine Carcinoma and Adenocarcinoma with Spindle Cell and Clear Cell Features in the Extrahepatic Bile Duct

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
John Wysocki ◽  
Rishi Agarwal ◽  
Laura Bratton ◽  
Jeremy Nguyen ◽  
Mandy Crause Weidenhaft ◽  
...  
Keyword(s):  
Bile Duct ◽  
Neuroendocrine Carcinoma ◽  
Spindle Cell ◽  
Clear Cell ◽  
Extrahepatic Bile Duct ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Duct Carcinoma ◽  
First Case ◽  
The Common

Mixed adenoneuroendocrine carcinomas, spindle cell carcinomas, and clear cell carcinomas are all rare tumors in the biliary tract. We present the first case, to our knowledge, of an extrahepatic bile duct carcinoma composed of all three types. A 65-year-old man with prior cholecystectomy presented with painless jaundice, vomiting, and weight loss. CA19-9 and alpha-fetoprotein (AFP) were elevated. Cholangioscopy revealed a friable mass extending from the middle of the common bile duct to the common hepatic duct. A bile duct excision was performed. Gross examination revealed a 3.6 cm intraluminal polypoid tumor. Microscopically, the tumor had foci of conventional adenocarcinoma (CK7-positive and CA19-9-postive) surrounded by malignant-appearing spindle cells that were positive for cytokeratins and vimentin. Additionally, there were separate areas of large cell neuroendocrine carcinoma (LCNEC). Foci of clear cell carcinoma merged into both the LCNEC and the adenocarcinoma. Tumor invaded through the bile duct wall with extensive perineural and vascular invasion. Circumferential margins were positive. The patient’s poor performance status precluded adjuvant therapy and he died with recurrent and metastatic disease 5 months after surgery. This is consistent with the reported poor survival rates of biliary mixed adenoneuroendocrine carcinomas.

scholarly journals Heterotopic Pancreas within the Proximal Hepatic Duct, Containing Intraductal Papillary Mucinous Neoplasm

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Alistair J. Lawrence ◽  
Aducio Thiessen ◽  
Amy Morse ◽  
A. M. James Shapiro
Keyword(s):  
Bile Duct ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Extrahepatic Bile Duct ◽  
Hepatic Duct ◽  
Heterotopic Pancreas ◽  
Hepatic Bile ◽  
Mucinous Neoplasm ◽  
First Case ◽  
Duct Excision ◽  
Left Hepatic Lobectomy

We report a unique first case of benign heterotopic pancreas arising within the proximal hepatic bile duct, containing a focus of intraductal papillary mucinous neoplasm (IPMN). The condition was diagnosed on pathological explant after left hepatic lobectomy with total extrahepatic bile duct excision.

scholarly journals Extrahepatic bile duct injury caused by a horse kicking injury

2019 ◽  
Vol 12 (6) ◽  
pp. e228176
Author(s):  
Ryan Pereira ◽  
Kellee Slater
Keyword(s):  
Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Bile Leakage ◽  
Regional Hospital ◽  
Quadrant Pain ◽  
Contrast Extravasation ◽  
Distal Common Bile Duct ◽  
T Tube ◽  
Duodenal Drainage ◽  
The Right

A 35-year-old man presented to a regional hospital after being kicked by a horse in the right upper quadrant. He was transferred to our hepatobiliary unit with bile peritonitis 8 days post trauma. Laparoscopic cholecystectomy and intraoperative cholangiography were performed, demonstrating distal common bile duct (CBD) obstruction with contrast extravasation from the distal duct. The CBD was drained with a T-tube via laparotomy. On postoperative day 14, T-tube cholangiography demonstrated no extravasation of contrast from the distal CBD and minor stricturing with eventual duodenal drainage. The T-tube was clamped and 5 weeks later, the patient represented with peri-T-tube bile leakage and right upper quadrant pain. A T-tube cholangiogram confirmed a complex distal CBD stricture. Two attempts at ERCP with intent of stenting the stricture were unsuccessful. The patient underwent an end to side Roux-en-Y choledochojejunostomy and was discharged home 4 days postoperatively on simple analgesia.

scholarly journals Simultaneous Extensive Intraductal Papillary Neoplasm of the Bile Duct and Pancreas: A Very Rare Entity

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Vor Luvira ◽  
Ake Pugkhem ◽  
Theerawee Tipwaratorn ◽  
Yaovalux Chamgramol ◽  
Chawalit Pairojkul ◽  
...  
Keyword(s):  
Bile Duct ◽  
Radical Surgery ◽  
Extrahepatic Bile Duct ◽  
Case Reports ◽  
Intrahepatic Bile Duct ◽  
Rare Entity ◽  
Intraductal Papillary Neoplasm ◽  
First Case ◽  
Slow Progression ◽  
Papillary Neoplasm

Intraductal papillary neoplasm of the bile duct (IPNB) is a specific type of bile duct tumor. It has been proposed that it could be the biliary counterpart of the intraductal papillary neoplasm of the pancreas (IPMN-P). This hypothesis is supported by the presence of simultaneous intraductal tumors of both the bile duct and pancreas. There have been five reports of patients with simultaneous IPNB and IPMN-P. In all of these cases, biliary involvement was limited to the intrahepatic and perihilar bile duct, which had characteristics similar to IPMN-P and usually had slow progression in nature. Herein, we present the first case of extensive intraductal neoplasm involving the extrahepatic bile duct, intrahepatic bile duct, and entire length of the pancreas with a poor outcome, even after being treated aggressively with radical surgery and adjuvant chemotherapy. Additionally, we summarize previous case reports of simultaneous intraductal lesions of the bile duct and pancreas.

scholarly journals Intraductal papillary neoplasia of the bile duct (IPNB): case report and literature review

2020 ◽  
Vol 40 (3) ◽  
pp. 278
Author(s):  
Rómulo Vargas ◽  
Oscar Patarroyo ◽  
Raúl Cañadas ◽  
Alan Ovalle
Keyword(s):  
Bile Duct ◽  
Surgical Management ◽  
Curative Resection ◽  
Biliary Tree ◽  
Clinical Suspicion ◽  
Endoscopic Drainage ◽  
Palliative Intent ◽  
Intraductal Papillary Neoplasm ◽  
Abdominal Abscesses ◽  
First Case

Intraductal papillary neoplasm of the bile duct (IPNB) is a rare premalignant condition, defined as an epithelial neoplasm of the bile duct with exophytic papillary growth that can develop in any segment of the biliary tree. This pathology, with the highest prevalence in Asia, has been associated with the presence of hepatolithiasis and eastern liver infection (clonorchiasis). The diagnosis will depend on the clinical suspicion against the findings evidenced in the different diagnostic supports (invasive and non-invasive). Curative resection with negative margins is the treatment of choice in patients candidates for surgical management. In the event that the patient is not a candidate for curative resection, palliative treatment includes chemotherapy, percutaneous and endoscopic drainage, laser cholangioscopy ablation and intraluminal therapy with iridium 192. We present two cases of two patients with a diagnosis of IPNB confirmed by histology treated at our institution. The first case in an 86-yearold patient had a history of recurrent obstructive biliary syndrome and clinical suspicion of a new episode of cholangitis, and the second case in a 73-year-old patient who had a disseminated infectious process (spondylodiscitis, pelvic and intra-abdominal abscesses), and with the clinical suspicion of presenting a primary hepatobiliary focus. Both patients underwent single-operatorcholangioscopy plus biopsy, confirming the diagnosis by histology. The first case was managed with palliative intent, indicating endoscopic diversion of the bile duct, while surgical management was indicated in the second case.

152 Intraluminal brachytherapy in a new strategy for unresectable extrahepatic bile duct and pancreatic cancer

1996 ◽  
Vol 39 ◽  
pp. S38
Author(s):  
P. Montemaggi ◽  
A.G. Morganti ◽  
G. Costamagna ◽  
P. Guerrieri ◽  
L.W. Brady
Keyword(s):  
Pancreatic Cancer ◽  
Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Intraluminal Brachytherapy ◽  
New Strategy
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