scholarly journals A critical analysis of the ten-year experience of using endoscopic transpapillary interventions in an urgent surgical hospital

2022 ◽  
Vol 99 (7-8) ◽  
pp. 457-464
Author(s):  
I. P. Parfеnov ◽  
M. D. Dibirov ◽  
O. P. Primasyuk ◽  
V. S. Fomin ◽  
G. P. Dmitrienko ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Critical Analysis ◽  
Bile Ducts ◽  
Duodenal Papilla ◽  
Treatment Results ◽  
Intraoperative Diagnosis ◽  
Major Duodenal Papilla ◽  
Therapeutic Measures ◽  
Overall Mortality

The aim of this work was to provide a critical analysis of the ten-year experience of using transpapillary interventions in an urgent surgical hospital with a detailed study of all groups of registered complications.Material and methods. In the period from 2008 to 2018, 1188 retrograde endoscopic transpapillary grafts were performed on the bile ducts with dissection of the major duodenal papilla in a typical and atypical way on the basis of our clinic. The group of observed patients included 1188 patients with endoscopic papillosphincterotomy, including 839 women (70.6%) and 349 men (29.4%). The average age was 63.2 ± 1.25.Results. During the period, 25 complications (2.1%) were revealed when performing transpapillary interventions with dissection of the major duodenal papilla: acute pancreatitis — 10 patients (0.8%); bleeding from the opening of the major duodenal papilla — 4 (0.33%), perforation 12p. intestines — 4 (0.33%), breakage of the basket cable with wedging — 1 (0.08%), cholangitis — 1 (0.08%), overlapping with a stent of the lobar duct — 1 (0.08%). The overall mortality associated with complications is 0.25%. Based on the analyzed material, the iatrogenic index was calculated. It was 0.044. After the analysis of complications, on the basis of the data obtained, we proposed an algorithm of actions when performing transpapillary interventions.Conclusion. Based on the study, we come to the conclusion that it will not be possible to completely level the risk and avoid possible papillotomic-induced complications. In this regard, the early, preferably intraoperative diagnosis of the latter and the prompt implementation of correlating therapeutic measures are of great importance, which will undoubtedly improve the treatment results and have a positive eff ect on the outcome of the disease.

scholarly journals Major Duodenal Papilla Stone and Acute Pancreatitis

2018 ◽  
Vol 20 (1) ◽  
pp. 90-95
Author(s):  
S. V. Mikhaylusov ◽  
E. V. Moiseenkova ◽  
M. M. Misrokov
Keyword(s):  
Acute Pancreatitis ◽  
Duodenal Papilla ◽  
Major Duodenal Papilla

scholarly journals TRANSFISTULAR NANOELECTROIMPULSE LITHOTRIPSY IN THE TREATMENT OF CHOLEDOCHOLITHIASIS

2019 ◽  
Vol 21 (1) ◽  
pp. 25-28
Author(s):  
A I Babak ◽  
E A Mozhaeva ◽  
D A Raskovalov ◽  
I S Andrienko ◽  
M I Prudkov
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
New Method ◽  
Bile Duct Stones ◽  
Duodenal Papilla ◽  
Nanosecond Duration ◽  
Safe Method ◽  
Electrohydraulic Lithotripsy ◽  
Major Duodenal Papilla ◽  
Highly Effective

In 2003, Russian developers proposed a new method of crushing stones by electric impulses of nanosecond duration, which has several advantages over contact electrohydraulic lithotripsy. The aim of the study was to evaluate the possibilities of transfistular nanoelectroimpulse lithotripsy (NEIL) in the treatment of choledocholithiasis. A nanoelectroimpulse lithotriptor "Urolit", manufactured by Medline Ltd. (Tomsk, Russia), was used to break down the gallstones. 66 patients with large and/or unmovable bile duct stones and bile ducts drains were performed transfistular NEIL. It was successful in 63 patients (95.5%). NEIL made it possible to perform removal of large and/or unmovable gallstones without destroying the sphincters of the major duodenal papilla in 89% cases. Transfistular NEIL is a new highly effective and safe method of crushing gallstones.

scholarly journals Upper digestive hemorrhage secondary to major duodenal papilla Dieulafoy’s lesion: Case report

2021 ◽  
Vol 10 (9) ◽  
pp. e22710918093
Author(s):  
Samuel Nuno Pereira Lima ◽  
Daniel Alves Branco Ribeiro ◽  
Luiz Paulo de Oliveira Gireli ◽  
Lauro Damasceno de Carvalho Faria ◽  
Glayson da Silveira Martins
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Gastrointestinal Bleeding ◽  
Rare Event ◽  
Clinical History ◽  
Abdominal Ultrasound ◽  
Duodenal Papilla ◽  
Dieulafoy’S Lesion ◽  
Major Duodenal Papilla ◽  
History Of

Introduction: Dieulafoy’s lesion (DL) is occasioned by a tortuous, persistent and large caliber artery that emerges the mucosa from the submucosa of an organ, eventually triggering gastrointestinal bleeding in the presence of eroding factors of the mucosa and arterial wall. The presence of DL has been described in many anatomic topographies and although it predominates in the upper digestive tract, the presence of this lesion exactly in the major duodenal papilla is a rare event. Objective: to report a case of upper gastrointestinal bleeding secondary to a major duodenal papilla DL. Case report: a 72 year-old female, admitted to hospital care with a clinical history of two months continuous, painless melena, multiple previous blood transfusions and symptomatic anemia. She was referred by another health service with the diagnostic hypothesis of hemobilia, suggested by two previous esophagogastroduodenoscopies. Her abdominal ultrasound and arteriography were normal. A third esophagogastroduodenoscopy evidenced active bleeding in the duodenal major papilla, and after a carefully analysis a papillar DL was diagnosed. It was treated by endoscopy with adrenaline 1:10000 injection and thermocoagulation. Following this procedure she evolved with severe acute pancreatitis due to papillitis and need of intensive care unit admission. No rebleeding was detected and hospitalar discharge occurred twenty days after hospitalization. Conclusion: The localization of a DL at the major papilla is a rare event and acute pancreatitis is a complication related to its endoscopic treatment.

Lymphangioma of the major duodenal papilla presenting as acute pancreatitis: Treatment by endoscopic snare papillectomy

2000 ◽  
Vol 51 (6) ◽  
pp. 733-736 ◽  
Author(s):  
Parupudi V.J. Sriram ◽  
Christian Weise ◽  
Uwe Seitz ◽  
Boris Brand ◽  
Sören Schröder ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Duodenal Papilla ◽  
Major Duodenal Papilla ◽  
Endoscopic Snare Papillectomy

scholarly journals Strictures of biliary tracts during opisthorchosis

2003 ◽  
Vol 2 (4) ◽  
pp. 58-66
Author(s):  
N. A. Brazhnikova ◽  
V. F. Tskhay
Keyword(s):  
Cystic Duct ◽  
Sclerosing Cholangitis ◽  
Bile Ducts ◽  
Duodenal Papilla ◽  
External Drainage ◽  
Major Duodenal Papilla ◽  
Biliary Tracts ◽  
Distal Section

1170 patients with chronic opisthorchosis have been operated by surgeons of Tomsk hepatology center for 35 years, 4756 patients have been treated. In 730 operated patients different strictures of biliary tracts have been revealed, strictures of cystic duct have been observed in 372 patients (51%), strictures of choledoch distal section and major duodenal papilla (MDP) of expanded character — in 124 patients (17%), stricture combination — in 205 patients (28%) and sclerosing cholangitis — in 29 (4%). The treatment of opisthorchosis strictures of biliary tracts is surgical. In case of any its localization a cholecystectomy is necessary, in case of strictures of choledoch distal section and MDP a supraduodenal choledochoduodenostomy is necessary. In early postsurgical period it is prescribed an anthelmintic therapy with iodinol through external drainage of bile ducts. Good farther results have been marked at 79,4% of patients.

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

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
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.

scholarly journals Abstract No. 228 EE: Duodenal stenting over the major duodenal papilla using a transhepatic approach

2010 ◽  
Vol 21 (2) ◽  
pp. S87-S88
Author(s):  
L.N. Boucher ◽  
C. Dey ◽  
R. Gadahadh ◽  
T. Cabrera ◽  
N. Khattar ◽  
...  
Keyword(s):  
Duodenal Papilla ◽  
Major Duodenal Papilla

scholarly journals A Case of Choriocarcinoma of the Major Duodenal Papilla

2010 ◽  
Vol 43 (11) ◽  
pp. 1129-1133
Author(s):  
Yasunori Kurahashi ◽  
Yoshiharu Shirakata ◽  
Koji Hirata ◽  
Hisashi Shinohara ◽  
Kazumi Itoi ◽  
...  
Keyword(s):  
Duodenal Papilla ◽  
Major Duodenal Papilla

WAYS TO IMPROVE DIAGNOSIS OF PATIENTS WITH POSTCHOLECYSTECTOMY SYNDROME

2021 ◽  
pp. 31-35
Author(s):  
O. V. Gorbulitch ◽  
S. H. Yefimenko ◽  
S. A. Pavlychenko ◽  
O. A. Lazutkina ◽  
K. A. Aleksanian
Keyword(s):  
Morphological Changes ◽  
Gallstone Disease ◽  
Diagnostic Algorithm ◽  
Sphincter Of Oddi ◽  
Duodenal Papilla ◽  
Biliary Surgery ◽  
Postcholecystectomy Syndrome ◽  
Functional Changes ◽  
Post Surgery ◽  
Major Duodenal Papilla

Postcholecystectomy syndrome is a symptom complex that occurs or worsens after cholecystectomy and is a functional and / or organic disorder. It often complicates the post−surgery course of gallstone disease. The presence of symptoms of the disease indicates a deterioration in the quality of life of patients, but the diagnostic examination is not always possible to detect morphological or functional changes. Thus, at present the syndrome is an urgent problem of gastroenterology and biliary surgery. Diagnostic issues with a differentiated approach to the functional or organic nature of postcholecystectomy syndrome are important for the choice of further treatment tactics. In order to improve the diagnostic algorithm taking into account the changes in the area of the major duodenal papilla, a study was conducted in 137 patients. To determine the functional disorders of the sphincter of Oddi there was used the method of ultrasound investigation of hepatobiliary area and Vater's papilla with choleretic loading on Boyden as well as the Grigoriev's methods in the absence of organic obstruction of the terminal choledochus at previous stages of examination. Morphological changes in the major duodenal papilla area were evaluated using the technique of parietal ph−impedancemetry, which was performed on the background of benign mechanical jaundice in the patients after cholecystectomy during endoscopic retrograde cholangiopancreatography prior to endoscopic papillosphincterotomy. The obtained results help to perform a differentiated approach to the patients who underwent cholecystectomy, taking into account morphofunctional changes in the area of the major duodenal papilla and allow the implementation of the selected methods to the research algorithm of patients with postcholecystectomy syndrome. Key words: postcholecystectomy syndrome, functional and organic changes of major duodenal papilla, patency of the terminal choledochus, treatment tactics.

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