Interventional radiology techniques in the treatment of cholangiolithiasis: indications, efficacy, accessibility

2021 ◽  
pp. 9-20
Author(s):  
Jerik Narimanovich Prazdnikov ◽  
Grigory Alexandrovich Baranov ◽  
Dmitry Ravilyevich Zinatulin ◽  
Vladimir Vladimirovich Naletov ◽  
Rifat Khamitovich Umyarov
Keyword(s):  
Interventional Radiology ◽  
Minimally Invasive ◽  
Treatment Option ◽  
Bile Ducts ◽  
Hepatobiliary Surgery ◽  
Endoscopic Retrograde ◽  
Endoscopic Intervention ◽  
X Ray ◽  
Complications Of Cholelithiasis ◽  
Minimally Invasive Methods

Our days, the problem of treating complicated forms of cholelithiasis continues to be relevant despite the undoubted successes in the field of hepatobiliary surgery. Cholangiolithiasis is one of the most frequent and dangerous complications of cholelithiasis, it is detected in 8–26 % of patients with cholelithiasis. In some cases, it is impossible to perform an endoscopic retrograde method, these special situations require the development of new original minimally invasive methods for resolving cholangiolithiasis, which have all the advantages of «small access». The analysis of the treatment of 466 operated patients with cholelithiasis complicated by cholangiolithiasis and mechanical jaundice in the period from 2013 to 2019 was carried out. The patients were divided into 3 groups: 1 — the endoscopic retrograde method was used (n = 369), 2 — laparotomic access (n = 26), 3 — antegrade X-ray interventional method (n = 71). The results obtained allow us to conclude that the antegrade interventional radiology technique for the treatment of choledocholithiasis has a high clinical efficacy comparable to the endoscopic technique. The use of this treatment option avoids traumatic laparotomies and open interventions on the bile ducts. The use of method is justified in cases of impossibility of performing endoscopic intervention, or its ineffectiveness.

scholarly journals DIAGNOSTIC TACTICS FOR TRAUMATIC INJURIES OF THE SPLEEN

2020 ◽  
pp. 155-159
Author(s):  
M. M. Belous
Keyword(s):  
Minimally Invasive ◽  
Information Content ◽  
Diagnostic Method ◽  
Diagnostic Methods ◽  
Traumatic Injuries ◽  
X Ray ◽  
Non Invasive ◽  
Examination Methods ◽  
Minimally Invasive Methods

Summary. Purpose. Having based on the determination of the degree of effectiveness and information content of the diagnostic methods for traumatic injuries of the spleen, to analyze the results of the instrumental diagnostic methods to create an algorithm for diagnostic and treatment tactics. Materials and methods: 355 victims were hospitalized with traumatic injuries of the spleen. Of these, physical and laboratory diagnostic methods were used in 100 % of cases, laparoscopy — 245 patients (69 %), laparocentesis — 21 (6 %), laparotomy —- 75 (21 %), ultrasound — 199 (56 %), x-ray — 67 (19 %), CT — 7 (2 %). Research results and discussion.The most informative diagnostic method is laparotomy. Of minimally invasive methods — laparoscopy, and of non-invasive methods — ultrasound. Conclusions. For successful recognition of spleen damage, it is necessary to use complex examination methods, depending on the indication developed for them, that significantly reduces the duration of the diagnostic phase.

A critical assessment of the place of endoscopy in gastroenterology

1977 ◽  
Vol 195 (1119) ◽  
pp. 251-259
Keyword(s):  
Bile Ducts ◽  
Upper Gastrointestinal Bleeding ◽  
Critical Assessment ◽  
Endoscopic Removal ◽  
Endoscopic Retrograde ◽  
X Ray ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Powerful Stimulus ◽  
Difficult Cases ◽  
Upper Gastrointestinal

The introduction of the flexible fibrescope has been one of the most important advances in gastroenterology this decade. The fibrescope has virtually replaced the old rigid instrument and provides fuller information and is much safer. It is invaluable in detecting lesions in the fundus and antrum of the stomach and has provided the radiologists with a powerful stimulus to improve their techniques. It is important in the investigation of X-ray negative dyspepsia and acute upper gastrointestinal bleeding, and in assessing the post-operative stomach before further surgery is undertaken. The development of endoscopic retrograde cannulation of the pancreatic and common bile ducts is progressing rapidly and is certainly of great help in the elucidation of jaundice in difficult cases. Visualization of the jejunum from above and the ileum from below is still in the early stages but will be of help in the diagnosis particularly of Crohn’s disease of the ileum. The treatment of polyps in the colon has been revolutionized by the colonoscope and the number of laparotomies has been reduced by the development of endoscopic removal.

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

1981 ◽  
Vol 194 (2) ◽  
pp. 171-175 ◽  
Author(s):  
SEIYO IKEDA ◽  
MASAO TANAKA ◽  
HIDEO YOSHIMOTO ◽  
HIDEAKI ITOH ◽  
FUMIO NAKAYAMA
Keyword(s):  
Bile Ducts ◽  
Balloon Catheter ◽  
Endoscopic Retrograde ◽  
Intrahepatic Bile Ducts

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 Surgical management of cystic dilatation bile ducts in adults

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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