Buried bumper syndrome: improving patient outcomes using a structured multidisciplinary team (MDT) approach to management.

Introduction: Buried bumper syndrome (BBS) is a complication seen in 2.4% of percutaneous endoscopic gastrostomy (PEG) tubes. We present a case series of 30 patients with BBS managed at a regional referral centre over 13 years.

R0 but not R1/R2 resection is associated with better survival than palliative photodynamic therapy in biliary tract cancer.

Background: There is a need for better management strategies to improve the survival and quality of life in patients with biliary tract cancer (BTC).

Aim: To assess prognostic factors for survival in a large, non-selective cohort of patients with BTC.

Method: We compared outcomes in 321 patients with a final diagnosis of BTC (cholangiocarcinoma n = 237, gallbladder cancer n = 84) seen in a tertiary referral cancer centre between 1998 and 2007.

MUC4 and MUC5AC are highly specific tumour-associated mucins in biliary tract cancer.

Alterations in epithelial mucin expression are associated with carcinogenesis, but there are few data in biliary tract cancer (BTC). In pancreatic malignancy, MUC4 is a diagnostic and prognostic tumour marker, whereas MUC5AC has been proposed as a sensitive serological marker for BTC. We assessed MUC4 and MUC5AC expression in (i) prospectively collected bile and serum specimens from 72 patients with biliary obstruction (39 BTC) by real-time reverse transcriptase-PCR (qPCR) and western blot analysis, and (ii) 79 archived biliary tissues (69 BTC) by immunohistochemistry.