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Surgical Step-Up Approach in Management of Necrotizing Pancreatitis.
Gastroenterol Clin North Am
March 2025
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Necrotizing pancreatitis often demands intervention; contemporary management is directed by the step-up approach. Timing of intervention and specific approach is best directed by a multi-disciplinary team including advanced endosocpists, interventional radiologists, and surgeons with interest and experience managing this complex problem. The intervention is often a combination of percutaneous drainage, transluminal endoscopic approaches, and surgical debridement (minimally invasive or open).
View Article and Find Full Text PDFEarly Laparoscopic Cholecystectomy Versus Percutaneous Cholecystostomy Followed by Delayed Laparoscopic Cholecystectomy in Patients with Grade II Acute Cholecystitis According to Tokyo Guidelines TG18.
J Laparoendosc Adv Surg Tech A
January 2025
General Surgery Department, GIT and Liver Unite, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
In the past, most patients with acute cholecystitis (AC) were treated conservatively. However, strong evidence from various studies has shown that laparoscopic cholecystectomy (LC) is safe and should be the primary treatment for AC. However, this may not be the case for all AC grades.
View Article and Find Full Text PDFIdentifying predictive markers for survival in malignant biliary obstruction following percutaneous transhepatic biliary drainage.
Clin Radiol
December 2024
University Hospital Southampton, Southampton General Hospital, Tremona Road, Southampton, Hampshire, SO16 6YD, UK. Electronic address:
Aim: Malignant biliary obstructive disease is commonly managed with percutaneous transhepatic biliary drainage (PTBD). Traditionally, outcomes are evaluated collectively despite substantial variability in the underlying aetiology and extent of disease. The purpose of this study was to investigate whether variability in survival could be explained by different underlying patient and disease factors.
View Article and Find Full Text PDFClinical evaluation of endoscopic biliary stenting in treatment of malignant obstructive jaundice.
World J Gastrointest Surg
January 2025
Department of General Surgery, Shenzhen University General Hospital, Shenzhen 518000, Guangdong Province, China.
Background: Malignant obstructive jaundice (MOJ) is characterized by the presence of malignant tumors infiltrating or compressing the bile duct, causing poor bile drainage, generalized yellowing, pain, itching, and malaise. MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.
Aim: To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement, complication rates, and long-term patient outcomes.
Application of DynaCT biliary soft tissue reconstruction technology in diagnosis and treatment of hepatolithiasis.
World J Gastrointest Surg
January 2025
Department of Emergency Medicine, Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China.
Background: Hepatobiliary stone disease involves an intrahepatic bile duct stone that occurs above the confluence of the right and left hepatic ducts. One-step percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) using the percutaneous transhepatic one-step biliary fistulation (PTOBF) technique enables the clearing of intrahepatic stones and the resolution of strictures. However, hepatolithiasis with associated strictures still has high residual and recurrence rates after one-step PTCSL.
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