Background: Minimally invasive interventions for choledocholithiasis are preferable in elderly patients because they tend to have multiple underlying disorders or a decreased activity of daily living. Endoscopic sphincterotomy and endoscopic papillary balloon dilation have been recognized as first-line treatments for choledocholithiasis excluding difficult cases such as large stones or multiple stones. Recently, the safety and efficacy of endoscopic papillary large balloon dilation (EPLBD) for difficult choledocholithiasis cases have been reported, although scarcely in elderly patients.
Aims: To investigate whether EPLBD can be safety and effectively performed in patients aged 75 years or older.
Methods: The medical records of 165 patients who underwent EPLBD from November 2006 to August 2013 were analyzed retrospectively. The patients were divided into 2 groups: Group A (≥ 75 years); Group B (<75 years).
Results: Some underlying diseases were significantly more common in Group A than in Group B (P < 0.05). However, there was no significant difference in the success rates in the first session (96.2 vs 95.0 %, P = 0.970) and in the final success rates (100 % in both groups) between Group A and Group B. The adverse event rates (2.9 vs 5.0 %, P = 0.783) and recurrence rates of choledocholithiasis (6.7 vs 10.0 %, P = 0.444) were not significantly different. Regarding patients with an altered anatomy, the EPLBD outcome was not significantly different.
Conclusion: EPLBD can be safely performed for elderly patients similarly to younger patients.
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http://dx.doi.org/10.1007/s10620-014-3156-9 | DOI Listing |
Sci Rep
January 2025
Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-ro, Seongnam-si, 13496, Gyeonggi-do, Republic of Korea.
The recent clinical outcomes of multi-regimen chemotherapy included prolonged survival and a high rate of conversion to surgery in Asian patients with advanced biliary tract cancer. The ability of single-operator cholangioscopy (SOC) to detect and stage extrahepatic cholangiocarcinoma (CCC) in intraductal lesions is becoming more important in determining the extent of surgery. The aim of this study was to evaluate the role of SOC in surgical planning for extrahepatic CCC.
View Article and Find Full Text PDFAktuelle Urol
January 2025
Klinik für Urologie & Urochirurgie, Universitätsklinikum Mannheim, Mannheim, Germany.
White light cystoscopy is a precise instrument for the detection and treatment of papillary bladder tumors. Various additional macroscopic detection methods have been established. Some of them, especially PDD or NBI, have been shown to have an additional benefit on the recurrence rate of bladder tumors, so they should be used as part of the diagnosis and treatment when available.
View Article and Find Full Text PDFWorld J Gastrointest Surg
January 2025
Department of Hepatobiliary Surgery, Shaoxing People's Hospital, Shaoxing 312000, Zhejiang Province, China.
Background: Intrahepatic and extrahepatic bile duct stones (BDSs) have a high rate of residual stones, a high risk of recurrence, and a high rate of reoperation. It is very important to take timely and effective surgical intervention for patients.
Aim: To analyze the efficacy, postoperative rehabilitation, and quality of life (QoL) of patients with intra- and extrahepatic BDSs treated with endoscopic retrograde cholangiopancreatography (ERCP) + endoscopic papillary balloon dilation (EPBD) + laparoscopic hepatectomy (LH).
Gut
January 2025
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Background: Cyst size, its growth rate, and diameter of the main pancreatic duct (MPD) are all associated with pancreatic carcinoma prevalence in intraductal papillary mucinous neoplasms (IPMNs).
Objective: To examine the above factors in relation to future risk of incident pancreatic carcinoma in individuals with IPMNs harbouring no high-risk stigmata.
Design: In a prospective longitudinal cohort, we analysed 2549 patients with IPMNs.
Diagnostics (Basel)
January 2025
Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
Detective flow imaging (DFI) endoscopic ultrasonography (EUS) can identify the microvascular flow imaging of a mural nodule (MN) in an intraductal papillary mucinous neoplasm (IPMN) without the use of contrast agents. This retrospective study evaluated the diagnostic accuracy of DFI-EUS and its ability to evaluate the blood flow of MNs in IPMNs. Between April 2021 and September 2023, 68 patients with MNs in IPMNs observed on EUS images were retrospectively analyzed.
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