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Efficacy and safety of endoscopic ultrasound-guided hepaticogastrostomy for biliary drainage in hypervascular hepatocellular carcinoma: a retrospective study from Japan.
Clin Endosc
November 2024
Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.
Background/aims: Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding.
View Article and Find Full Text PDFHow to manage difficult duodenal defects? Single center experience.
Turk J Surg
June 2024
Department of General Surgery, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye.
Objectives: The aim of this study was to investigate the surgical treatment methods and outcomes of difficult duodenal defects due to perforation.
Material And Methods: Data of patients who had undergone surgery for difficult duodenal defect between January 2012 and November 2022 were collected. Duodenal defect size of 2 cm or more was defined as difficult duodenal defect.
Laparoscopic common bile duct exploration and retrieval of endoscopic lithotripsy basket after mechanical failure.
J Minim Access Surg
November 2024
Department of General Surgery, Croydon Health Services NHS Trust, Thornton Heath, UK.
Impaction of a mechanical lithotripsy basket during endoscopic retrograde cholangiopancreatography is a rare but serious complication resulting from technical failure. We describe a novel case of lithotripsy basket retrieval aided by laser fragmentation. This 87-year-old male underwent an emergency laparoscopic subtotal cholecystectomy, common bile duct (CBD) exploration and laser lithotripsy after attempts at endoscopic mechanical lithotripsy caused a stone-basket complex to become impacted within the CBD.
View Article and Find Full Text PDFStent misdeployment and factors associated with failure in endoscopic ultrasound-guided choledochoduodenostomy: analysis of the combined datasets from two randomized trials.
Endoscopy
December 2024
Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
Article Synopsis
- Stent misdeployment (SMD) is a significant challenge in EUS-guided choledochoduodenostomy (EUS-CDS) for treating malignant distal biliary obstruction, with the study aiming to define its rate and outcomes, and propose a classification system.
- In a review of data from two randomized controlled trials involving 152 patients, SMD was found in 7.2% of cases, with most types being misdeployments of the distal flange (type I) and a small number causing minor adverse events.
- The analysis revealed that a smaller extrahepatic bile duct diameter (≤ 15 mm) increases the likelihood of SMD or technical failures, but most misdeployments can be successfully managed
Development of a Scoring System for Predicting the Difficulty of Bile Duct Cannulation and Selecting the Appropriate Cannulation Method.
Dig Dis Sci
September 2024
Gastroenterology Center, Ehime Prefectural Central Hospital, Kasugamachi, Matsuyama, Ehime, 790-0024, Japan.
Article Synopsis
- The study investigates the challenges of selective biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP), focusing on how different papillary morphologies can complicate the process.
- Researchers analyzed data from 776 patients to identify risk factors for cannulation difficulties, finding that certain types of papillae, the presence of periampullary diverticulum (PAD), and scope operability significantly impacted success rates.
- The study concluded that specific patterns can predict cannulation difficulties, helping to inform whether to use conventional or salvage techniques in treatment.
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