Background: The percutaneous approach (PA) for management of biliary stones (BS) with or without an underlying biliary stenosis is an option for patients in whom an endoscopic approach (EA) is not possible. The aim of this study was to evaluate the efficacy of a PA in patients with BS unsuitable for an EA.
Methods: A retrospective review of a database was performed. Inclusion criteria included patients with benign disease, BS who had undergone a PA. The outcomes were technical success rate, short (≤90 days) and long-term (>90 days) efficacy and safety.
Results: A total of 91 patients enrolled were divided into those with (n = 38) or without (n = 53) a biliary stenosis. A median of 5 (IQR:3-7) treatments/patient were performed. During a median follow-up of 23 months (IQR:3-52), the median time free from recurrence was 21 months (CI:14-29). In the long term, the PA was most efficacious in those patients without a biliary stenosis with long term success in 68% of patients as compared to 36% of patients with a biliary stenosis (p = 0.003).
Conclusion: A PA is an effective procedure with high initial success rate, however the coexistence of stenosis affects long-term efficacy, especially in patients with chronic biliary disease.
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http://dx.doi.org/10.1016/j.hpb.2018.12.007 | DOI Listing |
Sci Rep
December 2024
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku Nagoya, Nagoya, Aichi, 467-8601, Japan.
Biliary and pancreatic tract stenosis are hallmark symptoms in pancreaticobiliary diseases, transcending malignancy. Endoscopic techniques are pivotal for biliary/pancreatic drainage; however, challenging scenarios arise when attempting to pass a guidewire (GW) through obstruction. Cholangioscopy-assisted GW placement has proven valuable, but challenges persist in its execution, particularly in maneuvering the GW through cholangioscopy.
View Article and Find Full Text PDFGeorgian Med News
October 2024
3State Higher Medical College named after D. Kalmataev, Semey, Republic of Kazakhstan.
Purpose Of The Study: improving the surgical treatment of biliary pancreatitis by using a universal retractor and improved methods of omentobursostomy with drainage of the omental bursa.
Study Design: Non-randomized controlled clinical trial Material and methods: This study included thirty-nine patients who underwent surgical procedures between October 2022 and September 2023 in Semey, located in the Abay region. The study examined the general characteristics of surgical interventions performed for acute biliary pancreatitis using our proposed treatment methods and devices to improve the outcomes of acute biliary pancreatitis.
Ann Surg Open
December 2024
From the Department of Hepato-Biliary-Pancreatic Surgery, Kyorin University Hospital, Tokyo, Japan.
Surg Endosc
December 2024
Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
Background And Aims: The most common adverse event (AE) of orthotopic liver transplantation (OLT) is anastomotic biliary stricture (ABS). Management varies widely between centers, and it is not clear whether a combination of endoscopic dilation of the stenosis followed by multiple plastic stents (MPS) or placement of a fully covered self-expandable metal stent (fcSEMS) is better for the management of post-OLT ABS. This systematic review and meta-analysis aimed to compare the efficacy, safety, and cost of fcSEMS versus MPS in the treatment of post-OLT ABS.
View Article and Find Full Text PDFAnn Transplant
December 2024
Department of Surgery, Samsung Medical Center, Seoul, Sungkyunkwan University School of Medicine, Seoul, South Korea.
BACKGROUND Medical accessibility is important in liver transplantation (LT) because of the risk of infections associated with the use of immunosuppressants and complications that require continuous treatment, such as biliary stenosis. However, the effect of medical accessibility on LT success rates has yet to be scrutinized. The aim of this retrospective observational study is to determine whether medical accessibility affects LT outcomes.
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