A 92-year-old woman was hospitalized with upper abdominal pain. She had a history of acute biliary pancreatitis and chronic heart failure and had undergone gastrectomy with Roux-en-Y reconstruction. She was admitted with recurrent pancreatitis and an exacerbation of heart failure. Biliary drainage could not successfully be achieved endoscopically or with percutaneous transhepatic biliary drainage and EUS-guided biliary drainage because of the Roux-en-Y reconstruction and non-dilation of bile duct. We successfully accomplished biliary drainage in one session with percutaneous transhepatic puncture of the common bile duct with ultrasound guidance and the rendezvous technique. We report this case because it is rare.
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http://dx.doi.org/10.11405/nisshoshi.116.739 | DOI Listing |
PLoS One
January 2025
Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan.
Biliary stent occlusion is due, in part, to biofilm formation by bacteria. However, previous culture-based approaches may not have revealed all microorganisms on the surface. Twenty-seven patients underwent endoscopic retrograde biliary drainage for the removal or replacement of plastic biliary stents.
View Article and Find Full Text PDFWorld J Gastroenterol
January 2025
Department of Gastroenterology and Hepatology, Campus Virchow/Campus Mitte, Charité Berlin, Berlin 10117, Germany.
Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions. However, its use in complex biliary obstructions is limited. Over the past decades, therapeutic endosonography (EUS) and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring non-endoscopic or surgical approaches.
View Article and Find Full Text PDFJ Clin Med
December 2024
Gastroenterology and Gastrointestinal Endoscopy Division, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.
Endoscopic ultrasound (EUS)-guided interventions have revolutionized the management of malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), providing minimally invasive alternatives with improved outcomes. These procedures have significantly reduced the need for high-risk surgical interventions or percutaneous alternatives and have provided effective palliative care for patients with advanced gastrointestinal and bilio-pancreatic malignancies. EUS-guided biliary drainage (EUS-BD) techniques, including hepaticogastrostomy (EUS-HGS), choledochoduodenostomy (EUS-CDS), and antegrade stenting (EUS-AS), offer high technical and clinical success rates, with a good safety profile particularly when Endoscopic Retrograde Cholangiopancreatography (ERCP) is not feasible.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a key therapeutic procedure in diseases of the pancreas or bile ducts. The understanding and effective management of the risks associated with the procedure, especially in the context of possible infectious complications, is crucial for patients' safety. The aim of this review was to analyze the results of studies on antibiotic prophylaxis for infectious complications of ERCP, pancreatoscopy, and cholangioscopy.
View Article and Find Full Text PDFJ Laparoendosc Adv Surg Tech A
January 2025
A21 Surgery Department, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia.
The traditional method of performing open common bile duct exploration (OCBDE) was replaced by a less invasive procedure known as laparoscopic common bile duct exploration (LCBDE) in elective surgery. But at present, the application of this technique is considered novel and controversial to treat acute cholangitis (AC). The aim of our systematic review was to investigate the safety and efficacy of laparoscopic surgery in patients with AC.
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