Endoscopic retrograde cholangiopancreatography in a patient with achalasia and sigmoid esophagus poses a unique technical challenge, as one must safely guide the side viewing duodenoscope across a severely distorted distal esophagus and non-relaxing lower esophageal sphincter. In such patients, the use of an overtube is a simple solution that allows the safe passage of a duodenoscope and the removal of common bile duct stones.
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http://dx.doi.org/10.4166/kjg.2023.078 | DOI Listing |
Gastrointest Endosc
December 2024
Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Pancreatic Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China. Electronic address:
Background And Aims: Pancreas divisum (PD) is the most common developmental anatomic variant of pancreatic duct. The published data on the accuracy of the detection of pancreas divisum by linear-array endoscopic ultrasound (L-EUS) is limited. The current study aimed to assess the diagnostic accuracy of L-EUS compared with magnetic resonance cholangiopancreatography (MRCP) for identifying PD.
View Article and Find Full Text PDFPancreatology
December 2024
Department of Gastroenterology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Background/objectives: Positive pancreatic juice cytology (PJC) is an important finding when considering surgical resection in patients with intraductal papillary mucinous neoplasm (IPMN); however, guidelines do not recommend endoscopic retrograde cholangiopancreatography (ERCP) for PJC. This study aimed to clarify the findings worthy of adding PJC for diagnosing high-grade dysplasia (HGD) and invasive carcinoma (IC) in patients with IPMN.
Methods: Patients with IPMN who underwent preoperative PJC and surgical resection at Hiroshima University Hospital were enrolled, and the diagnostic yield of malignant IPMN based on PJC and clinical and imaging findings and the incidence of post-ERCP pancreatitis (PEP) were retrospectively analyzed.
Am J Gastroenterol
December 2024
Department of Gastroenterology, First Hospital of China Medical University, Shenyang, Liaoning, China.
Objective: Limitations are sometimes encountered in the application of laparoscopic cholecystectomy to the treatment of acute cholecystitis. Endoscopic gallbladder stenting (EGBS) has emerged as an additional option. However, the long-term stent patency remains an issue.
View Article and Find Full Text PDFNeuroendocrine tumors (NETs) of the biliary tract are extremely rare due to a paucity of Kulchitsky cells. While their preoperative diagnosis remains challenging due to the lack of specific diagnostic markers and imaging findings, there have been no detailed reports describing the diagnostic utility of various imaging modalities for bile duct NETs at the junction of the cystic and common hepatic ducts. We report a case of a woman in her 40s who presented with jaundice and elevated hepatobiliary enzymes.
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