Objectives: Distal malignant biliary obstruction (DMBO) caused by pancreatic cancer often complicates endoscopic retrograde cholangiopancreatography (ERCP), particularly biliary cannulation. While various factors influencing difficult biliary cannulation (DBC) have been studied, data specific to pancreatic cancer-related distant malignant biliary obstruction#x000A0;remains limited. This study identifies factors affecting ERCP success in this patient population to improve clinical outcomes.
Methods: We retrospectively analyzed 119 ERCP procedures for distant malignant biliary obstruction owing to pancreatic cancer with naïve papilla at Showa University Fujigaoka Hospital (January 2020-September 2024). Patient characteristics, duodenal invasion, ampullary bile duct status, papillary morphology, trainee involvement, and adverse events were evaluated. Multivariate analysis identified predictive factors of DBC.
Results: After excluding 17 ERCP failures, 102 patients were analyzed and categorized into non-DBC ( = 40) and DBC ( = 62) groups. The DBC incidence rate was 60.8%. The absence of the ampullary bile duct (odds ratio [OR]: 2.58, 95% confidence interval [CI]: 1.02-6.51; = 0.04) and the macroscopic appearance of type III papillary morphology (enlarged/protruding; OR: 3.32; 95% CI: 1.07-10.30; = 0.04) were significantly associated with DBC. Adverse events were slightly more frequent in the DBC group; however, this difference was not statistically significant. Alternative cannulation was performed more often in patients without the ampullary bile duct; however, no difference in adverse events was observed.
Conclusions: The absence of the ampullary bile duct and type III papillary morphology are anatomical risk factors for DBC during ERCP for patients with pancreatic cancer. Early consideration of alternative cannulation techniques or biliary drainage methods may be necessary for such patients.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880624 | PMC |
| http://dx.doi.org/10.1002/deo2.70092 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A review of how colors clue us into gross diagnosis in domestic animals.
Vet Pathol
March 2025
Universidade Federal do Mato Grosso do Sul, Campo Grande, Brazil.
Different tissues have a normal color spectrum that reflects their cellular composition and/or metabolic features. Similarly, distinct color variations may occur in tissues that have undergone pathologic or nonpathologic changes. Common examples of color changes in domestic animal tissues include red (associated with erythrocytes, hemoglobin, and myoglobin), brown (ferric hemoglobin or myoglobin, suppurative inflammation, lipid oxidation, postmortem autolysis, formalin fixation, neoplasms arising from cytochrome-rich tissues), yellow (hemoglobin and iron degradation, biliary pigment and by-products, carotenes, keratin, necrosis, suppurative or fibrinous inflammation), green (hemoglobin and iron degradation, biliary pigment and by-products, meconium, eosinophilic or suppurative inflammation, oomycete and algal infections), white (lack of blood, adipose tissue and its neoplasms, chylous effusion, necrosis, mineralization, fibrosis, lymphoid tissue, round cell neoplasms), translucent (transudate, cysts), black to gray (hemoglobin and iron degradation, melanin, carbon, tattoos), and blue to purple (poorly oxygenated blood, tattoos).
View Article and Find Full Text PDFIntraductal Papillary Mucinous Neoplasm of the Bile Duct: A Case Report.
Cureus
February 2025
Gastroenterology and Hepatology, Baylor Scott & White All Saints Medical Center, Fort Worth, USA.
Intraductal papillary mucinous neoplasms (IPMNs) are a prevalent subtype of pancreatic cystic lesions, especially among individuals with liver cirrhosis. Intraductal papillary neoplasms of the bile duct (IPNBs) differ in histopathology based on the location and cellular variability in each location. Intrahepatic IPNBs are less aggressive than the extrahepatic variant, highlighting its heterogeneity and complexity.
View Article and Find Full Text PDFMultimodal integration of liquid biopsy and radiology for the noninvasive diagnosis of gallbladder cancer and benign disorders.
Cancer Cell
March 2025
Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Shanghai Key Laboratory of Systems Regulation and Clinical Translation for Cancer, Shanghai 200127, China; State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Shanghai 200127, China. Electronic address:
Gallbladder cancer (GBC) frequently mimics gallbladder benign lesions (GBBLs) in radiological images, leading to preoperative misdiagnoses. To address this challenge, we initiated a prospective, multicenter clinical trial (ChicCTR2100049249) and proposed a multimodal, non-invasive diagnostic model to distinguish GBC from GBBLs. A total of 301 patients diagnosed with gallbladder-occupying lesions (GBOLs) from 11 medical centers across 7 provinces in China were enrolled and divided into a discovery cohort and an independent external validation cohort.
View Article and Find Full Text PDFRisk Factors for Cholecystitis After Self-expandable Metallic Stent Placement for Malignant Distal Biliary Obstruction: A Systematic Review and Meta-analysis.
J Clin Gastroenterol
March 2025
Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN.
Background And Goals: Endoscopic biliary stenting is a standard palliative procedure to improve the quality of life in patients with unresectable malignant distal biliary obstruction (MDBO). Self-expandable metallic stents (SEMS) are preferred for their longer patency than plastic stents. However, cholecystitis can complicate SEMS placement by obstructing the cystic duct.
View Article and Find Full Text PDFNovel orthotopic patient-derived xenograft model using human pancreatic cancer tissue fragments to recapitulate distant metastasis and cancer-related hypercoagulability.
Med Mol Morphol
March 2025
Department of Biophysics, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-Ku, Kobe, 654-0142, Japan.
Pancreatic cancer is a malignant tumor that metastasizes to distant organs, such as the liver and lungs from an early stage. Few animal models can reproduce early metastasis. In addition, no model has been reported that reproduces cancer-related hypercoagulability, which is characteristic of pancreatic ductal adenocarcinoma and other adenocarcinomas.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!