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Redefining endoluminal biliary drainage: Challenges and innovations in endosonography-guided techniques.
World 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 PDFThe Role of Therapeutic Endoscopic Ultrasound in Management of Malignant Double Obstruction (Biliary and Gastric Outlet): A Comprehensive Review with Clinical Scenarios.
J 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 PDFIMPROVEMENT OF SURGICAL TREATMENT OF ACUTE BILIARY PANCREATITIS.
Georgian 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.
Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction: A Comprehensive Review on Technical Tips and Clinical Outcomes.
Diagnostics (Basel)
November 2024
Gastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Endoscopic ultrasound-guided biliary drainage (EUS-BD) has dramatically spread and improved in the last two decades and is changing the paradigm of drainage in case of malignant biliary obstruction (MBO). EUS-BD can be achieved from different routes, including the common bile duct (choledochoduodenostomy), intrahepatic bile ducts (hepaticogastrostomy), and gallbladder as a rescue (cholecystogastrostomy/cholecystoduodenostomy). EUS-guided hepaticogastrostomy (EUS-HGS) is a valuable option for biliary drainage in MBO when ERCP fails or is not feasible.
View Article and Find Full Text PDFSump syndrome: Diagnosis dilemmas and therapeutic approaches-A case series.
Clin Case Rep
November 2024
Department of Internal Medicine Hamad Medical Corporation Doha Qatar.
Key Clinical Message: It is important to consider the diagnosis of Sump syndrome in patients with a history of open cholecystectomy, particularly in those who migrate from developing countries where alternative biliary interventions may be limited. The presentation may range from acute severe, mimicking acute ascending cholangitis, to chronic recurrent abdominal pain without evidence of inflammation. Management is a case-by-case decision, with principal management aims to decompress the biliary tract and address any underlying sepsis.
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