3,604 results match your criteria: "Percutaneous Cholangiography"

Recurrent cholangitis, intrahepatic stones and biliary and anastomotic strictures are common complications after Roux-en-Y hepaticojejunostomy. The surgically altered anatomy makes management of these complications with endoscopic retrograde cholangiopancreatography technically difficult. We present a case of recurrent cholangitis in a 25-year-old woman with a prior hepaticojejunostomy.

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Retroperitoneal biloma and accompanying bilioscrotum are very rare entities. A 49-year-old male patient underwent endoscopic retrograde cholangiopancreatography procedure with the preliminary diagnosis of stone-mud in the common bile duct. On the seventh day after the procedure, diffuse air densities observed around the duodenum and biliary stent protruding beyond the lumen in the non-contrast abdominal computed tomography examination were evaluated as duodenal perforation.

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Purpose Of Review: In this review, we discuss the role of endoscopic gallbladder drainage for acute cholecystitis in non-surgical candidates, describe technical aspects, clinical outcomes, and elaborate on considerations when determining which approach to adopt for a given patient.

Recent Findings: Cholecystectomy remains the criterion standard for management of acute cholecystitis in patients who can safely undergo surgery. For non-surgical candidates, percutaneous cholecystostomy (PTC-GBD) has been the traditional strategy to drain and decompress the gallbladder.

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Objective: Dyna computed tomography (DynaCT) is an innovative clinical imaging tool used to obtain three-dimensional (3D) images of biliary structures via the Artis Zee DSA system (SIEMENS Company, Germany). DynaCT is a type of 3D cone beam computed tomography (CBCT) reconstruction produced from a two-dimensional (2D) cholangiography system by rotating the C-arm without moving the patient. The aim of this study was to evaluate the technical approach and application value of DynaCT to diagnosis hepatolithiasis and biliary stenosis.

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Purpose: To evaluate the feasibility, reproducibility, and diagnostic value in biliary obstructive diseases using Fly-Thru (FT) technique.

Methods: In this single-center prospective study, patients with biliary obstruction who underwent both abdominal ultrasound and FT examinations were recruited between January 2013 and January 2023. 3D FT images (3D-FT) were reconstructed with FT volumetric data.

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Percutaneous transhepatic biliary drainage in patients with cholestasis following liver transplantation.

Abdom Radiol (NY)

November 2024

Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany.

Article Synopsis
  • Biliary strictures are common after liver transplantation, and when endoscopic techniques fail, percutaneous transhepatic biliary drainage (PTBD) can be an effective alternative.
  • A study involving 56 liver transplant recipients showed that PTBD has a high success rate (98%) and can improve various lab indicators, although the risk of subsequent biliary complications depends on the type of stricture present.
  • Patients who achieved internal drainage into the small intestine had better 12-month survival rates compared to those needing external drainage, highlighting the importance of the initial PTBD approach.
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Sump 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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Percutaneous transhepatic cholangiography: An effective option for endo-biliary radiofrequency ablation before stent insertion in unresectable biliary cancer?

World J Clin Cases

October 2024

Academic Department of Gastroenterology, Medical School of the National and Kapodistrian University of Athens, "Laiko" General Hospital, Athens 11527, Greece.

Biliary cancer is a highly aggressive disease that is typically diagnosed at advanced stages when surgical removal is no longer an option. In these cases, palliative care and mechanical widening of the blocked biliary system are preferred. The insertion of a stent is often necessary to prevent the recurrence of blockages caused by cancer progression.

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Management of Acute Cholangitis and Choledocholithiasis.

Surg Clin North Am

December 2024

Department of General Surgery, Alaska Native Medical Center in Anchorage, 4315 Diplomacy Drive, Anchorage, AK 99508, USA. Electronic address:

Acute cholangitis is a life-threatening emergency, caused by blockage of bile, most commonly by a gallstone (choledocholithiasis). Stasis of bile leads to an infection in the biliary tree known as cholangitis. Cholangitis is graded into 3 categories according to severity of symptoms.

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Article Synopsis
  • The use of percutaneous cholecystostomy (PC) for treating acute cholecystitis (AC) has increased due to an aging population and supportive guidelines, prompting a need for clearer management protocols.
  • An international consensus was developed through a two-round Delphi survey with 27 questions, and participants aimed for a minimum 70% agreement on the management of PCs.
  • Out of these, six key recommendations were established, including the timing of PC implementation and the need for cholangiography before PC removal, highlighting the necessity for comprehensive guidelines on PC management in AC patients.
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Article Synopsis
  • - The study assessed the safety and effectiveness of two procedures, PTCD and ERCP, for managing malignant obstructive jaundice (MOJ) in 520 patients, comparing their outcomes in palliative and preoperative drainage scenarios.
  • - PTCD showed higher technical success and better reductions in bilirubin levels compared to ERCP, although it had a higher risk of tube displacement, while ERCP had higher rates of biliary infections and pancreatitis.
  • - PTCD not only provided faster bilirubin reduction in preoperative settings but also facilitated quicker surgery dates, suggesting it may be preferred for improving liver function and infection control before surgery.
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Article Synopsis
  • Strictures following liver transplantation are a common complication, and while endoscopic retrograde cholangiopancreatography (ERCP) is typically the first line of treatment, it can fail, necessitating further procedures.
  • This study reviewed the use of a digital single operator cholangioscope (D-SOC) at two Australian centers to assist patients who had unsuccessful ERCP attempts for biliary strictures.
  • Out of 18 patients treated with D-SOC, 72% successfully achieved guidewire access, with some patients avoiding more invasive procedures, indicating D-SOC's potential as a viable option before resorting to less favorable techniques like percutaneous transhepatic cholangiography (PTC) or surgery.
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The impact of routine cholangiography for asymptomatic patients after cholecystostomy insertion for acute cholecystitis.

Am J Surg

December 2024

Department of Surgery, Meir Medical Center, Kfar Saba, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: We aim to investigate the impact of routine cholangiography on asymptomatic patients with percutaneous cholecystostomy (PCC) for acute cholecystitis (AC).

Methods: The study included all patients treated with PCC for AC from 2017 to 2020 ​at a single academic center. Patients who underwent routine cholangiography within 30 days post-discharge while asymptomatic were compared to patients who were only followed clinically.

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Objective: To report our experience of using biodegradable biliary stents for anastomotic biliary strictures in pediatric liver transplant patients.

Methods: Analysis of a retrospective data collection from January 2014 to January 2023, including all pediatric liver transplant recipients in our center treated for anastomotic biliary strictures with biodegradable biliary stents (BBS). In phase 1 (2014-2019), there was an initial percutaneous transhepatic cholangiography (PTC) with anastomotic dilatation followed two weeks after by a second PTC with BBS insertion.

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Feasibility of Endoscopic Ultrasound-Guided Hepaticogastrostomy for Malignant Hilar Biliary Obstruction.

Dig Dis Sci

September 2024

Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.

Article Synopsis
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Article Synopsis
  • Liver transplantation is a very important surgery for kids with serious liver problems, but there can be complications like biliary stones.
  • A 7-year-old boy who had a liver transplant faced issues with stones in his bile ducts and infection, making treatment difficult.
  • A special method called percutaneous endoscopic cholangioscopy was used to successfully remove the stones without needing more surgery, which is a great option for future cases like this.
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Article Synopsis
  • Percutaneous transhepatic biliary drainage is a crucial treatment for biliary obstruction, especially when endoscopic methods fail, as demonstrated in an 82-year-old man with cholangiocarcinoma.
  • After initial success with the drainage procedure, complications arose due to accidental dislodgement of the drain, resulting in biliary peritonitis and worsening health.
  • The extractive procedure to remove the fractured drain highlighted the significance of interventional radiology in addressing complications, and a new technique was developed to ensure better fixation and prevent future dislodgements.
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Management of biliary complications after LDLT.

Updates Surg

September 2024

Master in HPB Surgery (Henri Bismuth Hepatobiliary Institute, France), European Inter-University Diploma in HPB Oncology, Fellowship in Hepatobiliary Surgery and Liver Transplantation (Hopital Paul Brousse, France), Director, Liver Transplantation and Hepatobiliary Surgery, Medanta Institute Of Liver Transplantation and Regenerative Medicine, Medanta - The Medicity, Gurgaon, Delhi NCR, 122001, India.

Biliary complications (BC) in the recipient continue to be an as yet, unresolved issue following living donor liver transplantation (LDLT). Bile leaks (BL) and biliary anastomotic strictures (BAS) are the most common BCs, with the latter contributing to close to 80%. With increasing expertise, endoscopic treatment with endoscopic retrograde cholangiography (ERC) [the first-line treatment] and percutaneous transhepatic cholangiography (PTC) with percutaneous transhepatic biliary drainage (PTBD) alone or in combination with ERC lead to successful management in a majority of these cases.

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Article Synopsis
  • Fluoroscopic examinations, such as ERCP and PTC, are essential for diagnosing hepatobiliary diseases but expose patients to significant radiation, prompting a need to better assess radiation doses to critical organs.
  • The study used an Alderson RANDO phantom and Thermoluminescent Dosemeters to measure actual radiation exposure during these procedures, finding that PTC generally yields higher doses, particularly to the thyroid and spleen.
  • Results highlight the necessity of evaluating the risks versus benefits of these procedures due to the notable radiation exposure, suggesting a preference for ERCP when minimizing radiation is necessary, and advocating for continued improvements in medical imaging to enhance patient safety.
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Purpose: Early diagnosis of biliary atresia (BA) is critical for best outcomes, but is challenged by overlapping clinical manifestations with other causes of obstructive jaundice in neonates. We evaluate the performance of the modified Simple BA Scoring System (SBASS) in diagnosing BA.

Methods: We performed a prospective, cross-sectional study on infants with cholestatic jaundice (June 2021-December 2022).

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Introduction Obstructive jaundice due to proximal biliary obstruction presents significant diagnostic and therapeutic challenges. Accurate and timely diagnosis is essential for effective management. Objective/aim This study aimed to evaluate and compare the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP) and percutaneous transhepatic cholangiography (PTC) along with percutaneous transhepatic biliary drainage (PTBD) stenting in obstructive jaundice, while also incorporating the comparison of ultrasonography (USG) and computed tomography (CT) findings.

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Rationale: Complications after endoscopic retrograde cholangiopancreatography (ERCP) are diverse and usually treated with nonoperative management or percutaneous drainage; however, there are still some rare, life-threatening complications. This is an extremely rare case of biliary peritonitis caused by rupture of the intrahepatic bile duct after ERCP.

Patient Concerns: A 63-year-old male underwent ERCP for common bile duct stones.

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