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Intraoperative fluorescent imaging using indocyanine green for liver mapping and cholangiographyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion Application of this technique allows intraoperative identification of anatomical landmark in hepatobiliary surgery. Content Type Journal ArticleCategory TopicsDOI 10.1007/s00534-009-0197-0Authors Takeshi Aoki, Showa University Department of Gastroenterological & General Surgery, School of Medicine Tokyo 142-8666 JapanMasahiko Murakami, Showa University Department of Gastroenterological & General Surgery, School of Medicine Tokyo 142-8666 JapanDaisuke Yasuda, Showa University Department of Gastroenterological & General Surgery, School of Medicine Tokyo 142-8666 JapanYoshinori Shimizu, Showa Un...
Source: Journal of Hepato-Biliary-Pancreatic Surgery - October 21, 2009 Category: Surgery Tags: Journal of Hepato-Biliary-Pancreatic Surgery Source Type: journals

Image overlay navigation by markerless surface registration in gastrointestinal, hepatobiliary and pancreatic surgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions Our non-invasive markerless registration using physiological markers on the body surface reduced logistical efforts. The image overlay technique is a useful tool when highlighting hidden structures, giving more information. Content Type Journal ArticleCategory TopicsDOI 10.1007/s00534-009-0199-yAuthors Maki Sugimoto, Teikyo University Chiba Medical Center Department of Surgery 3426-3 Anesaki, Ichihara Chiba 299-0111 JapanHideki Yasuda, Teikyo University Chiba Medical Center Department of Surgery 3426-3 Anesaki, Ichihara Chiba 299-0111 JapanKeiji Koda, Teikyo University Chiba Medical Center ...
Source: Journal of Hepato-Biliary-Pancreatic Surgery - October 1, 2009 Category: Surgery Tags: Journal of Hepato-Biliary-Pancreatic Surgery Source Type: journals

The management of treatment-resistant biliary calculi using percutaneous endourologic techniques.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: Biliary calculi may be successfully treated using standard endourologic methods with high stone-free rates. This technique is generally well-tolerated even among high-risk patients. PMID: 19865576 [PubMed - in process] (Source: Canadian Journal of Surgery)
Source: Canadian Journal of Surgery - October 1, 2009 Category: Surgery Authors: Ray AA, Davies ET, Duvdevani M, Razvi H, Denstedt JD Tags: Can J Surg Source Type: journals

Selective Management of Patients with Acute Biliary PancreatitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion Presence of four or five variables significantly correlated with persistent CBD stone. Biliary evaluation by endoscopic retrograde cholangiopancreatography is suggested, as initial magnetic resonance cholangiopancreatography (MRCP) may only increase cost and delay time to intervention. In the absence of any variable, biliary evaluation by intraoperative cholangiogram may be sufficient. Decisions regarding patients with one to three variables should occur on a case-to-case basis. Initial biliary evaluation by MRCP is likely preferable, however, as no increased probability of CBD stone was identifie...
Source: Journal of Gastrointestinal Surgery - September 25, 2009 Category: Surgery Tags: Journal of Gastrointestinal Surgery Source Type: journals

Long-term outcome of endoscopic and/or percutaneous transhepatic therapy in patients with biliary stricture after orthotopic liver transplantationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions Endoscopic as well as percutaneous transhepatic approaches in combination or as monotherapy are effective in the management of anastomotic and non-anastomotic strictures after liver transplantation. Content Type Journal ArticleCategory Original Article—Liver, Pancreas, and Biliary TractDOI 10.1007/s00535-009-0123-xAuthors Andreas Weber, Technical University of Munich Department of Gastroenterology and Hepatology Munich GermanyChristian Prinz, Technical University of Munich Department of Gastroenterology and Hepatology Munich GermanyCarlos Gerngroß, Technical University of Munich Departme...
Source: Journal of Gastroenterology - September 18, 2009 Category: Gastroenterology Tags: Journal of Gastroenterology Source Type: journals

Long-term follow-up evaluation for more than 10 years after endoscopic treatment for postoperative bile duct stricturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions Endoscopic stent therapy is available for postoperative bile duct strictures. Long-term prognosis for more than 10 years is excellent. Repeat surgical interventions may be unavoidable in some cases, but endoscopic treatment should be proposed as the first-line treatment. Content Type Journal ArticleDOI 10.1007/s00464-009-0673-2Authors Yasuhisa Kuroda, Chiba University Department of Medicine and Clinical Oncology, Graduate School of Medicine 1-8-1 Inohana, Chuo-ku Chiba 260-0856 JapanToshio Tsuyuguchi, Chiba University Department of Medicine and Clinical Oncology, Graduate School of Me...
Source: Surgical Endoscopy - September 15, 2009 Category: Surgery Tags: Surgical Endoscopy Source Type: journals

Endoscopic retrograde cholangiography for intrabiliary rupture of hydatid cystEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report feasibility and outcome of the endoscopic method for treatment of ruptured hepatic hydatid cyst into the biliary tract that also benefited from drainage of the whole cyst and membranes into the major biliary duct. (Source: Digestive Endoscopy)
Source: Digestive Endoscopy - September 13, 2009 Category: Gastroenterology Authors: Manouchehr Khoshbaten, Sara Farhang, Naser Hajavi Tags: ENDOSCOPIC IMAGES OF INTEREST Source Type: journals

An unusual presentation of biloma five years following cholecystectomy: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 34-year-old female presented with right hypochondrial pain of 6 months following an uneventful open cholecystectomy about 5 years ago. A firm intra abdominal lump was felt in the right hypochondrium. Ultrasonography and computed tomography of the abdomen showed a large cystic lesion in relation to the porta hepatis. On exploration, a large cystic mass was found in relation to the undersurface of liver, adherent to the colon and duodenum. The cyst was excised leaving a cuff of cyst wall, densely adherent to the duodenum. A small opening with bile trickling through it was noted in the region of the confluence of hepatic du...
Source: Cases Journal - September 9, 2009 Category: Journals (General) Source Type: journals

[Small cell carcinoma of extahepatic bile duct presenting with hemobilia.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of small cell carcinoma of extrahepatic bile duct presenting with jaundice and hemobilia. A 59-year-old woman was admitted due to right upper quadrant pain and jaundice. An abdominal computed tomography revealed a 2 cm sized mass in the extrahepatic bile duct. Endoscopic retrograde cholangiopancreatography revealed bloody discharge coming out of the papillary orifice in endoscopic view and a dilated extrahepatic bile duct with multiple irregular filling defects in cholangiogram. A coronal T2-weighted image revealed a hyperintense mass at extrahepatic bile duct. Laparotomy was performed, and pathologic exam...
Source: Korean J Gastroenter... - August 31, 2009 Category: Gastroenterology Authors: Cho SB, Park SY, Joo YE Tags: Korean J Gastroenterol Source Type: journals

Intravenous Morphine for Augmentation of Postoperative T-tube Cholangiograms in Liver Transplant Recipients with Choledocho-choledochal AnastomosesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: In 92% of cases, intravenous morphine was successful in opacifying the biliary tract without complications. In well-positioned T-tubes, the use of morphine increased diagnostic yield from 85% to 93%. No predictors for inadequate filling were found. (Source: Journal of Vascular and Interventional Radiology : JVIR)
Source: Journal of Vascular and Interventional Radiology : JVIR - August 30, 2009 Category: Radiology Authors: Wael E.A. Saad, Ian J. Wilson, Mark G. Davies, Karin E. Westesson, Wael M. Darwish, David L. Waldman Tags: Clinical Studies Source Type: journals

Endoscopic transpapillary intraductal ultrasonography and biopsy in the diagnosis of IgG4-related sclerosing cholangitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions The IDUS findings were useful for distinction of IgG4-SC from cholangiocarcinoma. Transpapillary biopsy was not useful for direct diagnosis of IgG4-SC even after IgG4 immunostaining, but it did allow distinction of IgG4-SC from cholangiocarcinoma in some cases. IDUS and transpapillary biopsy after endoscopic retrograde cholangiopancreatography can provide further information for precise diagnosis of IgG4-SC. Content Type Journal ArticleCategory Original Article—Liver, Pancreas, and Biliary TractDOI 10.1007/s00535-009-0108-9Authors Itaru Naitoh, Nagoya City University Graduate School of ...
Source: Journal of Gastroenterology - July 27, 2009 Category: Gastroenterology Tags: Journal of Gastroenterology Source Type: journals

Prediction of Which Patients with an Abnormal Intraoperative Cholangiogram Will Have a Confirmed Stone at ERCPEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions Approximately one-half of patients with an abnormal IOC have a normal postoperative ERCP. None of the parameters evaluated in this retrospective study helped identify patients who merit further evaluation by ERCP. The argument could be made that in patients with an abnormal IOC, less invasive methods such as endoscopic ultrasound or magnetic resonance cholangiopancreatography could be used postoperatively if symptoms arise to assess for possible retained stone. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10620-009-0894-1Authors Matthew P. Spinn, University of Texas H...
Source: Digestive Diseases and Sciences - July 25, 2009 Category: Gastroenterology Tags: Digestive Diseases and Sciences Source Type: journals

Should radiocontrast be diluted for operative cholangiography?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The role of operative cholangiography for detecting common bile duct stones and for delineating biliary anatomy is well established. The first operative cholangiogram was described by Mirizzi in 1937 and popularized in the United States by Hickens. Operative cholangiography has resulted in improved detection of common bile duct stones from 83% based on clinical findings alone to over 95%. The introduction of portable C-arm fluoroscopy in the 1970s by Berci and Steckell has even further improved the accuracy of operative cholangiography. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 15, 2009 Category: Surgery Authors: Tomer Davidov, Terrence Curran, Stanley Trooskin Tags: Letters to the Editor Source Type: journals

Is laparoscopic fiberoptic choledochoscopy for common bile duct stones a fine option or a mandatory step?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions The laparoscopic basket blind technique and choledochoscopy are safe and effective for CBD stone removal. However, the latter seems to be better in terms of a higher stone removal rate and fewer minor complications despite its longer operation time. In the authors’ opinion, it may be preferable to reserve ERCP for very high-risk patients, taking into account that in addition to the related complications, it results in an approximate 10% rate of recurrent or persistent stones. Content Type Journal ArticleDOI 10.1007/s00464-009-0599-8Authors R. Campagnacci, Università Politecnica delle M...
Source: Surgical Endoscopy - July 9, 2009 Category: Surgery Tags: Surgical Endoscopy Source Type: journals

[A case of early bile duct cancer arising from villous adenoma in choledochal cyst.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Choledochal cyst is an uncommon premalignant anomaly. The morphology and pathogenesis of the premalignant lesion of cholangiocarcinoma arising from the choledochal cyst has not been well described. Herein, we report a rare case of bile duct adenoma arising from choledochal cyst with anomalous union of pancreaticobiliary duct (AUPBD). 50-year-old woman was admitted to our hospital with the complaint of epigastric pain. She had received common bile duct (CBD) exploration and choledocholithotomy and cholecystectomy 3 months earlier under the diagnosis of multiple CBD stones. Intraoperalive cholangiogram was not remarkable...
Source: Korean J Gastroenter... - June 30, 2009 Category: Gastroenterology Authors: Lee TS, Kim HK, Ahn HM, Lee UJ, Choi YC, John BM, Park TI, Koo JH Tags: Korean J Gastroenterol Source Type: journals

Liver injury from endoscopic insertion of self-expandable metallic stent to relieve biliary obstruction: a fatal complicationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 75-year-old man was diagnosed with advanced hilar cholangiocarcinoma and underwent an ERCP. His cholangiogram revealed a hilar stricture and mild left intrahepatic duct dilatation (A). A guidewire could be passed through the stricture into the left intrahepatic duct, and a noncovered self-expandable metallic stent was inserted over the wire. After stent deployment, an abdominal film was taken (B). On the first postoperative day, the patient developed a high fever, abdominal pain, and distention. CT scan of the abdomen demonstrated a malpositioned stent (C). In the operating room, the stent was found to have penetrated se...
Source: Gastrointestinal Endoscopy - June 25, 2009 Category: Gastroenterology Authors: Thawatchai Akaraviputh, Cherdsak Iramaneerat, Atthaphorn Trakarnsanga Tags: At the Focal Point Source Type: journals

Long-Term Results of Percutaneous Bilioenteric Anastomotic Stricture Treatment in Liver-Transplanted ChildrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, balloon dilation and percutaneous drainage placement is safe and effective, and it has long-term patency for children with BAS after liver transplantation. Because of prolonged treatment time, reintervention may be necessary, thereby increasing the complication rate. Balloon dilation and percutaneous drainage placement should be considered as the first treatment option because of its minimally invasive nature. Content Type Journal ArticleCategory Clinical InvestigationDOI 10.1007/s00270-009-9619-2Authors Airton Mota Moreira, São Paulo University Medical School Interventional Radiology Unit, Radiolo...
Source: CardioVascular and Interventional Radiology - June 20, 2009 Category: Radiology Tags: CardioVascular and Interventional Radiology Source Type: journals

Endoscopic Resection of Distal Bile Duct MassEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
1. This video demonstrated a case of endoscopic resection of a distal bile duct mass. 2. A 76-yr old patient with recurrent cholangitis under went EUS for evaluation of a dilated bile duct. 3. At EUS, a hyperechoic mass was seen in the distal CBD consistent with a polyp. 4. An ERCP was undertaken to evaluate the mass by intraductal ultrasound. 5. Cholangiogram confirmed the presence of a distal CBD mass. 6. At intraductal ultrasound, a dilated CBD was seen with a hyperechoic polypoid mass sparing the deep muscle layers. 7. A biliary sphincterotomy was undertaken and extended up to the duct-duodenal junction. 8. A s...
Source: The Digital Atlas of Video Education - Gastroenterology - June 1, 2009 Category: Gastroenterology Authors: Shyam S. Varadarajulu, MD,, University of Alabama at Birmingham Source Type: info

Direct Peroral Cholangioscopy in the Management of Refractory Stone DiseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Direct, peroral cholangioscopy in the management of refractory stone disease, presented by Gregory Cote, Steven Edmundowicz, Sreenivasa Jonnalagadda and Riad Azar. Cholangioscopy allows direct visualization of the bile duct; this has been used to distinguish malignant from benign bile duct lesions, as wall as in the management of complicated choledocholithiasis by allowing direct visualization for electrohydraulic lithotripsy, or EHL. Traditional mother-daughter systems are limited by the need for two experienced endoscipists, poor visualization and the absence of a meaningful working channel. Single operator, fiberopti...
Source: The Digital Atlas of Video Education - Gastroenterology - June 1, 2009 Category: Gastroenterology Authors: Gregory A. Cote, MD, MS,, University of Washington Source Type: info

Long-Term Effects of Iatrogenic Bile Duct Injury During CholecystectomyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Patients with iatrogenic reconstructed bile duct injury have a decreased survival rate compared with noninjured cholecystectomy patients. Patients' younger age, absence of other diseases, and routine use of intraoperative cholangiogram seem to be positive prognostic survival factors. These patients also may be at increased risk of dying from liver diseases, although this issue requires further study. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - May 24, 2009 Category: Gastroenterology Authors: Björn Törnqvist, Zongli Zheng, Weimin Ye, Anne Waage, Magnus Nilsson Tags: Original Articles-Liver, Pancreas, and Biliary Tract Source Type: journals

Neonatal cholestasis: differentiation of biliary atresia from neonatal hepatitis in a developing countryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: One-third of all NCS in India is due to BA and among the intrahepatic causes acquired infection and galactosaemia are common. Liver biopsy is the best method to differentiate NH from BA. (Source: Acta Paediatrica)
Source: Acta Paediatrica - May 15, 2009 Category: Pediatrics Authors: Ujjal Poddar, Babu Ram Thapa, Ashim Das, Anish Bhattacharya, KL Narasimha Rao, Kartar Singh Source Type: journals

Electronic Clinical Challenges and Images in GIEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Question: A 28-year-old Latin American woman presented with a 1-week history of right upper quadrant pain. Pain initially was severe along with vomiting, over the next few days pain subsided, and she was jaundiced on presentation to the hospital. Her past medical history was unremarkable. Pertinent laboratory data showed a normal white cell count, total bilirubin of 11.6 mg/dL (normal, 0.2–1.3), alkaline phosphatase 200 U/L(normal, 38–126), aspartate aminotransferase 157 U/L (normal, 13–40), alanine aminotransferase 471 U/L (normal, 10–40), and serum lipase 28 U/L (normal, 7–59). A right upper quadrant ultrasound...
Source: Gastroenterology - May 8, 2009 Category: Gastroenterology Authors: Shailender Singh, Shou-Jiang Tang Tags: Electronic Clinical Challenges and Images in GI Source Type: journals

Gs37pselective magnetic resonance cholangio-pancreatography (mrcp) in gallstone pancreatitis may miss choledocholithiasisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Choledocholithiasis is common in GP. Selective MRCP is highly specific in GP but may not be sensitive enough to exclude choledocholithiasis in this context. (Source: ANZ Journal of Surgery)
Source: ANZ Journal of Surgery - April 27, 2009 Category: Surgery Authors: S. Srinivasa, T. Sammour, B. Mcentee, N. Davis, A. G. Hill Tags: Royal Australasian College of Surgeons Annual Scientific Congress, 69 May 2009, Brisbane, Queensland, Australia. Conference Abstracts < br/ > General Surgery Program Abstracts Source Type: journals

Rs10plearning curve on intra-operative cholangiogram in the perspective of new surgeonsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: For training purpose junior surgeons should be increasingly exposed to IOC. IOC can identify missed stones, biliary anatomy and complications of Laparoscopic Cholecystectomy immediately. (Source: ANZ Journal of Surgery)
Source: ANZ Journal of Surgery - April 27, 2009 Category: Surgery Authors: M. W. Ashrafi, S. K. Pandey, H. Ghojavand, J. Roberts-thomson, D. Brockwell Tags: Royal Australasian College of Surgeons Annual Scientific Congress, 69 May 2009, Brisbane, Queensland, Australia. Conference Abstracts < br/ > Rural Surgery Program Abstracts Source Type: journals

Biliary - Type III Choledochal Cyst with Biliary Reflux through the Minor Papilla; Needle Knife Major PapillotomyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This 17 year old male was referred for unexplained acute pancreatitis. His initial episode of acute pancreatitis resulted in a 5 day hospitalization, with serum lipase 10 times normal, and CT showing mild interstitial pancreatitis. He has had intermittent mild abdominal pain since. Laparoscopic cholecystectomy was performed because of a dilated gallbladder; intraoperative cholangiogram showed dilation of the terminal bile duct. ERCP attempted locally resulted in inability to find any orifice or cannulate any duct in the major papilla. He was referred to us for further evaluation. MRCP with secretin was performed. With suc...
Source: The Digital Atlas of Video Education - Gastroenterology - April 23, 2009 Category: Gastroenterology Authors: Jose Vega-Peralta, MD,, Hennepin County Medical Center, University of Minnesota, Martin L. Freeman, M.D., Professor of Medicine, Hennepin County Medical Center, University of Minnesota Source Type: info

Mirizzi’s syndrome: a diagnostic dilemmaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract A 62-year-old male presented with a history of upper abdominal discomfort. Past history included asymptomatic gallstones. Abdominal ultrasound and CT demonstrated gallstones within a thick-walled gallbladder, and intra and extrahepatic duct dilatation. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a stricture within the mid-portion of the common bile duct. At laparotomy, a single large stone was found causing external compression of the common bile duct causing a Mirizzi’s-type stricture. At repeat ERCP, cholangiogram showed no evidence of stricture. Clinicians should be aware tha...
Source: Irish Journal of Medical Science - April 15, 2009 Category: Journals (General) Tags: Irish Journal of Medical Science Source Type: journals

Are there roles for intraductal US and saline solution irrigation in ensuring complete clearance of common bile duct stones?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: IDUS detected small residual CBD stones that persisted after EST and basket/balloon extraction. Saline solution irrigation appeared useful in clearing residual small stones. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - February 27, 2009 Category: Gastroenterology Authors: Tiing Leong Ang, Eng Kiong Teo, Kwong Ming Fock, Jessica Yi Lyn Tan Tags: Clinical Endoscopy Source Type: journals

Long-term outcome of endoscopic therapy in patients with bile duct injury after cholecystectomyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Endoscopic treatment of bile duct lesions after cholecystectomy is effective, particularly in patients with peripheral bile duct leakages and bile duct strictures. Therefore, it should be the first-line therapy used in these patients. Although endoscopic management is less successful in patients with central bile duct leakages, an attempt is warranted. (Source: Journal of Gastroenterology and Hepatology)
Source: Journal of Gastroenterology and Hepatology - February 9, 2009 Category: Gastroenterology Authors: Andreas Weber, Hubertus Feussner, Franziska Winkelmann, Jörg Rüdiger Siewert, Roland M Schmid, Christian Prinz Source Type: journals

An unusual variant of choledochal cyst: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The anatomy should be clearly defined before surgical excision as abnormal variants can occur, which usually do not fit into the known classification types and subtypes. (Source: Journal of Medical Case Reports)
Source: Journal of Medical Case Reports - February 9, 2009 Category: Journals (General) Authors: Javaid Sadiq, Biplap Nandi and Kokila Lakhoo Source Type: journals

Cholangiographic Features in the Diagnosis and Management of Obstructive Icteric Type Hepatocellular CarcinomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In 11 years and 3 months, 2037 patients with HCC were seen and 48 patients (2.4%) were diagnosed to have obstructive icteric type HCC. Five patients were terminally ill and were not investigated further. Forty three patients were initially investigated by endoscopic retrograde cholangiography (ERC) or percutaneous transhepatic cholangiogram (PTC) and classified as having obstructive icteric type 1, 2, or 3 HCC based on the cholangiographic findings. The obstruction in type 1 HCC was due to intraluminal tumour casts and/or tumour fragments obstructing the hepatic ductal confluence or common bile duct, while intraluminal...
Source: HPB Surgery - January 25, 2009 Category: Surgery Source Type: journals

Small-duct primary sclerosing cholangitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Patients with cholestatic liver tests and typical histologic features of primary sclerosing cholangitis (PSC) but a normal cholangiogram have been identified as having small-duct PSC. This subgroup of PSC has been less well characterized than the classic largeduct form. Some patients characterized as having small-duct PSC develop cholangiographic features of PSC during follow-up. Three papers published in 2002 on small-duct PSC patients suggested a better prognosis in patients with small-duct PSC than in those with large-duct PSC. However, these studies included a limited number of patients and had ...
Source: Current Gastroenterology Reports - January 17, 2009 Category: Gastroenterology Tags: Current Gastroenterology Reports Source Type: journals

Open common bile duct exploration — end of an epoch?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract With the advent of laparoscopic cholecystectomy and the impending replacement of open common bile duct exploration, we have reviewed our ten year experience of conventional common bile duct exploration. Open cholecystectomy was performed in 1681 patients and the common bile duct was explored in 325 (19%). Following initial duct exploration, rigid choledo identified residual choledocholithiasis in 58 and periampullary neoplasia in 2 patients. Unexpected retained stones were identified in 3 patients (0.9%). In a further 4 patients, stones which could not be dislodged from the hepatic ducts were con...
Source: Irish Journal of Medical Science - December 24, 2008 Category: Journals (General) Tags: Irish Journal of Medical Science Source Type: journals

Absence of glycochenodeoxycholic acid (GCDCA) in human bile is an indication of cholestasis: A 1H MRS studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The utility of 1H MR spectroscopy in detecting chronic cholestasis has been investigated. The amide proton region of the 1H MR spectrum of human bile plays a major role in differentiating cholestatic (Ch) patterns from the normal ones. Bile obtained from normal bile ducts contains both taurine and glycine conjugates of bile acids - cholic acid (CA), chenodeoxycholic acid (CDCA), and deoxycholic acid (DCA). Absence of a glycine-conjugated bile acid glycochenodeoxycholic acid (GCDCA) has been observed in bile samples obtained from primary sclerosing cholangitis (PSC) patients. A total of 32 patients with various hepatobiliar...
Source: NMR in Biomedicine - December 9, 2008 Category: Radiology Authors: Omkar B. Ijare, Tedros Bezabeh, Nils Albiin, Urban Arnelo, Annika Bergquist, Bo Lindberg, Ian CP Smith Source Type: journals

An unusual presentation of primary sclerosing cholangitis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This case report describes the unusual presentation of a patient who had findings which were initially suggestive of a type IV choledochal cyst. Her liver biopsy demonstrated biliary cirrhosis. She was treated with endoscopic retrograde cholangiopancreatography and biliary stent exchanges over one year. Her cholangiogram one year later demonstrated resolution of the biliary cystic dilation which led to her initial diagnosis, with beading and stricturing of the hepatic ducts consistent with primary sclerosing cholangitis. Liver-associated enzymes and physical findings also improved. A liver biopsy one year later demonst...
Source: World Journal of Gastroenterology : WJG - November 21, 2008 Category: Gastroenterology Authors: Goldwire FW, Norris WE, Koff JM, Goodman ZD, Smith MT Tags: World J Gastroenterol Source Type: journals

Urgent cholecystectomy for acute cholecystitis in a disctrict general hospital - is it feasible?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSIONS Urgent laparoscopic cholecystectomy for acute cholecystitis is a feasible treatment option in a district general hospital. A safe practice can be ensured by adherence to a care pathway and a multidisciplinary, consultant-delivered service. Urgent cholecystectomy service can be provided safely in a district general hospital without comes comparable to previously published literature. PMID: 18990272 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - November 4, 2008 Category: Surgery Authors: Khan M, Nordon I, Ghauri A, Ranaboldo C, Carty N Tags: Ann R Coll Surg Engl Source Type: journals

What technical barriers exist for real-time fluoroscopic and video image overlay in robotic surgery?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A hypothetical advantage of the da Vinci® console is its ability to integrate multiple visual data sources. Current platforms for augmented reality surgery fuse pre-operative radiographic studies but are limited with their ability to update with intra-operative imaging. The aim of our study was to evaluate the feasibility of real-time radiographic image overlay with current technology.S-video composite output from a fluoroscopic C-arm was superimposed onto the video output of the da Vinci device. Image superimposition disparity measurements were evaluated in a bench model. The feasibility of robotic dissection assisted by...
Source: The International Journal of Medical Robotics and Computer Assisted Surgery - October 31, 2008 Category: Surgery Authors: J. N. Afthinos, M. J. Latif, F. Y. Bhora, C. P. Connery, J. J. McGinty, A. Burra, M. Attiyeh, G. J. Todd, S. J. Belsley Source Type: journals

Congenital Common Bile Duct Web in Association with Hepatobiliary Pancreatic Ductal AnomaliesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Eur J Pediatr SurgDOI: 10.1055/s-2008-1038444AbstractCongenital webs are extremely rare anomalies of the extrahepatic ductal system. As the vast majority of such cases are asymptomatic, detection is usually incidental during surgery for some other cause. In a young boy presenting with features of cholangitis, a congenital common bile duct web was discovered on T-tube cholangiogram. Further anomalies of the intrahepatic and pancreatic ductal systems were also detected. Since all known causes of acquired web formation were excluded, a congenital origin of the web was assumed and the patient is continuing to do well after a f...
Source: European Journal of Pediatric Surgery - October 8, 2008 Category: Surgery Tags: Case Report Source Type: journals

A case of common bile duct stones, failed ERCP and sensitivity to iodine contrast media: what contrast media should we use for an on-table cholangiogram?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A case of common bile duct stones, failed ERCP and sensitivity to iodine contrast media: what contrast media should we use for an on-table cholangiogram? Ann R Coll Surg Engl. 2008 Oct;90(7):615 Authors: Massey JC, Gokhale JA, Kay CL, Griffith JP PMID: 18837121 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - October 1, 2008 Category: Surgery Authors: Massey JC, Gokhale JA, Kay CL, Griffith JP Tags: Ann R Coll Surg Engl Source Type: journals

A 56-Year-Old Man with Sudden Onset of Portosystemic Encephalopathy Years after Severe Electrocution TraumaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Liver Dis 2008; 28: 328-336DOI: 10.1055/s-0028-1085100ABSTRACTA 56-year-old white male painter, with a history of major electrocution and deep thermal injury, developed mental status changes initially ascribed to an acute neurological event. Unexpectedly, magnetic resonance imaging (MRI) of the head showed areas of high signal intensity in the basal ganglia, which can be observed in advanced liver disease. An electroencephalogram (EEG) suggested metabolic encephalopathy and coexistent elevation of ammonia, indicative of significant liver disease. The patient had had a long history of right upper quadrant pain and flu...
Source: Seminars in Liver Disease - September 25, 2008 Category: Gastroenterology Tags: DIAGNOSTIC PROBLEMS IN HEPATOLOGY Source Type: journals

[Vascular and Interventional Radiology] Thirty Years' Experience with Balloon Dilation of Benign Postoperative Biliary Strictures: Long-term OutcomesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: PBBD of benign strictures demonstrates long-term effectiveness. No significant difference was found in the rate of clinically significant restenosis after PBBD of biliary strictures at anastomotic and nonanastomotic sites. © RSNA, 2008 (Source: Continuous Publishing articles)
Source: Continuous Publishing articles - September 23, 2008 Category: Radiology Authors: Cantwell, C. P., Pena, C. S., Gervais, D. A., Hahn, P. F., Dawson, S. L., Mueller, P. R. Tags: Vascular and Interventional Radiology Source Type: journals

Management of Preoperatively Suspected Choledocholithiasis: A Decision AnalysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion LCBDE has lower morbidity and mortality rates compared to preoperative ERCP/ES in the management of patients with suspected CBD stones even if the chance of CBD stones reaches 100%. Using a common duct double-lumen catheter may be considered if LCBDE is not feasible and the chance of CBD stone is less than 65%. Content Type Journal ArticleCategory ssat poster presentationDOI 10.1007/s11605-008-0624-6Authors Bilal Kharbutli, Henry Ford Hospital Division of General Surgery, K-8 2799 West Grand Blvd. Detroit MI 48202 USAVic Velanovich, Henry Ford Hospital Division of General Surgery, K-8 2799 ...
Source: Journal of Gastrointestinal Surgery - August 6, 2008 Category: Surgery Tags: Journal of Gastrointestinal Surgery Source Type: journals

Primary closure of choledochotomy after emergency laparoscopic common bile duct explorationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions To our knowledge, this is the first publication in the literature in which primary closure after laparoscopic common bile duct exploration in emergency setting was used. With no significant difference in operative time, hospital stay and complications, in experienced hands primary closure of CBD in emergency settings is safe and feasible. Content Type Journal ArticleDOI 10.1007/s00464-008-0021-yAuthors Ali Alhamdani, Wrexham Maelor Hospital General Surgery Wrexham UKSajid Mahmud, Wrexham Maelor Hospital General Surgery Wrexham UKM. Jameel, Wrexham Maelor Hospital General Surgery Wrexham UK...
Source: Surgical Endoscopy - July 12, 2008 Category: Surgery Tags: Surgical Endoscopy Source Type: journals

ORIGINAL ARTICLE: Liver Resection for Primary Intrahepatic Stones: A Single-Center ExperienceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions Primary intrahepatic lithiasis more commonly involves 1 single liver segment or lobe. Partial hepatectomy is a safe and effective procedure, allowing definitive treatment of the disease and prevention of cancer. (Source: Archives of Surgery)
Source: Archives of Surgery - June 16, 2008 Category: Surgery Authors: Nuzzo, G., Clemente, G., Giovannini, I., De Rose, A. M., Vellone, M., Sarno, G., Marchi, D., Giuliante, F. Tags: Oncology, Oncology, Other, Prognosis/ Outcomes, Hepatobiliary Surgery, Gastroenterology, Liver/ Biliary Tract/ Pancreatic Diseases Original Article Source Type: journals

The Effects of Scolicidal Agent Propolis on Liver and Biliary TreeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions Propolis may be used as a scolicidal agent even in the case of cystobiliary communication with no side effects on liver and biliary tree. Content Type Journal ArticleCategory original articleDOI 10.1007/s11605-008-0555-2Authors Kemal Kismet, Ankara Training and Research Hospital Ulucanlar Department of General Surgery Ankara TurkeySibel Serin Kilicoglu, Ufuk University Department of Histology-Embryology Ankara TurkeyBulent Kilicoglu, Ankara Training and Research Hospital Ulucanlar Department of General Surgery Ankara TurkeySerap Erel, Ankara Training and Research Hospital Ulucanlar Departme...
Source: Journal of Gastrointestinal Surgery - May 30, 2008 Category: Surgery Tags: Journal of Gastrointestinal Surgery Source Type: journals

Autoimmune Pancreatitis and Concurrent Small Lymphocytic Lymphoma: Not Just a Coincidence?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion Autoimmune pancreatitis is the most common benign diagnosis after pancreatic resection for presumed malignancy. It has a well-documented association with autoimmune conditions, such as Sjögren’s syndrome, inflammatory bowel disease, and sclerosing cholangitis. Additionally, chronic lymphocytic leukemia–small lymphocytic lymphoma is often associated with autoimmune phenomena, most notably autoimmune hemolytic anemia. However, an association between autoimmune pancreatitis and small lymphocytic lymphoma has not been previously described. To our knowledge, this is the first reported case of a pa...
Source: Journal of Gastrointestinal Surgery - May 28, 2008 Category: Surgery Tags: Journal of Gastrointestinal Surgery Source Type: journals

Removal and Placement of Metallic Biliary StentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This is the case of an 81 year old gentleman with unresectable adenocarcenoma of the pancreas. He's treated with metallic stenting and presents with recurrent jaundice and colongitis three moths after stent placement. ERCP reveals obstruction of metallic stent. A balloon is placed within the stent and the cholangiogram is performed. As you see on the right screen, there are failing defects within the main bile duct. Balloon extraction yields leafy material; a corn kernel and other food residue. We decide to remove the stent in order to place a newer stent. We ensnare the stent and then gently remove it. It comes easy w...
Source: The Digital Atlas of Video Education - Gastroenterology - May 6, 2008 Category: Gastroenterology Authors: Giuseppe Aliperti, MD, Clinical Professor of Medicine, Midwest Therapeutic Endoscopy Consultants, St. Louis University School of Medicine Source Type: info

Improvement in accuracy of gamma-glutamyl transferase for differential diagnosis of biliary atresia by correlation with age.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In order to determine the accuracy of serum gamma-glutamyl transferase (GGT) as a test for biliary atresia, we reviewed the charts of 29 infants with cholestatic jaundice less than one year of age. All patients underwent liver biopsy or laparotomy with cholangiogram to establish neonatal hepatitis (NH) or extrahepatic biliary atresia (EHBA). We also gathered information from 176 patients from published studies. Sensitivity, specificity, and likelihood ratios (LR) were calculated with 95% confidence interval (95% CI). GGT levels of the EHBA group were higher than those from the NH group. For diagnosis of EHBA at a cut-o...
Source: The Turkish Journal of Pediatrics - May 1, 2008 Category: Pediatrics Authors: Rendón-Macías ME, Villasís-Keever MA, Castañeda-Muciño G, Sandoval-Mex AM Tags: Turk J Pediatr Source Type: journals

Biliary - Balloon Sphincteroplasty in the Removal of Difficult Bile Duct StonesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Endoscopic sphincterotomy (ES) has been a useful method in the removal of common bile duct (CBD) stones for some time. However, in certain patients, stone removal by endoscopic sphincterotomy is unsuccessful due to challenging access to the bile duct, stone size exceeding the diameter of ampullary orifice or impacted stones in the bile duct. In the past, such difficult-to-remove stones were extracted by methods like mechanical lithotripsy, intraductal shock-wave lithotripsy, extracorporeal shock-wave lithotripsy, biliary stenting, and chemical dissolution. Biliary sphincterotomy involves making an incision along the ampu...
Source: The Digital Atlas of Video Education - Gastroenterology - April 10, 2008 Category: Gastroenterology Authors: Omkar Dave, B.S., Medical Student, University of Texas Medical Branch, Gottumukkala S. Raju, M.D., Director of Endoscopy, Center for Endoscopic Research, Training and Innovation, University of Texas Medical Branch Source Type: info

Effects of honey as a scolicidal agent on the hepatobiliary system.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: According to these results, we concluded that 10% diluted honey could be used as scolicidal agent safely in the presence of biliary-cystic communication. PMID: 18395911 [PubMed - in process] (Source: World Journal of Gastroenterology)
Source: World Journal of Gastroenterology - April 7, 2008 Category: Gastroenterology Authors: Kilicoglu B, Kismet K, Kilicoglu SS, Erel S, Gencay O, Sorkun K, Erdemli E, Akhan O, Akkus MA, Sayek I Tags: World J Gastroenterol Source Type: journals

Pancreas - Biopsy of IPMN Nodule by Direct PancreatoscopyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 36 year old woman was referred to the Massachusetts General Hospital for evaluation of an incidental pancreatic cystic lesion found on abdominal ultrasound. An abdominal CT confirmed the finding, demonstrating a 5 cm multi-cystic lesion in the pancreatic head, with diffuse dilation of the pancreatic duct in the body and tail. ERCP and EUS performed at an outside institution were non-diagnostic. However, the EUS at the outside hospital demonstrated an intramural nodule, raising concern for malignancy, and thus warranting further evaluation. The patient was subsequently seen at the MGH. Endoscopic evaluation demonstrated a...
Source: The Digital Atlas of Video Education - Gastroenterology - April 2, 2008 Category: Gastroenterology Authors: Christopher J. DiMaio, MD, G.I. Fellow, Massachusetts General Hospital, William R. Brugge, M.D., Associate Professor of Medicine, Harvard Medical School, Massachusetts General Hospital, Peter B. Kelsey, M.D., Assistant Professor of Medicine, Harvard Medic Source Type: info