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[PMID]:29505527
[Au] Autor:Zhong H; Wang X; Yang L; Miao L; Ji G; Fan Z
[Ad] Endereço:The Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
[Ti] Título:Modified transprepancreatic septotomy reduces postoperative complications after intractable biliary access.
[So] Source:Medicine (Baltimore);97(1):e9522, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to assess the clinical value of transprepancreatic septotomy indwelling guide wire or pancreatic duct stent in intractable endoscopic retrograde cholangiopancreatography (ERCP) for bile duct cannulation.Of the 2107 patients treated by ERCP, a total of 81 cases with difficult bile duct cannulation underwent transprebiliopancreatic septotomy (referred to as the septotomy group, 37 cases) and transprepancreatic septotomy with pancreatic duct stent (modified septotomy group, 44 cases). Success rates of cannulation and postoperative complications for both methods were compared.Among them, 77 cases were successfully administered bile duct cannulation. The success rates of the septotomy and modified septotomy groups were 91.89% and 97.73%, respectively, with no significant difference (P = .489). Of the 77 patients, 12 cases had complications. The septotomy group included 7 acute pancreatitis, 1 bleeding, and 1 biliary tract infection cases; while in the modified septotomy group, there were 1 acute pancreatitis, 1 bleeding, and 1 biliary tract infection cases. The occurrence rate of acute pancreatitis in the modified septotomy group was lower than that of the septotomy group (2.33% vs 20.59%) with a significant difference (P = .026).These findings indicate that transprepancreatic septotomy with pancreatic duct stent seems to be a safe and feasible operation with reducing complication rates.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Biliar/estatística & dados numéricos
Colangiopancreatografia Retrógrada Endoscópica/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
Procedimentos Cirúrgicos do Sistema Biliar/instrumentação
Cateterismo/estatística & dados numéricos
China/epidemiologia
Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos
Colangiopancreatografia Retrógrada Endoscópica/estatística & dados numéricos
Feminino
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Stents
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009522


  2 / 14851 MEDLINE  
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[PMID]:29320821
[Au] Autor:Choi JH; Seo M
[Ad] Endereço:Division of Gastroenterology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan 31116, Korea.
[Ti] Título:A Case of Biliary Ascariasis in Korea.
[So] Source:Korean J Parasitol;55(6):659-660, 2017 Dec.
[Is] ISSN:1738-0006
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Biliary ascariasis is still the leading cause of surgical complication of ascariasis, though its incidence has been dramatically reduced. Herein, we report a case of biliary ascariasis for the purpose of enhancing awareness of parasitic infections as a possible cause. A 72-year-old male visited the emergency room of Dankook University Hospital on 12 July 2015, complaining of right-upper-quadrant pain. By endoscopic retrograde cholangiopancreatography (ERCP), a tubular filling defect in the right hepatic duct was detected. The defect was endoscopically removed and diagnosed as an adult female of Ascaris lumbricoides worm, of 30 cm length. Upon removal of the worm, the pain subsided, and the patient was discharged without any complication. When treating cases of biliary colic, physicians should not neglect biliary ascariasis as the possible cause.
[Mh] Termos MeSH primário: Ascaríase/parasitologia
Ascaríase/cirurgia
Ascaris lumbricoides/isolamento & purificação
Doenças dos Ductos Biliares/parasitologia
Doenças dos Ductos Biliares/cirurgia
[Mh] Termos MeSH secundário: Dor Abdominal/etiologia
Idoso
Animais
Ascaríase/complicações
Ascaríase/diagnóstico por imagem
Doenças dos Ductos Biliares/complicações
Doenças dos Ductos Biliares/diagnóstico por imagem
Colangiopancreatografia Retrógrada Endoscópica
Ducto Hepático Comum/diagnóstico por imagem
Ducto Hepático Comum/parasitologia
Ducto Hepático Comum/cirurgia
Seres Humanos
Masculino
República da Coreia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.3347/kjp.2017.55.6.659


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[PMID]:28453918
[Au] Autor:Vannas MJ; Boyd S; Färkkilä MA; Arola J; Isoniemi H
[Ad] Endereço:Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland.
[Ti] Título:Value of brush cytology for optimal timing of liver transplantation in primary sclerosing cholangitis.
[So] Source:Liver Int;37(5):735-742, 2017 May.
[Is] ISSN:1478-3231
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: Primary sclerosing cholangitis is associated with a high risk of cholangiocarcinoma. Here, we investigated the value of surveillance for dysplasia using brush cytology, to determine the optimal timing of liver transplantation in primary sclerosing cholangitis. We compared our preoperative findings, with the final explanted liver histopathology. METHODS: 126 consecutive patients were transplanted for primary sclerosing cholangitis from 1984 to 2012. Patients were divided into two groups: symptomatic (n=91), and asymptomatic (n=35). RESULTS: Brush cytology was available for 101 patients; 66 symptomatic and 35 asymptomatic. Suspicious cytological findings were found in nine patients (14%) in the symptomatic group and 17 (49%) in the asymptomatic group. DNA flow cytometry was available for 49 patients (25 symptomatic, 24 asymptomatic), with aneuploidy detected in six patients (24%) in the symptomatic group and 15 (63%) in the asymptomatic group. Explanted liver histology showed biliary dysplasia or cholangiocarcinoma in 11 symptomatic patients (12%) and 15 asymptomatic patients (43%). A combination of cytological and DNA flow cytometry findings resulted in a test sensitivity of 68%, with a specificity of 86%. Ten-year survival in the asymptomatic group was 91%. CONCLUSIONS: Dysplasia surveillance using brush specimens may help to select those patients likely to benefit from early liver transplantation. It remains unclear as to whether surveillance with brush cytology improves long-term survival, but there is presently no better method with which to predict transplantation timing.
[Mh] Termos MeSH primário: Sistema Biliar/patologia
Colangite Esclerosante/patologia
Colangite Esclerosante/cirurgia
Citodiagnóstico/métodos
Células Epiteliais/patologia
Transplante de Fígado
[Mh] Termos MeSH secundário: Adulto
Neoplasias dos Ductos Biliares/patologia
Carcinoma Hepatocelular/patologia
Colangiocarcinoma/patologia
Colangiopancreatografia Retrógrada Endoscópica
Diagnóstico Diferencial
Feminino
Finlândia
Seres Humanos
Estimativa de Kaplan-Meier
Neoplasias Hepáticas/patologia
Masculino
Meia-Idade
Sistema de Registros
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1111/liv.13276


  4 / 14851 MEDLINE  
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[PMID]:29465584
[Au] Autor:Fan X; He L; Khadaroo PA; Zhou D; Lin H
[Ad] Endereço:Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
[Ti] Título:Duplication of the extrahepatic bile duct: A case report and review of the literatures.
[So] Source:Medicine (Baltimore);97(8):e9953, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Duplication of the extrahepatic bile duct is an extremely rare congenital anomaly of the biliary system. PATIENT CONCERNS: A 44-year-old woman presented with a history of continuous upper abdominal pain and vomiting. DIAGNOSES: Magnetic resonance cholangiopancreatography (MRCP) disclosed diffuse dilatation of the intrahepatic and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) showed the presence of two extrahepatic bile ducts with calculus at the distal end of the CBD. INTERVENTIONS: Laparoscopic cholecystectomy (LC) was performed after an ERCP. Choledochoscopy, performed during the operation, showed duplicated common bile duct and the cystic duct was seen opening at the right side of the extrahepatic duct. OUTCOMES: The patient was doing well after 6 months of follow-up. LESSONS: We reported a case of a double common duct with choledocholithiasis and gallstone. This rare anomaly may lead to cholangitis, common bile duct injury during surgery, malignancy occurrence, and should be treated with extreme care.
[Mh] Termos MeSH primário: Doenças dos Ductos Biliares/congênito
Ductos Biliares Extra-Hepáticos/anormalidades
Ducto Colédoco/anormalidades
[Mh] Termos MeSH secundário: Adulto
Colangiopancreatografia Retrógrada Endoscópica
Colangiopancreatografia por Ressonância Magnética
Colecistectomia Laparoscópica
Coledocolitíase/congênito
Feminino
Cálculos Biliares/congênito
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009953


  5 / 14851 MEDLINE  
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[PMID]:29390530
[Au] Autor:Raasck K; Khoury J; Aoude A; Abduljabbar F; Jarzem P
[Ti] Título:Nonsurgical management of an extensive spontaneous spinal epidural hematoma causing quadriplegia and respiratory distress in a choledocholithiasis patient: A case report.
[So] Source:Medicine (Baltimore);96(51):e9368, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Spontaneous spinal epidural hematoma (SSEH) manifests from blood accumulating in the epidural space, compressing the spinal cord, and leading to acute neurological deficits. The disease's cloudy etiology and rarity contribute to dangerously suboptimal therapeutic principles. These neural deficits can be permanent, even fatal, if the SSEH is not treated in a timely and appropriate manner. Standard therapy is decompressive laminectomy, though nonsurgical management is a viable course of action for patients who meet a criterion that is continuously being refined. PATIENT CONCERNS: A 76-year-old woman on warfarin for a past pulmonary embolism presented to the emergency room with jaundice, myalgia, hematuria, neck pain, and an International Normalized Ratio (INR) of 14. Upon admission, she rapidly developed quadriplegia and respiratory distress that necessitated intubation. DIAGNOSES: T2-weighted magnetic resonance imaging (MRI) revealed an epidural space-occupying hyperintensity from C2 to S5 consistent with a spinal epidural hematoma. An incidental finding of dilated intrahepatic and common bile ducts prompted an endoscopic retrograde cholangiopancreatography, which demonstrated choledocholithiasis. INTERVENTIONS: The patient's INR was normalized with Vitamin K and Beriplex. Upon transfer to the surgical spine team for assessment of a possible intervention, the patient began to demonstrate recovery of neural functions. The ensuing sustained motor improvement motivated the team's preference for close neurologic monitoring and continued medical therapy over surgery. Thirteen hours after the onset of her symptoms, the patient was extubated. A sphincterotomy was later performed, removing 81 common bile duct stones. OUTCOMES: MRI demonstrated complete resorption of the SSEH and the patient maintained full neurological function at final follow-up. LESSONS: Nonsurgical management of SSEH should be considered in the context of early and sustained recovery. Severe initial neural deficit does not necessitate surgical decompression. Choledocholithiasis and subsequent Vitamin K deficiency, particularly when coupled with anticoagulant use, can increase INR and is a novel proposed risk factor for SSEH. Furthermore, coagulopathies should be medically corrected before surgical intervention within a given timeframe, as spontaneous recovery may manifest. This should be favored over surgery in patients demonstrating early and sustained recovery, as nonsurgical management is 25% more effective in achieving full recovery.
[Mh] Termos MeSH primário: Coledocolitíase/cirurgia
Hematoma Epidural Espinal/diagnóstico por imagem
Quadriplegia/reabilitação
Insuficiência Respiratória/terapia
Varfarina/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Colangiopancreatografia Retrógrada Endoscópica/métodos
Coledocolitíase/complicações
Coledocolitíase/diagnóstico por imagem
Tratamento Conservador
Serviço Hospitalar de Emergência
Feminino
Seguimentos
Hematoma Epidural Espinal/complicações
Hematoma Epidural Espinal/etiologia
Seres Humanos
Coeficiente Internacional Normatizado
Intubação Intratraqueal
Embolia Pulmonar/diagnóstico
Embolia Pulmonar/tratamento farmacológico
Quadriplegia/diagnóstico
Quadriplegia/etiologia
Recuperação de Função Fisiológica
Insuficiência Respiratória/diagnóstico
Medição de Risco
Índice de Gravidade de Doença
Varfarina/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
5Q7ZVV76EI (Warfarin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009368


  6 / 14851 MEDLINE  
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[PMID]:29298346
[Au] Autor:Iida T; Kaneto H; Wagatsuma K; Sasaki H; Naganawa Y; Nakagaki S; Satoh S; Shimizu H; Nakase H
[Ad] Endereço:Department of Gastroenterology, Muroran City General Hospital, Muroran, Hokkaido, Japan.
[Ti] Título:Efficacy and safety of endoscopic procedures for common bile duct stones in patients aged 85 years or older: A retrospective study.
[So] Source:PLoS One;13(1):e0190665, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Endoscopic procedures for common bile duct (CBD) stones are reportedly safe in the elderly patients. However, the definition of the elderly is different in each report. If the elderly are defined as people aged 85 years or older, data on the effectiveness and safety of endoscopic retrograde cholangiopancreatography (ERCP) for CBD stones are limited. This study investigated the efficacy and safety of endoscopic procedures for CBD stones in patients aged 85 years or older. 1,016 consecutive ERCP procedures were performed at our institution from January 2009 to December 2014. Of these, 235 cases with CBD stones were finally analyzed. Group A patients were younger than 85 years and Group B patients were 85 years or older. Patient background, details of endoscopic therapy, complications, and related factors were retrospectively reviewed for 185 cases in Group A, and 50 cases in Group B. Patients in Group B showed high rates of dementia and cerebrovascular disorders and larger CBD stones and diameters, in comparison with patients in Group A. The complete removal rate of bile duct stones was slightly higher in Group A. However, there was no difference between the two groups in recurrence rate of CBD stones, complication and mortality rates, and length and cost of hospitalization. Despite some differences between the two groups, endoscopic procedures for CBD stones in patients aged 85 years or older can be performed effectively and safely without increasing medical costs.
[Mh] Termos MeSH primário: Colangiopancreatografia Retrógrada Endoscópica/normas
Ducto Colédoco/patologia
Cálculos Biliares/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos
Feminino
Seres Humanos
Masculino
Segurança do Paciente
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190665


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[PMID]:29241860
[Au] Autor:de Miguel-Yanes JM; García-Cano J; Jiménez-García R; López-de-Andrés A
[Ad] Endereço:Internal Medicine Department, Hospital General Universitario Gregorio Marañón and Universidad Complutense de Madrid, Madrid, Spain.
[Ti] Título:Post-ERCP pancreatitis in patients with type 2 diabetes mellitus.
[So] Source:Gastrointest Endosc;87(1):321, 2018 01.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Colangiopancreatografia Retrógrada Endoscópica
Diabetes Mellitus Tipo 2
[Mh] Termos MeSH secundário: Seres Humanos
Pancreatite
Fatores de Risco
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:29241850
[Au] Autor:Adler DG
[Ad] Endereço:Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
[Ti] Título:Guidewire cannulation in ERCP: from zero to hero!
[So] Source:Gastrointest Endosc;87(1):202-204, 2018 01.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Cateterismo
Colangiopancreatografia Retrógrada Endoscópica
[Mh] Termos MeSH secundário: Seres Humanos
Pancreatite
Esfinterotomia Endoscópica
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:29241849
[Au] Autor:Xu MM; Carr-Locke DL
[Ad] Endereço:The Center for Advanced Digestive Care, Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, USA.
[Ti] Título:Early ERCP for severe cholangitis? Of course!
[So] Source:Gastrointest Endosc;87(1):193-195, 2018 01.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Colangiopancreatografia Retrógrada Endoscópica
Colangite
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


  10 / 14851 MEDLINE  
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[PMID]:29320523
[Au] Autor:Ishikawa-Kakiya Y; Shiba M; Maruyama H; Kato K; Fukunaga S; Sugimori S; Otani K; Hosomi S; Tanaka F; Nagami Y; Taira K; Yamagami H; Tanigawa T; Watanabe T; Fujiwara Y
[Ad] Endereço:Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
[Ti] Título:Risk of pancreatitis after pancreatic duct guidewire placement during endoscopic retrograde cholangiopancreatography.
[So] Source:PLoS One;13(1):e0190379, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND & AIMS: Advanced techniques have been developed to overcome difficult cannulation cases in endoscopic retrograde cholangiopancreatography (ERCP). Pancreatic duct guidewire placement method (PGW) is performed in difficult cannulation cases; it is possible that it places patients at risk of post-ERCP pancreatitis (PEP). The mechanism of PEP is still unclear, but pancreatic duct pressure and injury of pancreatic duct are known causes of PEP. Therefore, we hypothesized a relationship between pancreatic duct diameter and PEP and predicted that PGW would increase the risk of PEP in patients with non-dilated pancreatic ducts. This study aimed to investigate whether PGW increased the risk of PEP in patients with pancreatic duct diameter ≤ 3 mm. METHODS: We analyzed 332 patients with pancreatic duct ≤ 3 mm who performed first time ERCP session. The primary endpoint was the rate of adverse event of PEP. We evaluated the risk of PEP in patients who had undergone PGW compared to those who had not, using the inverse probability of treatment weighting (IPTW) analysis. RESULTS: PGW was found to be an independent risk factor for PEP by univariate analysis (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.12-5.38; p = 0.03) after IPTW in patients with pancreatic duct diameter ≤ 3 mm. Adjusted for all covariates, PGW remained an independent risk factor for PEP (OR, 3.12; 95% CI, 1.33-7.33; p = 0.01). CONCLUSION: Our results indicate that PGW in patients with pancreatic duct diameter ≤ 3 mm increases the risk of PEP.
[Mh] Termos MeSH primário: Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos
Pâncreas/cirurgia
[Mh] Termos MeSH secundário: Idoso
Colangiopancreatografia Retrógrada Endoscópica/instrumentação
Feminino
Seres Humanos
Masculino
Meia-Idade
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190379



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