• Title/Summary/Keyword: endoscopic retrograde

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Diagnosis of Malignant Biliary Strictures: Conventional or Negative Pressure Brush Cytology?

  • Abbasi, Mohammad Reza;Mirsaeed, Seyedeh Masoumeh Ghazi;Alizadeh, Amir Houshang Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4563-4566
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    • 2016
  • Background/Objective: The aim of this study was to perform a comparative evaluation of the yields of conventional brush cytology and brush cytology with negative pressure in the diagnosis of malignant biliary strictures. Methods: A total of 132 consecutive patients undergoing endoscopic were identified. Of these, 88.0 had brush cytology after ERCP and 44 were Brush cytology with negative pressure. Retrograde cholangiopancreatography (ERCP) including brush cytology and brush cytology with negative pressure in patients with biliary strictures between 2012-2015. Endoscopic retrograde cholangiography was performed with a standard videoduodenoscope Olympus TFJ 160-R (Olympus, Hamburg, Germany) and brush cytology with a Cook medical Double Lumen Biliary BrushTM (Cytology). Means and standard frequencies were used to calculate variables. Results: Positive results for malignancy were obtained in 22 of 88 patients (25%) by brush cytology and 31 of 44 patients (70.4 %) by brush cytology with negative pressure. Conclusions: Sensitivity of cytology sampling could be maximized by negative pressure during ERCP.

Post Laparoscopic Cholecystectomy Biloma in a Child Managed by Endoscopic Retrograde Cholangio-Pancreatography and Stenting: A Case Report

  • Tiwari, Charu;Makhija, Om Prakash;Makhija, Deepa;Jayaswal, Shalika;Shah, Hemanshi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.4
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    • pp.281-285
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    • 2016
  • Laparoscopic cholecystectomy, though an uncommon surgical procedure in paediatric age group is still associated with a higher risk of post-operative bile duct injuries when compared with the open procedure. Small leaks from extra hepatic biliary apparatus usually lead to the formation of a localized sub-hepatic bile collection, also known as biloma. Such leaks are rare complication after laparoscopic cholecystectomy, especially in paediatric age group. Minor bile leaks can usually be managed non-surgically by percutaneous drainage combined with endoscopic retrograde cholangio-pancreatography (ERCP). However, surgical exploration is required in cases not responding to non-operative management. If not managed on time, such injuries can lead to severe hepatic damage. We describe a case of an eight-year-old girl who presented with biloma formation after laparoscopic cholecystectomy who was managed by ERCP.

Biliary ascariasis misidentified as a biliary stent in a patient undergoing liver resection

  • Hochang Chae;Suk Won Suh;Yoo Shin Choi;Hee Ju Sohn;Seung Eun Lee;Jae Hyuk Do;Hyun Jeong Park
    • Parasites, Hosts and Diseases
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    • v.61 no.2
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    • pp.194-197
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    • 2023
  • Ascaris lumbricoides causes one of the most common soil-transmitted helminthiases globally. The worms mostly infect the human small intestine and elicit negligible or nonspecific symptoms, but there are reports of extraintestinal ectopic ascariasis. We describe a rare case of biliary ascariasis mistaken for biliary stent in a 72-year-old female patient with a history of liver resection. She visited our outpatient clinic complaining of right upper quadrant pain and fever for the past week. She had previously undergone left lateral sectionectomy for recurrent biliary and intrahepatic duct stones 2 years ago. Besides mildly elevated gamma-glutamyl transferase levels, her liver function tests were normal. Magnetic resonance cholangiopancreatography revealed a linear filling defect closely resembling an internal stent from the common bile duct to the right intrahepatic bile duct. A live female A. lumbricoides adult worm was removed by endoscopic retrograde cholangiopancreatography (ERCP). Despite a significant decrease of the ascariasis prevalence in Korea, cases of biliary ascariasis are still occasionally reported. In this study, a additional case of biliary ascariasis, which was radiologically misdiagnosed as the biliary stent, was described in a hepatic resection patient by the worm recovery with ERCP in Korea.

A Case of Childhood Biliary Stricture after Blunt Trauma Managed by Endoscopic Therapy (소아에서 둔상 후에 발생한 담도협착의 내시경적 치료 경험 1례)

  • Kim, Kyung-Mo;Kim, Seong-Chul;Seo, Dong-Wan;Yoon, Chong-Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.144-147
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    • 1998
  • Isolated injury to the extrahepatic biliary tract following blunt abdominal trauma is rare, and there is little information especially in children regarding the endoscopic diagnosis and management of occult injury to the biliary tract. We experienced a 5-year-old boy who presented with jaundice 16 days after blunt abdominal trauma and was diagnosed as isolated distal common bile duct stricture by ultrasonography of abdomen. We could get more detailed information about the injury by endoscopic retrograde cholangiopancreatography. We could also manage this isolated common bile duct stricture successfully with endoscopic nasobiliary drainage and plastic stent insertion instead of surgical correction. There appeared to be no recurrence of stricture as evidenced by biochemical test and ultrasonography during 2 years of follow up.

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Clinical Efficacy of Endoscopic Pancreatic Drainage for Pain Relief with Malignant Pancreatic Duct Obstruction

  • Gao, Fei;Ma, Shuren;Zhang, Ning;Zhang, Yingchun;Ai, Meina;Wang, Bing
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6823-6827
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    • 2014
  • Objective: This study was conducted to investigate the efficacy of pancreatic drainage for pain relief in advanced pancreatic cancer. Method: Seventy-one patients with pancreatic carcinoma were divided into two groups: dilated and non-dilated pancreatic ducts. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP), endoscopic biliary stenting and pancreatic stenting. Visual Analog Scale (VAS) scores, pain remission rates and survival time were evaluated during follow-up. Results: The post-ERCP VAS score of the dilated group was lower than that of the non-dilated group at 1 and 3 months post-ERCP. There was no difference at 6 months. The pain remission rate in the dilated duct group was significantly higher than that in non-dilated duct group in 1 and 3 months post-ERCP. The median survival times were 8.17 and 8.22 months respectively. Conclusion: Endoscopic pancreatic drainage can relieve pain of advanced pancreatic cancer accompanied by safe dilation of the pancreatic duct.

Successful Endoscopic Treatment of Hepatic Duct Confluence Injury after Blunt Abdominal Trauma: Case Report

  • Park, Chan Ik;Park, Sung Jin;Lee, Sang Bong;Yeo, Kwang Hee;Choi, Seon Uoo;Kim, Seon Hee;Kim, Jae Hun;Baek, Dong Hoon
    • Journal of Trauma and Injury
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    • v.29 no.3
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    • pp.93-97
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    • 2016
  • Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

A Case of Biliary Fascioliasis by Fasciola gigantica in Turkey

  • Goral, Vedat;Senturk, Senem;Mete, Omer;Cicek, Mutallib;Ebik, Berat;Kaya, Besir
    • Parasites, Hosts and Diseases
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    • v.49 no.1
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    • pp.65-68
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    • 2011
  • A case of Fasciola gigantica-induced biliary obstruction and cholestasis is reported in Turkey. The patient was a 37-year-old woman, and suffered from icterus, ascites, and pain in her right upper abdominal region. A total of 7 living adult flukes were recovered during endoscopic retrograde cholangiopancreatography (ERCP). A single dose of triclabendazole was administered to treat possible remaining worms. She was living in a village of southeast of Anatolia region and had sheeps and cows. She had the history of eating lettuce, mallow, dill, and parsley without washing. This is the first case of fascioliasis which was treated via endoscopic biliary extraction during ERCP in Turkey.

A Case of Chronic Relapsing Pancreatitis with Multiple Pancreatic Stones in Childhood (다발성 췌관석에 의한 만성 재발성 췌장염 1례)

  • Lee, Seung -Yeon;Um, Ji-Hyun;Chung, Ki-Sup;Kim, Myung-Joon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.256-260
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    • 2001
  • Chronic pancreatitis is a rare problem in childhood and sometimes shows pancreatic calcification. The most common symptom is recurrent upper abdominal pain with or without associated nausea or vomiting. Pancreatic calcifications are virtually pathognomonic of chronic pancreatitis. In our case, however, chronic pancreatitis caused by multiple pancreatic stones in dilated pancreatic duct, which was very rare in childhood. Endoscopic retrograde cholangiopancreaticography (ERCP) is valuable in confirming the diagnosis and decision making process for further medical or surgical management of pancreatic disease. We experienced a case of chronic relapsing pancreatitis with pancreatic stones in 13-year-old girl who presented with recurrent upper abdominal pain. She was investigated with ERCP and treated by endoscopic sphincterotomy of sphincter of Oddi and by some stone removal with endoscopic basket. We report this case and review related literatures briefly.

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