• 제목/요약/키워드: endoscopic retrograde

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원위부 총담관 결석으로 오인된 결석을 동반한 총담관류 치료 (Choledochocele containing a stone mistaken as a distal common bile duct stone)

  • 곽태영;박창환;엄석현;황홍석;정덕원;서지영;김영성;곽동협
    • Journal of Yeungnam Medical Science
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    • 제32권1호
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    • pp.60-64
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    • 2015
  • A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors' hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.

The efficacy of a novel integrated outside biliary stent and nasobiliary drainage catheter system for acute cholangitis: a single center pilot study

  • Naosuke Kuraoka;Tetsuro Ujihara;Hiromi Kasahara;Yuto Suzuki;Shun Sakai;Satoru Hashimoto
    • Clinical Endoscopy
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    • 제56권6호
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    • pp.795-801
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    • 2023
  • Background/Aims: Endoscopic biliary drainage is the gold standard treatment for cholangitis. The two methods of biliary drainage are endoscopic biliary stenting and nasobiliary drainage. A novel integrated outside biliary stent and nasobiliary drainage catheter system (UMIDAS NB stent; Olympus Medical Systems) was recently developed. In this study, we evaluated the efficacy of this stent in the treatment of cholangitis caused by common bile duct stones or distal bile duct strictures. Methods: We conducted a retrospective pilot study by examining the medical records of patients who required endoscopic biliary drainage for cholangitis due to common bile duct stones or distal bile duct strictures, and who were treated with a UMIDAS NB stent, between December 2021 and July 2022. Results: Records of 54 consecutive patients were reviewed. Technical and clinical success rates were 47/54 (87.0%) and 52/54 (96.3%), respectively. Adverse events were observed in 12 patients, with six patients experiencing pancreatitis as an adverse event, following endoscopic retrograde cholangiopancreatography (ERCP). Regarding late adverse events, five cases of biliary stent migration into the bile duct were observed. Disease-related death occurred in one patient. Conclusions: The outside-type UMIDAS NB stent is an efficacious new method for biliary drainage and can be applied to many indications.

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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    • 제17권10호
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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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    • 제19권4호
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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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    • 제61권2호
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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.

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

  • 김경모;김성철;서동완;윤종현
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제1권1호
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    • pp.144-147
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    • 1998
  • 저자들은 복부 둔상 후에 발생한 담도 단독 협착을 보인 환아에서 수술적인 치료를 대신하여 내시경적 경비담도 배액술과 플라스틱 스텐트 삽입으로 증상의 호전과 2년의 추적관찰에서 재발을 보이지 않고 있는 1례를 경험하여 문헌고찰과 함께 보고하는 바이다.

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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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    • 제15권16호
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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.