Search results for "Bile duct"

Partial or complete mesohepatectomy combined with resection of the hilar bifurcation in cases of Klatskin tumors: a reasonable strategy?

2009

A 9-Year Retained T-Tube Fragment Encased within a Stone as a Rare Cause of Jaundice

2008

Biliary diseases such as cholangitis may cause jaundice and liver damage. Here, we report on an unusual cause of jaundice in an 84-year-old man 9 years after cholecystectomy. Ultrasound analysis revealed unclear extrahepatic cholestasis and subsequent ERCP showed a large biliary stone sourrounding a T-tube fragment that had remained in the common bile duct for more than 9 years after surgery. The tip of the drainage and the stone could be successfully removed using Dormia baskets. This case suggests that plastic material accidentally left in the common bile duct favours the development of large biliary casts when present over long periods of time.

Management of retained bile duct stones: a prospective open trial comparing extracorporeal and intracorporeal lithotripsy.

1996

Abstract Background: Endoscopic management of common bile duct stones has become the approach of choice, especially in patients with high surgical risk. Problems are encountered if there are large stones or a duct stenosis. For these difficult stones, shock wave technology serves as an alternative to surgical intervention. Methods: A total of 125 patients with common bile duct stones in whom conventional endoscopic treatment had failed were selected and treated either by extracorporeal piezoelectric lithotripsy (ESWL, n=79) or intracorporeal electrohydraulic lithotripsy (EHL, n=46). The average age of our patients was 70 years. Results: In the ESWL group visualization of the stones by ultra…

Prospective, randomized, single-center trial comparing 3 different 10F plastic stents in malignant mid and distal bile duct strictures.

2003

Abstract Background: The aim of this study was to determine whether patency rates differ with respect to the material, design, and surface texture of 3 different plastic stents. Methods: A total of 120 patients (median age 70.5 years; interquartile range 62-78 years) with malignant mid or distal bile duct strictures, seen between March 1996 and May 1999, were prospectively randomized to receive a 10F polyurethane stent, a Teflon Tannenbaum stent, or a hydrophilic hydromer-coated polyurethane stent. The primary study outcome measure was the interval between stent insertion and the first episode of clogging (or the presence of jaundice at death without stent exchange). All 3 types of stent we…

Risk factors for extrahepatic biliary tract carcinoma in men: medical conditions and lifestyle: results from a European multicentre case-control stud…

2007

OBJECTIVES: To identify risk factors of carcinoma of the extrahepatic biliary tract in men. METHODS: Newly diagnosed and histologically confirmed patients, 35-70 years old, were interviewed between 1995 and 1997 in Denmark, Sweden, France, Germany and Italy. Population controls were frequency-matched by age and region. Adjusted odds ratios and 95%-confidence intervals were estimated by logistic regression. RESULTS: The analysis included 153 patients and 1421 controls. The participation proportion was 71% for patients and 61% for controls. Gallstone disease was corroborated as a risk factor for extrahepatic biliary tract carcinoma in men (odds ratio 2.49; 95% confidence interval 1.32-4.70), …

In the literature: June 2019

2019

Biliary tract cancer (BTC) includes cholangiocarcinoma and gallbladder cancer. BTCs are known to have a poor prognosis, with a 5-year overall survival below 20%.1 Unfortunately, majority of patients are diagnosed with advanced stage, being palliative chemotherapy with cisplatin and gemcitabine the current standard of care.2 Poor prognosis is due to the fact that only 20% of patients are diagnosed in early stages3 and the high risk of relapse following curative surgery. Unfortunately, the lack of randomised studies has made the role of adjuvant treatment in BTC following surgery an unresolved matter for many years.4 5 Adjuvant therapy (either in the form of chemotherapy or chemoradiotherapy)…

Gemcitabine plus sorafenib versus gemcitabine alone in advanced biliary tract cancer: a double-blind placebo-controlled multicentre phase II AIO stud…

2014

Background: Since sorafenib has shown activity in different tumour types and gemcitabine regimens improved the outcome for biliary tract cancer (BTC) patients, we evaluated first-line gemcitabine plus sorafenib in a double-blind phase II study. Patients and methods: 102 unresectable or metastatic BTC patients with histologically proven adenocarcinoma of gallbladder or intrahepatic bile ducts, Eastern Cooperative Oncology Group (ECOG) 0–2 were randomised to gemcitabine (1000 mg/m2 once weekly, first 7-weeks + 1-week rest followed by once 3-weeks + 1-week rest) plus sorafenib (400 mg twice daily) or placebo. Treatment continued until progression or unacceptable toxicity. Tumour samples were p…

Prognostic factors for progression-free and overall survival in advanced biliary tract cancer

2015

BACKGROUND: Biliary tract cancer is an uncommon cancer with a poor outcome. We assembled data from the National Cancer Research Institute (UK) ABC-02 study and 10 international studies to determine prognostic outcome characteristics for patients with advanced disease.METHODS: Multivariable analyses of the final dataset from the ABC-02 study were carried out. All variables were simultaneously included in a Cox proportional hazards model, and backward elimination was used to produce the final model (using a significance level of 10%), in which the selected variables were associated independently with outcome. This score was validated externally by receiver operating curve (ROC) analysis using…

Biliary Pancreatitis: Endoscopic Diagnostic and Therapeutic Techniques

1987

Acute pancreatitis constitutes one of the most hazardous emergencies in clinical gastroenterology. Although the diagnosis “biliary pancreatitis” is often used in clinical practice for patients presenting with concrements in the biliary tree or impacted in the papillary orifice [17, 32], the common phrase “biliary pancreatitis” has not so far been exactly defined. Patients with cholecystolithiasis may be included in this group, as well as patients with dysfunction of the sphincter of Oddi. Some authors have reported that juxtapapillary diverticula increase the risk for development of biliary pancreatitis [28].

Fibropolycystic Liver Disease: CT and MR Imaging Findings

2005

Fibropolycystic liver disease encompasses a spectrum of related lesions of the liver and biliary tract that are caused by abnormal embryologic development of the ductal plates. These lesions (congenital hepatic fibrosis, biliary hamartomas, autosomal dominant polycystic disease, Caroli disease, choledochal cysts) can be clinically silent or can cause signs and symptoms such as cholangitis, portal hypertension, gastrointestinal bleeding, infections, and space-occupying masses. The different types of fibropolycystic liver disease demonstrate characteristic findings at computed tomography (CT) and magnetic resonance (MR) imaging. Patients with congenital hepatic fibrosis typically have imaging…