Background: Percutaneous Transhepatic Biliary Drainage (PTBD) is a minimally invasive procedure to palliate the biliary obstruction caused by unresectable malignancy.
Aims and Objective: To analyze the outcome of PTBD in patients of unresectable gall bladder cancer presenting with obstructive jaundice in terms of reduction in serum bilirubin levels, symptomatic improvement, and overall survival (OS) at 4 weeks and 12 weeks following the procedure.
Materials and Methods: In this retrospective study, PTBD was attempted on 30 patients diagnosed with inoperable gall bladder cancer. Various patient and procedure-related variables were analyzed and recorded both pre and post-PTBD. Outcome data on OS was collected at 4 weeks and 12 weeks.
Results: Technical success was achieved in 29 (99.66%) patients. The mean fall in the serum bilirubin at the 7th post-procedural day was 41.5% after the successful PTBD. The most common complication in our study was cholangitis noted in six (21%) patients. OS at 4 weeks and 12 weeks was 79% and 41%, respectively.
Conclusion: Younger age and good performance status favored better survival rate in our study.
Background: Perianal fistula is a common and often an extremely distressing disorder. MRI is a preferred modality for the preoperative assessment of perianal fistulas.
Aims and Objective: To evaluate the accuracy and predictive values of pre-operative MRI in diagnosing severity of perianal fistulas and the conditions associated with it like internal anal opening, secondary tract, abscess and supralevator extension.
Materials and Methods: In this study, 44 patients with clinically suspected perianal fistulas underwent MRI for the evaluation of severity and presence of the associated conditions. St James’s University Hospital Classification was used to grade the perianal fistula. Pre-operative MRI grading was compared with the surgical findings in the 26 operated patients.
Results: Out of 44 clinically suspected perianal fistulas, 41 (93%) were diagnosed as perianal fistulas by MRI. The most common type was grade 1 seen in 12(27.3%) patients followed by grade 4 fistula seen in 10(22.7%) patients. All 26 patients evaluated by surgical findings for severity of perianal fistulas were found to be graded in identical grades by pre-operative MRI. MRI was 100% sensitive in picking up all five grades.
Conclusion: MRI helps in the accurate delineation of fistulous tract, identification of secondary tract and abscess.
Background: Gallbladder carcinoma is endemic in India. Though imaging findings of gallbladder carcinoma are very well-described in the literature, the research question that guided this study was to evaluate various imaging manifestations of the disease in this particular geographic region of North India which is a highly endemic region for gallbladder cancer and compare with studies from other parts of the world.
Aims and Objective: The purpose of the study was to retrospectively analyse spectrum of findings on Multidetector Computed Tomography (MDCT) in histologically proven gallbladder carcinoma detected at a tertiary care centre from the NorthIndia. The primary objective was to define the various patterns of growth while the secondary objective was to analyse the specific prevalence and patterns of spread of the disease.
Materials and Methods: We retrospectively studied contrast enhanced Computed Tomography (CECT) findings in 230 patients of histologically proven gallbladder carcinoma. Patients with previous cholecystectomy or biliary intervention were excluded.
Results: In our study, focal or asymmetrical wall thickening of the gallbladder was the most common growth pattern seen in 140(61%) patients. Contiguous infiltration of liver was seen in 190 (83%) cases. Regional nodal involvement was observed in 90 (39%) patients, while 100 (43%) patients had both regional & distant nodal involvement. Liver and peritoneal metastases were noted in 71 (31%) patients and 96 (42%) patients respectively. Majority (81%) of patients had stage IV disease.
Conclusion: MDCT provides comprehensive information regarding the local extent as well as distant spread of gallbladder carcinoma. Asymmetric gall bladder wall thickening in this geographical region must be considered suspicious and should evoke histopathological analysis to exclude malignancy.
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