Recommendations for Invasive Procedures in Patients With Diseases of the Liver and Biliary Tract: Report of a Joint Meeting of the Brazilian Society of Hepatology (Sbh), Brazilian Society of Digestive Endoscopy (Sobed) and Brazilian Society of Interventional Radiology and Endovascular Surgery (Sobrice)

Abstract

Liver and biliary tract diseases are common causes of morbidity and mortality worldwide. Invasive procedures are usually performed in those patients with hepatobiliary diseases for both diagnostic and therapeutic purposes. Defining proper indications and restraints of commonly used techniques is crucial for proper patient selection, maximizing positive results and limiting complications. In 2018, the Brazilian Society of Hepatology (SBH) in cooperation with the Brazilian Society of Interventional Radiology and Endovascular surgery (SOBRICE) and the Brazilian Society of Digestive Endoscopy (SOBED) sponsored a joint single-topic meeting on invasive procedures in patients with hepatobiliary diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to guide clinicians, gastroenterologists, hepatologists, radiologists, and endoscopists for the proper use of invasive procedures for management of patients with hepatobiliary diseases.

Transjugular intrahepatic portosystemic shunt in decompensated cirrhotic patients in a tertiary hospital in southern Brazil

“…TIPS was formally indicated according to the recommendations of the current guidelines [1][2][3][4]10,11 , and consent of the patients or guardians was obtained. Those patients who did not register of the indication for TIPS installation and the outcomes were excluded from the study.…”

Palliative percutaneous transhepatic placement of plastic biliary stents 7 and 10 French for the treatment of malignant biliary obstruction: a primary patency comparison

“…Endoscopic retrograde cholangiopancreatography (ERCP) is the usual ap proach for patients with distal malignant biliary obstruction. 1 However, even when performed by experienced endoscopists, ERCP has a failure rate of 3-12%. 2 Percutaneous transhepatic biliary drainage (PTBD) can be used for patients with distal and proximal malignant biliary obstruction or in cases where ERCP fails or cannot be performed, with excellent results.…”

“…7 In case of advanced unresectable hilar malignancies, pal liation with PTBD seems to be superior to ERCP. 1,8 Newly, Nunes TF et al started to use a 10F instead of 7F PBS for PTBD of palliative malignant biliary obstruction and it seems better results were achieved. 9 The purpose of this study was to compare the primary patency of 7F vs10F plastic biliary stents placed by percutaneous transhepatic technique in two cohort of patients that received palliative treatment for malignant biliary obstruction.…”

The Evolving Field of Hepatology in Brazil

“…Management of patients with liver diseases has evolved dramatically in Brazil in the last decades with the incorporation of several evidence-based recommendations in routine clinical practice. Most of those recommendations, endorsed by the Brazilian Society of Hepatology, were published as position papers or guidelines in different issues of Archives of Gastroenterology (1)(2)(3)(4)(5)(6)(7)(8) .…”