Biliary Stenosis and Gastric Outlet Obstruction

Sugimoto, Motokazu; Sonntag, David P.; Flint, Greggory S.; Boyce, Cody J.; Kirkham, John C.; Harris, Tyler J.; Carr, Sean; Nelson, Brent D.; Bell, Don A.; Barton, John M.; Traverso, L. William

doi:10.1097/mpa.0000000000001064

Cited by 9 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The timing of biliary stricture diagnosis was a median of 4 months after NP onset, a time during which most NP patients have active imaging surveillance. The timing of biliary stricture in NP in this series corroborates the timeline reported previously by Sugimoto et al 16 The majority of patients developed biliary stricture within the first year after NP onset, yet, 1 in 4 patients developed biliary stricture greater than 1 year after NP onset. The latter point highlights the importance of long-term follow-up to which not only biliary stricture, but other, often initially subtle long-term problems may arise in this complex group of patients.…”

Section: Discussionsupporting

confidence: 91%

“…In this series, biliary stricture was diagnosed a median of 150 days after AP onset, 16 similar to our experience. In this study by Sugimoto et al, 16 the incidence of biliary stricture was highest in patients with DPDS (19%). We report an incidence of biliary stricture in NP patients of 16%, higher than previously appreciated and more similar to the incidence observed in CP.…”

Section: Discussionsupporting

confidence: 87%

“…Biliary stricture is a known complication of CP and occurs in 3% to 21% of CP patients in large series; 10,11 however, the incidence of biliary stricture in NP patients to date has not been systematically described. Only 1 moderate sized study has reported the incidence of biliary stricture to be 6% of 141 AP patients with a fluid collection 16 . In this series, biliary stricture was diagnosed a median of 150 days after AP onset, 16 similar to our experience.…”

Section: Discussionsupporting

confidence: 85%

“…Only 1 moderate sized study has reported the incidence of biliary stricture to be 6% of 141 AP patients with a fluid collection 16 . In this series, biliary stricture was diagnosed a median of 150 days after AP onset, 16 similar to our experience. In this study by Sugimoto et al, 16 the incidence of biliary stricture was highest in patients with DPDS (19%).…”

Section: Discussionsupporting

confidence: 85%

“…In their descriptive report of biliary stricture in AP, Sugimoto et al 16 reported that the incidence of biliary stricture was highest among patients with DPDS (19%) with 27% of a subset of patients with DPDS involving the head/neck of the pancreas developing biliary stricture. Associated risk factors help provide insight as to potential pathophysiologic mechanisms of biliary stricture development in NP.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Biliary Stricture After Necrotizing Pancreatitis

et al. 2020

View full text Add to dashboard Cite

Biliary stricture in necrotizing pancreatitis (NP) has not been systematically categorized; therefore, we sought to define the incidence and natural history of biliary stricture caused by NP. Summary/Background DataBenign biliary stricture occurs secondary to bile duct injury, anastomotic narrowing, or chronic inflammation and fibrosis. The profound loco-regional inflammatory response of NP creates challenging biliary strictures. Methods:NP patients treated between 2005-2019 were reviewed. Biliary stricture was identified on cholangiography as narrowing of the extrahepatic biliary tree to <75% of the diameter of the unaffected duct. Biliary stricture risk factors and outcomes were evaluated. Results:Among 743 NP patients, 64 died, 13 were lost to follow up; therefore, a total of 666 patients were included in the final cohort. Biliary stricture developed in 108 (16%) patients. Mean follow up was 3.5±3.3 years. Median time from NP onset to biliary stricture diagnosis was 4.2 months (IQR, 1.8-10.9). Presentation was commonly clinical or biochemical jaundice, n = 30 (28%) each. Risk factors for stricture development were splanchnic vein thrombosis and pancreatic head parenchymal necrosis. Median time to stricture resolution was 6.0 months after onset (2.8-9.8). A mean of 3.3±2.3 procedures were performed. Surgical intervention was required in 22 (20%) patients. Endoscopic treatment failed in 17% (17/99) of patients and was not associated with stricture length. Operative treatment of biliary stricture was more likely in patients with infected necrosis or NP disease duration ≥6 months.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Biliary Stricture After Necrotizing Pancreatitis

et al. 2020

View full text Add to dashboard Cite

show abstract

Duodenal obstruction: A rare complication of severe acute pancreatitis in children

Leclercq,

Lecomte,

Stephenne

et al. 2023

JPGN rep.

View full text Add to dashboard Cite

Duodenal obstruction (DO) is an uncommon complication of pancreatitis. It has been described in groove and severe acute and chronic pancreatitis in adults but, to the best of our knowledge, it has not yet been reported in pediatric acute pancreatitis. Current guidelines comment on management of several early and late‐onset complications, but DO is not mentioned. We describe two patients with acute necrotizing pancreatitis who presented with several complications including walled‐off necrosis and DO. In adults, DO is generally managed with adapted nutrition but may require surgical bypass, such as gastroenterostomy. Our patients were managed conservatively and fully recovered 2 months after DO diagnosis. DO may require lengthy hospitalizations and markedly restrict patients' quality of life; however, prolonged conservative treatment was effective in our patients and should be considered even in severe pediatric cases.

show abstract