Cholangioscopy-Assisted Crossing of Severe Biliary-Enteric Anastomotic Stricture Following Failure of Standard Fluoroscopic Techniques

Trivedi, Premal S.; Pshak, Thomas

doi:10.1007/s00270-020-02743-8

Cited by 4 publications

(4 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A high-pressure injection of contrast media was completed in the aforementioned temporary complete airtight cavea. Under the high pressure of the contrast media, fiber scars or affixion in the narrowed anastomosis were partly split, and the fissure could be seen after the injection of the contrast media ( 16 ). The aim of these procedures was to create a passageway for guidewire access to the aforementioned dilacerated fissure to the intestinal tract.…”

Section: Discussionmentioning

confidence: 99%

A novel technique of percutaneous transhepatic treatment of biliary-enteric anastomotic occlusive strictures with compliant balloon-occluded distal cholangiography and large-bore catheter: a retrospective case series

Li,

Gong,

Huang

et al. 2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background Endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic biliary balloon dilatation (PTBD) is a challenge in resolving biliary-enteric anastomotic occlusive strictures (BEAOS) and/or coexisting stones. The biliary-enteric anastomosis (BEA) often cannot be seen because of the surgically altered gastrointestinal anatomy. Here, a technique that combined percutaneous compliant-occluded distal cholangiography and the maintenance of a large-bore catheter is described to resolve this issue. Methods A retrospective review of 10 patients who presented with BEAOS with/without coexisting stones who were treated with percutaneous compliant balloon-occluded distal cholangiography, bile duct stone removal, and the maintenance of a large-bore catheter between February 2017 and January 2021 was performed. Treatment response, laboratory examinations, including hepatic function tests, routine blood tests, and blood electrolytes, complications, and imaging data were evaluated. Paired t- tests were used to investigate the difference of laboratory examinations before and after the procedure. Results All 10 cases were technically successful. A total of 9 stones in 6 patients were successfully removed by the compliant balloon. All catheters were removed after the patency of the stricture was confirmed by percutaneous transhepatic cholangiography (PTHC) 6 months later. No severe adverse events occurred during the perioperative period. There were 2 patients who experienced episodes of cholangitis during the follow-up period (mean, 17 months; range, 4–24 months), and neither BEAOS nor bile duct stones recurred within 2 years after the procedure. White blood cells (WBC), total bilirubin (TB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were (6.0±1.4)×10 9 /L and (6.0±1.6)×10 9 /L (P=0.91), 31.4±15.7 and 29.6±10.3 µmol/L (P=0.74), 50.8±20.0 and 85.8±67.0 U/L (P=0.16), and 42.6±15.2 and 71.8±44.9 U/L (P=0.09) pre and postintervention, respectively. Conclusions Percutaneous transhepatic compliant balloon-occluded distal cholangiography and the maintenance of a large-bore catheter probably provide an effective and safe alternative method for resolving BEAOS and/or coexisting stones.

show abstract

Section: Discussionmentioning

confidence: 99%

A novel technique of percutaneous transhepatic treatment of biliary-enteric anastomotic occlusive strictures with compliant balloon-occluded distal cholangiography and large-bore catheter: a retrospective case series

Li,

Gong,

Huang

et al. 2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…A high-pressure injection of contrast media was completed in the aforementioned temporary complete airtight cavea. Under the high pressure of the contrast media, ber scars or a xion in the narrowed anastomosis were partly split, and the ssure could be seen after the injection of the contrast media [13]. The aim of these procedures was to create a passageway for guidewire access to the aforementioned dilacerated ssure to the intestinal tract.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous transhepatic treatment of biliary-enteric anastomotic occlusive strictures with compliant balloon cholangiography and large-bore catheter: A novel technique

Gong

Huang

et al. 2022

Preprint

View full text Add to dashboard Cite

ObjectivesEndoscopic retrograde cholangiopancreatography (ERCP) is a challenge in resolving biliary-enteric anastomotic occlusive strictures (BEAOS) and/or coexisting stones. Here, a novel technique that combined percutaneous compliant balloon block cholangiography and the maintenance of a large-bore catheter was described to resolve this issue.MethodsTen patients developed BEAOS and/or coexisting stones after a Roux-en-Y hepatico- or choledocho-jejunostomy. A percutaneous transhepatic compliant balloon was combined with a high-pressure injection of contrast media to mark the biliary-enteric anastomosis. The biliary-enteric anastomosis was dilated by high-pressure conventional angioplasty balloons, and the compliant balloon was used to push stones into the intestinal tract through the BEAOS. An internal/external biliary catheter was implanted as an alternative minor operation to resolve this problem. Then, the primary drain was exchanged for large-bore 12F and 16F catheters in monthly intervals . The preoperative clinical conditions, postoperative liver function tests and complications were recorded.ResultsAll ten cases had successful techniques, and a total of nine stones in six patients were successfully removed by the compliant balloon. All catheters were removed after the patency of the stricture was confirmed by PTHS six months later. No severe adverse events occurred during the perioperative period. Two patients had episodes of cholangitis during the follow-up period (mean, 17 months; range, 4–24 months), and neither BEAOS nor bile duct stones recurred within two years after the procedure.ConclusionsPercutaneous transhepatic compliant balloon cholangiography and the maintenance of a large-bore catheter were effective and safe alternative operations for resolving BEAOS and/or coexisting stones.

show abstract

“…The ultra-slim cholangioscope has also been successfully used to guide drainage in patient with difficult stones [54]. In cases of severe post liver transplantation anastomotic biliary strictures, cholangioscopy can also help guide a wire through the stricture [55]. Finally, in patients with acute cholecystitis, endoscopic transpapillary gallbladder drainage seems to be better achieved if guided by cholangioscopy [56].…”

Section: Indicationsmentioning

confidence: 99%

Cholangioscopy for biliary diseases

Becq

Soualy

Camus

2023

Current Opinion in Gastroenterology

View full text Add to dashboard Cite

Purpose of reviewCholangioscopy is a mini-invasive endoscopic procedure, which consists in a direct intraductal visualization of the biliary tract. The purpose of this review is to summarize the technique, the clinical applications, as well as future perspectives of cholangioscopy. Recent findingsNumerous technologic advances during the last decades have allowed for an improved utility and functionality, leading to a broader use of this procedure, for diagnostic or therapeutic purposes, in the setting of biliary diseases. Novel tools and emerging indications have been developed and more are yet to come. SummaryCholangioscopy can be performed by peroral, percutaneous transhepatic or intra-operative transcystic or transcholedochal access. Clinical applications of cholangioscopy are multiple, ranging from visual impression and optical guided biopsies of indeterminate biliary strictures to the management of difficult stones , guidance before biliary stenting and retrieval of migrated ductal stents. Multiple devices such as lithotripsy probes, biopsy forceps, snares and baskets have been developed to help achieve these procedures successfully. Cholangioscopy has improved the way biliary diseases can be visualized and treated. New technology, accessories, and applications are expected in the future.

show abstract

Cholangioscopy-Assisted Crossing of Severe Biliary-Enteric Anastomotic Stricture Following Failure of Standard Fluoroscopic Techniques

Cited by 4 publications

References 2 publications

A novel technique of percutaneous transhepatic treatment of biliary-enteric anastomotic occlusive strictures with compliant balloon-occluded distal cholangiography and large-bore catheter: a retrospective case series

A novel technique of percutaneous transhepatic treatment of biliary-enteric anastomotic occlusive strictures with compliant balloon-occluded distal cholangiography and large-bore catheter: a retrospective case series

Percutaneous transhepatic treatment of biliary-enteric anastomotic occlusive strictures with compliant balloon cholangiography and large-bore catheter: A novel technique

Cholangioscopy for biliary diseases

Contact Info

Product

Resources

About