Choledocholithiasis—a new clinical pathway

Bosley, Maggie E.; Zamora, Irving J.; Neff, Lucas P.

doi:10.21037/tgh-20-172

Cited by 23 publications

(23 citation statements)

References 68 publications

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“…Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) applications in pediatrics differ from those in adults [ 1 , 3 , 4 ]. Literature data suggest that ERCP and laparoscopic common bile duct exploration (LCBDE) can be safely and effectively performed in children with proper surgical skills, staff coordination, and procedural systematization [ 5 ]. Indications of ERCP and EUS procedures are infrequent in children.…”

Section: Introductionmentioning

confidence: 99%

Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children

et al. 2023

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Introduction: Endoscopic procedures are performed more frequently in children due to technological advances that can be safely performed in an adequate setting with a support of a multidisciplinary team. Pediatric indications for ERCP (endoscopic retrograde cholangiopancreatography) and EUS (endoscopic ultrasound) occur mainly due to congenital malformations. In a pediatric case series, we report the application of EUS combined with duodenoscopy, eventually associated with ERCP and minimally invasive surgery, highlighting the importance of defining a tailored dedicated management pathway for each patient. Patients and methods: A series of 12 patients, managed at our Center in the last three years, were evaluated, and their management was discussed. Results: EUS was performed in eight patients and permitted the differential diagnosis of duplication cysts and the visualization of the biliary tree and pancreatic anatomy. ERCP was attempted in five patients: in one case, it permitted the preservation of pancreatic tissue, postponing surgery and in three patients, it was technically unfeasible. MIS (minimally invasive surgery) was performed in seven patients, two with laparoscopic common bile duct exploration (LCBDE). Precise anatomical definition and the possibility of surgical simulation and team sharing were evaluated under VR HMD (Virtual Reality Head Mounted Display) in four cases. Conclusions: Exploration of the common bile duct in children differs from that of the adult population and combines echo-endoscopy and ERCP. The integrated use of minimally invasive surgery in the pediatric area is necessary for the whole management perspective in complex malformations and small patients. The introduction in the clinical practice of a preoperative study with Virtual Reality allows a better survey of the malformation and a tailored treatment.

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Section: Introductionmentioning

confidence: 99%

Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children

et al. 2023

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“…Esto con la finalidad de hacer un diagnóstico y tratamiento adecuado según la gravedad de las patologías, teniendo en cuenta que algunas de ellas son de conducta expectante cuando se encuentra asintomáticas, por lo que los controles regulares son indispensables, más aún en aquellos pacientes que han sido sometidos a intervenciones quirúrgicas, en donde los síntomas pueden recidivar a largo plazo. (Bosley et al, 2021)…”

Section: Introductionunclassified

Revisión bibliográfica: abordaje quirúrgico de las patologías de la vesícula biliar en niños

Daniel¹,

Valencia²,

Gavilanes³

et al. 2023

Braz. J. Hea. Rev.

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Los trastornos de la vesícula biliar en la población pediátrica han cambiado en las últimas tres décadas. Si bien antes se atribuían en gran medida a enfermedades hemolíticas, hoy en día se conoce que el aumento del sobrepeso y la obesidad son la principal causa de estos. El número de colecistectomías en niños ha incrementado debido a un mejor conocimiento de la patología de la vesícula biliar como causa de dolor abdominal, el uso rutinario de la ecografía en la evaluación del dolor abdominal y el aumento de la indecencia de las patologías biliares. En este artículo se analizará las patologías de la vesícula biliar: Discinesia biliar, colelitiasis, pólipos de la vesícula y el abordaje quirúrgico en pacientes pediátricos.

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“…In most cases, motility is overcome by air insufflation and the short and stable position of the duodenoscope. However, in some cases, even these attempts fail, requiring use of antimotility agents 1 . Multiple duodenal antimotility agents such as hyoscyamine sulfate, atropine, octreotide, and glucagon have been used in the past 2 .…”

Section: Introductionmentioning

confidence: 99%

“…, endoscopic retrograde cholangiopancreatography; SD, standard deviation; HTN, hypertension; DM, diabetes mellitus; COPD, chronic obstructive pulmonary disease; CKD, chronic kidney disease; ID, ischemic heart disease 1. A 1:1 propensity score matching was done based on the following variables: age, gender, HTN, DM, obesity, CKD, IHD, and COPD.…”

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confidence: 99%

Clinical safety and outcomes of glucagon use during endoscopic retrograde cholangiopancreatography (ERCP)

2022

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Background and study aims Injectable glucagon enables easier biliary cannulation by inhibiting gastrointestinal motility and decreasing the frequency and amplitude of phasic activity of the sphincter of Oddi during endoscopic retrograde cholangiopancreatography (ERCP). Data about the safety profile of glucagon use and patient clinical outcomes are scarce. Patients and methods We used a federated cloud-based network research database, TriNetX, comprising 92 US healthcare organizations to find adult patients undergoing ERCP with glucagon use (Group A) vs. without using glucagon (Group B) from August 1, 2010, to August 1, 2021. The primary outcomes were rates of gastrointestinal bleeding, gastrointestinal perforation, post-ERCP pancreatitis, inpatient hospitalizations, and 30-day overall mortality measured after 1:1 propensity matching of the groups based on the baseline demographics and comorbidities. Results There were 9,008 patients in Group A compared to 256,597 in Group B. After matching, Group A patients had lower rates of gastrointestinal bleeding (risk ratio [RR], 0.68; CI, 0.52–0.86), post-ERCP pancreatitis (RR, 0.64; CI, 0.58–71), inpatient hospitalization (RR 0.34; CI:0.32 to 0.36) and overall mortality (RR, 0.81; CI, 0.66–0.99). The rates of gastrointestinal perforation (RR, 0.64; CI: 0.34 to 1.19), hyperkalemia (RR, 0.83; CI, 0.64–1.09) and hyperglycemia (RR, 0.65; CI, 0.41–1.03) did not differ between the two groups. Discussion Glucagon use during ERCP was associated with low rates of gastrointestinal bleeding, post-ERCP pancreatitis, inpatient hospitalization, and overall mortality. Moreover, the rates of hyperkalemia and hyperglycemia did not differ between the two groups even after matching for diabetes, indomethacin use, obesity, and chronic kidney disease.

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Choledocholithiasis—a new clinical pathway

Cited by 23 publications

References 68 publications

Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children

Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children

Revisión bibliográfica: abordaje quirúrgico de las patologías de la vesícula biliar en niños

Clinical safety and outcomes of glucagon use during endoscopic retrograde cholangiopancreatography (ERCP)

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