Interventional Therapy for the Treatment of Severe Hemobilia After Percutaneous Transhepatic Cholangial Drainage: A Case Series

Cao, Huicun; Liu, Jian; Li, Tianxiao; Cao, Guangshao; Xu, Gelin; Zhai, Shengli; Xue, Jiangyu; Wang, Ziliang; Shu, Shi; Bai, Weixing

doi:10.9738/intsurg-d-13-cc194

Cited by 14 publications

(8 citation statements)

References 10 publications

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“…Percutaneous transhepatic cholangial drainage (PTCD) has been revealed to be one of the most important treatments for benign and malignant obstructive jaundice (28–30). Therefore, PTCD and operation were used as two different methods for obtaining bile in this study.…”

Section: Discussionmentioning

confidence: 99%

Bile cell‑free DNA as a novel and powerful liquid biopsy for detecting somatic variants in biliary tract cancer

Shen

Zhang²,

et al. 2019

Oncol Rep

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Tissue sampling of biliary tract carcinomas (BTCs) for molecular characterization is challenging. The aim of this study was to investigate the possibility of identifying individual actionable mutations derived from bile cell-free DNA (cfDNA) using targeted deep sequencing. Ten BTC patients, four with gallbladder carcinomas and six with cholangiocarcinomas, were enrolled in the present study. Using targeted deep sequencing with a panel of 150 tumor-related genes, paired bile cfDNA and tumor DNA were analyzed for mutational variants individually and then compared. The present study, to the best of our knowledge, is the first to reveal that bile cfDNA is predominantly comprised of long DNA fragments, which is not the case for plasma cfDNA. Herein, paired bile cfDNA and tumors from ten BTC patients were examined using targeted deep sequencing. When comparing bile cfDNA and tumor DNA for single nucleotide variation (SNV)/insertion and deletion (Indel), the results using targeted deep sequencing revealed high sensitivity (94.7%) and specificity (99.9%). Additionally, the sensitivity of detecting a copy number variation (CNV) was 75.0%, with a specificity of 98.9%. When comparing two bile extraction methods, including percutaneous transhepatic cholangial drainage and operation, no significant difference in SNV/Indel or CNV detection sensitivity was noted. Moreover, when examining the tumor stage and incidence site, AJCC stage II and the distal bile duct both had significantly decreased CNV detection sensitivities. The present study revealed that targeted deep sequencing can reliably detect mutational variants within bile cfDNA obtained from BTC patients. These preliminary results may shed light on bile cfDNA as a promising liquid biopsy for BTC patients.

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Section: Discussionmentioning

confidence: 99%

Bile cell‑free DNA as a novel and powerful liquid biopsy for detecting somatic variants in biliary tract cancer

Shen

Zhang²,

et al. 2019

Oncol Rep

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“…The incidence of hemobilia caused by iatrogenic injury is increasing because of the increase in hepatobiliary intervention procedures (2,4,13). Therefore, effective diagnosis and management of iatrogenic hemobilia are urgently required (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

mentioning

confidence: 99%

“…With more recent improvements in instrumentation and embolic materials, TAE has become a safe, less invasive, and effective alternative to surgery. Because most patients do not require surgical intervention, mortality and morbidity rates have subsequently decreased (5).…”

mentioning

confidence: 99%

Iatrogenic hemobilia: imaging features and management with transcatheter arterial embolization in 30 patients

Wen

Dong²,

Lu³

et al. 2016

Diagn Interv Radiol

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“…There are elderly patients due to excessive bile drainage caused by fluid and electrolyte imbalance or dyspepsia. There are also elderly patients accidentally removed T tubes in life, which can lead to bile leakage or hemobilia 21 .…”

Section: Discussionmentioning

confidence: 99%

The effect of the laparoscopic primary suture of the common bile duct in elderly patients: a retrospective study

Liu

Wang

Liu

et al. 2019

Preprint

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Background Traditionally, Surgical treatment strategies for elderly patients diagnosed with choledocholithiasis combined with cholecystolithiasis include laparoscopic choledocholithotomy, cholecystectomy, and T-tube drainage. However, T-tube drainage in the biliary tract can still cause pain and other complications. This study was designed to compare the primary closure of choledochotomy and the use of T-tube after laparoscopic choledochotomy to determine whether primary suture can be as feasible and safe as suture with T-tube drainage in elderly patients. Methods From January 2017 to January 2018, 85 patients were selected to undergo laparoscopic surgery. They were divided into two groups: primary suture group (n=56) and T tube group (n=29). Preoperative data, intraoperative index, postoperative complications were recorded. Results There were no differences in preoperative data in both groups. Compared with the T-tube group, the postoperative total drainage volume on the first day and patients of residual stones were fewer, and all drainage tube extubation time was shorter in the primary suture group. And there were statistically significant differences in postoperative TBIL between the two groups. There were no pressure sores, hypostatic pneumonia, deep vein thrombosis, serious complications of heart, lung and brain and even death in both groups. Conclusion Only if accurate preoperative risk assessment and strict treatment of basic diseases in elderly patients, intraoperative fine suture of the common bile duct, primary suture in elderly patients are feasible, safe, and valid after laparoscopic choledochotomy for verification of ductal clearance.

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Interventional Therapy for the Treatment of Severe Hemobilia After Percutaneous Transhepatic Cholangial Drainage: A Case Series

Cited by 14 publications

References 10 publications

Bile cell‑free DNA as a novel and powerful liquid biopsy for detecting somatic variants in biliary tract cancer

Bile cell‑free DNA as a novel and powerful liquid biopsy for detecting somatic variants in biliary tract cancer

Iatrogenic hemobilia: imaging features and management with transcatheter arterial embolization in 30 patients

The effect of the laparoscopic primary suture of the common bile duct in elderly patients: a retrospective study

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