期刊文献+
共找到2,700篇文章
< 1 2 135 >
每页显示 20 50 100
Undifferentiated high-grade pleomorphic sarcoma of the common bile duct:A case report and review of literature
1
作者 Li-Ping Zheng Wen-Yan Shen +4 位作者 Chun-Dong Hu Chun-Hua Wang Xu-Jian Chen Jing Wang Yi-Yu Shen 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第5期2253-2260,共8页
BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of ... BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of specific clinical manifestations and imaging features,UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive diagnosis.Here we report an extremely rare case of high-grade UPS in the common bile duct(CBD).There are limited available data on such cases.CASE SUMMARY A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 wk.Her laboratory data suggested significantly elevated hepatorenal function levels.The imaging data revealed calculous cholecystitis,intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi,and a space-occupying lesion at the distal CBD.After endoscopic biliary stenting and symptomatic support therapy,CBD exploration and biopsy were performed.The frozen section indicated malignant spindle cell tumor of the CBD mass,and further radical pancreaticoduodenectomy was performed.Finally,the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical results.CONCLUSION This extremely rare case highlighted the need for increasing physicians'vigilance,reducing the odds of misdiagnosis,and providing appropriate treatment strategies. 展开更多
关键词 Undifferentiated pleomorphic sarcoma Soft tissue sarcoma common bile duct Extrahepatic bile duct IMMUNOHISTOCHEMISTRY Case report
下载PDF
Surgical strategies for challenging common bile duct stones in the endoscopic era: A comprehensive review of current evidence
2
作者 Tharathorn Suwatthanarak Vitoon Chinswangwatanakul +4 位作者 Asada Methasate Chainarong Phalanusitthepha Minoru Tanabe Keiichi Akita Thawatchai Akaraviputh 《World Journal of Gastrointestinal Endoscopy》 2024年第6期305-317,共13页
While endoscopic retrograde cholangiopancreatography(ERCP)remains the primary treatment modality for common bile duct stones(CBDS)or choledocho-lithiasis due to advancements in instruments,surgical intervention,known ... While endoscopic retrograde cholangiopancreatography(ERCP)remains the primary treatment modality for common bile duct stones(CBDS)or choledocho-lithiasis due to advancements in instruments,surgical intervention,known as common bile duct exploration(CBDE),is still necessary in cases of difficult CBDS,failed endoscopic treatment,or altered anatomy.Recent evidence also supports CBDE in patients requesting single-step cholecystectomy and bile duct stone removal with comparable outcomes.This review elucidates relevant clinical anatomy,selection indications,and outcomes to enhance surgical understanding.The selection between trans-cystic(TC)vs trans-choledochal(TD)approaches is described,along with stone removal techniques and ductal closure.Detailed surgical techniques and strategies for both the TC and TD approaches,including instrument selection,is also provided.Additionally,this review comprehensively addresses operation-specific complications such as bile leakage,stricture,and entrapment,and focuses on preventive measures and treatment strategies.This review aims to optimize the management of CBDS through laparoscopic CBDE,with the goal of improving patient outcomes and minimizing risks. 展开更多
关键词 CHOLEDOCHOLITHIASIS common bile duct stone Difficult common bile duct stone common bile duct exploration Laparoscopic common bile duct exploration
下载PDF
Risk factors for recurrence of common bile duct stones after surgical treatment and effect of ursodeoxycholic acid intervention
3
作者 Wei-Hong Yuan Zheng Zhang +2 位作者 Qi Pan Bo-Neng Mao Tao Yuan 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第1期103-112,共10页
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve choles... BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve cholesterol stones and prevent their development and reappearance by lowering the cholesterol concen-tration in bile.Despite these treatment options,there are still patients who experience stone recurrence.The clinical data of 100 patients with choledochal stones who were hospitalized at the Yixing People’s Hospital and underwent ERCP for successful stone extraction between June 2020 and December 2022 were retrospectively collected.According to the post-ERCP treatment plan,100 patients were classified into UDCA(n=47)and control(n=53)groups.We aimed to assess the clinical efficacy and rate of relapse in the two patient populations.We then collected information(basic demographic data,clinical characteristics,and serum biochemical indicators)and determined the factors contributing to relapse using logistic regression analysis.Our secondary goal was to determine the effects of UDCA on liver function after ERCP.Compared to the control group,the UDCA group demonstrated a higher clinical effectiveness rate of 92.45%vs 78.72%(P<0.05).No significant differences were observed in liver function indices,including total bilirubin,direct bilirubin,gamma-glutamyl transpeptidase,alanine aminotransferase,alkaline phosphatase,and aspartate aminotransferase,between the two groups before treatment.After treatment,all liver function indices were significantly reduced.Comparing the control vs UDCA groups,the UDCA group exhibited significantly lower levels of all indices(55.39±6.53 vs 77.31±8.52,32.10±4.62 vs 45.39±5.69,142.32±14.21 vs 189.63±16.87,112.52±14.25 vs 149.36±15.36,122.61±16.00 vs 171.33±22.09,96.98±10.44 vs 121.35±11.57,respectively,all P<0.05).The stone recurrence rate was lower in the UDCA group(13.21%)in contrast with the control group(44.68%).Periampullary diverticula(OR:6.00,95%CI:1.69-21.30),maximum stone diameter(OR:1.69,95%CI:1.01-2.85),stone quantity>3(OR:4.23,95%CI:1.17-15.26),and positive bile culture(OR:7.61,95%CI:2.07-27.91)were independent factors that influenced the relapse of common bile duct stones after ERCP(P<0.05).Furthermore,postoperative UDCA was identified as a preventive factor(OR:0.07;95%CI:0.08-0.09).CONCLUSION The intervention effect of UDCA after ERCP for common bile duct stones is adequate,providing new research directions and references for the prevention and treatment of stone recurrence. 展开更多
关键词 Endoscopic retrograde cholangiopancreatography RECURRENCE Ursodeoxycholic acid common bile duct stones Clinical effective rate Risk factors
下载PDF
Clinical efficacy of laparoscopic cholecystectomy combined with endoscopic papillary balloon dilation in treatment of gallbladder stones with common bile duct stones: A retrospective study
4
作者 Hong-Dan Liu Qi Zhang +1 位作者 Wen-Si Xu Shuang Jin 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第6期1700-1708,共9页
BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic ... BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic papillary balloon dilation(EPBD)in patients with gallbladder stones(GS)with common bile duct stones(CBDS).METHODS The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC+EPBD group(n=50)or an LC+endoscopic sphincterotomy(EST)group(n=52)according to surgical methods.Surgery-related indexes,postoperative recovery,postoperative complications,and expression levels of inflammatory response indexes were compared between the two groups.RESULTS Total surgical time,stone free rate,rate of conversion to laparotomy,and successful stone extraction rate did not differ significantly between the LC+EPBD group and LC+EST group.Intraoperative hemorrhage,time to ambulation,and length of hospitalization in the LC+EPBD group were lower than those of the LC+EST group(P<0.05).The rate of total complications of the two groups was 9.80%and 17.65%,respectively,and the difference was not statistically significant.No serious complications occurred in either group.At 48 h postoperatively,the expression levels of interleukin-6,tumor necrosis factor-α,high-sensitivity Creactive protein,and procalcitonin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).At 3 d postoperatively,the expression levels of aspartate transaminase,alanine transaminase,and total bilirubin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).CONCLUSION LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS,in which LC combined with EPBD is beneficial to shorten the patient’s hospitalization time,reduce the magnitude of elevated inflammatory response indexes,and promote postoperative recovery. 展开更多
关键词 Gallbladder stone common bile duct stone Endoscopic papillary balloon dilation Laparoscopic cholecystectomy Endoscopic sphincterotomy
下载PDF
Results of Surgical Management of Malignant Obstruction of the Common Bile Duct in Yaoundé
5
作者 Eric Patrick Savom Gaël Tsanga Nomo +5 位作者 Richard II Mbele Mahamat Yannick Ekani Boukar Cédric Paterson Atangana Fred Dikongue Dikongue Guy Aristide Bang Arthur Essomba 《Surgical Science》 2024年第4期265-277,共13页
Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical tre... Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical treatment of MOCBD, evaluate the results and detect the factors associated with postoperative morbidity and mortality. Patients and Methods: We conducted an analytical observational study, with retrospective data collection from the files of patients operated upon for MOCBD. This was done in four referral hospitals in the city of Yaoundé for a 42-month period spanning from January 1, 2020 to June 30, 2023. Demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results: We collected 71 files. The sex ratio was 1.4 and the mean age was 56 ± 11 years. Fifty-three (53) patients (74.6%) were overweight or obese and 10 patients (14.1%) were hypertensive. A clinical cholestasis syndrome was present in 69 patients (97.2%). Fifty-five (55) patients (77.5%) had a cancer of the head of the pancreas, 8 patients (11.3%) had an extra-hepatic cholangiocarcinoma and 8 patients (11.3%) had an ampullary adenocarcinoma. Eight (8) resections (11.3%) with curative intent had been carried out and in 63 cases (88.7%), surgery was palliative. Postoperative morbidity was 55.7%, influenced by advanced WHO stage (p = 0.02). Postoperative mortality was 25.7%, associated with a high ASA score (p = 0.01). Conclusion: Pancreatic head cancer is the main etiology of malignant obstructions of the common bile duct in Cameroon. Surgical treatment is most often palliative. Postoperative morbidity and mortality are high, influenced by high WHO and ASA scores. 展开更多
关键词 Malignant Obstruction common bile duct Palliative Treatment MORBIDITY MORTALITY
下载PDF
Comprehensive review on small common bile duct stones 被引量:2
6
作者 Sakue Masuda Kazuya Koizumi +11 位作者 Kento Shionoya Ryuhei Jinushi Makomo Makazu Takashi Nishino Karen Kimura Chihiro Sumida Jun Kubota Chikamasa Ichita Akiko Sasaki Masahiro Kobayashi Makoto Kako Uojima Haruki 《World Journal of Gastroenterology》 SCIE CAS 2023年第13期1955-1968,共14页
Common bile duct stones are among the most common conditions encountered by endoscopists.Therefore,it is well researched;however,some items,such as indications for endoscopic papillary balloon dilatation(EPBD),safety ... Common bile duct stones are among the most common conditions encountered by endoscopists.Therefore,it is well researched;however,some items,such as indications for endoscopic papillary balloon dilatation(EPBD),safety of EPBD and endoscopic sphincterotomy in patients receiving dual antiplatelet therapy or direct oral anticoagulant,selection strategy for retrieval balloons and baskets,lack adequate evidence.Therefore,the guidelines have been updated with new research,while others remain unchanged due to weak evidence.In this review,we comprehensively summarize the standard methods in guidelines and new findings from recent studies on papillary dilation,stone retrieval devices,difficult-to-treat cases,troubleshooting during the procedure,and complicated cases of cholangitis,cholecystolithiasis,or distal biliary stricture. 展开更多
关键词 CHOLEDOCHOLITHOTOMY CHOLEDOCHOLITHIASIS common bile duct stones Endoscopic papillary balloon dilation Endoscopic sphincterotomy Small common bile duct stones
下载PDF
Removal of intrahepatic bile duct stone could reduce the risk of cholangiocarcinoma
7
作者 Gowthami Sai Kogilathota Jagirdhar Yatinder Bains Salim Surani 《World Journal of Clinical Cases》 SCIE 2024年第11期1881-1884,共4页
Hepatolithiasis(HL)poses a significant risk for cholangiocarcinoma(CCA)development,with reported incidences ranging from 5%-13%.Risk factors include older age,smoking,hepatitis B infection,and prolonged HL duration.Ch... Hepatolithiasis(HL)poses a significant risk for cholangiocarcinoma(CCA)development,with reported incidences ranging from 5%-13%.Risk factors include older age,smoking,hepatitis B infection,and prolonged HL duration.Chronic inflammation and mechanical stress on the biliary epithelium contribute to CCA pathogenesis.Hepatectomy reduces CCA risk by removing stones and atrophic liver segments.However,residual stones and incomplete removal increase CCA risk.Kim et al identified carbohydrate antigen 19-9,carcinoembryonic antigen,and stone laterality as CCA risk factors,reaffirming the importance of complete stone removal.Nonetheless,challenges remain in preventing CCA recurrence post-surgery.Longer-term studies are needed to elucidate CCA risk factors further. 展开更多
关键词 HEPATOLITHIASIS CHOLANGIOCARCINOMA Biliary stone common bile duct stone CHOLANGITIS
下载PDF
Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients:A technical review 被引量:2
8
作者 Bo-Ya Chiu Shu-Hung Chuang +1 位作者 Shih-Chang Chuang Kung-Kai Kuo 《World Journal of Clinical Cases》 SCIE 2023年第9期1939-1950,共12页
Situs inversus(SI)is a rare congenital condition characterized by a mirror-image transposition of the major visceral organs.Since the 1990s,more than one hundred SI patients have been reported to have successfully und... Situs inversus(SI)is a rare congenital condition characterized by a mirror-image transposition of the major visceral organs.Since the 1990s,more than one hundred SI patients have been reported to have successfully undergone laparoscopic cholecystectomy.In these cases,the major problem is to overcome is the left-right condition for right-handed surgeons.Laparoscopic common bile duct exploration(LCBDE),an alternative to treat patients with bile duct stones,has shown equivalent efficacy and is less likely to cause pancreatitis than endoscopic retrograde cholangiopancreatography.Recent updated meta-analyses revealed that a shorter postoperative hospital stay,fewer procedural interventions,cost-effectiveness,a higher stone clearance rate,and fewer perioperative complications are additional advantages of LCBDE.However,the technique is technically demanding,even for skilled laparoscopic surgeons.Conducting LCBDE in patients with difficult situations,such as SI,is more complex than usual.We herein review published SI patients with choledocholithiasis treated by LCBDE,including our own experience,and this paper focuses on the technical aspects. 展开更多
关键词 CHOLEDOCHOLITHIASIS CHOLEDOCHOTOMY Laparoscopic common bile duct exploration Single incision Situs inversus Transcystic
下载PDF
Asymptomatic bile duct stones:The devil is in the details
9
作者 Mohammed Omar Khalifa Elsayed Mohamed Gamal Talkhan 《World Journal of Gastrointestinal Endoscopy》 2024年第5期227-231,共5页
Common bile duct(CBD)stones are a common biliary tract disease.For asymp-tomatic CBD stones,stone removal by endoscopic retrograde cholangiopancreato-graphy(ERCP)is recommended in available guidelines.Because asymptom... Common bile duct(CBD)stones are a common biliary tract disease.For asymp-tomatic CBD stones,stone removal by endoscopic retrograde cholangiopancreato-graphy(ERCP)is recommended in available guidelines.Because asymptomatic CBD stones is a benign disease with no noticeable symptoms,the risk vs benefit strategy should be thoroughly considered before performing ERCP in these patients.Clinical care review,technical aspects of the procedure,and patient preferences should also be considered. 展开更多
关键词 ASYMPTOMATIC common bile duct stones Endoscopic retrograde cholangiopancreatography OUTCOME GUIDELINES
下载PDF
Expression and functional study of cholecystokinin-A receptors on the interstitial Cajal-like cells of the guinea pig common bile duct 被引量:1
10
作者 Dan Xu Song-Lin Ma +1 位作者 Man-Lin Huang Heng Zhang 《World Journal of Gastroenterology》 SCIE CAS 2023年第38期5374-5382,共9页
BACKGROUND Many studies have shown that interstitial Cajal-like cell(ICLC)abnormalities are closely related to a variety of dynamic gastrointestinal disorders.ICLCs are pacemaker cells for gastrointestinal movement an... BACKGROUND Many studies have shown that interstitial Cajal-like cell(ICLC)abnormalities are closely related to a variety of dynamic gastrointestinal disorders.ICLCs are pacemaker cells for gastrointestinal movement and are involved in the transmission of nerve impulses.AIM To elucidate the expression profile and significance of cholecystokinin-A(CCK-A)receptors in ICLCs in the common bile duct(CBD),as well as the role of CCK in regulating CBD motility through CCK-A receptors on CBD ICLCs.METHODS The levels of tyrosine kinase receptor(c-kit)and CCK-A receptors in CBD tissues and isolated CBD cells were quantified using the double immunofluorescence labeling technique.The CCK-mediated enhancement of the movement of CBD muscle strips through CBD ICLCs was observed by a muscle strip contraction test.RESULTS Immunofluorescence showed co-expression of c-kit and CCK-A receptors in the CBD muscularis layer.Observations of isolated CBD cells showed that c-kit was expressed on the surface of ICLCs,the cell body and synapse were colored and polygonal,and some cells presented protrusions and formed networks adjacent to the CBD while others formed filaments at the synaptic terminals of local cells.CCK-A receptors were also expressed on CBD ICLCs.At concentrations ranging from 10^(-6) mol/L to 10^(-10) mol/L,CCK promoted CBD smooth muscle contractility in a dose-dependent manner.In contrast,after ICLC removal,the contractility mediated by CCK in CBD smooth muscle decreased.CONCLUSION CCK-A receptors are highly expressed on CBD ICLCs,and CCK may regulate CBD motility through the CCK-A receptors on ICLCs. 展开更多
关键词 Interstitial Cajal-like cells Tyrosine kinase receptor common bile duct Cholecystokinin-A receptors
下载PDF
Cholangioscopy-assisted extraction through novel papillary support for small-calibre and sediment-like common bile duct stones 被引量:1
11
作者 Wen-Gang Zhang Ning-Li Chai +5 位作者 Bo Zhang Xiao Li Jia-Feng Wang Hao Dong Yu-Jie Feng En-Qiang Linghu 《World Journal of Gastroenterology》 SCIE CAS 2023年第16期2495-2501,共7页
BACKGROUND To date,endoscopic retrograde cholangiopancreatography has become a wellestablished treatment for common bile duct(CBD)stones.However,it is not suitable for some special patients,such as pregnant women,chil... BACKGROUND To date,endoscopic retrograde cholangiopancreatography has become a wellestablished treatment for common bile duct(CBD)stones.However,it is not suitable for some special patients,such as pregnant women,children or those who cannot stop taking anti-coagulation/anti-platelet agents because of radiation injury and the risk of postoperative bleeding resulting from endoscopic sphincterotomy.To overcome these two problems,this study introduced cholangioscopy-assisted extraction through a novel papillary support for small-calibre and sediment-like CBD stones.AIM To assess the feasibility and safety of cholangioscopy-assisted extraction through a novel papillary support(CEPTS)for small-calibre and sediment-like common bile duct(CBD)stones.METHODS This Retrospective study was approved by the Ethics Committee of the Chinese PLA General Hospital.We designed a covered single dumbbell-style papillary support between 2021 and 2022.Between July 2022 and September 2022,7 consecutive patients with small-calibre(cross diameter≤1.0 cm)or sediment-like CBD stones underwent CETPS procedures in our center.The clinical characteristics and treatment outcomes of these 7 patients were extracted from a prospectively collected database.And the related data were analyzed.Informed consent was obtained from all participating patients.RESULTS A total of 2 patients had yellow sediment-like CBD stones,and aspiration extraction was performed after the insertion of papillary support.Of the 5 patients with clumpy CBD stones(0.4-1.0 cm),2 underwent basket extraction under direct vision for a single stone(0.5-1.0 cm,black and black grey),1 underwent balloon plus aspiration extraction under direct vision for 5 stones(0.4-0.6 cm,brown),and 2 underwent aspiration extraction only for a single stone(0.5-0.6 cm,yellow,none).Technical success,namely,no residual stones in the CBD or left and right hepatic ducts,was achieved in all 7 cases(100%).The median operating time was 45.0 minutes(range 13.0–87.0 minutes).Postoperative pancreatitis(PEP)occurred in one case(14.3%).Hyperamylasaemia without abdominal pain was noted in 2 of 7 patients.No residual stones or cholangitis were found during the follow-up.CONCLUSION CETPS appeared to be feasible to treat patients with small-calibre or sediment-like CBD stones.Patients,especially pregnant women and those who cannot stop anticoagulation/anti-platelet agents,could benefit from this technique. 展开更多
关键词 CHOLANGIOSCOPY common bile duct stones Papillary support
下载PDF
Carcinosarcoma of common bile duct:A case report
12
作者 Yao Yao Hong-Gang Xiang +2 位作者 Lei Jin Ming Xu Shu-Yan Mao 《World Journal of Gastrointestinal Oncology》 SCIE 2023年第3期562-570,共9页
BACKGROUND Carcinosarcomas of the common bile duct(CBD)are an extremely rare finding in the clinical setting.Based on a review of 12 literatures,3 cases had the imaging features of ossification.Carcinosarcomas are pro... BACKGROUND Carcinosarcomas of the common bile duct(CBD)are an extremely rare finding in the clinical setting.Based on a review of 12 literatures,3 cases had the imaging features of ossification.Carcinosarcomas are prone to distant metastasis,as they possess clinical features of both carcinoma and sarcoma,and generally have with a poor prognosis.Due to the small number of cases reported,clinical experience in the diagnosis and treatment of the disease is lacking.CASE SUMMARY The patient was a 75-year-old woman who had experienced recurrent chills with nausea and vomiting for 3 mo.Computed tomography,magnetic resonance imaging,endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography led to the diagnosis of malignant tumor of the CBD.The patient ultimately underwent cholecystectomy,CBD resection,and choledochojejunostomy.Postoperative pathological examination revealed carcinosarcoma of the CBD,and the latest follow-up showed that the patient is recovering well.Based on previous case reports,some carcinosarcoma has ossification characteristics in imaging.If it is misdiagnosed as biliary calculi,the use of laser lithotripsy in surgery may lead to tumor diffusion.Choledochoscopy and narrow band staining of mucosa are very important for diagnosis.CONCLUSION We herein present a rare case of carcinosarcomas of the CBD,we found the tumours may have imaging features of polypoid growth and ossification only when the sarcomal components are bone differentiation,while show soft tissue shadow when non bone differentiation.Confirmation of diagnosis depends greatly upon postoperative pathological examination and the adjuvant treatment has not been established,which leads to the poor prognosis. 展开更多
关键词 CARCINOSARCOMA Sarcocarcinoma Sarcomatoid carcinoma Extrahepatic bile duct tumor common bile duct tumor Case report
下载PDF
Severe liver trauma with complex portal and common bile duct avulsion:A case report and review of the literature
13
作者 Bianca Mitricof Alin Kraft +7 位作者 Florentina Anton Alexandru Barcu Darina Barzan Carmen Haiducu Vladislav Brasoveanu Irinel Popescu Cosmin Alec Moldovan Florin Botea 《World Journal of Clinical Cases》 SCIE 2023年第16期3837-3846,共10页
BACKGROUND Given its size and location,the liver is the third most injured organ by abdominal trauma.Thanks to recent advances,it is unanimously accepted that the nonoperative management is the current mainstay of tre... BACKGROUND Given its size and location,the liver is the third most injured organ by abdominal trauma.Thanks to recent advances,it is unanimously accepted that the nonoperative management is the current mainstay of treatment for hemodynamically stable patients.However,those patients with hemodynamic instability that generally present with severe liver trauma associated with major vascular lesions will require surgical management.Moreover,an associated injury of the main bile ducts makes surgery compulsory even in the case of hemodynamic stability,thereby imposing therapeutic challenges in the tertiary referral hepato-biliopancreatic centers’setting.CASE SUMMARY We present the case of a 38-year-old male patient with The American Association for the Surgery of Trauma grade V liver injury and an associated right branch of portal vein and common bile duct avulsion,due to a crush polytrauma.The patient was referred to the nearest emergency hospital and because of the hemorrhagic shock,damage control surgery was performed by means of ligation of the right portal vein branch and right hepatic artery,and hemostatic packing.Afterwards,the patient was referred immediately to our tertiary hepato-bilio-pancreatic center.We performed depacking,a right hepatectomy and Roux-en-Y hepaticojejunostomy.On the 9th postoperative day,the patient developed a high output anastomotic bile leak that required a redo of the cholangiojejunostomy.The postoperative period was marked by a surgical incision site of incomplete evisceration that was managed non-operatively by negative wound pressure.The follow-up was optimal,with no complications at 55 mo.CONCLUSION In conclusion,the current case clearly supports that a favorable outcome in severe liver trauma with associated vascular and biliary injuries is achieved thru proper therapeutic management,conducted in a tertiary referral hepato-bilio-pancreatic center,where a stepwise and complex surgical approach is mandatory. 展开更多
关键词 SEVERE Liver TRAUMA AVULSION Right portal vein common bile duct Case report
下载PDF
Biliary hemorrhage caused by a malignant small round cell tumor in the common bile duct:A case report
14
作者 Ying-Li Jin Ye-Jiao Ruan Guang-Rong Lu 《World Journal of Clinical Cases》 SCIE 2023年第31期7706-7711,共6页
BACKGROUND Malignant small round cell tumor(MSRCT)metastasis to the common bile duct associated with recurrent biliary hemorrhage is extremely rare.Thus far,there have been no reports of metastatic small round cell tu... BACKGROUND Malignant small round cell tumor(MSRCT)metastasis to the common bile duct associated with recurrent biliary hemorrhage is extremely rare.Thus far,there have been no reports of metastatic small round cell tumors of the common bile duct.CASE SUMMARY Herein,we report the case of a 77-year-old female patient with an MSRCT in the common bile duct.The patient was admitted to hospital due to gastrointestinal hemorrhage and abdominal pain.We found a neoplasm in the common bile duct with active bleeding through a spyglass.We performed biopsy through the spyglass and placed a metal stent to stop bleeding.The pathological result suggested that it was an MSRCT metastasized from the back to the common bile duct.Later,we found using fluorescence in situ hybridization that the SS18 gene break test was negative,ruling out the diagnosis of synovial sarcoma.CONCLUSION MSRCT is a group of tumors with similar cell morphology and diffuse histological structure.Complete tumor resection results in improved survival in patients with MSRCT.Roux-en-Y cholangiojejunostomy was performed.After excision of the common bile duct tumor,the patient felt that the abdominal pain improved and hemorrhage disappeared.The patient underwent routine fecal examination one month after surgery,indicating a negative fecal occult blood test.On May 22,2023,the patient was reexamined by abdominal computed tomography,and no abdominal space occupying lesions or abdominal lymphadenopathy was found. 展开更多
关键词 common bile duct metastasis HEMORRHAGE Recurrent biliary hemorrhage Malignant small round cell tumor SpyGlass Case report
下载PDF
Two-stage vs single-stage management for concomitant gallstones and common bile duct stones 被引量:108
15
作者 Jiong Lu Yao Cheng +3 位作者 Xian-Ze Xiong Yi-Xin Lin Si-Jia Wu Nan-Sheng Cheng 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第24期3156-3166,共11页
AIM:To evaluate the safety and effectiveness of twostage vs single-stage management for concomitant gallstones and common bile duct stones.METHODS:Four databases,including PubMed,Embase,the Cochrane Central Register o... AIM:To evaluate the safety and effectiveness of twostage vs single-stage management for concomitant gallstones and common bile duct stones.METHODS:Four databases,including PubMed,Embase,the Cochrane Central Register of Controlled Trials and the Science Citation Index up to September 2011,were searched to identify all randomized controlled trials(RCTs).Data were extracted from the studies by two independent reviewers.The primary outcomes were stone clearance from the common bile duct,postoperative morbidity and mortality.The secondary outcomes were conversion to other procedures,number of procedures per patient,length of hospital stay,total operative time,hospitalization charges,patient acceptance and quality of life scores.RESULTS:Seven eligible RCTs [five trials(n = 621) comparing preoperative endoscopic retrograde cholangiopancreatography(ERCP)/endoscopic sphincterotomy(EST) + laparoscopic cholecystectomy(LC) with LC + laparoscopic common bile duct exploration(LCBDE);two trials(n = 166) comparing postoperative ERCP/EST + LC with LC + LCBDE],composed of 787 patients in total,were included in the final analysis.The metaanalysis detected no statistically significant difference between the two groups in stone clearance from the common bile duct [risk ratios(RR) =-0.10,95% confidence intervals(CI):-0.24 to 0.04,P = 0.17],postoperative morbidity(RR = 0.79,95% CI:0.58 to 1.10,P = 0.16),mortality(RR = 2.19,95% CI:0.33 to 14.67,P = 0.42),conversion to other procedures(RR = 1.21,95% CI:0.54 to 2.70,P = 0.39),length of hospital stay(MD = 0.99,95% CI:-1.59 to 3.57,P = 0.45),total operative time(MD = 12.14,95% CI:-1.83 to 26.10,P = 0.09).Two-stage(LC + ERCP/EST) management clearly required more procedures per patient than single-stage(LC + LCBDE) management.CONCLUSION:Single-stage management is equivalent to two-stage management but requires fewer procedures.However,patient's condition,operator's expertise and local resources should be taken into account in making treatment decisions. 展开更多
关键词 Laparoscopic cholecystectomy Laparoscop-ic common bile duct exploration Endoscopic retrogradecholangiopancreatography Endoscopic sphincterotomy GALLSTONES common bile duct stones META-ANALYSIS
下载PDF
Various approaches of laparoscopic common bile duct exploration plus primary duct closure for choledocholithiasis:A systematic review and meta-analysis 被引量:64
16
作者 Ming-Yan He Xia-Dong Zhou +3 位作者 Hao Chen Peng Zheng Fa-Zhan Zhang Wei-Wei Ren 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2018年第3期183-191,共9页
Background: Common bile duct (CBD) stones may occur in up to 3%–14.7% of all patients with cholecystectomy.Various approaches of laparoscopic CBD exploration plus primary duct closure (PDC) are the most commonly... Background: Common bile duct (CBD) stones may occur in up to 3%–14.7% of all patients with cholecystectomy.Various approaches of laparoscopic CBD exploration plus primary duct closure (PDC) are the most commonly used and the best methods to treat CBD stone. This systematic review was to comparethe effectiveness and safety of the various approaches of laparoscopic CBD exploration plus PDC forcholedocholithiasis 展开更多
关键词 LAPAROSCOPY CHOLEDOCHOLITHIASIS common bile duct exploration Primary duct closureMeta-analysis
下载PDF
Common bile duct stones on multidetector computed tomography:Attenuation patterns and detectability 被引量:28
17
作者 Chang Whan Kim Jae Hyuck Chang +3 位作者 Yeon Soo Lim Tae Ho Kim In Seok Lee Sok Won Han 《World Journal of Gastroenterology》 SCIE CAS 2013年第11期1788-1796,共9页
AIM:To investigate the attenuation patterns and detectability of common bile duct(CBD) stones by multidetector computed tomography(MDCT).METHODS:Between March 2010 and February 2012,191 patients with suspicion of CBD ... AIM:To investigate the attenuation patterns and detectability of common bile duct(CBD) stones by multidetector computed tomography(MDCT).METHODS:Between March 2010 and February 2012,191 patients with suspicion of CBD stones undergoing both MDCT and endoscopic retrograde cholangiopancreatography(ERCP) were enrolled and reviewed retrospectively.The attenuation patterns of CBD stones on MDCT were classified as heavily calcified,radiopaque,less radiopaque,or undetectable.The association between the attenuation patterns of CBD stones on MDCT and stone type consisting of pure cholesterol,mixed cholesterol,brown pigment,and black pigment and the factors related to the detectability of CBD stones by MDCT were evaluated.RESULTS:MDCT showed CBD stones in 111 of 130 patients in whom the CBD stones were demonstrated by ERCP with 85.4% sensitivity.The attenuation patterns of CBD stones on MDCT were heavily calcified 34(26%),radiopaque 31(24%),less radiopaque 46(35%),and undetectable 19(15%).The radiopacity of CBD stones differed significantly according to stone type(P < 0.001).From the receiver operating characteristic curve,stone size was useful for the determination of CBD stone by MDCT(area under curve 0.779,P < 0.001) and appropriate cut-off stone size on MDCT was 5 mm.The factors related to detectability of CBD stones on MDCT were age,stone type,and stone size on multivariate analysis(P < 0.05).CONCLUSION:The radiopacity of CBD stones on MDCT differed according to stone type.Stone type and stone size were related to the detectability by MDCT,and appropriate cut-off stone size was 5 mm. 展开更多
关键词 common bile duct GALLSTONES GALLSTONES MULTIDETECTOR computed tomography Endoscopic RETROGRADE CHOLANGIOGRAPHY
下载PDF
Role of laparoscopic common bile duct exploration in the management of choledocholithiasis 被引量:41
18
作者 Nikhil Gupta 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2016年第5期376-381,共6页
Surgical fraternity has not yet arrived at any consensus for adequate treatment of choledocholithiasis. Sequential treatment in the form of pre-operative endoscopic retrograde cholangio-pancreatography followed by lap... Surgical fraternity has not yet arrived at any consensus for adequate treatment of choledocholithiasis. Sequential treatment in the form of pre-operative endoscopic retrograde cholangio-pancreatography followed by laparoscopic cholecystectomy(LC) is considered as optimal treatment till date. With refinements in technique and expertise in field of minimal access surgery, many centres in the world have started offering one stage management of choledocholithiasis by LC with laparoscopic common bile duct exploration(LCBDE). Various modalities have been tried for entering into concurrent common bile duct(CBD) [transcystic(TC) vs transcholedochal(TD)], for confirming stone clearance(intraoperative cholangiogram vs choledochoscopy), and for closure of choledochotomy(T-tube vs biliary stent vs primary closure) during LCBDE. Both TC and TD approaches are safe and effective. TD stone extraction is involved with an increased risk of bile leaks and requires more expertise in intra-corporeal suturing and choledochoscopy. Choice depends on number of stones, size of stone, diameter of cystic duct and CBD. This review article was undertaken to evaluate the role of LCBDE for the management of choledocholithiasis. 展开更多
关键词 LAPAROSCOPIC common bile duct exploration CHOLEDOCHOSCOPY CHOLANGIOGRAM CHOLEDOCHOLITHIASIS Primary closure
下载PDF
Intraoperative endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy 被引量:19
19
作者 De Fei Hong Ming Gao +2 位作者 Urs Bryner Xiu Jun Cai Yi Ping Mou 《World Journal of Gastroenterology》 SCIE CAS CSCD 2000年第3期448-450,共3页
INTRODUCTION The advent of laparoscopic cholecystectomy(LC)inthe late 1980s gained widespread acceptance withina short period of time and has become the preferredtreatment for symptomatic gallstones,but themanagement ... INTRODUCTION The advent of laparoscopic cholecystectomy(LC)inthe late 1980s gained widespread acceptance withina short period of time and has become the preferredtreatment for symptomatic gallstones,but themanagement of coexisting gallbladder and commonbile duct(CBD)stones has remained controversialbecause the various strategies proposed have theirlimitations.In fact,choledocholithiasis 展开更多
关键词 LAPAROSCOPIC CHOLECYSTECTOMY common bile duct STONES endoscopic SPHINCTEROTOMY
下载PDF
Restoration of common bile duct diameter within 2 weeks after endoscopic stone retraction is a preventive factor for stone recurrence 被引量:26
20
作者 Jin Jeon Sung Uk Lim +3 位作者 Chang-Hwan Park Chung-Hwan Jun Seon-Young Park Jong-Sun Rew 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2018年第3期251-256,共6页
Background: Little information is available about the relationship between restoration of common bileduct (CBD) diameter after endoscopic stone retraction and recurrence of CBD stones in elderly patients.The presen... Background: Little information is available about the relationship between restoration of common bileduct (CBD) diameter after endoscopic stone retraction and recurrence of CBD stones in elderly patients.The present study was to determine whether restoration of CBD diameter is a preventive factor for CBDstone recurrence in elderly patients who underwent endoscopic retrograde cholangiopancreatography(ERCP). 展开更多
关键词 RESTORATION common bile duct Endoscopic retrograde CHOLANGIOPANCREATOGRAPHY common bile duct stone
下载PDF
上一页 1 2 135 下一页 到第
使用帮助 返回顶部