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Euroasian Journal of... 2022Disconnected pancreatic duct syndrome (DPDS) is a condition where there is a ductal disconnection between viable secreting distal pancreatic tissues and the...
UNLABELLED
Disconnected pancreatic duct syndrome (DPDS) is a condition where there is a ductal disconnection between viable secreting distal pancreatic tissues and the gastrointestinal tract. It may follow acute or chronic pancreatitis, abdominal trauma, and pancreatic surgery, leading to necrosis or structural disintegration of the pancreatic duct.
AIM
The aim of our study is to describe the imaging features of DPDS on ultrasound, computed tomography, and magnetic resonance cholangiopancreatography (MRCP) that helps in diagnosis.We present a case series of DPDS with their imaging features in two settings, one in the patient with acute necrotizing pancreatitis and the other with blunt abdominal trauma.
CONCLUSION
Imaging plays a significant role in preoperative diagnosis. Contrast-enhanced computed tomography provides a comprehensive assessment of pancreatic duct integrity, and it shows its type and site of ductal disruption. It is a simple, effective noninvasive imaging modality in diagnosing pancreatic duct disruption.
HOW TO CITE THIS ARTICLE
Satyam S, Singh S, Sah PK. Disconnected Pancreatic Duct Syndrome: A Case Series. Euroasian J Hepato-Gastroenterol 2022;12(1):60-63.
PubMed: 35990868
DOI: 10.5005/jp-journals-10018-1357 -
Alternative Therapies in Health and... Sep 2023To compare the clinical efficacy and safety of laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography in the treatment of bile duct...
Comparison of Laparoscopic Common Bile Duct Exploration and Endoscopic Retrograde Cholangiopancreatography in the Treatment of Bile Duct Stones and Analysis of Risk Factors for Postoperative Acute Pancreatitis.
OBJECTIVE
To compare the clinical efficacy and safety of laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography in the treatment of bile duct stones, and to analyze the related factors influencing postoperative acute pancreatitis.
METHODS
From March 2017 to June 2021, we recruited patients with bile duct stones to our study: 175 patients undergoing endoscopic retrograde cholangiopancreato-graphy and 147 patients undergoing laparoscopic common bile duct exploration. The operative time, intraoperative blood loss, conversion to laparotomy, postoperative exhaust time, hospitalization time, liver function before and after the operation, and the incidence of adverse events were compared. Logistic regression analysis was used to analyze the related factors influencing postoperative acute pancreatitis.
RESULTS
All patients were operated on successfully, with no conversion to laparotomy. Operative time, postoperative exhaust time, and hospitalization time were shorter, intraoperative blood loss was lower, and aspartate aminotransferase and alanine aminotransferase were higher in the endoscopic retrograde cholangiopancreato-graphy group compared with the laparoscopic common bile duct exploration group (P < .05). The endoscopic retrograde cholangiopancreatography group had a higher incidence of adverse events than the laparoscopic common bile duct exploration group (P < .05). After logistic regression analysis, white blood cell concentration, operative time, intraoperative blood loss, previous history of pancreatic disease, and endoscopic retrograde cholangiopancreatography operation all independently influenced the occurrence of acute pancreatitis.
CONCLUSION
Laparoscopic common bile duct exploration is our first choice for patients with bile duct stones who have no history of abdominal surgery, cardiac or pulmonary valve insufficiency, bile duct stenosis, and poor duodenal papilla function, as it can reduce the occurrence of postoperative complications and shorten rehabilitation. Further investigation of the factors that independently caused postoperative acute pancreatitis after stone removal is warranted.
PubMed: 37347694
DOI: No ID Found -
Asian Journal of Surgery Jan 2023To explore the risk factors of biliary tract infection after bile duct dilatation surgery.
OBJECTIVE
To explore the risk factors of biliary tract infection after bile duct dilatation surgery.
METHODS
The study included 135 patients with choledochal malformation after bile duct dilatation surgery at our hospital from January 2019 to June 2021. We analyzed general data of infected and uninfected groups after bile duct dilatation surgery. Single/multiple factor logistic regression was used to analyse the factors influencing postoperative biliary tract infection in bile duct dilatation.
RESULTS
There were statistically significant differences in preoperative history of biliary tract infection, partial hepatectomy, hilar anastomosis, and Todani staging between the two groups. Single factor Logistic regression analysis showed that preoperative history of biliary tract infection, partial hepatectomy, hepatic portal anastomosis and Todani staging IV and V were positively correlated with postoperative biliary tract infection following biliary duct dilatation (P<0.05). In addition, logistic regression analysis of these general data with differential indicators as independent variables and postoperative biliary tract infection in biliary duct dilatation as a dependent variable showed that history of preoperative biliary tract infection and hepatic portal anastomosis were risk factors of postoperative biliary tract infection following biliary duct dilatation.
CONCLUSION
Risk factors of biliary tract infection after bile duct dilatation include a history of preoperative biliary tract infection and hepatoportal anastomosis, which should be noted during clinical procedures to prevent or reduce the development of biliary tract infection after bile duct dilatation.
Topics: Humans; Hepatectomy; Common Bile Duct; Choledochal Cyst; Biliary Tract Surgical Procedures; Bile Duct Diseases; Risk Factors
PubMed: 35697611
DOI: 10.1016/j.asjsur.2022.05.127 -
Drug Discoveries & Therapeutics Dec 2022Cholestasis and obstructive jaundice can be extrahepatic or intrahepatic. Here we present one case with calculous cholecystitis who presenting with repeated obstructive...
Cholestasis and obstructive jaundice can be extrahepatic or intrahepatic. Here we present one case with calculous cholecystitis who presenting with repeated obstructive jaundice and without bile duct dilation. The patient received laparoscopic cholecystectomy, and cystohepatic duct was identified intraoperatively, there was no cholestasis or obstructive jaundice postoperatively. Cystohepatic duct is a rare biliary anomaly observed in 0.7% of all surgical cases and in 1.5% of all cadaveric dissections. The cystohepatic duct can be the bridge of calculous cholecystitis complicating cholangitis and obstructive jaundice, here we for the first time presented this entity.
Topics: Humans; Jaundice, Obstructive; Cholecystitis; Cholangitis; Cholecystectomy, Laparoscopic
PubMed: 36529506
DOI: 10.5582/ddt.2022.01078 -
Expert Review of Gastroenterology &... May 2021This review provides an overview regarding the current scenario and knowledge of the CCA genomic landscape and the potentially actionable molecular aberrations in each... (Review)
Review
AREAS COVERED
This review provides an overview regarding the current scenario and knowledge of the CCA genomic landscape and the potentially actionable molecular aberrations in each CCA subtype.
EXPERT OPINION
The establishment and advances of high-throughput methodologies applied to genetic and epigenetic profiling are changing many cancer types' therapeutic landscape , including CCA.The large body of data generated must be interpreted appropriately and eventually implemented in clinical practice. The following advancements toward precision medicine in CCA management will require designing better clinical trials with improved methods to stratify biliary tumor patients.
Topics: Bile Duct Neoplasms; Biomarkers, Tumor; Cholangiocarcinoma; Combined Modality Therapy; Epigenesis, Genetic; Gene Expression Profiling; Humans; Molecular Targeted Therapy; Mutation; Precancerous Conditions; Risk Factors
PubMed: 33888034
DOI: 10.1080/17474124.2021.1915128 -
World Journal of Gastroenterology Aug 2023Current abdominal surgery has several approaches for biliary reconstruction. However, the creation of functional and clinically applicable bile duct substitutes still...
Current abdominal surgery has several approaches for biliary reconstruction. However, the creation of functional and clinically applicable bile duct substitutes still represents an unmet need. In the paper by Miyazawa and colleagues, approaches to the creation of bile duct alternatives were summarized, and the reasons for the lack of development in this area were explained. The history of bile duct surgery since the nineteenth century was also traced, leading to the conclusion that the use of bioabsorbable materials holds promise for the creation of bile duct substitutes in the future. We suggest three ideas that may stimulate progress in the field of bile duct substitute creation. First, a systematic analysis of the causative factors leading to failure or success in the creation of bile duct substitutes may help to develop more effective approaches. Second, the regeneration of a bile duct is delicately balanced between epithelialization and subsequent submucosal maturation within limited time frames, which may be more apparent when using quantitative models to estimate outcomes. Third, the utilization of the organism's endogenous regeneration abilities may enhance the creation of bile duct substitutes. We are convinced that an interdisciplinary approach, including quantitative methods, machine learning, and deep retrospective analysis of the causes that led to success and failure in studies on the creation of bile duct substitutes, holds great value. Additionally, more attention should be directed towards the balance of epithelialization and submucosal maturation rates, as well as induced angiogenesis. These ideas deserve further investigation to pave the way for bile duct restoration with physiologically relevant outcomes.
Topics: Humans; Retrospective Studies; Bile Ducts; Biliary Tract Surgical Procedures; Machine Learning; Metaplasia
PubMed: 37662863
DOI: 10.3748/wjg.v29.i30.4701 -
Genes Aug 2022Extrahepatic cholangiocarcinomas, also called bile duct carcinomas, represent a special entity in gastrointestinal tumors, and histological specimens of the tumors are... (Review)
Review
Extrahepatic cholangiocarcinomas, also called bile duct carcinomas, represent a special entity in gastrointestinal tumors, and histological specimens of the tumors are often difficult to obtain. A special feature of these tumors is the strong neovascularization, which can often be seen in the endoluminal endoscopic procedure called cholangioscopy, performed alone or in combination with laserscanning techniques. The additional analysis of microRNA expression profiles associated with inflammation and neovascularization in bile duct tumors or just the bile duct fluid of these patients could be of enormous additional importance. In particular, the dysregulation of microRNA in these cholangiocarcinomas (CCA) was previously reported to affect epigenetics (reported for miR-148, miR-152), inflammation (determined for miR-200, miR-125, and miR-605), and chemoresistance (miR-200b, 204) in patients with cholangiocarcinoma. More importantly, in the context of malignant neovascularization, well-defined microRNAs including miR-141, miR-181, miR-191, and miR-200b have been found to be dysregulated in cholangiocarcinoma and have been associated with an increased proliferation and vascularization in CCA. Thus, a panel of these microRNA molecules together with the clinical aspects of these tumors might facilitate tumor diagnosis and early treatment. To our knowledge, this is the first review that outlines the unique potential of combining macroscopic findings from cholangioscopy with microRNA expression.
Topics: Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Cholangiocarcinoma; Humans; Inflammation; MicroRNAs; Prognosis
PubMed: 36011390
DOI: 10.3390/genes13081479 -
Frontiers in Cardiovascular Medicine 2023Despite the advancements in the technique of duct stenting (DS) in patients with duct-dependent pulmonary circulation (DDPC) and the valuable role of DS in preventing... (Review)
Review
Despite the advancements in the technique of duct stenting (DS) in patients with duct-dependent pulmonary circulation (DDPC) and the valuable role of DS in preventing the risk of surgical creation of shunts and early repair, not all ducts are amenable to being stented, and not all interventions with DS are safe and can achieve positive outcomes. Very few studies focusing on tortuous ducts have been conducted until now. Their results showed that stenting of highly tortuous ducts has the same risk as surgical options. This type of stenting has greater possibility of complications, early in-stent thrombosis, and stent failure than do other duct types. In such cases, the surgical options could be superior to DS and have better outcomes. This report aims to review the very scarce available data about stenting of high-tortuous ducts and criticisms of performing DS in ducts associated with pulmonary stenosis and to highlight the essential points that must be considered before deciding on intervention.
PubMed: 38054094
DOI: 10.3389/fcvm.2023.1275545 -
Journal of Gastrointestinal and Liver... Jun 2023
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms; Cholangiocarcinoma; Bile Ducts, Intrahepatic; Bile Duct Neoplasms; Retrospective Studies
PubMed: 37345590
DOI: 10.15403/jgld-5033