Quality Improvement Guidelines for Percutaneous Transhepatic Cholangiography and Biliary Drainage

Burke, Dana R.; Lewis, Curtis A.; Cardella, John F.; Citron, Steven J.; Drooz, Alain; Haskal, Ziv J.; Husted, James W.; McCowan, Timothy C.; Moore, Arl Van; Oglevie, Steven B.; Sacks, David; Spies, James B.; Towbin, Richard B.; Bakal, Curtis W.

doi:10.1016/s1051-0443(97)70630-4

Cited by 147 publications

(133 citation statements)

References 31 publications

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“…These results are similar to those reported in the literature review of Moreira et al [4], in Burke et al [9] (where technical success varied from 67 to 85 %) and in other studies (Table 3).…”

Section: Discussionsupporting

confidence: 92%

The role of interventional radiology in the treatment of biliary strictures after paediatric liver transplantation

Fonio¹,

Calandri²,

Faletti³

et al. 2014

Radiol med

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Purpose The aim of this study is to evaluate the safety and efficacy of percutaneous treatment of biliary strictures after paediatric liver transplantation. Materials and methods In the period between October 1999 and October 2010, a total of 92 transplants in 86 children were performed at our Liver Transplant Centre. Eighteen patients had anastomotic biliary strictures (in four cases associated with intrahepatic bile duct stenosis). Percutaneous treatment (transhepatic biliary drainage and conventional/cutting balloon dilatation) was proposed as a first approach in 13/18 patients. Strict radiation protection precautions were taken in accordance with the ALARA (as low as reasonably achievable) principle. Mean follow-up time was 2,364 days. Results Surgical correction was required in 3/13 patients; in 8/13 cases, there was complete disappearance of clinical symptoms without bile duct dilatation; in one case, an asymptomatic persistent bile duct dilatation was detected while in the other case, the liver is currently in cirrhotic degeneration (69 % clinical success including the asymptomatic patient with biliary dilatation). Two of the five patients who were initially treated with surgery required percutaneous revision (clinical success of 100 %). There were two cases of long-term restenosis and two cases of transient haemobilia.Conclusions Percutaneous procedures are safe and effective therapeutic options for the treatment of biliary strictures after paediatric liver transplantation.

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Section: Discussionsupporting

confidence: 92%

The role of interventional radiology in the treatment of biliary strictures after paediatric liver transplantation

Fonio¹,

Calandri²,

Faletti³

et al. 2014

Radiol med

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“…Major and minor complications have been defined by the Society of Interventional Radiology [50,51]. A major complication is defined as one that, if left untreated, might threaten the patient's life or result in a lengthened hospital stay.…”

Section: Complicationsmentioning

confidence: 99%

“…The most common complication in all studies was pain [33,34,38,[45][46][47][48][49][50][51][52] (Table 1). In the order of frequency, authors also reported hematomas [33,47,52], vomiting [47,52], skin burn [33,52], fever [38], and thyrotoxicosis [46].…”

Section: Complicationsmentioning

confidence: 99%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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Benign thyroid nodules are a common disease in the general population. Most often, they are completely asymptomatic and discovered occasionally during routine ultrasound examinations, and do not require any treatment. When thyroid nodules become symptomatic, surgical excision is still considered standard treatment. In the last few years, several experiences in the treatment of benign thyroid nodules through image-guided percutaneous thermal ablation have been reported with encouraging results, so that currently, these treatments are often proposed as first-choice options for patients with symptomatic benign thyroid nodules. In this paper, we discuss the present literature on the topic, focusing on different techniques available for image-guided percutaneous ablation, particularly radiofrequency (RFA), laser (LA), microwave (MWA), and high-intensity-focus ultrasound (HIFU). Little evidence about the efficacy of MWA and HIFU is now available. According to the literature, good results have been obtained with RFA and LA. Regarding RFA, volume reduction after ablative treatment has been found to range from 47 to 84 % at 3-6 months, and from 62 to 93 % at 1 year; LA also seems to be effective in achieving shrinkage of thyroid nodules, with volume reduction from 37 to 81 % at 3-6 months, and from 13 to 82 % at 1-year follow-up. Moreover, applications of advanced image-guidance modality, such as contrast-enhanced ultrasound and virtual navigation with fusion imaging, are discussed.Keywords Laser Á Radiofrequency Á Microwave Á Highintensity focused ultrasound Á Thyroid nodule SOMMARIO I noduli benigni della tiroide sono una evenienza comune nella popolazione generale. Più spesso vengono scoperti occasionalmente durante un esame ecografico fatto per altri motivi, sono asintomatici e non richiedono alcun trattamento. Qualora i noduli diventino sintomatici, l'escissione chirurgica è ancora considerato il trattamento standard. Tuttavia, negli ultimi anni, è cresciuta l'esperienza circa il trattamento di tali noduli tramite ablazione percutanea sotto guida ecografica tanto che, attualmente, questo viene spesso proposto come trattamento di scelta. Lo scopo del nostro lavoro è fare una revisione della letteratura riguardante l'argomento, con un particolare focus sulle differenti tecniche attualmente a disposizione, in particolare radiofrequenza (RFA), laser (LA), microonde (MWA) e high-intensity-focus ultrasound (HIFU). Al momento ci sono ancora poche evidenze sull'efficacia di MWA e HIFU. Secondo quanto riportato in letteratura, buoni risultati sono stati ottenuti con RFA e LA. Riguardo la radiofrequenza, la riduzione volumetrica dopo la procedura ablativa va da 47 a 84 % a 3-6 mesi e da 62 a 93 % a 1 anno; anche il laser sembra essere efficace nel causare la riduzione del nodulo, con percentuali che vanno da 37 a 81 % a 3-6-mesi a da 13 a 82 % a 1 anno di follow-up Abbiamo poi discusso brevemente le

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“…In the early days, overuse of the technique by inexperienced operators led to an increase in complications that soon became recognized, 51 and steps were taken to correct the problem and put appropriate guidelines in place for quality control. 52 The percutaneous transhepatic route was used early on for external drainage of obstructive lesions 53 and for the placement of endoprostheses. 54 Biliary ascariasis can be treated, 55 endoscopic sphincterotomy can be done, 56 intrahepatic stones can be cleared 57 and strictures can be dilated by the transhepatic route.…”

Section: University In 1971 Having Graduated In Medicine Frommentioning

confidence: 99%

A tree grows in the liver, and now we can see it†

Reuben

2005

Hepatology

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Quality Improvement Guidelines for Percutaneous Transhepatic Cholangiography and Biliary Drainage

Cited by 147 publications

References 31 publications

The role of interventional radiology in the treatment of biliary strictures after paediatric liver transplantation

The role of interventional radiology in the treatment of biliary strictures after paediatric liver transplantation

Image-guided thermal ablation of benign thyroid nodules

A tree grows in the liver, and now we can see it†

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