Therapeutic Biliary Endoscopy

Choudari, C. P.; Fogel, E.; Gottlieb, K.; Sherman, S.; Lehman, G. A.

doi:10.1055/s-2007-1001243

Cited by 13 publications

(6 citation statements)

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“…Traditionally, the initial therapy of patients with SOD has been a standard, pull-type biliary sphincterotomy. However, biliary sphincterotomy alone may leave the pancreatic sphincter unablated [4,7,9]. The transient edema following biliary sphincterotomy only may aggravate pancreatic sphincter hypertension, which may explain the high post-procedure pancreatitis rates observed in several series of SOD patients who underwent biliary sphincter therapy alone.…”

Section: Introductionmentioning

confidence: 99%

Sphincter of Oddi Dysfunction: Pancreaticobiliary Sphincterotomy with Pancreatic Stent Placement Has a Lower Rate of Pancreatitis Than Biliary Sphincterotomy Alone

et al. 2002

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Section: Introductionmentioning

confidence: 99%

Sphincter of Oddi Dysfunction: Pancreaticobiliary Sphincterotomy with Pancreatic Stent Placement Has a Lower Rate of Pancreatitis Than Biliary Sphincterotomy Alone

et al. 2002

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“…Biopsy histology was regarded as malignancy positive when invasion (n=22 patients) or highly dysplastic cells without stroma (n=4 patients) were found in tissue specimens. In this study, no further classification was made by the pathologist with regard to the origin (bile duct, pancreas, gall bladder) of the neoplastic lesion-that is, the samples were reported as adenocarcinomas with their respective histological grade (n=22) or as : 68% (n = 41) 1 3 cytologically positive cells with high grade dysplasia (n=4). All four cases with high grade dysplasia subsequently proved to be invasive carcinomas on examination of the surgical specimen.…”

Section: Final Diagnosesmentioning

confidence: 99%

“…E ndoscopic retrograde cholangiopancreatography (ERCP) is the most valuable tool for further diagnosis as well as temporary or definitive therapy in patients with biliary strictures. 1 Although the use of endoscopic stenting techniques is very effective in patients with obstructive jaundice, 2 further management of patients primarily depends on the benign or malignant nature of the underlying disease. 3 ERCP provides a unique opportunity to achieve biliary decompression and, simultaneously, to obtain a histological or cytological specimen of the biliary stricture.…”

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confidence: 99%

Endoscopic transpapillary biopsies and intraductal ultrasonography in the diagnostics of bile duct strictures: a prospective study

Domagk

Poremba²,

et al. 2002

Gut

107

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Background: In bile duct strictures, examination of wall layers by intraductal ultrasonography (IDUS) performed during endoscopic retrograde cholangiopancreatography (ERCP) may be diagnostically useful. Methods: In the present study 60 patients with bile duct strictures of unknown aetiology were examined preoperatively by ERCP, including transpapillary biopsies and IDUS. Histopathological correlation was available for all patients undergoing these procedures. Results: Postoperative diagnosis revealed 30 pancreatic carcinomas, 17 bile duct cancers, three gall bladder cancers, and 10 benign bile duct strictures. Using endoscopic transpapillary forceps biopsies (ETP), a correct preoperative diagnosis was achieved in 36 of 60 patients (60% of cases). Among the 50 malignant tumours, preoperative diagnosis by ETP revealed a sensitivity of 52% and a specificity of 100%. ERCP supplemented by IDUS allowed for correct preoperative diagnosis in 83% of cases (50 of 60 patients), which was significantly higher than the accuracy of ETP (p=0.008). By combining ETP with IDUS, a correct preoperative diagnosis was made in 59 of 60 patients resulting in an accuracy rate of 98%. Conclusions: Because of its low accuracy, exclusive use of ETP is not a reliable diagnostic tool for a definitive preoperative diagnosis of bile duct strictures. By combining IDUS and ETP with ERCP however, preoperative diagnostic accuracy can be improved substantially.

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“…In gro È ûeren Serien wurden Erfolgsraten von weit u È ber 95% fu È r die kombinierte endoskopisch-interventionelle Therapie unter Einschluû moderner Fragmentationsverfahren wie laserinduzierter Stoûwellenlithotripsie, elektrohydraulischer Lithotripsie und extrakorporaler Stoûwellenlithotripsie (ESWL) erreicht [10,11]. Diese transpapilla È ren endoskopischen Therapiemo È glichkeiten stoûen bei der Therapie der Hepatolithiasis an ihre technischen Grenzen und erlauben nur bei einer kleinen Gruppe [18].…”

Section: Transpapilla è Re Endoskopische Verfahrenunclassified

Hepatikolithiasis – endoskopisch-interventionelle Therapiemöglichkeiten

Jakobs¹,

Riemann²

1999

Visc Med

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Intrahepatic stones are a common problem in Asian countries. Recurrent acute cholangitis is the main manifestation of hepatic lithiasis; the disease may lead to liver cirrhosis. If the intrahepatic stones are limited to one area of the liver, surgical resection is the treatment of choice. But in most of the cases with hepatic lithiasis the stones are located in different areas and cannot be cured by hepatic resection. In these cases a combination of surgical resection with endoscopic intervention or endoscopic therapy alone seems to be most effective. In many patients lithotripsy is necessary to disintegrate those stones that are too large for removal or are impacted. The transpapillary route is less efficient for endoscopic treatment because stones often cannot be reached by the endoscope due to strictures of the bile ducts. Moreover, the risk for infectious complications is probably higher for the peroral therapy. Percutaneous endoscopic treatment performed via the dilated t tract after cholecystectomy or via the percutaneous transhepatic tract seems to be the most effective treatment option for diffuse hepatic lithiasis with success rates of more than 80%. Endoprosthetic dilation of bile duct strictures following stone extraction may diminish the risk for stone recurrence.

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Therapeutic Biliary Endoscopy

Cited by 13 publications

References 0 publications

Sphincter of Oddi Dysfunction: Pancreaticobiliary Sphincterotomy with Pancreatic Stent Placement Has a Lower Rate of Pancreatitis Than Biliary Sphincterotomy Alone

Sphincter of Oddi Dysfunction: Pancreaticobiliary Sphincterotomy with Pancreatic Stent Placement Has a Lower Rate of Pancreatitis Than Biliary Sphincterotomy Alone

Endoscopic transpapillary biopsies and intraductal ultrasonography in the diagnostics of bile duct strictures: a prospective study

Hepatikolithiasis – endoskopisch-interventionelle Therapiemöglichkeiten

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