Article
Surgery
Hikaru Hayashi, Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Hitoshi Masuo, Takahiro Yoshizawa, Kiyotaka Hosoda, Hiroki Sakai, Koya Yasukawa, Yuji Soejima
Summary: This study aimed to determine the optimal preoperative assessment methods for the longitudinal spread of perihilar cholangiocarcinoma. Intraductal ultrasound and mapping biopsy were found to be the most accurate single assessment methods, and a combination of all four methods achieved high accuracy. The accuracy of assessment was associated with the R0 resection rate, and R0 resection was associated with better relapse-free survival compared to R1 resection. Overall survival did not differ between these groups.
ASIAN JOURNAL OF SURGERY
(2023)
Article
Surgery
Takahisa Ogawa, Yoshihide Kanno, Shinsuke Koshita, Kaori Masu, Hiroaki Kusunose, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Toji Murabayashi, Fumisato Kozakai, Kazuki Endo, Yutaka Noda, Kei Ito
Summary: Between September 2016 and October 2018, a total of 28 patients (16 distal bile duct cancer and 12 perihilar bile duct cancer) were enrolled in this study and divided into two groups of 14 patients each: CMB first and FMB first. The rate of site-based successful biopsies using CMB was significantly higher than that using FMB, especially when evaluated using specimens obtained from multiple biopsy strokes.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Oncology
Zuxiao Chen, Xiaofeng Jiang, Ping Xue, Shaoyi Chen, Shiying Li, Zongyan Li, Weidong Pan, Dawei Zhang
Summary: PTCS-guided PDT significantly prolonged the survival time of patients with postoperative recurrent extrahepatic cholangiocarcinoma, and improved patient quality of life, with minimal complications.
PHOTODIAGNOSIS AND PHOTODYNAMIC THERAPY
(2022)
Article
Gastroenterology & Hepatology
Cheng-Han Chiang, Kuan-Chih Chen, Benedict Devereaux, Chen-Shuan Chung, Kuei-Chang Kuo, Chien Chu Lin, Cheng-Kuan Lin, Hsiu-Po Wang, Kuo-Hsin Chen
Summary: Cholangiocarcinoma is a highly aggressive cancer with poor prognosis. Surgical treatment is essential, and preoperative evaluation of tumor extent is crucial. Current imaging modalities have low accuracy. This case report highlights the potential role of SpyGlass cholangioscopy in precise localization, leading to modified surgical planning and successful outcome.
WORLD JOURNAL OF GASTROINTESTINAL SURGERY
(2023)
Article
Surgery
Alexandra D. Ladd, Jorge Zarate Rodriguez, Duncan Lewis, Curtis Warren, Sergio Duarte, Tyler J. Loftus, Ibrahim Nassour, Daiki Soma, Steven J. Hughes, Chet W. Hammill, Ali Zarrinpar
Summary: This study investigates the use of a lower dose of intravenous indocyanine green (ICG) to improve the visualization of biliary anatomy, and finds that low-dose ICG leads to quantitative improvement in biliary visualization by minimizing liver fluorescence.
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
(2023)
Article
Mathematical & Computational Biology
Min Gong, Qiang Li, You Xu, Yunhui Fu
Summary: This study aimed to explore the therapeutic effect of endoscopic retrograde cholangiography (ERCP) with metal stent and plastic stent for cholangiocarcinoma. The results showed that under ERCP treatment, the metal stent group had better improvement in liver function indices, lower incidence of postoperative complications, higher success rate of stent placement, and longer survival time compared to the plastic stent group. Tumor diameter, portal vein invasion, lymph node metastasis, and classification of hilar cholangiocarcinoma were identified as risk factors for postoperative cholangiocarcinoma, while the type of metal stent was a protective factor.
COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE
(2022)
Article
Surgery
Daniel J. Deziel
Summary: This study reviewed 785 consecutive LC surgeries and found that the primary value of LUS during LC is for anatomic identification in the presence of severe local inflammatory conditions. LUS can change operative management for patients who require common bile duct exploration for stone clearance.
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
(2022)
Article
Infectious Diseases
Naire Sansotta, Ester De Luca, Emanuele Nicastro, Alessandra Tebaldi, Alberto Ferrari, Lorenzo D'Antiga
Summary: The study found that transplanted children undergoing PTC had a relatively high incidence of post-procedural cholangitis, but a low rate of sepsis and no fatal events. Blood cultures identified a precise etiology in roughly a quarter of cases, with Enterococcus faecium and Pseudomonas aeruginosa being the predominant pathogens.
Review
Medicine, General & Internal
Aurelio Mauro, Stefano Mazza, Davide Scalvini, Francesca Lusetti, Marco Bardone, Pietro Quaretti, Lorenzo Cobianchi, Andrea Anderloni
Summary: Endoscopy, specifically cholangioscopy, is essential in the diagnosis and treatment of biliary diseases. It allows for direct visualization of the biliary tree and aids in determining the nature of strictures and guiding appropriate treatment. Recent advancements, including artificial intelligence and confocal laser endomicroscopy, have further improved diagnostic accuracy. Additionally, therapeutic cholangioscopy plays a primary role in managing difficult bile stones and other complex clinical situations.
Article
Surgery
Justin Turcotte, S. Daniel Leydorf, Moneim Ali, Cristina Feather, J. Robert Klune
Summary: This study aimed to evaluate the impact of indocyanine green on the bailout operation rate in patients with acute cholecystitis, and the results showed that indocyanine green did not reduce the rate of bailout operation. Acute cholecystitis cases were more likely to result in a bailout operation, and further research is needed to determine the rationale for the use of indocyanine green in this population.
Article
Medicine, General & Internal
Paul J. Brindley, Melinda Bachini, Sumera I. Ilyas, Shahid A. Khan, Alex Loukas, Alphonse E. Sirica, Bin Tean Teh, Sopit Wongkham, Gregory J. Gores
Summary: Cholangiocarcinoma is a highly lethal adenocarcinoma of the hepatobiliary system that can be associated with liver fluke infection but often has no identifiable cause. This Primer reviews the epidemiology, pathophysiological mechanisms, diagnosis and management of cholangiocarcinoma, and highlights the patient experience and future directions.
NATURE REVIEWS DISEASE PRIMERS
(2021)
Article
Medicine, General & Internal
Yuri Sakamoto, Yohei Takeda, Yuta Seki, Shiho Kawahara, Takuya Shimosaka, Wataru Hamamoto, Hiroki Koda, Taro Yamashita, Takumi Onoyama, Kazuya Matsumoto, Kazuo Yashima, Hajime Isomoto
Summary: Peroral Cholangioscopy (POCS) is effective in achieving complete stone removal for intrahepatic stones, but it is associated with a longer procedure time compared to fluoroscopic guidance. However, the incidence of cholangitis was not significantly different between patients with and without POCS. This study highlights the importance of specialized equipment and experienced staff for endoscopic treatment of intrahepatic stones.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Oncology
Matteo Renzulli, Daryl Ramai, Jameel Singh, Samridhi Sinha, Nicolo Brandi, Anna Maria Ierardi, Elisa Albertini, Rodolfo Sacco, Antonio Facciorusso, Rita Golfieri
Summary: Cholangiocarcinoma and combined hepatocellular cholangiocarcinoma are aggressive primary malignancies with liver resection as the main treatment modality. Locoregional therapies can provide local tumor control and increase chances of survival.
Article
Gastroenterology & Hepatology
Jennifer L. Tomlinson, Juan W. Valle, Sumera I. Ilyas
Summary: Recent literature has advanced our understanding of the tumour immune microenvironment and identified new patient subtypes. Inhibitory immune cells and immune escape mechanisms employed by tumour cells contribute to poor tumour immunogenicity. Strategies to block inhibitory immune cell recruitment can re-equip the immune system to target the tumour.
JOURNAL OF HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Divyanshoo R. Kohli, Stuart K. Amateau, Madhav Desai, Srinath Chinnakotla, M. Edwyn Harrison, Jean M. Chalhoub, Nayantara Coelho-Prabhu, Sherif E. Elhana, Nauzer Forbes, Larissa L. Fujii-Lau, Richard S. Kwon, Jorge D. Machicado, Neil B. Marya, Swati Pawa, Wenly Ruan, Sunil G. Sheth, Nikhil R. Thiruvengadam, Nirav C. Thosani, Bashar J. Qumseya
Summary: This clinical practice guideline provides evidence-based strategies for managing biliary strictures in liver transplant recipients. The guideline covers the role of different interventions and diagnostic modalities, such as ERCP, percutaneous transhepatic biliary drainage, cSEMSs, multiple plastic stents, and MRCP. It also discusses the administration of antibiotics during ERCP. Recommendations include the use of ERCP as the initial intervention and cSEMSs as the preferred stent for extrahepatic strictures, the use of MRCP for unclear diagnoses or intermediate probability of a stricture, and the administration of antibiotics when biliary drainage cannot be ensured during ERCP.
GASTROINTESTINAL ENDOSCOPY
(2023)