biliary tract diseases

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..Still representing a small percentage of total pediatric endoscopies, this procedure has been performed most commonly by a small subset of adult and pediatric gastroenterologists at quaternary referral centers...

..The results of endoscopic management of these strictures is also described in detail and should be of interest to therapeutic endoscopists, liver transplant physicians, transplant surgeons and therapeutic endoscopists...

..Information regarding biochemical abnormalities helpful for the diagnosis and the nonoperative management of such complications are limited...

..In this review, we describe various aspects of biliary complications occurring in RL-LDLT and their treatment...

..We evaluated the temporary placement of partially covered self-expandable metallic stents (PCMS) in patients with BBS due to chronic pancreatitis...

..Overall, temporary placement of CSEMS is efficacious atresolving bile leaks. CSEMS are less prone to migration, but are associated with ulcerations, de novo choledocholithiasis, and strictures...

..A cost analysis should be performed in order to evaluate whether to treat transplanted patients suffering from biliary complications with covered self-expandable metallic stent placement as first-line therapy...

..Familiarity with and early recognition of the imaging appearances of the various postoperative complications of pediatric liver transplantation are crucial for graft and patient survival...

..We further advocate that all organ procurement teams perform pressure perfusion on harvested organs...

..Covered self-expandable metal stents (CSEMSs) may be an alternative to the current endoscopic standard treatment with periodic plastic stent replacement...

..Donor, recipient, and technical factors appear to differentially affect the incidence of anastomotic biliary complications, with warm ischemia, use of HTK, and use of a stent emerging as the most important variables...

..Hilar strictures and those caused by chronic pancreatitis appear to respond poorly to this therapy...

..Bile leakage, representing a significant complication following conservative operations for hepatic hydatidosis, can be effectively treated conservatively or endoscopically, not justifying more aggressive surgical approaches...

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..Cross-sectional imaging modalities permit precise localization of the site and length of the segment involved, thereby serving as a road map to surgery, and permit exclusion of underlying malignancy...

..We describe the MR imaging appearance of a rare case of disseminated cryptococcosis in an immunocompetent child in whom the clinical presentation was dominated by biliary and lymph nodal involvement...

..The aim of this study was to assess the feasibility and efficiency of plasma argon trimming of gastrointestinal and biliary metallic stents...

..To evaluate the value of angiography and cholangiography on the diagnosis and interventional treatment of vascular and biliary complications after liver transplantation...

..Here we summarize the current knowledge of genetic factors that contribute to common biliary diseases, focusing on gallstones and carcinogenesis, and review the recent association studies...

..The treatment after HJS is still primarily surgical. Percutaneous transhepatic approaches should be avoided. Creation of an inspection stoma to allow endoscopic access is an option...

..This article reviews the currently published experience on SEMS and attempts to define their current role in the treatment of benign biliary diseases...

..CONCLUSIONS: Occlusion of a biliary Wallstent is best managed by endoscopic insertion of a second Wallstent or a plastic stent. Mechanical cleaning is less effective. The level of the initial biliary obstruction influences stent patency...

..There were no complications resulting from stent-graft retrieval. Intentional removal of Viabil stent-grafts is technically feasible. Further study is necessary to establish its potential role in the management of biliary disease...

..This study evaluates the long-term outcomes, biliary complication rates, and risk factors for biliary complications after liver transplantation from "donation after cardiac death" (DCD) donors...

..However, the major limitations of FCSEMSs are frequent migration and removal complications...

..5. Recipients of living related liver transplantation and donation after cardiac death allografts are at the highest risk for biliary and vascular complications late after transplantation...

..Although most hemorrhage occurs immediately after EST, delayed hemorrhage may occur, even several days after EST. We analyzed the incidence, clinical features, treatment and risk factors for delayed hemorrhage following EST...

..We attempted the endoscopic removal of malfunctioning SEMSs. The aim of this study was to assess the feasibility and safety of the endoscopic removal of SEMSs by comparing the results between removal of covered and uncovered SEMSs...

..We evaluated the infection states of CS in patients with biliary tract diseases using a bile sample...

..Measures should be used to limit radiation exposure of the staff and patients during ERCP...

..The aim of this study was to investigate the effectiveness of endoscopic treatment modalities in hydatid cyst patients with biliary complications who had previously undergone surgery...

..The aim of the present study was to evaluate the outcome of liver transplants performed with ABO-incompatible living-donor livers and to detect risk factors for development of complications...

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..CONCLUSIONS: ERCP in pregnancy seems to be safe for both mother and fetus; however, it should be restricted to therapeutic indications with additional intraprocedure safety measures...

..Biliary ascariasis is regarded as possible etiological factor for hepatolithiasis. Here we report one case of a patient with hepatolithiasis with biliary ascariasis who developed a liver abscess, which was treated with partial hepatectomy...

..However, there was no reduction in the 14- or 91-day case-fatality rate. Further research is needed to explain both the rise in the incidence rate of pancreatitis and the absence of any improvement in the early case-fatality rate...

..Although laparoscopic cholecystectomy can be performed safely during pregnancy, the timing and indications for this surgical intervention have not been firmly established...

..Though ascariasis is a problem in developing countries, because of increased travel and population migration, clinicians elsewhere should be aware of the problems associated with ascariasis...

..CONCLUSION: Surgical management of symptomatic cholelithiasis in pregnancy is safe, decreases days in hospital, and reduces the rate of labor induction and preterm deliveries...

..Intrabiliary rupture, although rare, carries severe health risks; timely diagnosis and appropriate management of this entity are vital for the patient's survival...

..At least part of the trypsinogen-2 and TATI found in bile appears to be derived from the biliary epithelium itself...

..This should be kept in mind in the management of an acute abdomen, especially in tropical countries. Endoscopic extraction is a safe and effective procedure for the treatment of HPA...

..To review our experience of endoscopic retrograde cholangiopancreatography (ERCP) in patients 90 years and older...

Enteric Helicobacter species might be a risk factor for chronic liver and biliary tract diseases.

..Our aims were to ensure full disclosure to donors and recipients of the risks and benefits of this procedure in a large University center and to help explain reporting inconsistencies...

..It is believed that bile examination is the most precise method for detecting eggs. We evaluated diagnostic usefulness of intradermal test (IDT) by comparing it with the result of bile examination...

..Microscopic sections of hepatic tissue show inflammatory infiltration around the Ascaris eggs. Emergency surgery is sometimes to be performed. The value of US, as we assessed it, has been already stressed by other authors...

..This study has been undertaken to analyze ERCP characteristics in a national referential center...

..Our conclusion is that the non invasive method allows us to have confidence in the findings for the biliopancreatic pathology...

..In this study we aimed to compare the utility and safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly and younger groups of people...

..ERCP is usually performed with the patient in the prone position. Little data exist on ERCP in the supine position, which is considered unsafe in nonintubated patients...

..The sequences of the 16S rRNA genes and cagA were 99% similar to Helicobacter pylori. CONCLUSION: Helicobacters are associated with the pathogenesis of various hepato-biliary disorders...

..CONCLUSIONS: ERCP is an effective and accurate approach for the diagnosis of biliary tract complications after OLT, and placement of a stent is a safe initial treatment for biliary complications after liver transplantation...

..We compared the accuracy of conventional MRCP and endoscopic retrograde cholangiopancreatography (ERCP) in making the diagnosis of congenital pancreaticobiliary malformations...

..Emerging investigational techniques include EUS-guided enteric anastomosis formation and fine-needle injection therapy for malignant disease...

..Endoscopic retrograde cholangiopncreatography is a challenging procedure but its curative potential is essential in treating some of the digestive tract diseases...

..The aim of this study was to evaluate the safety and efficacy of ERCP in very old patients (octogenarians)...

..Because of its inherent risks we analysed our series in an attempt to better define the diagnostic and therapeutic roles of ERCP and its effectiveness in children...

..ERCP is often made difficult by duodenal motility. Glucagon is typically used to inhibit this motility. L-hyoscyamine is an antimuscarinic, anticholinergic agent shown to be a feasible intravenous alternative to glucagon...

..We conducted a randomized controlled multicenter study to evaluate whether placement of a temporary pancreatic stent designed for spontaneous dislodgement prevents post-ERCP pancreatitis...

..The aim of the present study was to compare standard ERCP catheter and hydrophilic guide wire (HGW) in the selective cannulation of the CBD...

..ERCP on an outpatient basis could be as safe as on an inpatient basis and may also reduce medical costs...

..Endoscopic retrograde cholangio pancreatography failure is a rare and some dramatic reality too for the management of bilio-pancreatic tract disorders and in these cases it needs to utilize others operative technique...

..Biliary tract complications are a common cause of morbidity and mortality after orthotopic liver transplantation. We report our experience in the use of ERCP in the treatment of post liver transplantation biliary complications...

..The study aimed to investigate the new technology of the MRCP in infants with suspected pancreaticobiliary diseases...

..Diagnosis is by demonstration of caseation necrosis or the presence of acid-fast bacilli on Ziehl Neelson staining in the aspirated or biopsied specimen...

..This article reviews the nonsurgical methods for accessing the biliary and pancreatic ducts after failure of ERCP as well as the current status and possible future applications of EUS-assisted drainage techniques...

..To compare magnetic resonance cholangiography (MRC) with endoscopic retrograde cholangiography (ERC) in quantitatively evaluating biliary strictures in liver transplant recipients...

..In this review of intraductal endoscopy, we describe in detail the various endoscopic platforms and their diagnostic and clinical applications...

..Gastroduodenal and biliary complications were prospectively evaluated in 100 consecutive liver transplant patients in whom CMV was monitored during the first posttransplant year...

..Helicobacter has been identified in isolated cases of hepato-biliary diseases, but its role in the pathogenesis of these conditions remains unclear...

..Problems of training in ERCP have still not yet been resolved, due to the contradictions inherent in low case loads, the desire to offer a wide spectrum of training, and issues of quality assurance...

..Continued research into the design of the probes, which could improve durability and extend the depth of penetration, may promote more widespread use of this novel technology...

..To evaluate the value of S-MRCP in patients in whom ERCP performed by experts in a tertiary center were unsuccessful...

..Therefore, the choice between EUS, MRCP and ERCP will become simplified: MRCP as the first option for diagnosis, EUS in doubtful cases needing sampling for pathology and ERCP as a therapeutic alternative to some surgical procedures...

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..It is not known whether initial endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) is more cost effective than endoscopic retrograde cholangiopancreatography (ERCP)...

..CONCLUSIONS: A sequential combination of pure cut and blended current for sphincterotomy caused less visible bleeding than pure cut alone. This occurred without a change in the rate of post-ERCP pancreatitis...

..However, there have been no reports on a specially designed videoduodenoscope for pediatric ERCP...

..This has changed and at present the incidence of this complications is lower. The authors present their own series and discuss the role of ERCP in the management of complications...

..However, although advances continue rapidly, several new questions have also arisen, paving the way for further research. Several studies during the last year have also focused attention on cost-effectiveness...

..Biliary complications are a major drawback of liver transplantation...

..Thus, magnetic resonance cholangiopancreatography may replace diagnostic endoscopic retrograde cholangiopancreatography for purely diagnostic purposes, following an initial clinical and ultrasonographic exam...

..CONCLUSIONS: These results suggest that a 6.5-h infusion of gabexate (for a total of 500 mg) is not less effective than a 13 h infusion, with evident savings...

..They are complementary approaches that help to avoid surgery for these complications...

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..CONCLUSIONS: Because of its availability, diagnostic accuracy, treatment efficacy and safety, ERCP should be used as the first-line procedure for treatment of biliary tract complications after OLT...

..It is still unknown whether there is a difference in diagnostic accuracy and clinical impact between endoscopic ultrasonography (EUS) and magnetic resonance cholangiopancreatography (MRCP)...

..We sought to determine the indications, feasibility, safety, and effect on patient management of ERCP in pediatric patients of varying age...

..Data on current endoscopic retrograde cholangiopancreatography (ERCP) practice patterns drawn from large population-based samples are limited...

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..prior and subsequent to oral vaccination with Helicobacter spp. antigens and mucosal adjuvants, elucidate how these vaccine strategies influence microflora dynamics and impact gut cytokine responses. ..

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..These students will spend a summer in the same research environment in which the postdoctoral fellows conduct their research. ..

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..PUBLIC HEALTH RELEVANCE: Cholangiocarcinomas, the most important neoplastic biliary tract diseases are incurable cancers that are increasing in incidence...

..3) Health outcomes studies of use of endoscopic ultrasound in biliary tract diseases. (4) NASH - causes and treatment...

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..Renewal of the award will allow Dr. Garcia-Tsao to maintain both POR and her mentoring endeavors to their fullest extent so she can continue to make significant contributions in the field of chronic liver disease and its complications. ..

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..The primary outcome will be a reduction in pain at 1 month. Secondary outcomes will include the durability of pain control, quality of life, narcotic use and narcotic side effects. ..

..In the R33 component of the grant application these criteria will be prospectively evaluated and correlated with clinical outcome in a second, larger cohort of patients. ..

..The results of these studies may result in the development new diagnostic tools that can be applied at the onset of symptoms, and rational therapy to prevent the development of those pancreatic diseases that we cannot currently cure. ..

..Year 1: 25 patients) Aim 3: Apply the results of aims 1 and 2 to evaluate the clinical utility of in-vivo prostate cancer detection by sonoelastography. (Years 2-4: 90 patients) ..

..The results may shed new lights in the prevention of chronic implanted medical device related infections and specifically in prolonging plastic stent patency. ..

..Knowledge of the genetic basis of pancreatitis will lead to new treatments, and help remove the stigma that chronic pancreatitis is only a disease of drunkards. ..

..A more complete understanding of the etiopathogenesis of hepatobiliary disease and hepatocellular carcinoma is likely to result in new strategies for treatment and prevention of these important human diseases. ..

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..Postdoctoral graduates will be prepared to compete for independent funding and entry-level faculty positions in academic medicine ..

..Knowledge of the genetic basis of pancreatitis will lead to new treatments, and help remove the stigma that chronic pancreatitis is only a disease of drunkards. ..

..Answering this question may provide insight into the pathophysiology of acute and chronic pancreatitis and identify targets for new therapies, and help identify individuals at risk through genetic testing. ..

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..A more complete understanding of the etiopathogenesis of hepatobiliary disease and hepatocellular carcinoma is likely to result in new strategies for treatment and prevention of these important human diseases. ..

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..Thirdly, the choice of virulence factors ot be tested in vivo will in part be determined by in vitro assays as well as screening H. pylori isogenic mutants in a mouse model, recently developed in our laboratory. ..

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..pylori pathogenesis and specifically evaluate the role of regulatory T cells in limiting H. pylori-induced gastric pathology. ..

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..Significance: The study results have the potential to significantly improve the accurate diagnosis of biliary strictures. Earlier and more definitive diagnosis will translate into improved treatment options. ..

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..Results of this study should lead to clinical trials that test the efficacy of oral primary bile acids for constipation caused by defective bile acid biosynthesis. ..

..This unique combination will allow me to complete the first phase of my career development and progress on to independent research. ..

..We will use this model to study the pathogenesis of HUS and importantly to develop therapeutic regimens to prevent and treat EHEC disease. ..

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