Magnetic resonance cholangio-pancreatography versus endoscopic retrograde cholangio-pancreatography in the diagnosis of common bile duct stones: a … (original) (raw)
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Magnetic Resonance Cholangiopancreatography in the Diagnosis of Haemobilia
Case reports in radiology, 2013
Haemobilia is a rare cause of unrecognized gastrointestinal bleeding and is hard to diagnose. Through the present case report we aim to corroborate magnetic resonance relevance in the evaluation of biliary system and bile features, investigating on its role in patients with acute biliary diseases. We report a case of a Caucasian 48-year-old man who was admitted due to abdominal pain and fever. After an ultrasonography exam we detected multiple cysts in the hepatic left lobe: imaging features, laboratory findings, and patient past work experience (woodcutter) suggested a diagnosis of hepatic Echinococcosis. Once surgery decision was taken, patient underwent an intervention of cystopericystectomy. On the 8th postoperative day, the procedure was complicated by black stool, jaundice, and severe anaemia. Acomputed tomography revealed an inhomogeneous collection with some air bubbles in the area of previous surgical intervention, but it was not able to solve the diagnosis question. At this stage a magnetic resonance study was mandatory. On T2-weighted images we observed an expanse gallbladder with hypointense intraluminal material and a considerable intrahepatic biliary system dilatation due to bloody material. On the basis of these examination results, we supposed haemobilia arising from previous surgical intervention. A therapeutic endoscopic retrograde cholangiopancreatography procedure led to decompression of biliary system through a major papilla sphincterotomy with spillage of bile mixed with blood clots.
Electronic Poster-Biliary (EP223-EP258)
2021
P. J. Gil Vázquez, D. Ferreras Martinez, B. Gómez Pérez and F. Sánchez Bueno Hospital Clínico Universitario Virgen de la Arrixaca, Spain Introduction: The standard treatment of choledocholithiasis is endoscopic retrograde cholangiopancreatography (ERCP). In this way, it needs two interventions: ERCP and laparoscopic cholecystectomy (LC), so it is necessary two anesthetic processes, more possibilities of failure, complications, hospital stay and more expenses. Thanks to laparoscopic common bile duct exploration (LCBE) complete treatment is possible with a single intervention. Method: We designed this prospective, non-randomized study to analyze LCBE approach in terms of hospital stay and cost-effectiveness. Results: There are 118 patients in the study (67 women; mean age of 69.8 17.3 years old). Sixty-six patients received ERCP+LC management. Fifteen of them failed to clean the bile duct. LCBE was carried out in 59 patients (49 plus 11 ERCP failure). Seven of them required conversion...
1997
In order to assess the role of endoscopic retrograde cholangiography in evaluating the patients with post-operative biliary leak and of endoscopic nasobiliary drainage in its management, 36 patients with biliary leak seen over a period of 9 years were studied. Thirty-two had biliary leak following cholecystectomy, 3 following repair of liver trauma and I following choledochoduodenostomy. Patients presented at an interval of 4 days to 210 days (mean +/-SEM, 32.4 +/-6.7 days) following laparotomy. Hyperbilirubinemia was noticed in only 13 patients (36.1%), while abdominal nltrasonogram showed ascites or biloma in 24 (66.7%). Endoscopic retrograde cholangiography showed the leak to involve the common bile duct in 55.6%, cystic duct in 33.3% and intrahepatic biliary radicles in 8.3%. Associated lesions included bile duct obstruction due to stricture or accidental ligature in 20%, bile duct stone in 20% and liver abscess in 2.8%.
The annals of clinical and analytical medicine, 2024
Aim: Endoscopic retrograde cholangio-pancreatography (ERCP) should be performed as the first-line treatment after appropriate imaging and drainage in noncomplete biliary tract injuries. Our aim is to present our treatment strategy in such injuries in a tertiary center with the aim of contributing to the literature. Material and Methods: Between January 2016 and January 2022, 39 patients who underwent ERCP for iatrogenic simple biliary tract injury were included in our study. Magnetic resonance cholangiopancreatography was performed in all patients before the procedure. Sphincterotomy, balloon, basket catheter or balloon dilatation and plastic stent were performed under sedo-analgesia. Complication rates of the procedures were recorded. Results: 39 patients were included in the study. The mean age was 61.94±15.60 years. When the procedure characteristics of the patients who underwent ERCP were evaluated, 33 patients underwent selective cannulation and 6 patients underwent pre-cut. Primary cannulation was performed in 27 patients and secondary cannulation was performed in 12 patients. When we looked at the complications after ERCP, bleeding was not seen in any patient, while pancreatitis developed in 6 (15.40%) patients. After sphincterotomy and stenting, the procedure was successful in 35 (89.70%) patients and bile leakage disappeared in the follow-up. Discussion: Endoscopic interventional procedures should be considered as the first choice for idiopathic simple biliary tract leaks after laparoscopic cholecystectomy because they are minimally invasive, have a high success rate and eliminate the need for reoperation. Our early results are similar to the literature.
Case Reports in Gastrointestinal Medicine, 2021
Background. Endoscopic retrograde cholangiopancreatography (ERCP) can lead to several complications such as duodenal or bile duct perforation. The incidence of pneumoperitoneum post-ERCP is rarely seen (<1%) and is associated with perforations of the duodenum or common bile duct in therapeutic ERCP after sphincterotomy. In this case, we disclose a novel cause of biliary peritonitis after ERCP. Case Presentation. A 65-year-old man presented with abdominal pain and distended abdomen after uneventful ERCP with sphincterotomy. An abdominal computed tomography (CT) was performed whose finding indicated duodenal perforation. The patient was rushed to an emergency laparotomy where only a rupture of an otherwise normal subcapsular intrahepatic bile duct was found. The surrounding liver parenchyma was healthy. The cause of this condition was probably post-ERCP pneumobilia and the increase of pressure in the biliary tract. Conclusions. This is the first case in literature describing the ru...
Open Access Macedonian Journal of Medical Sciences, 2021
BACKGROUND: Laparoscopic cholecystectomy considers a golden surgery for gallbladder removal nowadays, and it carries some complications like biliary injuries, which can manage successfully by endoscopic retrograde cholangiopancreatography. AIM: To estimate the role of endoscopic management of bile duct injury (BDI) following laparoscopic cholecystectomy. PATIENT AND METHODS: A prospective study conducted at Al-Sader Medical City, Najaf City, Iraq, during the period between September 2018 and December 2020, included 44 patients complicated by the biliary injury resulting in a persistent biliary leak and/or jaundice after laparoscopic cholecystectomy and evaluated by endoscopic retrograde cholangiopancreatography (ERCP). RESULTS: Findings revealed that 25% of cases had complete BDI, only one managed by plastic stent placement, the other 10 referred for open surgical constructions, 61% had partial injury associated with the biliary leak, all managed by sphincterotomy and plastic stent ...