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Malignant Biliary Strictures (malignant + biliary_stricture)
Selected AbstractsENDOSCOPIC MANAGEMENT OF BILIARY and PANCREATIC DUCTS STRICTURESDIGESTIVE ENDOSCOPY, Issue 2004Hiroyuki Maguchi ABSTRACT Endoscopic treatment is applied to a relatively large number of biliary and pancreatic duct strictures, and is a practical matter. It is essential to select the most appropriate treatment for each lesion. For instance, when treating malignant biliary stricture, accurate diagnosis of whether surgical treatment is required or not is vital; and in choosing a stent for an inoperable case, location of the stricture, with or without anticancer treatment, prognosis, and management of possible post-stenting re-stricture must be taken into consideration. For benign strictures, not only short-term results in mobility and motality, but also decades of long-term results must be cautiously questioned. Bearing these in mind, we need to accumulate the worldwide data of the treatments and establish a proper treatment guideline. [source] BILIARY STENTING FOR MALIGNANT BILIARY OBSTRUCTIONDIGESTIVE ENDOSCOPY, Issue 1 2006Toshio Tsuyuguchi Management of patients with malignant biliary obstruction remains controversial. We reviewed our current status of biliary stenting for malignancy. The initial step in our management is endoscopic nasobiliary drainage, which is used not only for preoperative drainage but also to decide whether or not surgery is appropriate treatment. Although a metal stent has a longer patency time than a plastic stent, it costs up to thirty-fold more than the latter in Japan. Therefore, stent selection, metal or plastic, should be dependent on the expected prognosis of each patient with malignant biliary strictures. In the present paper, we also discuss the efficacy of the covered metal stent and stenting for malignant hilar obstruction. [source] Endoscopic removal of a dislocated covered wallstent using a wire-loop techniqueDIGESTIVE ENDOSCOPY, Issue 4 2003Takao Itoi Background:, Self-expandable metallic stents (SEMS) and covered-SEMS (cSEMS) are used for patients with unresectable malignant biliary strictures. Occasionally, there are cases where stent migration can easily occur. Methods and Results:, We experienced a dislocated distal cSEMS that was unable to be removed by previously described techniques. However, we could successfully remove cSEMS with a wire-loop technique using a polypectomy snare and guidewire. Conclusion:, This technique may provide hope for the removal of severely dislocated cSEMS. [source] Post-cholecystectomy biliary strictures: Not always benignJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt2 2008Ajay Sharma Abstract Background:, Post-cholecystectomy malignant biliary obstruction masquerading as benign biliary stricture (BBS) has not been reported in the literature; it presents a diagnostic and management challenge. Methods:, Of the 349 post-cholecystectomy BBS managed at a tertiary care hospital in northern India between 1989 and 2004, 11 patients were found to have biliary malignancy. Records of these 11 patients were analyzed retrospectively for the purpose of this study. Results:, Mean age of patients with malignant biliary strictures was significantly higher (52 vs 38 years, P = 0.000); they were more likely to have jaundice (100% vs 78%, P = 0.008) and pruritus (82% vs 48%, P = 0.03). Unlike most patients with BBS referred from elsewhere to us, they had had a smooth postoperative course uncomplicated by bile leak, had a longer cholecystectomy-presentation interval, and were more likely to have high strictures ((Bismuth type III/IV) 91% vs 49%, P = 0.008). Conclusions:, Post-cholecystectomy biliary obstruction is not always benign. High bilirubin levels and hilar strictures, especially after an uneventful cholecystectomy, in a middle-aged patient should raise a suspicion of underlying missed malignancy. [source] | ||||||||||