A novel technique for biliary strictures that cannot be passed with a guide wire

WOS: 000260451400234PubMed ID: 1827378

A novel technique for biliary strictures that cannot be passed with a guide wire.

PubMed ID: 18273782[No abstract available

Effective simple incision or partial snare resection for symptomatic duodenal cystic lesions, duplication cysts, and choledochoceles Reply

WOS: 00027116260001

Patients with bulhar papilla and choledocholithiasis and their endoscopic management

PubMed ID: 19453023Background/Aims: This study presents the endoscopic management of twenty-one patients with biliary stones, deformity at the duodenal bulb, and a flat shaped papilla ectopically located at duodenal bulb. Methodology: Most of the patients were male with a mean age of 53.9±9.6 years. In four (19%) of the 21 patients stenotic parts in the bulbus were dilated with TTS balloons, thus allowing ectopic papillae to be reached in all of the cases. Papillary orifice and distal CBD were dilated with balloons from 4 mm diameter and increasing the diameter of the balloons stepwise to 6 to 15 mm. Results: In 20 (95%) the patients, the stones could be extracted in either the first or subsequent endoscopy session as the cholangiography. In one patient, retroperitoneal perforation in the intrapancreatic segment of the CBD occured after dilatation of CBD with a 15 mm balloon, and an operation was necessary. Conclusion: The shared features which may constitute a unique clinical entity of the presented cases are 1) male gender, 2) bulbar papilla, 3) flat appearance of the major papilla endoscopically 4) deformed bulbus, and 5) presence of stones in the CBD. Bile duct stones can be treated with endoscopic balloon dilatation of the distal CBD and papilla. © H.G.E. Update Medical Publishing S.A., Athens-Stuttgart

A new endoscopic treatment method for a symptomatic duodenal duplication cyst

WOS: 000207783700020PubMed ID: 1928842

A severe case of esophageal ulcer causing a tight stricture despite long-term D-penicillamine treatment [Ein Fall eines ausgeprägten Ösophagusulkus mit Striktur trotz Langzeittherapie mit D-Penicillamin]

PubMed ID: 25234939D-penicillamine has long been used in the management of rheumatic diseases due to the effects on inhibition of collagen synthesis. Herein, we report a severe case of esophageal ulcer causing a tight stricture extending through the distal esophagus despite the longterm D-penicillamine treatment in a patient with Wilson’s disease. D-penicillamine would theoretically be expected to contribute to the healing of an esophageal ulcer. However, the drug failed to have a favorable outcome, which is notable and worth reporting. © Springer-Verlag Wien 2014

Biliary sphincterotomy plus dilation with a large balloon for bile duct stones that are difficult to extract

WOS: 000180730000002PubMed ID: 12556775Background: Bile duct stones are still present in 10% to 15% of patients after the application of conventional endoscopic extraction techniques and require additional procedures for duct clearance. In the vast majority of these cases, there are 2 main problems: large stone size (>15 mm) and tapering of distal bile duct. Methods: Fifty-eight patients in whom endoscopic sphincterotomy and standard basket/balloon extraction were unsuccessful in the removal of bile duct stones underwent dilation with a 10- to 20-mm diameter (esophageal/pyloric type) balloon at the same session. In 18 patients with tapered distal bile ducts (Group 1), 12- to 18-mm diameter balloon catheters were used to enlarge the orifice. In 40 patients with square, barrel shaped and/or large (>15mm) stones (Group 2), the sphincterotomy orifice was enlarged with 15- to 20-mm diameter balloon catheters. After dilatation, standard basket/balloon extraction techniques were used to remove the stone(s). Results: Stone clearance was successful in 16 patients (89%) in Group 1 and 35 (95%) in Group 2. Complications occurred in 9 (15.5%) patients. Conclusion: Dilation with a large-diameter balloon after endoscopic sphincterotomy is a useful alternative technique in patients with bile duct stones that are difficult to remove with standard methods