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Biliary tract schwannoma:A rare cause of obstructive jaundice in a young patient

World Journal of Gastroenterology 2012年第37期18卷 5305-5308页

作者： Gilton Marques Fonseca André Luis Montagnini Manoel de Souza Rocha Rosely Antunes Patzina Mário Vinícius Angelete Alvarez Bernardes Ivan Cecconello josé jukemura Digestive Surgery Division Department of GastroenterologySchool of MedicineUniversity of So Paulo

Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastro-intestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered well without signs of recurrence of the lesion after 12 mo. We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar. Resection is the treatment of choice for such cases and the tumordid not recur in any of the resected cases.

关键词： Schwannoma Neurilemoma Biliary tract Hilar adenocarcinoma Computadorized tomography

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Nonsteroidal anti-inflammatory drug effectivity in preventing postendoscopic retrograde cholangiopancreatography pancreatitis: A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2020年第11期12卷 469-487页

作者： Juan Pablo Román Serrano joséjukemura Samuel Galante Romanini Paúl Fernando Guamán Aguilar Juliana Silveira Lima de Castro Isabela Trindade Torres joséAndres Sanchez Pulla Otavio Micelli Neto Eloy Taglieri joséCelso Ardengh Department of Gastroenterology University of Sao PauloSão Paulo 05403-000São PauloBrazil Department of Gastrointestinal Endoscopy Service Hospital 9 de JulhoSão Paulo 01409002São PauloBrazil Department of Gastroinestinal Catholic University of CuencaCuenca 010101Ecuador Department of General Surgery Servidor Municipal HospitalSão Paulo 01532-001Brazil

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is the primary therapeutic procedure for the treatment of diseases affecting the biliary tree and pancreatic *** the therapeutic success rate of ERCP is high,the procedure can cause complications,such as acute pancreatitis[post-ERCP pancreatitis(PEP)],bleeding and *** To assess the efficacy of non-steroidal anti-inflammatory drugs(NSAIDs)in preventing PEP during *** Databases such as MEDLINE,EMBASE and Cochrane Central Library were *** randomized controlled trials(RCTs)comparing the efficacy of NSAIDs and placebo for the prevention of PEP were *** evaluated included the incidence of PEP,severity of pancreatitis,route of administration,types,dose,and timing of administration of *** Twenty-six RCTs were considered eligible with a total of 8143 patients ***,4020 patients used NSAIDs before ERCP and 4123 did not use NSAIDs(control group).Ultimately,298 cases of post-ERCP acute pancreatitis were diagnosed in the NSAID group and 484 cases in the placebo *** risk of PEP was lower in the NSAID group risk difference(RD):-0.04;95%confidence interval(CI):-0.07 to-0.03;number needed to treat(NNT),25;P<*** use effectively prevented mild pancreatitis compared to placebo use(2.5%vs 4.1%;95%CI:-0.05 to-0.01;NNT,33;P<0.05),but information on moderate PEP and severe PEP could not be fully *** rectal administration reduced the incidence of PEP with RD:-0.06;95%CI:-0.08 to-0.04;NNT,17;P<0.05).Furthermore,only the use of diclofenac or indomethacin was effective in preventing PEP,at a dose of 100 mg,which must be administered before performing *** Rectal administration of diclofenac and indomethacin significantly reduced the risk of developing mild *** RCTs are needed to compare the efficacy between NSAID routes of administration in preventing PEP.

关键词： Pancreatitis Endoscopic retrograde cholangiopancreatography Diclofenac Indomethacin Rectal

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Rare cause of abdominal incidentaloma: Hepatoduodenal ligament teratoma

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World Journal of Gastrointestinal Surgery 2014年第5期6卷 80-83页

作者： Vagner Birk Jeismann Rodrigo Blanco Dumarco Celso di Loreto Ricardo Correa Barbuti josé jukemura Department of Gastroenterology School of MedicineUniversity of Sao Paulo CICAP Pathology Laboratory Oswaldo CruzGerman Hospital The Adolfo Lutz Institute

The occurrence of a hepatoduodenal ligament teratoma is extremely rare,with only a few cases reported in the *** case report describes the discovery of a hepatoduodenal ligament lesion revealed during abdominal ultrasonography for cholelithiasis-related abdominal pain in a 27-year-old ***-sectional imaging identified a 5 cm×4 cm heterogeneous mass of fat tissue with irregular calcification located in the posterior-superior aspect of the head of the *** encapsulated lesion showing no invasion to the common bile duct or adjacent organs and vessels was exposed during laparotomy and ***-erative cholangiography during the cholecystectomy showed no *** postoperative course was *** analysis of the resected mass indicated hepatoduodenal ligament *** case report demonstrates that cross-sectional im-aging,such as computed tomography,can reveal sus-pected incidences of this rare type of teratoma,which can then be confirmed after pathologic analysis of the *** prognosis after complete surgical resec-tion of lesions presenting with benign pathological fea-tures is excellent.

关键词： Abdominal incidentaloma Teratoma Hepatoduodenal ligament Surgery Hepatobiliary surgery

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