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Clinicopathological features and prognosis of surgical resected cases of biliary cancer with pancreaticobiliary maljunction

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 97-100页

作者： tsukasa takayashiki Hideyuki Yoshitomi Katsunori Furukawa Satoshi Kuboki Masaru Miyazaki Masayuki Ohtsuka Department of General Surgery Graduate School of MedicineChiba University Department of Gastroenterological Surgery Mita HospitalInternational University of Health and Welfare

To the Editor:Pancreaticobiliary maljunction(PBM)is a congenital anomaly in which the pancreatic and bile ducts join anatomically outside of the duodenal wall away from the Oddi’s sphincter.This condition causes the reflux of pancreatic juice into the bile duct under high pressure,resulting in various pathologic changes.The features of PBM patients are common bile duct dilatation,long common channel,and high amylase levels in bile juice.Among them,one of the most significant problems is the development of biliary cancer,including extrahepatic bile duct and gallbladder cancers[1].A nationwide survey in Japan reported biliary cancer in 21.6%of adult patients with PBM concomitant with congenital biliary dilatation,32.1%and 62.3%extrahepatic bile duct and gallbladder cancers,respectively[2].

关键词： biliary cancer congenital

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Peripheral portal vein-oriented non-dilated bile duct puncture for percutaneous transhepatic biliary drainage

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World Journal of Gastroenterology 2015年第44期21卷 12628-12634页

作者： Hiroaki Shimizu Atsushi Kato tsukasa takayashiki Satoshi Kuboki Masayuki Ohtsuka Hideyuki Yoshitomi Katsunori Furukawa Masaru Miyazaki Department of General Surgery Chiba University Graduate School of Medicine Chiba City

AIM: To evaluate the efficacy of peripheral portal vein(PV)-oriented non-dilated bile duct(BD) puncture for percutaneous transhepatic biliary drainage(PTBD).METHODS: Thirty-five patients with non-dilated BDs underwent PTBD for the management of various biliary disorders, including benign bilioenteric anastomotic stricture(n = 24), BD stricture(n = 5) associated with iatrogenic BD injury, and postoperative biliary leakage(n = 6). Under ultrasonographic guidance, percutaneous transhepatic puncture using a 21-G needle was performed along the running course of the peripheral targeted non-dilated BD(preferably B6 for right-sided approach, and B3 for left-sided approach) or along the accompanying PV when the BD was not well visualized. This technique could provide an appropriate insertion angle of less than 30° between the puncture needle and BD running course. The puncture needle was then advanced slightly beyond the accompanying PV. The needle tip was moved slightly backward while injecting a small amount of contrast agent to obtain the BD image, followed by insertion of a 0.018-inch guide wire(GW). A drainage catheter was then placed usinga two-step GW method. RESULTS: PTBD was successful in 33(94.3%) of the 35 patients with non-dilated intrahepatic BDs. A rightsided approach was performed in 25 cases, while a left-sided approach was performed in 10 cases. In 31 patients, the first PTBD attempt proved successful. Four cases required a second attempt a few days later to place a drainage catheter. PTBD was successful in two cases, but the second attempt also failed in the other two cases, probably due to poor breath-holding ability. Although most patients(n = 26) had been experiencing cholangitis with fever(including septic condition in 8 cases) before PTBD, only 5(14.3%) patients encountered PTBD procedure-related complications, such as transient hemobilia and cholangitis. No major complications such as bilioarterial fistula or portal thrombosis were observed. There was no mortality in our series.CONCLUSION: Peripher

关键词： Percutaneous transhepatic biliary drainage Cholang

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