Duodenal perforation following bile duct endoprosthesis placement

T1 - Combined percutaneous-endoscopic approach for biliary endoprosthesis placement.

Placement of a metallic biliary endoprosthesis via cholecystostomy

N2 - Improved resolution of computed tomography (CT) and ultrasonography allows us to visualize the proximal extent of biliary obstruction and the presence of a periampullary mass in most patients with malignant extrahepatic biliary obstruction. Our purpose in this report is to challenge the need for preoperative percutaneous biopsy, endoscopic retrograde cholangiopancreatography, or preoperative placement of a biliary endoprosthesis in the good-risk patient in whom the imaging procedure clearly defines a periampullary mass and the proximal extent (hepatic extent) of biliary obstruction. We recently managed three patients in whom one of these invasive procedures led to a complication that delayed,prevented, or complicated appropriate operative resection of a pancreatic neoplasm. Because a negative percutaneous biopsy, cholangiographic imaging of a dilated bile/pancreatic duct clearly seen on CT or ultrasonography, or short-term preoperative biliary decompression does not alter the decision for operative exploration and may cause complications, we argue against their use in the good-risk patient with both extrahepatic biliary obstruction and a periampullary pancreatic mass well delineated on noninvasive imaging.

Partial distal deployment for precise placement of the GORE Thoracic Endoprosthesis

Placement of a metallic biliary endoprosthesis via cholecystostomy.

Improved resolution of computed tomography (CT) and ultrasonography allows us to visualize the proximal extent of biliary obstruction and the presence of a periampullary mass in most patients with malignant extrahepatic biliary obstruction. Our purpose in this report is to challenge the need for preoperative percutaneous biopsy, endoscopic retrograde cholangiopancreatography, or preoperative placement of a biliary endoprosthesis in the good-risk patient in whom the imaging procedure clearly defines a periampullary mass and the proximal extent (hepatic extent) of biliary obstruction. We recently managed three patients in whom one of these invasive procedures led to a complication that delayed,prevented, or complicated appropriate operative resection of a pancreatic neoplasm. Because a negative percutaneous biopsy, cholangiographic imaging of a dilated bile/pancreatic duct clearly seen on CT or ultrasonography, or short-term preoperative biliary decompression does not alter the decision for operative exploration and may cause complications, we argue against their use in the good-risk patient with both extrahepatic biliary obstruction and a periampullary pancreatic mass well delineated on noninvasive imaging.

1. Endoscopy. 2005 Apr;37(4):393-6. Drainage of gallbladder fossa fluid collections with endoprosthesis placement under endoscopic ultrasound guidance: a preliminary report of two cases.

Upon returning with graft thrombosis and outflow stenosis, a superior venacavogram, axillary venogram, subclavian venogram, shuntogram, and a selective brachial arteriogram were performed. Thrombectomy was performed with the AngioJet (Boston Scientific Corporation) device to clear the clot within the graft. Severe outflow stenosis of approximately 90% was noted and initially treated with balloon angioplasty using a 7 mm x 8 cm angioplasty balloon. The high-grade stenosis was refractory to this treatment, which persisted even after further balloon inflation of the lesion with an 8 mm x 4 cm angioplasty balloon. The results were suboptimal with rebounding of approximately 50% after use of the second angioplasty balloon. We identified that the stenosis on the graft vein anastomotic and perianastomotic area was going to be compromised. As a result, placement of a GORE® VIABAHN® Endoprosthesis was selected to prolong functionality of the AV graft circuit.

01/06/1995 · Biliary tract drainage, with or without placement of an endoprosthesis, is used as a palliative therapy for malignant biliary obstruction


Treatment of superior vena cava syndrome - SciELO

AB - Improved resolution of computed tomography (CT) and ultrasonography allows us to visualize the proximal extent of biliary obstruction and the presence of a periampullary mass in most patients with malignant extrahepatic biliary obstruction. Our purpose in this report is to challenge the need for preoperative percutaneous biopsy, endoscopic retrograde cholangiopancreatography, or preoperative placement of a biliary endoprosthesis in the good-risk patient in whom the imaging procedure clearly defines a periampullary mass and the proximal extent (hepatic extent) of biliary obstruction. We recently managed three patients in whom one of these invasive procedures led to a complication that delayed,prevented, or complicated appropriate operative resection of a pancreatic neoplasm. Because a negative percutaneous biopsy, cholangiographic imaging of a dilated bile/pancreatic duct clearly seen on CT or ultrasonography, or short-term preoperative biliary decompression does not alter the decision for operative exploration and may cause complications, we argue against their use in the good-risk patient with both extrahepatic biliary obstruction and a periampullary pancreatic mass well delineated on noninvasive imaging.

Tracheoesophageal Fistula Treatment & Management: …

Mar 29, 2016 The primary indication for total knee arthroplasty TKA; also referred to as total knee replacement is relief of significant, disabling pain caused by. The two major types of aortic dissection, type A and type B, are defined by the location of the tear. GORE TAG® Thoracic Endoprosthesis.