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C Liguory

Publications and source records attributed to C Liguory.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Endoscopic sphincterotomy complications and their management: an attempt at consensus.

Despite its relative safety (in comparison with surgery), and undoubted role in many clinical circumstances, biliary sphincterotomy is the most dangerous procedure routinely performed by endoscopists. Complications occur in about 10% of patients; 2 to 3% have a prolonged hospital stay, with a risk of dying. This document is an attempt to provide guidelines for prevention and management of complications, based on a workshop of selected experts, and a comprehensive review of the literature. We emphasize particularly the importance of specialist training, disinfection, drainage, and collaboration with surgical colleagues.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMedDate not supplied

[Percutaneous treatment of intrahepatic lithiasis].

AIM: To present our experience with percutaneous intracorporeal electrohydrolic lithotripsy in the treatment of intrahepatic lithiasis. SUBJECTS AND METHODS: From January 1989 to November 1998, 53 patients with intrahepatic lithiasis were treated with percutaneous intracorporeal electrohydrolic lithotripsy. Twenty-six patients had primary intrahepatic lithiasis. Intrahepatic stones were associated with intrahepatic duct abnormalities in 11 patients, 9 had strictures and 2 had cystic dilatations. Twenty-seven patients had secondary intrahepatic lithiasis formed a biliodigestive bypass in 20 patients. Intracorporeal electrohydrolic lithotripsy was performed under cholangioscopic guidance in all patients. The endoscope was introduced into the biliary ducts through a cutaneobiliary tract in 51 patients, through a cutaneocholecystic tract in one and through a cutaneojejunal tract in one. These tracts were created and gradually dilated in two sessions three days apart. In twenty-two patients stenosis or sharp angulation prevented adequate positioning of the scope which was only successful after balloon dilation or insertion of a stiff wire. RESULTS: Complete clearance of stones was achieved in 49 patients (92%). Biliary or hepaticojejunostomy strictures were successfully dilated with an angioplasty balloon in all patients. Ten patients (19%) had early complications: four had bilomas treated by percutaneous drainage, three had resolutive onset of cholangitis, two had transient arterial hemobilia, and one had a pneumothorax. The mean duration of follow-up was five years. During this period, 5 patients (9%) had recurrent symptoms of biliary obstruction. Among these patients, three (5.7%) had recurrent symptomatic intrahepatic lithiasis, one had a recurrent biliary stricture and one had secondary sclerosing cholangitis. Treatment of recurrent stones was repeated intracorporeal electrohydrolic lithotripsy in two and left hepatectomy in one; recurrent biliary stricture was treated by hepaticojejunostomy and secondary sclerosing cholangitis by antibiotics. CONCLUSION: Intracorporeal electrohydrolic lithotripsy is effective and safe and should be proposed as the first line treatment of primary or secondary intrahepatic lithiasis.

Adult↗
PubMedDate not supplied

[Cholestasis caused by an intradiverticular bezoar. Endoscopic treatment].

A 49 year old woman presented with fever. Blood chemistry showed cholestasis. Sonography and abdominal computed tomography showed a dilated biliary tract and a fluid collection in the head of the pancreas. A large, interposed, diverticulum of the second duodenum, filled with a bezoar, was documented by duodenoscopy. The bezoar was fragmented and removed by biopsy forceps. Retrograde visualization of the common bile duct then showed a normal biliary tree with good clearance of contrast material. The ulterior course was uncomplicated. This is the second reported case for cholestasis due to an intradiverticular bezoar in an interposed duodenal diverticula. Diagnosis and treatment were made by duodenoscopy.

Bezoars↗