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1.
Role of radiology in the treatment of malignant hilar biliary strictures 1: Review of the literature
Malignant strictures of the biliary tree are an uncommon cause of obstructive jaundice. There are a number of pathological subtypes, but tumours in this region tend to have similar clinical and diagnostic features and therapeutic and prognostic implications. We review the published literature on this topic discussing diagnostic modalities and treatment options with a focus on radiological intervention. Diagnosis currently is best achieved using a range of procedures. Direct cholangiography remains the gold standard in delineating anatomy, but the invasiveness of this procedure limits its use as a purely diagnostic tool. Magnetic resonance technology, in particular magnetic resonance cholangiopancreatography, has an increasing role as accessibility is improved. Treatment of these tumours is difficult. Surgical resection and palliative biliary enteric bypass are the most common methods used with endoscopic and percutaneous therapies reserved for palliating patients not fit for surgery. There is little firm evidence to suggest that any one palliative modality is superior. Interventional radiology is particularly suitable for palliative management of difficult and expansive lesions as the anatomy can preclude easy access by surgical or endoscopic techniques. Good palliative results with minimal mortality and morbidity can be achieved with percutaneous stenting . 相似文献
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Ahsun Riaz MD John P. Pinkard MD Riad Salem MD MBA Robert J. Lewandowski MD 《Journal of surgical oncology》2019,120(1):45-56
Percutaneous biliary interventions have established their role in the management of benign and malignant biliary disease. There are limited data comparing procedures performed by gastroenterologists and interventional radiologists in managing malignant biliary obstruction. Endoscopic procedures performed by gastroenterologists are not completely benign with reported complications ranging from 2% to 15%. It is important that gastroenterologists and interventional radiologists collaborate to form algorithms for management of malignant biliary obstruction which provide safe and efficacious care to these patients. 相似文献
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Oncologic effects of preoperative biliary drainage in resectable hilar cholangiocarcinoma: Percutaneous biliary drainage has no adverse effects on survival 下载免费PDF全文
Xu‐Feng Zhang MD PhD Eliza W. Beal MD MS Katiuscha Merath MD Cecilia G. Ethun MD Ahmed Salem MD Sharon M. Weber MD Thuy Tran MD George Poultsides MD Andre Y. Son MD Ioannis Hatzaras MD Linda Jin MD Ryan C. Fields MD Matthew Weiss MD Charles Scoggins MD Robert C.G. Martin MD Chelsea A. Isom MD Kamron Idrees MD Harveshp D. Mogal MD Perry Shen MD Shishir K. Maithel MD Carl R. Schmidt MD Timothy M. Pawlik MD MPH PhD 《Journal of surgical oncology》2018,117(6):1267-1277
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MELLER M.T., ARTS G.R.J. & DEAN J.R. (2010) European Journal of Cancer Care 19 , 664–668 Outcomes in percutaneous stenting of non‐hepato‐biliary/pancreatic malignant jaundice The aim of this study is to review the practice and outcomes at our institution of percutaneous transhepatic placement of metallic biliary stents for non‐hepato‐biliary/pancreatic (non‐HBP) malignant obstructive jaundice. A retrospective review was performed of the records of all patients undergoing transhepatic stenting for non‐HBP malignant obstructive jaundice over a 7‐year period. A total of 25 patients were successfully stented and linear regression analysis of a variety of demographic, clinical and laboratory markers against survival was performed. Survival after stenting varied from 1 to 1354 days (median 58, mean 152). An initial bilirubin level less than 300 µmol/L (P= 0.01) and a reduction of greater than 50% in bilirubin post stenting (P= 0.02) were strong predictors of improved survival. Older patients survived longer than younger ones (P < 0.01). There was a weak association of survival with an albumin >30 g/L (P= 0.06), but no statistically significant correlation with creatinine or haemoglobin levels or active tumour treatment after stenting. There were few major complications from the procedures. Transhepatic metallic biliary stenting for non‐HBP malignant biliary obstruction is a safe and effective procedure, and with careful patient selection, significant periods of survival and palliation of jaundice can be achieved. 相似文献
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Dustin G Roberts Adam N Plotnik Jeffrey FB Chick Ravi N Srinivasa 《Journal of Medical Imaging and Radiation Oncology》2019,63(3):340-345
Interventional radiology‐operated percutaneous endoscopy has seen a recent resurgence with potential to return to the scope of Interventional Radiology practice. Endoscopy adds a new dimension to the Interventional Radiology armamentarium by offering a unique opportunity to diagnose and treat conditions under direct visualization with improved maneuverability. Cholecystoscopy (gallbladder endoscopy), as a method for percutaneous removal of gallstones, is an effective treatment option in patients with symptomatic cholelithiasis who are poor candidates for surgical cholecystectomy. This article presents a case of Interventional Radiology‐operated cholecystoscopy using ultrasonic lithotripsy and stone basket retrieval with an emphasis on the equipment, technique, and peri‐procedural management essential to the procedure, as well as a review of the literature. 相似文献
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Adjuvant therapy is associated with improved survival after curative resection for hilar cholangiocarcinoma: A multi‐institution analysis from the U.S. extrahepatic biliary malignancy consortium 下载免费PDF全文
Bradley A. Krasnick MD Linda X. Jin MD Jesse T. Davidson MD IV Dominic E. Sanford MD MPHS Cecilia G. Ethun MD Timothy M. Pawlik MD MPH PhD George A. Poultsides MD Thuy Tran MD Kamran Idrees MD William G. Hawkins MD William C. Chapman MD Maria B.M. Doyle MD Sharon M. Weber MD Steven M. Strasberg MD Ahmed Salem MD Robert C.G. Martin MD PhD Chelsea A. Isom MD Charles Scoggins MD MBA Carl R. Schmidt MD Perry Shen MD Eliza Beal MD Ioannis Hatzaras MD MPH Rivfka Shenoy MD Shishir K. Maithel MD Ryan C. Fields MD 《Journal of surgical oncology》2018,117(3):363-371
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Ultrasound‐guided percutaneous tenotomy for the treatment of iliopsoas impingement: A description of technique and case study 下载免费PDF全文
Matthew J Sampson Nimah Rezaian James MK Hopkins 《Journal of Medical Imaging and Radiation Oncology》2015,59(2):195-199
Iliopsoas impingement is a commonly recognised source of groin pain following total hip replacement. When conservative measures fail, open or arthroscopic iliopsoas tendon release can reliably alleviate pain and improve function. This article describes an alternative ultrasound‐guided percutaneous technique, achieving iliopsoas tenotomy utilising a modified 18G coaxial needle and thus minimising the morbidity and cost associated with an open or arthroscopic procedure. This method proved successful with resultant complete resolution of patient symptoms. To the knowledge of the authors, this is the first case of ultrasound‐guided percutaneous iliopsoas tenotomy for iliopsoas impingement post total hip replacement. 相似文献
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CH‐K Wong LE Kelly LB Tripcony 《Journal of Medical Imaging and Radiation Oncology》2007,51(3):276-282
The purpose of this study was to compare the treatment outcomes of patients with nasopharyngeal carcinoma in Queensland in a 10‐year period during which synchronous chemoradiotherapy has come into use and to compare characteristics of patients of different racial origins and their prognostic factors. Eighty‐one patients treated between 1991 and 2001 at the Queensland Radium Institute, Brisbane, Queensland for histologically confirmed nasopharyngeal carcinoma were included. Seventeen patients were treated using the Intergroup protocol, 32 patients with miscellaneous synchronized chemoradiotherapy, 6 patients with neoadjuvant regimens and 26 patients with radiotherapy only. Asian patients were found to present earlier than White Australian patients (P < 0.02). No significant difference was identified in the histological presentation between the two ethnic groups. Asian patients were more likely to have a relapse and poor loco‐regional control. Overall survival, however, was not different. Patients treated according to the Intergroup protocol had better disease‐specific survival and relapse‐free survival than the other groups. The median follow up was 36 months. Twenty‐five patients (30%) developed recurrent disease. The 5‐year salvage survival or survival after relapse was 15%. Our experience with the Intergroup protocol in our population is similar to other studies, with likelihood of improved results. 相似文献
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C. HEIBL
MD V. TROMMET
MD S. BURGSTALLER
MD B. MAYRBAEURL
MD C. BALDINGER
MD R. KOPLMÜLLER
MD T. KÜHR
MD L. WIMMER
MD J. THALER
MD 《European journal of cancer care》2010,19(5):676-681
HEIBL C., TROMMET V., BURGSTALLER S., MAYRBAEURL B., BALDINGER C., KOPLMÜLLER R., KÜHR T., WIMMER L. & THALER J. (2010) European Journal of Cancer Care 19 , 676–681 Complications associated with the use of Port‐a‐Caths in patients with malignant or haematological disease: a single‐centre prospective analysis Totally implantable central venous catheters are widely used in the management of patients with haematological or malignant disease. This paper investigates device‐related complications and compares it with the literature. A total of 143 Port‐a‐Caths (PaCs) were implanted in 140 patients at a single centre during 2004 and followed until March 2005. Indication for implantation was mainly administration of chemotherapy. High standards of care were applied through intensive training of staff. Complications were registered prospectively and cross‐checked with the medical records at the end of the observational period. The ports were in place for a total of 29 107 days (mean 204, range 3–443 days per port). A total of 25 complications were recorded. These included 13 infections [9.1% with 5 cutaneous (3.5%) and 8 systemic (5.6%) infections], one deep vein thrombosis (0.7%). In 6 patients (4.2%) the device had to be removed because of complications. No device‐related death was observed. The use of totally implantable central venous catheters for treating haemoto‐oncological patients is safe. The need for device removal due to complications was particularly low in this analysis as compared with the literature. 相似文献
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Prevalence of the reversed halo sign in neutropenic patients compared with non‐neutropenic patients: Data from a single‐centre study involving 27 patients with pulmonary mucormycosis (2003‐2016) 下载免费PDF全文
Jessie Bourcier Pierre‐Marie Heudes Florent Morio Thomas Gastinne Patrice Chevallier Fanny Rialland‐Battisti Claire Garandeau Isabelle Danner‐Boucher Patrice Le Pape Eric Frampas Philippe Moreau Claire Defrance Pierre Peterlin 《Mycoses》2017,60(8):526-533
Pulmonary mucormycosis (PM) is a life‐threatening infection and the diagnosis can be challenging. The objective was to retrospectively explore the value of the RHS in our cohort of 27 patients with mucormycosis and its relation to neutropenia. This was a retrospective study including all patients with a diagnosis of probable or proven invasive PM according to the 2008 EORTC/MSG criteria between September 2003 to April 2016. Fisher's exact test and Mann‐Whitney test, with a P‐value statistically significant under .05 (P<.05), were used to compare neutropenic and non‐neutropenic groups. 27 patients were eligible. The RHS could be identified in 78% of cases in the neutropenic group, and was less common in the non‐neutropenic group (31%) (P<.05). Reticulations inside ground‐glass opacity in case of RHS were present in 13 out of 15 patients (87%). Mucorales DNA detection by PCR on serum provided, a median time to the first PCR‐positive sample of 3 days (?33 to +60 days) before diagnosis was confirmed. Six patients had IPA co‐infection. In conclusion, RHS is more frequent in case of PM in neutropenic patients compare to non‐neutropenic patients. Its presence in immunocompromised patients should be sufficient to promptly start Mucorales‐active antifungal treatment, while its absence especially in non‐neutropenic cases should not be sufficient to exclude the diagnosis. 相似文献
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Epidemiology of candidaemia in a tertiary care university hospital: 10‐year experience with 381 candidaemia episodes between 2001 and 2010 下载免费PDF全文
Sehnaz Alp Sevtap Arikan‐Akdagli Dolunay Gulmez Sibel Ascioglu Omrum Uzun Murat Akova 《Mycoses》2015,58(8):498-505
Defining the epidemiology of and risk factors for candidaemia is necessary to guide empirical treatment. The objectives of this study were to determine the ranking of Candida among positive blood cultures, to define the epidemiology of candidaemia and to investigate patient characteristics and their relationship with C. albicans vs. non‐albicans Candida (NAC) candidaemia. Candidaemia episodes between January 2001 and December 2010 were evaluated retrospectively. Patient characteristics were compared across Candida species. Candida ranked as the fifth most frequently isolated pathogen. Among 381 candidaemia episodes, 58.3% were due to C. albicans, followed by C. parapsilosis (15.2%), C. tropicalis (13.4%) and C. glabrata (6.8%). No statistically significant difference was observed in the distribution of C. albicans vs. NAC (P = 0.432). Patients with NAC had significantly higher rates of haematological disorders (P < 0.001) and neutropenia (P = 0.003), and were older (P = 0.024) than patients with C. albicans, whereas patients with urinary catheters had higher rates of C. albicans (P = 0.007). On species basis, C. tropicalis was more frequently isolated from patients with haematological disorders (P < 0.001) and neutropenia (P = 0.008). Patients with urinary catheters were less likely to have C. parapsilosis (P = 0.043). C. glabrata was most prevalent among patients with solid organ tumours (P = 0.038), but not evident in patients with haematological disorders. Local epidemiological features and risk factors may have important implications for the management of candidaemia. 相似文献
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Association of perioperative transfusion with survival and recurrence after resection of gallbladder cancer: A 10‐institution study from the US Extrahepatic Biliary Malignancy Consortium 下载免费PDF全文
Alexandra G. Lopez‐Aguiar MD Cecilia G. Ethun MD Mia R. McInnis BA Timothy M. Pawlik MD MPH PhD George Poultsides MD Thuy Tran MD Kamran Idrees MD Chelsea A. Isom MD Ryan C. Fields MD Bradley A. Krasnick MD Sharon M. Weber MD Ahmed Salem MD Robert C. G. Martin MD Charles R. Scoggins MD Perry Shen MD Harveshp D. Mogal MD Carl Schmidt MD Eliza W. Beal MD Ioannis Hatzaras MD Rivfka Shenoy MD Kenneth Cardona MD Shishir K. Maithel MD 《Journal of surgical oncology》2018,117(8):1638-1647
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High expression of karyopherin‐α2 and stathmin 1 is associated with proliferation potency and transformation in the bile duct and gall bladder epithelia in the cases of pancreaticobiliary maljunction 下载免费PDF全文
Fumiyoshi Saito MD Kenichiro Araki MD PhD Takehiko Yokobori MD PhD Norihiro Ishii MD Mariko Tsukagoshi MD Akira Watanabe MD PhD Norio Kubo MD PhD Bolag Altan MD PhD Ken Shirabe MD PhD Hiroyuki Kuwano MD PhD 《Journal of surgical oncology》2016,114(4):462-468