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Search results for: choledocholithiasis
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<div class="card-body"><strong>Commenced</strong> in January 2007</div> </div> </div> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Frequency:</strong> Monthly</div> </div> </div> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Edition:</strong> International</div> </div> </div> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Paper Count:</strong> 4</div> </div> </div> </div> <h1 class="mt-3 mb-3 text-center" style="font-size:1.6rem;">Search results for: choledocholithiasis</h1> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">4</span> Spectral Dual Layer CT for Choledocholithiasis: A Blinded Comparison Study</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Cheng%20Hong%20YEO">Cheng Hong YEO</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: Objective: To evaluate the effectiveness of Spectral Dual Layer CT (DECT) in diagnosing choledocholithiasis, specifically focusing on its accuracy in detecting small biliary stones compared to other imaging modalities. Background: DECT has shown promise in improving the detection and characterization of gallstones in the common bile duct, offering potential advantages over traditional imaging methods like standard CT and ultrasonography. Methodology: Study Design: Single-blinded retrospective study conducted at a teaching hospital. Patient Selection: Reviewed records of patients who underwent DECT for suspected choledocholithiasis and had follow-up MRCP, ERCP, or IOC within 8 weeks. 23 patients with proven choledocholithiasis and 23 controls without biliary filling defects were included. DECT Protocol: Used a Philips IQ 256-slice dual-energy CT scanner with standard protocols including 120 kVp and 40 keV mono-E images. Assessment: Four radiologists, blinded to the study question, evaluated images for the presence of choledocholithiasis. Sensitivity, specificity, PPV, and NPV were calculated based on consensus diagnoses. Results: Diagnostic Performance: DECT showed an overall sensitivity of 47.8% and specificity of 78.3% for detecting choledocholithiasis. The accuracy of the diagnosis ranged from 54% to 63% among observers. Stone Detection: Of the identified stones, 6 were calcified and 17 non-calcified. Detection of calcified stones was more accurate (83.3%) compared to non-calcified stones (35.3%). Differences in signal between stones and bile were noted in certain imaging parameters. Interobserver Agreement: The agreement among radiologists was fair, with a Fleiss Kappa coefficient of 0.30. Conclusion: This is the first study to specifically analyse the performance of spectral CT in choledocholithiasis detection using a control group and blinding of reviewers. Our modest results demonstrating lower overall sensitivity than had been reported previously at 47.8% overall while identifying 40% of non-calcified stones <9 mm. We believe further research and development on advancements in spectral CT technology or newer techniques such as photon counting CT is warranted. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=dual%20energy%20CT" title="dual energy CT">dual energy CT</a>, <a href="https://publications.waset.org/abstracts/search?q=choledocholithiasis" title=" choledocholithiasis"> choledocholithiasis</a>, <a href="https://publications.waset.org/abstracts/search?q=gallstones" title=" gallstones"> gallstones</a>, <a href="https://publications.waset.org/abstracts/search?q=body%20imaging" title=" body imaging"> body imaging</a> </p> <a href="https://publications.waset.org/abstracts/196959/spectral-dual-layer-ct-for-choledocholithiasis-a-blinded-comparison-study" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/196959.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">14</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">3</span> Diagnosis of Choledocholithiasis with Endosonography</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=A.%20Kachmazova">A. Kachmazova</a>, <a href="https://publications.waset.org/abstracts/search?q=A.%20Shadiev"> A. Shadiev</a>, <a href="https://publications.waset.org/abstracts/search?q=Y.%20Teterin"> Y. Teterin</a>, <a href="https://publications.waset.org/abstracts/search?q=P.%20Yartcev"> P. Yartcev</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: Biliary calculi disease (LCS) still occupies the leading position among urgent diseases of the abdominal cavity, manifesting itself from asymptomatic course to life-threatening states. Nowadays arsenal of diagnostic methods for choledocholithiasis is quite wide: ultrasound, hepatobiliscintigraphy (HBSG), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERCP). Among them, transabdominal ultrasound (TA ultrasound) is the most accessible and routine diagnostic method. Nowadays ERCG is the "gold" standard in diagnosis and one-stage treatment of biliary tract obstruction. However, transpapillary techniques are accompanied by serious postoperative complications (postmanipulative pancreatitis (3-5%), endoscopic papillosphincterotomy bleeding (2%), cholangitis (1%)), the lethality being 0.4%. GBSG and MRI are also quite informative methods in the diagnosis of choledocholithiasis. Small size of concrements, their localization in intrapancreatic and retroduodenal part of common bile duct significantly reduces informativity of all diagnostic methods described above, that demands additional studying of this problem. Materials and Methods: 890 patients with the diagnosis of cholelithiasis (calculous cholecystitis) were admitted to the Sklifosovsky Scientific Research Institute of Hospital Medicine in the period from August, 2020 to June, 2021. Of them 115 people with mechanical jaundice caused by concrements in bile ducts. Results: Final EUS diagnosis was made in all patients (100,0%). In all patients in whom choledocholithiasis diagnosis was revealed or confirmed after EUS, ERCP was performed urgently (within two days from the moment of its detection) as the X-ray operation room was provided; it confirmed the presence of concrements. All stones were removed by lithoextraction using Dormia basket. The postoperative period in these patients had no complications. Conclusions: EUS is the most informative and safe diagnostic method, which allows to detect choledocholithiasis in patients with discrepancies between clinical-laboratory and instrumental methods of diagnosis in shortest time, that in its turn will help to decide promptly on the further tactics of patient treatment. We consider it reasonable to include EUS in the diagnostic algorithm for choledocholithiasis. Disclosure: Nothing to disclose. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=endoscopic%20ultrasonography" title="endoscopic ultrasonography">endoscopic ultrasonography</a>, <a href="https://publications.waset.org/abstracts/search?q=choledocholithiasis" title=" choledocholithiasis"> choledocholithiasis</a>, <a href="https://publications.waset.org/abstracts/search?q=common%20bile%20duct" title=" common bile duct"> common bile duct</a>, <a href="https://publications.waset.org/abstracts/search?q=concrement" title=" concrement"> concrement</a>, <a href="https://publications.waset.org/abstracts/search?q=ERCP" title=" ERCP"> ERCP</a> </p> <a href="https://publications.waset.org/abstracts/159394/diagnosis-of-choledocholithiasis-with-endosonography" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/159394.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">92</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">2</span> Cost Based Analysis of Risk Stratification Tool for Prediction and Management of High Risk Choledocholithiasis Patients</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Shreya%20Saxena">Shreya Saxena</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of 拢328.00 (拢117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at 拢838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (拢580.04 vs 拢252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional 拢1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (拢2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=cost-analysis" title="cost-analysis">cost-analysis</a>, <a href="https://publications.waset.org/abstracts/search?q=choledocholithiasis" title=" choledocholithiasis"> choledocholithiasis</a>, <a href="https://publications.waset.org/abstracts/search?q=risk%20stratification%20tool" title=" risk stratification tool"> risk stratification tool</a>, <a href="https://publications.waset.org/abstracts/search?q=general%20surgery" title=" general surgery"> general surgery</a> </p> <a href="https://publications.waset.org/abstracts/153933/cost-based-analysis-of-risk-stratification-tool-for-prediction-and-management-of-high-risk-choledocholithiasis-patients" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/153933.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">103</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">1</span> Endoscopic Treatment of Patients with Large Bile Duct Stones</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Yuri%20Teterin">Yuri Teterin</a>, <a href="https://publications.waset.org/abstracts/search?q=Lomali%20Generdukaev"> Lomali Generdukaev</a>, <a href="https://publications.waset.org/abstracts/search?q=Dmitry%20Blagovestnov"> Dmitry Blagovestnov</a>, <a href="https://publications.waset.org/abstracts/search?q=Peter%20Yartcev"> Peter Yartcev</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=contact%20lithotripsy" title="contact lithotripsy">contact lithotripsy</a>, <a href="https://publications.waset.org/abstracts/search?q=choledocholithiasis" title=" choledocholithiasis"> choledocholithiasis</a>, <a href="https://publications.waset.org/abstracts/search?q=SpyGlass" title=" SpyGlass"> SpyGlass</a>, <a href="https://publications.waset.org/abstracts/search?q=cholangioscopy" title=" cholangioscopy"> cholangioscopy</a>, <a href="https://publications.waset.org/abstracts/search?q=laser" title=" laser"> laser</a>, <a href="https://publications.waset.org/abstracts/search?q=electrohydraulic%20system" title=" electrohydraulic system"> electrohydraulic system</a>, <a href="https://publications.waset.org/abstracts/search?q=ERCP" title=" ERCP"> ERCP</a> </p> <a href="https://publications.waset.org/abstracts/159352/endoscopic-treatment-of-patients-with-large-bile-duct-stones" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/159352.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">88</span> </span> </div> </div> </div> </main> <footer> <div id="infolinks" class="pt-3 pb-2"> <div class="container"> <div style="background-color:#f5f5f5;" class="p-3"> <div class="row"> <div class="col-md-2"> <ul class="list-unstyled"> About <li><a href="https://waset.org/page/support">About Us</a></li> <li><a href="https://waset.org/page/support#legal-information">Legal</a></li> <li><a target="_blank" rel="nofollow" href="https://publications.waset.org/static/files/WASET-16th-foundational-anniversary.pdf">WASET 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