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Introduction

Malignant biliary obstruction (MBO) is likely to be inoperative at first presentation. Palliative biliary drainage is essential to increase overall survival. Percutaneous transhepatic biliary stent (PTBS) is one of the most effective and safe procedure of biliary drainage in malignant biliary obstruction. However, there is no previous study in outcome, success rate and complications of PTBS insertion for biliary drainage of MBO in Thai population.

Aims & Methods

Aims: to determine outcome, success rate and complications of PTBS insertion in MBO in tertiary care medical center in Thailand.
Methods: A retrospective cohort study was performed on 41 patients with MBO underwent PTBS insertion from 2015 to 2021. Technical data, success rate, and outcome data including survival analysis, occlusion rate and complications were analysed.

Results

Of 41 patients, PTBS insertion had technical success 82.93% and functional success 70.59%. Median survival time of patients was 95 days (IQR 50-147 days). Occlusion rate occurred in only 22.6% of patients and all of them underwent percutaneous transhepatic biliary drainage (PTBD) as alternative palliative biliary drainage. Mean occlusion free survival time was 77.14 days (SD 51.68 days). Majority of patients (79.4%) did not have PTBS-related complications. The most common complication was acute cholangitis that found only in 6 patients (17.6%). Median complication free survival was 91 days (IQR 60-155 days). For the group of patients with functional success after PTBS insertion, the cumulative survival rates in 30- day,120-day, and 390-day and cumulative occlusion-free survival rates were statistically significantly better than those with functional failure (p=0.030 and p=0.007).

Demographic data	Patients
Age(year), mean (SD)	64.02 (9.21)
Male (%)	20 (48.78)
Etiologies of MBO Cholanhiocarcinoma (%) -Hilar type (%) -Distal type (%)	33 (80.49) 32 (96.97) 1 (3.03)
Pancreatic cancer (%)	3 (7.32)
Ampullary cancer (%)	3 (7.32)
Survival data after PTBS insertion	Days
Overall survival, median (IQR)	95 (50-147)
Occlusion free survival, mean (SD)	77.14 (51.58)
Complication free survival, median (IQR)	91 (60-155)

Conclusion

Outcomes and success rate of PTBS insertion in Srinagarind hospital were 82.93% in technical success and 70.59% in functional success. Functional success of PTBS insertion was the most important issue that related with better cumulative survival and occlusion-free survival.

References

1. Shim DJ et al. Percutaneous Metallic Stent Placement for Palliative Management of Malignant Biliary Hilar Obstruction. Korean J Radiol. 2018;19(4):597-605.
2. Zu QQ, Zhang JX, Wang B, Ye W, Liu S, Shi HB. Percutaneous transpapillary biliary stent placement for distal malignant biliary obstruction: Outcomes and survival analysis. Turk J Gastroenterol. 2019;30(8):714-21.
3. Fucilli F, Licinio R, Lorusso D, Giorgio P, Caruso ML. One stage percutaneous transhepatic biliary stenting for malignant jaundice: a safe, quick and economical option of treatment. Eur Rev Med Pharmacol Sci. 2019;23(17):7684-93.
4. Jeong YW, Shin KD, Kim SH, Kim IH, Kim SW, Lee KA, et al. [The safety assessment of percutaneous transhepatic transpapillary stent insertion in malignant obstructive jaundice: regarding the risk of pancreatitis and the effect of preliminary endoscopic sphincterotomy]. Korean J Gastroenterol. 2009;54(6):390-4.
5. Kozlov AV, Tarazov PG, Polikarpov AA, Popov VV. [Complications of trans- and suprapapillary percutaneous and transhepatic stenting of bile ducts in patients with mechanical jaundice of tumorous etiology]. Vestn Khir Im I I Grek. 2011;170(4):79-83.
6. Sun XR, Tang CW, Lu WM, Xu YQ, Feng WM, Bao Y, et al. Endoscopic Biliary Stenting Versus Percutaneous Transhepatic Biliary Stenting in Advanced Malignant Biliary Obstruction: Cost-effectiveness Analysis. Hepatogastroenterology. 2014;61(131):563-6.

STUDY OF OUTCOME AND SUCCESS RATE IN PERCUTANEOUS TRANSHEPATIC BILIARY STENT FOR MALIGNANT BILIARY OBSTRUCTION IN SRINAGARIND HOSPITAL, KHON KAEN UNIVERSITY

Chitchai Rattananukrom 1, Piyawat Eyosawat 2, Tanita Suttichaimongkol 1, Witsarut Manasirisuk 1, Jarin Chindaprasirt 3, Anucha Ahooja 2

1 Division of Gastroenterology and Hepatology, Department of Medicine, Srinagarind hospital, Khon Kaen University, Khon Kaen, Thailand

2 Department of Radiology, Srinagarind hospital, Khon Kaen University, Khon Kaen, Thailand

3 Division of Oncology, Department of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand

Conference

UEG Week Vienna 2024

Topics

Hepatobiliary

Submission format

Abstract

Session

BILIARY (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG Online Course

accredited

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Acute-on-Chronic Liver Failure (ACLF) is a critical medical condition characterised by the sudden deterioration of liver function in individuals with underlying chronic liver disease. This complex syndrome is marked by a rapid onset of severe liver dysfunction and is often associated with multiple organ failures. ACLF requires immediate medical attention and intervention, posing a high mortality risk. Effective management strategies and early detection are crucial in improving the prognosis for patients with ACLF, making it a significant focus in gastroenterology and hepatology.

Target audience

Gastroenterologists (in training)
Hepatologists (in training)
Intensive care specialists

Acute-on-Chronic Liver Failure

Benjamin Maasoumy, Tammo Lambert Tergast

Event

Acute-on-Chronic Liver Failure

Topics

Hepatobiliary

Accreditation status

accredited

Duration

1 hour

Published

2023

UEG Online Course

accredited

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Coeliac disease is a highly prevalent condition that, if left untreated, can be a major cause of morbidity worldwide. There is also increasing awareness of the role of a gluten-free diet in the management of patients with noncoeliac gluten sensitivity.

This online course provides the latest information on the diagnosis and management of coeliac disease and gluten-related disorders. Authors Stefania Chetcuti Zammit and David S. Sanders discuss the pathophysiology, epidemiology, symptoms, endoscopic features and extraintestinal manifestations of coeliac disease. They describe the general diagnostic approach to serology negative villous atrophy and present a diagnostic algorithm. Treatment options are also summarized, and awareness raised of the complications in patients with refractory coeliac disease.

The course includes comprehensive PPT slides and bespoke video presentations, which were filmed in June 2022. The estimated time needed to complete the course, including the final assessment, is 60 minutes

Target audience

This course is designed for gastroenterologists in training, other doctors with a special interest in coeliac disease, nurses (including nutrition nurses), dietitians, medical students and other health-care professionals looking after patients with coeliac disease or related disorders.

The diagnosis and management of coeliac disease and gluten-related disorders

David S. Sanders, Stefania Chetcuti Zammit

Event

The diagnosis and management of coeliac disease and gluten-related disorders

Topics

Small Intestine & Nutrition

Accreditation status

accredited

Duration

50 minutes

Published

2022

UEG Podcast Episode

Journal Podcast

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Toward a more precise prognostic stratification in acute decompensation of cirrhosis: The Padua model 2.0.

Haluk Tarik Kani 1, Alberto Zanetto 2

1 Department of Gastroenterology, Marmara University, School Of Medicine, Istanbul, Turkey

2 Gastroenterology/Multivisceral Transplant Unit, Padua, Italy

Topics

Hepatobiliary

Published

2024

UEG Online Course

not accredited

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Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent but largely asymptomatic disease that poses a major challenge to healthcare systems worldwide. Disease severity and outcome vary considerably and those at greatest risk of progression from steatosis and steatohepatitis to cirrhosis and hepatocellular carcinoma need to be identified.

This online course, from the multidisciplinary team of Quentin M. Anstee, Stuart McPherson, Kate Hallsworth and Laura Haigh, provides a comprehensive update on all aspects of NAFLD. After introducing the epidemiology and natural history of NAFLD, the course turns its attention to biomarkers, patient identification and care pathways, dietary and lifestyle interventions, and pharmacotherapy.

The course includes detailed PPT slides and bespoke video presentations, which were filmed in May 2022. The estimated time needed to complete the course, including the final assessment, is 120 minutes.

Target audience

This course is designed for gastroenterologists and/or hepatologists in training, liver pathologists, endocrinologists/diabetologists, primary care physicians, nurses, allied health professionals, basic scientists working in translational biomedicine, and medical students.

Metabolic Dysfunction-Associated Steatotic Liver Disease

Quentin Anstee, Stuart McPherson, Kate Hallsworth, Laura Haigh

Event

Metabolic Dysfunction-Associated Steatotic Liver Disease

Topics

Hepatobiliary

Accreditation status

not accredited

Duration

2 hours

Published

2022

UEG Online Course

accredited

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About this online course

Stem cells are primitive and undifferentiated cells in human tissues (foetal and adult) with self-renewal, multipotency and longevity properties. They are responsible for cellular regeneration within the gastrointestinal tract but also play an essential role in different GI pathologies (e.g., Barrett’s oesophagus).

A gastroenterologist’s guide to stem cells, by Simon Leedham and Stuart McDonalds, covers the basic definitions of stem cells and their different locations in the gastrointestinal tract, homeostasis, the role of stem cells in intestinal regeneration, metaplasia, and tumour heterogeneity. The course includes comprehensive PPT slides, and bespoke video presentations filmed in London in December 2022. Figures, schemes, and further readings are included for consideration. The combined material has a total duration of approximately 60 minutes. The estimated time needed to complete the course, including the final assessment, is 60 minutes.

Target audience

This course is suitable for gastroenterologists in training, but is also appropriate for nurses, basic scientist in gastroenterology, medical students with interest in gastroenterology as well as other physicians (oncology, regenerative medicine, research).

Gastroenterologist's guide to stem cells

Simon Leedham, Stuart McDonald

Event

Gastroenterologist's guide to stem cells

Accreditation status

accredited

Duration

1 hour

Published

2024

UEG Online Course

accredited

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Diverticular disease is a common and complex gastrointestinal condition, particularly in Western societies, where it places a significant burden on healthcare systems. While many with diverticulosis are asymptomatic, progression to conditions like diverticulitis, diverticular bleeding, or Segmental Colitis Associated with Diverticulosis (SCAD) can lead to serious health issues requiring effective management. This course, presented by experts Kassem Sharif, Adi Lahat, and Oded Zmora, offers a comprehensive overview of diverticular disease. It covers epidemiology, clinical presentation, diagnosis, pathophysiology, and treatment options, with a focus on managing complicated diverticulitis. The course includes 50 minutes of video lectures and PowerPoint presentations, with an estimated completion time of 60 minutes, including a final assessment.

Diverticular Disease

Oded Zmora, Kassem Sharif, Adi Lahat

Event

Diverticular Disease

Topics

Endoscopy

Accreditation status

accredited

Duration

1 hour

Published

2024

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