Percutaneous Cryoablation of Symptomatic Abdominal Wall Endometriosis: Mid-Term Outcomes and Comparison with Surgery Alone in a Single Institution
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Percutaneous transhepatic biliary drainage (PTBD) effectively treats biliary obstruction in patients who previously failed endoscopic retrograde therapy, offering a viable final or initial approach for biliary decompression with minimal complications.
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Abstract
malignant obstruction, 1 patient had occluded pre-placed metallic stent by debris and pus and one patient had a stenotic bilioenteric anastomosis with inadequate history of previous surgery prior to ERCP. Rendez-vous technique was used in 2 patients for eventual placement of metallic stents. Clinical improvement evidenced with dropping bilirubin levels, resolving jaundice and sepsis-related symptoms were seen in all patients. Two-step external drainage with later conversion to internal metallic-stent drainage was performed in 2 patients. Single-step internal-external drainage was performed in 12 patients. No major complications were reported. Minor complications included fever, self-limiting intra-catheter bleed, skin infection, transitional catheter blockage and partial catheter dislodgment. Conclusions: PTBD remains an efficient method in the treatment of biliary obstruction in patients with failed retrograde endoscopic therapy. Our small series shows that PTBD remains the final resort in patients with failed endoscopic therapy in addition to its proven role as an initial approach for biliary decompression.
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Method
in the treatment of biliary obstruction in patients with
failed retrograde endoscopic therapy. Our small series shows
that PTBD remains the final resort in patients with failed
endoscopic therapy in addition to its proven role as an initial
approach for biliary decompression.
P407
To Compare the Efficacy and Complications of
16 Gauge and 18 Gauge Trucut Biopsy Needle in
Ultrasound Guided Percutaneous Liver Biopsies
Sadia Rashid, Junaid Iqbal
Dow University of Health Sciences, Karachi, Pakistan.
E‑mail: [email protected]
Background
Ultrasound guided percutaneous liver biopsy
is the gold standard for characterization of liver lesions and
determination of diffuse liver disease and liver fibrosis. It is an
easy but invasive method which sometimes may cause severe
complications. Methods: This is a prospective study conducted
from January 2016 to December 2016. A total of 426 patients
were included in the study, out of which 244 (57.3%) were
males while 182 (42.7%) were females. Mean age of the
patients was 54.62 ± 13.25 years. 202 (47.41%) patients
underwent liver biopsy by 16 gauge trucut biopsy needle while
224 (52.58%) patients had biopsies using 18 gauge needle.
Results
Overall, mild pain was found in 86 (20.2%) patients,
severe pain in 36 (8.5%) patients, vasovagal in 13 (3.1%)
patients, local hematoma in 12 (2.8%), severe hemorrhage in
3 (0.7%), pneumothorax in 2 (0.5%) patients while 20 (4.7%)
samples were inadequate. Comparison of complications in
both groups showed that except inadequate specimen and
severe pain, insignificant association of complications was
observed in both group. Number of inadequate specimen was
significantly higher in patients who underwent biopsy by 18
gauge trucut needle as compared to the patients who underwent
biopsy by 16 gauge needle ( P value 0.001). Severe pain was
significantly higher in patients who underwent biopsy by 16
gauge needle as compared to 18 gauge needle ( P value 0.016).
Conclusions
Ultrasound guided percutaneous liver biopsy
using either 16 or 18 gauge trucut needle is safe and effective
Method
to characterize liver lesions with very low rate of
complications. However 16 gauge needle should be preferred
as the inadequacy of specimen in our study was higher for 18
gauge needle.
P408
Percutaneous Cryoablation of Symptomatic
Abdominal Wall Endometriosis: Mid-Term
Outcomes and Comparison with Surgery Alone
in a Single Institution
Francois H. Cornelis, Julie Maillot 1,
Jean Luc Brun 1, Nicolas Grenier 1
Tenon Hospital, Paris, 1Pellegrin Hospital, Bordeaux, France.
E‑mail: [email protected]
Background
To compare the outcomes of percutaneous
image-guided cryoablation of symptomatic abdominal wall
endometriosis (AWE) versus surgery alone. Methods: From
2004 to 2016, cryoablation or surgery alone was performed
for AWE in a single institution in 7 (mean age: 36.1 y) and
13 (mean age: 31.9 y) patients, respectively. Fifteen lesions were
treated by cryoablation (mean size: 2.3 cm; range 0.5-7 cm)
and 16 by surgery (2.5 cm; 1.1‑3.4 cm). Tolerance, efficacy
and patient and procedural characteristics were compared.
Results
Median follow-up was 22.5 (range: 6-42) months after
cryoablation and 54 (14-149) after surgery. The median procedure
and hospitalization durations were 41.5 minutes (24-66) and
0.8 days (0-1) after cryoablation, and 73.5 minutes (35-160)
and 2.8 days (1-12 days) after surgery (both P = 0.01). Fifteen
patients had general and 5 had local anesthesia (3 cryoablations
and 2 surgery). Three patients (23.1%) had severe complications
and 9 esthetic sequels (69.2%) after surgery, none after
cryoablation (P = 0.05). The median 12 and 24-month symptom
free-survival rates were 100% and 66.7% [95%CI: 5.4; 94.5]
after cryoablation and 92% [55.3; 98.9] after surgery at both time
points ( P = 0.45). Conclusions: Cryoablation presents similar
effectiveness to surgery alone for local control of AWE while
reducing hospitalization duration and complications.
P501
Efficacy of Trans‑arterial Chemoembolization
in Combination with Percutaneous Ethanol
Injection for Hepatocellular Carcinoma
Muhammad Shozab Ahmed, Atif Rana,
Maham Jehangir
Shifa International Hospital, Islamabad, Pakistan.
E‑mail: [email protected]
Background
To evaluate combined efficacy of trans‑arterial
chemoembolization (TACE) using drug eluting beads,
Hepasphere (Merit medical, USA), with percutaneous ethanol
injection (PEI) for hepatocellular carcinoma (HCC) a retrospective
review was conducted. Methods: During January 2015 to January
2017, 34 patients with hepatocellular carcinoma underwent
combined therapies (TACE + PEI). Out of these two patient’s
were excluded because lipid was used.The tumour response at
3 months, 6 months, 12 months and 24 months was evaluated
using a pre‑defined criterion. Results: Most of the tumours were
located in right lobe. The tumour size ranged from 1-10 cm with
mean size of 4.2 cm. The average amount of alcohol used was
12 ml. The tumour response rates in the combined TACE + PEI
showed more than 90% reduction in arterialisation at 3 and
Article published online: 2021-04-26
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