Clinical Approach Strategy in Managing Complex Biliary Cases: Lesson Learnt from a Tertiary Referral Private Hospital
Introduction: In the era of laparoscopic procedure, there are innovations on non-surgical management approaches for managing biliary tract disorders, such as therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and interventional endoscopic ultrasound (EUS). There is still no clear cons...
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| Format: | Article |
| Language: | English |
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Interna Publishing
2024-05-01
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| Series: | The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy |
| Online Access: | https://ina-jghe.com/index.php/jghe/article/view/998 |
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| author | Cosmas Rinaldi Adithya Lesmana Maria Satya Paramitha Yulia Estu Pratiwi Laurentius Adrianto Lesmana |
| author_facet | Cosmas Rinaldi Adithya Lesmana Maria Satya Paramitha Yulia Estu Pratiwi Laurentius Adrianto Lesmana |
| author_sort | Cosmas Rinaldi Adithya Lesmana |
| collection | DOAJ |
| description | Introduction: In the era of laparoscopic procedure, there are innovations on non-surgical management approaches for managing biliary tract disorders, such as therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and interventional endoscopic ultrasound (EUS). There is still no clear consensus yet in step-approach for managing difficult biliary disorders. Method: A retrospective endoscopy database study was conducted. Complex biliary cases which included in this study, where multi-management approach is needed, biliary obstruction accompanied with cholangitis or biliary sepsis, difficult CBD stone, recurrent CBD stone, or advanced progressive malignant biliary obstruction. Results: Sixty-one subjects in this retrospective database study were considered as complex biliary cases. In this study, 16.4% of the subjects underwent combination of therapeutic ERCP and EUS in one session based on the complexity of the case; and 8.2% of the subjects underwent therapeutic ERCP with additional single operator cholangioscopy procedure. One subject underwent rendezvous ERCP procedure through percutaneous approach. Around 4.9% of the subjects underwent EUS-guided biliary drainage procedure. Conclusion: Complex biliary cases require a good clinical approach algorithm to decide which procedure comes first based on comprehensive evaluation consists of patient’s factor, expertise, cost, and the risk of complications.
Keywords: biliary tract; endoscopic retrograde cholangiography; endoscopic ultrasound; laparoscopic procedure |
| format | Article |
| id | doaj-art-6a8ee2a57cbc4be4a680debb0dece266 |
| institution | OA Journals |
| issn | 1411-4801 2302-8181 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy |
| spelling | doaj-art-6a8ee2a57cbc4be4a680debb0dece2662025-08-20T01:53:37ZengInterna PublishingThe Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy1411-48012302-81812024-05-0125121010.24871/25120242-10859Clinical Approach Strategy in Managing Complex Biliary Cases: Lesson Learnt from a Tertiary Referral Private HospitalCosmas Rinaldi Adithya Lesmana0Maria Satya Paramitha1Yulia Estu Pratiwi2Laurentius Adrianto Lesmana3- Department of Internal Medicine, Hepatobiliary Division, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia - Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Indonesia - Gastrointestinal Cancer Center, MRCCC Siloam Semanggi Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Hepatobiliary Division, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, IndonesiaDigestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Indonesia- Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Indonesia - Gastrointestinal Cancer Center, MRCCC Siloam Semanggi Hospital, Jakarta, IndonesiaIntroduction: In the era of laparoscopic procedure, there are innovations on non-surgical management approaches for managing biliary tract disorders, such as therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and interventional endoscopic ultrasound (EUS). There is still no clear consensus yet in step-approach for managing difficult biliary disorders. Method: A retrospective endoscopy database study was conducted. Complex biliary cases which included in this study, where multi-management approach is needed, biliary obstruction accompanied with cholangitis or biliary sepsis, difficult CBD stone, recurrent CBD stone, or advanced progressive malignant biliary obstruction. Results: Sixty-one subjects in this retrospective database study were considered as complex biliary cases. In this study, 16.4% of the subjects underwent combination of therapeutic ERCP and EUS in one session based on the complexity of the case; and 8.2% of the subjects underwent therapeutic ERCP with additional single operator cholangioscopy procedure. One subject underwent rendezvous ERCP procedure through percutaneous approach. Around 4.9% of the subjects underwent EUS-guided biliary drainage procedure. Conclusion: Complex biliary cases require a good clinical approach algorithm to decide which procedure comes first based on comprehensive evaluation consists of patient’s factor, expertise, cost, and the risk of complications. Keywords: biliary tract; endoscopic retrograde cholangiography; endoscopic ultrasound; laparoscopic procedurehttps://ina-jghe.com/index.php/jghe/article/view/998 |
| spellingShingle | Cosmas Rinaldi Adithya Lesmana Maria Satya Paramitha Yulia Estu Pratiwi Laurentius Adrianto Lesmana Clinical Approach Strategy in Managing Complex Biliary Cases: Lesson Learnt from a Tertiary Referral Private Hospital The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy |
| title | Clinical Approach Strategy in Managing Complex Biliary Cases: Lesson Learnt from a Tertiary Referral Private Hospital |
| title_full | Clinical Approach Strategy in Managing Complex Biliary Cases: Lesson Learnt from a Tertiary Referral Private Hospital |
| title_fullStr | Clinical Approach Strategy in Managing Complex Biliary Cases: Lesson Learnt from a Tertiary Referral Private Hospital |
| title_full_unstemmed | Clinical Approach Strategy in Managing Complex Biliary Cases: Lesson Learnt from a Tertiary Referral Private Hospital |
| title_short | Clinical Approach Strategy in Managing Complex Biliary Cases: Lesson Learnt from a Tertiary Referral Private Hospital |
| title_sort | clinical approach strategy in managing complex biliary cases lesson learnt from a tertiary referral private hospital |
| url | https://ina-jghe.com/index.php/jghe/article/view/998 |
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