Diagnostic investigation, intervention, and outcome for post-subtotal gastrectomy patients who present with jaundice
PurposeEndoscopic retrograde cholangiopancreatography (ERCP) is a useful diagnostic and interventional tool in patients with obstructive jaundice. In patients who had subtotal gastrectomy, however, the implementation of ERCP has become more difficult. This study aims to investigate the accuracy of c...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1485442/full |
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| author | Duan Wang Duan Wang Liang Zhu Fanyi Kong Fanyi Kong Yingyu Pan Yingyu Pan Wei Liu Xuan Wang Weidong Pan Jian Cao Qiang Xu Dong Wu Dong Wu Dong Wu |
| author_facet | Duan Wang Duan Wang Liang Zhu Fanyi Kong Fanyi Kong Yingyu Pan Yingyu Pan Wei Liu Xuan Wang Weidong Pan Jian Cao Qiang Xu Dong Wu Dong Wu Dong Wu |
| author_sort | Duan Wang |
| collection | DOAJ |
| description | PurposeEndoscopic retrograde cholangiopancreatography (ERCP) is a useful diagnostic and interventional tool in patients with obstructive jaundice. In patients who had subtotal gastrectomy, however, the implementation of ERCP has become more difficult. This study aims to investigate the accuracy of contrast-enhanced CT, MRI/MRCP and PET/CT in lesion localization, characterization, and extent evaluation in post-subtotal gastrectomy patients who present with obstructive jaundice. The interventional methods for biliary drainage, their success rate and patient outcome were also investigated.MethodsElectronic medical records were reviewed to identify patients hospitalized for obstructive jaundice at Peking Union Medical College Hospital, who had previously undergone subtotal gastrectomy. The clinical information, imaging and interventional examination data of those patients were retrospectively collected.ResultsBetween 2018 and 2023, 36 patients with previous subtotal gastrectomy were hospitalized for ob-structive jaundice at our hospital. The majority of lesions were malignant, including 19 gastric cancer recurrence (47.5%), and 12 other malignancies (30.0%). Benign lesions included inflammatory biliary stricture, biliary stones, and IgG4-related disease. The three imaging modalities had similar performance in lesion localization and characterization, whereas PET/CT showed higher accuracy compared to MR and CT in detecting extensive disease (92.8% vs. 83.3% vs. 60.0%). Percutaneous transhepatic cholangial drainage was applied more frequently than ERCP and surgery (69.4% vs. 25.0% vs. 5.5%), and there was no significant difference concerning technical and clini-cal success rate and complication.ConclusionGastric cancer recurrence and newly-developed pancreaticobiliary malignancies were the main causes of obstructive jaundice in patients who had subtotal gastrectomy. PET/CT was superior to MRI/MRCP and contrast-enhanced CT in determining lesion extensiveness. Percutaneous transhepatic cholangial drainage (PTCD) was the preferred method for managing obstructive jaundice. Despite the effectiveness of interventions, a significant number of patients experienced short-term disease progression. |
| format | Article |
| id | doaj-art-71798ddccae54d09b2ce4a6780ce728f |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-71798ddccae54d09b2ce4a6780ce728f2025-02-12T07:25:51ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-02-011210.3389/fmed.2025.14854421485442Diagnostic investigation, intervention, and outcome for post-subtotal gastrectomy patients who present with jaundiceDuan Wang0Duan Wang1Liang Zhu2Fanyi Kong3Fanyi Kong4Yingyu Pan5Yingyu Pan6Wei Liu7Xuan Wang8Weidong Pan9Jian Cao10Qiang Xu11Dong Wu12Dong Wu13Dong Wu14Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Gastroenterology, Tibet Autonomous Region People's Hospital, Lhasa, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Gastroenterology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Gastroenterology, Tibet Autonomous Region People's Hospital, Lhasa, ChinaDepartment of Gastroenterology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Gastroenterology, Tibet Autonomous Region People's Hospital, Lhasa, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of General Surgery, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Gastroenterology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Gastroenterology, Tibet Autonomous Region People's Hospital, Lhasa, ChinaClinical Epidemiology Unit, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaPurposeEndoscopic retrograde cholangiopancreatography (ERCP) is a useful diagnostic and interventional tool in patients with obstructive jaundice. In patients who had subtotal gastrectomy, however, the implementation of ERCP has become more difficult. This study aims to investigate the accuracy of contrast-enhanced CT, MRI/MRCP and PET/CT in lesion localization, characterization, and extent evaluation in post-subtotal gastrectomy patients who present with obstructive jaundice. The interventional methods for biliary drainage, their success rate and patient outcome were also investigated.MethodsElectronic medical records were reviewed to identify patients hospitalized for obstructive jaundice at Peking Union Medical College Hospital, who had previously undergone subtotal gastrectomy. The clinical information, imaging and interventional examination data of those patients were retrospectively collected.ResultsBetween 2018 and 2023, 36 patients with previous subtotal gastrectomy were hospitalized for ob-structive jaundice at our hospital. The majority of lesions were malignant, including 19 gastric cancer recurrence (47.5%), and 12 other malignancies (30.0%). Benign lesions included inflammatory biliary stricture, biliary stones, and IgG4-related disease. The three imaging modalities had similar performance in lesion localization and characterization, whereas PET/CT showed higher accuracy compared to MR and CT in detecting extensive disease (92.8% vs. 83.3% vs. 60.0%). Percutaneous transhepatic cholangial drainage was applied more frequently than ERCP and surgery (69.4% vs. 25.0% vs. 5.5%), and there was no significant difference concerning technical and clini-cal success rate and complication.ConclusionGastric cancer recurrence and newly-developed pancreaticobiliary malignancies were the main causes of obstructive jaundice in patients who had subtotal gastrectomy. PET/CT was superior to MRI/MRCP and contrast-enhanced CT in determining lesion extensiveness. Percutaneous transhepatic cholangial drainage (PTCD) was the preferred method for managing obstructive jaundice. Despite the effectiveness of interventions, a significant number of patients experienced short-term disease progression.https://www.frontiersin.org/articles/10.3389/fmed.2025.1485442/fullobstructive jaundicesubtotal gastrectomyimaginginterventionoutcome |
| spellingShingle | Duan Wang Duan Wang Liang Zhu Fanyi Kong Fanyi Kong Yingyu Pan Yingyu Pan Wei Liu Xuan Wang Weidong Pan Jian Cao Qiang Xu Dong Wu Dong Wu Dong Wu Diagnostic investigation, intervention, and outcome for post-subtotal gastrectomy patients who present with jaundice Frontiers in Medicine obstructive jaundice subtotal gastrectomy imaging intervention outcome |
| title | Diagnostic investigation, intervention, and outcome for post-subtotal gastrectomy patients who present with jaundice |
| title_full | Diagnostic investigation, intervention, and outcome for post-subtotal gastrectomy patients who present with jaundice |
| title_fullStr | Diagnostic investigation, intervention, and outcome for post-subtotal gastrectomy patients who present with jaundice |
| title_full_unstemmed | Diagnostic investigation, intervention, and outcome for post-subtotal gastrectomy patients who present with jaundice |
| title_short | Diagnostic investigation, intervention, and outcome for post-subtotal gastrectomy patients who present with jaundice |
| title_sort | diagnostic investigation intervention and outcome for post subtotal gastrectomy patients who present with jaundice |
| topic | obstructive jaundice subtotal gastrectomy imaging intervention outcome |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1485442/full |
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