BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally needed.Here,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotrips...BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally needed.Here,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy(EHL)by the percutaneous approach and rendezvous endoscopic retrograde cholangiography(ERC)using a nasal endoscope.CASE SUMMARY A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 mm.She was referred to our institution after the failure of lithotomy by ERC,and after undergoing percutaneous transhepatic biliary drainage.We attempted to fragment the stone by transhepatic cholangioscopy using EHL.However,the stones were too large and partly soft clay-like for lithotripsy.Next,we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete lithotomy.No complication was observed at the end of this procedure.CONCLUSION Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones.展开更多
The most common primary cancer derived from the liver is hepatocellular carcinoma(HCC),and its incidence is increasing globally(1).Hepatic resection has been established as a safe and effective treatment in patients w...The most common primary cancer derived from the liver is hepatocellular carcinoma(HCC),and its incidence is increasing globally(1).Hepatic resection has been established as a safe and effective treatment in patients with HCC.However,the number of patients who develop recurrence after hepatic resection remains high(2).The body composition,which consists of the skeletal muscle mass and fat area,is an important used to determine the perioperative risk and prognosis in patients with cancer.展开更多
Atezolizumab plus bevacizumab is currently the main choice of first-line treatment for unresectable hepatocellular carcinoma(HCC),which has been proven superior to sorafenib for overall survival(OS)and progression-fre...Atezolizumab plus bevacizumab is currently the main choice of first-line treatment for unresectable hepatocellular carcinoma(HCC),which has been proven superior to sorafenib for overall survival(OS)and progression-free survival(PFS)in the phase III IMbrave150 trial(1).Up-data analysis from IMbrave150 showed that the median OS was 19.2 months for atezolizumab plus bevacizumab and 13.4 months for sorafenib[hazard ratio(HR)=0.66;95%confidence interval(CI):0.52-0.85;P=0.0009],and the median PFS was 6.9 and 4.3 months(HR=0.65;95%CI:0.53-0.81;P=0.0001)(2).展开更多
文摘BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally needed.Here,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy(EHL)by the percutaneous approach and rendezvous endoscopic retrograde cholangiography(ERC)using a nasal endoscope.CASE SUMMARY A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 mm.She was referred to our institution after the failure of lithotomy by ERC,and after undergoing percutaneous transhepatic biliary drainage.We attempted to fragment the stone by transhepatic cholangioscopy using EHL.However,the stones were too large and partly soft clay-like for lithotripsy.Next,we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete lithotomy.No complication was observed at the end of this procedure.CONCLUSION Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones.
基金This study was supported by the following grant:JSPS KAKENHI,a Grant-in-Aid from the Ministry of Health,Labour and Welfare,Japan(JP-19K09198)The funding sources had no role in the collection,analysis,or interpretation of the data,or in the decision to submit the article for publication.
文摘The most common primary cancer derived from the liver is hepatocellular carcinoma(HCC),and its incidence is increasing globally(1).Hepatic resection has been established as a safe and effective treatment in patients with HCC.However,the number of patients who develop recurrence after hepatic resection remains high(2).The body composition,which consists of the skeletal muscle mass and fat area,is an important used to determine the perioperative risk and prognosis in patients with cancer.
文摘Atezolizumab plus bevacizumab is currently the main choice of first-line treatment for unresectable hepatocellular carcinoma(HCC),which has been proven superior to sorafenib for overall survival(OS)and progression-free survival(PFS)in the phase III IMbrave150 trial(1).Up-data analysis from IMbrave150 showed that the median OS was 19.2 months for atezolizumab plus bevacizumab and 13.4 months for sorafenib[hazard ratio(HR)=0.66;95%confidence interval(CI):0.52-0.85;P=0.0009],and the median PFS was 6.9 and 4.3 months(HR=0.65;95%CI:0.53-0.81;P=0.0001)(2).
