ABSTRACT
PURPOSE: We sought to evaluate the feasibility and efficacy of percutaneous treatment of early postoperative biliary complications. The primary aims were to evaluate clinical and technical success and complications and perioperative mortality, and secondary aims were to evaluate treatment duration and recurrence rate. MATERIALS AND METHODS: Between March 2007 and March 2010, 75 patients (42 men and 33 women; age range, 17-88 years; mean age, 60.8 years) underwent interventional radiology procedures to treat early postoperative biliary complications of biliary and pancreatic-duodenal surgery with biliodigestive anastomosis (37.7%), laparoscopic cholecystectomy (30.6%), hepatic resection (21.1%) and several other surgical procedures (10.6%). Complications included fistulas (73%), stenoses (20%) and complete bile duct transections (7%). RESULTS: Interventional radiology achieved complete clinical success in 74 cases (85.9%) and in particular in 95.2% of fistulas, 76.5% of stenoses and 33.3% of complete bile duct transections. Mean indwelling catheter time was 34.9 days, with an average of 4.1 procedures. There were two cases of severe haemobilia (2.3%). Minor complications occurred in 7% of cases. Perioperative mortality rate was 1.2% and overall recurrence rate 6.7% (range, 1-18 months; mean, 10 months), with recurrences occurring predominantly in stenoses. All patients were retreated successfully. CONCLUSIONS: Percutaneous procedures are feasible, effective and safe for treating early postoperative biliary complications. They provide a valuable alternative to presendoscopy, which is precluded in many of these patients, and to surgery, which has higher morbidity and mortality rates.
Subject(s)
Biliary Tract Diseases/surgery , Duodenal Diseases/surgery , Liver Diseases/surgery , Pancreatic Diseases/surgery , Postoperative Complications/surgery , Radiography, Interventional , Ultrasonography, Interventional , Adolescent , Adult , Aged , Aged, 80 and over , Feasibility Studies , Female , Humans , Laparoscopy , Male , Middle Aged , Recurrence , Reoperation , Treatment OutcomeABSTRACT
A marker of neuroendocrine differentiation, neuron-specific enolase (NSE) is assessed in the diagnosis of small cell lung cancer (SCLC). The market was found to be highly sensitive and extremely specific in high risk groups (smokers and chronic bronchitics).
Subject(s)
Carcinoma, Small Cell/diagnosis , Lung Neoplasms/diagnosis , Phosphopyruvate Hydratase/analysis , Humans , SmokingABSTRACT
The value of CEA and Ca 19-9 assays in the diagnosis and staging of lung cancer is examined. The particular sensitivity of CEA especially in extensive or metastasised tumours is demonstrated. The minimal sensitivity of Ca 19-9 is pointed out but also its absolute specificity in high risk control groups (smokers and BPCO). It is therefore concluded that Ca 19-9 might be used together with CEA in the diagnosis and staging of lung cancer.
