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Vitiello A, Spagnuolo M, Persico M, Peltrini R, Berardi G, Calabrese P, De Werra C, Rescigno C, Troisi R, Pilone V. Biliary Leak from Ducts of Luschka: Systematic Review of the Literature. SURGERIES 2024; 5:63-72. [DOI: 10.3390/surgeries5010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2024] Open
Abstract
Injury to the Luschka ducts (LDs), also named “subvesicular” ducts, is an under-reported cause of biliary leak following laparoscopic cholecystectomy (LC). A systematic literature search according to PRISMA guidelines was conducted in PubMed, EMBASE and Cochrane Library including all publications that described a bile leak from an LD. A total of 136 articles were retrieved from the searched databases. After the removal of duplicates and non-eligible papers, 48 studies reporting 231 leaks were included: 20 (41.6%) case reports, 2 (4.3%) comparative studies, 7 (14.9%) meeting abstracts and 19 (40.4%) retrospective cohort articles. The rate of LD leak ranges from 0.05% to 1.9%, but injury to a duct of Luschka was the second most common cause of biliary leakage in all the cohort studies (5.5% to 41%). In 21 (43.7%) cases, the leak was successfully treated with a sphincterotomy through Endoscopic Retrograde Cholangiopancreatography (ERCP) plus or minus stenting, and in 12 (25%), re-laparoscopy was necessary.
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Affiliation(s)
- Antonio Vitiello
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
| | - Maria Spagnuolo
- Public Health Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
| | - Marcello Persico
- Public Health Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
| | - Roberto Peltrini
- Public Health Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
| | - Giovanna Berardi
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
| | - Pietro Calabrese
- Public Health Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
| | - Carlo De Werra
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
| | - Carmela Rescigno
- Presidio Ospedaliero Santa Maria Incoronata dell’Olmo di Cava de’ Tirreni, Azienda Ospedaliera Integrata con l’Università, Via de Marinis, 84131 Cava dei Tirreni, Italy
| | - Roberto Troisi
- Clinical Medicine and Surgery Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
| | - Vincenzo Pilone
- Public Health Department, Naples “Federico II” University, AOU “Federico II”—Via S. Pansini 5, 80131 Naples, Italy
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Koimtzis GD, Chalklin CG, Carrington-Windo E, Ramsden M, Stefanopoulos L, Kosmidis CS. The Role of Fine Needle Aspiration Cytology in the Diagnosis of Gallbladder Cancer: A Systematic Review. Diagnostics (Basel) 2021; 11:diagnostics11081427. [PMID: 34441361 PMCID: PMC8393940 DOI: 10.3390/diagnostics11081427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 01/27/2023] Open
Abstract
Gallbladder cancer is the most common malignancy of the biliary tract. When diagnosed in an advanced stage it has a very poor prognosis. Therefore, early diagnosis and thorough assessment of a suspicious gallbladder polyp is essential to improve survival rate. The aim of this systematic review is to assess the role of fine needle aspiration cytology (FNAC) in the management of gallbladder cancer. For that purpose, a systematic review was carried out in the MEDLINE, EMBASE, Cochrane, Scopus and Google Scholar databases between 1 July 2004 and 22 April 2021. Six studies with 283 patients in total were included. Pooled sensitivity and specificity of FNAC were 0.85 and 0.94, respectively, while the area under the calculated summary receiver operating characteristic (SROC curve (AUC) was 0.98. No complications were reported. Based on the high diagnostic performance of FNAC in the assessment of gallbladder masses, we suggest that every suspicious mass should be evaluated further with FNAC to facilitate the most appropriate management.
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Affiliation(s)
- Georgios D. Koimtzis
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (E.C.-W.); (M.R.)
- Correspondence: ; Tel.: +44-77-1646-6710
| | - Christopher G. Chalklin
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (E.C.-W.); (M.R.)
| | - Eliot Carrington-Windo
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (E.C.-W.); (M.R.)
| | - Mark Ramsden
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (E.C.-W.); (M.R.)
| | - Leandros Stefanopoulos
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Christoforos S. Kosmidis
- 3rd Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki (AUTH), 54621 Thessaloniki, Greece;
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