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Malignant biliary

Massimiliano Cadamuro, Simone Brivio, Joachim Mertens, Marta Vismara, Anja Moncsek, Chiara Milani, Christian Fingas, Maria Cristina Malerba, Giorgia Nardo, Luigi Dall'Olmo, Eleonora Milani, Valeria Mariotti, Tommaso Stecca, Marco Massani, Carlo Spirli, Romina Fiorotto, Stefano Indraccolo, Mario Strazzabosco, Luca Fabris
BACKGROUND: /Aims. In cholangiocarcinoma, early metastatic spread via lymphatic vessels often precludes curative therapies. Cholangiocarcinoma invasiveness is fostered by an extensive stromal reaction, enriched in cancer-associated fibroblasts (CAF) and lymphatic endothelial cells (LEC). Cholangiocarcinoma cells recruit and activate CAF by secreting PDGF-D. Here we investigated the role of PDGF-D and liver myofibroblasts in promoting lymphangiogenesis in cholangiocarcinoma. METHODS: Human cholangiocarcinoma specimens were immunostained for podoplanin (LEC marker), α-SMA (CAF), VEGF-A, VEGF-C, and their cognate receptors (VEGFR2, VEGFR3)...
December 13, 2018: Journal of Hepatology
Gudrun Aspelund, Elaa M Mahdi, David H Rothstein, Derek S Wakeman
Choledochal cysts (CDCs) and biliary atresia (BA) are rare pediatric hepatobiliary anomalies that require surgical intervention due to increased risk of malignancy and liver failure, respectively. The underlying disease and operative procedures place patients at risk for long-term complications, which may continue to affect them into adulthood. Lack of a transitional care model in the health care system potentiates the challenges they will face following aging out of their pediatric providers' care. We sought to elucidate the long-term complications and challenges patients with CDCs and BA face, review the current literature regarding transitioning care, and propose guidelines aiding adult providers in continued care and surveillance of these patients...
December 15, 2018: Journal of Gastroenterology and Hepatology
A V Shabunin, V V Bedin, M M Tavobilov, G M Chechenin, S S Lebedev, N A Ivanova
In the time period from 2009 to 2017 in Botkin Hospital (Moscow) bilateral biliary stenting was performed in 43 patients with malignant common hepatic duct stricture. Patients were divided into 2 statistically homogeneous groups: 'side-by-side' stenting in 28 patients and percutaneous 'Y'-biliary stent placement in 15 patients. The causes of malignant obstruction were as follows: in the 1st group 13 (46.4%) patients with extrahepatic cholangiocarcinoma (46.4%), 8 (28.6%) patients with intrahepatic cholangiocarcinoma, 4 (14...
2018: Khirurgiia
S S Shestopalov, S A Mikhaylova, E I Abramov, E V Ozhigina
AIM: To determine optimal terms of biliary decompression and bile reinfusion into gastrointestinal tract in patients with malignant obstructive jaundice. MATERIAL AND METHODS: 179 medical records of patients with obstructive jaundice were analyzed to identify risk factors of postoperative complications. Prospective research included bile examination in 34 patients with malignant obstructive jaundice. New algorithm of preoperative management was proposed. RESULTS: Hyperbilirubinemia over 50 μmol/l prior to radical surgery and 80 μmol/l before palliative surgery was followed by postoperative morbidity augmentation from 42...
2018: Khirurgiia
Kenjiro Yamamoto, Takao Itoi, Takayoshi Tsuchiya, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, Shuntaro Mukai, Mitsuru Fujita, Yasutsugu Asai, Yukitoshi Matsunami, Takashi Kurosawa, Atsushi Sofuni, Yuichi Nagakawa
Background and Objectives: Recently, a novel EUS-guided biliary drainage (EUS-BD) technique consisting of EUS-guided antegrade stenting and EUS-guided hepaticoenterostomy (EUS-AS+HES) using two conventional metal stents (MS) has been reported to decrease adverse events and maintain longer stent patency for malignant biliary obstruction (MBO). However, only a few limited reports have evaluated this technique. Finally, dedicated plastic stents (PSs) have been developed to perform EUS-HES safely...
November 2018: Endoscopic Ultrasound
Jintao Guo, Marc Giovannini, Anand V Sahai, Adrian Saftoiu, Christoph F Dietrich, Erwin Santo, Pietro Fusaroli, Ali A Siddiqui, Manoop S Bhutani, Anthony Yuen Bun Teoh, Atsushi Irisawa, Brenda Lucia Arturo Arias, Chalapathi Rao Achanta, Christian Jenssen, Dong-Wan Seo, Douglas G Adler, Evangelos Kalaitzakis, Everson Artifon, Fumihide Itokawa, Jan Werner Poley, Girish Mishra, Khek Yu Ho, Hsiu-Po Wang, Hussein Hassan Okasha, Jesse Lachter, Juan J Vila, Julio Iglesias-Garcia, Kenji Yamao, Kenjiro Yasuda, Kensuke Kubota, Laurent Palazzo, Luis Carlos Sabbagh, Malay Sharma, Mitsuhiro Kida, Mohamed El-Nady, Nam Q Nguyen, Peter Vilmann, Pramod Kumar Garg, Praveer Rai, Shuntaro Mukai, Silvia Carrara, Sreeram Parupudi, Subbaramiah Sridhar, Sundeep Lakhtakia, Surinder S Rana, Takeshi Ogura, Todd H Baron, Vinay Dhir, Siyu Sun
Background and Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed. Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD. Results: Forty-six endoscopists of them completed the survey...
November 2018: Endoscopic Ultrasound
Jaehyun Yim, Dongho Hyun, Sung Ki Cho, Kwang Bo Park, Hong Suk Park, Sung Wook Shin, Dong Wook Choi, Seonwoo Kim, Sung-Young Baek, Sang Yub Lee
PURPOSE: To retrospectively investigate the impact of hyperbilirubinemia on future liver remnant (FLR) volume after percutaneous transhepatic portal vein embolization (PVE) and incidence of post-hepatectomy liver failure in primary biliary malignancy. MATERIALS AND METHODS: Eighty-seven patients (62 men, overall mean age 66.9 y) who underwent PVE, using Gelfoam and coils before major hepatectomy between January 2004 and June 2016, were included in this study and divided into a hyperbilirubinemia (serum total bilirubin level at PVE 5...
December 6, 2018: Journal of Vascular and Interventional Radiology: JVIR
Grace Gold, Su Kah Goh, Christopher Christophi, Vijayaragavan Muralidharan
INTRODUCTION: Serum carbohydrate antigen 19-9 (CA19-9) is routinely used in the management of pancreatic cancer for diagnosis, prognostication and surveillance purposes despite its low specificity. CASE PRESENTATION: This case report demonstrates the challenges of interpreting elevated serum CA19.9 levels in a patient with pancreatic cancer. We performed a Whipple's procedure in an otherwise fit 78-year-old man for pancreatic adenocarcinoma. One year after surgery, he presented with a non-malignant anastomotic stricture that was associated with an elevated serum CA19-9...
November 20, 2018: International Journal of Surgery Case Reports
Audrey Fohlen, Celine Bazille, Benjamin Menahem, Marc Antoine Jegonday, Benoit Dupont, Vincent Le Pennec, Jean Lubrano, Boris Guiu, Jean Pierre Pelage
PURPOSE: This study was conducted in order to investigate the safety and accuracy of percutaneous transluminal forceps biopsy (PTFB) during percutaneous biliary drainage (PTBD) in patients with a suspicion of malignant biliary stricture. MATERIAL AND METHODS: Fifty consecutive patients with obstructive jaundice underwent PTFB during PTBD. Biopsy specimens were obtained using 5.2-F flexible biopsy forceps and these specimens were independently analysed by two pathologists...
December 3, 2018: European Radiology
Erik von Seth, Helena Ouchterlony, Katalin Dobra, Anders Hjerpe, Urban Arnelo, Stephan Haas, Annika Bergquist
BACKGROUND AND AIMS: Detection of early cholangiocarcinoma (CCA) in primary sclerosing cholangitis (PSC) is challenging. The aim of this study was to evaluate the diagnostic accuracy of a stepwise approach to biliary brush cytology with sequential use of fluorescence in-situ hybridization (FISH) for the detection of biliary malignancy in PSC. METHOD: We retrospectively studied consecutive patients with PSC who underwent biliary brushings at Karolinska University Hospital between 2009 and 2015 (n = 208)...
December 2, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Yilin Liu, Xiaotian Zhang
Acute abdomen in patients with malignant tumors is called malignant acute abdomen, often seen in the digestive system tumor or abdominal pelvic metastasis of the other primary tumors. Bleeding, perforation, gastrointestinal obstruction, biliary obstruction with infection, acute peritonitis are acute and severe, however, prevention is more important than treatment. For high-risk patients, even if acute abdomen does not occur when the disease is diagnosed, we should make precautions, including actively local treatment of local lymph nodes or primary lesions and careful choice of drugs...
November 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Wei-Zhong Zhou, Yong-Meng Fu, Zheng-Qiang Yang, Hai-Bin Shi, Sheng Liu, Jin-Guo Xia, Chun-Gao Zhou
PURPOSE: To evaluate the effectiveness and safety of simultaneous placement of a self-expandable metallic stents (SEMS) and iodine-125 seed strand in the management of malignant obstructive jaundice (MOJ). MATERIALS AND METHODS: This study included 132 patients with MOJ treated from November 2015 to October 2017. Forty-five patients underwent insertion of SEMS with iodine-125 seed strands (Seeds group); the remaining 87 patients underwent SEMS placement alone (Control group)...
November 30, 2018: Cardiovascular and Interventional Radiology
Ian Nora, Ravi Shridhar, Jamie Huston, Kenneth Meredith
Background: Accurate predictors of locally advanced and recurrence disease in patients with gastrointestinal cancer are currently lacking. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have emerged as possible markers for predicting recurrence in these patients. In this study, we sought to evaluate the utility of NLR and PLR in predicting the presence of regional nodal disease, metastasis and systemic recurrence in patients with gastrointestinal malignancies...
October 2018: Journal of Gastrointestinal Oncology
Adriana N López-Ramírez, Lidia F Villegas-González, Mónica L Serrano-Arévalo, Lorena Flores-Hernández, Leonardo S Lino-Silva, Ludwig E González-Mena
Background: Our aim was to evaluate the application of the classification of the Papanicolaou Cytopathology Society for the report of biopsies by fine-needle aspiration (FNA) of pancreas and bile duct. Methods: The FNAs obtained consecutively during 1 year were analyzed. Descriptive statistics were performed and sensitivity, specificity, positive predictive value, negative predictive value, and cytohistological correlation were determined. The reference standard test was the histopathological study...
October 2018: Journal of Gastrointestinal Oncology
Caterina L Mammola, Antonella Vetuschi, Luigi Pannarale, Roberta Sferra, Romina Mancinelli
Cholangiocarcinoma (CCA) is an aggressive biliary tract malignancy with limited treatment options and low survival rates. The intrahepatic subtype comprises two forms: mucin-iCCA and mixed-iCCA. Epidermal growth factor-like domain multiple (EGFL7) is overexpressed in less differentiated liver tumors. The aim of this study was to assess the presence of EGFL7 due to its possible role in the growth of CCA. Hematoxylin and Eosin and periodic acid-Schiff staining were used to evaluate the morphological aspects and glycogen deposition...
November 30, 2018: European Journal of Histochemistry: EJH
Filippo Parolini, Giovanni Boroni, Susanna Milianti, Luca Tonegatti, Andrea Armellini, Miguel Garcia Magne, Pierluigi Pedersini, Fabio Torri, Paolo Orizio, Stefano Benvenuti, Daniela Maria De Previde Prato, Daniele Alberti
INTRODUCTION: Biliary atresia (BA) represents the leading indication for liver transplantation in childhood. Only few studies reported the outcome of patients who survived more than 20 years on their native liver, and up to date there are no Italian data available. We reported our 40-year single centre experience with long-term follow-up of BA patients. MATERIALS AND METHODS: All consecutive patients who underwent Kasai portoenterostomy (KPE) for BA managed at our Institution between 1975 and 1996 were retrospectively reviewed...
November 6, 2018: Journal of Pediatric Surgery
Fatma Hüsniye Dilek, Şebnem Karasu, Osman Nuri Dilek
Heterotopic tissue in the bile duct is a very rare condition. There are a few case reports of heterotopic tissue including gastric and pancreatic cells. However, we could not find any data regarding heterotopic chondroid tissue obstructing the common bile duct in the literature. A 56-year-old woman was admitted to our hospital with complaints of progressive jaundice and pruritus. Laboratory test results were within the normal limits except bilirubin and alkaline phosphatase which were 10.8 mg/dL and 256 IU/L, respectively...
November 29, 2018: Clinical Journal of Gastroenterology
Antonio Pea, Giulio Riva, Riccardo Bernasconi, Elisabetta Sereni, Rita Teresa Lawlor, Aldo Scarpa, Claudio Luchini
Ampulla of Vater is a peculiar anatomical structure, characterized by the crossroad of three distinct epithelia: Intestinal, ductal pancreatic and biliary. Adenocarcinomas arising in this area represent an opportunity to understand the comparative biology of all periampullary malignancies. These neoplasms can exhibit intestinal, pancreaticobiliary or mixed features, whereas the subclassification based on morphology and immunohistochemical features failed in demonstrating a robust prognostic reliability. In the last few years, the molecular landscape of this tumor entity has been uncovered, identifying alterations that may serve as prognostic and predictive biomarkers...
November 15, 2018: World Journal of Gastrointestinal Oncology
M M Hasan, Y Zhen-Lin, M Jun-Yong
Biliary leakage is a postoperative complication of liver resection which may have considerable consequences. The aim of this study is to evaluate the incidence of post hepatectomy biliary leakage and to find out the preventive measures by systemic literature reviews. This observational study was conducted on 500 patients who required various forms of hepatic resection at the Department of Hepatic Surgery - 4, Eastern Hepatobiliary Surgery Hospital of The Second Military Medical University, Shanghai, China from September 2014 to July 2016...
October 2018: Mymensingh Medical Journal: MMJ
Igor Barjaktarevic, Roxana Cortes Lopez, Randolph Steadman, Christopher Wray, Nida Qadir, Steven Y Chang, Tisha Wang
Liver transplantation (LT) has the potential to cure patients with acute and chronic liver failure as well as a number of hepatic and biliary malignancies. Over time, due to the increasing demand for organs as well as improvements in the survival of LT recipients, patients awaiting LT have become sicker, and often undergo the procedure while critically ill. This trend has made the process of preoperative assessment and planning, intraoperative management, and postoperative management even more crucial to the success of LT programs...
October 2018: Seminars in Respiratory and Critical Care Medicine
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