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Jaundice AND gallbladder cancer

Davide La Regina, Francesco Mongelli, Stefano Cafarotti, Andrea Saporito, Marcello Ceppi, Matteo Di Giuseppe, Antonjacopo Ferrario di Tor Vajana
BACKGROUND: Surgical site infections complicate elective laparoscopic cholecystectomies in 2,4-3,2% of cases. During the operation the gallbladder is commonly extracted with a retrieval bag. We conducted a meta-analysis to clarify whether its use plays a role in preventing infections. METHODS: Inclusion criteria: elective cholecystectomy, details about the gallbladder extraction and data about local or systemic infection rate. EXCLUSION CRITERIA: cholecystitis, jaundice, concurrent antibiotic therapy, immunosuppression, cancer...
November 19, 2018: BMC Surgery
Bobby V M Dasari, Mihnea I Ionescu, Timothy M Pawlik, James Hodson, Robert P Sutcliffe, Keith J Roberts, Paolo Muiesan, John Isaac, Ravi Marudanayagam, Darius F Mirza
INTRODUCTION: Preoperative jaundice is considered a relative contraindication to radical gallbladder cancer (GBC) resection due to poor prognosis and high postoperative morbidity. Recent reports have indicated that aggressive surgery may improve long-term survival for patients with advanced GBC who present with obstructive jaundice. The current systematic review and meta-analysis aimed to compare postoperative outcomes among jaundiced and non-jaundiced patients with resectable GBC. METHODS: An electronic search was performed using several Medical Subject Headings terms: cholecyst, gallbladder, tumor, cancer, carcinoma, adenocarcinoma, neoplasia, neoplasm, jaundice, and icterus...
September 2018: Journal of Surgical Oncology
Gennaro Clemente, Andrea Tringali, Agostino M De Rose, Elena Panettieri, Marino Murazio, Gennaro Nuzzo, Felice Giuliante
Background: Mirizzi syndrome is a condition difficult to diagnose and treat, representing a particular "challenge" for the biliary surgeon. The disease can mimic cancer of the gallbladder, causing considerable diagnostic difficulties. Furthermore, it increases the risk of intraoperative biliary injury during cholecystectomy. The aim of this study is to point out some particular aspects of diagnosis and treatment of this condition. Methods: The clinical records of patients with Mirizzi syndrome, treated in the last five years, were reviewed...
2018: Canadian Journal of Gastroenterology & Hepatology
Wei-Yu Xu, Hao-Hai Zhang, Jian-Ping Xiong, Xiao-Bo Yang, Yi Bai, Jian-Zhen Lin, Jun-Yu Long, Yong-Chang Zheng, Hai-Tao Zhao, Xin-Ting Sang
AIM: To investigate the prognostic role of fibrinogen-to-albumin ratio (FAR) on patients with gallbladder cancer (GBC) in this study. METHODS: One hundred and fifty-four GBC patients were retrospectively analyzed, who received potentially curative cholecystectomy in our institute from March 2005 to December 2017. Receiver operating characteristic curve (ROC curve) was used to determine the optimal cut-offs for these biomarkers. In addition, Kaplan-Meier survival analysis as well as multivariate analysis were applied for prognostic analyses...
August 7, 2018: World Journal of Gastroenterology: WJG
Z H Tang, Z M Geng, C Chen, S B Si, Z Q Cai, T Q Song, P Gong, L Jiang, Y H Qiu, Y He, W L Zhai, S P Li, Y C Zhang, Y Yang
Objective: To investigate the clinical value of Bayesian network in predicting survival of patients with advanced gallbladder cancer(GBC)who underwent curative intent surgery. Methods: The clinical data of patients with advanced GBC who underwent curative intent surgery in 9 institutions from January 2010 to December 2015 were analyzed retrospectively.A median survival time model based on a tree augmented naïve Bayes algorithm was established by Bayesia Lab software.The survival time, number of metastatic lymph nodes(NMLN), T stage, pathological grade, margin, jaundice, liver invasion, age, sex and tumor morphology were included in this model...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Alexandra G Lopez-Aguiar, Cecilia G Ethun, Mia R McInnis, Timothy M Pawlik, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley A Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza W Beal, Ioannis Hatzaras, Rivfka Shenoy, Kenneth Cardona, Shishir K Maithel
BACKGROUND AND OBJECTIVES: Perioperative blood transfusion is associated with poor outcomes in several malignancies. Its effect in gallbladder cancer (GBC) is unknown. METHODS: All patients with GBC who underwent curative-intent resection at 10-institutions from 2000 to 2015 were included. The effect of blood transfusion on overall survival (OS) and recurrence-free (RFS) was evaluated. RESULTS: Of 262 patients with curative-intent resection for GBC, 61 patients (23%) received blood transfusions...
June 2018: Journal of Surgical Oncology
Iago Justo, Alberto Marcacuzco, Oana-Anisa Nutu, Alejandro Manrique, Jorge Calvo, Óscar Caso, Félix Cambra, Álvaro García-Sesma, Luis Carlos Jiménez-Romero
INTRODUCTION: gallbladder cancer is the most common biliary neoplasm and the sixth most common tumor of the digestive system. The disease has an ominous prognosis, with a 5-year survival rate of approximately 5%. It is usually diagnosed late and surgical resection is the only potential cure. METHODS: a retrospective study was carried out in 92 patients with a pathological diagnosis of gallbladder cancer from January 2000 to January 2016. RESULTS: the mean age of cases was 72 ± 11 years; 64 subjects were females and 28 were males...
August 2018: Revista Española de Enfermedades Digestivas
Yoshiki Hirooka, Takuya Ishikawa, Hiroki Kawashima, Eizaburo Ohno, Koji Nonogaki, Akira Kanamori, Takanori Hirai, Hiroki Uchida, Osamu Shirai, Hideki Ishikawa, Hidemi Goto
PURPOSE: To evaluate the efficacy and safety of gemcitabine plus cisplatin in Japanese patients with unresectable gallbladder cancer (GBC). METHODS: Chemo-naïve patients with histologically proven unresectable GBC were enrolled in this study. The patients received gemcitabine (1000 mg/m2 ) and cisplatin (25 mg/m2 ) on days 1 and 8, every 21 days. A response assessment was done by CT scan every 4 weeks. The primary end points were to determine the response rates [RR; complete response (CR) + partial response (PR)] and the disease control rate [DCR; CR + PR + stable disease (SD)]...
July 2017: Cancer Chemotherapy and Pharmacology
Thuy B Tran, Jeffrey A Norton, Cecilia G Ethun, Timothy M Pawlik, Stefan Buettner, Carl Schmidt, Eliza W Beal, William G Hawkins, Ryan C Fields, Bradley A Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Kamran Idrees, Chelsea A Isom, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, George A Poultsides
BACKGROUND: Jaundice as a presenting symptom of gallbladder cancer has traditionally been considered to be a sign of advanced disease, inoperability, and poor outcome. However, recent studies have demonstrated that a small subset of these patients can undergo resection with curative intent. METHODS: Patients with gallbladder cancer managed surgically from 2000 to 2014 in 10 US academic institutions were stratified based on the presence of jaundice at presentation (defined as bilirubin ≥4 mg/ml or requiring preoperative biliary drainage)...
August 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Pramod Kumar Mishra, Sundeep Singh Saluja, Nabi Prithiviraj, Vaibhav Varshney, Neeraj Goel, Nilesh Patil
BACKGROUND: Gallbladder cancer (GBC) is an aggressive malignancy. We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ). METHODS: Four hundred and thirty-seven patients with suspected GBC were analysed (52 excluded: benign pathology n = 35, missed GBC n = 17). The remaining 385 patients were divided into non-SOJ (n = 234) and SOJ (n = 151) groups. Predictors of resectability and long term survival were analysed and compared with their subgroups...
August 2017: American Journal of Surgery
Claudio Mengoa Quintanilla, Giovanni De la Cruz Robles, Sergio Puma Condori, Carol Durand Mendoza
Gallbladder cancer is the most common malignancy of the biliary tract. Usually seen in advanced stages. There are still many controversies about the type of curative surgical treatment for each stage of the disease. The only chance of long term survival for patients with advanced tumors is aggressive, large surgeries that implies multiorgan resection.We report the case of a patient with gallbladder cancer with jaundice at diagnosis, who underwent extended hepatectomy (segment IV B, segment I and extra hepatic hilar bile duct included)...
October 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Laurie Larson, Michelle James, Andrea Gossard
The most common causes of chronic cholestatic liver disease are primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). Both disease processes are characterized by a destruction of intrahepatic and/or extrahepatic biliary ducts. The etiology is not entirely clear; however, there is an underlying autoimmune component contributing to both disease processes. Although PBC and PSC are often diagnosed and managed in the outpatient setting, in some instances, a patient may have jaundice, fatigue, and pruritus requiring evaluation and determination of the cholestatic cause...
October 2016: AACN Advanced Critical Care
Hiroaki Aoki, Masayo Aoki, Jing Yang, Eriko Katsuta, Partha Mukhopadhyay, Rajesh Ramanathan, Ingrid A Woelfel, Xuan Wang, Sarah Spiegel, Huiping Zhou, Kazuaki Takabe
BACKGROUND: With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of three murine models of obstructive jaundice. METHODS: C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models...
November 2016: Journal of Surgical Research
Sujit S Kulkarni, Mayo Hotta, Linda Sher, Robert R Selby, Dilipkumar Parekh, James Buxbaum, Maria Stapfer
BACKGROUND: Mirizzi syndrome (MS) is characterized by an obstruction of the proximal bile duct due to extrinsic compression by either an impacted stone in the gallbladder neck or local inflammatory changes. Although this is a rare syndrome in developed countries (0.7-1.4 %), preoperative diagnosis and careful surgical management are essential to avoid bilio-vascular injuries and misdiagnosed malignancy. METHODS: The purpose of this study was to review our experience in the diagnosis and management of MS, assess the role of laparoscopy and the risk of concomitant gallbladder carcinoma...
May 2017: Surgical Endoscopy
Dao-Jian Gao, Bing Hu, Xin Ye, Tian-Tian Wang, Jun Wu
BACKGROUND AND AIM: Metal stents usually have a longer stent patency than plastic stents for malignant biliary obstruction. However, stent patency and patient survival may differ depending on the causative disease and stent type. There are no data regarding the selection of stents for unresectable gallbladder cancer (GC) with hilar duct obstruction. The aim of the present study was to evaluate the efficacy of metal versus plastic stents for unresectable GC with hilar duct obstruction...
January 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Naoki Sasahira, Tsuyoshi Hamada, Osamu Togawa, Ryuichi Yamamoto, Tomohisa Iwai, Kiichi Tamada, Yoshiaki Kawaguchi, Kenji Shimura, Takero Koike, Yu Yoshida, Kazuya Sugimori, Shomei Ryozawa, Toshiharu Kakimoto, Ko Nishikawa, Katsuya Kitamura, Tsunao Imamura, Masafumi Mizuide, Nobuo Toda, Iruru Maetani, Yuji Sakai, Takao Itoi, Masatsugu Nagahama, Yousuke Nakai, Hiroyuki Isayama
AIM: To determine the optimal method of endoscopic preoperative biliary drainage for malignant distal biliary obstruction. METHODS: Multicenter retrospective study was conducted in patients who underwent plastic stent (PS) or nasobiliary catheter (NBC) placement for resectable malignant distal biliary obstruction followed by surgery between January 2010 and March 2012. Procedure-related adverse events, stent/catheter dysfunction (occlusion or migration of PS/NBC, development of cholangitis, or other conditions that required repeat endoscopic biliary intervention), and jaundice resolution (bilirubin level < 3...
April 14, 2016: World Journal of Gastroenterology: WJG
Yuya Nasu, Satoshi Hirano, Takahiro Tsuchikawa, Toshiaki Shichinohe
OBJECTIVE: The aim of this study was to clarify the clinical impact of our departmental policy for advanced gallbladder cancer (GBC) even with obstructive jaundice. METHODS: Obstructive jaundice was defined as serum T-bil ≥2.0 mg/dl. Between 1998 and 2008, 112 patients with GBC were scheduled for surgical resection with curative intent. Thirty-six patients were converted to palliative surgery or exploration alone because of advanced disease. After excluding pathological T1 (UICC) patients (n = 11), the remaining 65 patients were divided into 2 groups; jaundiced group (n = 37) and non-jaundiced group (n = 28)...
2016: Digestive Surgery
Takeshi Furukawa, Hitoshi Takahashi, Kei Tanaka, Takaaki Muto
We report a case of unresectable gallbladder cancer successfully treated with gemcitabine (GEM). A 77-year-old man was admitted to our hospital in April 2010 with jaundice. He was diagnosed as having gallbladder cancer that had invaded the liver and hepatic artery, along with lymph node metastasis. The tumor was considered unresectable, and he received chemotherapy with GEM. Each course of treatment consisted of 1,000 mg/m2 GEM administered once a week for 3 weeks followed by a week of no treatment. After the 3rd course, computed tomography revealed reduction in liver invasion and disappearance of lymph node metastasis...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Bashar Mohamad, Amit Bhatt, Arthi Kumaravel, Federico Aucejo, Sunguk Jang, Tyler Stevens, John Vargo, Mansour Parsi
We present a 42-year-old man with a 1-month history of painless jaundice, dark urine, clay-colored stools, and a 13.5-kg weight loss. Laboratory tests revealed elevated liver enzymes and CA19-9. Imaging showed dilation of both the intra- and extrahepatic bile ducts, narrowing of the bile duct at the junction of the common bile duct and common hepatic duct, and a hypoechoic mass involving the neck of the gallbladder and the muscularis propria of the duodenum. Examination of the resected gallbladder and perihilar nodes ruled out malignancy and revealed a diffuse inflammatory infiltrate of giant histiocytes with clear, lipid-containing cytoplasm (xanthoma cells), consistent with xanthogranulomatous cholecystitis...
October 2015: ACG Case Reports Journal
S Reimão, E Francioni, E Bories, F Caillol, C Pesenti, M Giovannini
INTRODUCTION: Biliary obstruction is preferentially managed by endoscopic retrograde cholangiopancreatography (ERCP). However, after ERCP failed, alternatives include percutaneous transhepatic drainage, surgery and more recently, endoscopic ultrasonography (EUS)-guided hepaticogastrostomy. The limitation of this technique is that the drainage is restricted to the left side. The aim of this study is to describe a new method of drainage of both hepatic ductal systems by hepaticogastrostomy in patients with hilar obstruction...
April 2014: Endoscopic Ultrasound
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