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Bile duct alternative treatment

Kitti Intuyod, Aroonsri Priprem, Chawalit Pairojkul, Chariya Hahnvajanawong, Kulthida Vaeteewoottacharn, Porntip Pinlaor, Somchai Pinlaor
Cholangiocarcinoma (CCA) is a deleterious bile duct tumor with poor prognosis and is relatively resistant to chemotherapy. Therefore, alternative or supplementary agents with anticancer and chemosensitizing activities may be useful for the treatment of CCA. A novel anthocyanin complex (AC) nanoparticle, developed from extracts of cobs of purple waxy corn and petals of blue butterfly pea, has exhibited chemopreventive potential in vivo. In the present study, the anti-CCA activities of AC and their underlying molecular mechanisms were investigated further in vitro using a CCA cell line (KKU213)...
March 7, 2018: International Journal of Oncology
Shun-Ichi Wakabayashi, Takefumi Kimura, Naoki Tanaka, Satoru Joshita, Kazuhito Kawata, Takeji Umemura, Yuki Hiroshima, Hiromitsu Mori, Hikaru Kobayashi, Shuichi Wada, Eiji Tanaka
A 68-year-old woman was referred to our hospital due to fever and rash on the neck and extremities. Laboratory findings revealed hepatic dysfunction and positivity for anti-mitochondrial M2 antibody (AMA-M2). Hepatosplenomegaly and systemic lymphadenopathy were detected by enhanced computed tomography. One week after her first visit, hypoxemia, ascites, and Coomb test-positive autoimmune hemolytic anemia had newly appeared in addition to worsened fever, hepatosplenomegaly, and lymphadenopathy. Results of axillary lymph node, skin, and bone-marrow biopsies led to the diagnosis of angioimmunoblastic T-cell lymphoma (AITL), for which CEPP therapy (cyclophosphamide, etoposide, procarbazine, and prednisolone) was initiated...
February 10, 2018: Clinical Journal of Gastroenterology
Ayano Kabashima, Petra Hirsova, Steven F Bronk, Matthew C Hernandez, Mark J Truty, Sumera Rizvi, Scott H Kaufmann, Gregory J Gores
BACKGROUND & AIMS: Myeloid cell leukemia1 (MCL1), a prosurvival member of the BCL2 protein family, plays a pivotal role in human cholangiocarcinoma (CCA) cell survival. We have previously reported that fibroblast growth factor receptor (FGFR) signaling mediates MCL1-dependent survival of CCA cells in vitro and in vivo. However, the mode and mechanisms of cell death in this model were not delineated. METHODS: Human CCA cell lines were treated with the pan-FGFR inhibitor LY2874455 and the mode of cell death examined by several complementary assays...
February 2, 2018: Journal of Hepatology
Paola Saccomandi, Giuseppe Quero, Riccardo Gassino, Alfonso Lapergola, Ludovica Guerriero, Michele Diana, Alberto Vallan, Guido Perrone, Emiliano Schena, Guido Costamagna, Jaques Marescaux, Francesco M Di Matteo
OBJECTIVES: The palliative treatment of cholangiocarcinoma is based on stent placement with well-known procedure-related complications. Consequently, alternative energy-based techniques were put forward with controversial long-term results. This study aims to evaluate the safety and effectiveness of biliary tree laser ablation (LA) in terms of: i) absence of perforation, ii) temperature increase, iii) induced thermal damage in in vivo models. MATERIALS AND METHODS: The common bile duct and cystic ducts of two pigs were ablated with a diode laser (circumferential irradiation pattern) for 6 and 3 minutes at 7 W...
January 11, 2018: International Journal of Hyperthermia
Patrick R Varley, Samer T Tohme, Alexis P Chidi, Julie Goswami, Dirk van der Windt, David A Geller, Allan Tsung
BACKGROUND: Experiences at specialized hepatobiliary centers have demonstrated efficacy of minimally invasive liver resection, but concerns exist regarding whether these procedures would remain effective once disseminated to a broad range of clinical practices. We sought to present the first comparison of MILR and open liver resection (OLR) for primary liver malignancy from a nationally representative cancer registry. METHODS: Cases of liver and intrahepatic bile duct cancer were identified from the National Cancer Data Base Participant Use File...
January 4, 2018: Annals of Surgical Oncology
Pierre H Deprez, Rodrigo Garces Duran, Tom Moreels, Gianluca Furneri, Federica Demma, Len Verbeke, Schalk W Van der Merwe, Wim Laleman
BACKGROUND AND STUDY AIM:  Conventional endoscopic retrograde cholangiopancreatography (ERCP) combines endoscopy and radiography to diagnose and treat pathological conditions of the bile duct. The aim of the present analysis was to evaluate the clinical and economic impact of the use of single-operator intraductal cholangioscopy (IDC), which allows for direct visualization of the bile duct, as an alternative to ERCP for the treatment of difficult bile duct stones and the diagnosis of bile duct strictures...
February 2018: Endoscopy
Eduardo Tavio-Hernandez, Enrique Vazquez-Sequeiros, Enrique Rodriguez-Santiago, Juan Angel Gonzalez-Martin, Jose Ramón Foruny-Olcina, Vicente Benita-Leon, Victor Defarges-Pons, Daniel Boixeda-Miquel, Agustin Albillos-Martínez
Introduction: Endoscopic papillary large balloon dilatation (EPLBD) is an alternative for the treatment of common bile duct (CBD) stones. Existing evidence of factors associated with its outcomes is contradictory. Objective: To identify predictors (including the experience of an endoscopist) of success and adverse events in EPLBD. Methods: We reviewed the first 200 EPLBD with endoscopic sphincterotomy (EST) performed at our center. Demographic, clinical, and anatomic variables were studied, as well as the performance characteristics, correlating them with individual and group experience...
2017: Gastroenterology Research and Practice
Naruomi Jinno, Itaru Naitoh, Yoshihito Nagura, Kazutoshi Fujioka, Yusuke Mizuno, Junko Momose, Makoto Ooyama, Kazuki Hayashi, Tomokatsu Miyaki, Makoto Nakamura, Takashi Joh
We report the case of a 71-year-old man with afferent loop obstruction (ALO) after Roux-en-Y reconstruction due to gastric cancer. Computed tomography showed a distended afferent loop and a dilatated bile duct. We could not reach the stricture site in the afferent loop using a gastroscope. We performed percutaneous transhepatic biliary drainage (PTBD) and placed a self-expanding metallic stent (SEMS) in the duodenal stricture through the PTBD route. Although an endoscopic approach is preferable, when PTBD can be performed, percutaneous transhepatic SEMS placement might be an alternative option for treating ALO in cases in which it is not possible to reach the site of stenosis with an endoscope...
November 1, 2017: Internal Medicine
Stella Pak, Umar Darr, Zubair Khan, Andrew Kobalka, Zayd Safadi, Christine Dee
Primary biliary cirrhosis (PBC) is an autoimmune cholestatic disorder of the liver. A diagnostic serum marker for PBC is an anti-mitochondrial antibody. Most prominent histologic findings of PBC are portal inflammation and destruction of interlobular bile ducts. The PBC occurs only in 40 to 400 individuals per million in the general population. About 1.8 - 5.6% of individuals with this rare disorder have rheumatoid arthritis (RA). This case report describes a 56-year-old female with concurrent rheumatoid arthritis and primary biliary cirrhosis...
August 13, 2017: Curēus
Yuma Yamada, Mai Tabata, Jiro Abe, Masatoshi Nomura, Hideyoshi Harashima
Patients with type I diabetes, which is caused by the destruction of pancreatic islets, now require regular therapeutic injections of insulin. The use of transgene therapy represents an alternate and potent strategy for the treatment of type I diabetes. However, only a limited number of studies regarding in vivo gene delivery targeting the pancreas and islets have been reported. Here, we report on the possibility of in vivo transgene expression in the pancreas by the intraductal injection of naked plasmid DNA (pDNA)...
October 6, 2017: Journal of Pharmaceutical Sciences
Hideaki Kawabata, Misuzu Hitomi, Naonori Inoue, Yukino Kawakatsu, Yuji Okazaki, Masatoshi Miyata
Magnetic compression anastomosis (MCA) has been developed as a non-surgical alternative treatment for biliary obstruction without serious complications. A 70-year-old woman who had undergone pancreaticoduodenectomy with modified Child reconstruction for pancreatic head cancer suffered from obstructed choledochojejunostomy with no recurrent findings 4 months after the operation. Cholangiography using the percutaneous transhepatic cholangiographic drainage (PTCD) and fluoroscopy revealed complete obstruction of the upper common bile duct, and the length of the obstruction was 7 mm...
August 2017: Gastroenterology Research
Dong Li, Yu-Liang Li, Wu-Jie Wang, Bin Liu, Hai-Yang Chang, Wei Wang, Yong-Zheng Wang, Zheng Li
BACKGROUND: A 61-year-old man presented with upper abdominal pain and jaundice. Abdominal computed tomography imaging revealed stones in the gallbladder and the common bile duct, with a thickening of the gallbladder wall and an obvious increase in the volume of the gallbladder. Initial treatment using endoscopic retrograde cholangiopancreatography failed due to the presence of surgically altered gastrointestinal anatomy. Stones in the gallbladder and common bile duct were subsequently removed concurrently via percutaneous transhepatic papilla balloon dilatation combined with a percutaneous transcystic approach...
September 2017: Medicine (Baltimore)
Alexandra Dili, Claude Bertrand
AIM: To assess the role of laparoscopic ultrasound (LUS) as a substitute for intraoperative cholangiography (IOC) during cholecystectomy. METHODS: We present a MEDLINE and PubMed literature search, having used the key-words "laparoscopic intraoperative ultrasound" and "laparoscopic cholecystectomy". All relevant English language publications from 2000 to 2016 were identified, with data extracted for the role of LUS in the anatomical delineation of the biliary tract, detection of common bile duct stones (CBDS), prevention or early detection of biliary duct injury (BDI), and incidental findings during laparoscopic cholecystectomy...
August 7, 2017: World Journal of Gastroenterology: WJG
D Li, J R Zhu, X Q Hou, F Du, B Liu, W J Wang, Y L Li
Objective: To evaluate the feasibility, safety, and preliminary efficacy of percutaneous transcystic papilla balloon dilation for the common bile duct stones. Methods: A total of 11 patients with the common bile duct stones without dilatation of the intrahepatic bile ducts treated with percutaneous transcystic papilla balloon dilation in multiple center from April 2013 to May 2015 were analyzed retrospectively.In these 11 patients, there were 3 males and 8 females.And the average age was 68(52-91) years old...
August 15, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Ke-Yue Li, Cheng-Xian Shi, Ke-Li Tang, Jian-Zhao Huang, De-Lin Zhang
OBJECTIVE: To compare the efficacy, safety, and surgical outcomes of laparoscopic common bile duct exploration, endoscopic retrograde cholangiopancreatography, and open common bile duct exploration for treatment of common bile duct stones. METHODS: In total, 210 patients were prospectively randomized into 3 groups: laparoscopic common bile duct exploration, endoscopic retrograde cholangiopancreatography, and open common bile duct exploration. The primary outcome measures were the common bile duct stone clearance rate and the complication rate...
July 31, 2017: Wiener Klinische Wochenschrift
David Karsenti, Emmanuel Coron, Geoffroy Vanbiervliet, Jocelyn Privat, Eric Kull, Philippe Bichard, Bastien Perrot, Vincent Quentin, Arnaud Duriez, Franck Cholet, Clément Subtil, Jean Christophe Duchmann, Christine Lefort, Hervé Hudziak, Stéphane Koch, Philippe Granval, Stéphane Lecleire, Antoine Charachon, Karl Barange, Elodie Metivier Cesbron, Axel De Widerspach, Yann Le Baleur, Marc Barthet, Laurent Poincloux
Background and study aims Endoscopic sphincterotomy plus large-balloon dilation (ES-LBD) has been reported as an alternative to endoscopic sphincterotomy for the removal of bile duct stones. This multicenter study compared complete endoscopic sphincterotomy with vs. without large-balloon dilation for the removal of large bile duct stones. This is the first randomized multicenter study to evaluate these procedures in patients with exclusively large common bile duct (CBD) stones. Methods Between 2010 and 2015, 150 patients with one or more common bile duct stones ≥ 13 mm were randomized to two groups: 73 without balloon dilation (conventional group), 77 with balloon dilation (ES-LBD group)...
October 2017: Endoscopy
Fernanda Kreve, Jonas Takada, Janaina Gatto, Francisco S Loss, Everson L A Artifon
The choice treatment for choledocholithiasis when associated with lithiasic cholecystitis is endoscopic retrograde cholangiopancreatography (ERCP). However, in some cases this therapeutic fails, which requires an alternative method to extract the stones. The surgical approach tends to be the next step, but it is related to greater complexity of achievement and higher complications rates. In 1993, Deslandres et al. developed the combined treatment called laparoendoscopic rendez-vous, that unites in a single stage the endoscopic treatment of choledocholithiasis and laparoscopic removal of the gallbladder...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Yi-Ting Kuo, Tung-Ti Chang, Chih-Hsin Muo, Mei-Yao Wu, Mao-Feng Sun, Chia-Chou Yeh, Hung-Rong Yen
BACKGROUND: Many patients with cancer seek complementary and alternative medicine treatments. We investigated the use of traditional Chinese medicine (TCM) by adult cancer patients in Taiwan. METHODS: We reviewed the Registry for Catastrophic Illness Patients Database of Taiwan, and included all adult patients diagnosed cancer, based on the International Classification of Diseases (ninth revision), from 2001 to 2009 and followed until 2011. This database allowed categorization of patients as TCM users (n = 74 620) or non-TCM users (n = 508 179)...
June 1, 2017: Integrative Cancer Therapies
Pavan Najran, Angela Lamarca, Damian Mullan, Mairéad G McNamara, Thomas Westwood, Richard A Hubner, Jeremy Lawrence, Prakash Manoharan, Jon Bell, Juan W Valle
Cholangiocarcinoma is a rare form of gastrointestinal cancer with a poor prognosis. Patients often present with biliary obstruction or non-specific abdominal pain, and a high proportion of patients have advanced disease at initial diagnosis. The goal of this review is to discuss treatment options for patients with advanced bile duct tumours focusing on radioembolisation (RE) and its impact on overall survival. RE provides a therapeutic option for patients with unresectable cholangiocarcinoma. However, although systemic chemotherapy has demonstrated a survival benefit in randomised controlled trials, there is limited supporting evidence for the use of RE in this setting...
July 2017: Current Oncology Reports
Alan Isaac Valderrama-Treviño, Juan José Granados-Romero, Mariana Espejel-Deloiza, Jonathan Chernitzky-Camaño, Baltazar Barrera Mera, Aranza Guadalupe Estrada-Mata, Jesús Carlos Ceballos-Villalva, Jonathan Acuña Campos, Rubén Argüero-Sánchez
Mirizzi syndrome, known as extrinsic bile compression syndrome, is a rare complication of cholecystitis and chronic cholelithiasis, secondary to the obliteration of the infundibulum of the gallbladder or cystic duct caused by the impact of one or more calculations in these anatomical structures, which leads to compression of the adjacent bile duct, resulting in partial or complete obstruction of the common hepatic duct, triggering liver dysfunction. Our aim is to identify and describe the current epidemiology, diagnostic methods, and treatment of Mirizzi syndrome...
June 2017: Hepatobiliary Surgery and Nutrition
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