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https://www.readbyqxmd.com/read/29232532/reconsideration-of-laparoscopic-kasai-operation-for-biliary-atresia
#1
Sheng-Yang Huang, Chou-Ming Yeh, Hou-Chuan Chen, Chia-Man Chou
INTRODUCTION: Minimal invasive surgery for all kinds of surgical diseases had been practiced for years. The laparoscopic Kasai operation is one of the most challenging procedures and remains controversial for treating biliary atresia (BA). PURPOSE: This work presented the initial experience of our Institute and compared the outcomes of open and laparoscopic Kasai operations for BA. MATERIALS AND METHODS: Patients 18 years old and younger, and were operated in our Institute for BA from January 2011 to August 2017, were included in this study...
December 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29231757/structured-protocol-for-benign-biliary-anastomotic-strictures-impact-on-long-term-clinical-effectiveness
#2
Will S Lindquester, J David Prologo, Elizabeth A Krupinski, Gail L Peters
OBJECTIVE: The purpose of this study is to compare long-term clinical effectiveness before and after implementation of a structured protocol for percutaneous drainage of benign anastomotic biliary strictures. MATERIALS AND METHODS: Three hundred five adult patients undergoing percutaneous biliary drainage for biliary anastomotic strictures between 1994 and 2015 were identified using Current Procedural Terminology billing codes, with 234 undergoing intervention before implementation of a structured protocol and 71 undergoing intervention after implementation of the protocol...
December 12, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29231188/major-hepatic-complications-in-ursodeoxycholic-acid-treated-patients-with-primary-biliary-cholangitis-risk-factors-and-time-trends-in-incidence-and-outcome
#3
Maren H Harms, Willem J Lammers, Douglas Thorburn, Christophe Corpechot, Pietro Invernizzi, Harry L A Janssen, Pier M Battezzati, Frederik Nevens, Keith D Lindor, Annarosa Floreani, Cyriel Y Ponsioen, Marlyn J Mayo, George N Dalekos, Tony Bruns, Albert Parés, Andrew L Mason, Xavier Verhelst, Kris V Kowdley, Jorn C Goet, Gideon M Hirschfield, Bettina E Hansen, Henk R van Buuren
OBJECTIVES: In this era of near universal ursodeoxycholic acid (UDCA) treatment for primary biliary cholangitis (PBC), progression to cirrhosis still occurs in an important proportion of patients. The aim of this study was to describe the incidence of cirrhosis-associated complications in patients with PBC and assess risk factors and impact on survival. METHODS: Cohorts of UDCA-treated patients from 16 European and North-American liver centers were included. We used Cox proportional hazards assumptions and Kaplan-Meier estimates...
December 12, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29230974/diagnostic-yield-and-accuracy-of-a-new-cytology-brush-design-compared-to-standard-brush-cytology-for-evaluation-of-biliary-strictures
#4
Jeffrey S Bank, Benjamin L Witt, Linda J Taylor, Douglas G Adler
BACKGROUND: The sensitivity of brush cytology for biliary strictures has typically been low, usually 30%-60%. We compared the cellular yield and diagnostic accuracy using a new cytology brush (n = 16) versus standard biliary brushings (n = 16) in 32 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with brushings for evaluation of a biliary stricture for malignancy. METHODS: We performed retrospective chart reviews of 16 consecutive ERCPs with brushings performed for the cytologic evaluation of a biliary stricture for malignancy using the new cytology brush between January 2016 and February 2017 at our institution...
December 12, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29230246/usefulness-of-endoscopic-managements-in-patients-with-ceftriaxone-induced-pseudolithiasis-causing-biliary-obstruction
#5
Yasuhiro Doi, Yasushi Takii, Hiroyuki Ito, Norihiko Jingu, Kentaro To, Sinichiro Kimura, Koichi Kimura, Kensaku Sanefuji, Hirofumi Ikeda, Sayaka Tachibana, Takeshi Otsuka
Ceftriaxone (CTRX) is known to cause reversible biliary stones/sludge, which is called biliary pseudolithiasis. We report two rare cases of biliary obstruction by pseudolithiasis shortly after completing CTRX treatment. Stones and sludge, which had not been detected before CTRX administration, appeared in the gallbladder and common bile duct and led to biliary obstruction and acute cholangitis. The obstructions were successfully treated with endoscopic retrograde biliary drainage and endoscopic sphincterotomy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29229992/mirna-21-ablation-protects-against-liver-injury-and-necroptosis-in-cholestasis
#6
Marta B Afonso, Pedro M Rodrigues, André L Simão, Maria M Gaspar, Tânia Carvalho, Paula Borralho, Jesús M Bañales, Rui E Castro, Cecília M P Rodrigues
Inhibition of microRNA-21 (miR-21) prevents necroptosis in the mouse pancreas. Necroptosis contributes to hepatic necro-inflammation in the common bile duct ligation (BDL) murine model. We aimed to evaluate the role of miR-21 in mediating deleterious processes associated with cholestasis. Mechanistic studies established a functional link between miR-21 and necroptosis through cyclin-dependent kinase 2-associated protein 1 (CDK2AP1). miR-21 expression increased in the liver of primary biliary cholangitis (PBC) patients and BDL wild-type (WT) mice at both 3 and 14 days...
December 11, 2017: Cell Death and Differentiation
https://www.readbyqxmd.com/read/29229510/opacification-of-nondilated-bile-ducts-through-the-gallbladder-as-an-aid-to-percutaneous-transhepatic-biliary-drainage
#7
K Ozturk, O F Nas, E Soylu, K Hacikurt, C Erdogan
PURPOSE: The purpose of this study was to retrospectively assess the potential of percutaneous transhepatic biliary drainage (PTBD) in patients with nondilated bile ducts (NDBD) using a transgallbladder opacification of the bile ducts. PATIENTS AND METHODS: Eight patients with NDBD (7 men, 1 women; median age, 65 years; Q1-Q3, 35-69 years; range, 22-77 years) who underwent PTBD after opacification of the bile ducts through the gallbladder were evaluated. Opacification of NDBD was performed using a retrograde injection of contrast material through the gallbladder...
December 8, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29229482/selective-intraoperative-cholangiography-during-laparoscopic-cholecystectomy-in-children-is-justified
#8
Benjamin Martin, Evelyn Geok Peng Ong
AIMS: Intraoperative cholangiograms (IOC) during laparoscopic cholecystectomy have been advocated to detect biliary anomalies and intraductal calculi. However, IOC increases operative time and patient irradiation, and therefore is not universally used. We hypothesise selective IOC may be a valuable tool in children. METHODS: A retrospective case note review was performed of all children who underwent laparoscopic cholecystectomy at a single institution by a single surgeon between January 2011 and March 2017...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29229480/liver-transplantation-for-deterioration-in-native-liver-function-after-portoenterostomy-for-biliary-atresia-in-japan-short-versus-long-term-survivors
#9
Takanori Ochi, Hiroki Nakamura, Momoko Wada, Tsuyoshi Tamura, Hiroyuki Koga, Tadaharu Okazaki, Masahiko Urao, Yoichi Ishizaki, Seiji Kawasaki, Mureo Kasahara, Koichi Mizuta, Geoffrey J Lane, Atsuyuki Yamataka
PURPOSE: We reviewed our post-Kasai portoenterostomy biliary atresia (BA) patients who required liver transplantation (LTx) for deterioration in native liver (NL) function to investigate mortality in relation to age at LTx. METHODS: BA patients indicated for LTx when less than 18years old (U18; n=17) and when 18 or older (18+; n=13) were compared. All achieved jaundice clearance postoperatively (TBil ≤1.2mg/dL (≈20μmol/L)). RESULTS: In U18, living-donor (LD) LTxs were performed at a median of 6...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29229136/the-gut-liver-axis-impact-of-a-mouse-model-of-small-bowel-bacterial-overgrowth
#10
Qingqing Wang, Bin Wang, Vijay Saxena, Lili Miles, Josh Tiao, Joel E Mortensen, Jaimie D Nathan
BACKGROUND: The mechanisms by which intestinal bacteria impact liver diseases remain poorly understood. The aim of this study was to develop a mouse model of small-bowel bacterial overgrowth and to determine its impact on hepatobiliary injury. MATERIALS AND METHODS: A jejunal self-filling blind loop (SFBL) was created in C57BL/6 mice. Three weeks after surgery, the mice were euthanized, and bacterial cultures of luminal content of the loop and extraintestinal tissues were performed...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29228599/chicken-bile-powder-protects-against-%C3%AE-naphthylisothiocyanate-induced-cholestatic-liver-injury-in-mice
#11
Yi-Fei Li, Jia-Sheng Wu, Yuan-Yuan Li, Yan Dai, Min Zheng, Jia-Kai Zeng, Guo-Feng Wang, Tian-Ming Wang, Wen-Kai Li, Xue-Yan Zhang, Ming Gu, Cheng Huang, Li Yang, Zheng-Tao Wang, Yue-Ming Ma
This study explored the effects of chicken bile powder (CBP), a 2000-year-old Chinese medicine, on α-naphthyl isothiocyanate (ANIT)-induced intrahepatic cholestasis in mice. CBP treatment for 14 days significantly ameliorated ANIT-induced changes in serum alanine aminotransferase, aspartate aminotransferase, bile acids, bilirubin, γ-glutamyl transpeptidase, alkaline phosphatase, and liver tissue morphology. Serum metabolomics showed changes in 24 metabolites in ANIT-exposed mice; 16 of these metabolites were reversed by CBP treatment via two main pathways (bile acid biosynthesis and arachidonic acid metabolism)...
November 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/29228523/advanced-therapeutic-gastrointestinal-endoscopy-in-children-today-and-tomorrow
#12
Zaheer Nabi, Duvvur Nageshwar Reddy
Gastrointestinal (GI) endoscopy plays an indispensable role in the diagnosis and management of various pediatric GI disorders. While the pace of development of pediatric GI endoscopy has increased over the years, it remains sluggish compared to the advancements in GI endoscopic interventions available in adults. The predominant reasons that explain this observation include lack of formal training courses in advanced pediatric GI interventions, economic constraints in establishing a pediatric endoscopy unit, and unavailability of pediatric-specific devices and accessories...
December 12, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29228512/surgical-management-decreases-disease-recurrence-risk-in-recurrent-pyogenic-cholangitis
#13
Hwee Leong Tan, Ye Xin Koh, Weng Kit Lye, Ser Yee Lee, Brian Kim Poh Goh, Siong San Tan, Adrian Kah Heng Chiow, Chung Yip Chan
BACKGROUND: Recurrent pyogenic cholangitis (RPC) has a high risk of disease recurrence. We present our experience with RPC and examine the factors associated with disease recurrence. METHODS: We performed a retrospective review of all patients with RPC treated at two tertiary institutions between January 1990 and December 2013. Patients with liver atrophy and/or abscess were categorized as being associated with parenchymal disease (PD). RESULTS: We studied 157 patients with a median age of 59...
December 11, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29227744/molecular-epidemiology-of-klebsiella-pneumoniae-strains-causing-bloodstream-infections-in-adults
#14
Meritxell Cubero, Imma Grau, Fe Tubau, Román Pallarés, M Ángeles Domínguez, Josefina Liñares, Carmen Ardanuy
Molecular epidemiology of Klebsiella pneumoniae bacteremic strains allows for a better understanding of preventive and therapeutic strategies. Clinical and microbiological characteristics of 348 K. pneumoniae bacteremia cases (2007-2009) were retrospectively characterized by multilocus sequence typing and extended-spectrum beta-lactamases (ESBL) production. Overall, 223 (64.08%) cases were nosocomial (NA), 58 (16.67%) healthcare associated, and 67 (19.25%) community acquired. The main infection origins were urinary tract (16...
December 11, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/29226620/comparative-potency-of-obeticholic-acid-and-natural-bile-acids-on-fxr-in-hepatic-and-intestinal-in%C3%A2-vitro-cell-models
#15
Yuanyuan Zhang, Carl LaCerte, Sanjay Kansra, Jonathan P Jackson, Kenneth R Brouwer, Jeffrey E Edwards
Obeticholic acid (OCA) is a semisynthetic farnesoid X receptor (FXR) agonist, an analogue of chenodeoxycholic acid (CDCA) which is indicated for the treatment of primary biliary cholangitis (PBC) in combination with ursodeoxycholic acid (UDCA). OCA efficiently inhibits bile acid synthesis and promotes bile acid efflux via activating FXR-mediated mechanisms in a physiologically relevant in vitro cell system, Sandwich-cultured Transporter Certified ™ human primary hepatocytes (SCHH). The study herein evaluated the effects of UDCA alone or in combination with OCA in SCHH...
December 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/29226107/cholangitis-diagnosis-treatment-and-prognosis
#16
REVIEW
Amir Houshang Mohammad Alizadeh
Cholangitis is a serious life-threatening situation affecting the hepatobiliary system. This review provides an update regarding the clinical and pathological features of various forms of cholangitis. A comprehensive search was performed in the PubMed, Scopus, and Web of Knowledge databases. It was found that the etiology and pathogenesis of cholangitis are heterogeneous. Cholangitis can be categorized as primary sclerosing (PSC), secondary (acute) cholangitis, and a recently characterized form, known as IgG4-associated cholangitis (IAC)...
December 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29226045/neuroendocrine-tumor-of-the-cystic-duct-a-rare-and-incidental-diagnosis
#17
Fatima Ayub, Muhammad W Saif
Neuroendocrine tumors (NETs), also known as carcinoid tumors of the extrahepatic biliary tree, are extremely rare malignancies and account for 0.2% to 2% of all carcinoids of the gastrointestinal tract. The most common sites include NET in the common bile duct (CBD), followed by the perihilar region, cystic duct, and common hepatic duct (CHD). A review of the literature showed only eight cases of NETs of the cystic duct and we, hereby, present the ninth case of NET of the cystic duct in a 50-year-old woman...
October 6, 2017: Curēus
https://www.readbyqxmd.com/read/29226038/pencil-beam-scanning-proton-therapy-for-rhabdomyosarcoma-of-the-biliary-tract
#18
Luke Pater, Brian Turpin, Anthony Mascia
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma of childhood with 250-350 cases diagnosed annually in the United States. Biliary tract rhabdomyosarcoma is rare, representing <1% of the RMS cases. Due to its location, resection is clinically challenging, and functional complications exist and persist from biliary obstruction. The anatomical location of this tumor presents both opportunities and challenges for pencil beam scanning proton therapy. Proton therapy offers a dosimetric and clinical advantage by sparing the healthy liver, stomach, contra-lateral kidney and bowel...
October 5, 2017: Curēus
https://www.readbyqxmd.com/read/29225990/cholecystectomy-of-an-intrahepatic-gallbladder-in-an-ectopic-pelvic-liver-a-case-report-and-review-of-the-literature
#19
Rachel Mathis, Joshua Stodghill, Timothy Shaver, George Younan
Introduction: Ectopic pelvic liver is an exceedingly rare condition usually resulting after repair of congenital abdominal wall defects. Intrahepatic gallbladder is another rare condition predisposing patients to cholelithiasis and its sequelae. We describe a cholecystectomy in a patient with an intrahepatic gallbladder in a pelvic ectopic liver. Presentation of Case: A 33-year-old woman with a history of omphalocele repair as an infant presented with signs and symptoms of symptomatic cholelithiasis and chronic cholecystitis, however, in an unusual location...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29225328/gallbladder-hypoplasia-a-congenital-abnormality-of-the-gallbladder-a-case-report
#20
Christophoros S Kosmidis, Georgios D Koimtzis, Maria S Kosmidou, Fotini Ieridou, Triantafyllia Koletsa, Katerina T Zarampouka, Eleni Georgakoudi, Isaac Kesisoglou
BACKGROUND There are different variations in the anatomy of the gallbladder. Congenital abnormalities of the gallbladder such as agenesis and hypoplasia are rare conditions and difficult to diagnose with imaging studies. Patients are usually asymptomatic or have symptoms that mimic gallstone disease. The diagnosis is often made intraoperatively and is established by histopathological examination. CASE REPORT We report a case of a 62-year-old male who had cholelithiasis symptoms and was falsely diagnosed with gallstone disease by abdominal ultrasound scan...
December 11, 2017: American Journal of Case Reports
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