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Biliary injuries

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https://www.readbyqxmd.com/read/28726135/increasing-bile-duct-injury-and-decreasing-utilization-of-intraoperative-cholangiogram-and-common-bile-duct-exploration-over-14%C3%A2-years-an-analysis-of-outcomes-in-new-york-state
#1
Maria S Altieri, Jie Yang, Nabeel Obeid, Chencan Zhu, Mark Talamini, Aurora Pryor
INTRODUCTION: During laparoscopic cholecystectomy (LC), common bile duct (CBD) visualization either directly or with cholangiography (IOC) is less routine. Cholangiography can be used to identify and possibly prevent bile duct injury (BDI), which is a dreaded complication of cholecystectomy. The purpose of our study was to evaluate the trend of IOC/CBD exploration and BDI during LC for benign disease. METHODS: A state-wide database (SPARCS) was used to identify all LC for benign biliary non-obstructive and obstructive disease between 2000 and 2014 in the state of New York...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28716705/pathobiology-of-biliary-epithelia
#2
REVIEW
Angela C Cheung, Maria J Lorenzo Pisarello, Nicholas F LaRusso
Cholangiocytes are epithelial cells that line the intra- and extrahepatic biliary tree. They serve predominantly to mediate the content of luminal biliary fluid, which is controlled via numerous signaling pathways influenced by endogenous (e.g., bile acids, nucleotides, hormones, neurotransmitters etc.) and exogenous (microbes/microbial products, drugs etc.) molecules. When injured, cholangiocytes undergo apoptosis/lysis, repair and proliferation. They also become senescent, a form of cell cycle arrest, which may prevent propagation of injury and/or malignant transformation...
July 14, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28715721/pushing-the-boundaries-in-liver-graft-utilisation-in-transplantation-case-report-of-a-donor-with-previous-bile-duct-injury-repair
#3
Asma Sultana, James J Powell, Gabriel C Oniscu
INTRODUCTION: Liver transplantation is a recognised treatment for extensive bile duct injuries with secondary biliary cirrhosis or recurring sepsis. However, there have been no reports of successful liver transplantation from a donor who sustained a previous bile duct injury. PRESENTATION OF CASE: Here we discuss the case of a liver transplant from a 51-year-old brain dead donor who had suffered a Strasberg E1 bile duct injury and had undergone a Roux-en-Y hepaticojejunostomy 24 years prior to donation...
June 29, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28712691/biliary-bile-acids-in-hepatobiliary-injury-what-is-the-link
#4
REVIEW
Peter Fickert, Martin Wagner
The main trigger for liver injury in acquired cholestatic liver disease remains unclear. However, the accumulation of bile acids (BAs) undoubtedly plays a role. Recent progress in deciphering the pathomechanisms of inborn cholestatic liver diseases, decoding mechanisms of BA-induced cell death, and generating modern BA-derived drugs has improved the understanding of the regulation of BA synthesis and transport. Now is the appropriate time to reassess current knowledge about the specific role of BAs in hepatobiliary injury...
July 13, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28709963/animal-models-of-biliary-injury-and-altered-bile-acid-metabolism
#5
REVIEW
Valeria Mariotti, Mario Strazzabosco, Luca Fabris, Diego F Calvisi
In the last 25years, a number of animal models, mainly rodents, have been generated with the goal to mimic cholestatic liver injuries and, thus, to provide in vivo tools to investigate the mechanisms of biliary repair and, eventually, to test the efficacy of innovative treatments. Despite fundamental limitations applying to these models, such as the distinct immune system and the different metabolism regulating liver homeostasis in rodents when compared to humans, multiple approaches, such as surgery (bile duct ligation), chemical-induced (3,5-diethoxycarbonyl-1,4-dihydrocollidine, DDC, α-naphthylisothiocyanate, ANIT), viral infections (Rhesus rotavirustype A, RRV-A), and genetic manipulation (Mdr2, Cftr, Pkd1, Pkd2, Prkcsh, Sec63, Pkhd1) have been developed...
July 11, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28709962/the-role-of-macrophages-in-the-development-of-biliary-injury-in-a-lipopolysaccharide-aggravated-hepatic-ischaemia-reperfusion-model
#6
REVIEW
J Reiling, K R Bridle, F G Schaap, L Jaskowski, N Santrampurwala, L J Britton, C M Campbell, P L M Jansen, S W M Olde Damink, D H G Crawford, C H C Dejong, J Fawcett
INTRODUCTION: Endotoxins, in the form of lipopolysaccharides (LPS), are potent inducers of biliary injury. However the mechanism by which injury develops remains unclear. We hypothesized that hepatic macrophages are pivotal in the development of endotoxin-induced biliary injury and that no injury would occur in their absence. MATERIAL AND METHODS: Clodronate liposomes were used to deplete macrophages from the liver. Forty-eight rats were equally divided across six study groups: sham operation (sham), liposome treatment and sham operation (liposomes+sham), 1mg/kg LPS i...
July 11, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28706986/liver-preservation-by-aortic-perfusion-alone-compared-with-preservation-by-aortic-perfusion-and-additional-arterial-ex-situ-back-table-perfusion-with-histidine-tryptophan-ketoglutarate-solution-a-prospective-randomized-controlled-multicenter-study
#7
Gerd Otto, Michael Heise, Jochen Thies, Michael Pitton, Jens Schneider, Gernot Kaiser, Peter Neuhaus, Otto Kollmar, Michael Barthels, Josef Geks, Wolf Otto Bechstein, Achim Hellinger, Jürgen Klempnauer, Winfried Padberg, Nils Frühauf, Andre Ebbing, Dietmar Mauer, Astrid Schneider, Robert Kwiecien, Kai Kronfeld
BACKGROUND: Arterial ex situ back-table perfusion (BP) reportedly reduces ischemic-type biliary lesion after liver transplantation. We aimed to verify these findings in a prospective investigation. METHODS: Our prospective, randomized, controlled, multicenter study involved livers retrieved from patients in 2 German regions, and compared the outcomes of standard aortic perfusion to those of aortic perfusion combined with arterial ex situ BP. The primary endpoint was the incidence of ischemic-type biliary lesions over a follow-up of 2 years after liver transplantation, whereas secondary endpoints included 2-year graft survival, initial graft damage as reflected by transaminase levels, and functional biliary parameters at 6 months after transplantation...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28706580/risk-factors-for-acute-kidney-injury-after-partial-hepatectomy
#8
Luis Cesar Bredt, Luis Alberto Batista Peres
AIM: To identify risk factors for the occurrence of acute kidney injury (AKI) in the postoperative period of partial hepatectomies. METHODS: Retrospective analysis of 446 consecutive resections in 405 patients, analyzing clinical characteristics, preoperative laboratory data, intraoperative data, and postoperative laboratory data and clinical evolution. Adopting the International Club of Ascites criteria for the definition of AKI, potential predictors of AKI by logistic regression were identified...
June 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28702164/a-case-of-an-anomalous-biliary-tract-diagnosed-preoperatively
#9
Jun Kataoka, Toshikatsu Nitta, Yoshihiro Inoue, Masato Ota, Tomo Tominaga, Kensuke Fujii, Hiroshi Kawasaki, Takashi Ishibashi
We describe a 48-year-old man with cholecystolithiasis whose preoperative magnetic resonance cholangiopancreatography (MRCP) scan showed that the right accessory hepatic duct branching from the cystic duct dominated an anterior segment of the right hepatic lobe. We observed the right accessory hepatic duct using intraoperative cholangiography, and we were able to perform laparoscopic cholecystectomy without injuring it. He had no complication after discharge, and a drip-infusion cholangiography-computed tomography (DIC-CT) scan demonstrated that the right accessory hepatic duct was intact, and it dominated an anterior segment of the right hepatic lobe...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28700576/cholangiocytes-act-as-facultative-liver-stem-cells-during-impaired-hepatocyte-regeneration
#10
Alexander Raven, Wei-Yu Lu, Tak Yung Man, Sofia Ferreira-Gonzalez, Eoghan O'Duibhir, Benjamin J Dwyer, John P Thomson, Richard R Meehan, Roman Bogorad, Victor Koteliansky, Yuri Kotelevtsev, Charles Ffrench-Constant, Luke Boulter, Stuart J Forbes
After liver injury, regeneration occurs through self-replication of hepatocytes. In severe liver injury, hepatocyte proliferation is impaired-a feature of human chronic liver disease. It is unclear whether other liver cell types can regenerate hepatocytes. Here we use two independent systems to impair hepatocyte proliferation during liver injury to evaluate the contribution of non-hepatocytes to parenchymal regeneration. First, loss of β1-integrin in hepatocytes with liver injury triggered a ductular reaction of cholangiocyte origin, with approximately 25% of hepatocytes being derived from a non-hepatocyte origin...
July 12, 2017: Nature
https://www.readbyqxmd.com/read/28700364/helicobacter-pylori-infection-among-patients-with-liver-cirrhosis
#11
Joanna Pogorzelska, Magda Łapińska, Alicja Kalinowska, Tadeusz W Łapiński, Robert Flisiak
BACKGROUND AND AIM: Inflammatory changes in the stomach caused by Helicobacter pylori indirectly and directly affect liver function. Moreover, the bacteria may worsen the course of the liver cirrhosis. The study aimed at evaluating the incidence of H. pylori infection among patients with liver cirrhosis, depending on the etiology and injury stage, scored according to Child-Pugh classification. Stage of esophageal varices and endoscopic inflammatory lesions in the stomach were evaluated, depending on the presence of H...
July 11, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28698093/bile-acids-and-intestinal-microbiota-in-autoimmune-cholestatic-liver-diseases
#12
REVIEW
You Li, Ruqi Tang, Patrick S C Leung, M Eric Gershwin, Xiong Ma
Cholestatic liver diseases, including primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), are manifested as an impairment of normal bile flow and excessive accumulation of potentially toxic bile acids. Endogenous bile acids are involved in the pathogenesis and progression of cholestasis. Consequently, chronic cholestasis affects the expression of bile acids transporters and nuclear receptors, and results in liver injury. Several lines of evidence suggest that intestinal microbiota plays an important role in the etiopathogenesis of cholestatic liver diseases by regulating metabolism and immune responses...
July 8, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28695433/reconstruction-of-bile-duct-injury-and-defect-with-the-round-ligament
#13
Safi Dokmak, Béatrice Aussilhou, Emilia Ragot, Camille Tantardini, François Cauchy, Philippe Ponsot, Jacques Belghiti, Alain Sauvanet, Olivier Soubrane
Lateral injury of the bile duct can occur after cholecystectomy, bile duct dissection, or exploration. If direct repair is not possible, conversion to bilioenteric anastomosis can be needed with the risk of long-term bile duct infections and associated complications. We developed a new surgical technique which consist of reconstructing the bile duct with the round ligament. The vascularized round ligament is completely mobilized until its origin and used for lateral reconstruction of the bile duct to cover the defect...
July 10, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28694703/secondary-sclerosing-cholangitis-in-critically-ill-patients-current-perspectives
#14
REVIEW
Hafsteinn O Gudnason, Einar S Björnsson
Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28694659/induction-of-chronic-cholestasis-without-liver-cirrhosis-creation-of-an-animal-model
#15
Felix Dondorf, René Fahrner, Michael Ardelt, Eleonora Patsenker, Felix Stickel, Uta Dahmen, Utz Settmacher, Falk Rauchfuß
AIM: To analyze time intervals of inflammation and regeneration in a cholestatic rat liver model. METHODS: In 36 Lewis rats, divided into six groups of 6 animals (postoperative observation periods: 1, 2, 3, 4, 6, 8 wk), the main bile duct was ligated with two ligatures and observed for the periods mentioned above. For laboratory evaluation, cholestasis parameters (bilirubin, γ-GT), liver cell parameters (ASAT, ALAT) and liver synthesis parameters (quick, albumin) were determined...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28690174/clinical-outcomes-of-donation-after-circulatory-death-liver-transplantation-in-primary-sclerosing-cholangitis
#16
Palak J Trivedi, Irene Scalera, Emma Slaney, Richard W Laing, Bridget Gunson, Gideon M Hirschfield, Andrea Schlegel, James Ferguson, Paolo Muiesan
BACKGROUND AND AIM: Primary sclerosing cholangitis (PSC) is a progressive fibro-inflammatory cholangiopathy for which liver transplantation is the only life-extending intervention. These patients may benefit from accepting liver donation after circulatory death (DCD), however their subsequent outcome is unknown. METHODS: Clinical outcomes were prospectively evaluated in PSC patients undergoing transplantation from 2006 to 2016 stratified by donor type (DCD, n=35 vs...
July 6, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28687243/biliary-reconstruction-options-for-bile-duct-stricture-in-patients-with-prior-roux-en-y-reconstruction
#17
Mihir M Shah, Benjamin M Martin, Jamil L Stetler, Ankit D Patel, S Scott Davis, Edward Lin, Juan M Sarmiento
Comprehensive description with illustrations of the 4 biliary reconstruction options for bile duct injury in patients with history of Roux-en-Y gastric bypass.
May 25, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28682038/-hepato-renal-syndrome
#18
Luca Di Lullo, Claudio Ronco, Vincenzo Barbera, Francesca Santoboni, Antonio Bellasi
Hepatic and kidney failure are often closely linked (Hepato-Renal Sindrome - HRS). Acute kidney injury (AKI) represents a well-known complication of liver or biliary tract disease. Pathophysiology of HRS is still not completely clear. At this stage we know the biological pathways of several kidney abnormalities in end stage liver disease patients. At the same time patient's prognosis is poor with bad outcomes despite the reversible nature of the kidneys' involvement. Liver transplantation represents the ultimate treatment for HRS patients...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28676445/metformin-reduces-intrahepatic-fibrosis-and-intrapulmonary-shunts-in-biliary-cirrhotic-rats
#19
Mu-Tzu Ko, Hui-Chun Huang, Wen-Shin Lee, Chiao-Lin Chuang, I-Fang Hsin, Shao-Jung Hsu, Fa-Yauh Lee, Ching-Chih Chang, Shou-Dong Lee
BACKGROUND: Liver fibrosis causes portal hypertension which dilates collateral vasculature and enhances extra-hepatic angiogenesis including intrapulmonary shunts, which subsequently complicates with hepatopulmonary syndrome. Metformin is an anti-diabetic agent which possesses anti-inflammation and anti-angiogenesis properties. This study evaluated the effect of metformin treatment on liver and lung in a non-diabetic rat model with biliary cirrhosis induced via common bile duct ligation (CBDL)...
July 1, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28671689/reconstruction-of-the-mouse-extrahepatic-biliary-tree-using-primary-human-extrahepatic-cholangiocyte-organoids
#20
Fotios Sampaziotis, Alexander W Justin, Olivia C Tysoe, Stephen Sawiak, Edmund M Godfrey, Sara S Upponi, Richard L Gieseck, Miguel Cardoso de Brito, Natalie Lie Berntsen, María J Gómez-Vázquez, Daniel Ortmann, Loukia Yiangou, Alexander Ross, Johannes Bargehr, Alessandro Bertero, Mariëlle C F Zonneveld, Marianne T Pedersen, Matthias Pawlowski, Laura Valestrand, Pedro Madrigal, Nikitas Georgakopoulos, Negar Pirmadjid, Gregor M Skeldon, John Casey, Wenmiao Shu, Paulina M Materek, Kirsten E Snijders, Stephanie E Brown, Casey A Rimland, Ingrid Simonic, Susan E Davies, Kim B Jensen, Matthias Zilbauer, William T H Gelson, Graeme J Alexander, Sanjay Sinha, Nicholas R F Hannan, Thomas A Wynn, Tom H Karlsen, Espen Melum, Athina E Markaki, Kourosh Saeb-Parsy, Ludovic Vallier
The treatment of common bile duct (CBD) disorders, such as biliary atresia or ischemic strictures, is restricted by the lack of biliary tissue from healthy donors suitable for surgical reconstruction. Here we report a new method for the isolation and propagation of human cholangiocytes from the extrahepatic biliary tree in the form of extrahepatic cholangiocyte organoids (ECOs) for regenerative medicine applications. The resulting ECOs closely resemble primary cholangiocytes in terms of their transcriptomic profile and functional properties...
July 3, 2017: Nature Medicine
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