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https://www.readbyqxmd.com/read/29351369/heparin-but-not-tissue-plasminogen-activator-improves-outcomes-in-dcd-liver-transplantation-in-a-porcine-model
#1
Amelia J Hessheimer, Marina Vendrell, Javier Muñoz, Ángel Ruíz, Alba Díaz, Luís Flores Sigüenza, Jorge Rodríguez Lanzilotta, Eduardo Delgado Oliver, Jose Fuster, Miquel Navasa, Juan Carlos García-Valdecasas, Pilar Taurá, Constantino Fondevila
BACKGROUND: Ischemic type biliary lesions arise most frequently after DCD liver transplantation and result in high morbidity and graft loss. Many DCD grafts are discarded out of fear for this complication. In theory, microvascular thrombi deposited during donor warm ischemia might be implicated in ITBL pathogenesis. Herein, we aim to evaluate the effects of the administration of either heparin or the fibrinolytic drug TPA as means to improve DCD liver graft quality and potentially avoid ITBL...
January 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29349694/endoscopic-ultrasound-guided-rendezvous-technique-for-failed-biliary-cannulation-in-benign-and-resectable-malignant-biliary-disorders
#2
Hideyuki Shiomi, Kentaro Yamao, Noriyuki Hoki, Takeshi Hisa, Takeshi Ogura, Kosuke Minaga, Atsuhiro Masuda, Kazuya Matsumoto, Hironari Kato, Hideki Kamada, Daisuke Goto, Hajime Imai, Mamoru Takenaka, Chishio Noguchi, Hidefumi Nishikiori, Yasutaka Chiba, Hiromu Kutsumi, Masayuki Kitano
BACKGROUND: Endoscopic ultrasound-guided rendezvous technique (EUS-RV) has emerged as an effective salvage method for unsuccessful biliary cannulation. However, its application for benign and resectable malignant biliary disorders has not been fully evaluated. AIMS: To assess the efficacy and safety of EUS-RV for benign and resectable malignant biliary disorders. METHODS: This was a multicenter prospective study from 12 Japanese referral centers...
January 18, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29344573/development-of-an-external-to-internal-convertible-endoscopic-biliary-drainage-device-a-preliminary-prospective-feasibility-study
#3
Akihiro Mori, Shun Ito, Takayuki Yumura, Hiroki Hachiya, Masashi Sawada, Shintaro Hayashi, Noritsugu Ohashi
Background and study aims:  Endoscopic nasobiliary drainage (ENBD) for a malignant stricture in the bile duct has some advantages over endoscopic biliary stenting (EBS). However, ENBD may cause nasopharyngeal discomfort. We developed an external-to-internal convertible endoscopic biliary drainage (ETI-EBD) device that enables both internal and external drainage to occur during a single endoscopy. Patients and methods : This device consists of three parts, comprising a 5-Fr ENBD tube (250 cm) (ENBD-t), an 8...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29341040/risk-factors-for-allograft-failure-in-liver-transplant-recipients
#4
Anna Huesing-Kabar, Christina Zu Dohna, Hauke Heinzow, Vito Rosario Cicinnati, Susanne Beckebaum, Martina Schmidt, Hans Ulrich Gerth, Michele Pohlen, Christian Wilms, Daniel Palmes, Hartmut Hans-Jürgen Schmidt, Iyad Kabar
BACKGROUND:  With regard to quality of life and organ shortage, follow-up after liver transplantation (LT) should consider risk factors for allograft failure in order to avoid the need for re-LT and to improve the long-term outcome of recipients. Therefore, the aim of this study was to explore potential risk factors for allograft failure after LT. MATERIAL AND METHODS:  A total of 489 consecutive LT recipients who received follow-up care at the University Hospital of Muenster were included in this study...
January 16, 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29340917/biliary-bypass-with-laparoscopic-choledochoduodenostomy
#5
Joshua K Kays, Leonidas G Koniaris, Daniel P Milgrom, Attila Nakeeb
Laparoscopic choledochoduodenostomy (LCDD) is employed to treat many benign biliary diseases when endoscopic or percutaneous techniques are not feasible. We describe our technique for LCDD, which utilizes common bile duct transection and an end-to-side biliary-enteric anastomosis. This procedure includes the following elements: isolation and transection of the common bile duct, mobilization of the duodenum (Kocher maneuver), inspection of the common bile duct, and end-to-side biliary-enteric anastomosis. Key details and pitfalls are discussed...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29339651/albumin-indocyanine-green-evaluation-grading-system-predicts-post-hepatectomy-liver-failure-for-biliary-tract-cancer
#6
Yoshihiro Miyazaki, Takashi Kokudo, Katsumi Amikura, Amane Takahashi, Nobuhiro Ohkohchi, Hirohiko Sakamoto
BACKGROUND: In biliary tract cancer treatment, a precise preoperative evaluation of the patient's liver function is essential to avoid post-hepatectomy liver failure (PHLF) and mortality. The present study aimed to evaluate the role of the Albumin-Indocyanine Green Evaluation (ALICE) grading system in predicting PHLF in biliary tract cancer patients. METHODS: Data from 166 patients who underwent hepatectomy for biliary tract cancer between 2000 and 2016 were retrospectively analyzed...
January 16, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29336894/preoperative-surveillance-rectal-swab-is-associated-with-an-increased-risk-of-infectious-complications-in-pancreaticoduodenectomy-and-directs-antimicrobial-prophylaxis-an-antibiotic-stewardship-strategy
#7
Matteo De Pastena, Salvatore Paiella, Anna M Azzini, Giovanni Marchegiani, Giuseppe Malleo, Debora Ciprani, Annarita Mazzariol, Erica Secchettin, Deborah Bonamini, Clizia Gasparini, Ercole Concia, Claudio Bassi, Roberto Salvia
BACKGROUND: Despite improvements in the perioperative care, the morbidity rate after pancreaticoduodenectomy (PD) is still higher than 50%. The aim of this study was twofold: first, to assess the correlation between preoperative rectal swab (RS) and intraoperative bile cultures; to examine the impact of RS isolates on postoperative course after PD. METHODS: An observational study was conducted analyzing all consecutive PD performed from January 2015 to July 2016...
January 11, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29334530/antegrade-arterial-and-portal-flushing-versus-portal-flushing-only-for-right-lobe-live-donor-liver-transplantation-a-randomized-control-trial
#8
Viniyendra Pamecha, Rommel Sandhyav, Piyush Kumar Sinha, Kishore Gurumoorthy Subramanya Bharathy, Shridhar Sasturkar
INTRODUCTION: In live donor liver transplantation (LDLT) portal flush only of the graft is done on the bench. There is no data on antegrade arterial flush along with portal flush of the graft. METHODS: Consecutive patients undergoing elective right lobe LDLT were block-randomized to receive either portal flush only or both portal and antegrade arterial flush. The primary objectives were safety, rate of early allograft dysfunction (EAD), and impact on vascular and biliary complications RESULTS: After randomization there were 40 patients in each group...
January 12, 2018: Transplantation
https://www.readbyqxmd.com/read/29332405/endoscopic-ultrasound-guided-choledochoduodenostomy-after-a-failed-or-impossible-ercp
#9
Ana María Mora Soler, Alberto Álvarez Delgado, María Concepción Piñero Pérez, Antonio Velasco-Guardado, Marcos Prieto Héctor, Antonio Rodríguez Pérez
INTRODUCTION: Endoscopic ultrasound-guided biliary drainage (EUS-BD) is an alternative to percutaneous trans-hepatic biliary drainage (PTBD) in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). METHODS: This is a retrospective description of six cases of endoscopic ultrasound-guided biliary drainage via choledochoduodenostomy (EUCD), as well as the clinical characteristics, endoscopic procedure, complications and monitoring. RESULTS: All cases had malignant distal biliary obstruction...
January 15, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29331343/irradiation-stents-vs-conventional-metal-stents-for-unresectable-malignant-biliary-obstruction-a-multicentre-trial
#10
Hai-Dong Zhu, Jin-He Guo, Ming Huang, Jian-Song Ji, Hao Xu, Jian Lu, Hai-Liang Li, Wen-Hui Wang, Yu-Liang Li, Cai-Fang Ni, Hai-Bin Shi, En-Hua Xiao, Wei-Fu Lv, Jun-Hui Sun, Ke Xu, Guo-Hong Han, Lin-An Du, Wei-Xin Ren, Mao-Quan Li, Ai-Wu Mao, Hua Xiang, Kai-Xian Zhang, Jie Min, Guang-Yu Zhu, Chang Su, Li Chen, Gao-Jun Teng
BACKGROUND & AIMS: Placement of an irradiation stent has been demonstrated to offer longer patency and survival when compared to an uncovered SEMS in patients with unresectable malignant biliary obstruction (MBO). We aim to further assess the efficacy of an irradiation stent compared to an uncovered SEMS in those patients. METHODS: We performed a randomized, open-label trial of participants with unresectable MBO at 20 centers in China. A total of 328 participants were parallelly allocated into the irradiation stent group (ISG) or the uncovered SEMS group (USG)...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29325849/coagonist-of-glp-1-and-glucagon-decreases-liver-inflammation-and-atherosclerosis-in-dyslipidemic-condition
#11
Vishal Patel, Amit Joharapurkar, Samadhan Kshirsagar, Brijesh Sutariya, Maulik Patel, Dhreerendra Pandey, Hiren Patel, Ramchandra Ranvir, Shekhar Kadam, Dipam Patel, Rajesh Bahekar, Mukul Jain
Dyslipidemia enhances progression of atherosclerosis. Coagonist of GLP-1 and glucagon are under clinical investigation for the treatment of obesity and diabetes. Earlier, we have observed that coagonist reduced circulating and hepatic lipids, independent of its anorexic effects. Here, we investigated the role of coagonist of GLP-1 and glucagon receptors in complications of diet-induced dyslipidemia in hamsters and humanized double transgenic mice. Hamsters fed on high fat high cholesterol diet were treated for 8 weeks with coagonist of GLP-1 and glucagon receptors (75 and 150 μg/kg)...
January 8, 2018: Chemico-biological Interactions
https://www.readbyqxmd.com/read/29325521/adjuvant-treatment-of-resectable-biliary-tract-cancer-with-cisplatin-plus-gemcitabine-a-prospective-single-center-phase-ii-study
#12
Alexander R Siebenhüner, Heike Seifert, Helga Bachmann, Burkhardt Seifert, Thomas Winder, Jonas Feilchenfeldt, Stefan Breitenstein, Pierre-Alain Clavien, Roger Stupp, Alexander Knuth, Bernhard Pestalozzi, Panagiotis Samaras
BACKGROUND: Biliary tract cancer (BTC) is a dismal disease, even after curative intent surgery. We conducted this prospective, non-randomized phase II study to evaluate the feasibility and efficacy of cisplatin and gemcitabine as adjuvant treatment in patients with resected BTC. METHODS: Patients initially received gemcitabine 1000 mg/m2 alone on days 1, 8 and 15 every 28-days for a total of six cycles (single agent cohort), and after protocol amendment a combination therapy with gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on days 1 and 8 was administered every 21 days for a total of eight cycles (combined regimen cohort)...
January 11, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29324586/ten-year-experience-of-transjugular-intrahepatic-portosystemic-shunt-for-noncirrhotic-portal-hypertension
#13
David Regnault, Louis d'Alteroche, Charlotte Nicolas, Fanny Dujardin, Jean Ayoub, Jean Marc Perarnau
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is considered to be well suited for the treatment of noncirrhotic portal hypertension (NCPHT) because of a usually severe portal hypertension (PHT) and a mild liver failure, but very less data are available. PATIENTS AND METHODS: Records of patients referred for TIPS between 2004 and 2015 for NCPHT were reviewed. No patient should have clinical or biological or histological features of cirrhosis. RESULTS: Twenty-five patients with a wide variety of histological lesions (sinusoidal dilatations, granulomatosis, regenerative nodular hyperplasia, obliterative portal venopathy, or subnormal liver) and a wide variety of associated diseases (thrombophilia, sarcoidosis, common variable immunodeficiency, scleroderma, Castleman's disease, early primitive biliary cirrhosis, congenital liver fibrosis, chemotherapy, purinethol intake, and congenital varices) were included...
January 10, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29322853/laser-ablation-of-the-biliary-tree-in-vivo-proof-of-concept-as-potential-treatment-of-unresectable-cholangiocarcinoma
#14
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
https://www.readbyqxmd.com/read/29320821/a-case-of-biliary-ascariasis-in-korea
#15
Jun-Ho Choi, Min Seo
Biliary ascariasis is still the leading cause of surgical complication of ascariasis, though its incidence has been dramatically reduced. Herein, we report a case of biliary ascariasis for the purpose of enhancing awareness of parasitic infections as a possible cause. A 72-year-old male visited the emergency room of Dankook University Hospital on 12 July 2015, complaining of right-upper-quadrant pain. By endoscopic retrograde cholangiopancreatography (ERCP), a tubular filling defect in the right hepatic duct was detected...
December 2017: Korean Journal of Parasitology
https://www.readbyqxmd.com/read/29320323/multimodality-imaging-including-dual-energy-ct-in-the-evaluation-of-gallbladder-disease
#16
Lisa Ratanaprasatporn, Jennifer W Uyeda, Jeremy R Wortman, Ian Richardson, Aaron D Sodickson
Imaging of the gallbladder has a key role in the examination of patients with abdominal pain-especially pain localized to the right upper quadrant. Pathologic conditions that affect the gallbladder include cholelithiasis and associated complications such as acute and chronic cholecystitis, choledocholithiasis, gallstone pancreatitis, and cancer. Modalities used to image the gallbladder include ultrasonography (US), computed tomography (CT), magnetic resonance (MR) imaging, and nuclear scintigraphy. US is the primary imaging modality used to evaluate entities suspected of being gallbladder disease, as it is both sensitive and specific for demonstrating gallstones, biliary duct dilatation, and inflammatory features...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29317950/a-biliobronchial-fistula-in-a-patient-with-hepatocellcular-carcinoma-treated-with-chemoembolization-diagnosed-by-hepatobiliary-iminodiacetic-acid-scan-and-managed-by-endoscopic-retrograde-cholangiopancreatography
#17
Yousef Nassar, Sven Hida, Seth Richter
A biliobronchial fistula is an abnormal communication between the biliary tract and the bronchial tree. It may be a rare complication after treatment of hepatocellular carcinoma with transcatheter arterial chemoembolization (TACE). We present a case of a 71-year-old man that developed a biliobronchial fistula as a complication of hepatocellular carcinoma treated with TACE. It was successfully diagnosed by hepatobiliary iminodiacetic acid (HIDA) scan and treated with endoscopic retrograde pancreatography.
December 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29317337/heart-and-bile-acids-clinical-consequences-of-altered-bile-acid-metabolism
#18
REVIEW
Tharni Vasavan, Elisa Ferraro, Effendi Ibrahim, Peter Dixon, Julia Gorelik, Catherine Williamson
Cardiac dysfunction has an increased prevalence in diseases complicated by liver cirrhosis such as primary biliary cholangitis and primary sclerosing cholangitis. This observation has led to research into the association between abnormalities in bile acid metabolism and cardiac pathology. Approximately 50% of liver cirrhosis cases develop cirrhotic cardiomyopathy. Bile acids are directly implicated in this, causing QT interval prolongation, cardiac hypertrophy, cardiomyocyte apoptosis and abnormal haemodynamics of the heart...
January 6, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29317077/the-pruritus-of-cholestasis-from-bile-acids-to-opiate-agonists-relevant-after-all-these-years
#19
Nora V Bergasa
The pruritus of cholestasis is a maddening complication of liver disease. Increased opioidergic tone contributes to the pruritus of cholestasis, as evidenced by the amelioration of the symptom by opiate antagonists. Obeticholic acid, an agonist of the farnesoid receptor, has been approved for the treatment of primary biliary cholangitis, a disease characterized by cholestasis; this drug is associated with pruritus, the cause of which is unknown. In animal models, bile acids, which accumulate in the body as a result of cholestasis, have been reported to cause scratching behavior mediated by the TGR5 receptor, in an opioid-dependent manner, in laboratory animals...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29313126/an-observational-study-of-the-timing-of-surgery-use-of-laparoscopy-and-outcomes-for-acute-cholecystitis-in-the-usa-and-uk
#20
A C Murray, S Markar, H Mackenzie, O Baser, T Wiggins, A Askari, G Hanna, O Faiz, E Mayer, C Bicknell, A Darzi, R P Kiran
BACKGROUND: Evidence supports early laparoscopic cholecystectomy for acute cholecystitis. Differences in treatment patterns between the USA and UK, associated outcomes and resource utilization are not well understood. METHODS: In this retrospective, observational study using national administrative data, emergency patients admitted with acute cholecystitis were identified in England (Hospital Episode Statistics 1998-2012) and USA (National Inpatient Sample 1998-2011)...
January 8, 2018: Surgical Endoscopy
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