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https://www.readbyqxmd.com/read/28940029/-influence-of-bile-duct-anatomy-on-biliary-complications-in-hepatic-right-lobe-living-donors
#1
A Bauschke, A Altendorf-Hofmann, C Malessa, O Rohland, U Settmacher
Perioperative morbidity in the living donation of partial livers is mainly due to infections and biliary complications. Bile duct anatomy variants, in particular of the right system, are suspected to be causative. We investigated the influence of bile duct variants on the incidence of biliary donor complications in donations of the right liver lobe. We analyzed 103 donors. Twelve patients had a bile leak that required treatment. All of these were treated endoscopically without any residual defect. We did not see a central extrahepatic bile duct lesion Nagano type C...
September 22, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28940004/adjuvant-therapy-in-biliary-atresia-hopelessly-optimistic-or-potential-for-change
#2
REVIEW
Mark Davenport
Given that the aetiology of biliary atresia (BA) is complex and that there is a multiplicity of possible pathogenic mechanisms then it is perhaps not surprising that the evidence for effect of a number of different agents is contradictory. Post-operative cholangitis for instance is common, bacterial in origin and various antibiotic regimens have been tested (although none in a randomized trial) but continuation beyond the early post-operative period does not appear to offer any greater protection. There is an inflammatory reaction in about 25-35% of cases of BA illustrated by abnormal expression of class II antigen and upregulation of ICAM, VCAM and E-selectin with an infiltrate of immune-activated T cells (predominantly CD4 + Th1 and Th17) and NK cells and a systemic surge in inflammatory cytokines (e...
September 22, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28939398/the-emergency-medicine-focused-review-of-cholangitis
#3
Rachel Ely, Brit Long, Alex Koyfman
BACKGROUND: Cholangitis is a life-threatening infection of the biliary tract. Historically, the mortality secondary to cholangitis approached 100%. However, with early recognition, antibiotics, resuscitation, and surgical or endoscopic intervention, patient outcomes have significantly improved, although there is still progress to be made. OBJECTIVE OF REVIEW: The objective of this review is to provide an emergency medicine-centered approach to the risk factors, presentations, and various diagnostic and treatment modalities in cholangitis...
September 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28936550/feasibility-and-outcomes-of-percutaneous-thermal-ablation-of-hepatocellular-carcinoma-in-a-transplanted-allograft
#4
Brian T Welch, J J Schmitz, A N Kurup, T D Atwell, M R Callstrom, G Frey, R Paz-Fumagalli, A Allen, K Watt, J Heimbach, G D Schmit
PURPOSE: To examine the safety, feasibility, and oncologic control following percutaneous image-guided thermal ablation of hepatocellular carcinoma (HCC) in a transplanted allograft. MATERIALS AND METHODS: Retrospective review was performed to identify patients who underwent liver transplantation for HCC and subsequently underwent percutaneous hepatic thermal ablation for recurrent HCC within the allograft between January 1st, 2000-September 1st, 2016. Eleven patients with hepatic allograft HCC underwent twelve percutaneous thermal ablation procedures to treat 16 lesions...
September 21, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28935574/taurocholate-induces-biliary-differentiation-of-liver-progenitor-cells-causing-hepatic-stellate-cell-chemotaxis-in-the-ductular-reaction-role-in-pediatric-cystic-fibrosis-liver-disease
#5
Katarzyna N Pozniak, Michael A Pearen, Tamara N Pereira, Cynthia Sm Kramer, Priyakshi Kalita-De Croft, Sujeevi K Nawaratna, Manuel A Fernandez-Rojo, Geoffrey N Gobert, Janina Ee Tirnitz-Parker, John K Olynyk, Ross W Shepherd, Peter J Lewindon, Grant A Ramm
Cystic fibrosis liver disease (CFLD) in children causes progressive fibrosis leading to biliary cirrhosis, however its cause(s) and early pathogenesis are unclear. We hypothesised that a bile acid-induced Ductular Reaction (DR) drives fibrogenesis. We evaluated the DR by cytokeratin-7 immunohistochemistry in liver biopsies, staged for fibrosis, from 60 children with CFLD and demonstrated that the DR was significantly correlated with hepatic fibrosis stage and biliary taurocholate levels. To examine the mechanisms involved in DR induction liver progenitor cells (LPCs) were treated with taurocholate and key events in DR evolution were assessed: LPC proliferation, LPC biliary differentiation and hepatic stellate cell (HSC) chemotaxis...
September 18, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28931801/elizabethkingia-meningoseptica-in-a-case-of-biliary-tract-infection-following-liver-transplantation
#6
Hebah M Musalem, Yazan N Honjol, Lin M Tuleimat, Saleh I Al Abbad, Fahad I Alsohaibani
BACKGROUND Elizabethkingia meningoseptica (E. meningoseptica) is an aerobic Gram-negative bacillus known to thrive in moist environments, and is now recognized as a hospital-acquired infection, being found to contaminate hospital equipment, respiratory apparatus, hospital solutions, water, and drainage systems. Nosocomial infection with E. meningoseptica occurs in immunocompromised patients, requires specialized identification methods, and is resistant to conventional antibiotics. We report a case of E. meningoseptica infection arising from a percutaneous transhepatic biliary drainage (PTBD) tube...
September 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28926836/percutaneous-biliary-balloon-dilation-impact-of-an-institutional-three-session-protocol-on-patients-with-benign-anastomotic-strictures-of-hepatojejunostomy
#7
Matias E Czerwonko, Pablo Huespe, Oscar Mazza, Martin de Santibanes, Rodrigo Sanchez-Claria, Juan Pekolj, Miguel Ciardullo, Eduardo de Santibanes, Sung Ho Hyon
BACKGROUND: Percutaneous biliary balloon dilation (PBBD) stands as a safe, useful, and inexpensive treatment procedure performed on patients with benign anastomotic stricture of Roux-en-Y hepatojejunostomy (BASH). However, the optimal mode of application is still under discussion. METHODS: A retrospective cohort study was conducted including patients admitted between 2008 and 2015 with diagnosis of BASH. Patients were divided into 2 groups: group I (n = 22), included patients treated after the implementation of an institutional protocol of 3 PBBD sessions within a fixed time interval and group II (n = 24) consisted of our historical control of patients who underwent one or 2 dilation sessions...
September 20, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28922704/direct-acting-antivirals-for-chronic-hepatitis-c
#8
REVIEW
Janus C Jakobsen, Emil Eik Nielsen, Joshua Feinberg, Kiran Kumar Katakam, Kristina Fobian, Goran Hauser, Goran Poropat, Snezana Djurisic, Karl Heinz Weiss, Milica Bjelakovic, Goran Bjelakovic, Sarah Louise Klingenberg, Jian Ping Liu, Dimitrinka Nikolova, Ronald L Koretz, Christian Gluud
BACKGROUND: Millions of people worldwide suffer from hepatitis C, which can lead to severe liver disease, liver cancer, and death. Direct-acting antivirals (DAAs), e.g. sofosbuvir, are relatively new and expensive interventions for chronic hepatitis C, and preliminary results suggest that DAAs may eradicate hepatitis C virus (HCV) from the blood (sustained virological response). Sustained virological response (SVR) is used by investigators and regulatory agencies as a surrogate outcome for morbidity and mortality, based solely on observational evidence...
September 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28913747/primary-sj%C3%A3-gren-s-syndrome-extraglandular-manifestations-and-hydroxychloroquine-therapy
#9
J Demarchi, S Papasidero, M A Medina, D Klajn, R Chaparro Del Moral, O Rillo, V Martiré, G Crespo, A Secco, A Catalan Pellet, C Amitrano, C Crow, C Asnal, P Pucci, F Caeiro, N Benzanquen, J P Pirola, M Mayer, F Zazzetti, S Velez, J Barreira, N Tamborenea, L Santiago, L Raiti
The use of hydroxychloroquine (HCQ) in Primary Sjögren's Syndrome (pSS) has been assessed in different studies over the last years, with conflicting results regarding its efficacy in sicca syndrome and extraglandular manifestations (EGM). The goal of this study was to compare the incidence rate of EGM in pSS patients with and without HCQ therapy.We performed a multicenter retrospective study, including patients with pSS (European classification criteria) with at least 1 year of follow-up. Subjects with concomitant fibromyalgia, autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis were excluded...
September 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28913620/a-brief-review-on-prognostic-models-of-primary-biliary-cholangitis
#10
REVIEW
Sha Chen, Weijia Duan, Hong You, Jidong Jia
Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune liver disease characterized by progressive destruction of small intrahepatic bile ducts. If left untreated, PBC may eventually result in end-stage liver disease. For better management of PBC and optimal allocation of medical resources, it is pivotal to accurately estimate the prognosis of patients with PBC. This article will briefly review the models that predict long-term outcome of PBC patients, with special focus on the applicability, strengths and limitations of the widely used models reported from 1983 to 2016...
September 14, 2017: Hepatology International
https://www.readbyqxmd.com/read/28913619/bile-duct-obstruction-in-a-patient-treated-with-nivolumab-as-second-line-chemotherapy-for-advanced-non-small-cell-lung-cancer-a-case-report
#11
Jumpei Kashima, Yusuke Okuma, Ryoko Shimizuguchi, Kazuro Chiba
Immune checkpoint inhibitors (ICIs) are becoming a standard therapy for non-small-cell lung cancer in the advanced stage. As these ICIs become widely available in clinical practice, immune-related adverse effects will become more common. Here we report a patient with lung adenocarcinoma who was treated with nivolumab and developed obstruction because of biliary inflammation. A 63-year-old Japanese man having lung adenocarcinoma with pleural dissemination complained of epigastric pain on the fifth cycle of nivolumab...
September 14, 2017: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/28901029/successful-venoarterial-extracorporeal-membrane-oxygenation-for-postoperative-septic-shock-in-a-child-with-liver-transplantation-a-case-report
#12
Michiko Abe, Kentaro Ide, Nao Nishimura, Satoshi Nakagawa, Akinari Fukuda, Seisuke Sakamoto, Mureo Kasahara
Refractory septic shock after LT is a life-threatening complication. VA ECMO is used to treat refractory cardiorespiratory failure. We present herein the case of a 5-year-old girl with post-Kasai biliary atresia, who underwent a living donor LT and suffered refractory septic shock. VA ECMO was indicated due to progressive cardiac deterioration. After full recovery of her EF, she has been steadily improving and has shown good liver function and no neurological sequelae. This is the first report of successful VA ECMO in a post- LT patient with refractory septic shock...
September 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28892977/external-drainage-of-giant-infantile-choledochal-cyst-before-definitive-repair-is-it-worth
#13
Vijai Datta Upadhyaya, Basant Kumar, Sandeep Kumar Raut, Eti Sthapak
Infantile Choledochal Cysts (IFCC) usually present with jaundice, acholic stool and abdominal lump or abdominal distension. If the surgical intervention is delayed, they rapidly progress to liver fibrosis which is considered to be irreversible if progressed to cirrhosis. We present the data of four cases (aged one month to seven months) of IFCC presented with cholangitis managed in one surgical unit in last two years. In one case, cholangitis was treated with prolonged antibiotic course before definitive repair whereas in rest, external drainage of cyst was done in addition to intravenous antibiotic to treat cholangitis...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890824/gemcitabine-and-capecitabine-for-advanced-biliary-cancer
#14
Emmanuel Gabriel, Shipra Gandhi, Kristopher Attwood, Boris Kuvshinoff, Steven Hochwald, Renuka Iyer
BACKGROUND: Gemcitabine with capecitabine (gem-cap) is an established regimen for advanced biliary cancer (ABC) supported by our previously reported phase II trial. Here, we provide our updated experience. METHODS: Single institution, retrospective study from 2005 to 2015 of ABC treated with gem-cap. RESULTS: A total of 372 patients with ABC were identified, of whom 227 (61.0%) were treated with chemotherapy. 153 patients (67.4%) received gem-cap, of which 129 (56...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28885493/systematic-review-and-meta-analysis-of-posttransplant-hepatic-artery-and-biliary-complications-in-patients-treated-with-transarterial-chemoembolization-before-liver-transplantation
#15
Dimitri Sneiders, Thymen Houwen, Liset H M Pengel, Wojciech G Polak, Frank J M F Dor, Hermien Hartog
BACKGROUND: Hepatic artery complications are feared complications after liver transplantation and may compromise the biliary tract, graft and patient survival. The objective of this systematic review and meta-analysis was to compare risk of hepatic artery and biliary complications after liver transplantation in patients who underwent neoadjuvant transarterial chemoembolization (TACE) vs. no TACE. METHODS: Comprehensive searches were performed in Embase, MEDLINE OvidSP, Web of Science, Google Scholar and Cochrane databases to identify studies concerning hepatocellular cancer patients undergoing preliver transplantation TACE...
September 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28883243/an-hiv-positive-case-of-obstructive-jaundice-caused-by-immune-reconstitution-inflammatory-syndrome-of-tuberculous-lymphadenitis-successfully-treated-with-corticosteroids
#16
Naoaki Watanabe, Ryota Sato, Hideaki Nagai, Hirotoshi Matsui, Akira Yamane, Masahiro Kawashima, Junko Suzuki, Hiroyuki Tashimo, Nobuharu Ohshima, Kimihiko Masuda, Atsuhisa Tamura, Shinobu Akagawa, Akira Hebisawa, Ken Ohta
A 60-year-old man was admitted to our hospital because of a persistent fever with enlargement of multiple lymph nodes in the mediastinum and around the pancreatic head. He was diagnosed with tuberculosis and human immunodeficiency virus infection. We started antiretroviral therapy three weeks after the initiation of anti-tuberculous therapy. Two weeks later, jaundice appeared with dilatation of the biliary tract due to further enlargement of the lymph nodes, which seemed to be immune reconstitution inflammatory syndrome (IRIS)...
September 6, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28877392/prevalence-of-pruritus-in-patients-with-chronic-liver-disease-a-multicenter-study
#17
Satoshi Oeda, Hirokazu Takahashi, Hisako Yoshida, Yuji Ogawa, Kento Imajo, Masato Yoneda, Yuichi Koshiyama, Masafumi Ono, Hideyuki Hyogo, Takumi Kawaguchi, Hideki Fujii, Ken Nishino, Yoshio Sumida, Saiyu Tanaka, Miwa Kawanaka, Takuji Torimura, Toshiji Saibara, Atsushi Kawaguchi, Atsushi Nakajima, Yuichiro Eguchi
AIM: Pruritus is a common comorbidity in chronic liver disease. The aim of this study was to clarify the prevalence of pruritus and its characteristics in patients with chronic liver disease. METHODS: A total of 1,631 patients with chronic liver disease, who attended 9 joint-research facilities from January to June 2016 were enrolled. We investigated the prevalence of pruritus, itch location, itch duration, daily itch fluctuation, seasonal itch exacerbation, treatment drug, and therapeutic effect using a medical interview questionnaire...
September 6, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28876562/resection-of-benign-liver-tumours-an-analysis-of-62-consecutive-cases-treated-in-an-academic-referral-centre
#18
J E J Krige, E Jonas, S J Beningfield, A Booth, U K Kotze, M Bernon, S Burmeister
BACKGROUND: Benign tumours of the liver are increasingly diagnosed and constitute a substantial proportion of all hepatic tumours evaluated and resected at tertiary referral centres. This study assessed the safety and outcome after resection of benign liver tumours at a major referral centre. METHOD: All patients with symptomatic benign liver tumours who underwent resection were identified from a prospective departmental database of a total of 474 liver resections (LRs)...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28875690/use-of-fully-covered-self-expanding-metal-stents-for-benign-biliary-etiologies-a-large-multi-center-experience
#19
Abdul Haseeb, Ali Siddiqui, Linda J Taylor, Alyssa Mills, Thomas E Kowalski, David E Loren, Jessica Dahmus, Silpa Yalamanchili, Christopher Cao, Andrew Canakis, Tayebah Mumtaz, Meet Parikh, Douglas G Adler
INTRODUCTION: Fully-covered self-expandable metal stents (FCSEMS) have been used in benign biliary diseases although reported data is limited. These devices are most commonly used to treat biliary leaks, strictures, or both. The aim of this study was to evaluate effectiveness of FCSEMS in treating benign biliary disease and recognize the associated complications. METHODS: We performed a multi-center longitudinal retrospective cohort study of patients with benign biliary disease needing FCSEMS between 2011 and 2016...
September 5, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28871989/long-term-outcomes-of-phase-1-and-2-studies-of-sbrt-for-hepatic-colorectal-metastases
#20
Andrew McPartlin, Anand Swaminath, Ri Wang, Melania Pintilie, James Brierley, John Kim, Jolie Ringash, Rebecca Wong, Rob Dinniwell, Tim Craig, Laura A Dawson
PURPOSE: To report mature outcomes of prospective phase 1 and 2 studies of stereotactic body radiation therapy (SBRT) for the treatment of colorectal liver metastases (CLMs). METHODS AND MATERIALS: Patients with histologically confirmed CLMs unsuitable for resection or standard therapies were eligible for sequential phase 1 and 2 studies conducted from 2003 to 2012. RESULTS: Of 60 patients treated, 82% had received previous chemotherapy, 23% had undergone previous focal liver treatment, and 38% had extrahepatic disease at the time of SBRT...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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