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Chen-Yi Liao, Chi-Hsiang Chung, Pauling Chu, Kuang-Yu Wei, Tseng-Min Feng, Fu-Huang Lin, Chang-Huei Tsao, Chia-Chao Wu, Wu-Chien Chien
BACKGROUND: We evaluated the risk of osteoporosis in patients with primary biliary cirrhosis (PBC) using a nationwide population-based dataset. METHODS: In a cohort study of 986,713 individuals, we selected 2,493 PBC patients who were aged 18 years or older and had been diagnosed with PBC, based on the International Classification of Disease (ICD-9-CM) codes 571.6, during 20002010. The control cohort comprised 9,972 randomly selected, propensity matched patients (by age, gender, and index date), without PBC...
2018: PloS One
N Pinsker, M Papoulas, M Sodergren, P Harrison, N Heaton, K Menon
Introduction A bronchobiliary fistula (BBF) following liver directed therapy (resection/ablation) is a rare complication in which an abnormal communication between the biliary tract and bronchial tree is formed. This case report describes the successful management of a persistent BBF following multiple liver wedge resections and microwave ablation in a patient with a metastatic neuroendocrine tumour of the terminal ileum. Case history A 69-year-old man presented with unexplained weight loss and was subsequently diagnosed with a neuroendocrine tumour of the terminal ileum and liver metastasis...
March 15, 2018: Annals of the Royal College of Surgeons of England
Caoye Wang, Zhengqiang Yang, Jinguo Xia, Weiping Wang, Wenhua Chen, Qi Wang
Bronchobiliary fistula (BBF) is a rare condition, defined as an abnormal communication between the bronchial system and the biliary tree. Patients with this condition usually present with massive biliptysis, and the mortality rate is high. BBF has been reported to occur in patients with congenital conditions, complications of trauma, hepatic abscesses and biliary tract obstruction (surgical as well as non-surgical). However, to the best of our knowledge, BBF as a complication of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) has not been reported to date...
April 2018: Molecular and Clinical Oncology
Motoko Sasaki, Yasunori Sato, Yasuni Nakanuma
Dysregulated autophagy may be a central player in trehe pathogenesis of primary biliary cholangitis (PBC) by inducing autoimmune processes via abnormal expression of mitochondrial antigens such as pyruvate dehydrogenase complex, E2 component (PDC-E2) and also by inducing cellular senescence in biliary epithelial cells (BECs) in bile duct lesions in PBC. We examined the association of an impaired "biliary bicarbonate umbrella" due to dysfunction of anion exchanger 2 (AE2) with dysregulated autophagy and cellular senescence in PBC...
March 14, 2018: Laboratory Investigation; a Journal of Technical Methods and Pathology
Jarmo Niemelä, Raija Kallio, Pasi Ohtonen, Jukka Perälä, Juha Saarnio, Hannu Syrjälä
BACKGROUND: Malignant biliary obstruction is a challenging problem for cancer patients. Here we evaluate predictive factors for survival following percutaneous drainage for malignant biliary obstruction in patients in whom endoscopic drainage was unsuccessful or insufficient. METHODS: A retrospective register study in a tertiary-level university hospital. RESULTS: A total of 643 cancer patients (317 females and 326 males) with malignant biliary obstruction were treated with percutaneous drainage at our hospital between 1999 and 2016...
March 13, 2018: World Journal of Surgery
Ashwin Rammohan, Sripriya Srinivas, Yahya Al Azri, Mettu Srinivas Reddy, Mohamed Rela
Roux-en-Y (RY) hepaticojejunostomy (HJ) is a critical component of complex hepatobiliary operations, and it is the treatment of choice for post-cholecystectomy biliary strictures (PCBS). Complications related to the Roux limb, particularly those leading to cholangitis, can severely compromise outcomes. We present a case of a 54-year-old lady who had previously undergone two HJ procedures for recurrent PCBS. The same Roux limb had been used in each of the operations. Short Roux/Roux reflux syndrome led to recurrent cholangitis in this patient, as proven by the reflux of oral contrast into the biliary tree on imaging...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Bader Hamza Shirah, Hamza Asaad Shirah, Syed Husham Zafar, Khalid B Albeladi
Backgrounds/Aims: Postcholecystectomy syndrome represents a heterogeneous group of symptoms and findings in patients who have previously undergone cholecystectomy. It is rare and under-reported in Saudi Arabia. It can be attributed to many complications such as bile duct injury, biliary leak, retained common bile duct stones, recurrent bile duct stones, and bile duct strictures. In this study, we aimed to analyze the causes and evaluate the approach to postcholecystectomy syndrome in our local Saudi Arabian community because of the vast number of cases encountered in our hospital for gallbladder clinical conditions and its related complications...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Hyun Young Woo, In Seok Lee, Jae Hyuck Chang, Seung Bae Youn, Si Hyun Bae, Jong Young Choi, Ho Jong Chun, Young Kyoung You, Dong Goo Kim, Seung Kew Yoon
Background/Aims: Biliary complications are the most common donor complication following living donor liver transplantation (LDLT). The aim of this study is to investigate the long-term outcomes of biliary complications in right lobe adult-to-adult LDLT donors, and to evaluate the efficacy of endoscopic treatment of these donors. Methods: The medical charts of right lobe donors who developed biliary complications between June 2000 and January 2008 were retrospectively reviewed...
March 14, 2018: Korean Journal of Internal Medicine
Yuji Eso, Norimitsu Uza, Kotaro Shirakawa, Kenji Sawada, Kentaro Katsuragi, Minoru Matsuura, Hiroshi Seno
We herein report a patient with a history of rheumatoid arthritis treated with methotrexate, which caused methotrexate-associated lymphoproliferative disorder and obstructive jaundice due to an enlarged lymph node. The obstructive jaundice was treated with endoscopic biliary stenting. A histopathological examination revealed features of Hodgkin's lymphoma, and chemotherapy with brentuximab vedotin was administered. Cholangiography and duodenoscopy after four rounds of chemotherapy revealed a choledochoduodenal fistula that developed in response to chemotherapy...
March 9, 2018: Internal Medicine
Rachel E NeMoyer, Mihir M Shah, Omar Hasan, John L Nosher, Darren R Carpizo
INTRODUCTION: Benign strictures of the biliary system are challenging and uncommon conditions requiring a multidisciplinary team for appropriate management. PRESENTATION OF CASE: The patient is a 32-year-old male that developed a hilar stricture as sequelae of a gunshot wound. Due to the complex nature of the stricture and scarring at the porta hepatis a combined interventional radiologic and surgical approach was carried out to approach the hilum of the right and left hepatic ducts...
March 3, 2018: International Journal of Surgery Case Reports
Dong Il Gwon, Gi-Young Ko, Jong Woo Kim, Heung Kyu Ko, Hyun-Ki Yoon, Kyu-Bo Sung
Objective: To investigate the technical safety and clinical efficacy of a double-stent system with long duodenal extension in patients with malignant extrahepatic biliary obstruction. Materials and Methods: This prospective study enrolled 48 consecutive patients (31 men, 17 women; mean age, 61 years; age range, 31-77 years) with malignant extrahepatic biliary obstructions from May 2013 to December 2015. All patients were treated with a double-stent system with long duodenal covered extension (16 cm or 21 cm)...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Lara M de A Coutinho, Wanderley M Bernardo, Rodrigo S Rocha, Fabio R Marinho, Aureo Delgado, Eduardo T H Moura, Sergio E Matuguma, Dalton Chaves, Tomazo A P Franzini, Paulo Sakai, Eduardo G H de Moura
OBJECTIVES: The aim of the study was to evaluate the role of early endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of acute biliary pancreatitis, in comparison with conservative treatment. METHODS: Systematic review via databases (MEDLINE [PubMed], Latin-American and Caribbean Health Sciences Literature database, Embase, Cochrane Central, and the [Brazilian] Regional Library of Medicine) is conducted. We analyzed 10 randomized controlled trials (1091 patients)...
April 2018: Pancreas
Tarik Mahfoud, Rachid Tanz, Mohamed Réda Khmamouche, Mohamed Allaoui, Rhizlane Belbaraka, Mouna Khouchani, Mohamed Ichou
Synchronous primary cancers involving the pancreas and kidney are extremely rare and poorly documented. We report the first case of this association treated with chemotherapy and tyrosine kinase inhibitor. A 70-year-old woman presented with a 2-month history of epigastric pain with weight loss of 12 kg. Two weeks previously, she had presented with jaundice and pelvic pain. A computed tomography (CT) scan of the body revealed the presence of an irregular mass in the body of the pancreas, encasing the celiac trunk, with dilatation of the biliary tract...
September 2017: Case Reports in Oncology
Francisco Javier Garcia-Alonso, Ramón Sanchez-Ocana, Irene Peñas-Herrero, Ryan Law, Sergio Sevilla-Ribota, Raúl Torres-Yuste, Paula Gil-Simón, Carlos de la Serna Higuera, Manuel Perez-Miranda
BACKGROUND:  Delayed gastrointestinal (GI) bleeding and stent migration are known adverse events which may occur following placement of lumen-apposing metal stents (LAMSs). METHODS:  All consecutive patients who underwent LAMS placement between May 2011 and June 2017 at a single tertiary medical center were included. Demographics and procedural details were prospectively collected. Post-procedure follow-up and outcome measures were retrospectively collected...
March 7, 2018: Endoscopy
Jiaqi Wang, Yixuan Pan, Jiacheng Hu, Qiang Ma, Yi Xu, Yijian Zhang, Fei Zhang, Yingbin Liu
Gallbladder cancer (GBC) is the most common malignancy in the biliary tract. Without effective treatment, its prognosis is notoriously poor. Tea polyphenols (TPs) have many pharmacological and health benefits, including antioxidant, anti-inflammatory, anti-tumor, anti-thrombotic, antibacterial, and vasodilatory properties. However, the anti-cancer effect of TPs in human gallbladder cancer has not yet been determined. Cell viability and colony formation assay were used to investigate the cell growth. Cell cycle and apoptosis were evaluated by flow cytometry analysis...
March 1, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Gulraiz Chaudry, Anna P Lillis, Raja Shaikh, Horacio M Padua, Rush H Chewning, Ahmad I Alomari
PURPOSE: To characterize anatomy of congenital arterioportal fistulas (CAPF) and correlate this with technique and outcomes of transcatheter embolization (TCE). MATERIALS AND METHODS: Retrospective review was conducted of children with CAPF that underwent TCE in a 10-year period. Medical records, imaging and procedure details were reviewed. TCE was performed via transarterial (n = 5), portal (n = 5) or patent ductus venosus (n = 1) approach. Embolic agents used were coils (n = 10), Onyx (n = 1) and Amplatzer septal occluder (n = 1)...
March 6, 2018: Cardiovascular and Interventional Radiology
Tetsuro Akashi, Yuichi Tachibana, Susumu Matsuo, Junya Gibo
Acute cholangitis is a fatal condition if inadequately treated. It is possible to underestimate the severity of the condition because bacterial cultures are not immediately available. We evaluated the clinical features of patients with cholangitis due to bile duct stones who were diagnosed with severe bacteremia at the time of hospitalization, but not at the time of the initial visit. We conducted a retrospective analysis of cases of endoscopic retrograde cholangiopancreatography performed between January 2007 and October 2011 in patients with bile duct stones complicated by cholangitis...
February 2018: Gastroenterology Research
Arnaud Pasquer, Elise Pelascini, Gilles Poncet, Maud Robert
PURPOSE: Postoperative abdominal pain after Roux en Y gastric bypass associated with gastro esophageal reflux is difficult to manage. A gastro-gastric fistula can be the etiology and besides pain and weight regain, it can also be revealed by a dilatation of the excluded stomach and duodenum. METHODS: We present the case of a 45-year-old woman who had a medical history of revisional RYGB after failure of gastric band. She recently complained of recurrent epigastric abdominal pain and biliary GERD...
March 5, 2018: Obesity Surgery
Henggao Zhong, Xiaohong Wang, Lihua Yang, Lin Miao, Guozhong Ji, Zhining Fan
This study aimed to assess the clinical value of transprepancreatic septotomy indwelling guide wire or pancreatic duct stent in intractable endoscopic retrograde cholangiopancreatography (ERCP) for bile duct cannulation.Of the 2107 patients treated by ERCP, a total of 81 cases with difficult bile duct cannulation underwent transprebiliopancreatic septotomy (referred to as the septotomy group, 37 cases) and transprepancreatic septotomy with pancreatic duct stent (modified septotomy group, 44 cases). Success rates of cannulation and postoperative complications for both methods were compared...
January 2018: Medicine (Baltimore)
Fernando A Alvarez, Denis Castaing, Rodrigo Figueroa, Marc Antoine Allard, Nicolas Golse, Gabriella Pittau, Oriana Ciacio, Antonio Sa Cunha, Daniel Cherqui, Daniel Azoulay, René Adam, Eric Vibert
BACKGROUND: Portal vein embolization (PVE) use is nowadays debated due to the risk of technical or biological unresectability after the period of time needed to achieve future liver remnant (FLR) hypertrophy. We evaluated the safety and efficacy of PVE in a single high-volume hepatobiliary center, with emphasis in the feasibility to achieve tumor resection. METHODS: Patients undergoing PVE before major hepatectomy at our institution between 1993 and 2015 were retrospectively analyzed...
March 1, 2018: Surgery
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