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https://www.readbyqxmd.com/read/28448071/azathioprine-maintenance-therapy-to-prevent-relapses-in-autoimmune-pancreatitis
#1
Nicolò de Pretis, Antonio Amodio, Laura Bernardoni, Pietro Campagnola, Fabiana Capuano, Suresh T Chari, Stefano Crinò, Armando Gabbrielli, Arianna Massella, Mark Topazian, Luca Frulloni
OBJECTIVES: Steroids are used to induce remission in autoimmune pancreatitis (AIP). Low-dosage steroid therapy or immunosuppressant (IMs) has been proposed as maintenance therapy to prevent AIP relapse. Few and conflicting data have been published on the efficacy of azathioprine (AZA) in preventing AIP relapse. The aim of this study was to evaluate the indication and efficacy of AZA as maintenance therapy to prevent disease relapse in AIP. METHODS: Patients suffering from AIP diagnosed according to the ICDC in type 1, type 2, and not otherwise specified (NOS) were divided in those treated with AZA (AZA(+) group) as maintenance therapy and not treated with maintenance therapy (AZA(-) group)...
April 27, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28438130/the-safety-and-efficacy-of-percutaneous-intraductal-radiofrequency-ablation-in-unresectable-malignant-biliary-obstruction-a-single-institution-experience
#2
Wei Cui, Wenzhe Fan, Mingjian Lu, Yingqiang Zhang, Wang Yao, Jiaping Li, Yu Wang
BACKGROUND: Patients with unresectable malignant biliary obstruction have limited life expectancy because of limited stent patency and tumor progression. The aim of our study was to retrospectively evaluate the safety and efficacy of combining intraductal RFA with biliary metal stent placement for patients with malignant biliary obstruction. METHODS: Patients who received percutaneous intraductal RFA and biliary stent placement for malignant biliary obstruction between 2013 and 2015 were identified...
April 24, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28438089/feline-biliary-tree-and-gallbladder-disease
#3
Corma Ma Otte, Louis C Penning, Jan Rothuizen
Practical relevance Diseases of the biliary tree and gallbladder are more common in cats than diseases of the liver parenchyma. The parenchyma is usually affected secondarily to systemic illnesses, while the biliary system is the prime target for infectious agents (eg, bacteria and flukes) and non-infectious conditions (eg, neoplasia and cysts). Clinical approaches Cats with biliary disease are evaluated because of common feline clinical signs such as anorexia, nausea, vomiting and lethargy. Icterus may or may not be obvious...
May 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28428652/percutaneous-stent-placement-for-the-treatment-of-malignant-biliary-obstruction-nitinol-versus-elgiloy-stents
#4
Charles Edouard Zurstrassen, Almir Galvão Vieira Bitencourt, Marcos Duarte Guimaraes, Aline Cristine Barbosa Santos Cavalcante, Chiang Jeng Tyng, Mauricio Kauark Amoedo, João Paulo Kawaoka Matsushita Junior, Janio Szklaruk, Edson Marchiori, Rubens Chojniak
OBJECTIVE: This study aimed to compare two self-expanding stents, a nitinol stent and an elgiloy stent, both placed percutaneously, in terms of their efficacy in palliating inoperable malignant biliary obstruction. MATERIALS AND METHODS: We retrospectively investigated 99 patients with unresectable malignant biliary obstruction treated with percutaneous placement of a self-expanding metallic stent at our institution between May 2007 and January 2010. Serum bilirubin and liver enzyme levels were measured before and 30 days after stenting...
March 2017: Radiologia Brasileira
https://www.readbyqxmd.com/read/28427741/management-of-biliary-anastomotic-strictures-after-liver-transplantation
#5
REVIEW
Aydin Seref Koksal, Ahmet Tarik Eminler, Erkan Parlak, Ahmet Gurakar
Biliary strictures constitute 40% to 60% of the biliary complications after liver transplantation. They are more common after living donor related liver transplantation (LDLT) than orthotopic liver transplantation (OLT). Balloon dilation followed by multiple plastic stent insertion leads to a mean resolution rate of 84% in the treatment of ASs after OLT. Endoscopic treatment of ASs after LDLT is more difficult because of the small size of the ASs, their multiple number and peripheral location. Balloon dilation followed by multiple plastic stent insertion had a mean resolution rate of 53%...
March 30, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28425682/mild-acute-biliary-pancreatitis-the-timing-of-cholecystectomy-should-not-exceed-index-admission
#6
Luca Degrate, Davide P Bernasconi, Paola Meroni, Mattia Garancini, Daniele Macchini, Fabrizio Romano, Fabio Uggeri, Luca Gianotti
BACKGROUND: Laparoscopic cholecystectomy (LC) to treat mild biliary acute pancreatitis (MBAP) during index admission is recommended. However, the optimal surgical timing is controversial, considering that patients are actually often discharged from hospital and readmitted for elective cholecystectomy. Moreover, previous studies showed an uneven patients' stratification for pancreatitis severity. The aim of this study was to determine the outcome of patients homogenously categorised for MBAP according to the newest pancreatitis classifications, undergoing cholecystectomy with different timing...
April 19, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28425413/ursodeoxycholic-acid-therapy-in-patients-with-primary-biliary-cholangitis-with-limited-liver-transplantation-availability
#7
Yazmín Karel Melchor-Mendoza, Braulio Martínez-Benítez, Aline Mina-Hawat, Gustavo Rodríguez-Leal, Ximena Duque, Segundo Moran-Villota
INTRODUCTION: There is little information on survival rates of patients with primary biliary cholangtis (PBC) in developing countries. This is particularly true in Latin America, where the number of liver transplants performed remains extremely low for patients with advanced liver disease who fulfill criteria for liver transplantation. The goal of this study was to compare survival rate of patients with PBC in developing countries who were treated with ursodeoxycholic acid (UDCA) versus survival of patients who received other treatments (OT) without UDCA, prescribed before the UDCA era...
May 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28425273/radiation-therapy-for-biliary-tract-tumors-the-joint-experience-of-three-centers
#8
Mehmet Sinan Karabey, Eda Yirmibeşoğlu Erkal, Ahmet Yolcu, Bekir Hakan Bakkal, Özlem Ay, Maksut Görkem Aksu, Emine Binnaz Sarper, Haldun Şükrü Erkal
BACKGROUND/AIM: This study presents the joint experience of three centers in the treatment of patients with biliary tract tumors with radiation therapy (RT). MATERIALS AND METHODS: The records of 27 patients were retrospectively reviewed. All of the patients who had undergone surgical resection received postoperative adjuvant RT, whereas all of the patients who had not undergone a surgical resection received RT with palliative intent. Twenty patients with adequate performance status were treated with RT and chemotherapy, while the remaining seven patients were treated with RT alone...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28424862/laparoscopic-management-of-choledochal-cysts-is-a-keyhole-view-missing-the-big-picture
#9
REVIEW
Mark D Stringer
In recent years, numerous articles have promoted laparoscopic surgical treatment of choledochal cysts in children. Most of these reports assert that laparoscopic excision and biliary reconstruction are as safe as open surgery and achieve equivalent or better results. However, these conclusions are based on retrospective analyses with median follow-up periods that rarely exceed 5 years. Closer scrutiny of the laparoscopic literature indicates that the optimum procedure for treating type I and most type IVa choledochal cysts, namely radical excision of the extrahepatic bile ducts and reconstruction by wide hilar hepaticoenterostomy, preferably hepaticojejunostomy, is not being carried out in most cases...
April 19, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28420650/changes-in-lxr-signaling-influence-early-pregnancy-lipogenesis-and-protect-against-dysregulated-fetoplacental-lipid-homeostasis
#10
Vanya Nikolova, Georgia Papacleovoulou, Elena Bellafante, Luiza Borges Manna, Eugene Jansen, Silvère Baron, Shadi Abu-Hayyeh, Malcolm G Parker, Catherine Williamson
Human pregnancy is associated with enhanced de novo lipogenesis in the early stages followed by hyperlipidemia during advanced gestation. Liver X receptors (LXRs) are oxysterol-activated nuclear receptors which stimulate de novo lipogenesis and also promote the efflux of cholesterol from extrahepatic tissues followed by its transport back to the liver for biliary excretion. Although LXR is recognized as a master regulator of triglyceride and cholesterol homeostasis it is unknown whether it facilitates the gestational adaptations in lipid metabolism...
April 18, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28411359/incidence-and-treatment-of-bile-stones-after-liver-transplant
#11
Mahir Kırnap, Ebru Hative Ayvazoğlu Soy, Aydıncan Akdur, Sedat Yıldırım, Ali Harman, Gökhan Moray, Mehmet Haberal
OBJECTIVES: Although the incidence of bile stones after liver transplant is rare (2%-6%), various complications can occur, including recurrent cholangitis, biliary strictures, graft loss, and patient mortality. MATERIALS AND METHODS: We retrospectively evaluated bile stone incidence, pathogenesis, and treatment in 352 liver transplant recipients, comparing demographics, transplant indication, blood lipid profile, bile reconstruction technique, postoperative complications, time of diagnosis, and treatment regimens...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28408243/erlotinib-and-bevacizumab-in-patients-with-advanced-non-small-cell-lung-cancer-and-activating-egfr-mutations-belief-an-international-multicentre-single-arm-phase-2-trial
#12
Rafael Rosell, Urania Dafni, Enriqueta Felip, Alessandra Curioni-Fontecedro, Oliver Gautschi, Solange Peters, Bartomeu Massutí, Ramon Palmero, Santiago Ponce Aix, Enric Carcereny, Martin Früh, Miklos Pless, Sanjay Popat, Athanasios Kotsakis, Sinead Cuffe, Paolo Bidoli, Adolfo Favaretto, Patrizia Froesch, Noemí Reguart, Javier Puente, Linda Coate, Fabrice Barlesi, Daniel Rauch, Michael Thomas, Carlos Camps, Jose Gómez-Codina, Margarita Majem, Rut Porta, Riyaz Shah, Emer Hanrahan, Roswitha Kammler, Barbara Ruepp, Manuela Rabaglio, Marie Kassapian, Niki Karachaliou, Rachel Tam, David S Shames, Miguel A Molina-Vila, Rolf A Stahel
BACKGROUND: The tyrosine kinase inhibitor erlotinib improves the outcomes of patients with advanced non-small-cell lung carcinoma (NSCLC) harbouring epidermal growth factor receptor (EGFR) mutations. The coexistence of the T790M resistance mutation with another EGFR mutation in treatment-naive patients has been associated with a shorter progression-free survival to EGFR inhibition than in the absence of the T790M mutation. To test this hypothesis clinically, we developed a proof-of-concept study, in which patients with EGFR-mutant NSCLC were treated with the combination of erlotinib and bevacizumab, stratified by the presence of the pretreatment T790M mutation...
April 10, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28406769/dexamethasone-effect-on-the-expression-of-transforming-growth-factor-%C3%AE-1-smads-signaling-pathway-in-benign-biliary-stricture-fibroblasts-in-rodent
#13
Ke -Yue Li, Cheng -Xian Shi, Jian -Zhao Huang, Ke -Li Tang
OBJECTIVE: To investigate the effects of dexamethasone on transforming growth factor (TGF)-β1/Smads signaling pathway in benign biliary stricture (BBS) fibroblasts. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: Guizhou Medical University, Guiyang, Guizhou, China, from January to August 2016. METHODOLOGY: Fibroblasts derived from rabbit BBS model were cultured and identified, then treated by different concentration of dexamethasone (0...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28405328/photodynamic-therapy-with-polyhematoporphyrin-for-malignant-biliary-obstruction-a-nationwide-retrospective-study-of-150-consecutive-applications
#14
Werner Dolak, Hubert Schwaighofer, Brigitte Hellmich, Bernhard Stadler, Georg Spaun, Wolfgang Plieschnegger, Arnold Hebenstreit, Jutta Weber-Eibel, Franz Siebert, Klaus Emmanuel, Peter Knoflach, Michael Gschwantler, Wolfgang Vogel, Michael Trauner, Andreas Püspök
BACKGROUND: Photodynamic therapy (PDT) is a palliative treatment for malignant biliary obstruction. OBJECTIVE: The objective of this article is to assess the feasibility and safety of this technique. METHODS: In this nationwide, retrospective study of prospectively collected clinical data, all patients treated with PDT using polyhematoporphyrin in Austria from March 2004 to May 2013 were included. Feasibility, adverse events, stent patency and mortality rates were investigated...
February 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28404067/continuous-wound-infiltration-versus-epidural-analgesia-after-hepato-pancreato-biliary-surgery-pop-up-a-randomised-controlled-open-label-non-inferiority-trial
#15
Timothy H Mungroop, Denise P Veelo, Olivier R Busch, Susan van Dieren, Thomas M van Gulik, Tom M Karsten, Steve M de Castro, Marc B Godfried, Bram Thiel, Markus W Hollmann, Philipp Lirk, Marc G Besselink
BACKGROUND: Epidural analgesia is the international standard for pain treatment in abdominal surgery. Although some studies have advocated continuous wound infiltration with local anaesthetics, robust evidence is lacking, especially on patient-reported outcome measures. We aimed to determine the effectiveness of continuous wound infiltration in hepato-pancreato-biliary surgery. METHODS: In this randomised controlled, open label, non-inferiority trial (POP-UP), we enrolled adult patients undergoing hepato-pancreato-biliary surgery by subcostal or midline laparotomy in two Dutch hospitals...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403110/a-feasibility-study-of-digital-single-operator-cholangioscopy-for-diagnostic-and-therapeutic-procedure-with-videos
#16
Miyuki Imanishi, Takeshi Ogura, Yoshitaka Kurisu, Saori Onda, Wataru Takagi, Atsushi Okuda, Akira Miyano, Mio Amano, Nobu Nishioka, Daisuke Masuda, Kazuhide Higuchi
Recently, the novel SpyGlass DS Direct Visualization system (SPY DS) has become available. This system offers several advantages over the conventional SPYGlass system. This study evaluated the clinical feasibility and efficacy of diagnostic and therapeutic procedures for biliary disorder using SPY DS.In this retrospective study, consecutive patients who had biliary disorder were enrolled between November 2015 and February 2016. All patients could not be diagnosed or treated by standard endoscopic retrograde cholangiopancreatography in our hospital or at another hospital...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28397047/efficacy-and-safety-of-chemotherapy-with-or-without-targeted-therapy-in-biliary-tract-cancer-a-meta-analysis-of-7-randomized-controlled-trials
#17
Xin Zhuang, Ya-Ping Xiao, Ling-Hua Tan, Lu-Ting Wang, Qian Cao, Gui-Fang Qu, Shuang Xiao, Hua-Xin Duan
The systematic treatment based on gemcitabine plus cisplatin is recommended as the current standard chemotherapy for unresectable or metastatic biliary tract cancers. However, the exact benefits from the recognized regime are still dismal. We thus elicit this study in an attempt to analyze whether targeted therapy coupled with various chemotherapy could produce improvement of survival benefits. The clinical trials were searched electronically from databases till July 2016 published in English and Chinese. Nine hundred and sixty-four patients from 7 trials were identified in our analysis...
April 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28394402/dual-hypothermic-oxygenated-machine-perfusion-in-liver-transplants-donated-after-circulatory-death
#18
R van Rijn, N Karimian, A P M Matton, L C Burlage, A C Westerkamp, A P van den Berg, R H J de Kleine, M T de Boer, T Lisman, R J Porte
BACKGROUND: Experimental studies have suggested that end-ischaemic dual hypothermic oxygenated machine perfusion (DHOPE) may restore hepatocellular energy status and reduce reperfusion injury in donation after circulatory death (DCD) liver grafts. The aim of this prospective case-control study was to assess the safety and feasibility of DHOPE in DCD liver transplantation. METHODS: In consecutive DCD liver transplantations, liver grafts were treated with end-ischaemic DHOPE...
April 10, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28373474/evaluation-of-tumor-markers-and-their-impact-on-prognosis-in-gallbladder-bile-duct-and-cholangiocellular-carcinomas-a-pilot-study
#19
Vaclav Liska, Vladislav Treska, Tomas Skalicky, Jakub Fichtl, Jan Bruha, Ondrej Vycital, Ondrej Topolcan, Richard Palek, Jachym Rosendorf, Jiri Polivka, Lubos Holubec
BACKGROUND/AIM: The behavior of tumor markers in biliary tract malignancies is not well-known and has been scarcely studied. Such markers could play important roles in diagnostic and prognostic schemes as well as in decision-making about the best treatment strategies. This study analyzed the preoperative serum levels of conventional tumor markers (AFP, CEA, CA 19-9, CA 72-4), proliferative marker thymidine kinase (TK) and cytokeratins (TPA, TPS and CYFRA 21.1) in patients with gallbladder carcinoma, bile duct carcinoma (Klatskin) and cholangiocellular carcinoma, in relation to the patient prognosis...
April 2017: Anticancer Research
https://www.readbyqxmd.com/read/28372450/a-bronchobiliary-fistula-treated-with-cyanoacrylate-glue-in-a-patient-with-liver-cirrhosis
#20
Raúl Honrubia López, Ana Barbado Cano, Gloria Ruiz Fernández, Katherine Yelenia Bustamante Robles
A 60-year-old male was operated upon in 2002 for liver hydatidosis, which included partial right hepatectomy with cholecystectomy and bilioduodenal anastomosis. He then developed liver cirrhosis secondary to left hepatic duct stricture. He presents at the emergency room with dry cough, which he had for a month and then became associated with yellowish, bitter-tasting "fluid" expectoration. A chest-abdominal CT scan revealed a 6 x 5-cm collection roughly located somewhere between the middle pulmonary lobe and subphrenic area ...
April 2017: Revista Española de Enfermedades Digestivas
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