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Obstructive jaundice

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https://www.readbyqxmd.com/read/28088598/are-the-current-guidelines-for-the-surgical-management-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-adequate-a-multi-institutional-study
#1
Gregory C Wilson, Shishir K Maithel, David Bentrem, Daniel E Abbott, Sharon Weber, Clifford Cho, Robert Cg Martin, Charles R Scoggins, Hong Jin Kim, Nipun B Merchant, David A Kooby, Michael J Edwards, Syed A Ahmad
BACKGROUND: Controversy persists regarding the management of patients with IPMN. International consensus guidelines stratify patients into high risk, worrisome, and low risk categories. STUDY DESIGN: The medical records of 7 institutions were reviewed for patients that underwent surgical management of IPMN between 2000-2015. RESULTS: 324 patients were included in the analysis. 60.4% of patients had main-duct / mixed type, and 39.7% had branch-duct IPMN...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28079795/pancreatic-groove-cancer
#2
Yuan-Hao Ku, Shih-Chin Chen, Bor-Uei Shyr, Rheun-Chuan Lee, Yi-Ming Shyr, Shin-E Wang
Pancreatic groove cancer is very rare and can be indistinguishable from groove pancreatitis. This study is to clarify the characteristics, clinical features, managements, and survival outcomes of this rare tumor.Brief descriptions were made for each case of pancreatic groove cancer encountered at our institute. Individualized data of pancreatic groove cancer cases described in the literature were extracted and added to our database to expand the study sample size for a more complete analysis.A total of 33 patients with pancreatic groove cancer were included for analysis, including 4 cases from our institute...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28076503/effect-of-s%C3%A4-lymar%C3%A4-n-on-ox%C3%A4-dat%C3%A4-ve-stress-and-l%C3%A4-ver-h%C3%A4-stopathology-%C3%A4-n-exper%C3%A4-mental-obstruct%C3%A4-ve-jaund%C3%A4-ce-model
#3
Ali Kemal Onalan, Salih Tuncal, Sibel Kilicoglu, Salih Celepli, Esra Durak, Bulent Kilicoglu, Erdinc Devrim, Aziz Mutlu Barlas, Kemal Kismet
PURPOSE: To investigate the effect of silymarin on oxidative stress and hepatic injury induced by obstructive jaundice in an experimental model. METHODS: Thirty Wistar-Albino type female rats were divided into 3 groups each including 10 rats. Only laparotomy was performed in group 1. Bile duct ligation was performed in group 2. In group 3, bile duct ligation was performed and orogastic silymarin 300 mg/kg/day dose was given for seven days. At the end of seven days, rats were sacrificed...
December 2016: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28051047/evaluation-of-the-use-of-laparoscopic-guided-cholecystocholangiography-and-liver-biopsy-in-definitive-diagnosis-of-neonatal-cholestatic-jaundice
#4
Khalid Shreef, Abdullah Alhelal
BACKGROUND: Once it is established that a jaundiced infant has direct hyperbilirubinemia, the principal diagnostic concern is to differentiate hepatocellular from obstructive cholestasis. Traditional tests such as ultrasonography, percutaneous liver biopsy and technetium 99 m hepatobiliary iminodiacetic acid (HIDA) scan are often not sufficiently discriminating. Definitive exclusion of biliary atresia (BA) in the infant with cholestatic jaundice usually requires mini-laparotomy and intra-operative cholangiography...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28043693/preoperative-biliary-stenting-versus-operation-first-in-jaundiced-patients-due-to-malignant-lesions-in-the-pancreatic-head-a-meta-analysis-of-current-literature
#5
REVIEW
Florian Scheufele, Stephan Schorn, Ihsan Ekin Demir, Mine Sargut, Elke Tieftrunk, Lenika Calavrezos, Carsten Jäger, Helmut Friess, Güralp Onur Ceyhan
BACKGROUND: Obstructive jaundice is a common presenting symptom among patients with pancreatic cancer. While benefits of preoperative biliary drainage have been suggested by previous studies, recent evidence has shown no significant improvements of preoperative biliary drainage on the postoperative outcome but rather an increase of complications. There is no clear consensus on whether to treat malignant obstructive jaundice with preoperative biliary drainage prior to operative intervention or to proceed directly to resection...
December 30, 2016: Surgery
https://www.readbyqxmd.com/read/28034761/bile-acid-receptor-tgr5-overexpression-is-associated-with-decreased-intestinal-mucosal-injury-and-epithelial-cell-proliferation-in-obstructive-jaundice
#6
Chen-Guang Ji, Xiao-Li Xie, Jie Yin, Wei Qi, Lei Chen, Yun Bai, Na Wang, Dong-Qiang Zhao, Xiao-Yu Jiang, Hui-Qing Jiang
Bile acids stimulate intestinal epithelial proliferation in vitro. We sought to investigate the role of the bile acid receptor TGR5 in the protection of intestinal epithelial proliferation in obstructive jaundice. Intestinal tissues and serum samples were obtained from patients with malignant obstructive jaundice and from bile duct ligation (BDL) rats. Intestinal permeability and morphological changes in the intestinal mucosa were observed. The functions of TGR5 in cell proliferation in intestinal epithelial injury were determined by overexpression or knockdown studies in Caco-2 and FHs 74 Int cells pretreated with lipopolysaccharide (LPS)...
December 18, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28027099/my-first-patient-more-than-obstructive-jaundice
#7
R Conor Holton-Burke, Diana Stewart
No abstract text is available yet for this article.
January 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28025817/cost-effectiveness-of-metal-stents-in-relieving-obstructive-jaundice-in-patients-with-pancreatic-cancer
#8
J M Martinez, A Anene, T G K Bentley, M J Cangelosi, L M Meckley, J D Ortendahl, A J Montero
BACKGROUND: ASGE and ESGE guidelines recommend endoscopic metal stent placement for pancreatic carcinoma patients with biliary obstruction, and whose estimated life expectancy is greater than 6 months. Because median overall survival (OS) of metastatic pancreatic adenocarcinoma until recently has been less than 6 months, plastic biliary stents were preferentially placed rather than metal due to the greater upfront cost of the latter. Recent advances in the treatment of metastatic pancreatic cancer have extended median OS beyond the 6-month range...
December 27, 2016: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28018098/therapeutic-approaches-for-portal-biliopathy-a-systematic-review
#9
REVIEW
Irene Franceschet, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Marco Senzolo
Portal biliopathy (PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma (PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC (77%-100%), only a part of these (5%-38%) are symptomatic...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28003028/worsening-cholestasis-and-possible-cefuroxime-induced-liver-injury-following-successful-therapeutic-endoscopic-retrograde-cholangiopancreatography-for-a-distal-common-bile-duct-stone-a-case-report
#10
Madunil Anuk Niriella, Ravindu Sujeewa Kumarasena, Anuradha Supun Dassanayake, Aloka Pathirana, Janaki de Silva Hewavisenthi, Hithanadura Janaka de Silva
BACKGROUND: Cefuroxime very rarely causes drug-induced liver injury. We present a case of a patient with paradoxical worsening of jaundice caused by cefuroxime-induced cholestasis following therapeutic endoscopic retrograde cholangiopancreatography for a distal common bile duct stone. CASE PRESENTATION: A 51-year-old, previously healthy Sri Lankan man presented to our hospital with obstructive jaundice caused by a distal common bile duct stone. Endoscopic retrograde cholangiopancreatography with stone extraction, common bile duct clearance, and stenting failed to improve the cholestasis, with paradoxical worsening of his jaundice...
December 21, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28000721/overexcited-maxik-and-katp-channels-underlie-obstructive-jaundice-induced-vasoconstrictor-hyporeactivity-of-arterial-smooth-muscle
#11
Ya-Wei Yuan, Long Wang, Zhan-Ying Lu, Yue Long, Ying-Fu Jiao, Qiang Xia, Da-Xiang Wen, Wei-Feng Yu
Substantial evidence has shown that obstructive jaundice can induce vascular hyporesponsiveness. The present study was designed to investigate mechanisms of MaxiK channel and KATP underlying cholestasis-induced vascular dysfunction. The isolated thoracic aorta was used to explore norepinephrine (NE)-induced contraction. The function of MaxiK and KATP channels were investigated using whole-cell patch clamp recording. Compared with Sham group, NE-induced vascular contraction was blunted after bile duct ligation (BDL), which could not be ameliorated significantly after endothelial denudation...
December 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27994339/carcinoma-of-the-ampulla-of-vater-associated-with-annular-pancreas
#12
Mallika Tewari, Ashish Verma, H S Shukla
Carcinoma of the ampulla of Vater associated with annular pancreas is a rare entity. Only seven cases have been reported so far in the English literature. We herein report one such case in a 42-year-lady who presented with progressively increasing jaundice and pain in the upper abdomen for past 2 months. A magnetic resonance cholangiopancreaticography (MRCP) and MRI revealed an annular pancreas with an ampullary mass and a dilated CBD. An upper gastrointestinal endoscopic biopsy from the ampullary mass revealed a moderately differentiated adenocarcinoma...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27931107/a-diffusely-enlarged-pancreas-the-un-usual-suspect
#13
Pedro Magalhães-Costa, Maria José Brito, Pedro Pinto-Marques
An 81-years-old female presented with obstructive jaundice and a non-specific clinical picture of nausea and appetite loss. Labs demonstrated a conjugated hyperbilirrubinemia (7.7 mg/dL), increased aspartate aminotransferase and alanine aminotransferase (10xULN and 8xULN, respectively), increased lactate dehydrogenase (10xULN) and serum lipase (3xULN). CA 19.9 was 342 U/mL (Ref value < 37 U/mL). There was no evidence of peripheral lymphadenopathy or hepatosplenomegaly. Imaging (Figure 1A and 1B) revealed a marked homogeneous enlargement of the pancreas (without any well-defined mass), dilation of the extra and intra-hepatic bile ducts and ascites...
December 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27930504/aberrant-hepatic-arteries-running-through-pancreatic-parenchyma-encountered-during-pancreatoduodenectomy-two-rare-case-reports-and-strategies-for-surgical-treatment
#14
Lei Wang, Jianwei Xu, Dong Sun, Zongli Zhang
BACKGROUND: Aberrant hepatic arteries (HAs) encountered during pancreatoduodenectomy are difficult to manage. MEHTODS: Two cases with rare types of aberrant HA running through the pancreatic parenchyma were reviewed. RESULTS: The first case, a 68-year-old man, was admitted with obstructive jaundice. A tumor of the pancreatic head and aberrant HAs were suspected on computed tomography (CT) scan. At laparotomy, a new variation was identified; namely, 2 aberrant arteries-a right replaced HA and middle HA (RMHA) that both originated from the superior mesenteric artery (SMA) and ran via intrapancreatic paths posterior and anterior to the pancreatic head, respectively...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27916350/murine-model-of-long-term-obstructive-jaundice
#15
Hiroaki Aoki, Masayo Aoki, Jing Yang, Eriko Katsuta, Partha Mukhopadhyay, Rajesh Ramanathan, Ingrid A Woelfel, Xuan Wang, Sarah Spiegel, Huiping Zhou, Kazuaki Takabe
BACKGROUND: With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of three murine models of obstructive jaundice. METHODS: C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27912795/follicular-thyroid-carcinoma-presenting-as-solitary-liver-metastasis-a-case-report
#16
Azhar J Battoo, Zubaida Rasool, Zahoor A Sheikh, Altaf G Haji
BACKGROUND: Distant metastasis from differentiated thyroid carcinoma at presentation is rare and isolated liver metastasis on presentation is almost unknown. We report a case of primary follicular carcinoma of the thyroid with isolated liver metastasis at presentation. CASE PRESENTATION: A 65-year-old man of Kashmiri origin presented to our tertiary referral center with obstructive jaundice; he was evaluated with magnetic resonance cholangiopancreatography and positron emission tomography-computed tomography...
December 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27909644/primary-squamous-cell-carcinoma-of-the-pancreas-as-a-cause-of-biliary-obstruction
#17
Kyle Rowe, Jeet Mehta, Fredy Nehme, William Salyers
Primary squamous cell carcinoma of the pancreas (SCCP) is a rare neoplasm, given a lack of naturally occurring squamous cells within the pancreas, accounting for only 0.2% of all pancreatic cancers. The etiology is unknown. Symptomatology is non-specific and similar to other pancreatic neoplasms. No non-invasive testing can adequately rule in SCCP, and workup should proceed similarly to any pancreatic mass. Tissue sampling is required for diagnosis and guidance of further management, most commonly by endoscopic ultrasound with fine needle aspirate...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27906105/pancreatic-metastases-from-ocular-malignant-melanoma-the-use-of-endoscopic-ultrasound-guided-fine-needle-aspiration-to-establish-a-definitive-cytologic-diagnosis-a-case-report
#18
Diogo Turiani Hourneaux De Moura, Danielle Azevedo Chacon, Ryan Tanigawa, Martin Coronel, Spencer Cheng, Éverson L A Artifon, José Jukemura, Eduardo Guimarães Hourneaux De Moura
BACKGROUND: When encountering solid pancreatic lesions, nonpancreatic primary metastases are rare and differentiating a metastasis from a primary neoplastic lesion is challenging. The clinical presentation and radiologic features can be similar and the possibility of a pancreatic metastasis should be considered when the patient refers to a history of a different primary cancer. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound-guided fine-needle aspiration has become the gold standard method for diagnosing pancreatic lesions...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27906097/a-10-year-old-child-presenting-with-syndromic-paucity-of-bile-ducts-alagille-syndrome-a-case-report
#19
Girish Kumar Pati, Ayaskanta Singh, Preetam Nath, Jimmy Narayan, Pradeep Kumar Padhi, Prasanta Kumar Parida, Kaumudee Pattnaik, Chittaranjan Panda, Shivaram Prasad Singh
BACKGROUND: Alagille syndrome, a rare genetic disorder with autosomal dominant transmission, manifests with five major features: paucity of interlobular bile ducts, characteristic facies, posterior embryotoxon, vertebral defects, and peripheral pulmonary stenosis. Globally, only 500 cases have so far been reported, with only five cases reported in the Indian subcontinent. Rarely, Alagille syndrome also presents with skin manifestations and early-onset chronic liver disease, which was found in our case...
November 30, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27905370/-surgical-management-of-chronic-pancreatitis-complicated-by-biliary-and-duodenal-obstruction
#20
G M Barvanyan
AIM: To compare different surgical approaches to chronic pancreatitis complicated by biliary and duodenal obstruction. MATERIAL AND METHODS: In the study (n=42) and control (n=36) groups 18 and 4 resections were performed respectively (p=0.004). Early postoperative complications occurred in 15 cases of the study group and 4 cases of the control group (p=0.024). 7 and 1 re-operations were made in both groups respectively (p=0.99). There was no postoperative mortality in both groups...
2016: Khirurgiia
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