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biliary injure

Yusuke Takahashi, Naoyuki Yokoyama, Natsumi Matsuzawa, Daisuke Sato, Tetsuya Otani
INTRODUCTION: Bile duct injury during laparoscopic cholecystectomy occurs in rare cases. We report two cases using barbed suture for repair in bile duct injury during laparoscopic cholecystectomies. PRESENTATION OF CASES: The first patient was a 73-year-old woman who underwent elective laparoscopic cholecystectomy for cholecystolithiasis. When the gallbladder was dissected from the bed, bile spillage was observed and an injured small bile duct was detected. The bile duct could not be managed using a titanium clip...
2016: International Journal of Surgery Case Reports
Susanne Nicole Weber, Annika Bohner, Dianne H Dapito, Robert F Schwabe, Frank Lammert
BACKGROUND: The development of hepatocellular carcinoma (HCC) is a common consequence of advanced liver fibrosis but the interactions between fibrogenesis and carcinogenesis are still poorly understood. Recently it has been shown that HCC promotion depends on Toll-like receptor (TLR) 4. Pre-cancerogenous events can be modelled in mice by the administration of a single dose of diethylnitrosamine (DEN), with HCC formation depending amongst others on interleukin (IL) 6 production. Mice lacking the hepatocanalicular phosphatidylcholine transporter ABCB4 develop liver fibrosis spontaneously, resemble patients with sclerosing cholangitis due to mutations of the orthologous human gene, and represent a valid model to study tumour formation in pre-injured cholestatic liver...
2016: PloS One
Tohru Itoh
In severely or chronically injured livers where the proliferative capacity of hepatocytes is compromised, putative stem/progenitor cells are supposed to be activated. These cells are generally characterized as biliary epithelial cell marker-positive cells that emerge ectopically in the parenchymal region of the liver, as determined by histopathological examination of various liver diseases in humans and animal models. Whereas the biliary system indeed harbors cells with stem/progenitor activity that can be defined ex vivo, genetic lineage tracing studies in mice have casted doubt on their exact contribution as the genuine stem/progenitor cell population that differentiates in situ into hepatocytes...
August 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Haquima El Mourabit, Emilien Loeuillard, Sara Lemoinne, Axelle Cadoret, Chantal Housset
Myofibroblasts are matrix-producing cells with contractile properties, usually characterized by de novo expression of alpha-smooth muscle actin, that arise in fibrotic diseases. Hepatic stellate cells (HSCs), known as perisinusoidal cells containing auto-fluorescent vitamin A, are the major although not exclusive source of myofibroblasts in the injured liver. Portal myofibroblasts (PMFs) have been defined as liver myofibroblasts derived from cells that are distinct from HSCs and located in the portal tract...
2016: Frontiers in Physiology
V K Kapoor
UNLABELLED: Pancreato-duodenectomy (PD) is the procedure of choice for management of resectable periampullary and pancreatic cancers and some patients with chronic pancreatitis. PD is one of the most major GI/ HPB surgical procedures performed involving resection of multiple organs and reconstruction with multiple anastomoses. While mortality of PD has been brought down to less than 5% morbidity still remains high.Patients undergoing PD are usually elderly with comorbidities - general complications of a major operation e...
February 2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Naruhiko Honmyo, Shintaro Kuroda, Tsuyoshi Kobayashi, Kohei Ishiyama, Kentaro Ide, Hiroyuki Tahara, Masahiro Ohira, Hideki Ohdan
Laparoscopic cholecystectomy (LC) has been recently adapted to acute cholecystitis. Major bile duct injury during LC, especially Strasberg-Bismuth classification type E, can be a critical problem sometimes requiring hepatectomy. Safety and definitive treatment without further morbidities, such as posthepatectomy liver failure, is required. Here, we report a case of severe bile duct injury treated with a stepwise approach using (99m)Tc-galactosyl human serum albumin ((99m)Tc-GSA) single-photon emission computed tomography (SPECT)/CT fusion imaging to accurately estimate liver function...
December 2016: Surgical Case Reports
Ingrid Lua, Yuchang Li, Jessica A Zagory, Kasper S Wang, Samuel W French, Jean Sévigny, Kinji Asahina
BACKGROUND & AIMS: Contribution of hepatic stellate cells (HSCs), portal fibroblasts (PFs), and mesothelial cells (MCs) to myofibroblasts is not fully understood due to insufficient availability of markers and isolation methods. The present study aimed to isolate these cells, characterize their phenotypes, and examine their contribution to myofibroblasts in liver fibrosis. METHODS: Liver fibrosis was induced in Collagen1a1-green fluorescent protein (Col1a1(GFP)) mice by bile duct ligation (BDL), 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) diet, or CCl4 injections...
May 2016: Journal of Hepatology
Atsuyo Ikeda, Takehiro Noda, Hisanori Hatano, Akihiro Takata, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Takamichi Komori, Hiroshi Imamura, Shunji Morita, Takashi Iwazawa, Kenzo Akagi, Hideaki Yakushiji, Taku Yasumoto, Keizo Dono
An 83-year-old man underwent extended cholecystectomy for gallbladder cancer. On postoperative day 13, he developed fever and computed tomography (CT) revealed fluid collection at the cut surface of the liver. Ultrasound-guided fluid drainage was conducted, and he was diagnosed with biliary leakage. Radiological examination using a contrast agent revealed that the anterior branch of the bile duct (B5) was completely interrupted. Simple drainage and ethanol injections into the bile duct proved ineffective. Thus, we performed transcatheter arterial embolization (TAE) in the anterior segmental artery (A5) to stop the production of bile in the injured part of anterior segment...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hironari Kato, Koichiro Tsutsumi, Hiroyuki Okada
No abstract text is available yet for this article.
April 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Shaun C Daly, Daniel J Deziel, Xuan Li, Milot Thaqi, Keith W Millikan, Jonathan A Myers, Steven Bonomo, Minh B Luu
INTRODUCTION: Since the widespread adoption of laparoscopic techniques in biliary surgery, the incidence of bile duct injures (BDI) has not significantly declined despite increased operative experience and recognition of the critical view of safety (CVS) method for anatomic identification. We hypothesized that operative approaches in clinical practice may vary from well-described technical recommendations. The objective of this study was to access how practicing surgeons commonly identify anatomy during laparoscopic cholecystectomy (LC)...
August 2016: Surgical Endoscopy
G J Webb, K A Siminovitch, G M Hirschfield
Primary biliary cirrhosis (PBC), a classic autoimmune liver disease, is characterised by a progressive T cell predominant lymphocytic cholangitis, and a serologic pattern of reactivity in the form of specific anti-mitochondrial antibodies (AMA). CD4+ T cells are particularly implicated by PBC's cytokine signature, the presence of CD4+ T cells specific to mitochondrial auto-antigens, the expression of MHC II on injured biliary epithelial cells, and PBC's coincidence with other similar T cell mediated autoimmune conditions...
November 2015: Journal of Autoimmunity
Xiang-Wei Hua, Tian-Fei Lu, Da-Wei Li, Wei-Gang Wang, Jun Li, Zhen-Ze Liu, Wei-Wei Lin, Jian-Jun Zhang, Qiang Xia
AIM: To explore the potential of contrast-enhanced computed tomography (CECT) using ExiTron nano6000 for assessment of liver lesions in mouse models. METHODS: Three mouse models of liver lesions were used: bile duct ligation (BDL), lipopolysaccharide (LPS)/D-galactosamine (D-GalN), and alcohol. After injection with the contrast agent ExiTron nano6000, the mice were scanned with micro-CT. Liver lesions were evaluated using CECT images, hematoxylin and eosin staining, and serum aminotransferase levels...
July 14, 2015: World Journal of Gastroenterology: WJG
Akihiro Asai, Alexander Miethke, Jorge A Bezerra
Biliary atresia is a severe cholangiopathy of early infancy that destroys extrahepatic bile ducts and disrupts bile flow. With a poorly defined disease pathogenesis, treatment consists of the surgical removal of duct remnants followed by hepatoportoenterostomy. Although this approach can improve the short-term outcome, the liver disease progresses to end-stage cirrhosis in most children. Further improvement in outcome will require a greater understanding of the mechanisms of biliary injury and fibrosis. Here, we review progress in the field, which has been fuelled by collaborative studies in larger patient cohorts and the development of cell culture and animal model systems to directly test hypotheses...
June 2015: Nature Reviews. Gastroenterology & Hepatology
Yu-Long Yang, Cheng Zhang, Hong-Wei Zhang, Ping Wu, Yue-Feng Ma, Mei-Ju Lin, Li-Jun Shi, Jing-Yi Li, Mu Zhao
Fibrin glue is widely used in clinical practice and plays an important role in reducing postoperative complications. We report a case of a 65-year-old man, whose common bile duct was injured by fibrin glue, with a history of failed laparoscopic cholecystectomy and open operation for uncontrolled laparoscopic bleeding. In view of the persistent liver dysfunction, xanthochromia and skin itching, the patient was admitted to us for further management. Ultrasound, computed tomography, and magnetic resonance cholangiopancreatography (MRCP) revealed multiple stones in the common bile duct, and liver function tests confirmed the presence of obstructive jaundice and liver damage...
March 7, 2015: World Journal of Gastroenterology: WJG
Chen Zong, Meicong Wang, Fuchun Yang, Guojun Chen, Jiarong Chen, Zihua Tang, Quanwen Liu, Changyou Gao, Lie Ma, Jinfu Wang
The current clinical treatments for complications caused by hepatobiliary surgery still have some inevitable weakness. The aim of the study was to fabricate a tissue-engineered bile duct that utilized a novel bilayered polymer scaffold combined with human bone marrow-derived mesenchymal stem cells (hMSCs) for new treatment of biliary disease. The biocompatibility of polycaprolactone (PCL) (PCL)/poly(lactide-co-glycolide) (PLGA) scaffold with hMSCs was first examined, and the hMSC-PCL/PLGA constructs (MPPCs) prepared...
February 25, 2015: Journal of Tissue Engineering and Regenerative Medicine
Benjamin L Woolbright, Kenneth Dorko, Daniel J Antoine, Joanna I Clarke, Parviz Gholami, Feng Li, Sean C Kumer, Timothy M Schmitt, Jameson Forster, Fang Fan, Rosalind E Jenkins, B Kevin Park, Bruno Hagenbuch, Mojtaba Olyaee, Hartmut Jaeschke
Accumulation of bile acids is a major mediator of cholestatic liver injury. Recent studies indicate bile acid composition between humans and rodents is dramatically different, as humans have a higher percent of glycine conjugated bile acids and increased chenodeoxycholate content, which increases the hydrophobicity index of bile acids. This increase may lead to direct toxicity that kills hepatocytes, and promotes inflammation. To address this issue, this study assessed how pathophysiological concentrations of bile acids measured in cholestatic patients affected primary human hepatocytes...
March 15, 2015: Toxicology and Applied Pharmacology
Kota Kaneko, Kenji Kamimoto, Atsushi Miyajima, Tohru Itoh
UNLABELLED: Serving as the center for metabolism and detoxification, the liver is inherently susceptible to a wide variety of damage imposed by toxins or chemicals. Induction of cell populations with biliary epithelial phenotypes, which include progenitor-like cells and are referred to as liver progenitor cells, is often observed in histopathological examination of various liver diseases in both human patients and animal models and has been implicated in regeneration. However, the tissue dynamics underlying this phenomenon remains largely unclear...
June 2015: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Atsushi Suzuki
The liver can be thought of as a mysterious organ, because it has an elegant regenerative capability. This phenomenon has been well known since ancient times and is already applied to medical treatments for severe hepatic disorders by transplanting portions of liver received from living donors. However, it was not until quite recently that the mechanism underlying the principle of liver regeneration was investigated more deeply. Recent advances in the technologies for characterizing cell properties and examining the molecular nature of cells are enabling us to understand what occurs in the regenerating liver...
February 2015: Genes to Cells: Devoted to Molecular & Cellular Mechanisms
Terumi Kamisawa, Sawako Kuruma, Taku Tabata, Kazuro Chiba, Susumu Iwasaki, Satomi Koizumi, Masanao Kurata, Goro Honda, Takao Itoi
Pancreaticobiliary maljunction (PBM) is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall. Japanese clinical practice guidelines on how to deal with PBM were made in 2012, representing a world first. According to the 2013 revision to the diagnostic criteria for PBM, in addition to direct cholangiography, diagnosis can be made by magnetic resonance cholangiopancreatography (MRCP), 3-dimensional drip infusion cholangiography computed tomography, endoscopic ultrasonography (US), or multiplanar reconstruction images by multidetector row computed tomography...
March 2015: Journal of Gastroenterology
Branden D Tarlow, Carl Pelz, Willscott E Naugler, Leslie Wakefield, Elizabeth M Wilson, Milton J Finegold, Markus Grompe
Adult liver progenitor cells are biliary-like epithelial cells that emerge only under injury conditions in the periportal region of the liver. They exhibit phenotypes of both hepatocytes and bile ducts. However, their origin and their significance to injury repair remain unclear. Here, we used a chimeric lineage tracing system to demonstrate that hepatocytes contribute to the progenitor pool. RNA-sequencing, ultrastructural analysis, and in vitro progenitor assays revealed that hepatocyte-derived progenitors were distinct from their biliary-derived counterparts...
November 6, 2014: Cell Stem Cell
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