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Biliary stricture

R De Carlis, S Di Sandro, A Lauterio, F Ferla, A Dell'Acqua, M Zanierato, L De Carlis
The role of donation after cardiac death (DCD) in expanding the donor pool is mainly limited by the incidence of primary non-function (PNF) and ischemia-related complications. Even greater concern exists towards uncontrolled DCD, which represents the largest potential pool of DCD donors. We recently started the first Italian series of DCD liver transplantation, using normothermic regional perfusion (NRP) in 6 uncontrolled donors and in 1 controlled case to deal with the legally required no-touch period of 20 minutes...
October 26, 2016: Liver Transplantation
Manoj Kumar Gupta, Santosh Kumar Behara, Vadde Ramakrishna
In-silico attempt was made to identify the key hub genes which get differentially expressed in biliary stricture and hepatic carcinoma. Gene expression data, GSE34166, was downloaded from the GEO database, which contains 10 biliary stricture samples (4 benign control and 6 malignant carcinoma), for screening of key hub genes associated with the disease. R packages scripts were identified 85 differentially expressed genes. Further these genes were uploaded in WebGestalt database and identified nine key genes...
October 21, 2016: Gene
Erwin Santo, Anna Itshak, Liat Mlynarsky, Moshe Leshno, Nathan Gluck
BACKGROUND: Biliary strictures (BS) are a common complication of liver transplantation. The standard treatment is sequential insertion of increasing numbers of plastic stents by endoscopic retrograde cholangiopancreatography (ERCP). Despite high success rates, some strictures fail to resolve and require surgery as definitive treatment. GOALS: To identify predictors of response or failure of standard endoscopic treatment, allowing earlier referral to alternative modalities when needed and avoiding unnecessary procedures...
October 21, 2016: Journal of Clinical Gastroenterology
Kenneth Eng Ling Kwan, Vishalkumar G Shelat, Cher Heng Tan
Recurrent pyogenic cholangitis (RPC) is an infective process involving the biliary tree typified by pigmented intraductal calculi with dilatation of the intra- and extrahepatic biliary tree. Previously endemic to South-east Asia, RPC can now be seen in Western countries with the increasing access to international travel and immigration. Affected patients are often plagued by recurrent bouts of cholangitis, and commonly suffer from complications such as abscess formation and biliary strictures. In severe cases, cirrhosis with portal hypertension may develop...
October 21, 2016: Abdominal Radiology
Xiao Zheng, Zhi Yuan Bo, Wei Wan, Ye Chen Wu, Tian Tian Wang, Jun Wu, Dao Jian Gao, Bing Hu
AIM: Endoscopic biliary radiofrequency ablation (RFA) has been increasingly used for unresectable malignant biliary obstruction (MBO). However, its efficacy and safety remain unclear. METHODS: A comprehensive search of Cochrane Library, PubMed and EMBASE was conducted to collect studies to evaluate endoscopic biliary RFA in the management of MBO. Meta-analysis was performed by extracting the data from included studies with regards to the technical effectiveness, overall survival, adverse events and mortality of endoscopic RFA...
October 21, 2016: Journal of Digestive Diseases
Ulrich Keppler, Mohammed R Moussavian, Pascal Jeanmonod, Moritz J Strowitzki, Mathias Wagner, Claudia Scheuer, Michael D Menger, Maximilian von Heesen
BACKGROUND Ischemic type biliary lesions (ITBL) is a troublesome complication after liver transplantation. Little is known about its pathogenesis and there is particularly little data about morphological alterations. Prolonged warm and cold ischemia time and reduced hepatic arterial perfusion are risk factors leading to ITBL. There are only a few animal models described in literature. Therefore, we examined the effects of 3 h of hepatic artery ischemia-reperfusion (3 h I/R) and hepatic arterial ligation (HAL), both combined with ligation of the peribiliary plexus (PBP)...
October 21, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Sunguk Jang, Tyler Stevens, Mansour A Parsi, Rocio Lopez, John J Vargo
BACKGROUND & AIMS: Biliary self-expandable metallic stents (SEMSs) are widely used to treat malignant and benign conditions of bile duct. Despite their lower rate of occlusion and longer patency than plastic stents, SEMSs still have significant rates of occlusion. We aimed to identify factors associated with occlusion of biliary SEMS. METHODS: We performed a retrospective study of consecutive patients who underwent endoscopic retrograde cholangiopancreatography with biliary SEMS placement at the Cleveland Clinic Foundation from March 2011 to April 2016...
October 17, 2016: Clinical Gastroenterology and Hepatology
Hanna Vihervaara, Juha M Grönroos, Saija Hurme, Risto Gullichsen, Paulina Salminen
OBJECTIVE: Endoscopic stents are used to relieve obstructive jaundice. The purpose of this prospective randomized study was to compare the patency of antireflux and conventional plastic biliary stent in relieving distal malignant biliary obstruction. MATERIALS AND METHODS: All jaundiced patients admitted to hospital with suspected unresectable malignant distal biliary stricture between October 2009 and September 2010 were evaluated for the study. Eligible patients were randomized either to antireflux or conventional plastic stent arms...
October 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Dong Wook Lee, Hyeong Ho Jo, Juveria Abdullah, Michel Kahaleh
Endoscopic treatment of biliary strictures involving plastic stent placement has been used widely. The use of self-expandable metal stents (SEMSs) has been described for anastomotic strictures following liver transplantation (LT). This review aimed to assess and compare the efficacy of plastic stents with SEMS in LT patients. Information was retrieved regarding technical success, stricture resolution, the number of endoscopic retrograde cholangiography procedures, follow-up, immediate, and late complications...
September 2016: Clinical Endoscopy
Seiji Kaino, Manabu Sen-Yo, Shuhei Shinoda, Michitaka Kawano, Hirofumi Harima, Shigeyuki Suenaga, Isao Sakaida
Postoperative biliary strictures are usually complications of cholecystectomy. Endoscopic plastic stent prosthesis is generally undertaken for treating benign biliary strictures. Recently, fully covered metal stents have been shown to be effective for treating benign distal biliary strictures. We present the case of a 53-year-old woman with liver injury in which imaging studies showed a common hepatic duct stricture. Endoscopic retrograde cholangiopancreatography also confirmed the presence of a common hepatic duct stricture...
October 15, 2016: Clinical Journal of Gastroenterology
M Jiménez-Pérez, J M Melgar Simón, A Durán Campos, R González Grande, J M Rodrigo López, R Manteca González
OBJECTIVE: The aim of this work was to evaluate the safety and efficacy of a fully covered self-expandable metal stent (FCSEMS) in the treatment of post-liver transplantation biliary strictures. METHODS: From October 2009 to October 2014, 44 patients with post-liver transplantation biliary stenosis were treated with the use of endoscopic retrograde cholangiography and placement of FCSEMS after informed consent. The FCSEMS was scheduled to remain in situ for 3-6 months...
September 2016: Transplantation Proceedings
Toru Ikegami, Tomonari Shimagaki, Junji Kawasaki, Tomoharu Yoshizumi, Hideaki Uchiyama, Noboru Harada, Norifumi Harimoto, Shinji Itoh, Yuji Soejima, Yoshihiko Maehara
INTRODUCTION: Biliary anastomosis stricture (BAS) is still among the major concerns after living donor liver transplantation (LDLT), even after the technical refinements including the universal use of the blood flow-preserving hilar dissection technique. The aim of this study is to investigate what are still the factors for BAS after LDLT. METHODS: An analysis of 279 adult-to-adult LDLT grafts (left lobe, n=161; right lobe, n=118) with duct-to-duct (DD) biliary reconstruction, since the universal application of minimal hilar dissection technique and gradual introduction of eversion technique, was performed...
October 12, 2016: Transplantation
Min-Ho Shin, Deok-Bog Moon, Sung-Gyu Lee, Shin Hwang, Ki-Hun Kim, Chul-Soo Ahn, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Young-In Yun, Wan-Jun Kim, Woo-Hyoung Kang, Seok-Hwan Kim, Gi-Young Ko
BACKGROUND: Although perioperative portal vein (PV) stent implantation is an effective treatment for steno-occlusive disease in adult living donor liver transplantation (LDLT) recipients, we experienced high incidence of biliary anastomotic strictures (BAS) after PV stenting. In this study, we sought to clarify the relation between BAS and PV stenting and to suggest the possible mechanism of BAS and measures to reduce its incidence. METHODS: We retrospectively analyzed 44 LDLT recipients who underwent PV stent implantation across the line of PV anastomosis regardless of the location of steno-occlusion (stent group) and their matched controls (non-stented LDLT recipients, n=131)...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Shumyla Jabeen, Irfan Robbani, Naseer A Choh, Obaid Ashraf, Feroze Shaheen, Tariq Gojwari, Sabeeha Gul
OBJECTIVE: To characterize biliary abnormalities seen in portal cavernoma cholangiopathy (PCC) on Magnetic Resonance Cholangiopancreaticography(MRCP) and elucidate certain salient features of the disease by collaborating our findings with those of previous studies. METHODS: We prospectively enrolled 52 patients with portal cavernoma secondary to idiopathic Extrahepatic portal vein obstruction(EHPVO) who underwent a standard MRCP protocol. Images were analysed for abnormalities involving the entire biliary tree...
October 12, 2016: British Journal of Radiology
Gen Tohda, Masahiro Ohtani, Masaki Dochin
AIM: To investigate the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with acute cholangitis. METHODS: From June 2008 to May 2016, emergency ERCPs were performed in 207 cases of acute cholangitis at our institution. Patients were classified as elderly if they were aged 80 years and older (n = 102); controls were under the age of 80 years (n = 105). The patients' medical records were retrospectively reviewed for comorbidities, laboratory data, etiology of cholangitis (presence of biliary stones, biliary stricture and malignancy), details of the ERCP (therapeutic approaches, technical success rates, procedure duration), ERCP-related complications and mortality...
October 7, 2016: World Journal of Gastroenterology: WJG
María-Victoria Alvarez-Sánchez, Bertrand Napoléon
Most pancreatic cancers and extrahepatic cholangiocarcinomas are unresectable at the time of diagnosis, and even in case of a resectable cancer, for elderly or patients with coexistent comorbidities, surgery is not an option. Current treatment alternatives in these scenarios are very limited. Biliary stenting with self-expanding metal stents (SEMS) is the mainstay palliative treatment of biliary obstruction due to unresectable pancreatic cancer or cholangiocarcinoma. Nevertheless, more than 50% of SEMS become occluded after 6 mo due to tumour over- and ingrowth, leading to hospital readmissions and reinterventions that significantly impair quality of life...
October 7, 2016: World Journal of Gastroenterology: WJG
Congwen Bian, Yiqi Du, Rui Ding, Jun Huang, Yan Dai, Sujin Bao, Lijuan Zhao, Hefang Shen, Jing Dong, Jianjian Xu, Qiru Xiong, Lili Xu
Biliary complications remain a major source of morbidity in liver transplant patients. Among these complications, nonanastomotic biliary strictures (NAS) are especially common and they are frequently therapy resistant in part because biliary epithelial cells are more sensitive to warm ischemic injury than hepatocytes. It has been a challenge to maintain the physiological function of biliary epithelial cells during liver transplantation. In this work, we have examined the effect of oxygen on proliferation of biliary epithelial cells in the rat livers obtained from donation after circulatory death (DCD)...
2016: American Journal of Translational Research
A V Semenkov, E F Kim, A V Filin, D S Burmistrov, A V Metelin, Yu R Kamalov, T N Galyan, A V Goncharova
AIM: to estimate the effect of decompressive stented drainage of biliary anastomosis on incidence of biliary complications. MATERIAL AND METHODS: 294 patients aged from 5 months to 61 years (mean 13.8±0.81) were enrolled. They underwent liver fragments transplantation in the Department of Liver Transplantation of Petrovsky Russian Research Center of Surgery for the period from March 1997 to January 2016. Decompressive stented drainage tubes were used in 28 (9.5%) patients...
2016: Khirurgiia
Abdolmajid Taheri, Ayoob Rostamzadeh, Alireza Gharib, Daryoush Fatehi
INTRODUCTION: Recently, multidetector computed tomography (MDCT) has been introduced into clinical practice. MDCT has become the noninvasive diagnostic test of choice for detailed evaluation of biliary obstruction. AIM: the main objective of the present study was to evaluate the diagnostic value of MDCT compared to invasive procedures for detecting biliary obstruction causes. MATERIAL AND METHODS: Since February 2009 until May 2011 fifty biliary obstruction patients based on clinical, laboratory or ultrasonographic findings, were evaluated by Multidetector-row computed tomography...
July 16, 2016: Acta Informatica Medica: AIM
B Njei, T R McCarty, S Varadarajulu, U Navaneethan
BACKGROUND: The accuracy of current endoscopic modalities for diagnosing cholangiocarcinoma in primary sclerosing cholangitis (PSC) is suboptimal. AIM: To evaluate the comparative effectiveness of endoscopic retrograde cholangiopancreatography (ERCP)-based modalities, independently or in combination, for the diagnosis of cholangiocarcinoma in patients with PSC-induced biliary strictures. METHODS: Searches of PubMed, EMBASE, Web of Science and the Cochrane Library databases were performed through December 2015...
October 3, 2016: Alimentary Pharmacology & Therapeutics
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