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https://www.readbyqxmd.com/read/28074277/patient-reported-outcomes-for-acute-gallstone-pathology
#1
Ed Parkin, Martyn Stott, Joy Brockbank, Simon Galloway, Ian Welch, Andrew Macdonald
BACKGROUND: A number of prominent surgical trials and clinical guidelines regard length of hospital stay and rates of daycase surgery as being of upmost importance following cholecystectomy. However, it is unclear whether these outcomes also matter to patients. This study aimed to identify the factors patients regard as most important when admitted with acute gallstone pathology. METHODS: A 41-item survey was produced by combining outcomes assessed in recent clinical trials with results from a preliminary patient questionnaire...
January 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28028930/an-update-on-cancer-risk-and-surveillance-in-primary-sclerosing-cholangitis
#2
Jennifer L Horsley-Silva, Eduardo A Rodriguez, Diana L Franco, Keith D Lindor
Malignancy represents substantial morbidity and mortality in patients with primary sclerosing cholangitis (PSC). This subset of patients has been proven to be at increased risk for developing cholangiocarcinoma, gallbladder carcinoma, and colorectal cancer in those with overlapping inflammatory bowel disease. Herein we review the prevalence of these malignancies and recommend screening tools and current knowledge to reduce the disease burden in this population. Cholangiocarcinoma is the most dominant malignancy affecting PSC patients, with a lifetime risk ranging from 5-20%...
December 27, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28027992/short-course-antimicrobial-treatment-for-acute-cholangitis-with-gram-negative-bacillary-bacteremia
#3
Shunsuke Uno, Ryota Hase, Masayoshi Kobayashi, Toshiyasu Shiratori, So Nakaji, Nobuto Hirata, Naoto Hosokawa
OBJECTIVES: The optimal antimicrobial treatment duration for patients with acute cholangitis with bacteremia remains unknown. The updated Tokyo guidelines of 2013 recommend a minimum duration of 2 weeks only when bacteremia with Gram-positive cocci is present. Since May 2013, a shorter antimicrobial treatment duration of under 2 weeks has been implemented at the authors' institution for acute cholangitis with Gram-negative bacillary bacteremia. The aim of the present study was to validate this modified practice...
December 24, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28024739/pneumococcal-biliary-tract-infections-how-rare-are-they
#4
Hiroshi Morioka, Mitsutaka Iguchi, Mitsuru Oodate, Masaki Yoneda, Futoshi Ushijima, Aki Hirabayashi, Nobuyuki Tetsuka, Yuka Tomita, Daizo Kato, Tetsuya Yagi
Pneumococcal biliary tract infections (PBTIs) were reported as rare due to the bacterium's bile solubility. The purpose of this study was to determine the occurrence and clinical characteristics of PBTIs. A retrospective case series review was conducted from January 2006 to August 2014 at a tertiary referral university hospital in Japan. Patients with a blood or bile culture positive for Streptococcus pneumoniae diagnosed with definite cholangitis or cholecystitis according to Tokyo Guideline 2013 were enrolled in this study...
December 23, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27995906/acg-clinical-guideline-evaluation-of-abnormal-liver-chemistries
#5
Paul Y Kwo, Stanley M Cohen, Joseph K Lim
Clinicians are required to assess abnormal liver chemistries on a daily basis. The most common liver chemistries ordered are serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase and bilirubin. These tests should be termed liver chemistries or liver tests. Hepatocellular injury is defined as disproportionate elevation of AST and ALT levels compared with alkaline phosphatase levels. Cholestatic injury is defined as disproportionate elevation of alkaline phosphatase level as compared with AST and ALT levels...
January 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27981308/primary-biliary-cirrhosis-and-primary-sclerosing-cholangitis-an-update-on-mr-imaging-findings-with-recent-developments
#6
REVIEW
Jelena Djokić Kovač, Marc-André Weber
Primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC) are the most common immune-mediated chronic cholestatic liver diseases leading to cirrhosis and liver failure. Although magnetic resonance imaging (MRI) is not a necessary procedure for the diagnosis of PBC, MRI is recommended for monitoring disease progression and early detection of complications. Even though liver cirrhosis subtypes have similar MR imaging features, there are some findings which could indicate PBC, such as the periportal halo sign...
December 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27904248/percutaneous-cholecystostomy-evidence-based-current-clinical-practice
#7
REVIEW
Karan Gulaya, Shamit S Desai, Kent Sato
The role of percutaneous cholecystostomy (PC) in the management of acute cholecystitis and cholangitis is outlined in the revised 2013 Tokyo Guidelines. These two emergencies constitute the vast majority of PC performed today for therapeutic purposes, and research has repeatedly shown the utility of PC in these conditions. PC is typically employed in the management of critically ill patients who are not surgical candidates. Indications and contraindications to PC are reviewed. Additional innovative applications of PC have been developed since it was first described in 1980...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27891750/epidemiology-and-outcomes-of-primary-sclerosing-cholangitis-with-and-without-inflammatory-bowel-disease-in-an-australian-cohort
#8
Ken Liu, Ruoxi Wang, Viraj Kariyawasam, Mark Wells, Simone I Strasser, Geoff McCaughan, Crispin Corte, Rupert W Leong
BACKGROUND&AIMS: Epidemiological data on primary sclerosing cholangitis (PSC) outside the Northern hemisphere is limited. Similarly, the impact of inflammatory bowel disease (IBD) on PSC outcomes remains unclear. We aimed to study the epidemiology and outcomes of PSC patients with and without IBD in an Australian cohort. METHODS: We retrospectively studied PSC patients attending two tertiary referral hospitals over 20years. Diagnosis of PSC was made according to international guidelines by positive cholangiography and/or liver biopsy (for small duct PSC) with supporting clinical and laboratory evidence RESULTS: 208 PSC patients (61% male) were studied (2,271patient-years follow-up)...
November 28, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27783206/procalcitonin-is-a-useful-biomarker-to-predict-severe-acute-cholangitis-a-single-center-prospective-study
#9
Gyotane Umefune, Hirofumi Kogure, Tsuyoshi Hamada, Hiroyuki Isayama, Kazunaga Ishigaki, Kaoru Takagi, Dai Akiyama, Takeo Watanabe, Naminatsu Takahara, Suguru Mizuno, Saburo Matsubara, Natsuyo Yamamoto, Yousuke Nakai, Minoru Tada, Kazuhiko Koike
BACKGROUND: Procalcitonin is being increasingly used to diagnose and grade acute systemic bacterial infection at an early stage of disease onset. The aim of this prospective study was to evaluate the usefulness of procalcitonin for severity grading of acute cholangitis on patient admission. METHODS: Patients with acute cholangitis were prospectively enrolled. The severity of acute cholangitis was graded on the basis of the 2013 Tokyo guidelines (Japanese Society of Hepato-Biliary-Pancreatic Surgery, 2013)...
October 25, 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27649967/autoimmune-liver-diseases-in-the-asia-pacific-region-proceedings-of-apasl-symposium-on-aih-and-pbc-2016
#10
REVIEW
Atsushi Tanaka, Xiong Ma, Osamu Yokosuka, Martin Weltman, Hong You, Deepak N Amarapurkar, Yoon Jun Kim, Zaigham Abbas, Diana A Payawal, Ming-Ling Chang, Cumali Efe, Ersan Ozaslan, Masanori Abe, Robert Mitchell-Thain, Mikio Zeniya, Kwang Hyub Han, John M Vierling, Hajime Takikawa
During the 25th annual meeting of the Asia-Pacific Association for the Study of the Liver (APASL 2016) in Tokyo, we organized and moderated an inaugural satellite symposium on the autoimmune liver diseases, autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). Following the keynote lecture by John M. Vierling (USA), speakers from the Asia-Pacific region provided an up-to-date perspective on the epidemiology, clinical practice and research in AIH and PBC in the Asia-Pacific region. Although epidemiology and clinical features of AIH seem to be similar in East Asia compared to those in western countries, the majority of patients with AIH are detected at an advanced stage and have higher mortality rates in South Asia, indicating an unmet need for earlier diagnosis and the initiation of appropriate immunosuppressive treatment...
November 2016: Hepatology International
https://www.readbyqxmd.com/read/27568111/prospective-validation-of-an-initial-cholecystectomy-strategy-for-patients-at-intermediate-risk-of-common-bile-duct-stone
#11
Pouya Iranmanesh, Olivier Tobler, Sandra De Sousa, Jean-Louis Frossard, Philippe Morel, Christian Toso
BACKGROUND AND AIMS: Initial cholecystectomy for patients at intermediate risk of common bile duct (CBD) stones (including increased liver function tests but bilirubin <4 mg/dL and no cholangitis) showed shorter length of stay and fewer CBD investigations without increased morbidity compared with sequential CBD endoscopic assessment and subsequent cholecystectomy in a randomized controlled trial. The objectives were to prospectively validate these results in daily clinical practice and discuss current guidelines...
August 25, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27557050/association-of-admission-laboratory-values-and-the-timing-of-endoscopic-retrograde-cholangiopancreatography-with-clinical-outcomes-in-acute-cholangitis
#12
Alexander C Schwed, Monica M Boggs, Xuan-Binh D Pham, Drew M Watanabe, Michael C Bermudez, Amy H Kaji, Dennis Y Kim, David S Plurad, Darin J Saltzman, Christian de Virgilio
Importance: Acute cholangitis (AC), particularly severe AC, has historically required urgent endoscopic decompression, although the timing of decompression is controversial. We previously identified 2 admission risk factors for adverse outcomes in AC: total bilirubin level greater than 10 mg/dL and white blood cell count greater than 20 000 cells/µL. Objectives: To validate previously identified prognostic factors in AC, evaluate the effect of timing of endoscopic retrograde cholangiopancreatography on clinical outcomes, and compare recent experience with AC vs an historical cohort...
November 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27556102/clinical-features-of-gallstone-impaction-at-the-ampulla-of-vater-and-the-effectiveness-of-endoscopic-biliary-drainage-without-papillotomy
#13
Yuichi Takano, Masatsugu Nagahama, Naotaka Maruoka, Eiichi Yamamura, Nobuyuki Ohike, Tomoko Norose, Hiroshi Takahashi
BACKGROUND AND STUDY AIMS: Gallstone impaction at the ampulla of Vater is a critical condition, and the standard treatment is endoscopic papillotomy. However, the clinical features remain largely unclear, and some patients are reluctant to undergo papillotomy because of a bleeding tendency. The aim of this study was to clarify the clinical features of gallstone impaction at the ampulla of Vater and to examine the effectiveness of endoscopic biliary drainage without papillotomy. PATIENTS AND METHODS: We retrospectively examined 30 patients who had undergone endoscopic treatment for gallstone impaction at the ampulla of Vater between 2010 and 2015...
July 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27536366/clinical-course-and-prognosis-of-pediatric-onset-primary-sclerosing-cholangitis
#14
Andrea Tenca, Martti Färkkilä, Johanna Arola, Tytti Jaakkola, Roberto Penagini, Kaija-Leena Kolho
BACKGROUND: The natural history of pediatric-onset primary sclerosing cholangitis (PSC) and overlap with autoimmune hepatitis (PSC/AIH) is poorly known. OBJECTIVE: The aim of this study was to evaluate the clinical outcome of patients with pediatric-onset disease in a tertiary referral center. METHODS: We traced 33 patients (median age at diagnosis 16 years), with PSC or PSC/AIH in cholangiography and liver histology diagnosed between December 1993 and 2011, at Helsinki University Hospital...
August 2016: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/27503128/familial-occurrence-of-autoimmune-liver-disease-with-overlapping-features-of-primary-biliary-cholangitis-and-autoimmune-hepatitis-in-a-mother-and-her-daughter
#15
Kaoru Omori, Kanako Yoshida, Masaki Yokota, Tsutomu Daa, Masahiro Kan
We encountered two patients with overlapping features of primary biliary cholangitis and autoimmune hepatitis within the same family. A 68-year-old woman presented at our hospital from a previous medical institution because of the diagnosis of primary biliary cholangitis. Her 49-year-old daughter was admitted with liver dysfunction 4 years later. When compared, these two related patients were found to have overlapping features of primary biliary cholangitis and autoimmune hepatitis. Their human leukocyte antigen haplotype was DRB1*04:05/DRB1*15:02...
October 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27446845/factors-and-outcomes-associated-with-mrcp-use-prior-to-ercp-in-patients-at-high-risk-for-choledocholithiasis
#16
Gobind Anand, Yuval A Patel, Hsin-Chieh Yeh, Mouen A Khashab, Anne Marie Lennon, Eun Ji Shin, Marcia I Canto, Patrick I Okolo, Anthony N Kalloo, Vikesh K Singh
Background. Consensus guidelines recommend that patients at high risk for choledocholithiasis undergo endoscopic retrograde cholangiopancreatography (ERCP) without additional imaging. This study evaluates factors and outcomes associated with performing magnetic resonance cholangiopancreatography (MRCP) prior to ERCP among patients at high risk for choledocholithiasis. Methods. An institutional administrative database was searched using diagnosis codes for choledocholithiasis, cholangitis, and acute pancreatitis and procedure codes for MRCP and ERCP...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27249924/-surgical-treatment-of-acute-cholangitis-in-choledocholithiasis
#17
V A Sipliviy, D V Yevtushenko, G D Petrenko, S A Andreyeshchev, A V Yevtushenko
The results of surgical treatment of 184 patients for obstructive jaundice and an acute cholangitis in choledocholithiasis were analyzed. Acute cholangitis was diagnosed in 62 (33.7%) patients. Sensitivity of a Tokyo Guidelines (2013)--TG 13 criteria for diagnosis and estimation of the course severity of an acute cholangitis was studied. Dynamics of postoperative laboratory parameters was studied. There was established, that occurrence of obturation jaundice and cholangitis coincides with pronounced hepatic function disorders, which are preserved after a bile outflow restoration also, and changes in peripheral blood...
January 2016: Klinichna Khirurhiia
https://www.readbyqxmd.com/read/27215088/role-of-presepsin-for-the-assessment-of-acute-cholangitis-severity
#18
Jianbo Lin, Huidong Sun, Jiangong Li, Yanhong Zheng, Cunhua Shao, Yang Hong Zhang, Hong Chang
BACKGROUND: Presepsin is a new emerging inflammatory biomarker. The primary purpose of this study was to elucidate the predictive usability of presepsin for severity assessment in patients with acute cholangitis (AC). METHODS: A total of 119 treatment-naive patients with AC (64 males, 55 females) were enrolled in this study. Patients were classified with Grade I (mild), Grade II (moderate), or Grade III (severe) AC based on severity assessment guidelines. Presepsin concentrations were measured on admission...
2016: Clinical Laboratory
https://www.readbyqxmd.com/read/27083409/colorectal-cancer-in-patients-with-inflammatory-bowel-disease-the-need-for-a-real-surveillance-program
#19
REVIEW
Rosario Fornaro, Michela Caratto, Elisa Caratto, Giuseppe Caristo, Francesco Fornaro, Davide Giovinazzo, Camilla Sticchi, Marco Casaccia, Enzo Andorno
The association between inflammatory bowel disease (IBD) and colorectal cancer (CRC) has been widely shown. This association is responsible for 10% to 15% of deaths in patients with IBD, even if according to some studies, the risk of developing CRC seems to be decreased. An adequate surveillance of patients identified as at-risk patients, might improve the management of IBD-CRC risk. In this article we review the literature data related to IBD-CRC, analyze potential risk factors such as severity of inflammation, duration, and extent of IBD, age at diagnosis, sex, family history of sporadic CRC, and coexistent primary sclerosing cholangitis, and update epidemiology on the basis of new studies...
September 2016: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/27063334/accuracy-of-asge-criteria-for-the-prediction-of-choledocholithiasis
#20
Rodrigo Manuel Nárvaez Rivera, José Alberto González González, Roberto Monreal Robles, Diego García Compean, Jonathan Paz Delgadillo, Aldo Azael Garza Galindo, Héctor Jesús Maldonado Garza
BACKGROUND/AIMS: Few studies have validated the performance of guidelines for the prediction of choledocholithiasis (CL). Our objective was to prospectively assess the accuracy of the American Society for Gastrointestinal Endoscopy (ASGE) guidelines for the identification of CL. METHODS: A two-year prospective evaluation of patients with suspected CL was performed. We evaluated the ASGE guidelines and its component variables in predicting CL. RESULTS: A total of 256 patients with suspected CL were analyzed...
June 2016: Revista Española de Enfermedades Digestivas
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