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Acute cholangitis

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https://www.readbyqxmd.com/read/27919851/urgent-ercp-for-acute-cholangitis-reduces-mortality-and-hospital-stay-in-elderly-and-very-elderly-patients
#1
Chan Sun Park, Hee Seok Jeong, Ki Bae Kim, Joung-Ho Han, Hee Bok Chae, Sei Jin Youn, Seon Mee Park
BACKGROUND: Acute cholangitis in old people is a cause of mortality and prolonged hospital stay. We evaluated the effects of methods and timing of biliary drainage on the outcomes of acute cholangitis in elderly and very elderly patients. METHODS: We analyzed 331 patients who were older than 75 years and were diagnosed with acute calculous cholangitis. They were admitted to our hospital from 2009 to 2014. Patients' demographics, severity grading, methods and timing of biliary drainage, mortality, and hospital stay were retrospectively obtained from medical records...
December 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27904248/percutaneous-cholecystostomy-evidence-based-current-clinical-practice
#2
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/27893641/routine-surveillance-cholangiography-following-percutaneous-cholecystostomy-delays-drain-removal-and-cholecystectomy
#3
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Alicia M Mohr
INTRODUCTION: Percutaneous cholecystostomy (PC) is often performed for patients with acute cholecystitis who are at high risk for operative morbidity and mortality. However, the necessity for routine cholangiography following PC remains unclear. We hypothesized that routine surveillance cholangiography (RSC) following PC would provide no benefit compared to on-demand cholangiography (ODC) triggered by signs or symptoms of biliary pathology. METHODS: We performed a three-year retrospective cohort analysis of patients managed with PC for acute cholecystitis at two tertiary care hospitals...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27875357/optimal-timing-of-endoscopic-retrograde-cholangiopancreatography-in-acute-cholangitis
#4
Linda A Hou, Loren Laine, Nima Motamedi, Ara Sahakian, Christianne Lane, James Buxbaum
OBJECTIVES: Acute cholangitis mandates resuscitation, antibiotic therapy, and biliary decompression. Our aim was to define the optimal timing of endoscopic retrograde cholangiopancreatography (ERCP) for patients with acute cholangitis. METHODS: Clinical data on all cases of cholangitis managed by ERCP were prospectively collected from September 2010 to July 2013. The clinical impact of the time to ERCP, defined as the time from presentation in the emergency department to the commencement of the ERCP, was determined...
November 21, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27864721/intraoperative-endoscopic-nasobiliary-drainage-over-primary-closure-of-the-common-bile-duct-for-choledocholithiasis-combined-with-cholecystolithiasis-a-cohort-study-of-211-cases
#5
Pei Yin, Min Wang, Renyi Qin, Jian Zhang, Guangqin Xiao, Haifeng Yu, Zhiqiang Ding, Yahong Yu
BACKGROUND: Endoscopic nasobiliary drainage (ENBD) was often used for preoperative biliary drainage in cases like cholangiocarcinoma or acute obstructive suppurative cholangitis, reports on endoscopic nasobiliary drainage (ENBD) over primary closure of the common bile duct (CBD) are limited. This study compares outcomes of laparoscopic cholecystectomy (LC) + laparoscopic CBD exploration (LCBDE) + intraoperative ENBD + primary closure of CBD with equivalent patients who underwent preoperative endoscopic retrograde cholangiopancreatography (ERCP) and subsequent LC...
November 18, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27851341/1706-failure-of-biliary-stent-requiring-second-ercp-with-stone-extraction-in-acute-cholangitis
#6
Colin Wolslegel, Charles Ruzkowski, Matthew Lute, Henrique Fernadez
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27796825/complete-response-to-post-transplant-lymphoproliferative-disorder-by-surgical-resection-and-rituximab-after-living-donor-liver-re-transplantation-for-recurrent-primary-sclerosing-cholangitis
#7
Koichiro Haruki, Hiroaki Shiba, Junichi Shimada, Norimitsu Okui, Tomonori Iida, Katsuhiko Yanaga
Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation. We herein report a case of PTLD after living-donor liver re-transplantation (reLDLT) for recurrent primary sclerosing cholangitis (PSC), for which complete response was achieved by surgical resection and rituximab. A 47-year-old man, who had undergone living-donor liver transplantation (LDLT) twice at age of 43 and 45 years for end-stage liver disease firstly for PSC and secondary for recurrent PSC, suffered liver dysfunction due to an acute cellular rejection (ACR) 17 months after reLDLT...
October 31, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27783206/procalcitonin-is-a-useful-biomarker-to-predict-severe-acute-cholangitis-a-single-center-prospective-study
#8
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/27780944/the-usefulness-of-early-endoscopic-ultrasonography-in-acute-biliary-pancreatitis-with-undetectable-choledocholithiasis-on-multidetector-computed-tomography
#9
Jae Geun Park, Ki Bae Kim, Joung Ho Han, Soon Man Yoon, Hee Bok Chae, Sei Jin Youn, Seon Mee Park
Background/Aims: EUS can detect bile duct stones (BDS) that are undetectable on multidetector computed tomography (MDCT). BDS associated with acute biliary pancreatitis (ABP) are small and tend to be excreted spontaneously. This study evaluated the usefulness of early EUS in patients with ABP and undetectable BDS on MDCT. Methods: Forty-one patients with ABP and undetectable BDS on MDCT underwent EUS within 24 hours of admission and were diagnosed with BDS, sludge, dilated common bile duct (CBD), or normal CBD...
October 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27775958/predicting-efficacy-of-plastic-stents-for-posttransplantation-biliary-strictures
#10
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
https://www.readbyqxmd.com/read/27755342/liver-transplantation-for-children-with-primary-sclerosing-cholangitis-and-autoimmune-hepatitis-unos-database-analysis
#11
Jacqueline Jossen, Rachel Annunziato, Hee-Sung Kim, Jaime Chu, Ronen Arnon
OBJECTIVES: Autoimmune hepatitis (AIH) and primary sclerosing cholangitis (PSC) are progressive immune-mediated inflammatory diseases that may require liver transplant (LT). Outcomes in children undergoing LT for these diseases are poorly studied in the Pediatric End Stage Liver Disease (PELD) era. We aimed to characterize the outcome of LT in children with AIH and PSC. METHODS: Children ≤18 years with PSC or AIH who had a first, isolated LT from 2002-2012 were identified from the UNOS database...
October 13, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27729952/cirrhosis-and-autoimmune-liver-disease-current-understanding
#12
Rodrigo Liberal, Charlotte R Grant
Primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) constitute the classic autoimmune liver diseases (AILDs). While AIH target the hepatocytes, in PBC and PSC the targets of the autoimmune attack are the biliary epithelial cells. Persistent liver injury, associated with chronic AILD, leads to un-resolving inflammation, cell proliferation and the deposition of extracellular matrix proteins by hepatic stellate cells and portal myofibroblasts. Liver cirrhosis, and the resultant loss of normal liver function, inevitably ensues...
October 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27729744/efficacy-and-safety-of-emergency-endoscopic-retrograde-cholangiopancreatography-for-acute-cholangitis-in-the-elderly
#13
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
https://www.readbyqxmd.com/read/27717950/eosinophilic-cystitis-and-cholangitis-systemic-disease-triggered-by-mycobacterium-tuberculosis
#14
Piotr Buda, Ryszard Grenda, Anna Wieteska-Klimczak, Piotr Gietka, Lidia Skobejko-Włodarska, Karina Felberg, Janusz Książyk
Eosinophilic cystitis (EC) is a rare inflammatory disorder of the urinary tract characterized by infiltration of bladder with eosinophils. The cause remains unclear, immunological mechanisms have been implicated in pathogenesis. Potential etiological factors include: tumors, allergy, parasitic infections, trauma. The disease may have a variable course, from a mild self-limiting, through common symptoms like: dysuria, hematuria, abdominal pain, tumor, to severe renal failure, with eosinophilic infiltration of the other organs and systemic complications...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27689206/therapeutic-challenges-for-symptomatic-portal-cavernoma-cholangiopathy
#15
Adriana Cavași, Voicu Mercea, Ofelia Anton, Ion Cosmin Puia
Although transjugular intrahepatic portosystemic shunts are most frequently used for the management of portal hypertension, the surgical approach is preferred for symptomatic portal cavernoma cholangiopathy. We present the case of a 25-year old female patient with a portal cavernoma secondary to catheterization of the umbilical vein at birth. She had had two episodes of esophageal variceal bleeding, successfully treated by endoscopic banding. and an episode of acute cholangitis secondary to portal cavernoma cholangiopathy...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27685634/activation-of-necroptosis-in-human-and-experimental-cholestasis
#16
Marta B Afonso, Pedro M Rodrigues, André L Simão, Dimitry Ofengeim, Tânia Carvalho, Joana D Amaral, Maria M Gaspar, Helena Cortez-Pinto, Rui E Castro, Junying Yuan, Cecília M P Rodrigues
Cholestasis encompasses liver injury and inflammation. Necroptosis, a necrotic cell death pathway regulated by receptor-interacting protein (RIP) 3, may mediate cell death and inflammation in the liver. We aimed to investigate the role of necroptosis in mediating deleterious processes associated with cholestatic liver disease. Hallmarks of necroptosis were evaluated in liver biopsies of primary biliary cholangitis (PBC) patients and in wild-type and RIP3-deficient (RIP3(-/-)) mice subjected to common bile duct ligation (BDL)...
September 29, 2016: Cell Death & Disease
https://www.readbyqxmd.com/read/27681447/pouchitis-after-ileal-pouch-anal-anastomosis-in-ulcerative-colitis-diagnosis-management-risk-factors-and-incidence
#17
Keisuke Hata, Soichiro Ishihara, Hiroaki Nozawa, Kazushige Kawai, Tomomichi Kiyomatsu, Toshiaki Tanaka, Junko Kishikawa, Hiroyuki Anzai, Toshiaki Watanabe
Restorative proctocolectomy with ileal pouch-anal anastomosis has been the surgical treatment of choice for patients with ulcerative colitis who require surgery. The quality of life after this procedure is satisfactory in most cases; however, pouchitis is a troublesome condition involving inflammation of the ileal pouch. When a patient presents with symptoms of pouchitis, such as increased bowel movements, mucous and/or bloody exudates, abdominal cramps, and fever, endoscopy is essential for a precise diagnosis...
September 28, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27679428/single-centre-experience-of-the-macrophage-activation-marker-soluble-s-cd163-associations-with-disease-activity-and-treatment-response-in-patients-with-autoimmune-hepatitis
#18
H Grønbaek, M Kreutzfeldt, K Kazankov, N Jessen, T Sandahl, S Hamilton-Dutoit, H Vilstrup, H J Møller
BACKGROUND: Autoimmune hepatitis (AIH) is characterised by liver inflammation with reversibility upon anti-inflammatory treatment. Soluble (s)CD163, a specific macrophage activation marker, is associated with inflammation in other liver diseases, but never investigated in AIH. AIM: To investigate sCD163 in patients with acute AIH and in complete and incomplete responders to standard anti-inflammatory pharmacotherapy, and during follow-up in treatment naive patients...
November 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27672273/hepatobiliary-and-pancreatic-ascariasis
#19
REVIEW
Mohammad S Khuroo, Ajaz A Rather, Naira S Khuroo, Mehnaaz S Khuroo
Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides, in to the biliary tract and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Ascarides traverse the ducts repeatedly, get trapped and die, leading to formation of hepatolithiasis. HPA is ubiquitous in endemic regions and in Kashmir, one such region, HPA is the etiological factor for 36...
September 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27652304/initial-experience-with-a-novel-eus-guided-core-biopsy-needle-sharkcore-results-of-a-large-north-american-multicenter-study
#20
Christopher J DiMaio, Jennifer M Kolb, Petros C Benias, Hiral Shah, Shashin Shah, Oleh Haluszka, Jennifer Maranki, Kaveh Sharzehi, Eric Lam, Stuart R Gordon, Sarah M Hyder, Pavlos Z Kaimakliotis, Satya B Allaparthi, Frank G Gress, Amrita Sethi, Ashish R Shah, Jose Nieto, Vivek Kaul, Shivangi Kothari, Truptesh H Kothari, Sammy Ho, Manhal J Izzy, Neil R Sharma, Rabindra R Watson, V Raman Muthusamy, Douglas K Pleskow, Tyler M Berzin, Mandeep Sawhney, Emad Aljahdi, Marvin Ryou, Clarence K Wong, Parantap Gupta, Dennis Yang, Susana Gonzalez, Douglas G Adler
BACKGROUND AND AIMS: The ability to safely and effectively obtain sufficient tissue for pathologic evaluation by using endoscopic ultrasound (EUS) guidance remains a challenge. Novel designs in EUS needles may provide for improved ability to obtain such core biopsies. The aim of this study was to evaluate the diagnostic yield of core biopsy specimens obtained using a novel EUS needle specifically designed to obtain core biopsies. PATIENTS AND METHODS: Multicenter retrospective review of all EUS-guided fine-needle biopsies obtained using a novel biopsy needle (SharkCore FNB needle, Medtronic, Dublin, Ireland)...
September 2016: Endoscopy International Open
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