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Bile duct

Kwangwoo Nam, Jun-Ho Choi
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas runs along a large spectrum from benign adenoma to invasive carcinoma.(1) Fistulas between the pancreas and adjacent organs, such as the duodenum, bile duct, and stomach, have been reported,(2-4) but benign pancreaticogastric fistulas have rarely been reported.(5) Herein, we report a patient who was diagnosed with main duct type pancreatic IPMN complicated with spontaneous pancreaticogastric fistula formation. This article is protected by copyright...
October 26, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Amir Hossein Doustimotlagh, Ahmad Reza Dehpour, Shahroo Etemad-Moghadam, Mojgan Alaeddini, Yasaman Kheirandish, Abolfazl Golestani
Metabolic bone disease is a major issue in chronic liver disease. Increased production of nitric oxide (NO) and elevation of endogenous opioids have been suggested to occur during cholestasis/cirrhosis. We aimed to investigate the involvement of nitrergic and opioidergic systems in bone loss after bile-duct-ligation (BDL) in rats using optical density (OD) evaluation and histomorphometric analysis. BDL- and sham-operated (SO) rats received injections of 3mg/kg Nω-Nitro-L-arginine methyl-ester-hydrochloride (L-NAME) as an NO-synthase inhibitor, 10mg/kg naltrexone (NTX) as an opioid-receptors antagonist or saline once daily for 28 days...
October 26, 2016: Histology and Histopathology
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
Julien Aniort, Anaïs Poyet, Jean-Louis Kemeny, Carole Philipponnet, Anne-Elisabeth Heng
Acute kidney injury (AKI) is a major complication in patients with liver disease. Although hepatorenal syndrome is frequently involved, bile cast nephropathy, characterized by tubular bile cast formation, has been scarcely described in the setting of severe liver failure. Few renal histology studies are available in these patients. We describe a case of bile cast nephropathy in a patient with obstructive cholestasis caused by stones in the common bile duct. The kidney biopsy confirmed this diagnosis, with several green casts in tubular lumens, tubular injury, and bilirubin composition of the tubular casts with Hall stain...
October 22, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Xuan-Binh D Pham, Christian de Virgilio, Lutfi Al-Khouja, Michael C Bermudez, Alexander C Schwed, Amy H Kaji, David S Plurad, Steven L Lee, Robert S Bennion, Darin J Saltzman, Dennis Y Kim
BACKGROUND: The benefit of intraoperative cholangiography (IOC) is controversial in patients with gallstone pancreatitis whose bilirubin levels are normalizing. IOC with subsequent endoscopic retrograde cholangiopancreatography may lengthen duration of surgery and length of stay, whereas failure to clear the common bile duct may result in recurrent pancreatitis. METHODS: We performed a 6-year retrospective cohort analysis of consecutive adult patients with mild gallstone pancreatitis undergoing same-admission cholecystectomy at 2 university-affiliated medical centers...
September 28, 2016: American Journal of Surgery
John V Gahagan, Steven Maximus, Matthew D Whealon, Michael J Phelan, Aram Demirjian, Victor C Joe
The necessity of routine endoscopic retrograde cholangiopancreatography (ERCP) after positive intraoperative cholangiogram (IOC) during laparoscopic cholecystectomy is not well defined. We aimed to examine the incidence of positive IOC among patients who undergo IOC during cholecystectomy and the rate of subsequent ERCP stone extraction. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy with IOC from 2002 to 2012. Patients were then analyzed for ERCP and stone extraction...
October 2016: American Surgeon
Kouichi Sakamoto, Ngin Cin Khai, Yuqing Wang, Rie Irie, Hideo Takamatsu, Hiroshi Matsufuji, Ken-Ichiro Kosai
In contrast to hepatocyte growth factor (HGF), the therapeutic potential and pathophysiologic roles of heparin-binding epidermal growth factor-like growth factor (HB-EGF) in liver diseases remain relatively unknown. To address the lack of effective pharmacologic treatments for cholestatic liver injuries, as well as to clarify the biologic features of these growth factors, we explored the effects of HB-EGF and HGF in mice with cholestatic liver injury induced by bile duct ligation (BDL). The mice were assessed 3, 5 and/or 14 days after BDL (acute, subacute and/or chronic phases, respectively) and intravenous injection of adenoviral vector expressing LacZ (control), HB-EGF, HGF, or HB-EGF and HGF...
October 20, 2016: International Journal of Molecular Medicine
Hiroyuki Isayama, Yousuke Nakai, Tsuyoshi Hamada, Saburo Matsubara, Hirofumi Kogure, Kazuhiko Koike
Self-expandable metallic stent (SEMS) was an effective biliary endoprosthesis. Mechanical properties of SEMS, radial and axial force (RF, AF), may play important roles in the bile duct after placement. RF was well known dilation force and influenced on the occurrence of migration. AF, newly proposed by this author, was defined as the recovery force when the SEMS vended. AF was related with the cause of bile duct kinking, pancreatitis, and cholecystitis due to the compression of the bile duct, orifice of the cystic duct, and pancreatic orifice...
December 2016: Current Gastroenterology Reports
R Coppola, M Cartillone, D Borzomati, G Nappo, S Valeri, T Petitti, G Perrone
Microscopic residual tumor (R1) affects prognosis of resected pancreatic head cancer patients. Surgeon's ability, caseload and accuracy of pathological staging affect the rate of R1 resections. The goal of this study was to verify if a standardized histopathological workup of the specimen affects the rate of microscopic residual tumor after PD for cancer. Two groups of specimens were managed with (Group 1, Standardized Group, SG) or without (Group 2, Non Standardized Group, NSG) a standardized histopathological workup reported by the Royal College of Pathologists...
October 25, 2016: Updates in Surgery
Deniz Koksal, Aydin Seref Koksal, Ahmet Gurakar
Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic liver disease caused by diffuse inflammation, destruction and fibrosis of the intrahepatic bile ducts, ultimately leading to cirrhosis, portal hypertension and liver failure. The pathogenesis of PBC is incompletely understood, but current data suggest roles for genetic susceptibility and environmental factors. PBC is often thought of as an organ-specific autoimmune disease, which mainly targets the liver; however, lung tissue is also a site for autoimmune involvement of PBC...
September 28, 2016: Journal of Clinical and Translational Hepatology
Hai-da Shi, Xian-Jie Shi, Shao-Cheng Lv, Huan-Xian Ma, Yu-Rong Liang, Lin Zhou, Yong Shi
OBJECTIVE: To summarize the 23-year experience of laparoscopic biliary surgery in General Hospital of PLA and evaluate the application of laparoscopic surgery in the treatment of biliary diseases. METHODS: We retrospectively analyzed the clinical data of 11 419 consecutive patients with biliary diseases undergoing laparoscopic surgery from April, 1992 and December, 2014. The disease spectrum was compared between patients treated before December 31, 2003 and those treated after the time point...
October 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Yoshifumi Noda, Satoshi Goshima, Kimihiro Kajita, Hiroshi Kawada, Nobuyuki Kawai, Hiromi Koyasu, Masayuki Matsuo, Kyongtae T Bae
PURPOSE: To evaluate the association between gadoxetic-acid-enhanced magnetic resonance (MR) imaging measurements and laboratory and clinical biomarkers of liver function and fibrosis. MATERIALS AND METHODS: One hundred thirty nine consecutive patients with suspected liver disease or liver tumor underwent gadoxetic-acid-enhanced MR imaging. MR imaging measurements during the hepatobiliary phase included biliary tract structure-to-muscle signal intensity ratio (SIR)...
November 2016: European Journal of Radiology
Xin-Qiao Huang, Jian Shu, Li Luo, Ming-Li Jin, Xiao-Fei Lu, Shu-Gen Yang
PURPOSE-: To assess the pathological differentiation grade in the patients with extrahepatic bile duct adenocarcinoma (EBDA) using diffusion-weighted imaging (DWI) at 3.0-T MR. METHODS-: Sixty-eight patients who were clinically and histologically diagnosed with EBDA underwent abdominal DWI within 2 weeks before surgery. The lesion signal intensity, signal intensity ratio of the lesion and hepar (SIR-LH) value, and apparent diffusion coefficient (ADC) value in patients with EBDA were retrospectively analysed...
November 2016: European Journal of Radiology
Atsushi Takano, Hiroshi Nakagomi, Kou Ikegame, Atsushi Yamamoto, Hideki Watanabe, Haruka Nakada, Masayuki Inoue, Hidemitsu Sugai, Michiya Yasutome, Kazushige Furuya, Masao Hada, Yoshiaki Miyasaka, Toshio Oyama, Masao Omata
INTRODUCTION: The over-expression of P53 protein in gallbladder carcinoma is a biomarker correlating with a poor survival. However, the significance of P53 expression in peritumor tissues is unknown. We experienced a case of gallbladder carcinoma where the operative specimen showed over-expression of P53 on the peritumor epithelium, and early recurrence developed at the biliary tract. PRESENTATION OF CASE: A 74-year-old female patient was referred to our hospital due to wall thickening of the gallbladder on ultrasonography...
October 18, 2016: International Journal of Surgery Case Reports
Pierre Russo, John C Magee, Robert A Anders, Kevin E Bove, Catherine Chung, Oscar W Cummings, Milton J Finegold, Laura S Finn, Grace E Kim, Mark A Lovell, Margret S Magid, Hector Melin-Aldana, Sarangarajan Ranganathan, Bahig M Shehata, Larry L Wang, Frances V White, Zhen Chen, Catherine Spino
The liver biopsy guides diagnostic investigation and therapy in infants with undiagnosed cholestasis. Histologic features in the liver may also have prognostic value in the patient with biliary atresia (BA). We assessed the relative value of histologic features in 227 liver needle biopsies in discriminating between BA and other cholestatic disorders in infants enrolled in a prospective Childhood Liver Disease Research Network (ChiLDReN) cohort study by correlating histology with clinical findings in infants with and without BA...
October 21, 2016: American Journal of Surgical Pathology
Lindsey L Kennedy, Fanyin Meng, Julie K Venter, Tianhao Zhou, Walker A Karstens, Laura A Hargrove, Nan Wu, Konstantina Kyritsi, John Greene, Pietro Invernizzi, Francesca Bernuzzi, Shannon S Glaser, Heather L Francis, Gianfranco Alpini
Cholestasis is a condition that leads to chronic hepatobiliary inflammation, fibrosis, and eventually cirrhosis. Many microRNAs (miRs) are known to have a role in fibrosis progression; however, the role of miR-21 during cholestasis remains unknown. Therefore, the aim of this study was to elucidate the role of miR-21 during cholestasis-induced biliary hyperplasia and hepatic fibrosis. Wild-type (WT) and miR-21(-/-) mice underwent Sham or bile duct ligation (BDL) for 1 week, before evaluating liver histology, biliary proliferation, hepatic stellate cell (HSC) activation, fibrotic response, and small mothers against decapentaplegic 7 (Smad-7) expression...
October 24, 2016: Laboratory Investigation; a Journal of Technical Methods and Pathology
Sarikapan Wilailak, Nuttapong Lertchaipattanakul
Between the years of 2010-2012, it was estimated there were a total of 112,392 new cases of cancers in Thailand, thus, the total age-standardized rate (ASR) per 100,000 is 137.6. In regards to the most prevalent types of cancer in female, breast cancer has the highest ASR, followed by cervical cancer (ASR=14.4); liver and bile duct cancer; colon and rectum cancer; trachea, bronchus and lung cancer; ovarian cancer (ASR=6.0); thyroid cancer; non-Hodgkin lymphoma and uterine cancer (ASR=4.3). The trend of cervical cancer in Thailand is decreasing, one key factor in making this possible was the employment of dual tract strategy (Pap smear and visual inspection with acetic acid [VIA]) by the government in 2005...
November 2016: Journal of Gynecologic Oncology
Jenny M L Rystedt, Agneta K Montgomery
BACKGROUND: Existing reports on quality-of-life (QoL) after bile duct injury (BDI) are conflicting. METHODS: Case-control study were QoL assessment was performed using SF-36 (36-item short Form health survey). Patients with BDI were compared to a matched control group (1:2) subject to cholecystectomy. RESULTS: In total 168 BDIs (0.3%) were eligible for participation and 64% returned SF-36. Median follow-up was 4.3 years. Intraoperative cholangiography was performed/attempted in 93% of BDI patients and 92% were diagnosed intraoperatively...
October 20, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
M Tampellini, A La Salvia, G V Scagliotti
Cholangiocarcinoma (CCA) is an epithelial cell malignancy arising from bile ducts and/or peribiliary glands. Even though it is considered as a rare neoplasm, its incidence is raising, particularly in developed countries. Prognosis is generally poor with few patients who present the inclusion criteria for surgery (the mainstay treatment for this tumour). Several genetic alterations potentially driving tumour progression have been described, representing a possible target for new compounds. Areas covered: A clinical trial search in Clinicaltrials...
October 22, 2016: Expert Opinion on Investigational Drugs
Jonathan S Abelson, Joshua D Spiegel, Cheguevara Afaneh, Jialin Mao, Art Sedrakyan, Heather L Yeo
BACKGROUND: Although there is a large body of published data demonstrating improved outcomes for complex operations when performed by high-volume surgeons at high-volume hospitals, the literature is mixed regarding whether this same relationship applies in less complex and more common surgeries such as laparoscopic cholecystectomy. METHODS: This study utilized the New York State Department of Health Statewide Planning and Research Cooperative System database to identify patients undergoing laparoscopic cholecystectomy for acute and chronic biliary pathology...
October 19, 2016: Surgery
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