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https://www.readbyqxmd.com/read/29241102/utility-of-hepatobiliary-scintigraphy-for-recurrent-reflux-cholangitis-following-choledochojejunostomy-a-case-report
#1
Masateru Yamamoto, Hiroyuki Tahara, Michinori Hamaoka, Seiichi Shimizu, Shintaro Kuroda, Masahiro Ohira, Kentaro Ide, Tsuyoshi Kobayashi, Hideki Ohdan
INTRODUCTION: Reflux cholangitis is a frequent complication of Roux-en-Y choledochojejunostomy. PRESENTATION OF CASE: A 68-year-old male underwent left lobectomy of the liver, bile duct resection and choledochojejunostomy for intrahepatic cholangiocarcinoma located in Segment 2 of the liver, 40mm in diameter with a lymph node metastasis 5 years ago. He had frequent recurrences of postoperative reflux cholangitis and hepatic abscesses and was treated with antibiotics each time...
December 9, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29230622/detecting-bile-reflux-the-enigma-of-bariatric-surgery
#2
REVIEW
Thomas A Eldredge, Jennifer C Myers, George K Kiroff, Jonathan Shenfine
Duodeno-gastro-esophageal reflux, or bile reflux, is a condition for which there is no diagnostic gold standard, and it remains controversial in terms of carcinoma risk. This is pertinent in the context of an increasingly overweight population who are undergoing weight-loss operations that theoretically further increase the risk of bile reflux. This article reviews investigations for bile reflux based on efficacy, patient tolerability, cost, and infrastructure requirements. At this time, whilst no gold standard exists, hepatobiliary scintigraphy is the least invasive investigation with good-patient tolerability, sensitivity, and reproducibility to be considered first-line for diagnosis of bile reflux...
December 11, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29145338/pancreatogenic-choledocholithiasis-in-common-bile-duct-stump-after-roux-en-y-hepaticojejunostomy-a-case-report
#3
Yuan-Hui Jiang, An-Hong Zhang, Shao-Jun Zhou
RATIONALE: Choledocholithiasis in common bile duct (CBD) stump after Roux-en-Y hepaticojejunostomy (RYHJ) is incredibly rare and its pathophysiology is poorly understood. PATIENT CONCERNS: A 79-year-old woman was admitted to our hospital with upper abdominal pain radiating through to the back in November 2016. DIAGNOSES: Abdominal computed tomography (CT) scan and magnetic resonance cholangiopancreatography (MRCP) revealed filling defects in CBD stump, chronic pancreatitis, and dilatation of CBD stump and main pancreatic duct (MPD)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143121/telomere-length-of-gallbladder-epithelium-is-shortened-in-patients-with-congenital-biliary-dilatation-measurement-by-quantitative-fluorescence-in-situ-hybridization
#4
Yuto Aoki, Junko Aida, Youichi Kawano, Ken-Ichi Nakamura, Naotaka Izumiyama-Shimomura, Naoshi Ishikawa, Tomio Arai, Yoshiharu Nakamura, Nobuhiko Taniai, Eiji Uchida, Kaiyo Takubo, Toshiyuki Ishiwata
BACKGROUND: Congenital biliary dilatation (CBD) is a congenital malformation involving both dilatation of the extrahepatic bile duct and pancreaticobiliary maljunction. Persistent reflux of pancreatic juice injures the biliary tract mucosa, resulting in chronic inflammation and higher rates of carcinogenesis in the biliary tract, including the gallbladder. Telomeres are repetitive DNA sequences located at the ends of chromosomes. Chromosomal instability due to telomere dysfunction plays an important role in the carcinogenesis of many organs...
November 15, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29127549/preservation-of-the-celiac-branch-of-the-vagal-nerve-for-pylorus-preserving-gastrectomy-is-it-meaningful
#5
Haruna Furukawa, Manabu Ohashi, Michitaka Honda, Koshi Kumagai, Souya Nunobe, Takeshi Sano, Naoki Hiki
BACKGROUND: Preserving the hepatic and pyloric branches of the vagal nerve in laparoscopic pylorus-preserving gastrectomy (LPPG) is considered necessary to maintain the function of the pyloric cuff. However, the clinical benefits of preservation of the celiac branch of the vagal nerve (CBVN) remain unclear. METHODS: Of 391 patients who underwent LPPG for early gastric cancer, 116 patients in whom the CBVN was preserved (CBP group) and 58 patients in whom it was not preserved (non-CBP group) were selected through the propensity score-matching method...
November 10, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/29112883/a-new-paradigm-for-gerd-pathogenesis-not-acid-injury-but-cytokine-mediated-inflammation-driven-by-hif-2%C3%AE-a-potential-role-for-targeting-hif-2%C3%AE-to-prevent-and-treat-reflux-esophagitis
#6
REVIEW
Rhonda F Souza, Liela Bayeh, Stuart J Spechler, Uttam K Tambar, Richard K Bruick
Traditionally, reflux esophagitis was assumed to develop as a caustic, chemical injury inflicted by refluxed acid. Recently, however, studies in rats and humans suggest that reflux esophagitis develops as a cytokine-mediated inflammatory injury, with hypoxia inducible factor (HIF)-2α playing a major role. In response to the reflux of acid and bile, HIF-2α in esophageal epithelial cells becomes stabilized, thereby increasing production of pro-inflammatory cytokines that attract T lymphocytes and other inflammatory cells to damage the esophagus...
November 4, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29033769/ascending-cholangitis-due-to-heavy-lifting
#7
M J Bakkum, R J L F Loffeld
Gallstone disease is the most common risk factor for cholangitis. In an anatomically normal bile duct system, cholangitis does not occur without the presence of stones. Endoscopic retrograde cholangiography with papillotomy and stone extraction is a well-established curative therapy for gallstones in the common bile duct. More important, papillotomy prevents recurrent episodes. The present case report describes a 73-year-old male with recurring cholangitis in a clear bile duct system after previous papillotomy...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28989999/gallstone-cholecystectomy-and-risk-of-gastric-cancer
#8
Sung Hwa Kang, Young Hoon Kim, Young Hoon Roh, Kwan Woo Kim, Chan Joong Choi, Min Chan Kim, Su Jin Kim, Hee Jin Kwon, Jin Han Cho, Jin Seok Jang, Jong Hun Lee
BACKGROUNDS/AIMS: The aim of this retrospective study is to compare stomach cancer incidence, characteristics between gallstones, cholecystectomy and control groups. It also aims to investigate key variables' potential effects on overall survival. METHODS: A total of 99 patients, diagnosed with stomach cancers between April 1994 and December 2015, were identified. We excluded stomach cancer patients, accrued during the first year of follow-up in both the gallstones and cholecystectomy groups, assuming that they missed cancers...
August 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28970956/a-novel-roux-en-y-reconstruction-involving-the-use-of-two-circular-staplers-after-distal-subtotal-gastrectomy-for-gastric-cancer
#9
Hoon Hur, Chang Wook Ahn, Cheul Su Byun, Ho Jung Shin, Young Bae Kim, Sang-Yong Son, Sang-Uk Han
PURPOSE: Although Roux-en-Y (R-Y) reconstruction after distal gastrectomy has several advantages, such as prevention of bile reflux into the remnant stomach, it is rarely used because of the technical difficulty. This prospective randomized clinical trial aimed to show the efficacy of a novel method of R-Y reconstruction involving the use of 2 circular staplers by comparing this novel method to Billroth-I (B-I) reconstruction. MATERIALS AND METHODS: A total of 118 patients were randomly allocated into the R-Y (59 patients) and B-I reconstruction (59 patients) groups...
September 2017: Journal of Gastric Cancer
https://www.readbyqxmd.com/read/28941013/deoxycholic-acid-promotes-development-of-gastroesophageal-reflux-disease-and-barrett-s-oesophagus-by-modulating-integrin-%C3%AE-v-trafficking
#10
David O Prichard, Anne Marie Byrne, James O Murphy, John V Reynolds, Jacintha O'Sullivan, Ronan Feighery, Brendan Doyle, Osama Sharaf Eldin, Stephen P Finn, Aoife Maguire, Deirdre Duff, Dermot P Kelleher, Aideen Long
The fundamental mechanisms underlying erosive oesophagitis and subsequent development of Barrett's oesophagus (BO) are poorly understood. Here, we investigated the contribution of specific components of the gastric refluxate on adhesion molecules involved in epithelial barrier maintenance. Cell line models of squamous epithelium (HET-1A) and BO (QH) were used to examine the effects of bile acids on cell adhesion to extracellular matrix proteins (Collagen, laminin, vitronectin, fibronectin) and expression of integrin ligands (α3 , α4, α5 , α6 and αν )...
September 22, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28871567/a-case-of-biliary-atresia-with-pancreaticobiliary-maljunction
#11
Kosuke Endo, Akiko Yokoi, Yasuhiko Mishima, Akihiko Tamaki, Keiichi Morita, Yuichi Okata, Chieko Hisamatsu, Hiroaki Fukuzawa, Makiko Yoshida, Yoshinobu Akasaka, Kosaku Maeda
BACKGROUND: The pathogenesis of biliary atresia (BA) is still unknown. There are several reports on the etiology of BA, including pancreaticobiliary maljunction (PBM). We experienced a case of Kasai type IIIa BA with PBM, in which we found elevation of pancreatic enzymes in the gallbladder. We evaluated whether PBM is related to the pathogenesis of BA based on our findings. CASE PRESENTATION: The patient was born at 40 weeks of gestation. His body weight at birth was 2850 g...
September 5, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28855537/activation-of-nadph-oxidases-leads-to-dna-damage-in-esophageal-cells
#12
Vikas Bhardwaj, Ravindran Caspa Gokulan, Andela Horvat, Liudmila Yermalitskaya, Olga Korolkova, Kay M Washington, Wael El-Rifai, Sergey I Dikalov, Alexander I Zaika
Gastroesophageal reflux disease (GERD) is the strongest known risk factor for esophageal adenocarcinoma. In the center of tumorigenic events caused by GERD is repeated damage of esophageal tissues by the refluxate. In this study, we focused on a genotoxic aspect of exposure of esophageal cells to acidic bile reflux (BA/A). Analyzing cells generated from patients with Barrett's esophagus and human esophageal specimens, we found that BA/A cause significant DNA damage that is mediated by reactive-oxygen species...
August 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28853605/current-assessment-of-choledochoduodenostomy-130-consecutive-series
#13
H Okamoto, K Miura, J Itakura, H Fujii
Introduction Cholelithiasis usually can be managed successfully by endoscopic sphincterotomy. Choledochoduodenostomy (CDD) is one of the surgical treatment options but its acceptance remains debated because of the risk of reflux cholangitis and sump syndrome. The aim of this study was to assess the current features and outcomes of patient undergoing CDD. Patients and methods We retrospectively analysed the surgical results of consecutive 130 patients treated by CDD between 1991 and 2013 and excluded five cases with a malignant disorder...
September 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28834874/common-bile-duct-stones-associated-with-pancreatobiliary-reflux-and-disproportionate-bile-duct-dilatation
#14
Cheal Wung Huh, Hee Wook Kim, Seung Woo Yi, Dong Ki Lee, Se Joon Lee
Occult pancreatobiliary reflux (PBR) in patients with a normal pancreatobiliary junction has been studied by various methods, but the exact etiology, mechanisms, and implications of this reflux have not yet been clarified. The aim of this study was to investigate the degree of PBR and patterns of biliary ductal dilatation in patients with acute calculous cholangitis by endoscopic retrograde cholangiopancreatography (ERCP).We retrospectively evaluated the degree of PBR and pattern of bile duct dilatation in patients with acute calculous cholangitis due to distal CBD (common bile duct) stones (Group A) as compared with patients with malignant CBD obstruction due to distal CBD cancer (Group B)...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28827081/management-of-gastroesophageal-reflux-disease
#15
C Prakash Gyawali, Ronnie Fass
Management of GERD commonly starts with an empiric trial of proton pump inhibitor (PPI) therapy and complementary lifestyle measures, for patients without alarm symptoms. Optimization of therapy (improving compliance and timing of PPI doses), or increasing PPI dosage to twice daily in select circumstances, can reduce persistent symptoms. Patients with continued symptoms can be evaluated with endoscopy and tests of esophageal physiology, to better determine their disease phenotype and optimize treatment. Laparoscopic fundoplication, magnetic sphincter augmentation, and endoscopic therapies can benefit patients with well-characterized GERD...
August 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28803414/laparoscopic-reversal-of-mini-gastric-bypass-to-original-anatomy-for-severe-postoperative-malnutrition
#16
Laurent Genser, Antoine Soprani, Malek Tabbara, Jean-Michel Siksik, Jean Cady, Sergio Carandina
PURPOSE: Malnutrition after mini-gastric bypass (MGB) is a rare and dreaded complication with few data available regarding its surgical management. We aim to report the feasibility, safety, and results of laparoscopic reversal of MGB to normal anatomy (RMGB) in case of severe and refractory malnutrition syndrome after intensive nutritional support (SRMS). METHODS: A 10-year retrospective chart review was performed on patients who underwent RMGB (video included) for SRMS following MGB...
August 12, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28799115/remnant-gastropathy-due-to-bile-reflux-after-roux-en-y-gastric-bypass-a-unique-cause-of-abdominal-pain-and-successful-treatment-with-ursodiol
#17
Nitin Kumar, Christopher C Thompson
BACKGROUND: Chronic abdominal pain can occur after Roux-en-Y gastric bypass (RYGB), and can remain unexplained despite extensive investigation. Bile can pool in the gastric remnant and create a bile reflux gastropathy. The aim of this study was to assess gastric remnant findings in patients with RYGB and chronic abdominal pain of unclear etiology, and to determine the effectiveness of ursodiol therapy for patients with confirmed remnant gastropathy. METHODS: All consecutive patients with RYGB and a diagnosis of chronic abdominal pain, and a negative diagnostic workup (including physical examination, routine laboratory work, cross-sectional imaging, and standard upper endoscopy), who underwent device-assisted enteroscopy for evaluation of the gastric remnant, were included...
August 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28782883/gallbladder-mucosal-lesions-associated-with-high-biliary-amylase-irrespective-of-pancreaticobiliary-maljunction
#18
Jason Free, Frank Wang, Nick Williams, Justin S Gundara, Ralph F Staerkle, Thomas J Hugh, Jaswinder S Samra
BACKGROUND: Previous studies have focused on the presence of reflux in selected cohorts with pancreaticobiliary maljunction (PBM), but little is known regarding the wider incidence of occult reflux and associated mucosal changes. We aimed to correlate gallbladder mucosal abnormalities with objective evidence of PBM and occult pancreaticobiliary reflux (PBR) in an Australian population undergoing cholecystectomy. METHODS: Patients undergoing cholecystectomy between September 2010 and September 2012 were eligible for inclusion...
August 7, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28768359/-laryngopharyngeal-reflux-disease-lprd-in-children
#19
Oliver Reichel, Panagiotis Saravakos, Kai J Lorenz
LPRD in children is characterized by symptoms, clinical findings, and sequelae caused by the reflux of gastric acid, bile acid or refluxate containing pepsin beyond the esophagus. For diagnostic procedures and therapy of gastroesophageal reflux disease (GERD) in children and adults widely accepted guidelines have been established. However, diagnosis and therapy of LPRD in children remains a continuous issue of inter- and intradisciplinary discussions. Although both GERD and LPRD in children are reflux-induced diseases, these two entities are different in symptoms, cause, diagnostic procedures, and therapy...
July 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28761692/alteration-in-the-gastric-microbiota-and-its-restoration-by-probiotics-in-patients-with-functional-dyspepsia
#20
Muneki Igarashi, Hirohiko Nakae, Takashi Matsuoka, Shunsuke Takahashi, Takayoshi Hisada, Junko Tomita, Yasuhiro Koga
OBJECTIVE: The objective of this study was to comparatively analyse the gastric fluid (GF) microbiota between patients with functional dyspepsia (FD) and healthy controls (HC), and to assess the effect of probiotics on the microbiota. DESIGN: Twenty-four Japanese patients with FD who met the Rome III definition and 21 age-matched and gender-matched HC volunteers were enrolled. The patients with FD had been treated with LG21, a probiotic strain. The GF was sampled after an overnight fast using a nasogastric tube...
2017: BMJ Open Gastroenterology
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