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Sample records for biliary tract disease

  1. CT diagnosis of biliary tract diseases

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    Sobota, J.; Horak, J.; Antos, Z.; Vodak, M. (Ustredni Vojenska Nemocnice, Prague (Czechoslovakia))

    1983-09-01

    The possibilities are discussed offered by computed tomography in the diagnosis of biliary tract diseases. Attention is paid to difficulties associated with the diagnosis of pathological changes in the biliary tract, and to the detection of isodense concrements where diagnostic problems are reliably resolved by PTHC and ERCP. It is therefore useful to supplement CT with other examination methods. A suitable combination is cholescintigraphy and CT with the possibility of a final diagnosis or selection of further examination, as a rule of an invasive nature.

  2. CT diagnosis of biliary tract diseases

    International Nuclear Information System (INIS)

    The possibilities are discussed offered by computed tomography in the diagnosis of biliary tract diseases. Attention is paid to difficulties associated with the diagnosis of pathological changes in the biliary tract, and to the detection of isodense concrements where diagnostic problems are reliably resolved by PTHC and ERCP. It is therefore useful to supplement CT with other examination methods. A suitable combination is cholescintigraphy and CT with the possibility of a final diagnosis or selection of further examination, as a rule of an invasive nature. (author)

  3. Sonographic findings of biliary tract disease

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    Chung, Duck Soo; Kim, Jung Sick; Kim, Byung Young; Kim, Si Woon; Lee, Chong Kil [Fatima Hospital, Taegu (Korea, Republic of)

    1983-03-15

    Forty one patients gallbladder and bile duct diseases were studied clinically and sonographically. Twenty nine (seventy one percent) patients were distributed between age forty to fifty nine and male to female ratio was 1 : 1.4. The order of frequency of biliary tract disease was cholelithiasis, acclculous cholecystitis, CBD stone and CBD cancer. Sonographic findings of cholelithiasis were strong echo with posterior shadowing, faint internal echoes without shadowing, gallbladder wall thickening and anechoicity of the gallbladder wall. Instead of small proportion of gallbladder distension and wall anechoicity, faint internal echoes without shadowing were seen in ten of nineteen cases of choleithiasis. On choledocholithiasis, meniscus sign at the junction of the stone and gallbladder wall was identified in most cases and was helpful to differentiation stone from malignancy. The degree of CBD dilatation was more severe in malignancy than in CBD stone and ascaris in CBD. Sonographic examination was useful in detection of gallbladder and biliary tree pathology and the cause of biliary tract obstruction could be identified.

  4. Sonographic findings of biliary tract disease

    International Nuclear Information System (INIS)

    Forty one patients gallbladder and bile duct diseases were studied clinically and sonographically. Twenty nine (seventy one percent) patients were distributed between age forty to fifty nine and male to female ratio was 1 : 1.4. The order of frequency of biliary tract disease was cholelithiasis, acclculous cholecystitis, CBD stone and CBD cancer. Sonographic findings of cholelithiasis were strong echo with posterior shadowing, faint internal echoes without shadowing, gallbladder wall thickening and anechoicity of the gallbladder wall. Instead of small proportion of gallbladder distension and wall anechoicity, faint internal echoes without shadowing were seen in ten of nineteen cases of choleithiasis. On choledocholithiasis, meniscus sign at the junction of the stone and gallbladder wall was identified in most cases and was helpful to differentiation stone from malignancy. The degree of CBD dilatation was more severe in malignancy than in CBD stone and ascaris in CBD. Sonographic examination was useful in detection of gallbladder and biliary tree pathology and the cause of biliary tract obstruction could be identified

  5. Cystic diseases of the biliary tract and liver

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    Nafiye Urgancı

    2008-06-01

    Full Text Available Cystic diseases of liver are recognized in infancy and childhood initially. Cystic diseases of liver and biliary tract are choledocal cysts, autosomal recessive and autosomal dominant polycystic kidney disease, congenital hepatic fibrosis and Caroli disease (cystic dilatation of intrahepatic bile ducts. Choledochal cysts and Caroli disease do not allow biliary flow, cause chronic or obstructive cholestasis and progressive liver disease. In congenital hepatic fibrosis and polycystic kidney disease there is cystic formations at terminal interlobular bile ducts, but cholestasis is not seen. They don’t cause liver and biliary tract functional disturbances. (Turk Arch Ped 2008; 43: 40-5

  6. Cystic diseases of the biliary tract and liver Invited Editor

    OpenAIRE

    Urgancı, Nafiye

    2008-01-01

    Cystic diseases of liver are recognized in infancy and childhood initially Cystic diseases of liver and biliary tract are choledocal cysts autosomal recessive and autosomal dominant polycystic kidney disease congenital hepatic fibrosis and Caroli disease cystic dilatation of intrahepatic bile ducts Choledochal cysts and Caroli disease do not allow biliary flow cause chronic or obstructive cholestasis and progressive liver disease In congenital hepatic fibrosis and polycystic kidney disease th...

  7. Cystic diseases of the biliary tract and liver

    OpenAIRE

    Nafiye Urgancı

    2008-01-01

    Cystic diseases of liver are recognized in infancy and childhood initially. Cystic diseases of liver and biliary tract are choledocal cysts, autosomal recessive and autosomal dominant polycystic kidney disease, congenital hepatic fibrosis and Caroli disease (cystic dilatation of intrahepatic bile ducts). Choledochal cysts and Caroli disease do not allow biliary flow, cause chronic or obstructive cholestasis and progressive liver disease. In congenital hepatic fibrosis and polycystic kidney di...

  8. Cystic disease of the liver and biliary tract.

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    Forbes, A; Murray-Lyon, I M

    1991-01-01

    The widespread availability of ultrasound imaging has led to more frequent recognition of cystic disease affecting the liver and biliary tract. There is a wide range of possible causes. Cystic disease of infective origin is usually caused by an Echinococcal species, or as the sequel of a treated amoebic or pyogenic abscess. The clinical and radiological features are often then distinctive and will not be dwelt upon in this review, except in respect of their contribution to the differential di...

  9. Biopsy - biliary tract

    Science.gov (United States)

    Cytology analysis - biliary tract; Biliary tract biopsy ... A sample for a biliary tract biopsy can be obtained in different ways. A needle biopsy can be done if you have a well-defined tumor. The biopsy site ...

  10. Bile Acid Analysis in Biliary Tract Cancer

    OpenAIRE

    Park, Jeong Youp; Park, Byung Kyu; Ko, Jun Sang; Bang, Seungmin; Song, Si Young; Chung, Jae Bock

    2006-01-01

    The etiology of biliary tract cancer is obscure, but there are evidences that bile acid plays a role in carcinogenesis. To find the association between biliary tract cancer and bile acid, this study compared the bile acid concentration and composition among patients with biliary cancer, biliary tract stones, and no biliary disease. Bile was compared among patients with biliary tract cancer (n = 26), biliary tract stones (n = 29), and disease free controls (n = 9). Samples were obtained by per...

  11. Elevated serum levels of a biliary glycoprotein (BGP I) in patients with liver or biliary tract disease

    International Nuclear Information System (INIS)

    Human hepatic bile contains a glycoprotein (Biliary glycoprotein I BGP I) which cross-reacts with the carcinoembryonic antigen (CEA). A radioimmunoassay for BGP I was developed. The interference of CEA or 'non-specific cross-reacting antigen' (NCA) was small. The serum levels of BGP I were determined in healthy subjects, in patients with hepato-biliary diseases and in patients with various infections or inflammatory disorders. Healthy individuals, including pregnant women, had a serum BGP I concentration of about 0.5 - 1 mg/l. Diseases of the liver or biliary tract (e.g. hepatitis A or B, cytomegalovirus Hepatitis, obstructive jaundice or primary biliary cirrhosis) were associated with elevated serum levels of BGP I, as opposed to infectious diseases not affecting the liver mostly showing values within the normal range. Raised levels of serum BGP I activity may reflect biliary obstruction as a results of interference with normal BGP I secretion in the bile. (author)

  12. Comparative study of ultrasonography and oral cholecystography in evaluation of gallbladder and biliary tract diseases.

    Science.gov (United States)

    Paul, Y; Sarin, N K; Dhiman, D S; Kaushik, N K

    1991-07-01

    50 cases, aged between 14-60 years, clinically suspected of gall-bladder and biliary tract diseases were evaluated by ultrasonography and oral cholecystography. Ultrasound with a preliminary radiograph of gallbladder region, proved to be more sensitive and reliable procedure than oral cholecystography. Besides providing ancillary information regarding adjacent anatomic structures, it also guided the surgeon to decide preoperatively about the mode of surgery to be employed. Further, from the present study it can be fairly concluded that ultrasound should be used as the primary screening technique for evaluating gallbladder and biliary tract diseases, after plain skiagram of the gallbladder region, since it is non-invasive, more sensitive than OCG and is devoid of use of contrast media and its toxicity. PMID:1797657

  13. Grey-scale ultrasonography and percutaneous transhepatic cholangiography in biliary tract disease.

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    Wild, S. R.; Cruikshank, J G; Fraser, G M; Copland, W A; Grieve, D C

    1980-01-01

    Fifty-one patients with suspected obstructive jaundice and 14 without jaundice in whom disease of the biliary tract was suspected but infusion cholangiography had been unhelpful were examined by grey-scale ultrasonography and percutaneous transhepatic cholangiography and the findings analysed retrospectively. Grey-scale ultrasonography distinguished between obstructive and hepatocellular jaundice in 35 out of 46 patients (76%) and indicated the site of the obstruction in 27 (58%) and the caus...

  14. Helical computed tomography-multiplanar reconstruction for diagnosis of biliary tract diseases

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    Katsuki, Yusuke; Nakazawa, Saburo; Yoshino, Junji; Inui, Kazuo; Wakabayashi, Takao; Okushima, Kazumu; Miyoshi, Hironao; Nakamura, Yuta; Etou, Nao [Fujita Health Univ., Nagoya (Japan). Second Teaching Hospital

    2000-12-01

    Multiplanar reconstruction (MPR) of helical computed tomography (HCT) was performed on 54 patients, including 27 patients with obstructive jaundice, and its usefulness in diagnosing biliary tract disease was evaluated. Ultrasonography (US) was also performed in all patients. HCT-MPR was able to delineated the upper, middle and lower bile duct in 100%, 100% and 98.1% of the cases, respectively. Biliary stenosis was diagnosed by HCT-MPR with an accuracy of 96.3%. The differential diagnosis of biliary stenosis was established correctly with an accuracy of 63.0% using US, compared with 83.3% using axial images of HCT (HCT-Axial). However, the diagnostic accuracy for rate of choledocholithiasis was 87.5% with HCT-MPR, 95.8% with HCT-Axial, and 76% with US. The overall accuracy of HCT-MPR was 88.9% in case of obstructive jaundice. The result was superior to that obtained with HCT-Axial (81.5%). In conclusion, HCT-MPR is useful for follow-up examination after ultrasonography in patients suspected of having biliary tract diseases. (author)

  15. Helical computed tomography-multiplanar reconstruction for diagnosis of biliary tract diseases

    International Nuclear Information System (INIS)

    Multiplanar reconstruction (MPR) of helical computed tomography (HCT) was performed on 54 patients, including 27 patients with obstructive jaundice, and its usefulness in diagnosing biliary tract disease was evaluated. Ultrasonography (US) was also performed in all patients. HCT-MPR was able to delineated the upper, middle and lower bile duct in 100%, 100% and 98.1% of the cases, respectively. Biliary stenosis was diagnosed by HCT-MPR with an accuracy of 96.3%. The differential diagnosis of biliary stenosis was established correctly with an accuracy of 63.0% using US, compared with 83.3% using axial images of HCT (HCT-Axial). However, the diagnostic accuracy for rate of choledocholithiasis was 87.5% with HCT-MPR, 95.8% with HCT-Axial, and 76% with US. The overall accuracy of HCT-MPR was 88.9% in case of obstructive jaundice. The result was superior to that obtained with HCT-Axial (81.5%). In conclusion, HCT-MPR is useful for follow-up examination after ultrasonography in patients suspected of having biliary tract diseases. (author)

  16. Clinical indications and accuracy of gray scale ultrasonography in the patient with suspected biliary tract disease.

    Science.gov (United States)

    Prian, G W; Norton, L W; Eule, J; Eiseman, B

    1977-12-01

    One hundred patients with suspected biliary tract disease underwent gray scale cholecystosonography (GSCS) and had diagnostic confirmation by oral cholecystogram (OCG) and/or operation. Ultrasonography demonstrated the gallbladder in 94 of the 100 patients; 2 patients had had previous cholecystectomy and 3 of the 4 remaining patients had documented stones with no confirmation of a nonvisualizing OCG in the other patient. Among the 88 patients with OCG, GSCS findings correlated in 91 per cent (2 per cent false-positive; 7 per cent false-negative). Among the 43 operative patients, GSCS was proven correct in 91 per cent (no false positive; 9 per cent false-negative). Of 12 patients with jaundice GSCS correlated with operative findings in 75 per cent (no false-positive; 25 per cent false-negative). Diagnostic errors occurred in patients with very small biliary calculi, particularly when a single stone was impacted in the cystic duct. Failure to identify the gallbladder with ultrasound signifies probable cholelithiasis in the patient without previous cholecystectomy. On the basis of this experience, we conclude that (1) GSCS is most useful when jaundice or acute illness precludes conventional studies; (2) GSCS provides an inexpensive, quick, accurate means of diagnosing cholelithiasis with a very high specificity (97 per cent) and moderate sensitivity (88 per cent); and (3) GSCS is the optimal diagnostic procedure for evaluating the biliary tract in the acutely ill, jaundiced, vomiting, allergic, and/or pregnant patient. PMID:596532

  17. Diagnosis of liver, biliary tract and gastrointestine

    International Nuclear Information System (INIS)

    The role of RI imaging in the diagnosis of lesions of the liver, biliary tracts and gastrointestinal tracts are reviewed, and representative cases are shown. Liver scintigraphy was of value for the diagnosis of lesions limitted to the liver such as primary and metastatic liver cancer and inflammatory liver diseases. However, RI methods were less useful in the diagnosis of lesions of the biliary tracts and stomach. RI scintigraphy was more sensitive than angiography in the detection of Meckel's deverticulum, Ballet's esophagus, and gastrointestinal hemorrhage. (Tsunoda, M.)

  18. Viral infections of the biliary tract

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    Gupta Ekta

    2008-01-01

    Full Text Available Bacterial infections of the biliary tract are often considered to be an important cause of acute cholangitis. Viral infections of the biliary tract however, are very often mistaken as viral hepatitis. This article highlights various viral causes of common biliary tract infections. Viral cholangitis is both less common and less discussed than viral hepatitis. Hepatotropic viruses (A, B, C, and E are generally regarded as hepatocellular pathogens, yet cholangitic manifestations are now well described in association with these diseases. Systemic viral diseases also lead to cholangitis in varying proportion to hepatitis. Human immunodeficiency virus is associated with protean hepatic complications, including cholangitis due to several causes. Other systemic viruses, most notably those of the herpes virus family, also cause hepatic disease including cholangitis and possibly ductopenia in both immunocompromised and immunocompetent patients.

  19. Evaluation of biliary disease by scintigraphy

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    Ram, M.D.; Hagihara, P.F.; Kim, E.E.; Coupal, J.; Griffen, W.O.

    1981-01-01

    The value of biliary scintigraphy was studied in 180 patients with suspected biliary tract disease. Most of the patients were investigated additionally by conventional techniques such as cholecystography, cholangiography and ultrasonography. It is concluded that biliary scintigraphy is a simple and safe technique for visualization of the biliary tract. It is particularly useful in the evaluation of acute cholecystitis, in patients with iodine sensitivity obstructive from nonobstructive jaundice.

  20. Diagnosis of biliary tract and ampullary carcinomas

    OpenAIRE

    Tsukada, Kazuhiro; Takada, Tadahiro; Miyazaki, Masaru; Miyakawa, Shuichi; Nagino, Masato; Kondo, Satoshi; Furuse, Junji; Saito, Hiroya; Tsuyuguchi, Toshio; Kimura, Fumio; Yoshitomi, Hideyuki; Nozawa, Satoshi; YOSHIDA, Masahiro; Wada, Keita; Amano, Hodaka

    2008-01-01

    Diagnostic methods for biliary tract carcinoma and the efficacy of these methods are discussed. Neither definite methods for early diagnosis nor specific markers are available in this disease. When this disease is suspected on the basis of clinical symptoms and risk factors, hemato-biochemical examination and abdominal ultrasonography are performed and, where appropriate, enhanced computed tomography (CT) and/or magnetic resonance cholangiopancreatography (MRCP) is carried out. Diagnoses of e...

  1. Diet and biliary tract cancer

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    Moerman CJ; Bueno de Mesquita HB; Runia S; Smeets FWM

    1991-01-01

    We studied the relation between diet and biliary tract cancer in a case-control study, comprising 111 incident cases and 480 controls from the general population. Food intake was assessed with a semi- quantitative food frequency questionnaire, which covered diet comprehensively. In half of the cases and 30% of the controls the information was obtained from the spouse or other relatives (indirect respondents). Mono- and disaccharides showed an elevated risk, independent from other sources of e...

  2. Biliary tract duplication cyst with gastric heterotopia

    International Nuclear Information System (INIS)

    Cystic duplications of the biliary tract are rare anomalies, easily mistaken for choledochal cysts. Surgical drainage is the preferred therapy for choledochal cyst, but cystic duplication necessitates surgical excision as duplications may contain heterotopic gastric mucosa leading to peptic ulceration of the biliary tract. We report a case of biliary tract duplication cyst containing heterotopic alimentary mucosa which had initially been diagnosed and surgically treated as a choledochal cyst. (orig.)

  3. Biliary tract duplication cyst with gastric heterotopia

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    Grumbach, K.; Baker, D.H.; Weigert, J.; Altman, R.P.

    1988-05-01

    Cystic duplications of the biliary tract are rare anomalies, easily mistaken for choledochal cysts. Surgical drainage is the preferred therapy for choledochal cyst, but cystic duplication necessitates surgical excision as duplications may contain heterotopic gastric mucosa leading to peptic ulceration of the biliary tract. We report a case of biliary tract duplication cyst containing heterotopic alimentary mucosa which had initially been diagnosed and surgically treated as a choledochal cyst.

  4. Atrophy of the left hepatic lobe caused by a biliary tract disease

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    Song, Soon Young; Cho, On Koo; Kim, Yong Soo; Rhim, Hyun Chul; Koh, Buyng Hee; Hong, Eun Kyung; Lee, Kwang Soo [Hangyang Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-02-01

    To study the CT patterns of left lobar atrophy, including pathologic and hemodynamic features, in cases of primary biliary disease. CT findings of left hepatic lobar and segmental atrophy in 26 patients with histologically or radiologically-proven underlying bile-duct disease were reviewed. Seventeen cases were oriental choloangiohepatitis (OCH) with left intrahepatic stones and nine were cholnagiocarcinoma involving the hilar or left hepatic bile duct. The distribution and appearance of atrophy and adjacent lobar hypertrophy were studied. CT scans were examined for the presence of stenosis or obstruction of the left portal vein, and the enhancing pattern of lobar atrophy was analysed. In patients who had undergone left lobectomy, the mechanism of lobar atrophy was correlated with radiographic and pathologic features. Lobar or segmental left hepatic lobe atrophy is seen in bile duct disease caused by OCH or cholangiocarcinoma. This finding suggests that the disease process is advanced, and that there is obstruction or narrowing of the left vein, associated with peripheral fibrosis and inflammation. (author). 19 refs., 4 figs.

  5. Experimental and clinical results of biliary tract scintiscanning with sup(99m)Tc-labelled N-diethyliminodiacetic acid

    International Nuclear Information System (INIS)

    N(2,6-diethyl-acetanilido)-iminodiacetic acid was labelled by means of sup(99m)Tc. Pharmacokinetic studies were performed in various organs of mice. Clinical investigations were accomplished in healthy persons and in patients suffering from different diseases of the biliary tract. The scintigraphy of the biliary tract is most suitable in cases of both partial or total obstruction of the biliary tract and assessment of biliary tract dynamics

  6. Eclectic use of cholecystostomy in biliary tract procedures

    International Nuclear Information System (INIS)

    Twenty-seven patients underwent percutaneous aspiration or catheterization of gallbladder for the diagnosis or treatment of biliary tract disease, including 12 cases of cholecystitis, nine malignancies, two cases of choledocholithiasis, and one case of biliary structure. In three patients the cholangiograms were normal. Cholestostomy catheters were placed in 25 patients, including those with normal cholangiograms; the catheters were withdrawn from these patients after the procedure. In all other patients with obstruction the catheters were left in place for drainage, stone chemolysis, or assistance with ductal opacification during percutaneous biliary dilation. There were two minor and no major complications. In addition to its uses in gallbladder disease, percutaneous cholecystostomy is a safe, less painful alternative to percutaneous transhepatic cholangiography. In conjunction with transhepatic drainage for malignancy, it allows control of biliary opacification and optimal selection of the site of ductal puncture

  7. Targeted Therapy for Biliary Tract Cancer

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    Furuse, Junji, E-mail: jfuruse@ks.kyorin-u.ac.jp [Department of Internal Medicine, Medical Oncology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611 (Japan); Okusaka, Takuji [Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 (Japan)

    2011-05-03

    It is necessary to establish effective chemotherapy to improve the survival of patients with biliary tract cancer, because most of these patients are unsuitable candidates for surgery, and even patients undergoing curative surgery often have recurrence. Recently, the combination of cisplatin plus gemcitabine was reported to show survival benefits over gemcitabine alone in randomized clinical trials conducted in the United Kingdom and Japan. Thus, the combination of cisplatin plus gemcitabine is now recognized as the standard therapy for unresectable biliary tract cancer. One of the next issues that need to be addressed is whether molecular targeted agents might also be effective against biliary tract cancer. Although some targeted agents have been investigated as monotherapy for first-line chemotherapy, none were found to exert satisfactory efficacy. On the other hand, monoclonal antibodies such as bevacizumab and cetuximab have also been investigated in combination with a gemcitabine-based regimen and have been demonstrated to show promising activity. Furthermore, clinical trials using new targeted agents for biliary tract cancer are also proposed. This cancer is a relatively rare and heterogeneous tumor consisting of cholangiocarcinoma and gallbladder carcinoma. Therefore, a large randomized clinical trial is necessary to confirm the efficacy of chemotherapy, and international collaboration is important.

  8. Targeted Therapy for Biliary Tract Cancer

    International Nuclear Information System (INIS)

    It is necessary to establish effective chemotherapy to improve the survival of patients with biliary tract cancer, because most of these patients are unsuitable candidates for surgery, and even patients undergoing curative surgery often have recurrence. Recently, the combination of cisplatin plus gemcitabine was reported to show survival benefits over gemcitabine alone in randomized clinical trials conducted in the United Kingdom and Japan. Thus, the combination of cisplatin plus gemcitabine is now recognized as the standard therapy for unresectable biliary tract cancer. One of the next issues that need to be addressed is whether molecular targeted agents might also be effective against biliary tract cancer. Although some targeted agents have been investigated as monotherapy for first-line chemotherapy, none were found to exert satisfactory efficacy. On the other hand, monoclonal antibodies such as bevacizumab and cetuximab have also been investigated in combination with a gemcitabine-based regimen and have been demonstrated to show promising activity. Furthermore, clinical trials using new targeted agents for biliary tract cancer are also proposed. This cancer is a relatively rare and heterogeneous tumor consisting of cholangiocarcinoma and gallbladder carcinoma. Therefore, a large randomized clinical trial is necessary to confirm the efficacy of chemotherapy, and international collaboration is important

  9. Usefulness of magnetic resonance cholangiography and magnetic resonance cholangio-angiography using gadolinium compounds in the diagnosis of biliary tract diseases

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    Ohkawa, Shinichi [Keio Univ., Tokyo (Japan). School of Medicine

    1997-01-01

    MR cholangio-angiography (MRCA) which was a combination of MR cholangiography (MRC) and 2D time of flight MR angiography (2D-TOFMRA) was established by MRI using Gd-DTPA infused into the percutaneous transhepatic biliary drainage (PTBD) tube in patients with obstructive jaundice due to the malignant pancreato-biliary tract tumor. Patients giving informed consent were 26 males and 17 females of mean age 65.3 (41-89) y with the tumor. MRI apparatuses used were Shimadzu 1.0 Tesla SMT-100, GE-Yokokawa Medical System 1.5 Tesla Signa, 1.5 Tesla Sierra and 0.5 Tesla Vectra. Optimal dilution factor of Gd-DTPA was previously determined by T1-weighted and GRASS method MRIs. Routine MRI was done for T2-weighted horizontal section, T1-weighted horizontal section before and after intravenous Gd-DTPA and T1-weighted coronary section during breath-holding. MRC was performed for T1-weighted coronary section after infusion of x100 diluted Gd-DTPA into PTBD tube during breath-holding. MRCA image was made from 2D-TOFMRA which was obtained by coronary image processed with the maximum intensity projection method. It was revealed that the systems between the obstructed whole biliary tracts and causative disease mass and between the portal vein and obstructed bile tracts could be clearly and simultaneously imaged by MRC and MRCA, respectively. (K.H.)

  10. Roentgenological observation in the disease of biliary tract by plain film study of abdomen

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    Kim Byung Soo [Busan National University College of Medicine, Busan (Korea, Republic of)

    1979-06-15

    The author encountered 36 cases of the cholecystopathy confirmed by the operation or I.V. cholecystography after the plane films of abdomen were taken, and who were admitted through the emergency room at Busan National University and Busan Saint Benedict Hospitals from January 1977 to October 1978. Among them, the author analyzed especially 10 cases of the cholecystopathy showed the gallbladder shadow on the plain films of the abdomen and confirmed by the operation. After then, 104 cases of normal persons as a control group were taken the plain film study of the abdomen with the supine and erect positions. The findings obtained through this study were summarized as follows. 1. Among 36 cases of the cholecystopathy, the age distribution was 19 to 77 years of age, and the highest incidence was fifth decade. Sex ratio was equal in distribution.2. The most prominent symptom was right upper abdominal pain (97.2%). Then came radiating pain, fever, chilling, nausea, vomiting, and jaundice in that order. 3. The most common duration of the clinical onset was less 5 days. 4. The radiographic film of plain abdomen showed local meteorism in 91.7%, gallbladder shadow in 47.2%, and radiopaque gall stone, air in gallbladder and air in biliary duct in 2.7%, respectively. 5. In the control group, no gallbladder shadow and air in small intestine were seen on the radiographic films of plain abdomen, but some of the air shadow in hepatic and splenic flexures of colon were found in about 90.4% or more. 6. The diameters of the gallbladder shadow showed from 3.5 cm to 8,5 cm in width on the radiographic films of plain abdomen. The operative findings showed a severe inflammatory change in the wall of gallbladder, but no gall stone in the smaller cases of the gallbladder shadow. In the large cases, a single or multiple radiolucent stones in common bile duct or gall bladder, or tumor in common bile duct with inflammatory change in the call of gallbladder were found. 7. On the plain film

  11. Roentgenological observation in the disease of biliary tract by plain film study of abdomen

    International Nuclear Information System (INIS)

    The author encountered 36 cases of the cholecystopathy confirmed by the operation or I.V. cholecystography after the plane films of abdomen were taken, and who were admitted through the emergency room at Busan National University and Busan Saint Benedict Hospitals from January 1977 to October 1978. Among them, the author analyzed especially 10 cases of the cholecystopathy showed the gallbladder shadow on the plain films of the abdomen and confirmed by the operation. After then, 104 cases of normal persons as a control group were taken the plain film study of the abdomen with the supine and erect positions. The findings obtained through this study were summarized as follows. 1. Among 36 cases of the cholecystopathy, the age distribution was 19 to 77 years of age, and the highest incidence was fifth decade. Sex ratio was equal in distribution.2. The most prominent symptom was right upper abdominal pain (97.2%). Then came radiating pain, fever, chilling, nausea, vomiting, and jaundice in that order. 3. The most common duration of the clinical onset was less 5 days. 4. The radiographic film of plain abdomen showed local meteorism in 91.7%, gallbladder shadow in 47.2%, and radiopaque gall stone, air in gallbladder and air in biliary duct in 2.7%, respectively. 5. In the control group, no gallbladder shadow and air in small intestine were seen on the radiographic films of plain abdomen, but some of the air shadow in hepatic and splenic flexures of colon were found in about 90.4% or more. 6. The diameters of the gallbladder shadow showed from 3.5 cm to 8,5 cm in width on the radiographic films of plain abdomen. The operative findings showed a severe inflammatory change in the wall of gallbladder, but no gall stone in the smaller cases of the gallbladder shadow. In the large cases, a single or multiple radiolucent stones in common bile duct or gall bladder, or tumor in common bile duct with inflammatory change in the call of gallbladder were found. 7. On the plain film

  12. Preoperative scintigrafic evaluation of the liver and biliary tract in Caroli's disease

    International Nuclear Information System (INIS)

    Caroli's disease (congenital dilatation of the intrahepatic bile ducts) is a rare condition which is usually diagnosed postoperatively. Scintigraphic evaluation of this entity is very limited. We report here a patient with Caroli's disease in whom a dichotomy in hepatic uptake of 99sup(m)Tc-HIDA (hot spots) and 99sup(m)Tc-colloid (cold spots) was observed, leading to a correct preoperative evaluation of the disease. (orig.)

  13. Preoperative scintigrafic evaluation of the liver and biliary tract in Caroli's disease

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    Georgiou, E.; Proukakis, C.; Alevizaki, C.

    1983-01-01

    Caroli's disease (congenital dilatation of the intrahepatic bile ducts) is a rare condition which is usually diagnosed postoperatively. Scintigraphic evaluation of this entity is very limited. We report here a patient with Caroli's disease in whom a dichotomy in hepatic uptake of /sup 99/sup(m)Tc-HIDA (hot spots) and /sup 99/sup(m)Tc-colloid (cold spots) was observed, leading to a correct preoperative evaluation of the disease.

  14. State of the liver, biliary tract and pancreas in ulcer disease

    International Nuclear Information System (INIS)

    A study is presented of 175 patients with uncomlicated gastric and duodenal ulcer associated with pathology of the hepato-chaledocho-pancreatic system. The dynamics of structural-functional indices in the course of treatment of ulcer disease as well as the bile biochemistry (cholesterol, phospholipids, bile acids, bilirubin) and scintiscanning of liver and pancreas may be used as criteria in determination of the ''dependent'' and ''independent'' variants of pathology of the hepato-choledocho-pancreatic system. Scarring of the ulcer in associated pathology was 48.5 days, without associated pathology - 36.6 days

  15. Influence of the Biliary System on Biliary Bacteria Revealed by Bacterial Communities of the Human Biliary and Upper Digestive Tracts

    OpenAIRE

    Ye, Fuqiang; Shen, Hongzhang; Li, Zhen; Meng, Fei; Li, Lei; Yang, Jianfeng; Chen, Ying; Bo, Xiaochen; Zhang, Xiaofeng; Ni, Ming

    2016-01-01

    Biliary bacteria have been implicated in gallstone pathogenesis, though a clear understanding of their composition and source is lacking. Moreover, the effects of the biliary environment, which is known to be generally hostile to most bacteria, on biliary bacteria are unclear. Here, we investigated the bacterial communities of the biliary tract, duodenum, stomach, and oral cavity from six gallstone patients by using 16S rRNA amplicon sequencing. We found that all observed biliary bacteria wer...

  16. Imaging of malignancies of the biliary tract- an update

    OpenAIRE

    Hennedige, Tiffany Priyanthi; Neo, Wee Thong; Venkatesh, Sudhakar Kundapur

    2014-01-01

    Malignancies of the biliary tract include cholangiocarcinoma, gallbladder cancers and carcinoma of the ampulla of Vater. Biliary tract adenocarcinomas are the second most common primary hepatobiliary cancer. Due to their slow growing nature, non-specific and late symptomatology, these malignancies are often diagnosed in advanced stages with poor prognosis. Apart from incidental discovery of gall bladder carcinoma upon cholecystectomy, early stage biliary tract cancers are now detected with co...

  17. Guidelines for chemotherapy of biliary tract and ampullary carcinomas

    OpenAIRE

    Furuse, Junji; Takada, Tadahiro; Miyazaki, Masaru; Miyakawa, Shuichi; Tsukada, Kazuhiro; Nagino, Masato; Kondo, Satoshi; Saito, Hiroya; Tsuyuguchi, Toshio; Hirata, Koichi; Kimura, Fumio; Yoshitomi, Hideyuki; Nozawa, Satoshi; YOSHIDA, Masahiro; Wada, Keita

    2008-01-01

    Few randomized controlled trials (RCTs) with large numbers of patients have been conducted to date in patients with biliary tract cancer, and standard chemotherapy has not been established yet. In this article we review previous studies and clinical trials regarding chemotherapy for unresectable biliary tract cancer, and we present guidelines for the appropriate use of chemotherapy in patients with biliary tract cancer. According to an RCT comparing chemotherapy and best supportive care for t...

  18. Flowcharts for the management of biliary tract and ampullary carcinomas

    OpenAIRE

    Miyakawa, Shuichi; Ishihara, Shin; Takada, Tadahiro; Miyazaki, Masaru; TSUKADA, KAZUHIRO; Nagino, Masato; Kondo, Satoshi; Furuse, Junji; Saito, Hiroya; Tsuyuguchi, Toshio; Kimura, Fumio; Yoshitomi, Hideyuki; Nozawa, Satoshi; Yoshida, Masahiro; Wada, Keita

    2008-01-01

    No strategies for the diagnosis and treatment of biliary tract carcinoma have been clearly described. We developed flowcharts for the diagnosis and treatment of biliary tract carcinoma on the basis of the best clinical evidence. Risk factors for bile duct carcinoma are a dilated type of pancreaticobiliary maljunction (PBM) and primary sclerosing cholangitis. A nondilated type of PBM is a risk factor for gallbladder carcinoma. Symptoms that may indicate biliary tract carcinoma are jaundice and...

  19. Radiological biliary tract diagnosis after cholecystectomy

    Energy Technology Data Exchange (ETDEWEB)

    Schindler, G.; Kueper, K.

    1982-01-01

    Fifty-three patients with biliary symptoms were studied at least four years after cholecystectomy by isotope techniques. There was a highly significant correlation between symptoms and disturbances of bile flow, such as dyskinesia or obstruction. There was no correlation with serum enzyme levels such as gamma-GT, alkaline phosphatase, bilirubin or transaminases. Measurements of the diameter of the bile duct on cholangiograms provided no evidence of obstruction up to 15 mm, although a diameter in excess of 10 mm. made obstruction likely. The upper value for 'normal' bile flow derived from hilar flow curves of patients without dyskinesia showed a half value period of 27.5 minutes. The disturbances of flow demonstrated by isotope methods in the presence of typical symptoms, and without other pathological findings, indicate a pre-clinical stage of a partly compensated biliodynamic insufficiency. Where there is no morphological evidence of biliary obstruction, one must assume inflammatory changes round the papilla of Vater; these are frequent even in normal biliary tracts and almost always present after cholecystectomy. Quantitative hepato-biliary scintigraphy is the most reliable method for objective measurement of disturbances of bile flow and make it possible to avoid the vague diagnosis of 'postcholecystectomy syndrome'.

  20. Obstructive Biliary Tract Disease

    OpenAIRE

    White, Thomas Taylor

    1982-01-01

    The techniques that have come into general use for diagnosing problems of obstructive jaundice, particularly in the past ten years, have been ultrasonography, computerized tomography, radionuclide imaging, transhepatic percutaneous cholangiography using a long thin needle, transhepatic percutaneous drainage for obstructive jaundice due to malignancy, endoscopic retrograde cannulation of the papilla (ERCP), endoscopic sphincterotomy and choledochoscopy. It is helpful to review obstructive jaun...

  1. MR and CT cholangiography in evaluation of the biliary tract

    Energy Technology Data Exchange (ETDEWEB)

    Masui, T.; Fujiwara, T.; Ichijo, K.; Imaoka, I.; Naito, M. [Seirei Mikatabara General Hospital, Hamamatsu (Japan). Dept. of Radiology; Takehara, Y.; Kaneko, M. [Hamamatsu Univ. School of Medicine (Japan). Dept. of Radiology; Yamamoto, H.; Watahiki, H. [Seirei Mikatabara General Hospital, Hamamatsu (Japan). Dept. of Gastroenterology

    1998-09-01

    Objective: To compare MR and CT cholangiography (MRC and CTC) in evaluating the anatomy of the extrahepatic biliary tract and the pathology related to the gallbladder. Material and Methods: Twenty-three patients underwent MRC and CTC with a biliary contrast medium for investigation of biliary disease. 3D displays of both were also obtained. Endoscopic retrograde cholangiography was performed in 17 patients, and the pathology of all 23 was evaluated. Results: Overall, the image quality was higher with CTC than with MRC (4.7 vs 3.9, p<0.05). The cystic duct was demonstrated better by CTC than MRC (p<0.05). Multiplanar reformation (MPR) and source images provided additional information to that obtained from 3D MRC and CTC images. Gallstones were revealed in 6 patients by CTC and in 5 of these 6 by MRC. In 2 patients with cholecystitis, CTC demonstrated gallbladder wall thickening but MRC did not. In 3 patients with adenomyomatosis, MRC demonstrated Rokitansky-Aschoff sinuses (RAS) while CTC demonstrated focal gallbladder wall thickening in all 3 and RAS in 1 of them. Conclusion: Both MRC and CTC provided anatomical and pathological information about the biliary system. With both techniques, however, either MPR or source images proved necessary in addition for evaluating the biliary system anatomy and pathology. The gallbladder wall was depicted clearly in source CTC, but MRC is recommended for the evaluation of adenomyomatosis because its depicts RAS clearly. (orig.)

  2. Tumor extension along percutaneous transhepatic biliary drainage tracts

    International Nuclear Information System (INIS)

    Percutaneous Transhepatic Biliary Catheterization is commonly employed in the diagnosis and management of obstructive jaundice associated with malignant lesions. Tumor manipulation as an effort to obtain a histological diagnosis or to establish short or long-term internal-external biliary drainage is liable to disseminate the malignancy along the catheter tract. Two cases of malignant seeding of the catheter tract after biliary drainage have been observed. (orig.)

  3. Tumor extension along percutaneous transhepatic biliary drainage tracts

    Energy Technology Data Exchange (ETDEWEB)

    Tersigni, R.; Bochicchio, O.; Cavallini, M.; Bufalini, G.; Alessandroni, L.; Arena, L.; Armeni, O.; Miraglia, F.; Stipa, S.; Rossi, P.

    1986-11-01

    Percutaneous Transhepatic Biliary Catheterization is commonly employed in the diagnosis and management of obstructive jaundice associated with malignant lesions. Tumor manipulation as an effort to obtain a histological diagnosis or to establish short or long-term internal-external biliary drainage is liable to disseminate the malignancy along the catheter tract. Two cases of malignant seeding of the catheter tract after biliary drainage have been observed.

  4. Pathological diagnosis of flat epithelial lesions of the biliary tract with emphasis on biliary intraepithelial neoplasia.

    Science.gov (United States)

    Sato, Yasunori; Sasaki, Motoko; Harada, Kenichi; Aishima, Shinichi; Fukusato, Toshio; Ojima, Hidenori; Kanai, Yae; Kage, Masayoshi; Nakanuma, Yasuni; Tsubouchi, Hirohito

    2014-01-01

    Flat epithelial lesions of the biliary tract cannot be detected by the image analysis, and the diagnosis entirely depends on pathological examination. The biliary tract is often affected by inflammatory conditions, and the resultant changes of the biliary epithelium make it difficult to differentiate them from neoplasia. Thus, the pathological diagnosis of biliary flat epithelial lesions can be challenging. In the biliary tract, there are several forms of intraepithelial neoplasia of the flat type, and biliary intraepithelial neoplasia (BilIN) is known as one of such lesions that represent the multistep cholangiocarcinogenesis. In this article, the diagnostic criteria and the differential diagnosis of biliary flat epithelial lesions, particularly focusing on BilIN, were presented and discussed to provide help to advance clinical and research applications of the BilIN system. PMID:23616173

  5. Role of Adjuvant Chemoradiotherapy for Resected Extrahepatic Biliary Tract Cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate the effect of adjuvant chemoradiotherapy (CRT) on locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) for patients with extrahepatic biliary tract cancer treated with curative resection. Methods and Materials: The study involved 168 patients with extrahepatic biliary tract cancer undergoing curative resection between August 2001 and April 2009. Of the 168 patients, 115 received adjuvant CRT (CRT group) and 53 did not (no-CRT group). Gender, age, tumor size, histologic differentiation, pre- and postoperative carbohydrate antigen 19-9 level, resection margin, vascular invasion, perineural invasion, T stage, N stage, overall stage, and the use of adjuvant CRT were analyzed to identify the prognostic factors associated with LRC, DFS, and OS. Results: For all patients, the 5-year LRC, DFS, and OS rate was 54.8%, 30.6%, and 33.9%, respectively. On univariate analysis, the 5-year LRC, DFS, and OS rates in the CRT group were significantly better than those in the no-CRT group (58.5% vs. 44.4%, p = .007; 32.1% vs. 26.1%, p = .041; 36.5% vs. 28.2%, p = .049, respectively). Multivariate analysis revealed that adjuvant CRT was a significant independent prognostic factor for LRC, DFS, and OS (p < .05). Conclusion: Our results have suggested that adjuvant CRT helps achieve LRC and, consequently, improves DFS and OS in patients with extrahepatic biliary tract cancer.

  6. [Digestive endoscopy: biliary tract and pancreas].

    Science.gov (United States)

    Costamagna, Guido

    2016-06-01

    New technological developments in endoscopic retrograde cholangiopancreatography and endoscopic ultrasound, both for diagnosis and treatment of biliary and pancreatic diseases, have opened up new scenarios in the recent years. For instance, removal of large bile duct stones with endoscopic sphincterotomy followed by large balloon dilation has been proven to be a safe and effective technique. Also cholangioscopy evolved in terms of better imaging, tissue acquisition and stones management. Self-expandable metal stents are used mostly for malignant diseases, but their role in benign diseases has also been deeply investigated in the last years. The rapid evolution in the field of radiofrequency brought new devices for safer ablation and palliation of biliary tumours. Self-expandable metal stents are also used for ultrasound-guided drainage of walled off pancreatic necrosis and for choledocoduodenostomy and cholecystogastrostomy. PMID:27362720

  7. [Effect of dietotherapy with food-stuffs for enteral nutrition on the dynamic of clinical and biochemic parameters in biliary tract diseases].

    Science.gov (United States)

    Plotnikova, O A; Meshcheriakova, V A; Sharfetdinov, Kh Kh; Petrovskaia, O B; Mokhova, E O

    2005-01-01

    It was investigated the influence of dietary therapy with enteral formula "Nutricomp AND Braum fiber" on clinical and biochemic parameters in biliary tract diseases. Also it was carried out the comparative estimation of the gallbladder motility in this contingent of patients in process of the standard food loading and the loading with the tested enteral formula (25 g carbohydrates). It was indicated that the including of enteral formula "Nutricomp AND Braum fiber" (209 g/day) in traditional hypocaloric diet promotes the decrease of cholesterol level and activity of alkaline phosphatase. The gallbladder motility was some smaller after the consuming of enteral formula "Nutricomp AND Braum Diabetes" compared with the standard food loading (25 g carbohydrates). PMID:16313133

  8. LAPAROSCOPIC ANATOMY OF THE EXTRAHEPATIC BILIARY TRACT

    Directory of Open Access Journals (Sweden)

    E. Târcoveanu

    2005-01-01

    Full Text Available Development of mini-invasive surgery determinates a rapid improvement in laparoscopic regional anatomy. As laparoscopy is becoming common in most surgical departments, basic laparoscopic anatomy is mandatory for all residents in general surgery. Successful general surgery starts in the anatomy laboratory. Successfully minim invasive surgery starts in the operative theatre with laparoscopic exploration. The initial laparoscopic view of the right upper quadrant demonstrates primarily the subphrenic spaces, abdominal surface of the diaphragm and diaphragmatic surface of the liver. The falciform ligament is a prominent dividing point between the left subphrenic space and the right subphrenic space. The ligamentum teres hepatis is seen in the free edge of the falciform. Upward traction on the gallbladder exposes the structures of Calot’s triangle and the hepatoduodenal ligament. The liver is divided into anatomic segments based on internal anatomy that is invisible to the laparoscopist. Surface landmarks include the falciform ligament and the gallbladder fossa. The surgical procedures performed laparoscopically currently include liver biopsy, wedge resection, fenestration of hepatic cysts, laparoscopic approach of the hidatid hepatic cyst, and atypical hepatectomy. We present the laparoscopic anatomy of extrahepatic biliary tract. Once the gallbladder is elevated, inspection reveals Hartmann’s pouch and the cystic duct. The typical angular junction of the cystic duct on the common duct actually occurs in a minority of patients and the length and course of the cystic duct are highly variable. The boundaries of Calot’s triangle are often not well seen. The cystic artery is often visible under the peritoneum as it runs along the surface of the gallbladder. The variations of the structures of the hepatoduodenal ligament may occur to injuries during laparoscopic cholecystectomy. Cholangiography increases the safety of dissection of biliary tract by

  9. Preoperative biliary drainage for biliary tract and ampullary carcinomas

    OpenAIRE

    Nagino, Masato; Takada, Tadahiro; Miyazaki, Masaru; Miyakawa, Shuichi; TSUKADA, KAZUHIRO; Kondo, Satoshi; Furuse, Junji; Saito, Hiroya; Tsuyuguchi, Toshio; Yoshikawa, Tatsuya; Ohta, Tetsuo; Kimura, Fumio; Ohta, Takehiro; Yoshitomi, Hideyuki; Nozawa, Satoshi

    2008-01-01

    We posed six clinical questions (CQ) on preoperative biliary drainage and organized all pertinent evidence regarding these questions. CQ 1. Is preoperative biliary drainage necessary for patients with jaundice? The indications for preoperative drainage for jaundiced patients are changing greatly. Many reports state that, excluding conditions such as cholangitis and liver dysfunction, biliary drainage is not necessary before pancreatoduodenectomy or less invasive surgery. However, the morbidit...

  10. New device for dilatation of percutaneous biliary tract

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Sung-Gwon; Lim, Myung-Gwan; Cho, Young-Kook; Suh, Chang-Hae [Inha Univ. Hospital, Inchon (Korea, Republic of); Yoon, Hyun Ki; Song, Ho-Young; Sung, Kyu Bo [Asan Medical Center, Ulsan Univ. College of Medicine, Ulsan (Korea, Republic of); Shin, Joo-Won [Ulgi Hospital, Seoul (Korea, Republic of)

    1997-06-01

    To evaluate the usefulness of percutaneous transhepatic biliary drainage (PTBD) tract dilatation using a Nipro set. We dilated 28 percutaneous biliary drainage tracts up to 18F; 26 procedures involved PTBD, and two, cholecystostomy. A Nipro set was used for dilatation, the purposes of which were stone removal (n=18) and choledochoscopic biopsy (n=10). For dilatation, local anesthesia was used in all cases. In all patients, tract dilatation was successful. In 21 of 28 cases, dilatation of the right PTBD tract was involved, and in five of 28, dilatation of the left tract. In two cases, tract dilatation was done in cholecystostomy tracts. Complications encountered were pain (n=17), bradycardia (n=2), hemobilia (n=2), bleeding (n=1), and fever (n=1). In choledocoscopy, tract dilatation using a Nipro set is safe and simple.

  11. [Biliary tract diseases in persons suffering as a result of the accident at the Chernobyl Atomic Electric Power Station].

    Science.gov (United States)

    Komarenko, D I; Soboleva, L P; Kadiuk, E N; Glukhen'kiĭ, E V; Nosach, E V

    1999-07-01

    A retrospective analysis was performed of case histories and of results of sonographic investigations in liquidators of the Chernobyl accident suffering from chronic abnormalities of the biliary ducts. Patients with cholecystitis were studied for the biochemical composition of their bile. The incidence of the gallbladder disorders (chronic cholecystitis, angiocholitis, dyskinesias of the biliary ducts) has not changed much over the last 10 years having elapsed since the accident. The biochemical composition of bile was found to have been changed to a greater extent in the liquidators of the Chernobyl accident than it was in those having avoided danger of exposure to ionizing radiation. Mechanisms of origination of cholelithiasis are discussed on the basis of investigations designed to study biochemical properties of bile and findings secured with the aid of the ultrasound techniques. PMID:10822667

  12. Biliary tract carcinomas: from chemotherapy to targeted therapy.

    Science.gov (United States)

    Marino, Donatella; Leone, Francesco; Cavalloni, Giuliana; Cagnazzo, Celeste; Aglietta, Massimo

    2013-02-01

    Biliary tract carcinomas (BTC) are a group of tumours arising from the epithelial cells of intra- and extra-hepatic biliaryducts and the gallbladder, characterised by a poor prognosis. Surgery is the only curative procedure, but the risk of recurrence is high and furthermore, the majority of patients present with unresectable disease at the time of diagnosis. Systemic therapy is the mainstay of treatment for patients who present recurrent or metastatic disease. Progress has been made in the last decade to identify the most effective chemotherapy regimens, with the recent recommendation of the combination of gemcitabine-cisplatin as the standard schedule. Comprehension of the molecular basis of cholangiocarcinogenesis and tumour progression has recently led to the experimentation of targeted therapies in patients with BTC, demonstrating promising results. In this review we will discuss the clinical experience with systemic treatment for BTC, focusing on future directions with targeted therapies. PMID:22809696

  13. Risk factors for biliary tract and ampullary carcinomas and prophylactic surgery for these factors

    OpenAIRE

    Miyazaki, Masaru; Takada, Tadahiro; Miyakawa, Shuichi; Tsukada, Kazuhiro; Nagino, Masato; Kondo, Satoshi; Furuse, Junji; Saito, Hiroya; Tsuyuguchi, Toshio; Chijiiwa, Kazuo; Kimura, Fumio; Yoshitomi, Hideyuki; Nozawa, Satoshi; YOSHIDA, Masahiro; Wada, Keita

    2008-01-01

    Curative resection is the only treatment for biliary tract cancer that achieves long-term survival. However, patients with advanced biliary tract cancer have only a limited prognosis even after radical surgical resection. Thus, to improve the longterm results, the early detection of biliary tract cancer and subsequent cure seem to be essential. The purpose of this study was to review the literature concerning the risk factors for cancerous and precancerous lesions of the biliary tract, and pr...

  14. Chronic typhoid infection and the risk of biliary tract cancer and stones in Shanghai, China

    OpenAIRE

    Pruckler James; Chen Jinbo; Wang Bing-Shen; Rashid Asif; Quraishi Sabah M; Sakoda Lori C; Gao Yu-Tang; Safaeian Mahboobeh; Mintz Eric; Hsing Ann W

    2011-01-01

    Abstract Previous studies have shown a positive association between chronic typhoid carriage and biliary cancers. We compared serum Salmonella enterica serovar Typhi antibody titers between biliary tract cancer cases, biliary stone cases without evidence of cancer, and healthy subjects in a large population-based case-control study in Shanghai, China. Participants included 627 newly diagnosed primary biliary tract cancer patients; 1,037 biliary stone cases (774 gallbladder and 263 bile-duct) ...

  15. Radioanatomy and physiology of liver and biliary tract

    International Nuclear Information System (INIS)

    Peculiarities of the structure and functioning of liver and biliary tract are considered. Comparison with anatomy and physiology of these healthy organs is carried out. The know ledge of radioanatomy of the given organs is shown to be the necessary condition of right interpretation of roentgenological data

  16. Study of ursodeoxycholic acid influence on efficacy and safety of statin therapy in patients with diseases of the liver, gall bladder and/or biliary tract (the RAKURS study)

    OpenAIRE

    S.Yu. Martsevich; N. P. Kutishenko; L. Yu. Drozdova; O.V. Lerman; V.A. Nevzorova; I. I. Reznik; G. V. Shavkuta; D. A. Yahontov

    2014-01-01

    Aim. To assess the potential of ursodeoxycholic acid (UDCA) in the prevention of liver dysfunction in patients with cardiovascular diseases (CVD) and high risk of cardiovascular events (CVE) with indications for statins use.Material and methods. Patients (n=262, age 60.1±8.9 years) took statins for secondary prevention of CVE in observational cohort study. The follow-up duration was 6 months. UDCA was recommended for all patients because of liver diseases and/or biliary tract. Some of the pat...

  17. Biliary tract obstruction in chronic pancreatitis

    OpenAIRE

    Abdallah, Abdul A.; Krige, Jake E J; Bornman, Philippus C.

    2007-01-01

    Bile duct strictures are a common complication in patients with advanced chronic pancreatitis and have a variable clinical presentation ranging from an incidental finding to overt jaundice and cholangitis. The diagnosis is mostly made during investigations for abdominal pain but jaundice may be the initial clinical presentation. The jaundice is typically transient but may be recurrent with a small risk of secondary biliary cirrhosis in longstanding cases. The management of a bile duct strictu...

  18. Predictive Factors of Biliary Tract Cancer in Anomalous Union of the Pancreaticobiliary Duct.

    Science.gov (United States)

    Park, Jin-Seok; Song, Tae Jun; Park, Tae Young; Oh, Dongwook; Lee, Hyun Kyo; Park, Do Hyun; Lee, Sang Soo; Seo, Dong Wan; Lee, Sung Koo; Kim, Myung-Hwan

    2016-05-01

    The assessment of malignancies associated with anomalous union of the pancreaticobiliary duct (AUPBD) is essential for the design of appropriate treatment strategies. The aim of the present study is to measure the incidence of AUPBD-related pancreaticobiliary malignancy and to identify predictive factors. This retrospective cohort study included cases of 229 patients with AUPBD between January 1999 and December 2013. The impact of bile duct dilatation on the incidence of AUPBD-related pancreaticobiliary disease was measured, and predictive factors were evaluated.Among 229 patients with AUPBD, 152 had common bile duct dilatation (≥10 mm) (dilated group) and 77 did not (pancreatic enzymes refluxed in the bile duct were associated with occurrence of biliary tract cancers. In multivariate analysis, age ≥45 years (odds ratio [OR] 1.042, 95% confidence interval [CI] 1.011-1.073, P < 0.05), P-C type (OR 3.327, 95% CI 1.031-10.740, P < 0.05), and a high level of biliary lipase (OR 4.132, 95% CI 1.420-12.021, P < 0.05) showed a significant association with AUPBD-related biliary tract cancer.Intrahepatic cholangiocarcinoma may occur more frequently in AUPBD patients without bile duct dilatation. Age ≥45 years, P-C type, and biliary lipase level ≥45,000 IU/L are significantly associated with AUPBD-related biliary tract cancer. PMID:27196455

  19. Biliary tract obstruction secondary to cancer: management guidelines and selected literature review.

    Science.gov (United States)

    Lokich, J J; Kane, R A; Harrison, D A; McDermott, W V

    1987-06-01

    Malignant biliary tract obstruction (MBTO) due to either primary biliary tract cancer or metastasis to the porta hepatis is a common clinical problem. The most common metastatic tumors causing MBTO in order of frequency are gastric, colon, breast, and lung cancers. Radiographic diagnostic procedures should proceed in a cost-effective sequence from ultrasonography, computerized tomography (CT), percutaneous transhepatic cholangiography (PTHC), and endoscopic retrograde pancreatography with the goal of establishing the site of the biliary tract obstruction. The identification of the site of obstruction could be established by ultrasound 70% to 80%, CT scan 80% to 90%, PTHC 100%, and endoscopic retrograde cholangiography (ERCP) 85%. Therapeutic intervention by radiographic decompression (PTHC or endoscopic prosthesis), surgical bypass, or radiation therapy with or without chemotherapy may be selectively used based on (1) the site of obstruction; (2) the type of primary tumor; and (3) the presence of specific symptoms related to the obstruction. ("Prophylactic" biliary tract decompression to prevent ascending cholangitis is not supported by the literature in that the frequency of sepsis in the face of malignant obstruction is small (in contrast to sepsis associated with stone disease). Furthermore, PTHC with drainage as a long-term procedure is associated with a substantial frequency of sepsis and is unnecessary and possibly problematic as a preoperative procedure simply to reduce the bilirubin level. The use of radiation therapy in conjunction with chemotherapy for patients not deemed suitable for a surgical bypass because of the presence of proximal obstruction is an important alternative to PTHC. PMID:3295131

  20. Acute Pancreatitis due to Rupture of the Hydatid Cyst into the Biliary Tract: A Case Report

    Directory of Open Access Journals (Sweden)

    Zulfu Bayhan

    2014-02-01

    Full Text Available Hydatid disease is still endemic in our country and in many parts of the world. Liver is the most common site of hydatid disease. Rupture of hydatid cysts of liver into the biliary ducts can be seen as a complication. Obstructive jaundice, acute cholangitis and much more rarely acute pancreatitis may occur due to rupture of hydatid cysts into the biliary ducts. In this case report, a 38-year-old male patient with findings of acute pancreatitis and obstructive jaundice due to rupture of hydatid cyst into the biliary tract were presented . In our case, Endoscopic retrograde cholangiopancreatography (ERCP was performed to the patient with diagnostic and therapeutic purposes. Parts of germinative membrane located within the common bile duct and causing the obstruction of papillary orifice was seen in ERCP. Germinative membrane components were removed during the process. Endoscopic sphincterotomy was performed to the patient. After the procedure, the clinical findings and laboratory findings of the patient returned to normal rapidly. As a result, it should be noted that rupture of hepatic hydatid cysts into the bile ducts might be a rare cause of biliary pancreatitis. It must be kept in mind that endoscopic sphincterotomy and endoscopic removal of cyst membranes is a very important method for the diagnosis and treatment of the acute pancreatitis and obstructive jaundice due to rupture of hydatid cyst into the biliary tract. [Natl J Med Res 2014; 4(1.000: 92-94

  1. New and emerging treatment options for biliary tract cancer

    Directory of Open Access Journals (Sweden)

    Noel MS

    2013-10-01

    Full Text Available Marcus S Noel, Aram F Hezel James P Wilmot Cancer Center, University of Rochester, Rochester, NY, USA Abstract: Biliary tract cancer (BTC is a group of relatively rare tumors with a poor prognosis. The current standard of care consists of doublet chemotherapy (platinum plus gemcitabine; however, even with cytotoxic therapy, the median overall survival is less than 1 year. The genetic basis of BTC is now more clearly understood, allowing for the investigation of targeted therapy. Combinations of doublet chemotherapy with antiepidermal growth factor receptor agents have provided modest results in Phase II and Phase III setting, and responses with small molecule inhibitors are limited. Moving forward as we continue to characterize the genetic hallmarks of BTC, a stepwise, strategic, and cooperative approach will allow us to make progress when developing new treatments. Keywords: biliary tract cancer, cholangiocarcinoma, genetics, targeted therapy

  2. Congenital biliary tract malformation resembling biliary cystadenoma in a captive juvenile African lion (Panthera leo).

    Science.gov (United States)

    Caliendo, Valentina; Bull, Andrew C J; Stidworthy, Mark F

    2012-12-01

    A captive 3-mo-old white African lion (Panthera leo) presented with clinical signs of acute pain and a distended abdomen. Despite emergency treatment, the lion died a few hours after presentation. Postmortem examination revealed gross changes in the liver, spleen, and lungs and an anomalous cystic structure in the bile duct. Histologic examination identified severe generalized multifocal to coalescent necrotizing and neutrophilic hepatitis, neutrophilic splenitis, and mild interstitial pneumonia, consistent with bacterial septicemia. The abnormal biliary structures resembled biliary cystadenoma. However, due to the age of the animal, they were presumed to be congenital in origin. Biliary tract anomalies and cystadenomas have been reported previously in adult lions, and this case suggests that at least some of these examples may have a congenital basis. It is unclear whether the lesion was an underlying factor in the development of hepatitis. PMID:23272363

  3. Empiric antibiotic choices for community-acquired biliary tract infections

    OpenAIRE

    Kuo-Kuan Chang; Chin-Lu Chang; Fang-Ting Tai; Chun-Hsiang Wang; Ruey-Chang Lin

    2014-01-01

    Background: The study was conducted to reveal the most appropriate empiric antibiotics for the treatment of community-acquired biliary tract infections (CA-BTI) at a regional hospital in Taiwan. Methods: The study was performed between October 1, 2010 and October 31, 2012. All positive bile culture results of presumptive community-acquired origins were collected. The associated etiologic microorganisms and their antimicrobial susceptibilities were analyzed. The appropriateness of empiric t...

  4. Photodynamic therapy for pancreatic and biliary tract carcinoma

    Science.gov (United States)

    Pereira, Stephen P.

    2009-02-01

    Patients with non-resectable pancreatic and biliary tract cancer (cholangiocarcinoma and gallbladder cancer) have a dismal outlook with conventional palliative therapies, with a median survival of 3-9 months and a 5 year survival of less than 3%. Surgery is the only curative treatment but is appropriate in less than 20% of cases, and even then is associated with a 5-year survival of less than 30%. Although most applications of photodynamic therapy (PDT) in gastroenterology have been on lesions of the luminal gut, there is increasing experimental and clinical evidence for its efficacy in cancers of the pancreas and biliary tract. Our group has carried out the only clinical study of PDT in pancreatic carcinoma reported to date, and showed that PDT is feasible for local debulking of pancreatic cancer. PDT has also been used with palliative intent in patients with unresectable cholangiocarcinoma, with patients treated with stenting plus PDT reporting improvements in cholestasis, quality of life and survival compared with historical or randomized controls treated with stenting alone. Further controlled studies are needed to establish the influence of PDT and chemotherapy on the survival and quality of life of patients with pancreatic and biliary tract carcinoma.

  5. Interventional management for biliary tract complications following liver transplantation

    International Nuclear Information System (INIS)

    Objective: To investigate the role of interventional procedures in the management of biliary tract complications following liver transplantation, and so as the effect of t-tube indwelling. Methods: A review was made of data collected from 55 patients in two groups designated according to t-tube indwelling (28)or not (27). Data were retrospectively analyzed in terms of interventional procedures performed, and outcomes. Results: A total of 55 liver transplantation patients survived more than 1 month after interventional treatment for biliary tract complications, including 11 only with a drainage T-tube, the other 44 (80.0%) with one or more interventional procedures such as PTBD, balloon dilation to cure obstructive jaundice. Additionally 8 cases undertook stenting for hepatic artery, hepatic vein or portal vein stenosis. Conclusions: Interventional procedures are safe and effective for most patients with biliary tract complications following liver transplantation, with easy repetition in performance, including T-tube indwelling to provide a route for further diagnosis and treatment. Yet it is necessary to have other various interventional managements for the whole intact satisfaction of patients. (authors)

  6. Evaluation of the biliary tract in patients with functional biliary symptoms

    Institute of Scientific and Technical Information of China (English)

    Peter Funch-Jensen; Asbj(φ)rn Mohr Drewes; László Madácsy

    2006-01-01

    The aim of this paper was to describe functional biliary syndromes and methods for evaluation of the biliary tract in these patients. Functional biliary symptoms can be defined as biliary symptoms without demonstrable organic substrate. Two main syndromes exist: Gallbladder dysfunction and sphincter of Oddi dysfunction. The most important investigative tools are cholescintigraphy and endoscopic sphincter of Oddi manometry. In gallbladder dysfunction a scintigraphic gallbladder ejection fraction below 35% can select patients who will benefit from cholecystectomy. Endoscopic sphincter of Oddi manometry is considered the gold standard in sphincter of Oddi dysfunction but recent development in scintigraphic methods is about to change this. Thus,calculation of hilum-to-duodenum transit time and duodenal appearance time on cholescintigraphy have proven useful in these patients. In conclusion, ambient methods can diagnose functional biliary syndromes.However, there are still a number of issues where further knowledge is needed. Probably the next step forward will be in the area of sensory testing and impedance planimetric methods.

  7. Biliary tract obstruction secondary to Burkitt lymphoma

    International Nuclear Information System (INIS)

    The abdomen, in particular the ileocecal region, appendix and colon, is the most common primary site for Burkitt non Hodgkin's lymphoma (NHL). Involvement of the bile duct is rare. The authors describe a patient with abdominal NHL in which jaundice due to bile duct obstruction was the first clinical sign. Case report: a 3 year old white boy presented with one month of progressive jaundice, clay-colored stools, tea colored urine and increase of abdominal volume. Physical examination showed jaundice 3+/4+ and pale mucosa. The abdomen was moderately distended and timpanous and the liver was enlarged. Laboratory examinations confirmed cholestasis with total bilirubin of 8.2 mg/dl (direct bilirubin of 7.8 mg/dl), and microcytic and hypochromic anemia. Ultrasonography (US) and abdominal CT showed two solid tumors in hepatic hilar topography, and dilated intrahepatic biliary tree. The Doppler US showed hepatic artery and portal vein dislocation by the nodules. Comment: although jaundice occurs frequently as a late manifestation of NHL, it is rarely seen as the presenting sign. When jaundice is the first clinical sign and image studies show hepatic hilar tumor and bile duct obstruction, NHL should be considered in the differential diagnosis. (author)

  8. Three Living Fasciola Hepatica in the Biliary Tract of a Woman

    OpenAIRE

    Ramin Niknam; Mohammad Hassan Kazemi; Laleh Mahmoudi

    2015-01-01

    Fasciola hepatica (F. hepatica) as a foodborne trematode can occasionally cause hepatobiliary diseases. We report a 67-year-old woman who was referred to our center because of the diagnosis of cholangitis. She was a resident of mountainous area with the history of unsafe water and contaminated vegetables. Endoscopic retrograde cholangiopancreatography (ERCP) was performed as a diagnostic and therapeutic modality for her. Three living F. hepatica was removed from biliary tract with a basket vi...

  9. Diabetes in relation to biliary tract cancer and stones: a population-based study in Shanghai, China

    OpenAIRE

    Shebl, F M; Andreotti, G; Rashid, A; Gao, Y-T; Yu, K; Shen, M-C; Wang, B-S; Li, Q.; Han, T-Q; Zhang, B-H; Fraumeni, J F; Hsing, A W

    2010-01-01

    Background: Biliary tract cancers are rare but fatal malignancies. Diabetes has been related to biliary stones, but its association with biliary tract cancers is less conclusive. Methods: In a population-based case–control study of 627 cancers, 1037 stones, and 959 controls in Shanghai, China, we examined the association between diabetes and the risks of biliary tract cancer and stones, as well as the effect of potential mediating factors, including serum lipids and biliary stones (for cancer...

  10. Circulating MicroRNAs as Biomarkers in Biliary Tract Cancers

    Science.gov (United States)

    Letelier, Pablo; Riquelme, Ismael; Hernández, Alfonso H.; Guzmán, Neftalí; Farías, Jorge G.; Roa, Juan Carlos

    2016-01-01

    Biliary tract cancers (BTCs) are a group of highly aggressive malignant tumors with a poor prognosis. The current diagnosis is based mainly on imaging and intraoperative exploration due to brush cytology havinga low sensitivity and the standard markers, such as carcinoembryonic antigen (CEA) and carbohydrate 19-9 (CA19-9), not having enough sensitivity nor specificity to be used in a differential diagnosis and early stage detection. Thus, better non-invasive methods that can distinguish between normal and pathological tissue are needed. MicroRNAs (miRNAs) are small, single-stranded non-coding RNA molecules of ~20–22 nucleotides that regulate relevant physiological mechanisms and can also be involved in carcinogenesis. Recent studies have demonstrated that miRNAs are detectable in multiple body fluids, showing great stability, either free or trapped in circulating microvesicles, such as exosomes. miRNAs are ideal biomarkers that may be used in screening and prognosis in biliary tract cancers, aiding also in the clinical decisions at different stages of cancer treatment. This review highlights the progress in the analysis of circulating miRNAs in serum, plasma and bile as potential diagnostic and prognostic markers of BTCs. PMID:27223281

  11. STUDY OF URSODEOXYCHOLIC ACID INFLUENCE ON EFFICACY AND SAFETY OF STATIN THERAPY IN PATIENTS WITH DISEASES OF THE LIVER, GALL BLADDER AND/OR BILIARY TRACT (THE RAKURS STUDY

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2015-09-01

    Full Text Available Aim. To assess the potential of ursodeoxycholic acid (UDCA in the prevention of liver dysfunction in patients with cardiovascular diseases (CVD and high risk of cardiovascular events (CVE with indications for statins use.Material and methods. Patients (n=262, age 60.1±8.9 years took statins for secondary prevention of CVE in observational cohort study. The follow-up duration was 6 months. UDCA was recommended for all patients because of liver diseases and/or biliary tract. Some of the patients with high treatment compliance strictly followed recommendations to take UDCA, and another part of the patients with low treatment compliance did not take UDCA. Comparison of these groups allowed highlighting UDCA effects.Results. Controlled lipid-lowering therapy in combination with UDCA resulted in a significant reduction in total cholesterol (TC and low density lipoprotein cholesterol levels after 6 months of follow-up to 4.3 mmol/L and 2.3 mmol/L, respectively (p<0.001. Deterioration in the dynamics of alanine-aminotransferase (ALT, aspartate aminotransferase (AST, creatinphosphokinase (CPK and gamma glutamine transferase (GGT, as well as increase in serum bilirubin was not found. Moreover, in general significant decrease in ALT, AST, GGT and alkaline phosphatase (p<0.001 was observed, the levels of total serum bilirubin and CPK did not change at the end of the study (p=0.65 and p=0.16, respectively. Taking UDCA simultaneously with statins led to additional reduction in TC and low density cholesterol compared with statin monotherapy (p=0.01.Conclusion. One of the affordable and effective ways to deal with a wider statin use in patients with liver and biliary tract disorders is their co-administration with UDCA.

  12. A relationship between migraine and biliary tract disorders

    DEFF Research Database (Denmark)

    Nilsson, S; Edvinsson, L; Malmberg, B; Johansson, B; Linde, M

    2010-01-01

    -pairs was 2.7 (1.6-4.5). Migraine was associated with female sex and waist circumference. CONCLUSIONS: There is a relationship between the occurrence of migraine and BTD, also when controlling for the fact that both disorders are more frequent in women. The association appears to be partly attributable to......OBJECTIVES: To investigate whether there is a relationship between the clinical occurrence of migraine and biliary tract disorders (BTD) and to study whether there is a genetic influence on such an association. MATERIALS AND METHODS: The near lifetime morbidity for migraine and BTD was examined in...... two Swedish twin-samples: OCTO-Twin (149 MZ and 202 DZ pairs; 234 men, 468 women; 80 years of age or older at inclusion), and the GENDER study (249 unlike-sex DZ-pairs; 70-80 years of age at inclusion). The diagnosis of BTD was established by perusal of medical records from the last twenty years. The...

  13. [The estimation of antioxidative vitamins concetrations in blood plasma of patients with neoplasms of gallblader and biliary tract].

    Science.gov (United States)

    Drozda, Rafał; Grzegorczyk, Krzysztof; Rutkowski, Maciej; Smigielski, Jacek; Kołomecki, Krzysztof

    2007-05-01

    Gallbladder and biliary tract cancer is a serious clinical problem. In-spite of wide range of new diagnostic and therapeutic methods, the significant improvement of treatment results, has not been noticed so far. The research about prevention methods, seems to be important, among the ways of improvement of the diagnosis and therapy outcomes of these diseases. It is related for example to study about one of the cause of biliary tract carcinogenesis--the imbalance between production of reactive oxygen species (ROS) and their inactivation by the antioxidative barrier. One of the components of this organism protection complex are antioxidative vitamins. The aim of this study was to measure the concentration of antioxidative vitamins (A, C, E, and beta-carotene) in serum, in patients with cancer of gallbladder and and biliary tract, in comparison to the results of healthy volunteers. The study groups comprised of 56 patients, both sexes with acute and chronic cholecystitis and with above-mentioned neoplasmas. The results shoved, that concentration of antioxidative vitamins in serum of patients with gallbladder and biliary tract cancer, was significantly decreased. The outcomes of this research, seem to confirm the participation of antioxidative barrier in inhibition of carcinogenesis of in those important parts of digestive system. PMID:17679377

  14. Biliary tract perforation following percutaneous endobiliary radiofrequency ablation: A report of two cases

    Science.gov (United States)

    ZHOU, CHUANGUO; WEI, BAOJIE; GAO, KUN; ZHAI, RENYOU

    2016-01-01

    Endobiliary radiofrequency ablation (RFA) has recently been recognized as a beneficial treatment option for malignant biliary obstruction using percutaneous or endoscopic approaches. The feasibility and safety of this method has been demonstrated in clinical studies, with pain, cholangitis and asymptomatic biochemical pancreatitis reported as relatively common complications. By contrast, hepatic coma, newly diagnosed left bundle branch block and partial liver infarction have been reported as uncommon complications. Biliary tract perforation is a serious potential complication of percutaneous intraductal RFA, which may result in severe infection, peritonitis or even mortality, and which has not been previously reported in clinical research. The current study presents the first reports of biliary tract perforation in two patients with unresectable malignant biliary obstruction following percutaneous intraductal RFA. Although the patient in case 1 succumbed 12 days after RFA, the minor biliary tract perforation in case 2 was successfully treated by the deployment of a self-expanding metal stent. This study demonstrates that biliary tract perforation should be recognized as a serious potential complication of endobiliary RFA, and that metal stent deployment should be considered as a treatment option for minor biliary tract perforation.

  15. Mechanisms of oxysterol-induced disease: insights from the biliary system.

    Science.gov (United States)

    Kuver, Rahul

    2012-10-01

    Oxysterols are oxidized species of cholesterol that are derived from exogenous (e.g. dietary) and endogenous (in vivo) sources. Oxysterols play critical roles in normal physiologic functions as well as in pathophysiologic processes in a variety of organ systems. This review provides an overview of oxysterol biology from the vantage point of the biliary system. Several oxysterols have been identified in human bile in the context of biliary tract infection and inflammation. This finding has led to investigations regarding the potential pathophysiologic significance of biliary oxysterols in diseases affecting the biliary system, with an emphasis on cholangiocarcinoma. Emerging evidence implicates specific oxysterols in the development and progression of this malignancy. This review will summarize the literature on oxysterols in the biliary system and discuss how the accumulated evidence contributes to a hypothesis describing the molecular basis of cholangiocarcinogenesis. PMID:23630545

  16. Chronic typhoid infection and the risk of biliary tract cancer and stones in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Pruckler James

    2011-05-01

    Full Text Available Abstract Previous studies have shown a positive association between chronic typhoid carriage and biliary cancers. We compared serum Salmonella enterica serovar Typhi antibody titers between biliary tract cancer cases, biliary stone cases without evidence of cancer, and healthy subjects in a large population-based case-control study in Shanghai, China. Participants included 627 newly diagnosed primary biliary tract cancer patients; 1,037 biliary stone cases (774 gallbladder and 263 bile-duct and 959 healthy subjects without a history of cancer, randomly selected from the Shanghai Resident Registry. Overall only 6/2,293 (0.26% were Typhi positive. The prevalence of Typhi was 1/457 (0.22%, 4/977 (0.41%, and 1/859 (0.12% among cancer cases, biliary-stone cases, and population controls, respectively. We did not find an association between Typhi and biliary cancer in Shanghai, due to the very low prevalence of chronic carriers in this population. The low seroprevalence of S. Typhi in Shanghai is unlikely to explain the high incidence of biliary cancers in this population.

  17. Biliary wound healing, ductular reactions, and IL-6/gp130 signaling in the development of liver disease

    Institute of Scientific and Technical Information of China (English)

    A J Demetris; John G Lunz Ⅲ; Susan Specht; Isao Nozaki

    2006-01-01

    Basic and translational wound healing research in the biliary tree lag significantly behind similar studies on the skin and gastrointestinal tract. This is at least partly attributable to lack of easy access to the biliary tract for study. But clinical relevance, more interest in biliary epithelial cell (BEC) pathophysiology, and widespread availability of BEC cultures are factors reversing this trend. In the extra-hepatic biliary tree, ineffectual wound healing,scarring and stricture development are pressing issues.In the smallest intra-hepatic bile ducts either impaired BEC proliferation or an exuberant response can contribute to liver disease. Chronic inflammation and persistent wound healing reactions in large and small bile ducts often lead to liver cancer. General concepts of wound healing as they apply to the biliary tract, importance of cellular processes dependent on IL-6/gp130/STAT3 signaling pathways, unanswered questions, and future directions are discussed.

  18. EGFR and HER2 expression in advanced biliary tract cancer

    Institute of Scientific and Technical Information of China (English)

    Jan Harder; Oliver Waiz; Florian Otto; Michael Geissler; Manfred Olschewski; Brigitte Weinhold; Hubert E Blum; Annette Schmitt-Graeff; Oliver G Opitz

    2009-01-01

    AIM: To analyze the pathogenetic role and potential clinical usefulness of the epidermal growth factor receptor (EGFR) and the human epidermal growth factor receptor 2 (HER2) in patients with advanced biliary tract cancer (BTC). METHODS: EGFR and HER2 expression was studied in biopsy samples from 124 patients (51% women;median age 64.8 years), with advanced BTC diagnosed between 1997 and 2004. Five micrometers sections of paraffin embedded tissue were examined by standard, FDA approved immunohistochemistry. Tumors with scores of 2+ or 3+ for HER2 expression on immunochemistry were additionally tested for HER2 gene amplification by fluorescence in situ hybridisation (FISH).RESULTS: 34/124 patients (27.4%) had gallbladder cancer, 47 (37.9%) had intrahepatic BTC and 43 (34.7%) had extrahepatic or perihilar BTC. EGFR expression was examined in a subset of 56 samples. EGFR expression was absent in 22/56 tumors (39.3%).Of the remaining samples expression was scored as 1+ in 12 (21.5%), 2+ in 13 (23.2%) and 3+ in 9 (16%), respectively. HER2 expression was as follows: score 0 73/124 (58.8%), score 1+ 27/124 (21.8%), score 2+ 21/124 (17%) and score 3+ 4/124 (3.2%). HER2 gene amplification was present in 6/124, resulting in an overall amplification rate of 5%.CONCLUSION: Our data suggest that routine testing and therapeutic targeting of HER2 does not seem to be useful in patients with BTC, while targeting EGFR may be promising.

  19. Clinical Evaluation of ERCP and Naobiliary Drainage for Biliary Fungal Infection--A Report of Five Cases of Severe Combined Bacterial and Fungal Infection of Biliary Tract

    Institute of Scientific and Technical Information of China (English)

    ZHAO Qiu; LIAO Jiazhi; QIN Hua; WANG Jialong

    2005-01-01

    This study studied the use of ERCP and nasobiliary tube in the diagnosis of fungal infection of biliary tract and the efficacy of combined use of local administration via nasobiliary tube and intravenous antifungal treatment for severe biliary tract fungal infection. 5 patients in our series,with age ranging from 47 to 68 y (mean 55.8), were diagnosed as having mixed bacterial and fungal infection of biliary tract as confirmed by smear or/and culture of bile obtained by ERCP and nasobiliary drainage. Besides routine anti-bacteria therapy, all patients received local application of fluconazole through nasobiliary tube and intravenous administration of fluconazole or itraconazole in terms of the results of in vitro sensitivity test. The mean duration of intravenous fluconazole or itraconazole was 30 days (24-40 days), and that of local application of fluconazole through nasobiliary drainage tube was 19 days (8-24 days). During a follow-up period of 3-42 months, all patient's fungal infection of biliary tract was cured. It is concluded that on the basis of typical clinical features of biliary tract infection, fungal detection of smear/culture of bile obtained by ERCP was the key for the diagnosis of fungal infection of biliary tract. Local application antifungal drug combined with intravenous anti-fungal drugs might be an effective and safe treatment for fungal infection of biliary tract.

  20. Gallstones and the risk of biliary tract cancer: a population-based study in China

    OpenAIRE

    Hsing, A W; Gao, Y-T; Han, T-Q; Rashid, A; Sakoda, L C; Wang, B-S; Shen, M-C; Zhang, B-H; Niwa, S; Chen, J.; Fraumeni, J F

    2007-01-01

    We conducted a population-based study of 627 patients with biliary tract cancers (368 of gallbladder, 191 bile duct, and 68 ampulla of Vater), 1037 with biliary stones, and 959 healthy controls randomly selected from the Shanghai population, all personally interviewed. Gallstone status was based on information from self-reports, imaging procedures, surgical notes, and medical records. Among controls, a transabdominal ultrasound was performed to detect asymptomatic gallstones. Gallstones remov...

  1. Importance and Potential of ERCP in Diagnostics and Treatment of the Biliary Tract and Pancreas Disorders

    International Nuclear Information System (INIS)

    Importance and Potential of ERCP in Diagnostics and Treatment of the Biliary Tract and Pancreas Disorders. Endoscopic retrograde cholangiopancreatography (ERCP) is combined endoscopic and radiographic method for imaging of biliary and pancreatic system. Significant progress in technology of imaging methods like CT, MRI, EUS has been achieved since ERCP was first introduced into clinical practice. At present time, these imaging methods are taking over diagnostic part of ERCP, ERCP procedure is currently performed most frequently for therapeutic interventions. (author)

  2. Transcatheter arterial chemoembolization with gemcitabine and oxaliplatin for the treatment of advanced biliary tract cancer

    Directory of Open Access Journals (Sweden)

    Zhao Q

    2015-03-01

    Full Text Available Qing Zhao,* Sheng Qian,* Liang Zhu, Xu-Dong Qu, Wei Zhang, Zhi-Ping Yan, Jie-Min Cheng, Qing-Xin Liu, Rong Liu, Jian-Hua Wang Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: The aim of this study was to determine the therapeutic efficacy and safety of transarterial chemoembolization (TACE with gemcitabine and oxaliplatin in patients with advanced biliary tract cancer (BTC. Methods: We retrospectively analyzed the outcomes for 65 patients with advanced BTC treated by TACE with gemcitabine 1,000 mg/m2 and oxaliplatin 100 mg/m2. Follow-up laboratory tests and computed tomography or magnetic resonance imaging were performed routinely to evaluate the response of the tumor to treatment. All patients were assessed for adverse effects. Results: Of the 65 patients, 19 (29.2% achieved a partial response, 36 (55.4% showed stable disease, and ten (15.4% showed progressive disease. The overall response rate was 29.2%. At the end of this study, five patients were still alive. The median overall survival was 12.0 months (95% confidence interval 8.5–15.5. There were no serious complications after TACE. Conclusion: The disease control rate and overall survival in this retrospective study were consistent with those in previous reports. TACE with gemcitabine and oxaliplatin was well tolerated and highly effective in patients with advanced BTC. Keywords: gemcitabine, oxaliplatin, transcatheter arterial chemoembolization, biliary tract cancer 

  3. Radiologic evaluation of biliary tract complications after liver transplantation: Experience with 57 transplants

    International Nuclear Information System (INIS)

    Initial attempts at human liver transplantation were marred by serious biliary tract complication in nearly 50% of patients. Recent improvements in patient selection, operative technique, and postoperative care have resulted in fewer complications and lower morbidity. Careful cholangiographic evaluaton is necessary in identifying biliary tract complications and planning management. The authors report their institutional experience with 57 liver transplantations from February 1984 to April 1988. Cholangiography revealed biliary tract complications in 25% of cases. Major complications (leak, stenosis, bile fistula) were seen in eight patients, and minor complications (subhepatic leak after T-tube removal, intraductal mucous plug, T-tube malposition or occlusion) were noted in six. Interventional procedures were performed in four cases

  4. Radiation diagnosis of hepatic and biliary diseases

    International Nuclear Information System (INIS)

    The paper deals with combined diagnosis of hepatic and biliary diseases, involving a wide range of nosological entities. It shown the potentialities of currently available diagnostic techniques for the most common diseases. A complex of the used diagnostic techniques involved ultrasonic scanning, X-ray computed tomography, hepatobiliary scintigraphy, angiography, retrograde cholangiopancreatography, transhepatic cholangiography, etc. The authors have demonstrated that each method used is highly diagnostically effective. At the same time they have shown the limits of each technique in the diagnosis of certain diseases. The authors' data suggest that the total efficiency of the applied complex of diagnostic means approaches 100%. 64 refs., 7 figs., 3 tabs

  5. The predictive value of transabdominal ultrasonography in the diagnosis of biliary tract complications after orthotopic liver transplantation

    OpenAIRE

    Hussaini, S; Sheridan, M.; Davies, M.

    1999-01-01

    BACKGROUND—In transplant recipients with choledococholedocostomy (CDCD), endoscopic retrograde cholangiopancreatography (ERCP) remains the gold standard for the diagnosis of biliary leak or strictures. Transabdominal ultrasonography (TAUS) has been used to screen patients with suspected biliary tract complications, prior to ERCP, although the clinical effectiveness remains unclear.
AIMS—To assess the predictive value of TAUS in the diagnosis of biliary tract complications after liver transpla...

  6. Body size and the risk of biliary tract cancer: a population-based study in China

    OpenAIRE

    Hsing, A W; Sakoda, L C; Rashid, A; Chen, J.; Shen, M. C.; Han, T Q; Wang, B. S.; Gao, Y.T. (Yu-Tang)

    2008-01-01

    Though obesity is an established risk factor for gall bladder cancer, its role in cancers of the extrahepatic bile ducts and ampulla of Vater is less clear, as also is the role of abdominal obesity. In a population-based case–control study of biliary tract cancer in Shanghai, China, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for biliary tract cancer in relation to anthropometric measures, including body mass index (BMI) at various ages and waist-to-hip ratio (WHR), a...

  7. Percutaneous Transhepatic Biliary Interventions in Benign Diseases of Children

    OpenAIRE

    Medih Celiktas

    2015-01-01

    Purpose: Percutaneous transhepatic biliary interventions are performed safely and effectively in adults. There is less experience of these interventions in benign diseases of children. We aimed to evaluate the safety and efficacy of percutaneous biliary interventions in benign diseases of children. Materials and Methods: In this retrospective study, percutaneous biliary interventions were performed in fifteen children with a mean age of 10.2 years (range 14 days-14 years). Patients present...

  8. Percutaneous Transhepatic Biliary Interventions in Benign Diseases of Children

    OpenAIRE

    Çeliktaş, Medih

    2015-01-01

    Purpose: Percutaneous transhepatic biliary interventions are performed safely and effectively in adults. There is less experience of these interventions in benign diseases of children. We aimed to evaluate the safety and efficacy of percutaneous biliary interventions in benign diseases of children. Materials and Methods: In this retrospective study, percutaneous biliary interventions were performed in fifteen children with a mean age of 10.2 years (range 14 days-14 years). Patients presented ...

  9. Phase II marker-driven trial of panitumumab and chemotherapy in KRAS wild-type biliary tract cancer

    DEFF Research Database (Denmark)

    Jensen, L H; Lindebjerg, J; Ploen, J;

    2012-01-01

    BACKGROUND: Combination chemotherapy has proven beneficial in biliary tract cancer and further improvements may be achieved by individualizing treatment based on biomarkers and by adding biological agents. We report the effect of chemotherapy with panitumumab as first-line therapy for KRAS wild...... a single institution. The primary end point, fraction of progression-free survival (PFS) at 6 months, was 31/42 [74%; 95% confidence interval (CI) 58% to 84%]. Forty-two patients had measurable disease. Response rate was 33% and disease control rate 86%. Median PFS was 8.3 months (95% CI 6.......7-8.7 months) and median overall survival was 10.0 months (95% CI 7.4-12.7 months). Toxicity was manageable including eight cases of epidermal growth factor receptor-related skin adverse events of grade 2 or more. CONCLUSIONS: Marker-driven patient selection is feasible in the systemic treatment of biliary...

  10. Lymph node metastasis in the biliary tract carcinoma: CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Hee; Lee, Ah Ra; Kim, Kie Hwan; Do, Young Soo; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1994-07-15

    The primary biliary carcinoma is usually unresectable at presentation, because of early lymphatic spread. To determine the incidence and the spread pattern of lymph node metastases according to the location of the primary tumor, we analyzed the CT scans of the patients with primary biliary adenocarcinoma. We reviewed the CT scans of 92 patients with pathologically proven primary biliary adenocacinima, including 45 peripheral cholangiocarcinomas, 22 hilar cholangiocarcinomas, 18 gallbladder carcinomas, and 7 common bile duct carcinomas. Positive adenopathy was diagnosed when the node exceeded 10 mm in short axis. The overall incidence of nodal metastases was 59.8% (55/92); 66.7% in peripheral cholangiocarcinoma, 54.5% in hilar cholangiocarcinoma, 55.6% in gallbladder carcinoma, and 42.9% in common bile duct carcinoma. The most commonly involved nodal group was the lesser omentum, followed by the celiac, periaortic, and peripancreatic group. The phrenic node group was only involved in the cases with the peripheral or hilar cholangiocarcinoma. The primary biliary carcinoma has a high incidence of lymph node metastases at the time of diagnosis, and shows different nodal spread pattern according to the location of the primary tumor. Involvement of the phrenic node was limited to the peripheral and hilar cholangiocarcinoma.

  11. Methods and technique of roentgenoradionuclide investigations of gallbladder and biliary tract. Characteristics of clinical materials

    International Nuclear Information System (INIS)

    Methods for X-ray radionuclide investigation of gallbladder and biliary tracts-peroral, intravenous and infusion cholecystocholangiography, tomocholecystography, γ-scintigraphy, as well as pharmacologic contrast substances used in the methods given, are described. The characteristic of clinical material is presented

  12. Catheter tract implantation metastases associated with percutaneous biliary drainage for extrahepatic cholangiocarcinoma

    OpenAIRE

    SAKATA, JUN; Shirai, Yoshio; Wakai, Toshifumi; Nomura, Tatsuya; Sakata, Eiko; Hatakeyama, Katsuyoshi

    2005-01-01

    AIM: To estimate the incidence of catheter tract implantation metastasis among patients undergoing percutaneous transhepatic biliary drainage (PTBD) for extrahepatic cholangiocarcinoma, and to provide data regarding the management of this unusual complication of PTBD by reviewing cases reported in the literature.

  13. Adjuvant Radio-chemotherapy for extrahepatic biliary tract cancers

    Directory of Open Access Journals (Sweden)

    Mentha Gilles

    2011-06-01

    Full Text Available Abstract Background Extrahepatic biliary duct cancers (EBDC are uncommon malignancies characterized by a poor prognosis with high rate of loco-regional recurrence. The purpose of the present study is to assess the feasibility and the potential impact of adjuvant radiotherapy (RT in a series of patients treated in one institution. Methods Twenty three patients with non-metastatic bile duct cancer treated surgically with curative intent (4 gallbladder, 7 ampullary and 12 cholangiocarcinoma received 3D conformal external beam RT to a median total dose of 50.4Gy. Concurrent chemotherapy based on 5-FU was delivered to 21 patients (91%. Surgical margins were negative in 11 patients (48%, narrow in 2 (9%, and microscopically involved in 8 (35%. Eleven patients (55% had metastatic nodal involvement. The average follow-up time for all patients was 30 months (ranging from 3-98. Results Acute gastrointestinal grade 2 toxicity (RTOG scale was recorded in 2 patients (9%. Nausea or vomiting grade 1 and 2 was observed in 8 (35% and 2 patients (9% respectively. Only one patient developed a major late radiation-induced toxicity. The main pattern of recurrence was both loco-regional and distant (liver, peritoneum and/or lung. No difference was observed in loco-regional control according to the tumor location. The 5-year actuarial loco-regional control rate was 48.3% (67% and 30% for patients operated on with negative and positive/narrow/unknown margins respectively, p = 0.04. The 5-year actuarial overall survival was of 35.9% for the entire group (61.4% in case of negative margins and 16.7% in case of positive/narrow/unknown margins, p = 0.07. Conclusions Postoperative RT with 50-60 Gy is feasible with acceptable acute and late toxicities. The potential benefit observed in our series may support the use of adjuvant RT in patients with locally advanced disease. Prospective randomized trials are warranted to confirm definitively the role of RT in this tumor

  14. Adjuvant Radio-chemotherapy for extrahepatic biliary tract cancers

    International Nuclear Information System (INIS)

    Extrahepatic biliary duct cancers (EBDC) are uncommon malignancies characterized by a poor prognosis with high rate of loco-regional recurrence. The purpose of the present study is to assess the feasibility and the potential impact of adjuvant radiotherapy (RT) in a series of patients treated in one institution. Twenty three patients with non-metastatic bile duct cancer treated surgically with curative intent (4 gallbladder, 7 ampullary and 12 cholangiocarcinoma) received 3D conformal external beam RT to a median total dose of 50.4Gy. Concurrent chemotherapy based on 5-FU was delivered to 21 patients (91%). Surgical margins were negative in 11 patients (48%), narrow in 2 (9%), and microscopically involved in 8 (35%). Eleven patients (55%) had metastatic nodal involvement. The average follow-up time for all patients was 30 months (ranging from 3-98). Acute gastrointestinal grade 2 toxicity (RTOG scale) was recorded in 2 patients (9%). Nausea or vomiting grade 1 and 2 was observed in 8 (35%) and 2 patients (9%) respectively. Only one patient developed a major late radiation-induced toxicity. The main pattern of recurrence was both loco-regional and distant (liver, peritoneum and/or lung). No difference was observed in loco-regional control according to the tumor location. The 5-year actuarial loco-regional control rate was 48.3% (67% and 30% for patients operated on with negative and positive/narrow/unknown margins respectively, p = 0.04). The 5-year actuarial overall survival was of 35.9% for the entire group (61.4% in case of negative margins and 16.7% in case of positive/narrow/unknown margins, p = 0.07). Postoperative RT with 50-60 Gy is feasible with acceptable acute and late toxicities. The potential benefit observed in our series may support the use of adjuvant RT in patients with locally advanced disease. Prospective randomized trials are warranted to confirm definitively the role of RT in this tumor location

  15. Diagnosis of urinary tract diseases

    International Nuclear Information System (INIS)

    Radiological exploration of the urinary tract has become highly sophisticated. The information provided by the new imaging techniques is extremely accurate and useful in the diagnosis and pretherapeutic assessment of most urinary tract diseases. Interventional radiology has given radiologists an important role in the treatment of some types of pathology. The authors describe the value of modern imaging and its different aspects in each of the principal branches of urinary tract pathology. viz.: tumours, obstructions, infections, vascular and prostatic diseases

  16. Adjuvant Radio-chemotherapy for extrahepatic biliary tract cancers

    OpenAIRE

    Mentha Gilles; Roth Arnaud D; Bonet Beltrán Marta; Allal Abdelkarim S

    2011-01-01

    Abstract Background Extrahepatic biliary duct cancers (EBDC) are uncommon malignancies characterized by a poor prognosis with high rate of loco-regional recurrence. The purpose of the present study is to assess the feasibility and the potential impact of adjuvant radiotherapy (RT) in a series of patients treated in one institution. Methods Twenty three patients with non-metastatic bile duct cancer treated surgically with curative intent (4 gallbladder, 7 ampullary and 12 cholangiocarcinoma) r...

  17. Expression of Bcl-2 and Bax in extrahepatic biliary tract carcinoma and dysplasia

    Institute of Scientific and Technical Information of China (English)

    Sheng-Mian Li; Shu-Kun Yao; Nobuyoshi Yamamura; Toshitsugu Nakamura

    2003-01-01

    AIM: To compare the difference of expression of Bcl-2 and Bax in extrahepatic biliary tract carcinoma and dysplasia, and to analyze the role of Bcl-2 and Bax proteins in the progression from dysplasia to carcinoma and to evaluate the correlation of Bcl-2/Bax protein expression with the biological behaviors.METHODS: Expressions of Bcl-2 and Bax were examined immunohistochemically in 27 cases of extrahepatic biliary tract carcinomas (bile duct carcinoma: n=21, carcinoma of ampulla of Vater: n=6), and 10 cases of atypical dysplasia.Five cases of normal biliary epithelial tissues were used as controls. A semiquantitative scoring system was used to assess the Bcl-2 and Bax reactivity.RESULTS: The expression of Bd-2 was observed in 10 out of 27 (37.0 %) invasive carcinomas, 1 out of 10 clysplasias, none out of 5 normal epithelial tissues. Bax expression rate was 74.1% (20/27) in invasive carcinoma, 30 % (3/10) in dysplasia,and 40 % (2/5) in normal biliary epithelium. Bcl-2 and Bax activities were more intense in carcinoma than in dysplasia,with no significant difference in Bcl-2 expression (P=0.1:10),and significant difference in Bax expression (P=0.038). Level of Bax expression was higher in invasive carcinoma than in dysplasia and normal tissue (P=0.012). Bcl-2 expression was correlated to Bax expression (P=0.0059). However, Bcl-2/Bax expression had no correlation with histological subtype,grade of differentiation, or level of invasion.CONCLUSION: Increased Bcl-2/Bax expression from dysplasia to invasive tumors supports the view that this is the usual route for the development of extrahepatic biliary tract carcinoma. Bcl-2/Bax may be involved, at least in part,in the apoptotic activity in extrahepatic biliary carcinoma.

  18. An evaluation of MRC in assessing complication of biliary tract surgery

    International Nuclear Information System (INIS)

    Objective: To evaluate the magnetic resonance cholangiography (MRC) for assessing the complication of biliary tract surgery. Methods: 24 patients who had complication of biliary tract operation confirmed by clinic and surgery undertook MRC as well as the standard MR examination. Data were collected with FRFSE heavy T2WI 3D digital acquisition and MIP reconstruction was then performed. Results: Post-cholangiojejunostomy anastomotic stenosis was revealed in 4 cases, in which truncation sign, salvia sign and beads string sign were shown on MRI. There was anastomotic fistula after cholangiojejunostomy in 2 cases, which was demonstrated by MRC. Residual choledochus stone in 8 cases and stenosis of the common bile duct in 4 cases after cholecystectomy plus choledocholithotomy presented with low signal intensity crater-shaped filling defect with well defined border, while there was circumscribed and segmental stenosis of the common bile duct. Choledochus stenosis found in S cases and biliary fistula in 1 case after laprascopic cholecystectomy, showing centripetal stenosis of the common bile duct at cystic duct section and the residual cystic duct usually shorter than 5mm. Conclusion: As an non-invasive method, MRC provides precise assessments of various complication after biliary tract surgery, which is highly recommendable in clinic. (authors)

  19. Imaging diagnosis--extrahepatic biliary tract obstruction secondary to a duodenal foreign body in a cat.

    Science.gov (United States)

    Della Santa, Daniele; Schweighauser, Ariane; Forterre, Franck; Lang, Johann

    2007-01-01

    A 13-month-old, neutered female domestic shorthaired cat was evaluated for vomiting, anorexia, and lethargy. The cat was icteric and hyperbilirubinemic. Radiographically a partially radiolucent proximal duodenal foreign body was suspected. Ultrasonographically, there was a foreign body at the level of the duodenal papilla and dilation of the common bile duct and cystic duct; a diagnosis of extrahepatic biliary tract obstruction secondary to a duodenal foreign body was made. Sonographic findings were confirmed at surgery and a duodenal foreign body was removed. This information defines duodenal foreign body as a cause of extrahepatic biliary obstruction in cats. PMID:17899980

  20. On differential diagnosis of dyskinesia and inflammatory processes of biliary tract in children according to the cholecystography data

    International Nuclear Information System (INIS)

    Children with diseases of biliferous system were examined. Cholecystograms were used to study the following characteristics: girth and log of bile cyst before and after reception of yolks, the volume of bile cyst before and after reception of yolks, the volume of residual bile, the degree of girth and log reduction before and after reception of yolks, the difference of ratios of girth to log of bile cyst before and after reception of yolks. The distinguished characteristics were summarized in the tables, which are recommended to use in infantile gastroenterological departments during differential diagnosis of dyskinesia and inflammatory processes of biliary tract

  1. Manual of extravascular minimally invasive interventional procedures of the liver and biliary tract

    International Nuclear Information System (INIS)

    The use of interventional radiology and image-guided surgery has increased. Interventional radiologists are involved in patient treatment, well as in the diagnosis of the disease carrying his knowledge to the tumor treatment and procedures more invasive. Large amount of didactic material there are available, but the country lacks a manual to standardize interventional radiological techniques carried out. Also, those that could be instituted and adapted effectively in the management of hepatobiliary pathology of the Sistema de Salud Publica in Costa Rica, that covers the main procedures and adopt guidelines in a standardized way. A manual of procedures minimally invasive radiologic extravascular of the liver and biliary tract, is presented with broad bibliographic support that directs, standardizes and is adaptable to the needs and own resources of Costa Rica. Interventional radiology has been a non surgical alternative of a low index of complications, useful for the management of some health problems, avoids surgery and certainly lower costs. An alternative to surgical treatment of many conditions is offered, thereby reducing complications (morbidity) and can eliminate the need for hospitalization, in some cases. The development of new materials has allowed the most common working tools of the medical field are improved and become increasingly more efficient in the diagnosis and treatment of diseases, improving the training of radiologists in the interventional field. (author)

  2. Whole genome RNA expression profiling for the identification of novel biomarkers in the diagnosis and prognosis of biliary tract cancer

    OpenAIRE

    Chapman, M H

    2011-01-01

    Biliary tract cancer (BTC) is difficult to diagnose, in part related to the lack of reliable tumour markers. The aim of this project was to use whole genome RNA expression profiling in order to identify novel biomarkers for diagnosis and prognosis in biliary tract cancer. Chapter 1 summarises clinical aspects of BTC as well as current diagnostic and prognostic tests. Chapter 2 addresses the identification of circulating tumour cells for the diagnosis of BTC. It includes d...

  3. Imaging diagnosis of biliary tract lesions (with a report of 486 cases)

    International Nuclear Information System (INIS)

    Objective: To evaluate the various imaging modalities in the diagnosis of biliary tract lesions. Methods: The imaging findings of 486 cases of biliary tract lesions proved surgically and pathologically were retrospectively reviewed. The advantage and the limitation of each examination were analyzed. Results: Twenty six cases with negative stone in gallbladder were demonstrated in conventional cholecystography. The anatomical morphology and the pathogenesis were well shown on direct cholangiography. The positive accuracy of ultrasonography (US) and CT for biliary duct calculus was 91.3% and 90.3%, respectively. Sanded stone were missed on CT in 13 cases. The consistent rate of US diagnosis of chronic cholecystitis and gallbladder polyps was 100% and 93.3%, respectively. The 'bile duct tree' at MRCP helped the diagnosis of the cholangiocarcinoma arising at the portal hepatics. Conclusion: The negative stone in gallbladder can be demonstrated by conventional cholecystography. Direct cholangiography can provide important evidence for the qualitative diagnosis. US and CT are superior to other modalities in detecting biliary duct calculus. US is the best imaging modality for chronic cholecystitis and polypoid lesion of gallbladder. 3D MRCP is an ideal imaging for severe bile duct obstruction

  4. Targeted medical therapy of biliary tract cancer: Recent advances and future perspectives

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The limited efficacy of cytotoxic therapy for advanced biliary tract and gallbladder cancers emphasizes the need for novel and more effective medical treatment options. A better understanding of the specific biological features of these neoplasms led to the development of new targeted therapies, which take the abundant expression of several growth factors and cognate tyrosine kinase receptors into account. This review will briefly summarize the status and future perspectives of antiangiogenic and growth factor receptor-based pharmacological approaches for the treatment of biliary tract and gallbladder cancers. In view of multiple novel targeted approaches, the rationale for innovative therapies, such as combinations of growth factor (receptor)-targeting agents with cytotoxic drugs or with other novel anticancer drugs will be highlighted.

  5. Experimentally induced extrahepatic stenosis of the biliary tract - hepatobiliary dynamic scintigraphy and related procedures

    International Nuclear Information System (INIS)

    Biliary tract stenoses of varying degrees that have been artificially induced in rabbits are identified and quantified to a significant extent on the basis of hepatobiliary dynamic scintigraphy using 99mTc HIDA as well as of organisomorphic principles. Biochemical and physical parameters relevant to the function of the hepatobiliary tract are ascertained in long-term animal studies (pig model) both for physiological and experiment-induced pathological conditions. Moreover, the information provided by hepatobiliary dynamic scintigraphy is contrasted with that from parallel microsamples of bile. Comparisons between the results of contact cholangiography and hepatobiliary dynamic scintigraphy in pigs showing biliodigestive anastomoses fail to point to any links between the morphology and function of the extrahepatic biliary system. (TRV)

  6. Occupational exposure to endocrine-disrupting compounds and biliary tract cancer among men

    DEFF Research Database (Denmark)

    Ahrens, Wolfgang; Mambetova, Chinara; Bourdon-Raverdy, Nicole;

    2007-01-01

    OBJECTIVES: This study investigated the association between cancer of the extrahepatic biliary tract and exposure to endocrine-disrupting compounds. METHODS: Altogether 183 men with histologically confirmed carcinoma of the extrahepatic biliary tract and 1938 matched controls were interviewed...... between 1995 and 1997 in the frame of an international multicenter case-control study in six European countries (Denmark, France, Germany, Italy, Spain, and Sweden). Self-reported job descriptions were converted to semiquantitative variables (intensity, probability, and duration of exposure) for 14...... exposure to endocrine-disrupting compounds resulted in an OR of 1.4 (95% CI 1.0-2.1) with no dose-effect relationship for cumulative exposure (low: OR 1.3, 95% CI 0.6-3.0; medium: OR 1.5, 95% CI 0.8-2.7; high: OR 1.4, 95% CI 0.9-2.4) (only index participants). The elevated risk was restricted to...

  7. Risk of primary biliary cirrhosis in patients with coeliac disease

    DEFF Research Database (Denmark)

    Sørensen, Henrik Toft; Thulstrup, Ane Marie; Blomqvist, P;

    1999-01-01

    BACKGROUND: Several case reports, but only a few studies, have examined the coexistence of coeliac disease and primary biliary cirrhosis. AIM: To estimate the risk of primary biliary cirrhosis in two national cohorts of patients with coeliac disease in Denmark and Sweden. METHODS: Through record...... linkage all Danish patients hospitalised with coeliac disease were followed for possible occurrence of primary biliary cirrhosis from 1 January 1977 until 31 December 1992. All patients hospitalised with coeliac disease in Sweden from 1987 to 1996 were also followed in a separate analysis. RESULTS: A...... total of 896 patients with coeliac disease were identified in Denmark with a median follow up period of 9.1 years for a total of 8040 person-years at risk. Two cases of primary biliary cirrhosis were observed where 0.07 were expected, giving a standardised incidence ratio of 27.6 (95% confidence...

  8. Restorative treatment program with physical exercise of patients with dysfunction of the biliary tract.

    Directory of Open Access Journals (Sweden)

    Parhotik I.I.

    2011-06-01

    Full Text Available In the thesis there has been shown that biliary dyskinesia takes a leading position among hepatobiliary diseases. 54 women and 14 men aged between 19 and 64 years old, who suffered from hypo kinetic and hyper kinetic forms of dyskinesia, took part in the research. Based on the character of the functional disorders, it was defined that at hyper kinetic form of dyskinesia the best rehabilitation effects were achieved at the application of physical exercises promoting relaxation of the gallbladder, sphincter and biliary duct musculature combined with the stimulation of bile formation. It was proved that means and methods of motion therapy for patients with hyper kinetic dyskenisia had to be aimed at the restoration of the gallbladder till its full reduction. It was defined that application of different forms of therapeutic physical training considering the type of biliary dyskinesia promoted the improvement of the patients' clinical condition, motor and evacuator function of the biliary ducts.

  9. Ki-ras point mutations and proliferation activity in biliary tract carcinomas.

    OpenAIRE

    Ohashi, K; Tstsumi, M.; Nakajima, Y.; Nakano, H; Konishi, Y

    1996-01-01

    The association between Ki-ras mutations and proliferation activity was investigated in a comprehensive series of biliary tract carcinomas (BTCs). We precisely microdissected samples of tissue from paraffin-embedded sections of 77 BTCs including 22 intrahepatic cholangiocarcinomas (ICCs), 36 extrahepatic cholangiocarcinomas (ECCs), and 19 gall bladder carcinomas (GBCs). Ki-ras mutations at exons 1 and 2 were determined by the polymerase chain reaction-single strand conformation polymorphism (...

  10. Guidelines for the management of biliary tract and ampullary carcinomas: surgical treatment

    OpenAIRE

    Kondo, Satoshi; Takada, Tadahiro; Miyazaki, Masaru; Miyakawa, Shuichi; Tsukada, Kazuhiro; Nagino, Masato; Furuse, Junji; Saito, Hiroya; Tsuyuguchi, Toshio; Yamamoto, Masakazu; KAYAHARA, MASATO; Kimura, Fumio; Yoshitomi, Hideyuki; Nozawa, Satoshi; YOSHIDA, Masahiro

    2008-01-01

    The only curative treatment in biliary tract cancer is surgical treatment. Therefore, the suitability of curative resection should be investigated in the first place. In the presence of metastasis to the liver, lung, peritoneum, or distant lymph nodes, curative resection is not suitable. No definite consensus has been reached on local extension factors and curability. Measures of hepatic functional reserve in the jaundiced liver include future liver remnant volume and the indocyanine green (I...

  11. Radiation therapy and photodynamic therapy for biliary tract and ampullary carcinomas

    OpenAIRE

    Saito, Hiroya; Takada, Tadahiro; Miyazaki, Masaru; Miyakawa, Shuichi; Tsukada, Kazuhiro; Nagino, Masato; Kondo, Satoshi; Furuse, Junji; Tsuyuguchi, Toshio; Kimura, Fumio; Yoshitomi, Hideyuki; Nozawa, Satoshi; YOSHIDA, Masahiro; Wada, Keita; Amano, Hodaka

    2008-01-01

    The purpose of radiation therapy for unresectable biliary tract cancer is to prolong survival or prolong stent patency, and to provide palliation of pain. For unresectable bile duct cancer, there are a number of studies showing that radiation therapy is superior to the best supportive care. Although radiation therapy is used in many institutions, no large randomized controlled trials (RCTs) have been performed to date and the evidence level supporting the superiority of this treatment is low....

  12. Prognostic impact of tumour-infiltrating immune cells on biliary tract cancer

    OpenAIRE

    Goeppert, B; Frauenschuh, L; Zucknick, M; Stenzinger, A; Andrulis, M; Klauschen, F; Joehrens, K; Warth, A; Renner, M.; Mehrabi, A; Hafezi, M.; Thelen, A; Schirmacher, P; Weichert, W

    2013-01-01

    Background: Biliary tract cancers (BTC) are relatively rare malignant tumours with poor prognosis. It is known from other solid neoplasms that antitumour inflammatory response has an impact on tumour behaviour and patient outcome. The aim of this study was to provide a comprehensive characterisation of antitumour inflammatory response in human BTC. Methods: Tumour-infiltrating T lymphocytes (CD4+, CD8+, and Foxp3+), natural killer cells (perforin+), B lymphocytes (CD20+), macrophages (CD68+) ...

  13. Tumor growth effects of rapamycin on human biliary tract cancer cells

    OpenAIRE

    Heuer Matthias; Dreger Nici M; Cicinnati Vito R; Fingas Christian; Juntermanns Benjamin; Paul Andreas; Kaiser Gernot M

    2012-01-01

    Abstract Background Liver transplantation is an important treatment option for patients with liver-originated tumors including biliary tract carcinomas (BTCs). Post-transplant tumor recurrence remains a limiting factor for long-term survival. The mammalian target of rapamycin-targeting immunosuppressive drug rapamycin could be helpful in lowering BTC recurrence rates. Therein, we investigated the antiproliferative effect of rapamycin on BTC cells and compared it with standard immunosuppressan...

  14. Biliary tract intraductal papillary mucinous neoplasm: A brief report and review of literature

    OpenAIRE

    Raveendran Subhash; Iyoob Ali Valiyaveettil; Bonny Natesh; Laila Raji

    2014-01-01

    Biliary Tract Intraductal Papillary Mucinous Neoplasm (BT-IPMN) is a very rare entity, gradually emerging into attention as sporadic cases are being reported worldwide. In this brief report we discuss about such an entity from our part of the world, based on a case from our institution. A 47-year-old female was referred to our department with jaundice, intermittent fever with chills and rigor of 6 weeks duration. Initial evaluation revealed obstructive jaundice with distended gall bladder. Im...

  15. Frequency of Loss Exprssion of DPC4 Protein in Various Locations of Biliary Tract Carcinoma

    Institute of Scientific and Technical Information of China (English)

    TANGZhahohui; HAOYouhua; 等

    2002-01-01

    Objective To clarify the relationship between loss of expression of DPC4 proteins and pathogenesis of biliary tract carcinoma. Methods 71 primary biliary tract carcinomas(BTCa),including 38 common bile duct(CBD) carcinomas,18 gallbladder carcinomas,and 15 hilar bile ducts(HBD) carcinomas were examined by immunohistochemical staining .In addition,the CBD carcinomas were divid-ed into two groups,a trmor group with metastasis(M+ group ,27 cases)and a tumor group without metastasis(M-group,11 cases). Results The frequency of loss expression of DPC4 protein was 32.8% in BTCa ,47.3% in CBD carcinoma ,11% in gallbladder carcino-ma and 13% in HBD carcinoma.A comparison of the frequency of loss expression of DPC4 showed singnificantly statistical difference in the CBD carcinoma versus gallbladder carcinoma and HBD carcinoma (P0.05). Conclusion There is a close relationship between the pathogenesis of BTCa and inactivation of DPC4 with different frequencies of DPC4 gene alteration in various locations of the biliary tract,but inactivation of DPC4 is not related with tumor metastasis in BTCa.

  16. Biliary tract intraductal papillary mucinous neoplasm: A brief report and review of literature

    Directory of Open Access Journals (Sweden)

    Raveendran Subhash

    2014-01-01

    Full Text Available Biliary Tract Intraductal Papillary Mucinous Neoplasm (BT-IPMN is a very rare entity, gradually emerging into attention as sporadic cases are being reported worldwide. In this brief report we discuss about such an entity from our part of the world, based on a case from our institution. A 47-year-old female was referred to our department with jaundice, intermittent fever with chills and rigor of 6 weeks duration. Initial evaluation revealed obstructive jaundice with distended gall bladder. Imaging with ultrasonogram (USG and magnetic resonance imaging (MRI showed hugely dilated intra and extrahepatic biliary radicles with multiple and diffuse soft tissue lesions filling the common bile duct (CBD extending to the ductal system of left lobe of liver. A side viewing endoscopy demonstrated mucin extruding from a prominent ampulla of Vater. The patient was managed successfully by left hepatectomy with pancreaticoduodenectomy (HPD. Gross pathological examination of the specimen showed marked dilatation of intra and extra hepatic bile ducts with multiple polypoidal lesions and plenty of mucin filling the entire biliary ductal system. Histopathology revealed predominantly intraductal papillary mucinous adenocarcinoma at the hilum extending to left bile duct with diffuse dysplastic changes throughout the biliary tree. Thus the clinical, radiological and pathological features of this lesion clearly fit into the diagnosis of BT-IPMN, which is slowly being established as a definite clinical entity with features much similar to its pancreatic counterpart.

  17. Biliary Tract Disorders, Gallbladder Disorders, and Gallstone Pancreatitis

    Science.gov (United States)

    ... ACG on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos en Español What is a Gastroenterologist? Podcasts and Videos GI Health Centers Colorectal Cancer Hepatitis C Inflammatory Bowel Disease Irritable Bowel Syndrome Obesity © ...

  18. Tube within Tube: Ascaris in Bowel and Biliary-Tract

    OpenAIRE

    Goyal, Ankur; Gamanagatti, Shivanand; Sriram, Jaganathan

    2010-01-01

    Ascaris lumbricoides is one of the most common human helminthic diseases worldwide. On ultrasound, it is seen as linear non-shadowing echogenic structures with target appearance in cross section, and the live worm may show writhing movements in real time. On barium meal follow through, it appears as radiolucent tubular filling defects within the bowel lumen. Though not sensitive, direct real-time visualization of Ascaris on ultrasound is quick, non-invasive, and definitive.

  19. [Pathology of biliary tract IN elderly patients with the system approach. Principles of therapy].

    Science.gov (United States)

    Pal'tsev, A I; Eremina, A A; Gorbunova, E N; Torgashov, M N

    2011-01-01

    The biliary tract pathology gains the increasing distribution.So cholelitiasis in different camps is registered from 7.8 to 38%. In Russia the given indicator from 3 to 12%. Special importance cholelitiasis and chronic cholecystitis without cholelitiasis get at persons of the advanced age, connected as with morfofunkcional'nymi changes in an organism of senior citizens, and with a wrong way of life. All it demands the differentiated approach to treatment of this group of patients and includes change of a way of life, a dietotherapy, farmako- and physiotherapeutic treatment. PMID:21916202

  20. Elimination of biliary stones through the urinary tract: a complication of the laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Castro Maurício Gustavo Bravim de

    1999-01-01

    Full Text Available The introduction and popularization of laparoscopic cholecystectomy has been accompanied with a considerable increase in perforation of gallbladder during this procedure (10%--32%, with the occurrence of intraperitoneal bile spillage and the consequent increase in the incidence of lost gallstones (0.2%--20%. Recently the complications associated with these stones have been documented in the literature. We report a rare complication occurring in an 81-year-old woman who underwent laparoscopic cholecystectomy and developed cutaneous fistula to the umbilicus and elimination of biliary stones through the urinary tract. During the cholecystectomy, the gall bladder was perforated, and bile and gallstones were spilled into the peritoneal cavity. Two months after the initial procedure there was exteriorization of fistula through the umbilicus, with intermittent elimination of biliary stones. After eleven months, acute urinary retention occurred due to biliary stones in the bladder, which were removed by cystoscopy. We conclude that efforts should be concentrated on avoiding the spillage of stones during the surgery, and that no rules exist for indicating a laparotomy simply to retrieve these lost gallstones.

  1. Clinical significance of L-type amino acid transporter 1 expression as a prognostic marker and potential of new targeting therapy in biliary tract cancer

    International Nuclear Information System (INIS)

    The expression of L-type amino acid transporter 1 (LAT1) has been described to play essential roles in tumor cell growth and survival. However, it remains unclear about the clinicopathological significance of LAT1 expression in biliary tract cancer. This study was conducted to determine biological significance of LAT1 expression and investigate whether LAT1 could be a prognostic biomarker for biliary tract cancer. A total of 139 consecutive patients with resected pathologic stage I-IV biliary tract adenocarcinoma were retrospectively reviewed. Tumor specimens were stained by immunohistochemistry for LAT1, Ki-67, microvessel density determined by CD34, and p53; and prognosis of patients was correlated. Biological significance of LAT1 expression was investigated by in vitro and in vivo experiments with LAT inhibitor, 2-aminobicyclo-(2,2,1)-heptane-2-carboxylic acid (BCH) using cholangiocarcinoma cell line. In total patients, high LAT1 expressions were recognized in 64.0%. The expression of LAT1 was closely correlated with lymphatic metastases, cell proliferation and angiogenesis, and was a significant indicator for predicting poor outcome after surgery. LAT1 expression was a significant independent predictor by multivariate analysis. Both in vitro and in vivo preliminary experiments indicated that BCH significantly suppressed growth of the tumor and yielded an additive therapeutic efficacy to gemcitabine and 5-FU. High expression of LAT1 is a promising pathological marker to predict the outcome in patients with biliary tract adenocarcinoma. Inhibition of LAT1 may be an effective targeted therapy for this distressing disease

  2. Updates of interstitial Cajal-like cell of biliary tract%胆道Cajal样间质细胞的研究进展

    Institute of Scientific and Technical Information of China (English)

    王锴; 范莹

    2016-01-01

    Interstitial cell of Cajal (ICC) is a kind of special interstitial cell in the gastrointestinal tract,which has close connection with the smooth muscle cells and neuron cells.It is involved in gastrointestinal motility and nerve signal transduction and is considered as the pacemaker cell of slow wave of gastrointestinal tract.ICC which exists in the non-gastrointestinal organs such as biliary tract,urethra,bladder and so on is named interstitial Cajal-like cell (ICLC).This article will review the progress in the research of ICLC in the biliary system in terms of their morphology,identification,classification,function,distribution and related biliary diseases.%Cajal间质细胞是位于胃肠道肌群的一种特殊间质细胞,其与平滑肌细胞,神经元细胞有密切联系,参与胃肠道的蠕动和神经信号传导,是胃肠道慢波的起搏细胞.存在于胆道、尿道、膀胱等胃肠道外器官的Cajal间质细胞被命名为Caal样间质细胞(ICLC),笔者就ICLC在胆道系统的形态、鉴别、分类、功能、分布及其与胆道系统疾病的关系等方面作一综述.

  3. The clinical application of double-tube drainage technique in treating biliary tract stricture occurred after orthotopic liver transplantation: report of 4 cases

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical value of double-tube drainage with the help of percutaneous transhepatic puncture technique in treating biliary tract stricture which occurred after orthotopic liver transplantation. Methods: Double-tube drainage management was carried out in four patients with biliary tract stricture which occurred after orthotopic liver transplantation. With the help of percutaneous transhepatic puncture technique one or two tunnels were established, via which two tubes were established, via which two tubes were inserted and double-tube drainage was performed. The clinical data were retrospectively analyzed. Results: All the four patients were suffered multiple biliary tract strictures accompanied with biliary sludge. The mean age, the cold ischemia time and warm ischemia time of grafting liver were 55 year, 11.4 hours and 6 minutes, respectively. Biliary reconstruction was accomplished by end-to-end anastomosis of the bile ducts. The two drainage tubes were inserted through one tunnel in two cases and through two tunnels in another two cases. In the four cases the biliary balloon dilatation and bile drainage were respectively performed 3, 9, 11 and 35 times. Good clinical result was obtained in three cases and ineffective result was seen in one case. Conclusion: The double-tube drainage technique can be selectively applied in the patients with multiple biliary tract strictures and biliary sludge. Repeated biliary plasty and thoroughly drainage are the keys to ensure an effective treatment of biliary stricture occurred after orthotopic liver transplantation. (authors)

  4. Malignant biliary obstruction complicated by ascites: Closure of the transhepatic tract with cyanoacrylate glue after placement of an endoprosthesis

    International Nuclear Information System (INIS)

    A new technique using cyanoacrylate glue is suggested for closing the transparenchymal tract following metallic endoprosthesis placement in a patient with malignant biliary obstruction complicated by ascites. With this technique, complications related to bile reflux through the transparenchymal tract would be avoided after transhepatic endoprosthesis placement in patients who have ascites. This technique would also be useful for avoiding bleeding following transhepatic portal venous puncture

  5. Solitary percutaneous transhepatic biliary drainage tract metastasis after curative resection of perihilar cholangiocarcinoma: report of a case

    OpenAIRE

    Hwang, Shin; Jung, Sung-Won; Namgoong, Jung-Man; Yoon, Sam-Youl; Park, Gil-Chun; Jung, Dong-Hwan; Song, Gi-Won; Ha, Tae-Yong; Ko, Gi-Young; Suh, Dong-Wan; Lee, Sung-Gyu

    2011-01-01

    Percutaneous transhepatic biliary drainage (PTBD) has been widely used, but it has a potential risk of tumor spread along the catheter tract. We herein present a case of solitary PTBD tract metastasis after curative resection of perihilar cholangiocarcinoma. Initially, endoscopic nasobiliary drainage was done on a 65 year-old female patient, but the cholangitis did not resolve. Thus a PTBD catheter was inserted into the right posterior duct. Right portal vein embolization was also performed. ...

  6. Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort

    NARCIS (Netherlands)

    Stepien, Magdalena; Duarte-Salles, Talita; Fedirko, Veronika; Trichopoulou, Antonia; Lagiou, Pagona; Bamia, Christina; Overvad, Kim; Tjønneland, Anne; Hansen, Louise; Boutron-Ruault, Marie Christine; Fagherazzi, Guy; Severi, Gianluca; Kühn, Tilman; Kaaks, Rudolf; Aleksandrova, Krasimira; Boeing, Heiner; Klinaki, Eleni; Palli, Domenico; Grioni, Sara; Panico, Salvatore; Tumino, Rosario; Naccarati, Alessio; Bueno-de-Mesquita, H. Bas; Peeters, Petra H.; Skeie, Guri; Weiderpass, Elisabete; Parr, Christine L.; Quirós, José Ramón; Buckland, Genevieve; Molina-Montes, Esther; Amiano, Pilar; Chirlaque, Maria Dolores; Ardanaz, Eva; Sonestedt, Emily; Ericson, Ulrika; Wennberg, Maria; Nilsson, Lena Maria; Khaw, Kay Tee; Wareham, Nick; Bradbury, Kathryn E.; Ward, Heather A.; Romieu, Isabelle; Jenab, Mazda

    2016-01-01

    Purpose: The aim of the study was to assess associations between intake of combined soft drinks (sugar sweetened and artificially sweetened) and fruit and vegetable juices and the risk of hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBC) and biliary tract cancers (GBTC) using data from t

  7. Efficacy of preoperative biliary tract decompression in patients with obstructive jaundice.

    Science.gov (United States)

    Gundry, S R; Strodel, W E; Knol, J A; Eckhauser, F E; Thompson, N W

    1984-06-01

    Fifty consecutive matched patients with benign or malignant biliary tract obstruction were compared to determine the efficacy of preoperative percutaneous biliary drainage (PBD). Twenty-five patients underwent PBD for an average of nine days before operation; 25 patients underwent percutaneous transhepatic cholangiography ( PTHC ) followed immediately by operation. Serum bilirubin levels before PTHC were 16.5 +/- 7.6 mg/dL and 14.9 +/- 7.6 mg/dL in PBD and non-PBD groups, respectively. Serum bilirubin levels decreased to 6.5 +/- 6.2 mg/dL preoperatively in patients having PBD. One week after operation, bilirubin levels were 4.2 +/- 4.3 mg/dL and 9.0 +/- 5.2 mg/dL in the PBD and non-PBD groups, respectively. Major morbidity (sepsis, abscess, renal failure, or bleeding) occurred in two patients (8%) having PBD and in 13 patients (52%) without PBD. One patient (4%) with PBD, and five patients (20%) without PBD, died. The mean hospital stay was shorter for the PBD group. Preoperative PBD reduces operative mortality and morbidity and results in a more rapid resolution of hyperbilirubinemia during the postoperative period. PMID:6428380

  8. MR imaging of the biliary tract with Gd-EOB-DTPA: Effect of liver function on signal intensity

    Energy Technology Data Exchange (ETDEWEB)

    Takao, Hidemasa, E-mail: takaoh-tky@umin.ac.jp [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Akai, Hiroyuki; Tajima, Taku [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Kiryu, Shigeru [Department of Radiology, Institute of Medical Science, University of Tokyo, 74-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639 (Japan); Watanabe, Yasushi [Department of Radiological Technology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Imamura, Hiroshi [Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-8431 (Japan); Akahane, Masaaki; Yoshioka, Naoki [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Kokudo, Norihiro [Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Ohtomo, Kuni [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan)

    2011-02-15

    Objective: To quantitatively evaluate the signal intensity of the biliary tract in gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging and to investigate the effect of liver function on the signal intensity of the biliary tract. Materials and methods: A total of 32 patients with and without chronic liver disease (normal liver group, n = 15; chronic liver disease group, n = 17) were included in this study. All patients were prospectively enrolled for evaluation of known or suspected focal liver lesions. In the chronic liver disease group, the etiologies were chronic hepatitis C virus infection (n = 12) and chronic hepatitis B virus infection (n = 5). The median Child-Pugh score was 5 (range, 5-7). Each patient received the standard dose of Gd-EOB-DTPA (0.025 mmol/kg of body weight). Post-contrast T1-weighted MR images were obtained at 5, 10, 15, 20, 25, and 30 min after administration of Gd-EOB-DTPA. Maximum signal intensities (SIs) of the right and left hepatic ducts, common hepatic duct, and common bile duct were measured. Relative signal intensity was calculated as follows: relative SI = maximum SI{sub bileduct}/mean SI{sub muscle}. Serum albumin level, serum total bilirubin level, prothrombin time, indocyanine green retention rate at 15 min (ICG-R15), and estimated glomerular filtration rate were entered into regression analysis. Results: The signal intensity of the bile duct reached a peak 30 min after administration of Gd-EOB-DTPA. The mean relative signal intensity of the right and left hepatic ducts at the peak time point was not significantly different between the two groups, while increase in signal intensity was delayed in the chronic liver disease group. The mean relative signal intensity of the common hepatic duct and that of the common bile duct at the peak time point were significantly different between the two groups (Wilcoxon rank-sum test, P = 0.03, respectively). Stepwise regression

  9. MR imaging of the biliary tract with Gd-EOB-DTPA: Effect of liver function on signal intensity

    International Nuclear Information System (INIS)

    Objective: To quantitatively evaluate the signal intensity of the biliary tract in gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging and to investigate the effect of liver function on the signal intensity of the biliary tract. Materials and methods: A total of 32 patients with and without chronic liver disease (normal liver group, n = 15; chronic liver disease group, n = 17) were included in this study. All patients were prospectively enrolled for evaluation of known or suspected focal liver lesions. In the chronic liver disease group, the etiologies were chronic hepatitis C virus infection (n = 12) and chronic hepatitis B virus infection (n = 5). The median Child-Pugh score was 5 (range, 5-7). Each patient received the standard dose of Gd-EOB-DTPA (0.025 mmol/kg of body weight). Post-contrast T1-weighted MR images were obtained at 5, 10, 15, 20, 25, and 30 min after administration of Gd-EOB-DTPA. Maximum signal intensities (SIs) of the right and left hepatic ducts, common hepatic duct, and common bile duct were measured. Relative signal intensity was calculated as follows: relative SI = maximum SIbileduct/mean SImuscle. Serum albumin level, serum total bilirubin level, prothrombin time, indocyanine green retention rate at 15 min (ICG-R15), and estimated glomerular filtration rate were entered into regression analysis. Results: The signal intensity of the bile duct reached a peak 30 min after administration of Gd-EOB-DTPA. The mean relative signal intensity of the right and left hepatic ducts at the peak time point was not significantly different between the two groups, while increase in signal intensity was delayed in the chronic liver disease group. The mean relative signal intensity of the common hepatic duct and that of the common bile duct at the peak time point were significantly different between the two groups (Wilcoxon rank-sum test, P = 0.03, respectively). Stepwise regression analysis

  10. Tumor growth effects of rapamycin on human biliary tract cancer cells

    Directory of Open Access Journals (Sweden)

    Heuer Matthias

    2012-06-01

    Full Text Available Abstract Background Liver transplantation is an important treatment option for patients with liver-originated tumors including biliary tract carcinomas (BTCs. Post-transplant tumor recurrence remains a limiting factor for long-term survival. The mammalian target of rapamycin-targeting immunosuppressive drug rapamycin could be helpful in lowering BTC recurrence rates. Therein, we investigated the antiproliferative effect of rapamycin on BTC cells and compared it with standard immunosuppressants. Methods We investigated two human BTC cell lines. We performed cell cycle and proliferation analyses after treatment with different doses of rapamycin and the standard immunosuppressants, cyclosporine A and tacrolimus. Results Rapamycin inhibited the growth of two BTC cell lines in vitro. By contrast, an increase in cell growth was observed among the cells treated with the standard immunosuppressants. Conclusions These results support the hypothesis that rapamycin inhibits BTC cell proliferation and thus might be the preferred immunosuppressant for patients after a liver transplantation because of BTC.

  11. Factors influencing survival outcome for radiotherapy for biliary tract cancer: A multicenter retrospective study

    International Nuclear Information System (INIS)

    Purpose: To seek for the possible factors influencing overall survival (OS) with radiotherapy (RT) for biliary tract cancer. Materials and methods: Data were collected retrospectively from RT database of 31 institutions in Japan. All patients underwent at least external beam RT. The factors influencing OS were investigated. Results: Data of 498 patients were analyzed. Median OS of the 212 patients who underwent surgery was significantly better than that of the 286 patients without surgery (31 vs. 15 months, p < 0.001). The OS for the R0 or R1 resection group was significantly longer than that for the R2 or non-surgery group, as well as for n0 compared to n1 (all p < 0.001). Chemoradiotherapy (CRT), both sequential and concurrent, resulted in a better OS than RT alone for the n1 group (31 vs. 13 months, p < 0.001), and marginally better for the R0/R1 group (p = 0.065; p = 0.054 for concurrent CRT). However, no such benefit was observed for the R2/non-surgical patients. Multivariate analysis identified performance status, clinical stage, and surgery as significant factors. Conclusion: Surgery, especially R0/R1 resection, seemed as the gold standard for treatment of biliary tract cancer including RT, even in the highly heterogeneous population obtained from the multicenter retrospective study. The possibility was shown that CRT yielded better survival benefit especially for n1 patients. We recommend that future prospective trials include an arm of adjuvant CRT at least for n1 and possibly R0/R1 patients

  12. Polymorphisms of Genes in the Lipid Metabolism Pathway and the Risk of Biliary Tract Cancers and Stones: A Population-based Case-Control Study in Shanghai, China

    OpenAIRE

    Andreotti, Gabriella; Chen, Jinbo; Gao, Yu-Tang; Rashid, Asif; Chen, Bingshu E.; Rosenberg, Philip; Sakoda, Lori C.; Jie DENG; Shen, Ming-Chang; Wang, Bing-Sheng; Han, Tian-Quan; Zhang, Bai-He; Yeager, Meredith; Welch, Robert; Chanock, Stephen

    2008-01-01

    Biliary tract cancers, encompassing the gallbladder, extrahepatic bile duct, and ampulla of Vater, are uncommon, yet highly fatal malignancies. Gallstones, the primary risk factor for biliary cancers, are linked with hyperlipidemia. We examined the associations of 12 single nucleotide polymorphisms (SNPs) of five genes in the lipid metabolism pathway with the risks of biliary cancers and stones in a population-based case-control study in Shanghai, China. We included 235 gallbladder, 125 extra...

  13. Stenting and interventional radiology for obstructive jaundice in patients with unresectable biliary tract carcinomas

    OpenAIRE

    Tsuyuguchi, Toshio; Takada, Tadahiro; Miyazaki, Masaru; Miyakawa, Shuichi; Tsukada, Kazuhiro; Nagino, Masato; Kondo, Satoshi; Furuse, Junji; Saito, Hiroya; Suyama, Masafumi; Kimura, Fumio; Yoshitomi, Hideyuki; Nozawa, Satoshi; Yoshida, Masahiro; Wada, Keita

    2008-01-01

    Together with biliary drainage, which is an appropriate procedure for unresectable biliary cancer, biliary stent placement is used to improve symptoms associated with jaundice. Owing to investigations comparing percutaneous transhepatic biliary drainage (PTBD), surgical drainage, and endoscopic drainage, many types of stents are now available that can be placed endoscopically. The stents used are classified roughly as plastic stents and metal stents. Compared with plastic stents, metal stents...

  14. Recent progress in the etiopathogenesis of pediatric biliary disease, particularly Caroliâ s disease with congenital hepatic fibrosis and biliary atresia

    OpenAIRE

    Nakanuma, Yasuni; Harada, Kenichi; Sato, Yasunori; Ikeda, Hiroko

    2010-01-01

    Recent progress in elucidating the etiopathogenesis of pediatric biliary diseases, particularly Caroli’s disease with congenital hepatic fibrosis (CHF) and biliary atresia (BA), is reviewed. The former is characterized by multiple saccular dilatations of the intrahepatic bile ducts. An animal model of this disease, the PCK rat, is being extensively studied. PCK rats and Calori’s disease with CHF belong to autosomal recessive polycystic kidney disease (ARPKD) with ductal plate malformation. Mu...

  15. Scintigraphy with 99mTc-HIDA in assessment of the postoperative course after traumatic lesions of the liver and biliary tract

    DEFF Research Database (Denmark)

    Rasmussen, L; Oster-Jörgensen, E; Hovendal, C P;

    1990-01-01

    99mTc-HIDA scintigraphy was used as a diagnostic procedure in five children with liver and biliary tract injuries following blunt abdominal trauma. The method was used in patients after surgical intervention. The children fell into three groups. The first, focal reduction in activity with or......-tube drainage. This method is also recommended preoperatively in children who are clinically stable and in whom trauma to the liver and biliary tract is suspected....

  16. Interval Biliary Stent Placement Via Percutaneous Ultrasound Guided Cholecystostomy: Another Approach to Palliative Treatment in Malignant Biliary Tract Obstruction

    International Nuclear Information System (INIS)

    Percutaneous cholecystostomy is a minimally invasive procedure for providing gallbladder decompression, often in critically ill patients. It can be used in malignant biliary obstruction following failed endoscopic retrograde cholangiopancreatography when the intrahepatic ducts are not dilated or when stent insertion is not possible via the bile ducts. In properly selected patients, percutaneous cholecystostomy in obstructive jaundice is a simple, safe, and rapid option for biliary decompression, thus avoiding the morbidity and mortality involved with percutaneous transhepatic biliary stenting. Subsequent use of a percutaneous cholecystostomy for definitive biliary stent placement is an attractive concept and leaves patients with no external drain. To the best of our knowledge, it has only been described on three previous occasions in the published literature, on each occasion forced by surgical or technical considerations. Traditionally, anatomic/technical considerations and the risk of bile leak have precluded such an approach, but improvements in catheter design and manufacture may now make it more feasible. We report a case of successful interval metal stent placement via percutaneous cholecystostomy which was preplanned and achieved excellent palliation for the patient. The pros and cons of the procedure and approach are discussed.

  17. Impact of Intraluminal Brachytherapy on Survival Outcome for Radiation Therapy for Unresectable Biliary Tract Cancer: A Propensity-Score Matched-Pair Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Yasuo [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Ogawa, Kazuhiko, E-mail: kogawa@radonc.med.osaka-u.ac.jp [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Oikawa, Hirobumi [Department of Radiology, Iwate Medical University, Iwate (Japan); Onishi, Hiroshi [Department of Radiology, University of Yamanashi, Yamanashi (Japan); Kanesaka, Naoto [Department of Radiology, Tokyo Medical University, Tokyo (Japan); Tamamoto, Tetsuro [Department of Radiation Oncology, Nara Medical University of Medicine, Nara (Japan); Kosugi, Takashi [Department of Radiology, Hamamatsu University School of Medicine, Shizuoka (Japan); Hatano, Kazuo [Department of Radiation Oncology, Chiba Cancer Center, Chiba (Japan); Kobayashi, Masao [Department of Radiology, Jikei University School of Medicine, Tokyo (Japan); Ito, Yoshinori [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Takayama, Makoto [Department of Radiology, Kyorin University School of Medicine, Tokyo (Japan); Takemoto, Mitsuhiro [Department of Radiology, Okayama University, Okayama (Japan); Karasawa, Katsuyuki [Department of Radiation Oncology, Tokyo Metropolitan Komagome Hospital, Tokyo (Japan); Nagakura, Hisayasu [Department of Radiology, KKR Sapporo Medical Center, Hokkaido (Japan); Imai, Michiko [Department of Radiation Oncology, Iwata City Hospital, Shizuoka (Japan); Kosaka, Yasuhiro [Department of Radiation Oncology, Kobe City Medical Center General Hospital, Hyogo (Japan); Yamazaki, Hideya [Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto (Japan); Isohashi, Fumiaki [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Nemoto, Kenji [Department of Radiation Oncology, Yamagata University, Yamagata (Japan); Nishimura, Yasumasa [Department of Radiation Oncology, Kinki University Faculty of Medicine, Osaka (Japan)

    2014-07-15

    Purpose: To determine whether adding intraluminal brachytherapy (ILBT) to definitive radiation therapy (RT) for unresectable biliary tract cancer has a positive impact on survival outcome. Methods and Materials: The original cohort comprised 209 patients, including 153 who underwent external beam RT (EBRT) alone and 56 who received both ILBT and EBRT. By matching propensity scores, 56 pairs (112 patients) consisting of 1 patient with and 1 patient without ILBT were selected. They were well balanced in terms of sex, age, performance status, clinical stage, jaundice, and addition of chemotherapy. The impact of ILBT on overall survival (OS), disease-specific survival (DSS), and local control (LC) was investigated. Results: The 2-year OS rates were 31% for the ILBT+ group and 40% for theILBT– group (P=.862). The 2-year DSS rates were 42% for the ILBT+ group and 41% for the ILBT– group (P=.288). The 2-year LC rates were 65% for the ILBT+ group and 35% for the ILBT– group (P=.094). Three of the 4 sensitivity analyses showed a significantly better LC for the ILBT+ group (P=.010, .025, .049), and another showed a marginally better LC (P=.068), and none of the sensitivity analyses showed any statistically significant differences in OS or DSS. Conclusions: In the treatment for unresectable biliary tract cancer, the addition of ILBT to RT has no impact on OS or DSS but is associated with better LC. Therefore, the role of ILBT should be addressed by other measures than survival benefit, for example, by less toxicity, prolonged biliary tract patency decreasing the need for further palliative interventions, or patient quality of life.

  18. Current Status of Biliary Metal Stents

    OpenAIRE

    Nam, Hyeong Seok; Kang, Dae Hwan

    2016-01-01

    Many advances have been achieved in biliary stenting over the past 30 years. Endoscopic stent placement has become the primary management therapy to relieve obstruction in patients with benign or malignant biliary tract diseases. Compared with plastic stents, a self-expandable metallic stent (SEMS) has been used for management in patients with malignant strictures because of a larger lumen and longer stent patency. Recently, SEMS has been used for various benign biliary strictures and leaks. ...

  19. Anti-cancer effect and gene modulation of ET-743 in human biliary tract carcinoma preclinical models

    OpenAIRE

    Peraldo-Neia, Caterina; Cavalloni, Giuliana; Soster, Marco; Gammaitoni, Loretta; Marchiò, Serena; Sassi, Francesco; Trusolino, Livio; Bertotti, Andrea; Medico, Enzo; Capussotti, Lorenzo; Aglietta, Massimo; Leone, Francesco

    2014-01-01

    Background Standard chemotherapy in unresectable biliary tract carcinoma (BTC) patients is based on gemcitabine combined with platinum derivatives. However, primary or acquired resistance is inevitable and no second-line chemotherapy is demonstrated to be effective. Thus, there is an urgent need to identify new alternative (chemo)therapy approaches. Methods We evaluated the mechanism of action of ET-743 in preclinical models of BTC. Six BTC cell lines (TFK-1, EGI-1, TGBC1, WITT, KMCH, HuH28),...

  20. Pancreaticoduodenectomy for biliary tract carcinoma with situs inversus totalis: difficulties and technical notes based on two cases

    OpenAIRE

    Kyuno, Daisuke; Kimura, Yasutoshi; Imamura, Masafumi; Uchiyama, Motonobu; Ishii, Masayuki; Meguro, Makoto; Kawamoto, Masaki; Mizuguchi, Toru; Hirata, Koichi

    2013-01-01

    Situs inversus totalis (SIT) denotes complete right-left inversion of the thoracic and abdominal viscera. Diagnosis and surgical procedures for abdominal pathology in patients with SIT are technically more complicated because of mirror-image transposition of the visceral organs. Moreover, SIT is commonly associated with cardiovascular and hepatobiliary malformations, which make hepatobiliary-pancreatic surgery difficult. Two cases of pancreaticoduodenectomy for biliary tract carcinoma in pati...

  1. [Prevalence and risk factors of gastroduodenal and biliary system diseases in infants and preschool children].

    Science.gov (United States)

    Malanicheva, T G; Ziatdinova, N V; Denisova, S N

    2013-01-01

    To study the prevalence and risk factors of digestive diseases in children performed continuous screening questionnaire 786 children from 1.5 to 7 years. Were Revealed that 47.1 +/- 3.5% of children have symptoms of diseases of the gastrointestinal tract and biliary system. This symptoms occur in children aged 4 to 7 years in 2.3 times more frequently than in children from 1.5 to 3 years. In-depth study was revealed that the frequency of biliary dyskinesia (BD) was 33 +/- 3.3%, chronic gastritis (CG) and gastroduodenitis (CGD)--6.2 +/- 1.8%, chronic cholecystitis--4.2 +/- 1.4%, functional disorders of the stomach (FSD)--2.8 +/- 1.2%, and peptic duodenal ulcer (DU)--0.3 + 0.4%. In the structure of digestive diseases in children from 1.5 to 7 years on the 1st place are BD--70% on the 2nd--CG and CGD--14.7% on the 3rd chronic cholecystitis--8.9%, on the 4th FSD-5.9% and 5th place DU-0.5%. For dispensary observation in the children's clinic with digestive diseases consist of only 7.9 +/- 1.9% of children, which is 5.9 times lower than according to the active diagnostics data. The leading medical and social risk factors and their complex influence on the formation of digestive disorders in infants and preschool children. PMID:24933954

  2. Percutaneous Transhepatic Biliary Interventions in Benign Diseases of Children

    Directory of Open Access Journals (Sweden)

    Medih Celiktas

    2015-06-01

    Materials and Methods: In this retrospective study, percutaneous biliary interventions were performed in fifteen children with a mean age of 10.2 years (range 14 days-14 years. Patients presented with jaundice (n=5 and/or cholangitis (n=10. Percutaneous transhepatic biliary drainage (PTBD performed in 10 patients, PTBD plus balloon dilation in 3, percutaneous cholecystostomy (PC in 1, PTBD following PC in 1. Results: All procedures were technically successful. No procedure-related mortality occurred in patients. Serum bilirubin levels returned to normal or near normal in ten of twelve cases. Preexisting cholangitis and acute cholecystitis resolved in all patients. Six patients underwent surgery following percutaneous management. Nine patients cured primarily with percutaneous interventions with no further treatment. Conclusion: Percutaneous biliary interventions can be performed effectively in benign diseases of children. It can be performed either as a primary treatment modality or as a bridge prior to surgery. In most of cases, percutaneous treatment is sufficient and unnecessary surgery is prevented. [Cukurova Med J 2015; 40(2.000: 298-305

  3. Evidence and consensus of diagnosis of biliary tract and ampullary cancer

    International Nuclear Information System (INIS)

    This paper explains the content and background of the recent guideline of the cancers in the title where, as the currently available evidence is mostly lower than level IV, experts' consensual recommendations are mainly described. For the biliary tract (BT) cancer, in cases of jaundice, right upper abdominal pain and abnormal biochemical findings, recommended is the examination by abdominal ultrasonography (US). There is no specific tumor marker for the cancer. Next diagnostic mean is the enhanced CT, especially multidetector-row CT, and MR-cholangio-pancreatic duct imaging. Direct BT imaging is necessary for diagnosis of the horizontal extension of the BT cancer. In the gallbladder cancer, no particular clinical symptoms are known and its differential diagnosis involving the stage decision is important from benign polyp, cholecystitis and gallstone by endoscopic US (EUS), CT and multi detector row CT (MDCT). Endoscopic direct biopsy is possible in the case of ampullary cancer and preoperative pathologic diagnosis is possible. For metastases and local extension, recommended are CT, MRI, EUS and intraductal-US. The guideline above is written standing on the low level evidences and on current experts' consensus, and further examination and evaluation are needed in those diagnoses. (R.T.)

  4. The value of the hepatobiliaric function scintigraphy with Tc-99m-DAIDA for post-operative biliary tract function diagnosis

    International Nuclear Information System (INIS)

    The goal of this work was the examination of the value of biliary tract scintigraphy with 99m Tc DAIDA for post-operative supervision after biliary tract operations. The subjects were made up of 22 patients, who between 1969 and 1980 had undergone a choledochus revision with the insertion of a T drainage. In all cases with cholestase-specific laboratory findings the intra- and extrahepatic biliary tracts were expanded and in 71% of the cases were combined with an organically dependent drainage retardation which was scintigraphically proven. The proof of an organically dependent drainage retardation in scintigraphy coincided almost always with expanded biliary paths and in almost half the cases with blockage-specific changes in the laboratory values. Conclusion: By patients with operations on the biliary tracts the indication for biliary tract scintigraphy with 99m Tc DAIDA is always given, if with cholestase- oder liver-specifically changed laboratory values no concretions using sonography or preliminary radiographs could be proven. (TRV)

  5. [Phytotherapy of respiratory tract diseases].

    Science.gov (United States)

    Bylka, Wiesława; Witkowska-Banaszczak, Ewa; Studzińska-Sroka, Elzbieta; Matławska, Irena

    2012-01-01

    Herbal medicines have been used in cough due to their antitussive and expectorant activity. Antitussives act either centrally on the cough center of the brain or peripherally on the cough receptors in the respiratory passages. The antitussive effect of many herbs results from the content of mucilage, which exerts protective and demulcent activity. The activity of expectorant herbs results primarily from their influence on the gastric mucose (saponins and ipec alkaloids). This proves reflex stimulation which leads to an increase in the secretion of bronchial glands. Volatile-oil type expectorant herbs exert a direct stimulatory effect on the bronchial glands by means of local irritation with antibacterial activity. In colds and flu, herbs containing volatile oil can be used; also, volatile oils are ingredients of syrups and liquids as well as external phytomedicines in the form of liniments, ointments, and inhalations. The paper shows the herbs and phytomedicines present on the Polish market used for the treatment of respiratory tract diseases. PMID:23289257

  6. EVALUATION OF PANCREATICO-BILIARY DISEASE BY MRCP

    Directory of Open Access Journals (Sweden)

    Shivanand S

    2015-12-01

    Full Text Available MRCP means magnetic resonance cholangio-pancreatography. First described in clinical practice in 1991. MRCP technique is based on heavily T2 weighted pulse sequences, which result in dramatic increase in contrast between stationary fluid (bile and background tissue. OBJECTIVES OF STUDY  To describe features of pancreaticobiliary diseases on MRCP.  Outlining the extent in terms of involvement of adjacent structures, vessels and soft tissues.  To help in deciding further course of management.  To identify the anatomical variants.  Comparing MRCP to ERCP whenever necessary.  To prove the Magnetic Resonance Cholangio-Pancreatography (MRCP is one of the best imaging modality for evaluation of pancreatico-biliary disease. MATERIAL AND METHODS The present study was undertaken to evaluate the role of MRCP in evaluation of pancreaticobiliary diseases. The study will be done on patients presenting with features suggestive of pancreatico-biliary diseases attending the OPD or admitted in various wards of Basaveshwar Teaching and General Hospital and Sangameshwar Teaching Hospital, Kalaburagi, attached to M.R. Medical College, Kalaburagi. A total of 50 patients were included in our study. RESULT Majority of patients in study population were males (58%, while 42% were females. The mean age of the study sample was 46.6 years and maximum numbers of cases were observed in 30-70 years of age group. Benign causes were seen in 11-50 years of age group, while malignant causes were more common between 41-75 years of age group. Majority of pathologies observed were benign 38 (76%. Most common benign disorder observed was cholelithiasis with choledocholithiasis (20% followed by acute pancreatitis (12%. Majority of CBD strictures were benign and commonly seen in females (8%. CBD strictures were more commonly observed in the distal common bile duct. Malignant pathologies were observed in 24% patients. Most common malignant pathology seen was

  7. Comparison of a new tumour marker CA 242 with CA 19-9, CA 50 and carcinoembryonic antigen (CEA) in digestive tract diseases.

    OpenAIRE

    Kuusela, P.; Haglund, C.; Roberts, P. J.

    1991-01-01

    The levels of CA 242, a new tumour marker of carbohydrate nature, were measured in sera of 185 patients with malignancies of the digestive tract and of 123 patients with benign digestive tract diseases. High percentages of elevated CA 242 levels (greater than 20 U ml-1) were recorded in patients with pancreatic and biliary cancers (68%). The sensitivity was somewhat lower than that of CA 19-9 (76%) and CA 50 (73%). On the other hand, in benign pancreatic and biliary tract diseases the CA 242 ...

  8. Biliary intraepithelial neoplasia (BilIN) is frequently found in surgical margins of biliary tract cancer resection specimens but has no clinical implications.

    Science.gov (United States)

    Matthaei, Hanno; Lingohr, Philipp; Strässer, Anke; Dietrich, Dimo; Rostamzadeh, Babak; Glees, Simone; Roering, Martin; Möhring, Pauline; Scheerbaum, Martin; Stoffels, Burkhard; Kalff, Jörg C; Schäfer, Nico; Kristiansen, Glen

    2015-02-01

    Biliary tract cancers are aggressive tumors of which the incidence seems to increase. Resection with cancer-free margins is crucial for curative therapy. However, how often biliary intraepithelial neoplasia (BilIN) occurs in resection margins and what its clinical and therapeutic implications might be is largely unknown. We reexamined margins of resection specimens of adenocarcinoma of the biliary tree including the gallbladder for the presence of BilIN. When present, it was graded. The findings were correlated with clinicopathological parameters and overall survival. Complete examination of the resection margin could be performed on 55 of 78 specimens (71%). BilIN was detected in the margin in 29 specimens (53%) and was mainly low-grade (BilIN-1; N = 14 of 29; 48%). In resection specimens of extrahepatic cholangiocarcinoma, BilIN was most frequent (N = 6 of 8; 75%). BilIN was found in the resection margin more frequently in extrahepatic cholangiocarcinomas (P = 0.007) and in large primary tumors (P = 0.001) with lymphovascular (P = 0.006) and perineural invasion (P = 0.049). Patients with cancer in the resection margin (R1) had a significantly shorter overall survival than those with resection margins free of tumor (R0) irrespective of the presence of BilIN (R0 vs R1; P < 0.001) or BilIN grade (BilIN-positive vs BilIN-negative, P = 0.6, and BilIN-1 + 2 vs BilIN-3, P = 0.58). BilIN is frequently found in the surgical margin of resection specimens of adenocarcinoma of the biliary tract. Hepatopancreatobiliary surgeons will be confronted with this recently defined entity when an intraoperative frozen section of a resection margin is requested. However, this diagnosis does not require additional resection and in the intraoperative evaluation of resection, the emphasis should remain on the detection of residual invasive tumor. PMID:25425476

  9. Usefulness of magnetic resonance cholangiography in the diagnosis of biliary tract lesions in patients with suspected complication following cholecystectomy

    International Nuclear Information System (INIS)

    Objective: to determine the usefulness of magnetic resonance cholangiopancreatography (MRCP) in the diagnoses of bile duct injuries following cholecystectomy. Material and method: MRCP was retrospectively evaluated in 40 patients with suspected bile duct injury after laparoscopic or conventional cholecystectomy. Eight of these patients had been submitted to biliary reconstruction. All patients were symptomatic (jaundice, fever and chills, weight loss and abdominal pain). The scans were independently reviewed by two radiologists. The results were confirmed by surgery, percutaneous drainage, endoscopic retrograde cholangiopancreatography and clinical follow-up. The level and severity of bile duct injury were rated according to the Bismuth classification. Results: in a total of 40 symptomatic patients, 10 (25%) had normal findings on MRCP; Postoperative complications were seen in 29 (72.5%) patients, seven of them with more than one finding. Pancreatic head neoplasia was diagnoses in one patient. The most frequent finding was sclerosing (41.4%) followed by biliary duct stenosis (34.5%), residual or recurrent biliary stones (31.0%) and fluid collections (17.2%). The images obtained by MRCP were considered of good quality. Conclusion: MRCP is an effective method for the evaluation of patients with suspected postcholecystectomy biliary tract complications. (author)

  10. Mechanisms of oxysterol-induced disease: insights from the biliary system

    OpenAIRE

    Kuver, Rahul

    2012-01-01

    Oxysterols are oxidized species of cholesterol that are derived from exogenous (e.g. dietary) and endogenous (in vivo) sources. Oxysterols play critical roles in normal physiologic functions as well as in pathophysiologic processes in a variety of organ systems. This review provides an overview of oxysterol biology from the vantage point of the biliary system. Several oxysterols have been identified in human bile in the context of biliary tract infection and inflammation. This finding has led...

  11. Cholescintigraphy, ultrasonography and computerized tomography in the evaluation of biliary tract disorders

    International Nuclear Information System (INIS)

    Newer modalities available for the evaluation of hepatobiliary disease include cholescintigraphy, ultrasonography, and computerized tomography. We have examined the relative strengths and weaknesses of each of these noninvasive techniques and developed a rational diagnostic approach for the evaluation of acute cholecystitis, chronic cholecystitis, and cholestasis. The procedure of choice for suspected acute cholecystitis is /sup 99m/Tc-HIDA cholescintigraphy because it is a highly accurate method for obtaining functional information with regard to cystic duct patency. In suspected chronic cholecystitis, the oral cholecystogram is the best screening procedure, followed by ultrasound for confirmation of gallbladder disease as the cause of nonvisualizaion. The role of /sup 99m/Tc-HIDA cholescintigraphy in suspected chronic cholecystitis is limited to those cases where the oral cholecystogram and sonogram yield disparate results, or where a patient is known to have chronic gallbladder disease and super-imposed acute exacerbation is suspected. Ultrasonography is recommended as the initial procedure for evaluation of the patient with cholestasis. It is highly accurate in distinguishing hepatocellular disease from obstructive jaundice, and when dilated biliary radicles are visualized, ultrasonography is frequently capable of identifying the cause of obstruction. If the patient's body habitus or gaseous distention makes ultrasonographic evaluation difficult, then computerized tomography is recommended, followed by endoscopic retrograde cholangiopancreatography or transhepatic cholangiography, when needed

  12. Metal stent and endoluminal high-dose rate 192iridium brachytherapy in palliative treatment of malignant biliary tract obstruction

    International Nuclear Information System (INIS)

    Since December 1989, 9 patients with inoperable malignant biliary tract obstruction were treated palliatively by a combined modality treatment consisting of placement of a permanent biliary endoprosthesis followed by intraluminal high dose-rate 192Ir brachytherapy. A dose of 10 Gy was delivered in a hyperfractionated schedule at the point of reference in a distance of 7.5 mm of centre of the source. External small field radiotherapy (50.4 Gy, 1.8 Gy per day, 5 fractions per week) was also given in six cases (M/O, Karnofsky >60%). In 9/9 cases an unrestrained bile flow and an interruption of pruritus was achieved, in 78% (7/9) of cases the duration of palliation was as long as the survival time (median survival time 7.5 months). (orig.)

  13. Chemical coding and chemosensory properties of cholinergic brush cells in the mouse gastrointestinal and biliary tract

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    Burkhard eSchütz

    2015-03-01

    Full Text Available The mouse gastro-intestinal and biliary tract mucosal epithelia harbor choline acetyltransferase (ChAT-positive brush cells with taste cell-like traits. With the aid of two transgenic mouse lines that express green fluorescent protein (EGFP under the control of the ChAT promoter (EGFPChAT and by using in situ hybridization and immunohistochemistry we found that EGFPChAT cells were clustered in the epithelium lining the gastric groove. EGFPChAT cells were numerous in the gall bladder and bile duct, and found scattered as solitary cells along the small and large intestine. While all EGFPChAT cells were also ChAT-positive, expression of the high-affinity choline transporter (ChT1 was never detected. Except for the proximal colon, EGFPChAT cells also lacked detectable expression of the vesicular acetylcholine transporter (VAChT. EGFPChAT cells were found to be separate from enteroendocrine cells, however they were all immunoreactive for cytokeratin 18 (CK18, transient receptor potential melastatin-like subtype 5 channel (TRPM5, and for cyclooxygenases 1 (COX1 and 2 (COX2. The ex vivo stimulation of colonic EGFPChAT cells with the bitter substance denatonium resulted in a strong increase in intracellular calcium, while in other epithelial cells such an increase was significantly weaker and also timely delayed. Subsequent stimulation with cycloheximide was ineffective in both cell populations. Given their chemical coding and chemosensory properties, EGFPChAT brush cells thus may have integrative functions and participate in induction of protective reflexes and inflammatory events by utilizing ACh and prostaglandins for paracrine signaling.

  14. MicroRNAs Associated with the Efficacy of Photodynamic Therapy in Biliary Tract Cancer Cell Lines

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    Andrej Wagner

    2014-11-01

    Full Text Available Photodynamic therapy (PDT is a palliative treatment option for unresectable hilar biliary tract cancer (BTC showing a considerable benefit for survival and quality of life with few side effects. Currently, factors determining the cellular response of BTC cells towards PDT are unknown. Due to their multifaceted nature, microRNAs (miRs are a promising analyte to investigate the cellular mechanisms following PDT. For two photosensitizers, Photofrin® and Foscan®, the phototoxicity was investigated in eight BTC cell lines. Each cell line (untreated was profiled for expression of n = 754 miRs using TaqMan® Array Human MicroRNA Cards. Statistical analysis and bioinformatic tools were used to identify miRs associated with PDT efficiency and their putative targets, respectively. Twenty miRs correlated significantly with either high or low PDT efficiency. PDT was particularly effective in cells with high levels of clustered miRs 25-93*-106b and (in case of miR-106b a phenotype characterized by high expression of the mesenchymal marker vimentin and high proliferation (cyclinD1 and Ki67 expression. Insensitivity towards PDT was associated with high miR-200 family expression and (for miR-cluster 200a/b-429 expression of differentiation markers Ck19 and Ck8/18. Predicted and validated downstream targets indicate plausible involvement of miRs 20a*, 25, 93*, 130a, 141, 200a, 200c and 203 in response mechanisms to PDT, suggesting that targeting these miRs could improve susceptibility to PDT in insensitive cell lines. Taken together, the miRNome pattern may provide a novel tool for predicting the efficiency of PDT and—following appropriate functional verification—may subsequently allow for optimization of the PDT protocol.

  15. Tratamento cirúrgico das estenoses da via biliar Surgical management of the biliary tract stricture

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    Antônio César Marson

    2004-08-01

    Full Text Available OBJETIVO: As estenoses benignas da via biliar (EBVB decorrem de lesões iatrogênicas em 95% casos. Embora pouco freqüentes seu prognóstico é sombrio, e a prevenção é o melhor tratamento. O objetivo deste trabalho é estudar a conduta cirúrgica nas EBVB e seus resultados. MÉTODO: Foram analisados retrospectivamente, 11 pacientes submetidos à correção de EBVB no Hospital Universitário Regional do Norte do Paraná (HURNP no período de Julho/1992 a Dezembro/2001. RESULTADOS: Nove pacientes eram do sexo feminino e dois do masculino,com média de idade de 43,71 (± 17,05 anos. A cirurgia que originou a lesão foi colecistectomia aberta em 81,8% dos pacientes e por laparoscopia em 18,2%. Os sinais e sintomas mais freqüentes foram icterícia (64,3%, dor (64,3%, e febre (21,4%. O diagnóstico foi confirmado por colangiopancreatografia retrógrada endoscópica (CPRE em 90,9% dos casos e por colangiografia transparieto- hepática (CTPH em 9,1%. Segundo os critérios de Bismuth lesões do tipo I ocorreram em 18,2% dos casos, tipo II em 45,4%, tipo III em 18,2% e tipo IV em 18,2%. O tratamento cirúrgico para as EBVB foi anastomose colédoco-duodenal, anastomose hepático-jejunal em Y de Roux , anastomose hepático-jejunal à Hepp- Couinaud e anastomose hepático-jejunal com enxertia de mucosa (Smith, para as lesões tipo I,II,III e IV, respectivamente. Seis (54,55% pacientes apresentaram complicações pós-operatórias , e dois (18,2% evoluíram para óbito CONCLUSÕES: As correções cirúrgicas das EBVB apresentam altos índices de complicações e devem ser realizadas em centros especializados. Em geral estas estenoses decorrem de lesões iatrogênicas durante colecistectomias.BACKGROUND: Benign stricture of biliary tract (BSBT are iatrogenic in about 95% of the cases. Although rare, its outcome is poor; therefore prevention is the best option. The objective of this study is to evaluate the surgical management and its results in BSBT

  16. Outcome of stenting in biliary and pancreatic benign and malignant diseases: A comprehensive review.

    Science.gov (United States)

    Mangiavillano, Benedetto; Pagano, Nico; Baron, Todd H; Luigiano, Carmelo

    2015-08-14

    Endoscopic stenting has become a widely method for the management of various malignant and benign pancreatico-biliary disorders. Biliary and pancreatic stents are devices made of plastic or metal used primarily to establish patency of an obstructed bile or pancreatic duct and may also be used to treat biliary or pancreatic leaks, pancreatic fluid collections and to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis. In this review, relevant literature search and expert opinions have been used to evaluate the outcome of stenting in biliary and pancreatic benign and malignant diseases. PMID:26290631

  17. Cisplatin/gemcitabine or oxaliplatin/gemcitabine in the treatment of advanced biliary tract cancer: a systematic review

    International Nuclear Information System (INIS)

    Cisplatin/gemcitabine association has been a standard of care for first-line regimen in advanced biliary tract cancer nevertheless oxaliplatin/gemcitabine regimen is frequently preferred. Because comparative effectiveness in clinical outcomes of cisplatin- versus oxaliplatin-containing chemotherapy is not available, a systematic review of studies assessing cisplatin/gemcitabine or oxaliplatin/gemcitabine chemotherapies in advanced biliary tract cancer was performed. Published studies evaluating cisplatin/gemcitabine or oxaliplatin/gemcitabine in advanced biliary tract cancer were included. Each study was weighted according to the number of patients included. The primary objective was to assess weighted median of medians overall survival (mOS) reported for both regimens. Secondary goals were to assess weighted median of medians progression-free survival (mPFS) and toxic effects were pooled and compared within each arm. Thirty-three studies involving 1470 patients were analyzed. In total, 771 and 699 patients were treated by cisplatin/gemcitabine and oxaliplatin/gemcitabine, respectively. Weighted median of mOS was 9.7 months in cisplatin group and 9.5 months in oxaliplatin group. Cisplatin-based chemotherapy was significantly associated with more grade 3 and 4 asthenia, diarrhea, liver toxicity, and hematological toxicity. Sensitivity analysis including only the studies with the standard regimen of cisplatin (25–35 mg/m2 administered on days 1 and 8) showed that the weighted median of mOS increased from 9.7 to 11.7 months but Gem/CDDP regimen remained more toxic than Gemox regimen. These results suggest that the Gem/CDDP regimen with cisplatin (25–35 mg/m2) administered on days 1 and 8 is associated with survival advantage than Gemox regimen but with addition of toxicity

  18. Biliary Microbiota, Gallstone Disease and Infection with Opisthorchis felineus

    Science.gov (United States)

    Saltykova, Irina V.; Petrov, Vjacheslav A.; Logacheva, Maria D.; Ivanova, Polina G.; Merzlikin, Nikolay V.; Sazonov, Alexey E.; Ogorodova, Ludmila M.; Brindley, Paul J.

    2016-01-01

    Background There is increasing interest in the microbiome of the hepatobiliary system. This study investigated the influence of infection with the fish-borne liver fluke, Opisthorchis felineus on the biliary microbiome of residents of the Tomsk region of western Siberia. Methodology/Principal Findings Samples of bile were provided by 56 study participants, half of who were infected with O. felineus, and all of who were diagnosed with gallstone disease. The microbiota of the bile was investigated using high throughput, Illumina-based sequencing targeting the prokaryotic 16S rRNA gene. About 2,797, discrete phylotypes of prokaryotes were detected. At the level of phylum, bile from participants with opisthorchiasis showed greater numbers of Synergistetes, Spirochaetes, Planctomycetes, TM7 and Verrucomicrobia. Numbers of > 20 phylotypes differed in bile of the O. felineus-infected compared to non-infected participants, including presence of species of the genera Mycoplana, Cellulosimicrobium, Microlunatus and Phycicoccus, and the Archaeans genus, Halogeometricum, and increased numbers of Selenomonas, Bacteroides, Rothia, Leptotrichia, Lactobacillus, Treponema and Klebsiella. Conclusions/Significance Overall, infection with the liver fluke O. felineus modified the biliary microbiome, increasing abundance of bacterial and archaeal phylotypes. PMID:27447938

  19. Considerations Regarding Biliary-digestive Bypasses in Benign and Malignant Diseases of the Biliary- Pancreatic Confluence

    OpenAIRE

    Horațiu Flaviu Coman; Cornel Iancu; Octavian Andercou; Bogdan Stancu; Aurel Andercou

    2014-01-01

    Introduction. The usual indication for a biliary-digestive bypass is the obstruction by a benign or a malignant stricture which can occur at the biliary- pancreatic confluence. Benign strictures mostly occur in the distal bile duct as a result of stones or chronic pancreatitis. Malignant obstructions involve mostly the distal end as a result of a ductal adenocarcinoma of the head of the pancreas, the ampulla of Vater and cholangiocarcinoma and can be virtually impossible to distinguish from e...

  20. Influence of Five Potential Anticancer Drugs on Wnt Pathway and Cell Survival in Human Biliary Tract Cancer Cells

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    Julia WACHTER, Daniel NEUREITER, Beate ALINGER, Martin PICHLER, Julia FUEREDER, Christian OBERDANNER, Pietro Di FAZIO, Matthias OCKER, Frieder BERR, Tobias KIESSLICH

    2012-01-01

    Full Text Available Background: The role of Wnt signalling in carcinogenesis suggests compounds targeting this pathway as potential anti-cancer drugs. Several studies report activation of Wnt signalling in biliary tract cancer (BTC thus rendering Wnt inhibitory drugs as potential candidates for targeted therapy of this highly chemoresistant disease.Methods: In this study we analysed five compounds with suggested inhibitory effects on Wnt signalling (DMAT, FH535, myricetin, quercetin, and TBB for their cytotoxic efficiency, mode of cell death, time- and cell line-dependent characteristics as well as their effects on Wnt pathway activity in nine different BTC cell lines.Results: Exposure of cancer cells to different concentrations of the compounds results in a clear dose-dependent reduction of viability for all drugs in the order FH535 > DMAT > TBB > myricetin > quercetin. The first three substances show high cytotoxicity in all tested cell lines, cause a direct cytotoxic effect by induction of apoptosis and inhibit pathway-specific signal transduction in a Wnt transcription factor reporter activity assay. Selected target genes such as growth-promoting cyclin D1 and the cell cycle progression inhibitor p27 are down- and up-regulated after treatment, respectively.Conclusions: Taken together, these data demonstrate that the small molecular weight inhibitors DMAT, F535 and TBB have a considerable cytotoxic and possibly Wnt-specific effect on BTC cell lines in vitro. Further in vivo investigation of these drugs as well as of new Wnt inhibitors may provide a promising approach for targeted therapy of this difficult-to-treat tumour.

  1. Identification of Serum Biomarkers for Biliary Tract Cancers by a Proteomic Approach Based on Time-of-Flight Mass Spectrometry

    International Nuclear Information System (INIS)

    Biliary tract cancers (BTCs) are lethal malignancies currently lacking satisfactory methods for early detection and accurate diagnosis. Surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) is a promising diagnostic tool for this disease. In this pilot study, sera samples from 50 BTCs and 30 cholelithiasis patients as well as 30 healthy subjects from a population-based case-control study were randomly grouped into training set (30 BTCs, 20 cholelithiasis and 20 controls), duplicate of training set, and blind set (20 BTCs, 10 cholelithiasis and 10 controls); all sets were analyzed on Immobilized Metal Affinity Capture ProteinChips via SELDI-TOF-MS. A decision tree classifier was built using the training set and applied to all test sets. The classification tree constructed with the 3,400, 4,502, 5,680, 7,598, and 11,242 mass-to-charge ratio (m/z) protein peaks had a sensitivity of 96.7% and a specificity of 85.0% when comparing BTCs with non-cancers. When applied to the duplicate set, sensitivity was 66.7% and specificity was 70.0%, while in the blind set, sensitivity was 95.0% and specificity was 75.0%. Positive predictive values of the training, duplicate, and blind sets were 82.9%, 62.5% and 79.2%, respectively. The agreement of the training and duplicate sets was 71.4% (Kappa = 0.43, u = 3.98, P < 0.01). The coefficient of variations based on 10 replicates of one sample for the five differential peaks were 15.8–68.8% for intensity and 0–0.05% for m/z. These pilot results suggest that serum protein profiling by SELDI-TOF-MS may be a promising approach for identifying BTCs but low assay reproducibility may limit its application in clinical practice

  2. Diseases of the respiratory tract of chelonians.

    Science.gov (United States)

    Origgi, F C; Jacobson, E R

    2000-05-01

    Diseases of the respiratory tract commonly occur in captive chelonians, and several diseases also have occurred in wild chelonians. Infectious causes include viruses, bacteria, fungi, and parasites. Herpesviruses have surfaced as important pathogens of the oral cavity and respiratory tract in Hermann's tortoise (Testudo hermanii), spur-thighed tortoise (Testudo graeca), and other tortoises in Europe and the United States. Herpesvirus-associated respiratory diseases also have been reported in the green turtle, Chelonia mydas, in mariculture in the Cayman Islands. Of diseases caused by bacteria, an upper respiratory tract disease caused by Mycoplasma sp has been reported in free-hanging and captive gopher tortoises in the southeastern United States and in desert tortoises in the Mojave Desert of the southwestern United States. Mycotic pulmonary disease is commonly reported in captive chelonians, especially in those maintained at suboptimal temperatures. An intranuclear coccidia has been seen in several species of captive tortoises in the United States, and, in one case, a severe proliferative pneumonia was associated with organisms in the lung. The most common noninfectious cause of respiratory disease in chelonians results from trauma to the carapace. Although pulmonary fibromas commonly occur in green turtles with fibropapillomatosis, for the most part, tumors of the respiratory tract are uncommon in chelonians. PMID:11228895

  3. High dose rate sup 60 Co-RALS intraluminal radiation therapy for advanced biliary tract cancer with obstructive jaundice

    Energy Technology Data Exchange (ETDEWEB)

    Tamada, Toshiaki; Yoshimura, Hitoshi; Yoshioka, Tetsuya; Iwata, Kazuro; Ohishi, Hajime; Uchida, Hideo (Nara Medical Univ., Kashihara (Japan))

    1991-12-01

    High-dose-rate intraluminal irradiation with a {sup 60}Co remote afterloading system, using our newly developed applicator, was performed in 15 cases of advanced biliary tract cancer (2 gallbladder cancers, 13 cholangiocarcinomas). The applicator which was thin with an outer diameter of 14 Fr had a double lumen which included a small lumen for a guide wire for easy exchange to a drainage tube. Therefore, the irradiation procedure could be easily finished in a short time within little distress to the patient. The tumor marker CA1 19-9 was useful in assessing the therapeutic effect and follow-up observation after treatment. The average tube-free period and survival time were 5.9 months and 8.3 months, respectively. Histopathological examination of the cases autopsied showed that the combination of intraluminal (30 Gy) and external (30 Gy) irradiation offered good local control of the cancer that was within 1 cm from the source. Cholangiocarcinoma with relatively short length of obstruction, stage III or stage IV when the cancer infiltration was localized around the bile duct, achieved a comparatively long survival time. It was suggested that the combined use of high-dose-rate intraluminal radiotherapy, with precisely delivered radical radiation to tumors localized in the bile duct wall, and external radiotherapy delivered as additional radiation to the surrounding bile duct would provide radiotherapeutic advantage and contribute to survival after treatment for advanced biliary tract cancer. (author).

  4. Optimal dose of gemcitabine for the treatment of biliary tract or pancreatic cancer in patients with liver dysfunction.

    Science.gov (United States)

    Shibata, Takashi; Ebata, Tomoki; Fujita, Ken-ichi; Shimokata, Tomoya; Maeda, Osamu; Mitsuma, Ayako; Sasaki, Yasutsuna; Nagino, Masato; Ando, Yuichi

    2016-02-01

    A clear consensus does not exist about whether the initial dose of gemcitabine, an essential anticancer antimetabolite, should be reduced in patients with liver dysfunction. Adult patients with biliary tract or pancreatic cancer were divided into three groups according to whether they had mild, moderate, or severe liver dysfunction, evaluated on the basis of serum bilirubin and liver transaminase levels at baseline. As anticancer treatment, gemcitabine at a dose of 800 or 1000 mg/m(2) was given as an i.v. infusion once weekly for 3 weeks of a 4-week cycle. The patients were prospectively evaluated for adverse events during the first cycle, and the pharmacokinetics of gemcitabine and its inactive metabolite, difluorodeoxyuridine, were studied to determine the optimal initial dose of gemcitabine as monotherapy according to the severity of liver dysfunction. A total of 15 patients were studied. Liver dysfunction was mild in one patient, moderate in six, and severe in eight. All 15 patients had been undergoing biliary drainage for obstructive jaundice when they received gemcitabine. Grade 3 cholangitis developed in one patient with moderate liver dysfunction who received gemcitabine at the dose level of 1000 mg/m(2). No other patients had severe treatment-related adverse events resulting in the omission or discontinuation of gemcitabine treatment. The plasma concentrations of gemcitabine and difluorodeoxyuridine were similar among the groups. An initial dose reduction of gemcitabine as monotherapy for the treatment of biliary tract or pancreatic cancers is not necessary for patients with hyperbilirubinemia, provided that obstructive jaundice is well managed. (Clinical trial registration no. UMIN000005363.) PMID:26595259

  5. {sup 99m}Tc-EHIDA Scintigraphic Demonstrability of Biliary Elements and Liver Function Tests in Hepatobiliary Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Choon Yul; Baik, Yong Whee; Lee, Myung Hee [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1982-09-15

    In the present communication, the results will be reported on a clinical study of how well scintigraphic visualization of the hepatobiliary elements and several commonly used clinical liver function tests correlate each other in various diseases of hepatobiliary system. The demonstrability of the biliary tract, gallbladder (GB) and duodenum was rather closely paralleled to serum bilirubin level and less closely to alkaline phosphatase and rather poorly to SGOT and SGPT. The usefulness of {sup 99m}Tc-EHIDA [N-(2,6-diethylacetanilido) iminodiacetic acid, made by Amersham, England] hepatobiliary scintigraphy (Tc EHIDA HBS) in settling diagnostic controversy and ambiguity raised by oral cholecystography, intravenous cholangiography and ultrasonography in many hepatobiliary diseases is well known. The purpose of this investigation was to semiquantitatively evaluate the scintigraphy demonstrability of the hepatobility tract, GB and duodenum following intravenous injection of {sup 99m}Tc-EHIDA in normal subjects and in patients with a disturbed liver function from various hepatobility diseases. The hepatobiliary scintigraphy was performed in 10 normal subjects and 39 patients with various hepatobiliary diseases (Table 1) at the Dept. of Radiology, St. Mary's Hospital Catholic Medical College, Seoul, Korea during 2 years period from September 1979. Scintigraphy examination was started at end of 3 minutes after intravenous injection of {sup 99m}Tc-EHIDA in the amount of 50 muCi/kg and was continued until after 30 minutes at 5 minutes interval. The imaging was usually terminated when the tracer could be seen in the duodenum. Late scintigrams were obtained at 1 1/2, 2, 3, 4 and 6 hours when needed. Scintigrams were analyzed in terms of promptness and clarity of visualization of the biliary tree, GB and duodenum and demonstrability of these anatomical landmarks was correlated with the values of liver function tests. The demonstrability of the common hepatic duct, common

  6. Prion Diseases and the Gastrointestinal Tract

    OpenAIRE

    Davies, Gwynivere A; Bryant, Adam R; John D. Reynolds; Jirik, Frank R.; Keith A Sharkey

    2006-01-01

    The gastrointestinal (GI) tract plays a central role in the pathogenesis of transmissible spongiform encephalopathies. These are human and animal diseases that include bovine spongiform encephalopathy, scrapie and Creutzfeldt-Jakob disease. They are uniformly fatal neurological diseases, which are characterized by ataxia and vacuolation in the central nervous system. Alhough they are known to be caused by the conversion of normal cellular prion protein to its infectious conformational isoform...

  7. Parasitic disease of the liver and biliary tree

    Directory of Open Access Journals (Sweden)

    Mohamed Abdulrahman

    1997-01-01

    Full Text Available Several parasites infest liver or biliary tree, either during their maturation stages or as adult worms. Bile iry tree parasites may cause pancreatitis, cholecystitis, biliary tree obstruction, recurrent cholangitis, biliary tree strictures and some may lead to cholangiocarcinoma. This review discusses the hepatobiliary parasites, and shows our experience in diagnosis and management of these parasites. Ultrasonography of the liver is diagnostic in schistosomiasis, hydatid cysts, amebic liver abscess, ascariasis and other biliary tree parasites showing bile duct dilatation. Percutaneous aspiration under ultrasonography guidance of hydatid liver cysts or amebic abscess are effective measures in management. Endoscopic retrograde cholangiopancreatography (ERCP is safe and effective in diagnosis and management of biliary tree parasites.

  8. Association of diverse bacterial communities in human bile samples with biliary tract disorders: a survey using culture and polymerase chain reaction-denaturing gradient gel electrophoresis methods.

    Science.gov (United States)

    Tajeddin, E; Sherafat, S J; Majidi, M R S; Alebouyeh, M; Alizadeh, A H M; Zali, M R

    2016-08-01

    Bacterial infection is considered a predisposing factor for disorders of the biliary tract. This study aimed to determine the diversity of bacterial communities in bile samples and their involvement in the occurrence of biliary tract diseases. A total of 102 bile samples were collected during endoscopic retrograde cholangiopancreatography (ERCP). Characterization of bacteria was done using culture and polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) methods. Antimicrobial susceptibility of the isolates was determined based on the Clinical and Laboratory Standards Institute (CLSI) guidelines and identity of the nucleotide sequences of differentiated bands from the DGGE gels was determined based on GenBank data. In total, 41.2 % (42/102) of the patients showed bacterial infection in their bile samples. This infection was detected in 21 % (4/19), 45.4 % (5/11), 53.5 % (15/28), and 54.5 % (24/44) of patients with common bile duct stone, microlithiasis, malignancy, and gallbladder stone, respectively. Escherichia coli showed a significant association with gallstones. Polymicrobial infection was detected in 48 % of the patients. While results of the culture method established coexistence of biofilm-forming bacteria (Pseudomonas aeruginosa, E. coli, Klebsiella pneumoniae, Enterococcus spp., and Acinetobacter spp.) in different combinations, the presence of Capnocytophaga spp., Lactococcus spp., Bacillus spp., Staphylococcus haemolyticus, Enterobacter or Citrobacter spp., Morganella spp., Salmonella spp., and Helicobacter pylori was also characterized in these samples by the PCR-DGGE method. Multidrug resistance phenotypes (87.5 %) and resistance to third- and fourth-generation cephalosporins and quinolones were common in these strains, which could evolve through their selection by bile components. Ability for biofilm formation seems to be a need for polymicrobial infection in this organ. PMID:27193890

  9. A Study of Exocrine Pancreatic Function by Pancreatic Function Diagnostant (PFD) on Cancer of Pancreas and Biliary Tract

    OpenAIRE

    Kodama, Motomu; Tanaka, Tsuneo; Seikoh, Rokuro; Takeuchi, Hitoshi; Harada, Mitsuo; Itoh, Nobuaki; Kodama, Osamu; Ezaki, Haruo

    1983-01-01

    Since 1976, the authors administered the test meal PFD to patients mainly with pancreatic diseases in order to know the changes in the exocrine function of the remaining part of the pancreas. In the present study, investigation was made on the usefulness of PFD in the cases undergoing surgery for pancreatic and biliary cancers, according to the sites of cancers. Urinary PABA in 6-hour urine showed low levels in the cases of pancreatic head cancers and ampullary cancers, and their excretion pa...

  10. Endo-biliary stents for benign disease: not always benign after all!

    Directory of Open Access Journals (Sweden)

    Jo-Etienne Abela

    2011-11-01

    Full Text Available This case report describes the presentation, management and treatment of a patient who suffered small bowel perforation due to the migration of his biliary stent which had been inserted for benign disease.

  11. Treatment of malignant stenosis of biliary tract with introduction of percutaneous selfexpandible metallic stent

    International Nuclear Information System (INIS)

    On a case of a female patients with malignant biliary stenosis the author presents his first experiences with selfexpandible metallic stent. The main indications of percutaneous insertion of stents are inoperable malignant biliary stenoses. In this case, there was an inoperable ventricular carcinoma with metastatic involvement of porta hepatitis and left lobe of the liver with extrahepatic bile duct stenosis, diagnosed by ERCP (endoscopic retrograde cholangio-pancreaticography) USG (ultrasonography) and PTC (percutaneous transhepatic cholangiography). Despite of repeated attempts the endoscopic internal drainage has failed. Because of malignant jaundice - PTC had been performed and just then, PTBD (percutaneous transhepatic biliary drainage) without direst communication between the biliary tree and duodenum. Twelve days after the procedure we performed an external-internal (combinated) drainage by pushing the catheter to duodenum and thus - outflow of bile to the duodenum was secured even throughout the extrahepatic portion of the bile duct. Ten days later, after these initial drainage procedures a selfexpendible metallic stent has been inserted into the extrahepatic bile duct and sufficient drainage to duodenum has been reached. (author)

  12. Chlamydia and Male Lower Urinary Tract Diseases

    OpenAIRE

    Lee, Young-Suk; Lee, Kyu-Sung

    2013-01-01

    Of the chlamydia species that can cause infections in humans, C. trachomatis is responsible for lower urinary tract diseases in men and women. C. trachomatis infections are prevalent worldwide, but current research is focused on females, with the burden of disease and infertility sequelae considered to be a predominantly female problem. However, a role for this pathogen in the development of male urethritis, epididymitis, and orchitis is widely accepted. Also, it can cause complications such ...

  13. Feasibility of gemcitabine and oxaliplatin in patients with advanced biliary tract carcinoma and a performance status of 2.

    Science.gov (United States)

    Mir, Olivier; Coriat, Romain; Dhooge, Marion; Perkins, Géraldine; Boudou-Rouquette, Pascaline; Brezault, Catherine; Ropert, Stanislas; Durand, Jean-Philippe; Chaussade, Stanislas; Goldwasser, François

    2012-08-01

    The use of gemcitabine and oxaliplatin is well documented in selected patients with advanced biliary tract carcinoma (BTC), but little is known on the feasibility of systemic treatments in patients with a performance status (PS) of 2. We retrospectively examined the medical records of consecutive BTC patients with a PS of 2 receiving gemcitabine 1000 mg/m(2) plus oxaliplatin 100 mg/m(2) every 2 weeks from January 2003 to December 2011 in our institution. Body composition was analysed by computed tomography scan to detect sarcopenia. The primary evaluation criterion was safety. The secondary evaluation criteria were the response rate, progression-free survival (PFS) and overall survival (OS). Twenty-eight patients (median age: 63 years, range 41-83) received a total of 175 cycles (median per patient: 6, range 2-12). Ten patients (35.7%) had sarcopenia on the pretreatment computed tomography scan. The most frequent toxicities were thrombocytopenia (grades 2-4: n=4, 14.3%), peripheral neuropathy (grades 2-3: n=9, 32.1%) and cholangitis (n=4, 14.3%). The best response was a partial response in 10.7% of patients [95% confidence interval (CI): 0-22.2] and stable disease in 42.9% of patients. The median PFS and OS were 4.6 (95% CI: 2.5-6.3) and 7.5 (95% CI: 5.2-9.5) months, respectively. The median PFS and OS were significantly longer in patients without sarcopenia: 7.0 months (95% CI: 4.4-8.0) vs. 2.2 months (95% CI: 2.0-2.5), P less than 0.01, and 10.4 months (95% CI: 7.5-11.6) vs. 4.9 months (95% CI: 3.7-5.2), P less than 0.01, respectively. In our experience, gemcitabine-oxaliplatin was feasible and induced effective palliation in PS2 patients with advanced BTC. Further studies are warranted to confirm these findings. PMID:22700002

  14. Gemcitabine-based versus fluoropyrimidine-based chemotherapy with or without platinum in unresectable biliary tract cancer: a retrospective study

    Directory of Open Access Journals (Sweden)

    Im Seock-Ah

    2008-12-01

    Full Text Available Abstract Background There is no standard palliative chemotherapy regimen in biliary tract cancers (BTC. Fluoropyrimidine or gemcitabine, with or without platinum, are most frequently used. We conducted this study to clarify the efficacy of palliative chemotherapy in BTC. Methods Patients with unresectable BTC treated with palliative chemotherapy between Oct 2001 and Aug 2006 at Seoul National University Hospital were reviewed retrospectively. Histologically confirmed cases of intrahepatic cholangiocarcinoma, gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater carcinoma were enrolled. We analyzed the efficacy of regimens: gemcitabine (G versus fluoropyrimidine (F and with or without platinum (P. Results A total of 243 patients were enrolled. 159 patients (65% were male and the median age of the patients was 60 years (range 26–81. Intrahepatic cholangiocarcinoma, gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater carcinoma were 92, 72, 58, and 21 cases, respectively. The median progression free survival (PFS was 4.3 months (95% CI, 3.7–4.9 and median overall survival (OS was 8.7 months (95% CI, 7.4–10.0. Ninety-nine patients received G-based chemotherapy (94 GP, 5 G alone, and 144 patients received F-based chemotherapy (83 FP, 61 F alone. The response rate (RR, disease control rate (DCR, PFS and OS of G-based chemotherapy versus F-based chemotherapy were 16.7% vs. 19.5% (P = 0.591, 52.8% vs. 58.9% (P = 0.372, 4.0 months vs. 4.3 months (P = 0.816, and 7.8 months vs. 9.1 months (P = 0.848, respectively. Sixty-six patients received F or G without P, and 177 patients received F or G with P. The RR, DCR, PFS and OS of chemotherapy without P versus chemotherapy including P were 12.7% vs. 20.6% (P = 0.169, 46.0% vs. 60.6% (P = 0.049, 3.3 months vs. 4.4 months (P = 0.887, and 10.6 months vs. 8.1 months (P = 0.257, respectively. Conclusion In unresectable BTC, F-based and G-based chemotherapy showed similar

  15. Gastrointestinal tract modelling in health and disease

    Institute of Scientific and Technical Information of China (English)

    Dong-Hua Liao; Jing-Bo Zhao; Hans Gregersen

    2009-01-01

    The gastrointestinal (GI) tract is the system of organs within multi-cellular animals that takes in food, digests it to extract energy and nutrients, and expels the remaining waste. The various patterns of GI tract function are generated by the integrated behaviour of multiple tissues and cell types. A thorough study of the GI tract requires understanding of the interactions between cells, tissues and gastrointestinal organs in health and disease. This depends on knowledge, not only of numerous cellular ionic current mechanisms and signal transduction pathways, but also of large scale GI tissue structures and the special distribution of the nervous network. A unique way of coping with this explosion in complexity is mathematical and computational modelling; providing a computational framework for the multilevel modelling and simulation of the human gastrointestinal anatomy and physiology. The aim of this review is to describe the current status of biomechanical modelling work of the GI tract in humans and animals, which can be further used to integrate the physiological, anatomical and medical knowledge of the GI system. Such modelling will aid research and ensure that medical professionals benefit, through the provision of relevant and precise information about the patient's condition and GI remodelling in animal disease models. It will also improve the accuracy and efficiency of medical procedures, which could result in reduced cost for diagnosis and treatment.

  16. Biliary tract perforation following percutaneous endobiliary radiofrequency ablation: A report of two cases

    OpenAIRE

    Zhou, Chuanguo; Wei, Baojie; Gao, Kun; Zhai, Renyou

    2016-01-01

    Endobiliary radiofrequency ablation (RFA) has recently been recognized as a beneficial treatment option for malignant biliary obstruction using percutaneous or endoscopic approaches. The feasibility and safety of this method has been demonstrated in clinical studies, with pain, cholangitis and asymptomatic biochemical pancreatitis reported as relatively common complications. By contrast, hepatic coma, newly diagnosed left bundle branch block and partial liver infarction have been reported as ...

  17. Transcatheter arterial chemoembolization with gemcitabine and oxaliplatin for the treatment of advanced biliary tract cancer

    OpenAIRE

    Zhao Q.; Qian S; Zhu L; Qu XD; Zhang W; Yan ZP; Cheng JM; Liu QX; Liu R; Wang JH

    2015-01-01

    Qing Zhao,* Sheng Qian,* Liang Zhu, Xu-Dong Qu, Wei Zhang, Zhi-Ping Yan, Jie-Min Cheng, Qing-Xin Liu, Rong Liu, Jian-Hua Wang Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: The aim of this study was to determine the therapeutic efficacy and safety of transarterial chemoembolization (TACE) with gemcitabine and oxaliplatin in patients with advanced biliary tra...

  18. An Unusual Presentation of Biliary Ascariasis

    OpenAIRE

    Arsad Bashir Khan, Sanjay Kumar Bhasin, Rajesh Kumar Bhagat, R. K. Chrungoo

    2007-01-01

    Ascariasis is one of the most common disease in human being worldwide. Ascariasis is 2nd to gall stone asa cause of biliary symptoms. The invasion of biliary tract by round worms during early post operativeperiod is an infrequent but serious complication. We present 42 years old man operated for cholelithiasiswith Choledocholthiasis on whom choledochotomy and T -Tube insertion was done. On 5th postoperativeday Ascaris extruded peri-T-Tube and immediate T - Tube cholangiogram done that showed ...

  19. Reality named endoscopic ultrasound biliary drainage

    OpenAIRE

    Guedes, Hugo Gonçalo; Lopes, Roberto Iglesias; de Oliveira, Joel Fernandez; Artifon, Everson Luiz de Almeida

    2015-01-01

    Endoscopic ultrasound (EUS) is used for diagnosis and evaluation of many diseases of the gastrointestinal (GI) tract. In the past, it was used to guide a cholangiography, but nowadays it emerges as a powerful therapeutic tool in biliary drainage. The aims of this review are: outline the rationale for endoscopic ultrasound-guided biliary drainage (EGBD); detail the procedural technique; evaluate the clinical outcomes and limitations of the method; and provide recommendations for the practicing...

  20. Outcomes of liver transplantation for end-stage biliary disease: A comparative study with end-stage liver disease

    OpenAIRE

    Lai, Yan-Hua; Duan, Wei-Dong; Yu, Qiang; Ye, Sheng; Xiao, Nian-Jun; Zhang, Dong-Xin; Huang, Zhi-Qiang; Yang, Zhan-Yu; Dong, Jia-hong

    2015-01-01

    AIM: To evaluate the outcomes of patients with end-stage biliary disease (ESBD) who underwent liver transplantation, to define the concept of ESBD, the criteria for patient selection and the optimal operation for decision-making.

  1. A prospective, comparative study of magnetic resonance cholangipancreatography and direct cholangiography in the diagnosis of biliary diseases

    International Nuclear Information System (INIS)

    To assess the sensitivity and specificity of magnetic resonance cholangiopancreatography (MRCP) as a noninvasive diagnostic technique, comparing it with endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTHC) in the diagnosis of biliary disease, focusing particularly on patients with choledocholithiasis. Between June 1997 and february 1998, 109 patients referred by the Corporacio Sanitaria del Parc Tauli and the Hospital Mutua de terrasa in Barcelona, Spain were evaluated. MRCP and ERCP or PTHC were performed in every case, always in that order and separated by a maximum of 7 days. Twenty-four patients were excluded from the study for different reasons, leaving a series of 85 patients. All the studies were performed with a 1-Tesla Siemens Magneton Impact Expert using half-fourier single-short turbo spin-echo (HASTE) and rapid acquisition with relaxation enhancement (RARE) methods in several coronal and axial planes. The MRCP readings were carried out by consensus by two radiologists who are experts in the assessment of diseases of the digestive tract. In this series of 85 patients; MCRP showed a sensitivity of 98.4%, a specificity of 94.7%, a positive predictive value of 98.4% and a negative predictive value of 94.7% for the detection of biliary diseases. For the detection choledocholithiasis, these values were 100%, 89.5%, 88% and 100%, respectively. MRCP is extremely reliable in the diagnosis of biliary diseases, especially in cases of choledocholithiasis. Its high negative predictive value obviates the need for other invasive diagnostic tests. (Author) 30 refs

  2. Animal experimental study of percutaneous transhepatic cholangiogastric drainage for the management of biliary tract obstruction

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility, safety and efficacy of percutaneous transhepatic cholangio-gastric drainage (PTCGD) for the management of obstructive jaundice, especially, for the refractory cases. Methods: The ligations of common bile ducts were performed in 20 healthy pigs, including 9 males and 11 females. They were randomly divided into two groups after 14 days of ligation. Group A (n=10) underwent PTCGD, and Croup B (n=10) served as control group (without management). Liver function, including TBIL, DBIL, ALT and ALB in plasma; and furthermore with CT of liver were carried out in different period for comparison between the 2 groups consisting those before and after the ligation. The changes were demonstrated on CT and the pathology was investigated through hematoxylin and eosin stain under microscopy. Results: The technical success rate reached 100% in Group A, with complications occurred mainly of biliary hemobilia and fever. TBIL,DBIL and ALT continuously increased after the ligation but obviously decreased after PTCGD, with rebuilt of the damaged liver tissue. On the contrary, all animals in Group B died on the 23 rd to 32nd day after the ligation of common bile duct. The mean survival time was 28.3 days. TBIL, DBIL and ALT continuously increased from ligation until death. The intra-and extra-hepatic ducts were obviously dilated on the cholangiograms. Severe necrosis of hepatic cells and bile stasis of infra-lobule biliary ducts appeared under microscopy. Conclusions: PTCGD is a safe, microinvasive and effective palliative therapy for biliary obstruction, especially the refractory cases in the experimental animals. (authors)

  3. Congenital absence of the common bile duct: A rare anomaly of extrahepatic biliary tract.

    Science.gov (United States)

    Mittal, Tarun; Pulle, Mohan V; Dey, Ashish; Malik, Vinod K

    2016-01-01

    Congenital absence of the common bile duct (CBD) is an extremely rare developmental anomaly with right and left hepatic ducts draining directly into the gallbladder (GB). Other synonyms for this clinical condition are "cholecystohepatic ducts", "transverse lie of the GB" or "interposition of the GB". The potential for iatrogenic injury is high, because of either inadvertent division or ligation of the ducts. Diagnosis is mostly made intraoperatively, and needs some form of biliary reconstruction. Herein, we are reporting a case of congenital absence of the CBD in a 36-year-old lady that was detected intraoperatively. PMID:27279403

  4. Current Status of Biliary Metal Stents.

    Science.gov (United States)

    Nam, Hyeong Seok; Kang, Dae Hwan

    2016-03-01

    Many advances have been achieved in biliary stenting over the past 30 years. Endoscopic stent placement has become the primary management therapy to relieve obstruction in patients with benign or malignant biliary tract diseases. Compared with plastic stents, a self-expandable metallic stent (SEMS) has been used for management in patients with malignant strictures because of a larger lumen and longer stent patency. Recently, SEMS has been used for various benign biliary strictures and leaks. In this article, we briefly review the characteristics of SEMS as well as complications of stent placement. We review the current guidelines for managing malignant and benign biliary obstructions. Recent developments in biliary stenting are also discussed. PMID:26911896

  5. Current Status of Biliary Metal Stents

    Science.gov (United States)

    Nam, Hyeong Seok; Kang, Dae Hwan

    2016-01-01

    Many advances have been achieved in biliary stenting over the past 30 years. Endoscopic stent placement has become the primary management therapy to relieve obstruction in patients with benign or malignant biliary tract diseases. Compared with plastic stents, a self-expandable metallic stent (SEMS) has been used for management in patients with malignant strictures because of a larger lumen and longer stent patency. Recently, SEMS has been used for various benign biliary strictures and leaks. In this article, we briefly review the characteristics of SEMS as well as complications of stent placement. We review the current guidelines for managing malignant and benign biliary obstructions. Recent developments in biliary stenting are also discussed. PMID:26911896

  6. Prospective study of periostitis and finger clubbing in primary biliary cirrhosis and other forms of chronic liver disease.

    OpenAIRE

    Epstein, O; Dick, R; Sherlock, S

    1981-01-01

    The association of finger clubbing and periostitis has been reported in primary biliary cirrhosis and, more rarely, in other forms of chronic liver disease. The prevalence of periostitis and its relationship to finger clubbing is unknown. In this prospective study, we have determined the prevalence of periostitis and finger clubbing in 74 patients with primary biliary cirrhosis and 54 with other forms of chronic liver disease. Clubbing was present in 24% of patients with primary biliary cirrh...

  7. Prion diseases and the gastrointestinal tract.

    Science.gov (United States)

    Davies, G A; Bryant, Adam R; Reynolds, John D; Jirik, Frank R; Sharkey, Keith A

    2006-01-01

    The gastrointestinal (GI) tract plays a central role in the pathogenesis of transmissible spongiform encephalopathies. These are human and animal diseases that include bovine spongiform encephalopathy, scrapie and Creutzfeldt-Jakob disease. They are uniformly fatal neurological diseases, which are characterized by ataxia and vacuolation in the central nervous system. Although they are known to be caused by the conversion of normal cellular prion protein to its infectious conformational isoform (PrPsc) the process by which this isoform is propagated and transported to the brain remains poorly understood. M cells, dendritic cells and possibly enteroendocrine cells are important in the movement of infectious prions across the GI epithelium. From there, PrPsc propagation requires B lymphocytes, dendritic cells and follicular dendritic cells of Peyer's patches. The early accumulation of the disease-causing agent in the plexuses of the enteric nervous system supports the contention that the autonomic nervous system is important in disease transmission. This is further supported by the presence of PrPsc in the ganglia of the parasympathetic and sympathetic nerves that innervate the GI tract. Additionally, the lymphoreticular system has been implicated as the route of transmission from the gut to the brain. Although normal cellular prion protein is found in the enteric nervous system, its role has not been characterized. Further research is required to understand how the cellular components of the gut wall interact to propagate and transmit infectious prions to develop potential therapies that may prevent the progression of transmissible spongiform encephalopathies. PMID:16432555

  8. Colloid Carcinoma of the Extrahepatic Biliary Tract with Metastatic Lymphadenopathy Mimicking Cystic Neoplasm: A Case Report

    International Nuclear Information System (INIS)

    The patient is a previously healthy 52-year-old woman who presented with dyspepsia for two months. Multiple imaging modalities including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) showed diffuse bile duct dilatation with an obstructive lesion of the distal extrahepatic biliary duct (EHD) as well as two masses in the peripancreatic area. The peripancreatic masses appeared cystic with posterior acoustic enhancement on ultrasound, low density on CT imaging, and high signal intensity on T2-weighted MRI. The lesion in the distal EHD exhibited similar characteristics on CT and MRI. A Whipple procedure was performed and histological specimens showed malignant cells with large mucin pools that was consistent with a diagnosis of colloid carcinoma of the EHD with metastatic lymphadenopathies. Colloid carcinoma, also called mucinous carcinoma, is classified as a histologic variant of adenocarcinoma. Because the colloid carcinoma of the biliary tree is exceedingly rare, the imaging characteristics and the clinical features of colloid carcinoma remain relatively unknown. We report a case of colloid carcinoma of the common bile duct and its accompanied metastatic lymphadenopathies with characteristic imaging findings reflecting abundant intratumoral mucin pools

  9. Congenital diseases of the gastrointestinal tract.

    Science.gov (United States)

    Lentze, M

    2014-05-01

    With the rapid increase in knowledge on the genetic origin of diseases within the gastrointestinal tract the number of congenital diseases, which already manifest during childhood have drastically increased. Due to the large application of molecular genetics the number is steadily increasing. To make the access to these rare diseases fast and efficient the data base of the National Library of Medicine (Online Mendelian Inheritance of Man - OMIN) is a very helpful online tool, with which all these disease entities can be found easily (http://www.ncbi.nlm.nih.gov/omim). Detailed tables are given to find most of the congenitally inherited disease, which affect the gastrointestinal tract. A variety of congenital diarrheas with disturbances of digestion, hydrolysis, absorption and secretion is described in detail: lactose intolerance, sucrose intolerance, glucose-galactose malabsorption, fructose malabsorption, trehalase and enterokinase deficiency, congenital chloride and sodium diarrhea, congenital hypomagnesaemia, primary bile acid malabsorption, acrodermatitis enteropathica and Menke's syndrome. Also described in detail are diseases with structural anomalies of the intestine like microvillous inclusion disease, congenital tufting enteropathy and IPEX syndrome. The diagnosis in the disturbances of carbohydrate hydrolysis or absorption can be established by H2-breath tests after appropriate sugar challenge. Treatment consists of elimination of the responsible sugar from the diet. The diagnosis of the congenital secretory diarrheas is established by investigation of electrolytes in blood and stool. Substitution of high doses of the responsible mineral can improve the clinical outcome. In acrodermatitis enteropathica low serum zinc level together with the typical skin lesions guide to the diagnosis. High doses of oral zinc aspartate can cure the symptoms of the disease. The diagnosis of structural congenital lesions of the intestine can be established by histology and

  10. Inflammatory diseases of the gall bladder and biliary system. Part I: Imaging - cholelithasis - inflammation of the gall bladder; Entzuendliche Erkrankungen der Gallenblase und der Gallenwege. Teil I: Bildgebende Verfahren - Cholelithiasis - Entzuendungen der Gallenblase

    Energy Technology Data Exchange (ETDEWEB)

    Helmberger, H. [Krankenhaus Dritter Orden Muenchen-Nymphenburg (Germany). Abteilung fuer Diagnostische und Interventionelle Radiologie/Nuklearmedizin; Kammer, B. [Haunersches Kinderspital der Ludwig-Maximilians-Universitaet Muenchen (Germany). Abteilung Paediatrische Radiologie

    2005-05-01

    Cholelithiasis is the most common affliction of the gallbladder and biliary tract. Including its complications, gallstone disease represents the basis for cholecystitis and cholangitis in the majority of cases. Inflammatory diseases of the biliary system are divided into acute and chronic forms originating from the gallbladder as well as from the biliary tract. Although acute calculous cholecystitis is the most common form, gangrenous, and emphysematous inflammation of the gallbladder as well as gallbladder empyema are included in this group of diseases. In the chronic forms, calculous and acalculous inflammation is also differentiated. Recent developments in cross-sectional imaging in sonography, computed tomography, and magnetic resonance imaging offer numerous tools for depicting the biliary system with high diagnostic accuracy. Invasive imaging modalities of the biliary system are mainly used for therapeutic aspects. (orig.) [German] Die Cholelithiasis ist die haeufigste Erkrankung von Gallenblase und Gallenwegen. Zusammen mit seinen Komplikationen stellt das Gallensteinleiden zugleich in der Mehrzahl der Faelle die Ursache entzuendlicher Erkrankungen des Gallesystems dar. Dabei wird zwischen akuten und chronischen Formen sowohl der Gallenblase als auch der Gallenwege unterschieden. Zu den akuten Cholezystitiden zaehlen neben der begleitenden Entzuendung beim Gallensteinleiden auch die gangraenoese und emphysematoese Cholezystitis sowie das Gallenblasenempyem. Auch bei den chronischen Formen werden Entzuendungen ohne und mit Steinleiden differenziert. Mit den modernen Schnittbildverfahren Sonographie, Computertomographie und Magnetresonanztomographie stehen zahlreiche Moeglichkeiten der Bildgebung des Gallensystems mit hoher diagnostischer Aussagekraft zur Verfuegung. Die Verfahren der direkten Darstellung des Gallesystems kommen hauptsaechlich im Rahmen der Therapie zum Einsatz. (orig.)

  11. Hepatic Tract Plug-Embolisation After Biliary Stenting. Is It Worthwhile?

    Energy Technology Data Exchange (ETDEWEB)

    Dale, Adam P., E-mail: adamdale@doctors.org.uk [Basingstoke and North Hampshire Hospital, Department of Medical Microbiology (United Kingdom); Khan, Rafeh, E-mail: rafeh.khan@yahoo.com; Mathew, Anup, E-mail: anup.mathew@sth.nhs.uk; Hersey, Naomi O., E-mail: Naomi.Hersey@sth.nhs.uk; Peck, Robert, E-mail: Robert.Peck@sth.nhs.uk; Lee, Frederick, E-mail: fred.lee@sth.nhs.uk [Northern General Hospital, Department of Radiology (United Kingdom); Goode, Stephen D., E-mail: S.Goode@sheffield.ac.uk [Northern General Hospital, Sheffield Vascular Institute (United Kingdom)

    2015-10-15

    PurposePTC and stenting procedures are associated with significant risks including life-threatening haemorrhage, sepsis, renal failure and high mortality rates. PTC tract closure methods are utilised to reduce haemorrhagic complications despite little evidence to support their use. The current study assesses the incidence of haemorrhagic complications following PTC and stenting procedures, both prior to and following the introduction of a dedicated expanding gelatin foam-targeted embolisation liver tract closure technique.Materials and MethodsHaemorrhagic complications were retrospectively identified in patients undergoing PTC procedures both prior to (subgroup 1) and following (subgroup 2) the introduction of a dedicated targeted liver tract closure method between 9/11/2010 and 10/08/2012 in a single tertiary referral centre. Mean blood Hb decrease following PTC was established in subgroups 1 and 2. Kaplan–Meier life-table analysis was performed to compare survival outcomes between subgroups using the log-rank test.ResultsHaemorrhagic complications were significantly reduced following the introduction of the targeted PTC tract closure method [(12 vs. 3 % of subgroups 1 (n = 101) and 2 (n = 92), respectively (p = 0.027)]. Mean blood Hb decrease following PTC was 1.40 versus 0.68 g/dL in subgroups 1 and 2, respectively (p = 0.069). 30-day mortality was 14 and 12 % in subgroups 1 and 2, respectively. 50 % of the entire cohort had died by 174 days post-PTC.ConclusionIntroduction of liver tract embolisation significantly reduced haemorrhagic complications in our patient cohort. Utilisation of this method has the potential to reduce the morbidity and mortality burden associated with post-PTC haemorrhage by preventing bleeding from the liver access tract.

  12. Hepatic Tract Plug-Embolisation After Biliary Stenting. Is It Worthwhile?

    International Nuclear Information System (INIS)

    PurposePTC and stenting procedures are associated with significant risks including life-threatening haemorrhage, sepsis, renal failure and high mortality rates. PTC tract closure methods are utilised to reduce haemorrhagic complications despite little evidence to support their use. The current study assesses the incidence of haemorrhagic complications following PTC and stenting procedures, both prior to and following the introduction of a dedicated expanding gelatin foam-targeted embolisation liver tract closure technique.Materials and MethodsHaemorrhagic complications were retrospectively identified in patients undergoing PTC procedures both prior to (subgroup 1) and following (subgroup 2) the introduction of a dedicated targeted liver tract closure method between 9/11/2010 and 10/08/2012 in a single tertiary referral centre. Mean blood Hb decrease following PTC was established in subgroups 1 and 2. Kaplan–Meier life-table analysis was performed to compare survival outcomes between subgroups using the log-rank test.ResultsHaemorrhagic complications were significantly reduced following the introduction of the targeted PTC tract closure method [(12 vs. 3 % of subgroups 1 (n = 101) and 2 (n = 92), respectively (p = 0.027)]. Mean blood Hb decrease following PTC was 1.40 versus 0.68 g/dL in subgroups 1 and 2, respectively (p = 0.069). 30-day mortality was 14 and 12 % in subgroups 1 and 2, respectively. 50 % of the entire cohort had died by 174 days post-PTC.ConclusionIntroduction of liver tract embolisation significantly reduced haemorrhagic complications in our patient cohort. Utilisation of this method has the potential to reduce the morbidity and mortality burden associated with post-PTC haemorrhage by preventing bleeding from the liver access tract

  13. Interventional treatment of biliary stent restenosis: recent progress in clinical management

    International Nuclear Information System (INIS)

    Malignant obstructive jaundice is biliary obstruction disorders which are caused by various malignant tumors. Usually the disease is at its advanced stage and is inoperable when the diagnosis is confirmed. At present, percutaneous transhepatic biliary drainage (PTCD) and endoscopic or interventional implantation of plastic or self-expanding metal stent (SEMS) are the main managements in clinical practice. Due to the improved survival time, biliary stent restenosis has become a quite common clinical problem. Photodynamic therapy (PDT) and biliary tract radiofrequency ablation (RFA) have provided new therapeutic means for clinical use. Especially, with its development in technology and equipment, RFA has played more and more important role in treating biliary stent restenosis. (authors)

  14. Personalized peptide vaccination for advanced biliary tract cancer: IL-6, nutritional status and pre-existing antigen-specific immunity as possible biomarkers for patient prognosis

    OpenAIRE

    Yoshitomi, Munehiro; Yutani, Shigeru; Matsueda, Satoko; IOJI, TETSUYA; Komatsu, Nobukazu; SHICHIJO, SHIGEKI; Yamada, Akira; ITOH, KYOGO; SASADA, TETSURO; Kinoshita, Hisafumi

    2011-01-01

    Considering that the prognosis of patients with advanced biliary tract cancer (BTC) remains very poor, with a median survival of less than 1 year, new therapeutic approaches need to be developed. In the present study, a phase II clinical trial of personalized peptide vaccination (PPV) was conducted in advanced BTC patients to evaluate the feasibility of this treatment and to identify potential biomarkers. A maximum of 4 human leukocyte antigen-matched peptides, which were selected based on th...

  15. Glycemic index, glycemic load, dietary carbohydrate, and dietary fiber intake and risk of liver and biliary tract cancers in Western Europeans

    Science.gov (United States)

    Fedirko, V.; Lukanova, A.; Bamia, C.; Trichopolou, A.; Trepo, E.; Nöthlings, U.; Schlesinger, S.; Aleksandrova, K.; Boffetta, P.; Tjønneland, A.; Johnsen, N. F.; Overvad, K.; Fagherazzi, G.; Racine, A.; Boutron-Ruault, M. C.; Grote, V.; Kaaks, R.; Boeing, H.; Naska, A.; Adarakis, G.; Valanou, E.; Palli, D.; Sieri, S.; Tumino, R.; Vineis, P.; Panico, S.; Bueno-de-Mesquita, H. B(as).; Siersema, P. D.; Peeters, P. H.; Weiderpass, E.; Skeie, G.; Engeset, D.; Quirós, J. R.; Zamora-Ros, R.; Sánchez, M. J.; Amiano, P.; Huerta, J. M.; Barricarte, A.; Johansen, D.; Lindkvist, B.; Sund, M.; Werner, M.; Crowe, F.; Khaw, K. T.; Ferrari, P.; Romieu, I.; Chuang, S. C.; Riboli, E.; Jenab, M.

    2013-01-01

    Background The type and quantity of dietary carbohydrate as quantified by glycemic index (GI) and glycemic load (GL), and dietary fiber may influence the risk of liver and biliary tract cancers, but convincing evidence is lacking. Patients and methods The association between dietary GI/GL and carbohydrate intake with hepatocellular carcinoma (HCC; N = 191), intrahepatic bile duct (IBD; N = 66), and biliary tract (N = 236) cancer risk was investigated in 477 206 participants of the European Prospective Investigation into Cancer and Nutrition cohort. Dietary intake was assessed by country-specific, validated dietary questionnaires. Hazard ratios and 95% confidence intervals were estimated from proportional hazard models. HBV/HCV status was measured in a nested case–control subset. Results Higher dietary GI, GL, or increased intake of total carbohydrate was not associated with liver or biliary tract cancer risk. For HCC, divergent risk estimates were observed for total sugar = 1.43 (1.17–1.74) per 50 g/day, total starch = 0.70 (0.55–0.90) per 50 g/day, and total dietary fiber = 0.70 (0.52–0.93) per 10 g/day. The findings for dietary fiber were confirmed among HBV/HCV-free participants [0.48 (0.23–1.01)]. Similar associations were observed for IBD [dietary fiber = 0.59 (0.37–0.99) per 10 g/day], but not biliary tract cancer. Conclusions Findings suggest that higher consumption of dietary fiber and lower consumption of total sugars are associated with lower HCC risk. In addition, high dietary fiber intake could be associated with lower IBD cancer risk. PMID:23123507

  16. Biliary tract obstruction secondary to Burkitt lymphoma; Linfoma de Burkitt associado a obstrucao de vias biliares

    Energy Technology Data Exchange (ETDEWEB)

    Mendes, Wellington L.; Bezerra, Alanna Mara P.S.; Carvalho Filho, Nevicolino P.; Coelho, Robson C. [Hospital do Cancer, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Pediatria; Soares, Fernando A. [Hospital do Cancer, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Patologia; Pecora, Marcela S. [Hospital do Cancer, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Imagem; Chapchap, Paulo [Hospital do Cancer, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Servico de Cirurgia Pediatrica

    2004-09-01

    The abdomen, in particular the ileocecal region, appendix and colon, is the most common primary site for Burkitt non Hodgkin's lymphoma (NHL). Involvement of the bile duct is rare. The authors describe a patient with abdominal NHL in which jaundice due to bile duct obstruction was the first clinical sign. Case report: a 3 year old white boy presented with one month of progressive jaundice, clay-colored stools, tea colored urine and increase of abdominal volume. Physical examination showed jaundice 3+/4+ and pale mucosa. The abdomen was moderately distended and timpanous and the liver was enlarged. Laboratory examinations confirmed cholestasis with total bilirubin of 8.2 mg/dl (direct bilirubin of 7.8 mg/dl), and microcytic and hypochromic anemia. Ultrasonography (US) and abdominal CT showed two solid tumors in hepatic hilar topography, and dilated intrahepatic biliary tree. The Doppler US showed hepatic artery and portal vein dislocation by the nodules. Comment: although jaundice occurs frequently as a late manifestation of NHL, it is rarely seen as the presenting sign. When jaundice is the first clinical sign and image studies show hepatic hilar tumor and bile duct obstruction, NHL should be considered in the differential diagnosis. (author)

  17. Phenylethyl isothiocyanate reverses cisplatin resistance in biliary tract cancer cells via glutathionylation-dependent degradation of Mcl-1

    Science.gov (United States)

    Li, Qiwei; Zhan, Ming; Chen, Wei; Zhao, Benpeng; Yang, Kai; Yang, Jie; Yi, Jing; Huang, Qihong; Mohan, Man; Hou, Zhaoyuan; Wang, Jian

    2016-01-01

    Biliary tract cancer (BTC) is a highly malignant cancer. BTC exhibits a low response rate to cisplatin (CDDP) treatment, and therefore, an understanding of the mechanism of CDDP resistance is urgently needed. Here, we show that BTC cells develop CDDP resistance due, in part, to upregulation of myeloid cell leukemia 1 (Mcl-1). Phenylethyl isothiocyanate (PEITC), a natural compound found in watercress, could enhance the efficacy of CDDP by degrading Mcl-1. PEITC-CDDP co-treatment also increased the rate of apoptosis of cancer stem-like side population (SP) cells and inhibited xenograft tumor growth without obvious toxic effects. In vitro, PEITC decreased reduced glutathione (GSH), which resulted in decreased GSH/oxidized glutathione (GSSG) ratio and increased glutathionylation of Mcl-1, leading to rapid proteasomal degradation of Mcl-1. Furthermore, we identified Cys16 and Cys286 as Mcl-1 glutathionylation sites, and mutating them resulted in PEITC-mediated degradation resistant Mcl-1 protein. In conclusion, we demonstrate for the first time that CDDP resistance is partially associated with Mcl-1 in BTC cells and we identify a novel mechanism that PEITC can enhance CDDP-induced apoptosis via glutathionylation-dependent degradation of Mcl-1. Hence, our results provide support that dietary intake of watercress may help reverse CDDP resistance in BTC patients. PMID:26848531

  18. Patterns of radiotherapy practice for biliary tract cancer in Japan: results of the Japanese radiation oncology study group (JROSG) survey

    International Nuclear Information System (INIS)

    The patterns of radiotherapy (RT) practice for biliary tract cancer (BTC) in Japan are not clearly established. A questionnaire-based national survey of RT used for BTC treatment between 2000 and 2011 was conducted by the Japanese Radiation Oncology Study Group. Detailed information was collected for 555 patients from 31 radiation oncology institutions. The median age of the patients was 69 years old (range, 33–90) and 81% had a good performance status (0–1). Regarding RT treatment, 78% of the patients were treated with external beam RT (EBRT) alone, 17% received intraluminal brachytherapy, and 5% were treated with intraoperative RT. There was no significant difference in the choice of treatment modality among the BTC subsites. Many patients with EBRT were treated with a total dose of 50 or 50.4 Gy (~40%) and only 13% received a total dose ≥60 Gy, even though most institutions (90%) were using CT-based treatment planning. The treatment field consisted of the primary tumor (bed) only in 75% of the patients. Chemotherapy was used for 260 patients (47%) and was most often administered during RT (64%, 167/260), followed by after RT (63%, 163/260). Gemcitabine was the most frequently used drug for chemotherapy. This study established the general patterns of RT practice for BTC in Japan. Further surveys and comparisons with results from other countries are needed for development and optimization of RT for patients with BTC in Japan

  19. S100A9 is a Biliary Protein Marker of Disease Activity in Primary Sclerosing Cholangitis

    Science.gov (United States)

    Ruppert, Thomas; Giese, Thomas; Flechtenmacher, Christa; Weiss, Karl Heinz; Kloeters-Plachky, Petra; Stremmel, Wolfgang; Schirmacher, Peter; Sauer, Peter; Gotthardt, Daniel Nils

    2012-01-01

    Background and Aims Bile analysis has the potential to serve as a surrogate marker for inflammatory and neoplastic disorders of the biliary epithelium and may provide insight into biliary pathophysiology and possible diagnostic markers. We aimed to identify biliary protein markers of patients with primary sclerosing cholangitis (PSC) by a proteomic approach. Methods Bile duct-derived bile samples were collected from PSC patients (n = 45) or patients with choledocholithiasis (n = 24, the control group). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed to analyse the proteins, 2-D-gel patterns were compared by densitometry, and brush cytology specimens were analysed by RT-PCR. Results A reference bile-duct bile proteome was established in the control group without signs of inflammation or maligancy comprising a total of 379 non-redundant biliary proteins; 21% were of unknown function and 24% had been previously described in serum. In PSC patients, the biliary S100A9 expression was elevated 95-fold (p<0.005), serum protein expression was decreased, and pancreatic enzyme expression was unchanged compared to controls. The S100A9 expression was 2-fold higher in PSC patients with high disease activity than in those with low activity (p<0.05). The brush cytology specimens from the PSC patients with high disease activity showed marked inflammatory activity and leukocyte infiltration compared to the patients with low activity, which correlated with S100A9 mRNA expression (p<0.05). Conclusions The bile-duct bile proteome is complex and its analysis might enhance the understanding of cholestatic liver disease. Biliary S100A9 levels may be a useful marker for PSC activity, and its implication in inflammation and carcinogenesis warrants further investigation. PMID:22253789

  20. S100A9 is a biliary protein marker of disease activity in primary sclerosing cholangitis.

    Directory of Open Access Journals (Sweden)

    Lisa Reinhard

    Full Text Available BACKGROUND AND AIMS: Bile analysis has the potential to serve as a surrogate marker for inflammatory and neoplastic disorders of the biliary epithelium and may provide insight into biliary pathophysiology and possible diagnostic markers. We aimed to identify biliary protein markers of patients with primary sclerosing cholangitis (PSC by a proteomic approach. METHODS: Bile duct-derived bile samples were collected from PSC patients (n = 45 or patients with choledocholithiasis (n = 24, the control group. Liquid chromatography-tandem mass spectrometry (LC-MS/MS was performed to analyse the proteins, 2-D-gel patterns were compared by densitometry, and brush cytology specimens were analysed by RT-PCR. RESULTS: A reference bile-duct bile proteome was established in the control group without signs of inflammation or maligancy comprising a total of 379 non-redundant biliary proteins; 21% were of unknown function and 24% had been previously described in serum. In PSC patients, the biliary S100A9 expression was elevated 95-fold (p<0.005, serum protein expression was decreased, and pancreatic enzyme expression was unchanged compared to controls. The S100A9 expression was 2-fold higher in PSC patients with high disease activity than in those with low activity (p<0.05. The brush cytology specimens from the PSC patients with high disease activity showed marked inflammatory activity and leukocyte infiltration compared to the patients with low activity, which correlated with S100A9 mRNA expression (p<0.05. CONCLUSIONS: The bile-duct bile proteome is complex and its analysis might enhance the understanding of cholestatic liver disease. Biliary S100A9 levels may be a useful marker for PSC activity, and its implication in inflammation and carcinogenesis warrants further investigation.

  1. Primary biliary cirrhosis and autoimmune cholangitis are not associated with coeliac disease in Crete

    Directory of Open Access Journals (Sweden)

    Dimoulios Philippos

    2002-03-01

    Full Text Available Abstract Background An increased prevalence of coeliac disease in patients with primary biliary cirrhosis has been recently reported. However, in other studies the association has not been confirmed. There have been no formal attempts to systematically evaluate patients with autoimmune cholangitis for coeliac disease. Methods Sera from 62 patients with primary biliary cirrhosis, 17 with autoimmune cholangitis and 100 blood donors were screened for anti-gliadin, anti-endomysial, anti-reticulin, and IgA class antibodies to guinea pig liver-derived tissue transglutaminase. Eighteen untreated coeliacs served as methodological controls. Analyses were performed by using the χ2 and Fischer's exact tests. Results Anti-gliadin antibodies were detected in 21% of patients with primary biliary cirrhosis, 35% of patients with autoimmune cholangitis, and 3% of controls (p Conclusions We were unable to demonstrate an increased risk of coeliac disease in patients with primary biliary cirrhosis and autoimmune cholangitis. Our results confirm the previously reported high prevalence of false-positive anti-gliadin and guinea pig liver-derived anti-tissue transglutaminase antibodies in patients with chronic liver disease.

  2. Evaluation of the anatomical correlation between biliary branches of the left lobe of the liver and the umbilical portion of the portal vein (UP) by CT with injection of contrast material into biliary tract

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Hiroshi; Watanabe, Kazuo [Chiba Cancer Center Hospital (Japan); Shinohara, Yasushi; Amano, Hodaka; Okazumi, Shinichi; Asano, Takehide; Isono, Kaichi; Ryu, Munemasa

    1995-12-01

    We analyzed anatomical correlation between biliary trees of the left lobe of the liver and the umbilical portion of the portal vein (UP) by CT with injection of contrast material into biliary tract through the percutaneous transhepatic biliary drainage tube (Cholangio-CT). Cholangio-CT was performed in 27 patients with obstructive jaundice. In 15 cases out of these 27 cases, left lateral superior subsegment branch (B2) and left lateral inferior subsegment branch (B3) originated in the right side of UP and ran in the cranial side of UP. In 6 cases, B2 and B3 arose in the cranial side of UP from the common duct of B2 and B3. In 5 cases, B2 and B3 arose in the left side of UP from the common duct which ran in the cranial side of UP. In one patient, B3 ran in the caudate side of UP. In 10 out of 27 cases, a bile duct branch which originated and ran in the cranial side of UP was depicted. It was not clear whether this branch belonged to medial segment branch or B3. (author).

  3. Nursing of patients with T-tube drainage after operation on biliary tract%胆道手术T管引流的护理

    Institute of Scientific and Technical Information of China (English)

    侯密群

    2012-01-01

    目的 探讨胆道手术T管引流的护理经验.方法 回顾性分析和总结204例因胆道梗阻或结石行胆道手术患者的T管引流护理要点.结果 本组204例患者中,有2例患者拔除T管后发生胆漏,经处理治愈出院;其余202例患者无1例发生T管堵塞、脱出及逆行感染等并发症.结论 做好健康宣教,妥善固定T管,保持引流通畅,观察引流液性质,做好T管周围皮肤护理、拔管前后护理,对保证T管的护理质量具有重要意义.%Objective To explore the experience of nursing the patients with T-tube drainage after operation on biliary tract. Method The nursing histories of 204 patients with T-tube drainage after operation on biliary tract because of biliary obstruction or calculus were retrospectively reviewed for concluding the nursing points. Results Among 204 patients, 2 had biliary leakage after withdrawal of T-tube, but they were cured and discharged after treatment for 3 ~ 5 days. No complication like T-tube obstruction, shedding and retroinfection occurred. Conclusion The T-tubes for drainage may be well cared and protected only if health education, T-tube fixation, unobstructed drainage, observation of drained fluids, care of the skin around the T-tube and nursing of patients at pre- and post-withdrawal of the tube are conducted.

  4. Feasibility of gadoxetate disodium-enhanced MR cholangiography in chronic cholestatic biliary disease

    International Nuclear Information System (INIS)

    Aim: To investigate the feasibility of gadoxetate disodium-enhanced magnetic resonance (MR) cholangiography in chronic obstructive cholestatic biliary disease in the clinical setting. Materials and methods: Twenty-three patients with dilated bile duct trees and ten volunteers underwent gadoxetate disodium-enhanced liver MR cholangiography and were enrolled in the present retrospective study. Gadoxetate disodium was given in a standardized manner as a bolus injection at a dose of 0.25 mmol/kg of body weight (0.1 ml/kg). Region of interest-based measurement of mean enhancement of the dilated bile ducts was performed in series before gadoxetate disodium administration and during hepatobiliary phases. Results: Direct comparison of mean bile duct enhancement during hepatobiliary phases in the clinical imaging window between healthy volunteers [4.7 ± 2.2 arbitrary units (au)] and patients with dilated bile ducts (0.1 ± 0.3 au) revealed significantly lower or absent enhancement in dilated bile ducts (p = 0.001). Conclusion: Standard clinical gadoxetate disodium-enhanced MR cholangiography is not a reliable technique for the evaluation of the biliary trees, because of altered biliary gadoxetate disodium elimination in patients with chronic obstructive biliary diseases. - Highlights: • Biliary excretion of gadoxetic disodium is impaired in subjects with chronic central or segmental bile duct obstruction. • MR cholangiography using gadoxetic disodium is not feasible in patients with chronic cholestatic bile duct disease. • Gadoxetic disodium enhanced MRI is a potential biomarker to measure hepatobiliary transporter function

  5. Percutaneous Cholangioscopy in the Management of Biliary Disease: Experience in 25 Patients

    International Nuclear Information System (INIS)

    Purpose: To present our experience performing percutaneous cholangioscopy in the management of 25 patients with biliary disease.Methods: During the last 3 years, 26 percutaneous cholangioscopies were performed in 25 patients with common bile duct disease (n = 16), intrahepatic ducts disease (n = 6), and gallbladder disease (n = 4). Our patient population group included seven with common bile duct stones, three with intrahepatic lithiasis, and eight with benign strictures (six iatrogenic and two postinflammatory). In four patients malignancy was to be excluded, in two the tumor extent was to be evaluated, whereas in one case the correct placement of a metallic stent needed to be controlled. A 9.9 Fr flexible endoscope URF-P (Olympus, 1.2 mm working channel, 70-cm length) was used.Results: In total, percutaneous cholangioscopy answered 30 diagnostic questions, was technically helpful in 19 cases (performing lithotripsy or biopsy or guiding a wire), and of therapeutic help in 12 (performing stone retrieval). In 24 of 26 cases the therapeutic decision and the patient management changed because of the findings or because of the help of the method. In two cases biliary intervention failed to treat the cause of the disease. No major complication due to the use of the endoscopy was noted.Conclusions: Percutaneous cholangioscopy is a very useful tool in the management of patients with biliary disease. The method can help in diagnosis, in performing complex interventional procedures, and in making or changing therapeutic decisions

  6. State of the art of radiological diagnostics of the biliary tract

    International Nuclear Information System (INIS)

    Apart from cholegraphy with contrast media, sonography has shown the best results so far for diagnoses of epigastric diseases. Initial results of computerized tomography have shown that this method can give supplementary information especially in tumour cases. For investigations of occlusion symptoms, the invasive methods of ERCP and PTC are available after sequential scintiscanning. (orig.)

  7. Biliary diseases in heart transplanted patients: a comparison between cyclosporine a versus tacrolimus-based immunosuppression

    Directory of Open Access Journals (Sweden)

    Stief J

    2009-05-01

    Full Text Available Abstract A cyclosporine (CsA-based immunosuppression is associated with an increased incidence of cholelithiasis after heart transplantation. It is not known if tacrolimus (Tac has comparable biliary side effects in humans. We evaluated the incidence of gallbladder sludge and cholelithiasis under Tac-based immunosuppression by ultrasound examinations in 31 cardiac transplants (25 male, 6 female, mean age: 59 ± 11 years. Data were compared to 57 patients (47 male, 10 female, mean age: 58 ± 11 years who received CsA-based immunosuppression. 6 patients receiving Tac and 6 patients receiving CsA had already gallstones prior to transplantation so that finally 25 patients of the Tac group and 51 patients of the CsA group could be evaluated. In the Tac group the incidence of biliary sludge was 4% (1 of 25, of gallstones 28% (7 of 25. In comparison, patients receiving CsA developed biliary sludge in also 4% (2 of 51 and gallstones in 25% (13 of 51. Nine of 42 males in the CsA group (21% and eight of 20 males in the Tac group (40% developed either gallstones or sludge (n.s. Six of nine females in the CsA group (67%, but none of five females in the Tac group (0% developed either gallstones or sludge (p = 0.01. In summary, the incidence of biliary disease in patients with Tac is comparable with CsA-based immunosuppression. We recommend regular sonographical examinations to detect biliary diseases as early as possible. In cases of clinically, laboratory and sonographical signs of cholecystitis cholecystectomy is indicated. It seems that towards lithogenicity female patients benefit more from a Tac-based treatment because the occurrence of gallstones is rare.

  8. Biomechanics of the Gastrointestinal Tract in Health and Disease

    DEFF Research Database (Denmark)

    Zhao, Jingbo; Liao, Donghua; Gregersen, Hans

    2010-01-01

    The gastrointestinal (GI) tract is functionally subjected to dimensional changes. Hence, biomechanical properties such as the stress-strain relationships are of particularly importance. These properties vary along the normal GI tract and remodel in response to growth, aging and disease. The biome...

  9. Serum and pancreatic juice carcinoembryonic antigen in pancreatic and biliary disease.

    OpenAIRE

    Carr-Locke, D L

    1980-01-01

    Serum and pancreatic juice carcinoembryonic antigen (CEA) concentrations were studied in a group of 144 patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) with a variety of benign and malignant pancreatic and biliary diseases. Serum CEA was found to be a poor diagnostic and discriminating marker for pancreatic disorders and was raised in obstructive jaundice from various causes correlating with serum alkaline phosphatase. A pancreatic juice CEA concentration of greater ...

  10. Tumour-associated trypsin inhibitor, TATI, in patients with pancreatic cancer, pancreatitis and benign biliary diseases.

    OpenAIRE

    Haglund, C.; Huhtala, M L; Halila, H.; Nordling, S.; Roberts, P. J.; Scheinin, T. M.; Stenman, U H

    1986-01-01

    The serum and urine concentrations of a tumour-associated trypsin inhibitor, TATI, were determined by radioimmunoassay in patients with pancreatic cancer and with benign pancreatic and biliary diseases. Elevated serum levels (greater than 20 micrograms l-1) were found in 85% of the patients with pancreatic cancer, and elevated urine levels (greater than 50 micrograms g-1 creatinine) in 96% of the patients. Thus low TATI level, especially in urine, makes the possibility of pancreatic cancer le...

  11. Novel therapeutics for primary biliary cholangitis: Toward a disease-stage-based approach.

    Science.gov (United States)

    Mousa, Hani S; Carbone, Marco; Malinverno, Federica; Ronca, Vincenzo; Gershwin, M Eric; Invernizzi, Pietro

    2016-09-01

    Primary biliary cholangitis (PBC; previously "primary biliary cirrhosis") is a cholestatic, putatively autoimmune-mediated liver disease with a clear female preponderance affecting the intrahepatic small and medium-size bile ducts and resulting in bile duct destruction, ductopenia and portal fibrosis that progresses slowly to biliary cirrhosis. Despite suboptimal response in one third of patients treated with ursodeoxycholic acid (UDCA), this remains the only FDA-approved agent for this disease. In this review, we cover recent advances in research that have yielded numerous agents currently at different stages of the drug pipeline, some of which are expected to be approved in the near future. We also discuss accumulating evidence supporting the use of older agents (fibrates and glucocorticoids) as an adjunctive therapy to UDCA in non-responsive patients. We suggest that with the imminent expansion of the therapeutic armamentarium for PBC, a more comprehensive approach - ideally taking into account not only biochemical markers of disease stage - is needed to better select patients in whom these strategies might be most useful. Studies are also needed to compare the relative efficacy of different proposed second-line treatments not only against UDCA monotherapy. PMID:27393766

  12. Pathologic relations and diagnostic difficulties of biliary and pancreatic diseases in patients after gastric surgery

    International Nuclear Information System (INIS)

    The authors studied the diagnostic possibilities of biliary and pancreatic diseases in patients after different types of operation of the stomach. In theses cases, too, ERCP and PTC are suitable methods of examination. The authors studied 28 patients after gastric surgery: Billroth I gastrectomy: 6 cases, Billroth II gastrectomy: 21 cases and gastroenterostomy without gastrectomy: 1 case. Technical difficulties in connection with ERCP arose only with patients after Billroth II gastrectomy and the examination was successful in 67% only of the patients. The rate of successful examination of the bile duct system can be improved with the help of PTC. Apart from the technical difficulties, the analysis of the clinical material revealed data on the connections between gastric surgery and the development of biliary and pancreatic diseases. A few of these are well known in literature, but the traction and torsion of the duodenum during the preparation of the duodenal stumpf or gastroduodenostomy can also lead to the ductal deformity and the development of biliary and pancreatic diseases. (orig.)

  13. Targeting EGFR/HER2 pathways enhances the antiproliferative effect of gemcitabine in biliary tract and gallbladder carcinomas

    International Nuclear Information System (INIS)

    Advanced biliary tract carcinomas (BTCs) have poor prognosis and limited therapeutic options. Therefore, it is crucial to combine standard therapies with molecular targeting. In this study EGFR, HER2, and their molecular transducers were analysed in terms of mutations, amplifications and over-expression in a BTC case series. Furthermore, we tested the efficacy of drugs targeting these molecules, as single agents or in combination with gemcitabine, the standard therapeutic agent against BTC. Immunohistochemistry, FISH and mutational analysis were performed on 49 BTC samples of intrahepatic (ICCs), extrahepatic (ECCs), and gallbladder (GBCs) origin. The effect on cell proliferation of different EGFR/HER2 pathway inhibitors as single agents or in combination with gemcitabine was investigated on BTC cell lines. Western blot analyses were performed to investigate molecular mechanisms of targeted drugs. EGFR is expressed in 100% of ICCs, 52.6% of ECCs, and in 38.5% of GBCs. P-MAPK and p-Akt are highly expressed in ICCs (>58% of samples), and to a lower extent in ECCs and GBCs (<46%), indicating EGFR pathway activation. HER2 is overexpressed in 10% of GBCs (with genomic amplification), and 26.3% of ECCs (half of which has genomic amplification). EGFR or its signal transducers are mutated in 26.5% of cases: 4 samples bear mutations of PI3K (8.2%), 3 cases (6.1%) in K-RAS, 4 (8.2%) in B-RAF, and 2 cases (4.1%) in PTEN, but no loss of PTEN expression is detected. EGI-1 cell line is highly sensitive to gemcitabine, TFK1 and TGBC1-TKB cell lines are responsive and HuH28 cell line is resistant. In EGI-1 cells, combination with gefitinib further increases the antiproliferative effect of gemcitabine. In TFK1 and TGBC1-TKB cells, the efficacy of gemcitabine is increased with addiction of sorafenib and everolimus. In TGBC1-TKB cells, lapatinib also has a synergic effect with gemcitabine. HuH28 becomes responsive if treated in combination with erlotinib. Moreover, HuH28 cells are

  14. 成人活体肝移植胆道并发症的防治%Prevention and treatment of biliary tract complications following adult living donor liver transplantation

    Institute of Scientific and Technical Information of China (English)

    夏天; 马玉奎; 陈哲宇; 吴鸿; 严律南; 李波; 曾勇; 文天夫; 赵继春; 王文涛; 杨家印; 徐明清

    2008-01-01

    Objective To investigate the prevention and treatment of biliary tract complications following adult-adult living donor liver transplantation (A-A LDLT). Methods One hundred and eight patients, aged 38 (18 -63), underwent A-A LDLT, including transplantation of the right liver graft without middle hepatic vein (MHV) in 102 cases and dual graft transplantation in 6 cases (of left lobe from relative in 1 case, of right lobe + left lobe from relative in 3 cases, of right lobe from relative + cadaveric left lobe in 2 cases). Preoperative 3-dimensional computerized tomography (3D CT) and intra-operafive cholangiography were employed to reveal the state of the liver, caution was exercised to protect the peripheral vasculature of the right hepatic duct during resection. The bile duct was reconstructed by duct-to-duct (D-D) biliary anastomosis or Roux-en-Y anastomosis of the hepatic duct and jejunum (H-J). Results Twenty-four of the 108 patients (22. 2%) suffered from complications, including bile leakage (n = 4), cutting surface bile leakage (n = 1), and anastomotic biliary stricture (n=3), etc. Seven donors (6. 3%) suffered from complications too, including 2 cases of bile leakage from the remnant cut surface. All the biliary tract complications were properly managed with good outcomes, except for 1 case of recipient death. Conclusion Measures such as improvement of pre- and intra-surgical examinations and assessments, choice of appropriate approach of biliary tract reconstruction, employment of subtle operations of microscopic procedures, and timely detection and management of complications may reduce the incidence and mortality of biliary tract complications following A-A LDLT.%目的 探讨成人活体肝移植胆道并发症的防治策略.方法 回顾性分析2002年1月至2007年8月间108例成人活体肝移植胆道并发症的发生与处理,其中102例为不含肝中静脉(MHV)右半肝移植,6例双供肝移植(双亲属左半肝1

  15. Primary biliary cirrhosis associated with Graves' disease in a male patient.

    Science.gov (United States)

    Suzuki, Yuji; Ishida, Kazuyuki; Takahashi, Hiroshi; Koeda, Norihiko; Kakisaka, Keisuke; Miyamoto, Yasuhiro; Suzuki, Akiko; Takikawa, Yasuhiro

    2016-04-01

    Primary biliary cirrhosis (PBC), which predominantly affects women, has been associated with various autoimmune diseases. Although hypothyroidism accompanying PBC is well documented, the concomitance of PBC and hyperthyroidism is rare. Herein, we report the case of a 62-year-old man who was diagnosed with PBC several years after the development of Graves' disease. This is the first case of a male patient developing PBC with Graves' disease. Both serum alanine aminotransferase levels and serum thyroid hormone levels were normalized after the administration of thiamazole for Graves' disease. However, the cholestatic liver enzyme abnormalities continued, indicating that the PBC was actualized by the administration of thiamazole. After starting ursodeoxycholic acid treatment, cholestatic liver enzyme abnormalities improved. Taken together, when a cholestatic pattern of liver enzymes is observed during follow-up for Graves' disease, an association between Graves' disease and PBC should be considered as a differential diagnosis. PMID:26935935

  16. Tract specific analysis in patients with sickle cell disease

    Science.gov (United States)

    Chai, Yaqiong; Coloigner, Julie; Qu, Xiaoping; Choi, Soyoung; Bush, Adam; Borzage, Matt; Vu, Chau; Lepore, Natasha; Wood, John

    2015-12-01

    Sickle cell disease (SCD) is a hereditary blood disorder in which the oxygen-carrying hemoglobin molecule in red blood cells is abnormal. It affects numerous people in the world and leads to a shorter life span, pain, anemia, serious infections and neurocognitive decline. Tract-Specific Analysis (TSA) is a statistical method to evaluate white matter alterations due to neurocognitive diseases, using diffusion tensor magnetic resonance images. Here, for the first time, TSA is used to compare 11 major brain white matter (WM) tracts between SCD patients and age-matched healthy subjects. Alterations are found in the corpus callosum (CC), the cortico-spinal tract (CST), inferior fronto-occipital fasciculus (IFO), inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus (SLF), and uncinated fasciculus (UNC). Based on previous studies on the neurocognitive functions of these tracts, the significant areas found in this paper might be related to several cognitive impairments and depression, both of which are observed in SCD patients.

  17. The Gastrointestinal Tract Microbiota and Allergic Diseases.

    Science.gov (United States)

    Kyburz, Andreas; Müller, Anne

    2016-01-01

    The gastrointestinal (GI) tract microbiota is required for optimal digestion of foods, for the development of resistance against pathogens (termed colonization resistance), for the development of mucosa-associated lymphoid tissue, and for local as well as systemic immune homeostasis. Certain constituents of the GI tract microbiota are widely recognized as critical regulators and modulators of their host's immune response. These include bacterial members of the microbiota as well as parasitic nematodes. Immune regulation by immunomodulatory members of the GI microbiota primarily serves to subvert host antimicrobial immune defenses and promote persistent colonization, but as a side effect may prevent or suppress immunological disorders resulting from inappropriate responses to harmless antigens, such as allergy, colitis or autoimmunity. Many of the best understood GI-resident immunomodulatory species have co-evolved with their mammalian hosts for tens of thousands of years and masterfully manipulate host immune responses. In this review, we discuss the epidemiological evidence for the role of the GI tract microbiota as a whole, and of specific members, in protection against allergic and other immunological disorders. We then focus on the mechanistic basis of microbial immunomodulation, which is presented using several well-understood paradigmatic examples, that is, helminths, Helicobacter pylori, Bifidobacteria and Lactobacilli. In a final chapter, we highlight past and ongoing attempts at harnessing the immunomodulatory properties of GI microbiota species and their secreted products for intervention studies and describe the promises and limitations of these experimental approaches. The effects of pro- and prebiotics, bacterial lysates, as well as of fecal microbiota transplantation are presented and compared. PMID:27028536

  18. The increasing role of endoscopic ultrasound (EUS) in the management of pancreatic and biliary disease

    International Nuclear Information System (INIS)

    Pancreatic and biliary disease continues to have a significant impact on the workload of the National Health Service (NHS), for which there exists a multimodality approach to investigation and diagnosis. Endoscopic ultrasound (EUS) is fast becoming a fundamental tool in this cohort of patients, not only because of its ability to provide superior visualization of a difficult anatomical region, but also because of its valuable role as a problem-solving tool and ever-improving ability in an interventional capacity. We provide a comprehensive review of the benefits of EUS in everyday clinical practice

  19. Expression levels of ROS1/ALK/c-MET and therapeutic efficacy of cetuximab plus chemotherapy in advanced biliary tract cancer.

    Science.gov (United States)

    Chiang, Nai-Jung; Hsu, Chiun; Chen, Jen-Shi; Tsou, Hsiao-Hui; Shen, Ying-Ying; Chao, Yee; Chen, Ming-Huang; Yeh, Ta-Sen; Shan, Yan-Shen; Huang, Shiu-Feng; Chen, Li-Tzong

    2016-01-01

    Aberrant expression of ROS1, ALK or c-MET (RAM) is implicated in carcinogenesis and cancer drug resistance. We retrospectively evaluated the effect of RAM expression on outcomes for advanced biliary tract cancer patients, who were treated with gemcitabine plus oxaliplatin (GEMOX), with or without cetuximab, in a randomized phase II trial. RAM expression levels on archived tissue sections were scored using immunohistochemistry (IHC). Of 110 tumors with IHC staining for all three markers, 18 were RAM(high) (IHC intensity 3+ for any markers). Ninety-two tumors were RAM(low) (IHC intensity free survival (7.3 vs. 4.9 months, p = 0.026), and marginally prolonged median OS (14.1 vs 9.6 months, p = 0.056), compared to GEMOX treatment alone. Future trials of anti-EGFR inhibitors for IHCC may consider RAM expression as a patient stratification factor. PMID:27136744

  20. On the mechanical behavior of the human biliary system

    Institute of Scientific and Technical Information of China (English)

    Xiaoyu Luo; Wenguang Li; Nigel Bird; Swee Boon Chin; NA Hill; Alan G Johnson

    2007-01-01

    This paper reviews the progress made in understanding the mechanical behaviour of the biliary system.Gallstones and diseases of the biliary tract affect more than 10% of the adult population. The complications of gallstones, i.e. acute pancreatitis and obstructive jandice, can be lethal, and patients with acalculous gallbladder pain often pose diagnostic difficulties and undergo repeated ultrasound scans and oral cholecystograms. Moreover, surgery to remove the gallbladder in these patients, in an attempt to relieve the symptoms, gives variable results. Extensive research has been carried out to understand the physiological and pathological functions of the biliary system, but the mechanism of the pathogenesis of gallstones and pain production still remain poorly understood. It is believed that the mechanical factors play an essential role in the mechanisms of the gallstone formation and biliary diseases. However, despite the extensive literature in clinical studies, only limited work has been carried out to study the biliary system from the mechanical point of view. In this paper, we discuss the state of art knowledge of the fluid dynamics of bile flow in the biliary tract, the solid mechanics of the gallbladder and bile ducts, recent mathematical and numerical modelling of the system,and finally the future challenges in the area.

  1. 胆道手术中胆心反射的护理干预%Nursing Intervention of Bilicardiac Reflex in Biliary Tract Operations

    Institute of Scientific and Technical Information of China (English)

    王艳书; 赵媛

    2014-01-01

    Objective: To explore effective prevention and nursing intervention of bilicardiac reflex in biliary tract operations. Methods: Extensive studies and literature were consulted, combined with the author's own clinical nursing experience. Results:Preoperative complete physical assessment, the choice of anesthetic methods, the use of drugs, elimination of mental factors such as tension; intraoperative selection of incision, calmness of patients' nerves, good intraoperative coordination and timely and effective treatment of bilicardiac reflex were critical measures to ensure patient safety. Conclusion: Preoperative, intraoperative and postoperative comprehensive and effective nursing intervention could prevent the occurrence of the bilicardiac reflex in the biliary tract operations to a maximum degree and improve the quality of clinical care.%目的:探讨胆道手术中全面预防和及时有效处理胆心反射的护理干预措施;方法:结合自身的临床护理经验及查阅大量文献资料;结果:术前全面的身体评估、麻醉方式的选择、药物的使用、紧张等精神因素的消除;术中注意切口的选择、缓解患者的紧张情绪、良好的术中配合、及时有效的处理胆心反射是预防胆心反射保证患者生命安全的关键措施。结论:术前、术中、术后全面而有效的护理干预可以最大限度的预防胆道手术中胆心反射的发生,提高临床护理质量。

  2. Re-expression of RASSF1A by 5-Aza-CdR Induced Demethylation of the Promoter Region in Human Biliary Tract Carcinoma Cells

    Institute of Scientific and Technical Information of China (English)

    ZUO Shi; CHEN Yongjun; XU Lining; TANG Qibin; ZOU Shengquan

    2007-01-01

    Hypermethylation of the promoter region is an important mean for the transcriptional repression of a number of cancer-associated genes, and over-expression and/or increased activity of DNA methyltransferase are considered to be the main cause of promoter hypermethylation. In order to further explore the epigenetic mechanism of tumor suppressor gene RASSF1A inactivation,5-aza-2'-deoxycytidine (5-Aza-CdR), a DNA methyltransferase inhibitor, was used to treat the human biliary tract carcinoma cell line QBC-939 at the concentration of 5 μmol/L for 24 h in this study. After the chemical intervention with 5-Aza-CdR, the methylation status in the promoter region of RASSF1A gene was detected by methylation specific PCR (MS-PCR), and the expression alteration of RASSF1A mRNA and protein were observed by RT-PCR and Western Blot respectively. Following the treatment with 5-Aza-CdR, methylaiton status in the promoter region of RASSF1A gene was reversed from methylation to unmethylation. A 280 bp DNA band which represented RASS1FA expression at transcriptional level and a 40 kDa (1kDa=0.9921 ku) protein band which represented RASSF1A expression at protein level were detected by RT-PCR and Western Blot respectively in the experimental group cells and there were no corresponding bands in the control group cells. The experimental results suggest that 5-Aza-CdR can induce demethylation in the promoter region of RASSF1A. It can also reverse epigenetic transcriptional silencing caused by DNA methylation and induce the re-expression of RASSF1A in QBC-939. This study also suggest that the mechanism of RASSF1A inactivation is very closely related to the methylation of the promoter region, which may provide a new epigenetic understanding for tumor related gene inactivation and the pathogenesis of biliary tract carcinoma.

  3. Biliary complications following liver transplantation

    OpenAIRE

    Kochhar, Gursimran; Parungao, Jose Mari; Hanouneh, Ibrahim A; Parsi, Mansour A

    2013-01-01

    Biliary tract complications are the most common complications after liver transplantation. These complications are encountered more commonly as a result of increased number of liver transplantations and the prolonged survival of transplant patients. Biliary complications remain a major source of morbidity in liver transplant patients, with an incidence of 5%-32%. Post liver transplantation biliary complications include strictures (anastomotic and non-anastomotic), leaks, stones, sphincter of ...

  4. Multidetector CT and MRI in diseases of the GI tract

    International Nuclear Information System (INIS)

    With the introduction of spiral scanning then multidetector technologies, the accuracy for diagnosing digestive tract diseases with CT has been highly improved, and CT is used more and more in the evaluation of patients with suspected gastrointestinal disorders. CT is able to demonstrate both the intramural and the extra-mural components of the disease, and has a major role in the preoperative staging and the follow-up Improvements of CT protocols, such as CT-enteroclysis, or multiplanar 2D and 3D post-processing, including now techniques for 'virtual endoscopy', lead to discuss new indications in which CT could now compete with conventional X-rays series and video-endoscopy. This precise study of the digestive wall, the peri-digestive fat, the digestive tract blood supply, may be performed by MRI, under the condition of access to high level machines and standardized protocols. MR-enteroclysis and MR-virtual colonoscopy could be performed with much lower risk for the patient, in terms of radiation dose or contrast adverse effects. Endo-luminal coils should give to MR an ultra-high resolution for analysing the different layers of the gastrointestinal wall. Learning objectives: to review how to perform CT and MRI protocols for digestive tract imaging, to recognize the CT arid MR patterns of the main digestive tract diseases, to discuss the value, limits and role of CT and MR in digestive tract diseases, to discuss the potential role of CT and MR new technological developments for digestive tract imaging in the upcoming future Conclusion: CT is nowadays a modality of choice for digestive imaging. Improvements in technologies and indications, the necessary discussion of the risks and benefits for the patient should let the radiologists consider MRI in gastrointestinal disorders as an important part of the routine activity in clinical MRI. (authors)

  5. Feline Lower Urinary Tract Disease – Report of Four Cases

    Directory of Open Access Journals (Sweden)

    Ali Zohaib*, Zeeshan Taj, Awais-ur-Rehman Sial, Muhammad Ahsan Naeem and Muhammad Saqlein

    2013-01-01

    Full Text Available This report describes the lower urinary tract disease (LUTD in four male cats with two different etiologies. All animals were under three years of age and on commercial dry diet. Treatment guidelines prescribed for obstructive and non-obstructive cases were followed. This appears to be the first clinical report on feline LUTD in Pakistan.

  6. Feline Lower Urinary Tract Disease – Report of Four Cases

    OpenAIRE

    Ali Zohaib*, Zeeshan Taj, Awais-ur-Rehman Sial, Muhammad Ahsan Naeem and Muhammad Saqlein

    2013-01-01

    This report describes the lower urinary tract disease (LUTD) in four male cats with two different etiologies. All animals were under three years of age and on commercial dry diet. Treatment guidelines prescribed for obstructive and non-obstructive cases were followed. This appears to be the first clinical report on feline LUTD in Pakistan.

  7. Three-dimensional drip infusion CT cholangiography in patients with suspected obstructive biliary disease: a retrospective analysis of feasibility and adverse reaction to contrast material.

    Directory of Open Access Journals (Sweden)

    Smedby Ö

    2006-04-01

    Full Text Available Abstract Background Computed Tomography Cholangiography (CTC is a fast and widely available alternative technique to visualise hepatobiliary disease in patients with an inconclusive ultrasound when MRI cannot be performed. The method has previously been relatively unknown and sparsely used, due to concerns about adverse reactions and about image quality in patients with impaired hepatic function and thus reduced contrast excretion. In this retrospective study, the feasibility and the frequency of adverse reactions of CTC when using a drip infusion scheme based on bilirubin levels were evaluated. Methods The medical records of patients who had undergone upper abdominal spiral CT with subsequent three-dimensional rendering of the biliary tract by means of CTC during seven years were retrospectively reviewed regarding serum bilirubin concentration, adverse reaction and presence of visible contrast media in the bile ducts at CT examination. In total, 153 consecutive examinations in 142 patients were reviewed. Results Contrast media was observed in the bile ducts at 144 examinations. In 110 examinations, the infusion time had been recorded in the medical records. Among these, 42 examinations had an elevated bilirubin value (>19 umol/L. There were nine patients without contrast excretion; 3 of which had a normal bilirubin value and 6 had an elevated value (25–133 umol/L. Two of the 153 examinations were inconclusive. One subject (0.7% experienced a minor adverse reaction – a pricking sensation in the face. No other adverse effects were noted. Conclusion We conclude that drip infusion CTC with an infusion rate of the biliary contrast agent iotroxate governed by the serum bilirubin value is a feasible and safe alternative to MRC in patients with and without impaired biliary excretion. In this retrospective study the feasibility and the frequency of adverse reactions when using a drip infusion scheme based on bilirubin levels has been evaluated.

  8. Three-dimensional drip infusion CT cholangiography in patients with suspected obstructive biliary disease: a retrospective analysis of feasibility and adverse reaction to contrast material

    International Nuclear Information System (INIS)

    Computed Tomography Cholangiography (CTC) is a fast and widely available alternative technique to visualise hepatobiliary disease in patients with an inconclusive ultrasound when MRI cannot be performed. The method has previously been relatively unknown and sparsely used, due to concerns about adverse reactions and about image quality in patients with impaired hepatic function and thus reduced contrast excretion. In this retrospective study, the feasibility and the frequency of adverse reactions of CTC when using a drip infusion scheme based on bilirubin levels were evaluated. The medical records of patients who had undergone upper abdominal spiral CT with subsequent three-dimensional rendering of the biliary tract by means of CTC during seven years were retrospectively reviewed regarding serum bilirubin concentration, adverse reaction and presence of visible contrast media in the bile ducts at CT examination. In total, 153 consecutive examinations in 142 patients were reviewed. Contrast media was observed in the bile ducts at 144 examinations. In 110 examinations, the infusion time had been recorded in the medical records. Among these, 42 examinations had an elevated bilirubin value (>19 umol/L). There were nine patients without contrast excretion; 3 of which had a normal bilirubin value and 6 had an elevated value (25–133 umol/L). Two of the 153 examinations were inconclusive. One subject (0.7%) experienced a minor adverse reaction – a pricking sensation in the face. No other adverse effects were noted. We conclude that drip infusion CTC with an infusion rate of the biliary contrast agent iotroxate governed by the serum bilirubin value is a feasible and safe alternative to MRC in patients with and without impaired biliary excretion. In this retrospective study the feasibility and the frequency of adverse reactions when using a drip infusion scheme based on bilirubin levels has been evaluated

  9. GALLBLADDER (BILLARY TRACT) DISEASE IN RETT SYNDROME

    Science.gov (United States)

    Gallstone formation appears to be common in girls with Rett Syndrome (RS) and they may be affected at a young age. It is important to recognize this condition because it is a treatable cause of pain and distress. The exact cause of gallbladder disease in RS is not known. All children with gallstones...

  10. Decreased biliary excretion of cefamandole after percutaneous biliary decompression in patients with total common bile duct obstruction.

    OpenAIRE

    Levi, J U; Martinez, O V; Malinin, T I; Zeppa, R; Livingstone, A.; Hutson, D; Calhoun, P.

    1984-01-01

    The biliary penetration of cefamandole was studied in six patients with total biliary obstruction before and after placement of a transhepatic bile drainage catheter. Biliary levels of cefamandole remained depressed even when the drug was administered as late as 7 days after decompression of the biliary tract.

  11. A case of primary biliary cirrhosis complicated by Behcet's disease and palmoplantar pustulosis

    Institute of Scientific and Technical Information of China (English)

    Haruyo Iwadate; Yukio Sato; Hiromasa Ohira; Hironobu Saito; Atsushi Takahashi; Tsuyoshi Rai; Junko Takiguchi; Tomomi Sasajima; Hiroko Kobayashi; Hiroshi Watanabe

    2006-01-01

    A 46-year-old woman was diagnosed with palmoplantar pustulosis (PPP) at the Department of Dermatology,Fukushima Medical University Hospital in 2000, and was treated with ointment. However, because liver dysfunction developed in 2003, she was referred to our department, where primary biliary cirrhosis (PBC)was also diagnosed on the basis of clinical findings.One year later, at the age of 49, she developed manifestations of Behcet's disease (BD), including erythema nodosum in the lower extremities. Because she had a history of uveitis, recurrent oral ulceration was present, and the HLA typing was positive for B51, BD was additionally diagnosed. Liver function normalized within three months of the start of treatment with ursodesoxycholic acid (UDCA). This is the first case of PBC associated with BD and PPP.

  12. Outcome of stenting in biliary and pancreatic benign and malignant diseases: A comprehensive review

    OpenAIRE

    Mangiavillano, Benedetto; Pagano, Nico; Baron, Todd H.; Luigiano, Carmelo

    2015-01-01

    Endoscopic stenting has become a widely method for the management of various malignant and benign pancreatico-biliary disorders. Biliary and pancreatic stents are devices made of plastic or metal used primarily to establish patency of an obstructed bile or pancreatic duct and may also be used to treat biliary or pancreatic leaks, pancreatic fluid collections and to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis. In this review, relevant literature search and expert o...

  13. Innervation of Extrahepatic Biliary Tract, With Special Reference to the Direct Bidirectional Neural Connections of the Gall Bladder, Sphincter of Oddi and Duodenum in Suncus murinus, in Whole-Mount Immunohistochemical Study.

    Science.gov (United States)

    Yi, S-Q; Ren, K; Kinoshita, M; Takano, N; Itoh, M; Ozaki, N

    2016-06-01

    Sphincter of Oddi dysfunction is one of the most important symptoms in post-cholecystectomy syndrome. Using either electrical or mechanical stimulation and retrogradely transported neuronal dyes, it has been demonstrated that there are direct neural pathways connecting gall bladder and the sphincter of Oddi in the Australian opossum and the golden hamster. In the present study, we employed whole-mount immunohistochemistry staining to observe and verify that there are two different plexuses of the extrahepatic biliary tract in Suncus murinus. One, named Pathway One, showed a fine, irregular but dense network plexus that ran adhesively and resided on/in the extrahepatic biliary tract wall, and the plexus extended into the intrahepatic area. On the other hand, named Pathway Two, exhibiting simple, thicker and straight neural bundles, ran parallel to the surface of the extrahepatic biliary tract and passed between the gall bladder and duodenum, but did not give off any branches to the liver. Pathway Two was considered to involve direct bidirectional neural connections between the duodenum and the biliary tract system. For the first time, morphologically, we demonstrated direct neural connections between gall bladder and duodenum in S. murinus. Malfunction of the sphincter of Oddi may be caused by injury of the direct neural pathways between gall bladder and duodenum by cholecystectomy. From the viewpoint of preserving the function of the major duodenal papilla and common bile duct, we emphasize the importance of avoiding kocherization of the common bile duct so as to preserve the direct neural connections between gall bladder and sphincter of Oddi. PMID:26179953

  14. Massive infestation by Ascaris lumbricoides of the biliary tract: report of a successfully treated case Infestação maciça por Ascaris lumbricoides nas vias biliares: relato de um caso tratado com sucesso

    OpenAIRE

    Dahir Ramos de Andrade Júnior; José Abi Karam; Maria do Patrocínio Tenório Nunes Warth; Alexandre Frederico de Marca; José Jukemura; Marcel Cerqueira Cesar Machado; Antonino dos Santos Rocha

    1992-01-01

    This is a report of a 25 years old black woman from the city of São Paulo, Brazil, who developed acute obstructive cholangitis of Ascaris lumbricoides with septicemia and multiple hepatic abscesses. The patient had sickle cell trait and normal delivery 3 months ago. Massive infestation of the biliary tract by Ascaris lumbricoides was diagnosed by abdominal ultrasonography and endoscopic retrograde cholangiography. Sixty worms were removed from the common bile duct and hepatic abscesses were d...

  15. Experience of Treatment of Functional Delayed Gastric Emptying after Biliary Tract Operation%胆道术后胃功能性排空障碍治疗体会

    Institute of Scientific and Technical Information of China (English)

    白明辉; 董玉宁; 刘建洛; 宋剑锋

    2011-01-01

    To approach the diagnosis and treatment experince to the functional delayed gastric emptying(FDGE)after biliary tract operation, the clincal data of 32 cases with functional delayed gastric emptying after biliary tract operation were analyzed retrospectively. FDGE occurred in 5 to 10 days after surgery. All the 32 patients recovered after conservative treatment. The functional delayed gastric emptying after biliary tract operation belongs to functional disorders and it can be cured by non-surgical treatment.%探讨胆道术后胃功能性排空障碍的诊治经验.回顾性分析32例胆道术后胃功能性排空障碍病例.结果32例胃功能性排空障碍发生于术后5天~10天,经保守治疗后均痊愈.胆道术后胃功能性排空障碍是胃的功能性病变,经综合保守治疗是可以治愈的.

  16. Percutaneous transhepatic biliary drainage in 107 patients

    International Nuclear Information System (INIS)

    Percutaneous transhepatic biliary drainage has played a major role in treatment of patients of patients with biliary tract disease, especially obstruction by malignant disease. Percutaneous transhepatic biliary drainage was performed 128 times in 107 patients of obstructive jaundice for recent 2 years and 8 months from July, 1981 to March, 1984 at department of radiology, Seoul National University Hospital. The results were as follows: 1) The male to female ratio was 2:1 and the age ranged from 19 to 88 with average of 54/ 2) The causes of obstructive jaundice included 94 malignant diseases and 13 benign diseases. Malignant diseases were 48 cases of bile duct cancer, 20 cases of metastasis, 20 cases of pancreatic cancer, 4 cases of gallbladder cancer, 1 case of ampulla Vater cancer, and 1 case of duodenal cancer. Benign diseases were 8 cases of common bile duct stone and 3 cases of benign stricture and 2 cases of cholangitis. 3) The most common indication was palliative drainage of obstruction secondary to malignant tumor in 78 cases. 4) The overall success rate was 93.7%. Internal drainage was achieved in 34 (26.5%) and external drainage was accomplished in 86 (67.2%). 5) Decline in serum bilirubin level was found in 100 cases (93.3%) with the most rapid decline within 1 week after the procedure. 6) Acute major complication occurred in 6 of 107 cases (5.6%). Percutaneous transheaptic biliary drainage is a proven technique for non-operative biliary decompression and established alternative to surgery

  17. Percutaneous transhepatic biliary drainage in 107 patients

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byung Ihn; Lim, Duk; Park, Jae Hyung; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-06-15

    Percutaneous transhepatic biliary drainage has played a major role in treatment of patients of patients with biliary tract disease, especially obstruction by malignant disease. Percutaneous transhepatic biliary drainage was performed 128 times in 107 patients of obstructive jaundice for recent 2 years and 8 months from July, 1981 to March, 1984 at department of radiology, Seoul National University Hospital. The results were as follows: 1) The male to female ratio was 2:1 and the age ranged from 19 to 88 with average of 54/ 2) The causes of obstructive jaundice included 94 malignant diseases and 13 benign diseases. Malignant diseases were 48 cases of bile duct cancer, 20 cases of metastasis, 20 cases of pancreatic cancer, 4 cases of gallbladder cancer, 1 case of ampulla Vater cancer, and 1 case of duodenal cancer. Benign diseases were 8 cases of common bile duct stone and 3 cases of benign stricture and 2 cases of cholangitis. 3) The most common indication was palliative drainage of obstruction secondary to malignant tumor in 78 cases. 4) The overall success rate was 93.7%. Internal drainage was achieved in 34 (26.5%) and external drainage was accomplished in 86 (67.2%). 5) Decline in serum bilirubin level was found in 100 cases (93.3%) with the most rapid decline within 1 week after the procedure. 6) Acute major complication occurred in 6 of 107 cases (5.6%). Percutaneous transheaptic biliary drainage is a proven technique for non-operative biliary decompression and established alternative to surgery.

  18. Reproductive tract inflammatory disease in postpartum dairy cows.

    Science.gov (United States)

    LeBlanc, S J

    2014-05-01

    Up to half of dairy cows are affected by at least one of metritis, purulent vaginal discharge, endometritis or cervicitis in the postpartum period. These conditions result from inadequate immune response to bacterial infection (failure to clear pathogenic bacteria from the uterus) or persistent inflammation that impairs rather than enhances reproductive function. The degree of mobilization of fat and how effectively it is used as a metabolic fuel is well recognized as a risk factor for metabolic and infectious disease. Release of non-esterified fatty acids has direct effects on liver and immune function but also produces pro-inflammatory cytokines (tumor necrosis factor α and interleukin-6), which contribute to systemic inflammation and to insulin resistance. Therefore, reproductive tract inflammatory disease may be a function of both local and systemic inflammatory stimuli and regulation as well as regulation of fat metabolism. Better understanding of variables associated with insulin resistance and inflammatory regulation in the liver and adipose tissue may lead to improvement of reproductive tract health. This paper reviews factors that may contribute to postpartum reproductive tract inflammatory diseases in dairy cows and their inter-relationships, impacts and treatment. PMID:24679404

  19. Preoperative biliary drainage.

    Science.gov (United States)

    Saxena, Payal; Kumbhari, Vivek; Zein, Mohamad E L; Khashab, Mouen A

    2015-01-01

    The role of preoperative biliary drainage (PBD) in patients with distal or proximal biliary obstruction secondary to resectable tumors has been a matter for debate. A review of the literature using Medline, Embase and Cochrane databases was undertaken for studies evaluating routes of drainage (endoscopic or percutaneous) and stent types (plastic or metal) in patients with resectable disease. Preoperative biliary drainage is indicated for relief of symptomatic jaundice, cholangitis, patients undergoing neoadjuvant therapy or those patients where surgery may be delayed. Endoscopic methods are preferred over percutaneous methods because of lower complication rates. In patients with proximal biliary obstruction, PBD should be guided by imaging studies to aid in selective biliary cannulation for unilateral drainage in order to reduce the risk of cholangitis in undrained liver segments. PMID:25293587

  20. Biliary cysts: Etiology, diagnosis and management

    Institute of Scientific and Technical Information of China (English)

    Beata Jablo(n)ska

    2012-01-01

    Biliary cysts (BC) are rare dilatations of different parts of a biliary tract.They account for approximately 1% of all benign biliary diseases.BC occur the most frequently in Asian and female populations.They are an important problem for pediatricians,gastroenterologists,radiologists and surgeons.Clinical presentation and management depend on the BC type.Cholangiocarcinoma is the most serious and dangerous BC complication.The other complications associated with BC involve cholelithiasis and hepatolithiasis,cholangitis,acute and chronic pancreatitis,portal hypertension,liver fibrosis and secondary liver cirrhosis and spontaneous cyst perforation.Different BC classifications have been described in the literature.Todani classification dividing BC into five types is the most useful in clinical practice.The early diagnosis and proper treatment are very important,because BC are associated with a risk of carcinogenesis.A malignancy risk increases with the age.Radiological investigations (ultrasonography,computed tomography,endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography) play an important role in BC diagnostics.Currently,prenatal diagnosis using ultrasonography is possible.It allows to differentiate biliary disorders in fetals and to perform the early surgical treatment that improves results.In most patients,total cyst excision with Roux-Y hepaticojejunostomy is the treatment of choice.Surgical treatment of BC is associated with high success rate and low morbidity and mortality.The early treatment is associated with a lower number of complications.Patients following BC surgery require permanent and careful postoperative observation using laboratory and imaging investigations because of possibility of biliary anastomosis stricture and biliary cancer in tissue remnant.

  1. Biliary duct obstruction treatment with aid of percutaneous transhepatic biliary drainage

    Directory of Open Access Journals (Sweden)

    Daniel Knap

    2016-06-01

    Conclusions: PTBD is an effective method of biliary tract decompression and it is an important alternative to endoscopic drainage. This method is indicated in patients with neoplastic obstruction of biliary tract with low expected survival rate and thus is a palliative procedure.

  2. 血清降钙素原在胆道感染中的诊断价值%Clinical application of serum procalcitonin level in diagnosing biliary tract infection

    Institute of Scientific and Technical Information of China (English)

    李惠; 高堃; 翟仁友; 戴定可; 黄强; 王剑锋

    2013-01-01

    Objective To discuss the clinical value of serum procalcitonin level in diagnosing biliary tract infection. Methods A total of 53 patients with obstructive jaundice were enrolled in this study. The serum procalcitonin level was determined in all patients by immunolofluoreseence sandwich method. Percutanous biliary drainage was performed in all patients. Based on the bile culture result and the clinical manifestations, the patients were divided into the bacterial infection group (n = 33) and the non-bacterial infection group (n = 20). The serum procalcitonin level, white blood cell (WBC) count and the percentage of neutrophilic granulocyte were determined, and the results were compared between the two groups. Results Taking 0.25 ng/ml as the positive threshold of serum procalcitonin level, the sensitivity and the specificity for the diagnosis of biliary tract bacterial infection were 91.9% and 87.5% respectively. When WBC of 8.89 × 109/L was taken as the positive threshold, the sensitivity and the specificity for the diagnosis of biliary tract bacterial infection were 54.8% and 83.3% respectively. If neutrophilic granulocyte of 74.25% was regarded as the positive threshold, the sensitivity and the specificity for the diagnosis of biliary tract bacterial infection were 66.1% and 70.8% respectively. The serum procalcitonin level in the bacterial infection group was significantly higher than that in the non-bacterial infection group (P < 0.05). Conclusion Determination of serum procalcitonin level is very helpful for the diagnosis of biliary tract bacterial infection with much higher sensitivity and specificity. Therefore, serum procalcitonin level can be used as an effective index for biliary tract bacterial infection.%目的 探讨血清降钙素原(PCT)浓度在胆道感染中的诊断价值.方法 采用荧光免疫夹心法检测53例梗阻性黄疸患者血清PCT浓度,所有患者均行经皮经肝穿刺胆管引流术,根据胆汁培养结果及临床症状

  3. What Causes Biliary Atresia? Unique Aspects of the Neonatal Immune System Provide Clues to Disease Pathogenesis

    OpenAIRE

    Mack, Cara L.

    2015-01-01

    Biliary atresia (BA) is the most frequent identifiable cause of neonatal cholestasis and the majority of patients will need liver transplantation for survival. Despite surgical intervention with the Kasai portoenterostomy, significant fibrosis and cirrhosis develops early in life. An increased understanding of what causes this inflammatory fibrosing cholangiopathy will lead to therapies aimed at protecting the intrahepatic biliary system from immune-mediated damage. This review focuses on stu...

  4. Pathological spectrum of intrahepatic cholangiocarcinoma arising in non-biliary chronic advanced liver diseases.

    Science.gov (United States)

    Nakanuma, Yasuni; Xu, Jing; Harada, Kenichi; Sato, Yasunori; Sasaki, Motoko; Ikeda, Hiroko; Kim, Jihun; Yu, Eunsil

    2011-05-01

    Intrahepatic cholangiocarcinoma (ICC) is reported to develop in non-biliary chronic advanced liver diseases (CALD). Herein, we characterize the pathological features of ICC arising in CALD in comparison with those in non-CALD livers. Of 471 surgically resected cases of ICC in Kanazawa, Japan and Seoul, Korea, 53 were associated with CALD (group A), while the remaining 418 arose in otherwise normal livers (group B). When ICC were classified into bile duct type, bile ductular type, variants, and intraductal papillary neoplasm of the bile duct (IPNB), the whole spectrum of subtypes were found in group A; the majority of ICC belonged to the bile duct type in both groups. In group A, bile ductular type was rather frequent (22.6%) compared with group B (8.4%). IPNB was more frequent in group B (22.5%) than group A (3.8%), and in group B, frequent in Seoul cases (24.8%), but rare in Kanazawa cases (2.3%). Variants of ICC were rare in both groups. These results imply that cholangiocarcinogenesis itself is upregulated in group A in comparison with group B and that the bile ductular type is specifically related to group A. Some unique environmental factors in Seoul may be responsible for the frequent development of IPNB. PMID:21501296

  5. Comparison of three-dimensional negative-contrast CT cholangiopancreatography with three-dimensional MR cholangiopancreatography for the diagnosis of obstructive biliary diseases

    International Nuclear Information System (INIS)

    Purpose: The purpose of our study was to compare three-dimensional (3D) negative-contrast CT cholangiopancreatography (3D-nCTCP) with 3D MR cholangiopancreatography (3D-MRCP) for the diagnosis of obstructive biliary diseases. Materials and methods: 3D-nCTCP and 3D-MRCP were performed on seventy clinically documented obstructive biliary diseases patients. The accuracy of each technique in determining the location and cause of biliary obstruction was evaluated compared with the final clinical diagnoses. Results: Both methods achieved 100% of accuracy in the diagnosis of the presence and location of biliary obstruction, and had a similar sensitivity, specificity, accuracy in differentiating benign from malignant biliary obstruction or calculous from noncalculous biliary obstruction (p > 0.05). At 3D-nCTCP, six patients with stones were misinterpreted as cholangitis (N = 2), papillitis (N = 3), or bile duct adenocarcinoma (N = 1); two metastases were mistaken as acute pancreatitis or pancreatic head carcinomas, and one intrahepatic cholangiocarcinoma was misled as bile duct adenoma. At 3D-MRCP, one small stone, one ampullary adenoma, and one intrahepatic cholangiocarcinoma were mistaken as cholangitis, ampullary stone, and intrahepatic bile duct stone, respectively, and three gallbladder carcinomas and another intrahepatic cholangiocarcinoma were misdiagnosed as hilar cholangiocarcinoma (N = 3) or common hepatic duct stone (N = 1); four metastases were mistaken as pancreatic head carcinomas (N = 3) or distal cholangiocarcinoma (N = 1). The overall accuracy in making specific diagnosis of the cause of biliary obstruction was 87.1% for 3D-nCTCP and 84.3% for 3D-MRCP, respectively, (p > 0.05). Conclusion: 3D-nCTCP has the similar effects as 3D-MRCP for the diagnosis of biliary obstruction and, the location and the cause of biliary obstruction. In view of selected cases contraindications for MRI, 3D-nCTCP is a potential substitute.

  6. Reality named endoscopic ultrasound biliary drainage.

    Science.gov (United States)

    Guedes, Hugo Gonçalo; Lopes, Roberto Iglesias; de Oliveira, Joel Fernandez; Artifon, Everson Luiz de Almeida

    2015-10-25

    Endoscopic ultrasound (EUS) is used for diagnosis and evaluation of many diseases of the gastrointestinal (GI) tract. In the past, it was used to guide a cholangiography, but nowadays it emerges as a powerful therapeutic tool in biliary drainage. The aims of this review are: outline the rationale for endoscopic ultrasound-guided biliary drainage (EGBD); detail the procedural technique; evaluate the clinical outcomes and limitations of the method; and provide recommendations for the practicing clinician. In cases of failed endoscopic retrograde cholangiopancreatography (ERCP), patients are usually referred for either percutaneous transhepatic biliary drainage (PTBD) or surgical bypass. Both these procedures have high rates of undesirable complications. EGBD is an attractive alternative to PTBD or surgery when ERCP fails. EGBD can be performed at two locations: transhepatic or extrahepatic, and the stent can be inserted in an antegrade or retrograde fashion. The drainage route can be transluminal, duodenal or transpapillary, which, again, can be antegrade or retrograde [rendezvous (EUS-RV)]. Complications of all techniques combined include pneumoperitoneum, bleeding, bile leak/peritonitis and cholangitis. We recommend EGBD when bile duct access is not possible because of failed cannulation, altered upper GI tract anatomy, gastric outlet obstruction, a distorted ampulla or a periampullary diverticulum, as a minimally invasive alternative to surgery or radiology. PMID:26504507

  7. An Unusual Presentation of Biliary Ascariasis

    Directory of Open Access Journals (Sweden)

    Arsad Bashir Khan, Sanjay Kumar Bhasin, Rajesh Kumar Bhagat, R. K. Chrungoo

    2007-01-01

    Full Text Available Ascariasis is one of the most common disease in human being worldwide. Ascariasis is 2nd to gall stone asa cause of biliary symptoms. The invasion of biliary tract by round worms during early post operativeperiod is an infrequent but serious complication. We present 42 years old man operated for cholelithiasiswith Choledocholthiasis on whom choledochotomy and T -Tube insertion was done. On 5th postoperativeday Ascaris extruded peri-T-Tube and immediate T - Tube cholangiogram done that showed multiplefilling defects in Common Bile Duct (CBD. Patient was managed with saline irrigation of CBD viaT-Tube and anti-heliminthic was given. In view of its rarity and unusual presentation the case is beingreported.

  8. Clinical significance of serum levels of vascular endothelial growth factor and its receptor in biliary disease and carcinoma

    Institute of Scientific and Technical Information of China (English)

    Munechika Enjoji; Hajime Nawata; Makoto Nakamuta; Koji Yamaguchi; Kazuhiro Kotoh; Marie Fukushima; Masami Kuniyoshi; Masao Tanaka

    2005-01-01

    AIM: To investigate the clinical significance of serum vascular endothelial growth factor (VEGF) and soluble VEGF receptor-1 (VEGFR1/Flt-1) (sVEGFR1) levels in biliary diseases.METHODS: We analyzed the serum levels of these proteins in patients with acute cholangitis (group 1), biliary malignancies (group 2), and primary biliary cirrhosis or primary sclerosing cholangitis (group 3), and in healthy donors (group 4). The influence of inflammation was also analyzed. Serum VEGF levels were expressed as VEGF per platelet (VEGF/PLT, pg/106) in order to exclude the influence of platelet counts.RESULTS: sVEGFR1 levels were significantly higher in groups 1 and 2 than in the control group, but did not correlate with inflammatory markers. VEGF/PLT levels were generally higher in patients with active inflammation than in those with carcinoma. C-reactive protein strongly correlated with the levels of serum VEGF independently of platelet and leukocyte counts, even in cancer patients. In cancer patients, VEGF/PLT and sVEGFR1 levels might be indicators for evaluating the effect of medical treatment or the disease progression.CONCLUSION: Serum VEGF and VEGFR1 might be useful markers for gauging the clinical effect of various treatments on patients.

  9. TWO-STAGE SURGICAL TREATMENT OF A CHILD OF ONE YEAR FROM CONGENITAL HEART DISEASE AND BILIARY CIRRHOSIS

    Directory of Open Access Journals (Sweden)

    S. V. Gautier

    2014-01-01

    Full Text Available Aim: Clinical case of successful two-stage surgical treatment of a 1-year-old child with congenital heart disease and biliary cirrhosis is represented in this article. At the first day of life laparotomy was performed because of high intestinal obstruction. Kasai procedure and Roux-en-Y choledochojejunostomy were per- formed on 12th day and at the end of second month of life, respectively. Liver biopsy showed the signs of biliary cirrhosis. At the same time ventricular septal defect and atrial septal defect with pulmonary hyper- tension were diagnosed. The first step of treatment was the surgical septal defects closure. No complications during procedure, cardiopulmonary bypass and post-operative period were registered. There were no nega- tive effects on liver function after cardiac surgery. 11 months later living-donor liver transplantation was performed without any complications. Patient was discharged at 35th post-transplant day with stable graft function. 

  10. Biliary scintigraphy in acute pancreatitis

    International Nuclear Information System (INIS)

    A prospective study was carried out in 60 patients to determine the efficacy of 99/sup m/Tc-PIPIDA scintigraphy in differentiating biliary pancreatitis from nonbiliary pancreatitis. Forty patients were classified as having biliary pancreatitis and 20 patients as having the nonbiliary type. Scintigraphic scans were divided into five main types according to the time to visualization of the gallbladder and the time to excretion of 99/sup m/Tc-PIPIDA into the intestinal tract. Normal scans were obtained in 95% of patients (19/20) with nonbiliary pancreatitis; 22.5% of patients (9/40) with biliary pancreatitis had normal scans. It is concluded that elevated amylase levels together with an abnormal biliary scan, as defined by the criteria presented here, indicate biliary pancreatitis, while a normal scan largely excludes such diagnosis

  11. Biliary scintigraphy in acute pancreatitis

    International Nuclear Information System (INIS)

    A prospective study was carried out in 60 patients to determine the efficacy of /sup 99m/Tc-PIPIDA scintigraphy in differentiating biliary pancreatitis from nonbiliary pancreatitis. Forty patients were classified as having biliary pancreatitis and 20 patients as having the nonbiliary type. Scintigraphic scans were divided into five main types according to the time to visualization of the gallbladder and the time to excretion of /sup 99m/Tc-PIPIDA into the intestinal tract. Normal scans were obtained on 95% of patients (19/20) with nonbiliary pancreatitis; 22.5% of patients (9/40) with biliary pancreatitis had normal scans. It is concluded that elevated amylase levels together with an abnormal biliary scan, as defined by the criteria presented here, indicate biliary pancreatitis, while a normal scan largely excludes such diagnosis

  12. Prevention strategies of biliary tract injury of LC (600 cases report)%腹腔镜胆囊切除术胆管损伤的预防对策(附600例分析)

    Institute of Scientific and Technical Information of China (English)

    王广义; 刘亚辉; 刘瑾琨; 王磊; 陈光; 刘铮; 张文良; 李楠; 王有德; 谭毓铨

    2001-01-01

    目的总结连续开展腹腔镜胆囊切除术(LC)600例无胆管损伤等严重并发症的成功经验。方法回顾分析本组成功实施LC 600例的临床资料,其中胆囊结石466例,急性胆囊炎23例,胆囊息肉85例,胆囊结石合并息肉15例,慢性胆囊炎11例。结果完成588例,中转手术12例,600例全部治愈,无胆管损伤等严重并发症发生。结论严格的技术培训,采用钝性锐性分离相结合法谨慎解剖Calot三角,适时中转手术是成功避免LC术中胆管损伤等严重并发症的关键。%Objective To summarize the successful experience of LC 600 cases without biliary tract injury and other severe complications.Methods Retrospective analysis was made on 600 patients underwent LC successfully including 466 cases of gallbladder gallstone, 23 cases of acute cholecystitis, 85 cases of gallbladder polyps, 15 cases of gallbladder gallstone with polyps, 11 cases of chronic cholecystitis.Results LC was performed on 588 cases, 12 cases converted to open cholecystectomy. All patients were cured without biliary tract injury and other severe complications.Conclusion It is key point for preventing biliary tract injury to keep strict technique training,to disect carefully the calot triangle by dull and sharp dissection, and to convert to open cholecystectomy timely.

  13. A prospective, comparative study of magnetic resonance cholangipancreatography and direct cholangiography in the diagnosis of biliary diseases; Estudio propsective comparativo en el diagnostico de la patologia biliar. Colangiopancreatografia por resonancia magnetica frente a colangiografia directa

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez, E.; Falco, J.; Martin, J.; Brullet, E.; Campo, R.; Espinos, J.; Darnell, A.

    2001-07-01

    To assess the sensitivity and specificity of magnetic resonance cholangiopancreatography (MRCP) as a noninvasive diagnostic technique, comparing it with endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTHC) in the diagnosis of biliary disease, focusing particularly on patients with choledocholithiasis. Between June 1997 and february 1998, 109 patients referred by the Corporacio Sanitaria del Parc Tauli and the Hospital Mutua de terrasa in Barcelona, Spain were evaluated. MRCP and ERCP or PTHC were performed in every case, always in that order and separated by a maximum of 7 days. Twenty-four patients were excluded from the study for different reasons, leaving a series of 85 patients. All the studies were performed with a 1-Tesla Siemens Magneton Impact Expert using half-fourier single-short turbo spin-echo (HASTE) and rapid acquisition with relaxation enhancement (RARE) methods in several coronal and axial planes. The MRCP readings were carried out by consensus by two radiologists who are experts in the assessment of diseases of the digestive tract. In this series of 85 patients; MCRP showed a sensitivity of 98.4%, a specificity of 94.7%, a positive predictive value of 98.4% and a negative predictive value of 94.7% for the detection of biliary diseases. For the detection choledocholithiasis, these values were 100%, 89.5%, 88% and 100%, respectively. MRCP is extremely reliable in the diagnosis of biliary diseases, especially in cases of choledocholithiasis. Its high negative predictive value obviates the need for other invasive diagnostic tests. (Author) 30 refs.

  14. Hepatic manifestations of celiac disease

    Directory of Open Access Journals (Sweden)

    Hugh James Freeman

    2010-05-01

    Full Text Available Hugh James FreemanDepartment of Medicine (Gastroenterology, University of British Columbia, Vancouver, British Columbia, CanadaAbstract: Different hepatic and biliary tract disorders may occur with celiac disease. Some have been hypothesized to share genetic or immunopathogenetic factors, such as primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis. Other hepatic changes in celiac disease may occur with malnutrition resulting from impaired nutrient absorption, including hepatic steatosis. In addition, celiac disease may be associated with rare hepatic complications, such as hepatic T-cell lymphoma.Keywords: celiac disease, autoimmune liver disease, primary biliary cirrhosis, fatty liver, gluten-free diet

  15. The Impact of Gd-Eob-Dtpa-Enhanced MR Cholangiography in Biliary Diseases: Comparison with T2-Weighted MR Cholangiopancreatography

    Science.gov (United States)

    Özmen, Evrim; Algın, Oktay; Evrimler, Şehnaz; Arslan, Halil

    2016-01-01

    Background: Contrast enhanced magnetic resonance cholangiography is a novel technique and promising method in demonstrating biliary tree anatomy and evaluating biliary disorders. However, to date, there are a limited number of studies that have focused on the impact of this technique. Aims: We aimed to evaluate the additional role of contrast enhanced MR cholangiography (MRC) and compare contrast enhanced MRC with T2-weighted (w) magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of biliary disorders. Study Design: Diagnostic accuracy study. Methods: The T2w-MRCP and contrast enhanced MRC sequences of 31 patients whose gold standard test results were available were scored visually for the existence of pathological findings with regard to any of the biliary diseases. Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) was used as the contrast agent. The correlation values were determined according to the statistical analysis made from those scores and the sensitivity, specificity and accuracy values of each sequence were detected as well. Results: We detected that the correlation values with gold standard methods of contrast enhanced MRC sequences were significantly higher than the ones of T2w-MRCP sequences. The correlation ratios of T2w-MRCP sequences were between 26 and 34%, while those for contrast enhanced MRC sequences were between 81 and 83% for the first reader and the correlation ratios of T2w-MRCP sequences were between 10 and 61%, whereas those of contrast enhanced MRC were between 79 and 81% for the second reader The mean sensitivity, specificity and accuracy values of T2w-MRCP sequences were 14.3–42.5%, 85–89.2% and 59.3–72.5%, respectively, while the mean sensitivity, specificity and accuracy values of contrast enhanced MRC sequences were 100%, 86.7% and 93.2–93.3%, respectively. Conclusion: We suggest that obtaining of contrast enhanced MRC sequences in addition to the T2w-MRCP can be useful in the

  16. Biliary ascariasis

    International Nuclear Information System (INIS)

    Biliary ascariasis is a complication of intestinal ascariasis. This results in characteristic findings in the intravenous cholangiocholecystogram and in the sonogram. Characteristic signs of biliary ascariasis are, in the longitudinal section, the 'strip sign', 'spaghetti sign', 'inner tube sign', and in transverse section 'a bull's eye in the triple O'. The helminth can travel from out of the biliary duct system back into the intestinum, so that control examinations can even be negative. (orig.)

  17. Percutaneous biliary drainage in acute suppurative cholangitis with biliary sepsis

    International Nuclear Information System (INIS)

    Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as result of partial or complete obstruction of the bile duct, and may manifest clinically severe form of disease, rapidly deteriorating to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying cause were 12 benign disease(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis(n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients resulting in improvement of general condition and failed in three patients. The procedure were preterminated due to the patient's condition in two and biliary-proto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggest that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment

  18. Percutaneous biliary drainage in acute suppurative cholangitis with biliary sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung Lyul; Cho, June Sik; Kwon, Soon Tae; Lee, Sang Jin; Rhee, Byung Chull [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1993-11-15

    Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as result of partial or complete obstruction of the bile duct, and may manifest clinically severe form of disease, rapidly deteriorating to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying cause were 12 benign disease(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis(n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients resulting in improvement of general condition and failed in three patients. The procedure were preterminated due to the patient's condition in two and biliary-proto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggest that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment.

  19. Radiographic and ultrasonographic evaluation of the upper urinary tract diseases in dogs: 22 cases

    OpenAIRE

    TEMİZSOYLU, Mustafa Doğa; BUMİN, Ali; KAYA, Mahir; ALKAN, Zeki

    2006-01-01

    The objectives of the present study were to describe the complementary use of radiography and ultrasonography in the diagnosis of upper urinary tract disorders in dogs, and to compare ultrasonographic findings with the survey and contrast radiographic findings in the evaluation of canine upper urinary tract diseases. The study materials were composed of 22 dogs of various breed, age, and sex with upper urinary tract diseases. Pyelonephritis (9 cases), acute renal failure (7 cases), policystic...

  20. Diagnostic performance of contrast enhanced CT and 18F-FDG PET/CT in suspicious recurrence of biliary tract cancer after curative resection

    International Nuclear Information System (INIS)

    Because of the late clinical presentation of biliary tract cancer (BTC), only 10% of patients are eligible for curative surgery. Even among those patients who have undergone curative surgery, most patients develop recurrent cancer. This study is to determine the clinical role of 18F-FDG PET/CT during post-operative surveillance of suspected recurrent BTC based on symptoms, laboratory findings and contrast-enhanced CT (ceCT) findings. We consecutively enrolled 50 patients with BTC who underwent curative surgery. An 18F-FDG PET/CT was obtained for assessment of recurrence based on clinical suspicion during post-operative surveillance. The final confirmation of recurrence was determined pathologically or clinically. When a pathologic confirmation was impossible or inconclusive, a clinical confirmation was used by radiologic correlation with subsequent follow-up ceCT at a minimum of 3-month intervals. Diagnostic efficacy was evaluated by comparing the results of ceCT and 18F-FDG PET/CT with the final diagnosis. Among the 50 patients, 34(68%) were confirmed to have a recurrence. PET/CT showed higher sensitivity (88% vs. 76%, p = 0.16) and accuracy (82% vs. 66%, p = 0.11) for recurrence compared to ceCT, even though the difference was not significant. The positive (86% vs. 74%, p = 0.72) and negative predictive values for recurrence (73% vs. 47%, p = 0.55) were not significantly different between PET/CT and ceCT. However, an additional PET/CT on ceCT significantly improved the sensitivity than did a ceCT alone (94% [32/34] for PET/CT on ceCT vs. 76% [26/34] for ceCT alone, p = 0.03) without increasing the specificity, positive predictive value, and negative predictive value. 18F-FDG PET/CT alone is not more sensitive or specific than ceCT in the detection of recurrent BTC after curative surgery. These results do not reach statistical significance, probably due to the low number of patients. However, an additional 18F-FDG PET/CT on ceCT significantly improves the

  1. Optimal biliary drainage for inoperable Klatskin's tumor based on Bismuth type

    OpenAIRE

    Lee, Sang Hyub; Park, Joo Kyung; Yoon, Won Jae; Lee, Jun Kyu; Ryu, Ji Kon; Yoon, Yong Bum; Kim, Yong-Tae

    2007-01-01

    AIM: To investigate differences in the effects of biliary drainage procedures in patients with inoperable Klatskin’s tumor based on Bismuth type, considering endoscopic retrograde biliary drainage (ERBD), external percutaneous transhepatic biliary drainage (EPTBD) and internal biliary stenting via the PTBD tract (IPTBD).

  2. Diagnostic imaging of digestive tract involvement in cystic fibrosis. Part 1: hepatobiliary disease

    International Nuclear Information System (INIS)

    Cystic fibrosis is a severe hereditary disease characterized by epithelial chloride channel dysfunction, leading to the production of abnormally thick secretions. The abnormal gene is located on the long arm of chromosome 7. Hepatobiliary involvement derives from ductal obstruction causing cholestasis, steatosis, cirrhosis and portal hypertension. Biliary sludge, cholelithiasis and gallbladder sclerosis and atrophy are common findings. As the correlation between the hepatobiliary changes and their clinical and analytical impact is very limited, imaging techniques are essential in this disease. Ultrasound is the basic imaging tool, both for initial evaluation and follow-up of the hepatic and biliary involvement, although other techniques such as radionuclide imaging, magnetic resonance and computed tomography can be highly useful. Given the long-term, chronic nature of this disease, the use of aggressive techniques or irradiation should be carefully weighed. (Author) 38 refs

  3. Endoscopic ultrasound-guided biliary drainage of hilar biliary obstruction.

    Science.gov (United States)

    Park, Do Hyun

    2015-09-01

    Only 20-30% of patients with hilar cholangiocarcinoma (CC) are candidates for potentially curative resection. However, even after curative (R0) resection, these patients have a disease recurrence rate of up to 76%. The prognosis of hilar cholangiocarcinoma (CC) is limited by tumor spread along the biliary tree leading to obstructive jaundice, cholangitis, and liver failure. Therefore, palliative biliary drainage may be a major goal for patients with hilar CC. Endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is an established method for palliation of patients with malignant biliary obstruction. However, there are patients for whom endoscopic stent placement is not possible because of failed biliary cannulation or tumor infiltration that limits transpapillary access. In this situation, percutaneous transhepatic biliary drainage (PTBD) is an alternative method. However, PTBD has a relatively high rate of complications and is frequently associated with patient discomfort related to external drainage. Endoscopic ultrasound-guided biliary drainage has therefore been introduced as an alternative to PTBD in cases of biliary obstruction when ERCP is unsuccessful. In this review, the indications, technical tips, outcomes, and the future role of EUS-guided intrahepatic biliary drainage, such as hepaticogastrostomy or hepaticoduodenostomy, for hilar biliary obstruction will be summarized. PMID:26178753

  4. [Malignant biliary obstruction].

    Science.gov (United States)

    Hucl, Tomáš

    2016-01-01

    Pancreatic cancer and cholangiocarcinoma are the most common causes of malignant biliary obstruction. They are diseases of increasing incidence and unfavorable prognosis. Only patients with localized disease indicated for surgery have a chance of long-term survival. These patients represent less than 20 % of all patients, despite the progress in our diagnostic abilities.Locally advanced and metastatic tumors are treated with palliative chemotherapy or chemoradiotherapy; the results of such treatments are unsatisfactory. The average survival of patients with unresectable disease is 6 months and only 5-10 % of patients survive 5 years.Biliary drainage is an integral part of palliative treatment. Endoscopically or percutaneosly placed stents improve quality of life, decrease cholestasis and pruritus, but do not significantly improve survival. Biliary stents get occluded over time, possibly resulting in acute cholangitis and require repeated replacement.Photodynamic therapy and radiofrequency ablation, locally active endoscopic methods, have been increasingly used in recent years in palliative treatment of patients with malignant biliary obstruction. In photodynamic therapy, photosensitizer accumulates in tumor tissue and is activated 48 hours later by light of a specific wave length. Application of low voltage high frequency current during radiofrequency ablation results in tissue destruction by heat. Local ablation techniques can have a significant impact in a large group of patients with malignant biliary obstruction, leading to improved prognosis, quality of life and stent patency. PMID:26898789

  5. Magnetic Resonance Cholangiopancreatographv: A Meta-Analysis of Test Performance in Suspected Biliary Disease

    International Nuclear Information System (INIS)

    Magnetic resonance cholangiopancreatography (MRCP) is one of many newer noninvasive tests that can image the biliary tree. To precisely estimate the overall sensitivity and specificity of MRCP in suspected biliary obstruction and to evaluate clinically important subgroups. MEDLINE search (January 1987 to March 2003) for studies in English or French, bibliographies, and subject matter experts. Studies were included if they allowed construction of 2x2 contingency tables of MRCP compared with a reasonable gold standard for at least 1 of the following: the presence, level, or cause of biliary obstruction. Two independent observers graded study quality, which included consecutive enrollment, blinding, use of a single (versus composite) gold standard, and nonselective use of the gold standard. Logistic regression was used to examine the influence of publication year, quality score, proportion of patients having a direct gold standard, and clinical context on diagnostic performance. Of 498 studies identified, 67 were included (4711 patients). Mixed-effect models were used to estimate the sensitivity and specificity, and quantitative receiver-operating characteristic analysis was performed. Magnetic resonance cholangiopancreatography had a high overall pooled sensitivity (95% (+/-1.96 SD: spread of SD, 75% to 99%) and specificity (97% (spread of SD, 86% to 99 %)) The procedure was less sensitive for stones (92%; odds ratio, 0.51 (CI, 0.35 to 0.75) and malignant conditions (88%; odds ratio, 0.28 (CI, 0.18 to 0.44f) than for the presence of obstruction, In addition, diagnostic performance was higher in studies that were larger, did not use consecutive enrollment, and did not use gold standard assessment for some patients. Magnetic resonance cholangiopancreatography is a noninvasive imaging test with excellent overall sensitivity and specificity for demonstrating the level and presence of biliary obstruction; however, it seems less sensitive for detecting stones or

  6. Hydrogen Sulfide in Physiology and Diseases of the Digestive Tract

    Directory of Open Access Journals (Sweden)

    Sudha B. Singh

    2015-11-01

    Full Text Available Hydrogen sulfide (H2S is a Janus-faced molecule. On one hand, several toxic functions have been attributed to H2S and exposure to high levels of this gas is extremely hazardous to health. On the other hand, H2S delivery based clinical therapies are being developed to combat inflammation, visceral pain, oxidative stress related tissue injury, thrombosis and cancer. Since its discovery, H2S has been found to have pleiotropic effects on physiology and health. H2S is a gasotransmitter that exerts its effect on different systems, such as gastrointestinal, neuronal, cardiovascular, respiratory, renal, and hepatic systems. In the gastrointestinal tract, in addition to H2S production by mammalian cystathionine-β-synthase (CBS, cystathionine-γ-lyase (CSE, H2S is also generated by the metabolic activity of resident gut microbes, mainly by colonic Sulfate-Reducing Bacteria (SRB via a dissimilatory sulfate reduction (DSR pathway. In the gut, H2S regulates functions such as inflammation, ischemia/ reperfusion injury and motility. H2S derived from gut microbes has been found to be associated with gastrointestinal disorders such as ulcerative colitis, Crohn’s disease and irritable bowel syndrome. This underscores the importance of gut microbes and their production of H2S on host physiology and pathophysiology.

  7. Upper Tract Urothelial Carcinomas in Patients with Chronic Kidney Disease: Relationship with Diagnostic Challenge

    OpenAIRE

    Li-Jen Wang; Shen-Yang Lee; Bin Tean Teh; Cheng-Keng Chuang; Joëlle Nortier

    2014-01-01

    Chronic kidney disease and upper tract urothelial carcinomas display a bidirectional relationship. Review of the literature indicates that early diagnosis and correct localization of upper tract urothelial carcinomas in dialysis patients and kidney transplant recipients are important but problematic. Urine cytology and cystoscopy have limited sensitivity for the diagnosis of upper tract urothelial carcinomas in dialysis patients. Enhanced computed tomography and magnetic resonance imaging cou...

  8. Biliary ascariasis

    Energy Technology Data Exchange (ETDEWEB)

    Mensing, M.; Cruz y Rivero, M.A.; Alarcon Hernandez, C.; Garcia Himmelstine, L.; Vogel, H.

    1986-06-01

    Biliary ascariasis is a complication of intestinal ascariasis. This results in characteristic findings in the intravenous cholangiocholecystogram and in the sonogram. Characteristic signs of biliary ascariasis are, in the longitudinal section, the 'strip sign', 'spaghetti sign', 'inner tube sign', and in transverse section 'a bull's eye in the triple O'. The helminth can travel from out of the biliary duct system back into the intestinum, so that control examinations can even be negative.

  9. Environmental factors in primary biliary cirrhosis.

    Science.gov (United States)

    Juran, Brian D; Lazaridis, Konstantinos N

    2014-08-01

    The etiology of the autoimmune liver disease primary biliary cirrhosis (PBC) remains largely unresolved, owing in large part to the complexity of interaction between environmental and genetic contributors underlying disease development. Observations of disease clustering, differences in geographical prevalence, and seasonality of diagnosis rates suggest the environmental component to PBC is strong, and epidemiological studies have consistently found cigarette smoking and history of urinary tract infection to be associated with PBC. Current evidence implicates molecular mimicry as a primary mechanism driving loss of tolerance and subsequent autoimmunity in PBC, yet other environmentally influenced disease processes are likely to be involved in pathogenesis. In this review, the authors provide an overview of current findings and touch on potential mechanisms behind the environmental component of PBC. PMID:25057950

  10. Hepatic manifestations of celiac disease

    OpenAIRE

    Hugh James Freeman

    2010-01-01

    Hugh James FreemanDepartment of Medicine (Gastroenterology), University of British Columbia, Vancouver, British Columbia, CanadaAbstract: Different hepatic and biliary tract disorders may occur with celiac disease. Some have been hypothesized to share genetic or immunopathogenetic factors, such as primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis. Other hepatic changes in celiac disease may occur with malnutrition resulting from impaired nutrient absorption, ...

  11. 检测胆汁糖蛋白糖链结构变化鉴别良恶性胆道疾病分析%Detection and analysis of biliary glycoprotein glycan structure changes in differential diagnosis of benign and malignant biliary disease

    Institute of Scientific and Technical Information of China (English)

    候鹏; 高峰; 马树民

    2014-01-01

    目的:探讨胆汁糖蛋白糖链结构变化对于鉴别良恶性胆道疾病的作用。方法选取青岛市海慈医疗集团普外科收治的胆道疾病患者100例,按照良、恶性将其分为对照组(良性胆道疾病)和观察组(胆管癌),每组各50例。取两组患者胆汁滴于硝酸纤维膜上,通过比较麦胚凝集素( WGA )、欧曼陀罗凝集素( DSA)、小扁豆凝集素( LCA)、刀豆凝集素( CONA)试验阳性率,探讨胆汁糖蛋白糖链结构变化与良恶性胆道疾病的关系。结果对照组 WGA、DSA、LCA、CONA 凝集素试验阳性率分别为22.0%、14.0%、2.0%、76.0%,观察组分别为76.0%、66.0%、76.0%、82.0%。两组CONA凝集素试验阳性率差异无统计学意义(P>0.05),观察组WGA、LCA、DSA凝集试验阳性率均明显高于对照组,差异均有统计学意义(χ2=29.17、28.17、57.55,均P<0.05)。结论胆汁糖蛋白糖链结构变化与胆道疾病良、恶性密切相关,可以通过WGA、LCA、DSA凝集试验阳性率判断胆管疾病良、恶性,值得在临床上广泛推广。%Objective To investigate the effects of changes in protein bile sugar chain structure for differen-tiating benign and malignant biliary tract disease .Methods 100 patients with biliary tract diseases who were treated in Department of General Surgery ,Qingdao Haici Medical Group were selected in this study .According to benign or malignant biliary disease ,the patients were divided into control group ( benign biliary tract disease ) and observation group ( cholangiocarcinoma ) ,50 cases in each group .Two groups of patients with bile drops on the nitrocellulose mem-brane,through the comparison of wheat germ agglutinin (WGA),Datura stramonium agglutinin (DSA),lentil lectin (LCA),concanavalin A(CONA) positive rate of test,to explore the relationship between sugar chain of glycoprotein in bile and bile duct benign and

  12. Gallbladder ejection fraction (GBEF) after cholecystokinin (CCK) infusion in patients with a low probability of biliary disease

    International Nuclear Information System (INIS)

    Full text: Compared with the rapid 3-minute injection of CCK, the twenty-minute infusion is claimed to give a higher and more reproducible GBEF. The purpose of this clinical study was to determine GBEF in patients considered not to have gallbladder disease. 112 consecutive patients with abdominal pain referred to Westmead Medical Imaging had DISIDA biliary scans with dynamic one minute images for 90 minutes. When the gallbladder was well filled (usually at 40-60 minutes) 0.01(g/kg of CCK was infused over 20 minutes. Quantitative assessment was performed by regions of interest over the liver, common bile duct and gallbladder and from the GB activity time curve, the GBEF was calculated. Nine patients were excluded because of previous cholecystectomy and six patients because of known gallbladder disease. Follow-up, a minimum of three months after their scan, was attempted in 97 patients, by contact with their referring doctors to ascertain whether the cause of the abdominal pain had been found. Information on 65 patients was obtained: three were lost to follow-up, 12 were considered to have gallbladder disease and 50 unlikely to have biliary disease on the basis of normal liver function tests and abdominal ultrasound. Only in a minority (6) was the cause of pain determined. The 50 patients (19 males and 31 females, mean age 48.5 yrs) had a mean GBEF of 56.8%±17.8%. Thus in a patient population with low probability of gallbladder disease there remains a wide range of GBEF despite the 20 minute CCK infusion. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  13. Future developments in biliary stenting

    Directory of Open Access Journals (Sweden)

    Hair CD

    2013-06-01

    Full Text Available Clark D Hair,1 Divyesh V Sejpal21Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA; 2Department of Medicine, Section of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, North Shore University Hospital, Manhasset, NY, USAAbstract: Biliary stenting has evolved dramatically over the past 30 years. Advancements in stent design have led to prolonged patency and improved efficacy. However, biliary stenting is still affected by occlusion, migration, anatomical difficulties, and the need for repeat procedures. Multiple novel plastic biliary stent designs have recently been introduced with the primary goals of reduced migration and improved ease of placement. Self-expandable bioabsorbable stents are currently being investigated in animal models. Although not US Food and Drug Administration approved for benign disease, fully covered self-expandable metal stents are increasingly being used in a variety of benign biliary conditions. In malignant disease, developments are being made to improve ease of placement and stent patency for both hilar and distal biliary strictures. The purpose of this review is to describe recent developments and future directions of biliary stenting.Keywords: plastic stents, self-expandable metal stents, drug eluting stents, bioabsorbable stents, malignant biliary strictures, benign biliary strictures

  14. Somatostatin receptors in the gastrointestinal tract in health and disease.

    OpenAIRE

    Reubi, J. C.

    1992-01-01

    The multiple actions of somatostatin are mediated by specific membrane-bound receptors present in all somatostatin target tissues, such as brain, pituitary, pancreas, and gastrointestinal tract. Three different types of tissues in the human gastrointestinal tract express somatostatin receptors: (1) the gastrointestinal mucosa, (2) the peripheral nervous system, and (3) the gut-associated lymphoid tissue, where the receptors are preferentially located in germinal centers. In all these cases, s...

  15. Spontaneous Biliary Peritonitis in Children

    Directory of Open Access Journals (Sweden)

    Supreethi Kohli

    2013-01-01

    Full Text Available Pediatric Spontaneous Bile duct perforation is a rare clinical condition with only around 150 cases reported worldwide. Early management gives excellent prognosis but the condition often presents a diagnostic dilemma. Hepato-biliary Technetium-99m-iminodiacetic acid scintiscan is the diagnostic investigation of choice but its availability in third world countries is limited. We present two cases of spontaneous biliary peritonitis in children, which were diagnosed without scintiscanning. The first case was a one-and -a half-year-old child, who was diagnosed with biliary peritonitis without pneumoperitoneum by a combination of Ultrasound (USG, Contrast enhanced computed tomography (CECT, and Magnetic Resonance Imaging (MRI. The child underwent USG-guided drainage and subsequent cholecystectomy with hepatico-jejunostomy. The second child also had biliary peritonitis without pneumoperitoneum, which was initially suspected on USG. CECT revealed dilated gall bladder and fluid collection in sub-hepatic space and pelvis. Abdominal paracentesis revealed presence of bile. The child responded to conservative therapy. Both are doing well on two-year follow-up. In a patient with jaundice, biliary tract abnormalities and/or free fluid, either generalized or localized to peri-cholecystic/sub-hepatic space on USG/CT/MRI, in the absence of pneumoperitoneum, suggest a diagnosis of biliary perforation even in the absence of scintiscanning.

  16. 临床药师对1例胆道感染患者的药学监护%Pharmaceutical Care of Clinical Pharmacist for One Patient with Biliary Tract Infection

    Institute of Scientific and Technical Information of China (English)

    李海燕; 胡斌

    2016-01-01

    Objective:To analyze the pharmaceutical care performed by clinical pharmacist for one patient with biliary tract infec -tion to investigate the role of clinical pharmacists in clinical treatment .Methods:The clinical pharmacist supervised the whole process of treatment for the patient and optimized the treatment regimen together with the clinical doctors to achieve good efficacy .Results:With the cooperation of clinical pharmacist , the clinical doctors changed the treatment drugs to avoid the potential adverse drug reac -tions until the patient was cured .Conclusion:The participation of clinical pharmacist in the pharmaceutical care for the patients with biliary tract infection can provide a new thought of working mode .%目的:分析临床药师对1例胆道感染患者抗感染治疗的药学监护,探讨临床药师如何在临床治疗中发挥作用。方法:临床药师监护患者用药全过程,协助医师优化给药方案。结果:临床药师建议医师及时换用恰当药物,避免了潜在药品不良反应的发生,并取得良好治疗效果。结论:为临床药师在胆道感染的药学监护中提供新思路。

  17. Pancreaticojejunostomy, hepaticojejunostomy and double Roux-en-Y digestive tract reconstruction for benign pancreatic diseases

    OpenAIRE

    Jia, Chang-Ku; Lu, Xue-Fei; Yang, Qing-Zhuang; Weng, Jie; Chen, You-Ke; Fu, Yu

    2014-01-01

    Surgery such as digestive tract reconstruction is usually required for pancreatic trauma and severe pancreatitis as well as malignant pancreatic lesions. The most common digestive tract reconstruction techniques (e.g., Child’s type reconstruction) for neoplastic diseases of the pancreatic head often encompass pancreaticojejunostomy, choledochojejunostomy and then gastrojejunostomy with pancreaticoduodenectomy, whereas these techniques may not be applicable in benign pancreatic diseases due to...

  18. ePTFE/FEP-Covered Metallic Stents for Palliation of MalignantBiliary Disease: Can Tumor Ingrowth Be Prevented?

    International Nuclear Information System (INIS)

    Purpose. To determine the application and clinical effectiveness of ePTFE/FEP-covered metallic stents for palliation of malignant biliary disease, and to evaluate the efficiency of stent coverage in preventing tumor ingrowth. Methods. During a 3-year period, 36 patients with malignant obstructive jaundice were treated with ePTFE/FEP-covered stents, with or without proximal side holes. The stricture was located in the lower common bile duct (CBD) in 18 cases, the upper CBD in 9, the lower common hepatic duct (CHD) in 6, and the upper CHD in 3 patients. Results.Thirty-seven covered stents were percutaneously implanted. The technical success rate was 97%. Reintervention was required in 6 cases. The 30-day mortality rate was 40%, not procedure-related. Mean survival was 128 days. Primary patency rates were 100%,55.5%, and 25% at 3, 6, and 12 months, respectively, while the assisted patency rate was 100% at 12 months. Stents without side holes had higher primary patency rates compared with those with side holes, where occlusion was always due to tumor ingrowth. Tumor ingrowth did not occur in the completely covered stents. No stent dysfunction due to sludge incrustation was found.Complications were 1 case of arterial laceration that occurred during percutaneous transhepatic cholangiography, and a subcapsular hematoma and 1 case of bile peritonitis, that both occurred during primary stenting. No complications followed the secondary stenting technique. Conclusion. ePTFE/FEP-covered metallic stents are safe and effective for palliation of malignant biliary disease. The presence of the ePTFE/FEP coating is likely to prevent from tumor ingrowth

  19. Clinical study of spiral CT urography in the diagnosis of urinary tract disease in children

    International Nuclear Information System (INIS)

    Objective: To evaluate the ability of excretory CT urography (CTU) in the application of the upper urinary tract in children by comparing with intravenous urography (IVU) and magnetic resonance urography (MRU) , and to evaluate the value of CTU in the diagnosis of various diseases on upper urinary tract in children. Methods: Sixty-two children suspected with upper urinary tract disease were imaged by CTU, 31 of them underwent IVU, and 13 of them underwent MRU, Each urinary tract was arbitrarily divided into five parts (calices, pelvis, upper, middle, and lower ureters) for scoring of images on a five-point scale for opacification by contrast material. Opacification scores for the two groups (normal and abnormal) of urinary tracts were then compared. Compared with IVU and MRU, CTU was evaluated in the diagnosis of upper urinary tract disease in children. Results: The score of IVU and CTU was higher than that of MRU for all parts of the normal urinary tracts (P < 0.01) . The score of CTU was higher than that of IVU and MRU for calices and pelvis of the abnormal urinary' tracts (P < 0.01 ) . Differences in scores for upper ureter were not statistically significant among IVU, CTU, and MRU. The score of CTU and MRU was higher than that of IVU for middle and lower ureters (P < 0.01). The accurate rate of CTU in diagnosing renal duplication and renal hypoplasia was 100% , which was higher than that of IVU and MRU. In diagnosing the hydronephrosis, CTU (100%) and MRU (100%) were better than IVU (62.5%); CTU was also more reliable in detecting the ectopic ureteral orifice, ureterocele, and severe renal injury than IVU and MRU. Conclusion: CTU is a reliable technique for the diagnosis of urinary tract diseases. If a child was suspected to have each of the following diseases by ultrasound examination, such as renal duplication, renal hypoplasia, and severe renal injury, CTU could be selected as the first choice

  20. Early adaptive immune responses in the respiratory tract of foot and mouth disease-infected cattle

    Science.gov (United States)

    Foot and mouth disease (FMD) is a highly contagious viral disease which affects both domestic and wildlife biungulate species. This acute disease, caused by the FMD virus (FMDV), usually includes an active replication phase in the respiratory tract up to 72 h post-infection followed by hematogenous ...

  1. Biliary ascariasis

    Directory of Open Access Journals (Sweden)

    Sivakumar K

    2007-01-01

    Full Text Available Ascaris lumbricoides, or the common roundworms, has a worldwide distribution but is mainly seen in Asian and Latin American countries. In humans the usual habitat is in the small intestine, mainly in the jejunum. But if the worm load is high, which may go up to a thousand worms, the worms tend to migrate away from the usual site of habitat. This brief paper aims at highlighting the condition of biliary ascariasis through the authors′ experience in managing three such cases over a period of 1 year. The clinical features which arouse suspicion of biliary ascariasis, as well as diagnostic modalities and management, are described. Initially the cases were managed conservatively, but we conclude that if worms are retained in biliary tree for more than 10 days, surgery should be performed; since retention of degraded and calcified dead worm can occur, and this can lead to complications which are difficult to manage.

  2. Analysis of drug resistance of extended spectrum β-lactamases-producing strains in biliary tract infection%胆道感染产超广谱β-内酰胺酶菌的耐药性分析

    Institute of Scientific and Technical Information of China (English)

    唐双意; 刘滔滔; 蒋霞; 万瑞融; 钟小斌

    2014-01-01

    目的:探讨医院近5年胆道感染产超广谱β‐内酰胺酶(ESBLs)菌的耐药性和其危险因素,并为临床经验性治疗用药提供参考依据。方法对2007-2011年收集的216例胆汁细菌培养结果为革兰阴性菌的胆道感染患者进行分析,其中产ESBLs菌胆道感染患者97例作为观察组,非产ESBLs菌胆道感染患者119例作为对照组,对两组胆道感染细菌的耐药性进行比较,并采用单因素分析和多因素 logistic回归分析ESBLs菌株致胆道感染的危险因素。结果216株革兰阴性菌中大肠埃希菌155株占71.76%;检出产ESBLs菌97株,其中大肠埃希菌82株占84.54%;产ESBLs组对头孢菌素等多种抗菌药物的耐药性均显著高于非产ESBLs组,差异有统计学意义(P<0.01)。结论胆道产ESBLs菌株的耐药比率较高,临床上要严格掌握ERCP操作治疗的适应证,合理应用抗菌药物,注意控制第三代头孢菌素类抗菌药物的应用,可减少产ESBLs细菌感染的发生。%OBJECTIVE To explore drug resistance and risk factors of extended spectrum β‐lactamases (ESBLs)‐producing strains in biliary tract infection in our hospital during last five years and provide a basis for clinical em‐pirical treatment .METHODS The data of 216 patients with biliary tract infection whose bile bacterial culture showed gram -negative bacteria infection from 2007 to 2011 were analyzed .The 97 patients with bile infection caused by ESBLs‐producing bacteria were set as the observation group ,the 119 patients with bile infection caused by non ESBLs‐producing bacteria were set as the control group .The drug resistance was compared between the two groups ,and the logistic regression analysis was adopted to investigate the clinical risk factors for biliary tract infection caused by ESBLs‐producing strains .RESULTS Most of gram‐negative bacteria were Escherichiacoli (155 strains ,71 .76% ) .The positive rate

  3. Distribution of pathogenic bacteria and clinical characteristics in patients with biliary tract infections%胆道感染患者病原菌分布与临床特征分析

    Institute of Scientific and Technical Information of China (English)

    蔡轶伦; 刘玉国; 张磊; 张炀; 何花

    2016-01-01

    OBJECTIVE To analyze the distribution of pathogenic bacteria and clinical characteristics in biliary tract infections , and to provide objective evidence for development of clinical prevention and control program . METHODS Totally 150 patients had bile culture from Jan .2013 to Jan .2014 were selected as the research sub‐jects .The distribution of pathogenic bacteria in bile and the clinical characteristics of the patients were observed and analyzed .RESULTS A total of 113 cases of patients'bile culture were positive ,the positive rate was 75 .3% . A total of 131 strains of pathogens were isolated ,among them ,gram negative bacterial dominated ,accounting for 67 .2% .According to logistic multivariate regression analysis ,biliary operation history ,complication of gallstone , complication of pancreatic cancer were independent risk factors of biliary tract infections ( P < 0 .05 ) . CONCLUSION The distribution of pathogenic bacteria and clinical characteristics in patients with biliary tract in‐fections has certain characteristics ,which the clinicians should pay high attention to and employ effective preven‐tion and treatment measures to improve the therapeutic effects and prognosis of patients .%目的:分析胆道感染的病原菌分布和临床特征,为制定临床预防控制方案提供参考依据。方法选取2013年1月-2014年1月胆道感染的患者150例作为研究对象,对其胆汁中的病原菌分布和临床特征进行观察和分析。结果共有113例患者的胆汁培养结果呈阳性,阳性率为75.3%,共分离出131株病原菌,以革兰阴性菌为主,共88占67.2%;logistic多元回归分析结果显示,胆道手术史、合并胆结石、合并胰腺癌为发生胆道感染的独立危险因素(P<0.05)。结论胆道感染患者的病原菌分布和临床特征均具有一定的特性,临床医师应给予高度关注,采用有效的预防和治疗措施,达到提高治疗效果和改善患者预后的目的。

  4. Activation of the MEK5/ERK5 Cascade Is Responsible for Biliary Dysgenesis in a Rat Model of Caroli’s Disease

    OpenAIRE

    Sato, Yasunori; Harada, Kenichi; Kizawa, Kazuo; Sanzen, Takahiro; Furubo, Shinichi; Yasoshima, Mitsue; Ozaki, Satoru; Ishibashi, Masahiko; Nakanuma, Yasuni

    2005-01-01

    Polycystic kidney (PCK) rats exhibit a multiorgan cyst pathology similar to human autosomal recessive polycystic kidney disease, and are proposed as an animal model of Caroli’s disease with congenital hepatic fibrosis (CHF). This study investigated the expression and function of selected components of the mitogen activated protein kinase (MAPK) pathway in cultured intrahepatic biliary epithelial cells (BECs) of PCK rats. Compared to the proliferative activity of cultured BECs of control rats,...

  5. Primary Biliary Cirrhosis Is a Generalized Autoimmune Epithelitis

    Directory of Open Access Journals (Sweden)

    Jun Gao

    2015-03-01

    Full Text Available Primary biliary cirrhosis (PBC is a chronic progressive autoimmune cholestatic liver disease characterized by highly specific antimitochondrial antibodies (AMAs and the specific immune-mediated injury of small intrahepatic bile ducts. Unique apoptotic feature of biliary epithelial cells (BECs may contribute to apotope presentation to the immune system, causing unique tissue damage in PBC. Perpetuation of inflammation may result in senescence of BECs, contributing to irreversible loss of bile duct. In addition to the classic liver manifestations, focal inflammation and tissue damage are also seen in salivary glands and urinary tract in a significant proportion of PBC patients. These findings provide potent support to the idea that molecular mimicry may be involved in the breakdown of autoimmune tolerance and mucosal immunity may lead to a systematic epithelitis in PBC patients. Thus, PBC is considered a generalized epithelitis in clinical practice.

  6. Primary Biliary Cirrhosis Is a Generalized Autoimmune Epithelitis

    Science.gov (United States)

    Gao, Jun; Qiao, Liang; Wang, Bingyuan

    2015-01-01

    Primary biliary cirrhosis (PBC) is a chronic progressive autoimmune cholestatic liver disease characterized by highly specific antimitochondrial antibodies (AMAs) and the specific immune-mediated injury of small intrahepatic bile ducts. Unique apoptotic feature of biliary epithelial cells (BECs) may contribute to apotope presentation to the immune system, causing unique tissue damage in PBC. Perpetuation of inflammation may result in senescence of BECs, contributing to irreversible loss of bile duct. In addition to the classic liver manifestations, focal inflammation and tissue damage are also seen in salivary glands and urinary tract in a significant proportion of PBC patients. These findings provide potent support to the idea that molecular mimicry may be involved in the breakdown of autoimmune tolerance and mucosal immunity may lead to a systematic epithelitis in PBC patients. Thus, PBC is considered a generalized epithelitis in clinical practice. PMID:25803105

  7. Upper Tract Urothelial Carcinomas in Patients with Chronic Kidney Disease: Relationship with Diagnostic Challenge

    Directory of Open Access Journals (Sweden)

    Li-Jen Wang

    2014-01-01

    Full Text Available Chronic kidney disease and upper tract urothelial carcinomas display a bidirectional relationship. Review of the literature indicates that early diagnosis and correct localization of upper tract urothelial carcinomas in dialysis patients and kidney transplant recipients are important but problematic. Urine cytology and cystoscopy have limited sensitivity for the diagnosis of upper tract urothelial carcinomas in dialysis patients. Enhanced computed tomography and magnetic resonance imaging could prove useful for the detection and staging of upper tract urothelial carcinomas in dialysis patients. Renal ultrasound can detect hydronephrosis caused by upper tract urothelial carcinomas in kidney transplant recipients but cannot visualize the carcinomas themselves. High detection rates for upper tract urothelial carcinomas in kidney transplant recipients have recently been demonstrated using computed tomography urography, which appears to be a promising tool. To detect carcinomas in dialysis patients and kidney transplant recipients as early as possible, regular screening in asymptomatic patients and diagnostic work-up in symptomatic patients should be performed using a combination of urological and imaging methods. Careful assessment of subsequent recurrence within the contralateral upper urinary tract and the urinary bladder is necessary for dialysis patients and kidney transplant recipients with upper tract urothelial carcinomas.

  8. Treatment of iron deficiency anemia associated with gastrointestinal tract diseases

    Institute of Scientific and Technical Information of China (English)

    Ulas; D; Bayraktar; Soley; Bayraktar

    2010-01-01

    The gastrointestinal (GI) tract is a common site of bleeding that may lead to iron deficiency anemia (IDA). Treatment of IDA depends on severity and acuity of patients’ signs and symptoms. While red blood cell transfusions may be required in hemodynamically unstable patients, transfusions should be avoided in chronically anemic patients due to their potential side effects and cost. Iron studies need to be performed after episodes of GI bleeding and stores need to be replenished before anemia develops. Oral ...

  9. Mechanisms of biliary carcinogenesis and growth

    OpenAIRE

    Wise, Candace; Pilanthananond, Metaneeya; Perry, Benjamin F; Alpini, Gianfranco; McNeal, Michael; Glaser, Shannon S.

    2008-01-01

    Cholangiocarcinoma is a rare cancer originating from the neoplastic transformation of the epithelial cells (i.e. cholangiocytes) that line the biliary tract. The prognosis for patients with cholangiocarcinoma is grim due to lack of viable treatment options. The increase in world-wide incidence and mortality from cholangiocarcinoma highlights the importance of understanding the intracellular mechanisms that trigger the neoplastic transformation of cholangiocytes and the growth of biliary cance...

  10. Interactions between Cytokines, Congenital Anomalies of Kidney and Urinary Tract and Chronic Kidney Disease

    OpenAIRE

    Ana Cristina Simões e Silva; Flávia Cordeiro Valério; Mariana Affonso Vasconcelos; Débora Marques de Miranda; Eduardo Araújo Oliveira

    2013-01-01

    Fetal hydronephrosis is the most common anomaly detected on antenatal ultrasound, affecting 1–5% of pregnancies. Postnatal investigation has the major aim in detecting infants with severe urinary tract obstruction and clinically significant urinary tract anomalies among the heterogeneous universe of patients. Congenital uropathies are frequent causes of pediatric chronic kidney disease (CKD). Imaging techniques clearly contribute to this purpose; however, sometimes, these exams are invasive, ...

  11. Phytotherapy as the part of the complex treatment of lower urinary tract diseases

    OpenAIRE

    Bachurin, G. V.

    2015-01-01

    The use of phytotherapy in the treatment of urinary tract diseases has been known for a long time. But at present it has become widely used and got scientific justification for urological pathology, particularly in the treatment of prostatitis.Aim. To investigate the best phytotherapeutic medications for the complex treatment of lower urinary tract diseas.Methods and results. Reasonable combinations of various compatible herbs have been investigated. The best phytotherapeutic medications to r...

  12. Hepatobiliary scintigraphy in the assessment of biliary obstruction after hepatic resection with biliary-enteric anastomosis

    International Nuclear Information System (INIS)

    We investigated the usefulness of hepatobiliary scintigraphy (HBS) for diagnosing biliary obstruction after curative hepatic resection with biliary-enteric anastomosis. The study population consisted of 54 patients who underwent surgery for benign (n=18) or malignant (n=36) biliary disease. We analysed 68 technetium-99m DISIDA scintigrams which were performed at least 1 month after the surgery (median: 9 months). Final diagnosis was made by operative exploration, other invasive radiological studies or clinical and radiological follow-up for at least 6 months after the surgery. Diagnostic accuracy was analysed according to the pretest likelihood of biliary obstruction. There were two total and 15 segmental biliary obstructions. In patients with symptoms of biliary obstruction and abnormal liver function, HBS always allowed correct diagnosis (two instances of total obstruction, seven of segmental obstruction and seven of non-obstruction). Among the patients with non-specific symptoms or isolated elevation of serum alkaline phosphatase, HBS diagnosed segmental biliary obstruction in seven of the eight instances, and non-obstruction in 22 of 23 instances. There were no cases of biliary obstruction and no false-positive results of HBS in 21 instances with no clinical signs or symptoms of biliary obstruction. The diagnostic sensitivity and specificity of HBS for biliary obstruction were 94% (16/17) and 97% (50/51), respectively. In conclusion, HBS is a highly accurate modality for the diagnosis of segmental biliary obstruction during long-term follow-up after hepatic resection with biliary-enteric anastomosis. (orig.)

  13. Cholecystokinin (CCK) functional cholescintigraphy (FC) in patients suspected of acalculous biliary disease (ABD)

    International Nuclear Information System (INIS)

    To determine if CCK FC can aid in the diagnosis (Dx.) of ABD, the authors retrospectively analyzed the max. gallbladder (GB) ejection fraction response (EFR) to CCK in 240 patients (pts.) with persistent symptoms of biliary colic, a normal GB Ultrasound exam and/or OCG. Each pt. (NPO after 12 A.M.) received 5 mCi of technetium (Tc)-99 Hepatolite. After max GB filling, .02 μg/kg CCK was administered (1-3 minutes) I.V. Background corrected GB EFs were determined q.5 min x4 by ratioing the pre-CCK GB cts. minus post-CCK GB cts. to pre-CCK GB cts. In 131/240 pts. the max. GBEFR was 35%. Eleven underwent surgery, 98 medical Rx. 4/11 Cx. apts had CAC, 7 were normal. Of the 98 medical Rx. pts. 21 lack followup, 71 are clinically felt not to have ABD; 6 are felt to have ABD. CCK FC appears to be a useful test for the detection of ABD. Its predictive value (GBEF <35%) in Cx. pts. is 97%; in all pts. (assuming medical Rx. correct), 94% (sensitivity - 91%, specificity - 93%)

  14. Diagnostic utility and feasibility on MR virtual endoscopy for hepato-biliary-pancreatic diseases

    International Nuclear Information System (INIS)

    This paper describes examinations to evaluate diagnostic utility and feasibility of MR virtual endoscopy (VE) in the hepato-biliary-pancreatic field. Images are obtained by Siemens Magnetom Symphony Maestro class 1.5T with the prospective acquisition correction-3D-turbo-spin echo (TSE) method under conditions of TR 1,380 ms-TE 395 ms, slice thickness 1 mm and matrix 256 x 256 (1 x 1 x 1 mm) and by procession station of Siemens Leonardo, to compare 2D-HASTE and -RARE images. Examined are optimal MRCP (MR cholangio-pancreatography) imaging, luminal VE imaging with phantom, clinical application of VE with MRI/MRCP, and utility of MR-VE in laparoscopic cholecystectomy. Subjects are images from patients with cholelithiasis (36 cases), cholangiocarcinoma (6), pancreatitis (4), cholangitic cyst (2), and others (2). The bile duct is imaged by VE at 81.4% (cystic), 97.7% (bilateral hepatic) and 88.4% (intrahepatic), and the bifurcating portion at cystic duct in 25 cases of cholecystectomy, at 52.0% by conventional MR/MRCP and 92.0% by 3D-TSE-MR/MRCP+VE. Thus the last method made it possible to evaluate anatomy of the duct system before operation for increasing its safety. (T.I.)

  15. Selection of biliary drainage route and the effect of adjunctive therapy for unresectable malignant biliary stricture

    Energy Technology Data Exchange (ETDEWEB)

    Shinohara, Yasushi; Takeda, Kazuya [Tokyo Medical Coll. (Japan)

    2000-03-01

    The outcome of combination of biliary tract drainage with other adjunctive therapies for unresectable malignant biliary tract stricture was evaluated in the 135 patients with known outcome treated in this unit between June, 1986 and May, 1998. Compared to percutaneous transhepatic drainage, transpapillary drainage significantly shortened the jaundice reduction period but yielded a slightly inferior technical success rate. The efficacy of transpapillary drainage for jaundice was extremely poor in cases of stricture in the upper part of the biliary tract. A histological comparison of bile duct lumen after various adjunctive therapies showed that intraluminal therapy was much more effective than extracorporeal radiation. Adjunctive therapies significantly increased the survival period in patients with cholangiocarcinoma but they were less effective in patients with pancreatic carcinoma and not effective at all in patients with gallbladder carcinoma. Intraluminal therapy markedly prolonged the internal fistula maintenance period and was effective in improving the quality of life in patients with superior bile duct stricture at multiple sites. The hospital stay was significantly longer in patients who received adjunctive therapy than in those who received biliary tract drainage alone. This finding suggests that adjunctive therapy should not be conducted if it is not expected to result in an increase in the survival period that compensates for disadvantages of a prolonged hospital stay. In conclusion, in the treatment of inoperable malignant biliary tract stricture, adjunctive therapy should be conducted whenever possible in combination with percutaneous biliary tract drainage, which enable intraluminal therapy, in patients with cholangiocarcinoma. However, biliary tract drainage alone is recommended in patients with pancreatic and gallbladder carcinoma because adjunctive therapy does not seem to be effective. A transpapillary approach is recommended for pancreatic

  16. Radiation diagnosis of the biliary system before laparascopic cholecystectomy (a review of literature). Part 2: Non-ultrasonic techniques

    International Nuclear Information System (INIS)

    The paper is defined as a review of literature on radiation diagnostic of biliary tract. High-quality intraoperative cholangiogramms securing is actual now. The role of selective cholangiography with laproscopic cholecystectomy, a review of 737 consecutive cases of intraoperative cholangiography in laproscopic cholecystectomy, the abilities of spiral computed tomographic cholangiography before laproscopic cholecystectomy are under consideration. Magneto-resonance cholangiopancreatography as a new method of diagnosis of biliary system diseases is analysed in certain papers. The problem of indications to conducting some diagnostic methods as well as sequences their use (algorithm) touches upon all scientific investigations devoted tactics of medical examinations of patients before laproscopic cholecystectomy

  17. Surgical significance of variations in anatomy in the biliary region

    OpenAIRE

    Ashfaq Ul Hassan; Showqat A. Zargar; Aijaz Malik; Pervez Shah

    2013-01-01

    Variations in the anatomy of the gallbladder, the bile ducts, and the arteries that supply them and the liver are important to the surgeon, because failure to recognize them can cause iatrogenic injury to the biliary tract. A surgeon should be always be careful while operating in this area. In addition these anomalies are associated with a range of other congenital anomalies, including biliary atresia and cardiovascular or other gastrointestinal malformations, biliary lithiasis, choledochal c...

  18. Percutaneous transhepatic biliary biopsy using gastrofiberscopic biopsy forceps.

    OpenAIRE

    Kim, C. S.; Han, Y M; Song, H. Y.; Choi, K. C.; Kim, D. G.; B.H. Cho

    1992-01-01

    To obtain a histopathologic diagnosis at the site of a biliary obstruction, we recently have performed 24 cases of biliary biopsy using gastrofiberscopic biopsy forceps (Olympus, Tokyo, Japan) via transhepatic tracts provided in the course of the procedure of percutaneous biliary drainage. Histopathologic diagnosis was successfully made at the first attempt of biopsy procedure but a second trial was made a week later in 6 cases who were negative for malignant cells on the first attempt. The h...

  19. Sarcoid-like lymphocytosis of the lower respiratory tract in patients with active Crohn's disease.

    Science.gov (United States)

    Smiéjan, J M; Cosnes, J; Chollet-Martin, S; Soler, P; Basset, F M; Le Quintrec, Y; Hance, A J

    1986-01-01

    To re-evaluate the relationship between Crohn's disease and sarcoidosis, we compared the numbers and types of cells recovered by bronchoalveolar lavage from normal volunteers and patients with Crohn's disease, with other forms of inflammatory bowel disease, and with sarcoidosis. Patients with Crohn's disease, but not patients with other inflammatory bowel disorders, had an increase in the number of T lymphocytes on the surface of the lower respiratory tract similar to that seen in patients with sarcoidosis. As in sarcoidosis, this lymphocytosis results from an expansion of the T4+ T-lymphocyte subset, is characteristic of patients with active disease only, and is not associated with similar abnormalities in the peripheral blood. Thus, patients with apparently localized Crohn's disease have sarcoid-like lymphocytosis of the lower respiratory tract, a finding that emphasizes the systemic nature of Crohn's disease and the disorder's close relationship to sarcoidosis. PMID:3940500

  20. Westernblottinginthediagnosisof duodenal-biliary and pancreaticobiliary relfuxesinbiliarydiseases

    Institute of Scientific and Technical Information of China (English)

    Guo-Zhe Xian; Shuo-Dong Wu; Chun-Chih Chen; Yang Su

    2009-01-01

    BACKGROUND: Currently adopted diagnostic methods for duodenal-biliary and pancreaticobiliary relfuxes carry many lfaws, so the incidence of the two relfuxes demands further larger sample size studies. This study aimed to evaluate Western blotting for the diagnosis of relfuxes in biliary diseases. METHODS: An oral radionuclide 99mTc-DTPA test (radio-nuclide, RN) was conducted for the observation of duodenal-biliary relfux prior to measuring bile radioactivity and Western blotting for detecting bile enterokinase (EK). Pancreaticobiliary relfux was assessed by biochemical and Western blotting tests for biliary amylase activity and trypsin-1, respectively. In accordance with bile sample origin, our samples were classiifed into ductal bile and gall bile groups;based on each individual biliary disease, we further classiifed the ductal bile group into ifve sub-groups, and the gall bile group into four sub-groups. Western blotting was conducted to assess the two relfuxes in biliary diseases. RESULTS: Consistencies were noted between EK and RN tests when diagnosing duodenal-biliary relfux (P0.05); in the common bile duct cyst group, the EK positive rate was signiifcantly lower than the trypsin-1 positive rate (P CONCLUSIONS: Western blotting can accurately relfect duodenal-biliary and pancreaticobiliary relfuxes. EK has greater sensitivity than RN for duodenal-biliary relfux. The majority of biliary amylase and lipase comes from the pancreas in all biliary diseases;pancreaticobiliary relfux is the predominant source in the common bile duct cyst group and duodenal-biliary relfux is responsible for the ductal pigment stone group.

  1. Clinical characteristics and the incidence of extrahepatic autoimmune disease and malignant tumor in primary biliary cirrhosis-autoimmune hepatitis overlap syndrome

    Institute of Scientific and Technical Information of China (English)

    杨蜜蜜

    2013-01-01

    Objective To analyze clinical pathologic characteristics of patients with primary biliary cirrhosis-autoimmune hepatitis overlap syndrome (PBC-AIH OS) ,the incidence of extrahepatic autoimmune disease,malignant tumor and the abdominal lymph node enlargement.Methods From January 2000 to January 2012,the clinical data of 49 patients with PBC-AIH OS were retrospectively analyzed,which included general information,clinical manifestations,biochemical parameters,immu-

  2. Meta-analysis: antioxidant supplements for liver diseases - the Cochrane Hepato-Biliary Group

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Gluud, L L; Nikolova, D; Bjelakovic, M; Nagorni, A; Gluud, C

    2010-01-01

    Several liver diseases have been associated with oxidative stress. Accordingly, antioxidants have been suggested as potential therapeutics for various liver diseases. The evidence supporting these suggestions is equivocal.......Several liver diseases have been associated with oxidative stress. Accordingly, antioxidants have been suggested as potential therapeutics for various liver diseases. The evidence supporting these suggestions is equivocal....

  3. Endoscopic management of biliary complications after liver transplantation: An evidence-based review.

    Science.gov (United States)

    Macías-Gómez, Carlos; Dumonceau, Jean-Marc

    2015-06-10

    Biliary tract diseases are the most common complications following liver transplantation (LT) and usually include biliary leaks, strictures, and stone disease. Compared to deceased donor liver transplantation in adults, living donor liver transplantation is plagued by a higher rate of biliary complications. These may be promoted by multiple risk factors related to recipient, graft, operative factors and post-operative course. Magnetic resonance cholangiopancreatography is the first-choice examination when a biliary complication is suspected following LT, in order to diagnose and to plan the optimal therapy; its limitations include a low sensitivity for the detection of biliary sludge. For treating anastomotic strictures, balloon dilatation complemented with the temporary placement of multiple simultaneous plastic stents has become the standard of care and results in stricture resolution with no relapse in > 90% of cases. Temporary placement of fully covered self-expanding metal stents (FCSEMSs) has not been demonstrated to be superior (except in a pilot randomized controlled trial that used a special design of FCSEMSs), mostly because of the high migration rate of current FCSEMSs models. The endoscopic approach of non-anastomotic strictures is technically more difficult than that of anastomotic strictures due to the intrahepatic and/or hilar location of strictures, and the results are less satisfactory. For treating biliary leaks, biliary sphincterotomy and transpapillary stenting is the standard approach and results in leak resolution in more than 85% of patients. Deep enteroscopy is a rapidly evolving technique that has allowed successful treatment of patients who were not previously amenable to endoscopic therapy. As a result, the percutaneous and surgical approaches are currently required in a minority of patients. PMID:26078829

  4. Cholangiography and Interventional Biliary Radiology in Adult Liver Transplantation

    OpenAIRE

    Zajko, Albert B.; Campbell, William L.; Bron, Klaus M.; Lecky, James W.; Iwatsuki, Shunzaburo; Shaw, Byers W.; Starzl, Thomas E.

    1985-01-01

    Radiographic assessment of the biliary tract is often essential in patients who have undergone liver transplantation. T- or straight-tube cholangiography, percutaneous transhepatic cholangiography, and endoscopic retrograde cholangiography all may be used. A total of 264 cholangiograms in 79 adult liver transplant patients (96 transplants) was reviewed. Normal radiographic features of biliary reconstructive procedures, including choledochocholedochostomy and choledochojejunostomy, are demonst...

  5. 莱芜地区胆道感染患者胆汁细菌学及药敏结果分析%Analysis of bile bacteriology and drug sensitive results in patients with biliary tract infection in Laiwu area

    Institute of Scientific and Technical Information of China (English)

    苏爱美; 王云

    2015-01-01

    目的:研究莱芜地区胆道感染患者胆汁中细菌谱的变化及其药物敏感性变化,为本地区胆道感染患者合理应用抗生素提供理论依据。方法:对2009年1月-2014年12月间收治的262例本地区胆道感染患者的胆汁细菌培养阳性的231株病原菌分布及耐药情况作回顾性分析。结果:对于2009年1月-2011年12月、2012年1月-2014年12月两个时间段90、172份胆汁标本中各有63、132份病原菌培养阳性,分别检出病原菌73、158株;所分离的病原菌以革兰阴性杆菌为主,2个时间段分别占78.07%、73.48%,革兰阳性菌分别为20.56%、21.97%,真菌分别占1.37%、4.55%;革兰阴性菌在胆道感染中所占的比率下降,而革兰阳性菌及真菌的比率上升;大肠埃希氏菌仍占最大比例,2个时间段分别为34.21%、31.82%,大肠埃希氏菌中ESBLs阳性耐药株分别为16.0%(4/25),54.8%(23/42)(P<0.05),胆道感染的病原菌发生明显的变迁。结论:胆道感染的病原菌中主要以大肠埃希氏菌、肠球菌属等为主,6年来胆道感染的病原菌发生明显的变迁,临床应用广泛的抗菌药物耐药率增加。%Objective:To study the changes of biliary bacteria and drug sensitivity to antibiotics in patients with biliary tract infection in laiwu, to provide the theory basis for clinical medicaton.Methods:The data of 231 strains of microbes were found in 262 patients with positive bile culture from Jan 2001 to Dec 2006 and their sensitivity to antibiotics were retrospectively analyzed.Results: There were 63 and 132 positive samples respectively in 90 samples during the first half of this study (2009-2011)and 172 ones during the second half (2012-2014) as well as 73 and 158 strains cultured. Respectively, Gram-negative bacteria accounted for 78.07% and 73.48%, Gram-positive bacteria accounted for 20.56% and 21.97%, fungi accounted for 1.37% and 4.55%; Escherichia coli was the

  6. Caroli's Disease: Current Knowledge of Its Biliary Pathogenesis Obtained from an Orthologous Rat Model

    OpenAIRE

    Yasunori Sato; Xiang Shan Ren; Yasuni Nakanuma

    2011-01-01

    Caroli's disease belongs to a group of hepatic fibropolycystic diseases and is a hepatic manifestation of autosomal recessive polycystic kidney disease (ARPKD). It is a congenital disorder characterized by segmental saccular dilatations of the large intrahepatic bile duct and is frequently associated with congenital hepatic fibrosis (CHF). The most viable theory explaining its pathogenesis suggests that it is related to ductal plate malformation. The development of the polycystic kidney (PCK)...

  7. Metagenomic Sequencing of the Chronic Obstructive Pulmonary Disease Upper Bronchial Tract Microbiome Reveals Functional Changes Associated with Disease Severity

    OpenAIRE

    Cameron, Simon J S; Keir E Lewis; Huws, Sharon A.; Wanchang Lin; Hegarty, Matthew J.; Lewis, Paul D.; Mur, Luis A. J.; Pachebat, Justin A

    2016-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is a major source of mortality and morbidity worldwide. The microbiome associated with this disease may be an important component of the disease, though studies to date have been based on sequencing of the 16S rRNA gene, and have revealed unequivocal results. Here, we employed metagenomic sequencing of the upper bronchial tract (UBT) microbiome to allow for greater elucidation of its taxonomic composition, and revealing functional changes associate...

  8. DIFFUSE AND FOCAL CORTICOSPINAL TRACT DISEASE AND ITS IMPACT ON PATIENT DISABILITY IN MULTIPLE SCLEROSIS

    Science.gov (United States)

    Tovar-Moll, Fernanda; Evangelou, Iordanis E.; Chiu, Annie W.; Auh, Sungyoung; Chen, Christina; Ehrmantraut, Mary; Ohayon, Joan M.; Richert, Nancy; Bagnato, Francesca

    2014-01-01

    Background and Purpose We investigated the impact of focal and diffuse corticospinal tracts damage on sensory-motor disability in multiple sclerosis (MS) patients. Methods Twenty-five MS patients underwent 3.0 Tesla (3T) magnetic resonance imaging with diffusion tensor imaging (DTI). The Expanded Disability Status Scale (EDSS) and the Timed 25-Foot Walk test (T25FW) quantified patient physical disability. Fractional anisotropy (FA) and mean diffusivity (MD) of the corticospinal tracts, whole brain and corticospinal tracts lesion volume were also computed. Spearman rank correlation analyses measured the associations between DTI-derived metrics and other measures of disease. Partial correlation analyses between DTI and disability measures were performed and corrected for lesion volumes as appropriate. Results Significant associations were seen between FA of the corticospinal tracts and EDSS (r =−0.500, p =0.0011), motor-EDSS (r = −0.519, p=0.008), and T25WF (r=−0.637, p =0.001) scores and MD of the corticospinal tracts and motor-EDSS (r=0.469, p=0.018) and T25WF (r=0.428, p=0.033) scores. When correcting for lesion volumes, only the association between FA of the corticospinal tracts and EDSS (p≤0.01, r≤ −0.516) or motor-EDSS score (p=0.03, r=−0.468,) persisted. Conclusions DTI at 3T shows that the impact of diffuse corticospinal tracts disease on sensory-motor disability is greatly mediated by focal lesions in MS. PMID:25318661

  9. 胆石症患者胆道感染的病原学分析与治疗探讨%Etiological analysis and treatment of biliary tract infections suffered by cholelithiasis patients

    Institute of Scientific and Technical Information of China (English)

    马红梅; 戴丐国; 连建安; 姜斌骅

    2014-01-01

    OBJECTIVE To investigate the etiological status of biliary tract infections among cholelithiasis patients and offer corresponding measures for treatment so as to improve the level of clinical treatment .METHODS The clinical data of 370 cases of cholelithiasis patients from Jan 2010 to Jan 2013 were retrospectively analyzed ,and the pathogen distribution and drug resistance were analyzed among those patients who suffered from biliary tract infec-tions ;PPMS software was adopted for statistical analysis ,t-test was adopted for testing measurement data and Chi-square was adopted for testing enumeration data .RESULTS Totally ,79 cases of the 370 cases of cholelithiasis patients suffered from biliary tract infections ,with the infection rate of 21 .35% ;a total of 79 strains of pathogens were detected ,gram-positive bacteria were 32 strains ( 40 .51% ) with the top 3 pathogens of Enterococcus f aeca-lis ,Streptococcus pyogenes and Staphylococcus aureus ,accounting for 13 .92% ,11 .39% and 11 .39% respective-ly ;gram-negative strains were 47 strains (59 .49% ) ,with the top 3 pathogens of Escherichia coli ,K lebsiella and Pseudomonas aeruginoosa ,accounting for 18 .99% ,16 .46% and 11 .39% respectively ;all the drug resistance rates of dominant gram-negative bacteria to meropenem ,imipenem and ceftriaxone were between 0-11 .11% ,be-sies ,the resistance rates of E .coli ,and P .aeruginosa to cefotaxime were 13 .33% and 22 .22% respectively ,and the drug resistance rate of K lebsiella to levofloxacin was 15 .38% ;the dominant gram-positive bacteria had low drug resistance rate between 0 and 11 .11% to vancomycin ,teicoplanin and cefminox ,the drug resistance rates of E .f aecalis and Staphylococcus aureus to cefotaxime were 18 .18% and 11 .11% respectively ,and the drug resist-ance rates of S .pyogenes to ampicillin-sulbactam was 11 .11% .CONCLUSION Gram-negative bacteria are the dom-inant pathogens causing biliary tract infection to cholelithiasis patients ,and it is

  10. Biliary ascariasis: radiological clue to diagnosis

    OpenAIRE

    Sundriyal, Deepak; Bansal, Satish; KUMAR, NAVEEN; Sharma, Navneet

    2015-01-01

    Ascariasis is caused by Ascaris lumbricoides. It is the most common helminthic infection seen worldwide. Ascariasis is an endemic disease in our country. This is due to the prevailing poor sanitary conditions and low level of education. Biliary ascariasis is an uncommon cause of obstructive jaundice. We report a case of biliary ascariasis in a young labourer who presented with acute abdominal pain.

  11. Biliary ascariasis

    OpenAIRE

    Sivakumar K; Varkey Sam; George Mathan; Rajendran S; Hema R

    2007-01-01

    Ascaris lumbricoides, or the common roundworms, has a worldwide distribution but is mainly seen in Asian and Latin American countries. In humans the usual habitat is in the small intestine, mainly in the jejunum. But if the worm load is high, which may go up to a thousand worms, the worms tend to migrate away from the usual site of habitat. This brief paper aims at highlighting the condition of biliary ascariasis through the authors′ experience in managing three such cases over a perio...

  12. Pathobiology of biliary epithelia and cholangiocarcinoma: proceedings of the Henry M. and Lillian Stratton Basic Research Single-Topic Conference.

    Science.gov (United States)

    Sirica, Alphonse E; Nathanson, Michael H; Gores, Gregory J; Larusso, Nicholas F

    2008-12-01

    In June 2008, the American Association for the Study of Liver Diseases (AASLD) sponsored the Henry M. and Lillian Stratton Basic Research Single-Topic Conference on the Pathobiology of Biliary Epithelia and Cholangiocarcinoma, which was held in Atlanta, GA. Attendees from 12 different countries participated in this conference, making it a truly international scientific event. Both oral and poster presentations were given by multidisciplinary experts, who highlighted important areas of current basic and translational research on biliary epithelial cell biology and pathophysiology, and on the etiology, cellular and molecular pathogenesis, and target-based therapy of cholangiocarcinoma. The specific goals and objectives of the conference were: (1) to advance knowledge of basic and molecular mechanisms underlying developmental and proliferative disorders of the biliary tract; (2) to foster a better and more comprehensive understanding of mechanisms regulating biliary epithelial (cholangiocyte) growth and transport, signaling, cell survival, and abnormalities that result in disease; and (3) to understand basic mechanisms of cholangiocarcinoma development and progression, with the added goal of identifying and exploiting potentially critical molecular pathways that may be targeted therapeutically. A number of interrelated themes emerged from the oral and poster sessions that affected current understandings of the complex organization of transcriptional and signaling mechanisms that regulate bile duct development, hepatic progenitor cell expansion, cholangiocyte secretory functions and proliferation, and mechanisms of cholangiocarcinogenesis and malignant cholangiocyte progression. Most notable were the critical questions raised as to how best to exploit aberrant signaling pathways associated with biliary disease as potential targets for therapy. PMID:18855901

  13. Urinary Tract Infection due to Paenibacillus alvei in a Chronic Kidney Disease: A Rare Case Report

    OpenAIRE

    Padhi, Sanghamitra; Dash, Muktikesh; Sahu, Rani; Panda, Pritilata

    2013-01-01

    Paenibacilli, the Gram positive, aerobic spore bearing bacilli are found normally in the environment. Though these organisms were not known to cause human disease, until recently; few species of this genus have been reported to cause infections in humans. We report here, a case of urinary tract infection in a 60-year-old chronic kidney disease patient due to this rare bacterium. The patient presented with complains of fever, dysuria, and flank pain. Routine and microscopic examination of urin...

  14. Extended tracts of homozygosity identify novel candidate genes associated with late onset Alzheimer’s Disease

    OpenAIRE

    Nalls, M A; Guerreiro, R.J.; Simon-Sanchez, J.; Bras, J. T.; Traynor, B.J.; Gibbs, J. R.; Launer, L.; Hardy, J.; Singleton, A B

    2009-01-01

    Large tracts of extended homozygosity are more prevalent in outbred populations than previously thought. With the advent of high-density genotyping platforms, regions of extended homozygosity can be accurately located allowing for the identification of rare recessive risk variants contributing to disease. We compared measures of extended homozygosity (greater than 1 megabase in length) in a population of 837 late onset Alzheimer’s disease (LOAD) cases and 550 controls. In our analyses, we ide...

  15. Diffusion abnormalities of the uncinate fasciculus in Alzheimer's disease: diffusion tensor tract-specific analysis using a new method to measure the core of the tract

    International Nuclear Information System (INIS)

    Our aim was to determine diffusion abnormalities in the uncinate fasciculus (UF) in Alzheimer's disease (AD) by diffusion tensor tractography (DTT) using a new method for measuring the core of the tract. We studied 19 patients with AD and 19 age-matched control subjects who underwent MRI using diffusion tensor imaging (DTI). DTT of the UF was generated. The mean diffusivity (MD) and fractional anisotropy (FA) of the core of the tract were measured after voxelized tract shape processing. Student's t-test was used to compare results between patients with AD and controls. Intraobserver correlation tests were also performed. FA was significantly lower (P 0.93 for measured FA and r > 0.92 for measured MD. Our results suggest that FA reflects progression of AD-related histopathological changes in the UF of the white matter and may represent a useful biological index in monitoring AD. Diffusion tensor tract-specific analysis with voxelized tract shape processing to measure the core of the tract may be a sensitive tool for evaluation of diffusion abnormalities of white matter tracts in AD. (orig.)

  16. Biliary endoprosthesis

    International Nuclear Information System (INIS)

    Biliary endoprosthesis could provide permanent internal biliary drainage in patient with obstructive jaundice with advantages of absence of troublesome external catheter and no loss of fluid, bile and electrolytes over external drainage. Incidence of sepsis and cholangitis be lowered. Endoprosthesis was performed in 18 patients of obstructive jaundice from January, 1985 to December, 1985 at Department of Radiology, Kyungpook National University Hospital. The results are as follows 2. The cases of obstructive jaundice included bile duct cancer in 11, stomach ca. metastasis in 3, ca. of ampulla of Vater in 1, ca. of head of pancreas in 1, CBD cancer with postop. recurrence in 1, and impacted CBD stone in 1 case. 2. The levels of obstruction were at the trifurcation in 8, CHD in 5, proximal CBD in 3, and distal CBD in 2 cases. 3. Decline of serum bilirubin level was noted in 15 cases with the most rapid decline within 1 week after the procedure. 4. The complication occurred in 5 cases. The three cases were recovered spontaneously, but one died of bile peritonitis, another experienced obstruction of endoprosthesis. 5. The endoprosthesis is beneficial in treatment of obstructive jaundice for which surgery is not indicated, and saving expensive abdominal surgery and less advantageous percutaneous external drainage, hence enhancing life quality.

  17. Biliary enhanced MR imaging by Gd-DTPA

    Energy Technology Data Exchange (ETDEWEB)

    Ohkawa, Shinichi; Fujikura, Yuji; Kanai, Toshio (Hiratsuka City Hospital, Kanagawa (Japan)); Hiramatsu, Kyoichi

    1992-05-01

    Biliary enhanced MRI (BEMRI) by Gd-DTPA via PTCD and/or PTGBD tube for obstructive jaundice was performed in 8 patients. In all cases, biliary tract was clearly visualised as high signal intensity on T1 weighted images. On same images, primary lesion such as common bile duct cancer was also visualised as well as portal system. In addition, MR angiography (MRA) by 2D-time of flight method was performed. MRA with BEMRI shows portal encasement on the same image as biliary tract obstruction. This suggests MRA with BEMRI may replace the other modality for obstructive jaundice. (author).

  18. Peritoneal seeding of cholangiocarcinoma in patients with percutaneous biliary drainage

    International Nuclear Information System (INIS)

    Percutaneous transhepatic catheter decompression is performed increasingly as an adjunct or alternative to surgery in patients with benign or malignant biliary obstruction. The authors recently saw three patients with cholangiocarcinoma in whom metastatic seeding of the peritoneal serosa was identified some months after initial percutaneous transhepatic biliary drainage. Although no tumor was found along the hepatic tract of the biliary drainage catheters to implicate the drainage tubes as the direct source of peritoneal spread, the occurrence of this rare type of metastasis of cholangiocarcinoma in patients with potential access of tumor cells to the peritoneal cavity via the catheter tracts does suggest such a relation. The clinical history of one patient is presented

  19. Peritoneal seeding of cholangiocarcinoma in patients with percutaneous biliary drainage

    Energy Technology Data Exchange (ETDEWEB)

    Miller, G.A. Jr.; Heaston, D.K.; Moore, A.V. Jr.; Mills, S.R.; Dunnick, N.R.

    1983-09-01

    Percutaneous transhepatic catheter decompression is performed increasingly as an adjunct or alternative to surgery in patients with benign or malignant biliary obstruction. The authors recently saw three patients with cholangiocarcinoma in whom metastatic seeding of the peritoneal serosa was identified some months after initial percutaneous transhepatic biliary drainage. Although no tumor was found along the hepatic tract of the biliary drainage catheters to implicate the drainage tubes as the direct source of peritoneal spread, the occurrence of this rare type of metastasis of cholangiocarcinoma in patients with potential access of tumor cells to the peritoneal cavity via the catheter tracts does suggest such a relation. The clinical history of one patient is presented.

  20. IgG4-related Disease of the Genitourinary Tract

    OpenAIRE

    Divatia, Mukul K; Ro, Jae Y.

    2014-01-01

    IgG4-related disease (IgG4-RD) is a recently established albeit well recognized fibro-inflammatory condition with distinctive features including a characteristic histopathological appearance; a propensity to develop tumefactive lesions in multiple body sites; and oft elevated serum IgG4 levels. The consensus statement on IgG-4 RD equips practicing pathologists with a set of working guidelines for the diagnosis of pathologic lesions identified in a host of different organ system affected with ...

  1. Usefulness of magnetic resonance cholangiography in the diagnosis of biliary tract lesions in patients with suspected complication following cholecystectomy; Valor da colangiopancreatografia por ressonancia magnetica no diagnostico de lesoes das vias biliares em pacientes com suspeita de complicacao pos-colecistectomia

    Energy Technology Data Exchange (ETDEWEB)

    Cecin, Alexandre de Oliveira [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil); Goldman, Suzan Menasce; Caetano, Simone; Rosas, George de Queiroz; Coelho, Rafael Darahem de Souza [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem; Lobo, Edson Jose [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Gastroenterologia Cirurgica; Abdalla, Nitamar; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem

    2005-01-15

    Objective: to determine the usefulness of magnetic resonance cholangiopancreatography (MRCP) in the diagnoses of bile duct injuries following cholecystectomy. Material and method: MRCP was retrospectively evaluated in 40 patients with suspected bile duct injury after laparoscopic or conventional cholecystectomy. Eight of these patients had been submitted to biliary reconstruction. All patients were symptomatic (jaundice, fever and chills, weight loss and abdominal pain). The scans were independently reviewed by two radiologists. The results were confirmed by surgery, percutaneous drainage, endoscopic retrograde cholangiopancreatography and clinical follow-up. The level and severity of bile duct injury were rated according to the Bismuth classification. Results: in a total of 40 symptomatic patients, 10 (25%) had normal findings on MRCP; Postoperative complications were seen in 29 (72.5%) patients, seven of them with more than one finding. Pancreatic head neoplasia was diagnoses in one patient. The most frequent finding was sclerosing (41.4%) followed by biliary duct stenosis (34.5%), residual or recurrent biliary stones (31.0%) and fluid collections (17.2%). The images obtained by MRCP were considered of good quality. Conclusion: MRCP is an effective method for the evaluation of patients with suspected postcholecystectomy biliary tract complications. (author)

  2. IgG4-related Disease of the Genitourinary Tract

    Directory of Open Access Journals (Sweden)

    Mukul K. Divatia

    2014-02-01

    Full Text Available IgG4-related disease (IgG4-RD is a recently established albeit well recognized fibro-inflammatory condition with distinctive features including a characteristic histopathological appearance; a propensity to develop tumefactive lesions in multiple body sites; and oft elevated serum IgG4 levels. The consensus statement on IgG-4 RD equips practicing pathologists with a set of working guidelines for the diagnosis of pathologic lesions identified in a host of different organ system affected with this disease. The diagnosis of IgG4-RD requires the combined presence of the characteristic histopathological appearance and increased numbers of IgG4-positive plasma cells. The essential histopathological features include a dense lymphoplasmacytic infiltrate, a storiform pattern of fibrosis, and obliterative phlebitis. Tissue IgG4-positive plasma cell counts and IgG4: IgG ratios are significant ancillary aids in establishing the diagnosis. The spectrum of IgG4-RD continues to expand and involve multiple body sites. The genitourinary system comprising of the kidneys, ureters, urinary bladder, urethra, prostate gland, testes and penis is one of the multiple organ systems to be affected by IgG4-RD. This review describes the clinical and histopathologic patterns of involvement of the genitourinary system by IgG4-RD, in association with serologic and radiological features. [J Interdiscipl Histopathol 2014; 2(1.000: 3-18

  3. Hepatobiliary diseases in small animals: a comparison of ultrasonography and multidetector-row computed tomography

    OpenAIRE

    Borsetto, Antonella

    2011-01-01

    Ultrasonography (US) is an essential imaging tool for identifying abnormalities of the liver parenchyma, biliary tract and vascular system. US has replaced radiography as the initial imaging procedure in screening for liver disease in small animals. There are few reports of the use of conventional and helical computed tomography (CT) to assess canine or feline parenchymal and neoplastic liver disease and biliary disorders. In human medicine the development of multidetector- row helical comput...

  4. Ultrasonographic diagnosis of acute pancreatitis caused by ruptured hydatid disease to the biliary system

    OpenAIRE

    Ozcaglayan, O; Halefoglu, A M; Ozcaglayan, T; Sumbul, H A

    2014-01-01

    Acute pancreatitis is a rare complication of hydatic disease which occurs following the rupture of a cyst to the intrahepatic bile ducts. Herein, we report a case of a 34-year-old Turkish man, who presented with upper abdominal pain. In laboratory examination, amylase and lipase levels were elevated. Ultrasound examination showed a cystic hypoechoic mass lesion located in the right lobe of the liver with dilated intrahepatic bile ducts, and germinative membranes were detected originating from...

  5. CT biliary cystoscopy of gallbladder polyps

    Institute of Scientific and Technical Information of China (English)

    Ming-Wu Lou; Wei-Dong Hu; Yi Fan; Jin-Hua Chen; Zhan-Sen E; Guang-Fu Yang

    2004-01-01

    AIM: CT virtual endoscopy has been used in the study of various organs of body including the biliary tract, however,CT virtual endoseopy in diagnosis of gallbladder polyps has not yet been reported. This study was to evaluate the diagnostic value of CT virtual endoscopy in polyps of the gallbladder.METHODS: Thirty-two cases of gallbladder polyps were examined by CT virtual endoscopy, ultrasound, CT scan with oral biliary contrast separately and confirmed by operation and pathology. CT biliary cystoscopic findings were analyzed and compared with those of ultrasound and CT scan with oral biliary contrast, and evaluated in comparison with operative and pathologic findings in all cases.RESULTS: The detection rate of gallbladder polyps was 93.8%(90/96), 96.9%(93/96) and 79.2%(76/96) for CT cystoscopy, ultrasound and CT scan with oral contrast,respectively. CT biliary cystoscopy corresponded well with ultrasound as well as pathology in demonstrating the location, size and configuration of polyps. CT endoscopy was superior to ultrasound in viewing the polyps in a more precise way, 3 dimensionally from any angle in space, and showing the surface in details. CT biliary cystoscopy was also superior to CT scan with oral biliary contrast in terms of observation of the base of polyps for the presence of a pedicle, detection rates as well as image quality. The smallest polyp detected by CT biliary cystoscopy was measured 1.5 mmx2.2 mmx2.5 mm.CONCLUSION: CT biliary cystoscopy is a non-invasive and accurate technique for diagnosis and management of gallbladder polyps.

  6. [The curative action of Monticelli Term's water in upper respiratory tract diseases (author's transl)].

    Science.gov (United States)

    Turchi, R; Jemmi, G; Barani, B

    1976-01-01

    The Authors study the action of the sodio bromide-iodic water of Monticelli Terme in upper respiratory tract disease and particularly assert that is not to neglect the organic ground on which establishes mucosa's disease. Therman treatment gives the best therapeutic results in every patient presenting chronic inflammatory processes of the upper respiratory trach alternating periods of quiescency and of activity, and poor therapeutic action in patients presenting chronic inveterate diseases with great alterations in vascular and glandular components of the mucosa. PMID:1021139

  7. Metal stent and endoluminal high-dose rate [sup 192]iridium brachytherapy in palliative treatment of malignant biliary tract obstruction. First experiences. Metallgeflecht-Endoprothese und intraluminare High-dose-rate-[sup 192]Iridium-Brachytherapie zur palliativen Behandlung maligner Gallengangsobstruktionen. Erste Erfahrungen

    Energy Technology Data Exchange (ETDEWEB)

    Pakisch, B.; Stuecklschweiger, G.; Poier, E.; Leitner, H.; Poschauko, J.; Hackl, A. (Universitaets-Klinik fuer Radiologie, Abt. fuer Strahlentherapie, Graz (Austria)); Klein, G.E.; Lammer, J.; Hausegger, K.A. (Universitaets-Klinik fuer Radiologie, Abt. fuer Spezielle Roentgendiagnostik und Digitale Bilddiagnostische Verfahren, Graz (Austria))

    1992-06-01

    Since December 1989, 9 patients with inoperable malignant biliary tract obstruction were treated palliatively by a combined modality treatment consisting of placement of a permanent biliary endoprosthesis followed by intraluminal high dose-rate [sup 192]Ir brachytherapy. A dose of 10 Gy was delivered in a hyperfractionated schedule at the point of reference in a distance of 7.5 mm of centre of the source. External small field radiotherapy (50.4 Gy, 1.8 Gy per day, 5 fractions per week) was also given in six cases (M/O, Karnofsky >60%). In 9/9 cases an unrestrained bile flow and an interruption of pruritus was achieved, in 78% (7/9) of cases the duration of palliation was as long as the survival time (median survival time 7.5 months). (orig.).

  8. The experimental research on the anti-infection of biliary tract with ofloxacin and ciprofloxacin%氧氟沙星、环丙沙星抗胆道感染作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    孙桂华; 赵树进; 黄小让

    2001-01-01

    Objective:To observe the metabolic process of 4-quinoles antibiotic and provide the theoretic basis for physician selecting effective antibiotic rationally when biliary tract is infected.Mothods:Dog experiment:Carry out choledochostomy in order to reserve samples of bile.After injecting ofloxacin or ciprofloxacin,reserve samples of bile and vein blood,detect drug density with microbiological method,process data with 3P87 statistical software and obtain pharmacokinetics parameters.Results :After injecting ofloxacin or ciprofloxacin through vein,the main metabolic parameters about bile:Tpeak(min)was 58.72;Cmax(μg/ml)were 8.02,8.81;T1/2(h)were 7.66,8.23;CL(ml/min) were 30.35,26.70. Conclusion: After injected through vein,the density of ofloxacin or ciprofloxacin in bile was high and their half life time was long comparatively. The results suggested that ofloxacin or ciprofloxacin would be one of the better antibiotic for treating biliary tract infection.%目的:观察喹诺酮类抗生素(环丙沙星、氧氟沙星)在胆汁中的代谢过程,为临床医师提供胆道感染时合理选用有效抗生素的理论依据。方法:犬为实验动物,行胆总管造瘘,以备留取胆汁标本。静脉滴注氧氟沙星(Ofloxacin)、环丙沙星(Ciprofloxacin)后,留取静脉及胆汁标本,用微生物法测定药物浓度,3P87软件数据处理,得出药物动力学参数。结果:静脉滴注氧氟沙星、环丙沙星后,胆汁中主要的代谢参数:峰值时间(Tpeak min)分别为58、72;峰值浓度(Cmax μg/ml)分别为8.02、8.81;半衰期(T1/2h)分别为7.66、8.23;清除率(CL ml/min)分别为30.35、26.7。结论:静脉滴注氧氟沙星及环丙沙星后,二者在胆汁中浓度较高,半衰期长,是治疗胆道感染较为理想的抗生素之一。

  9. Analysis of divergences of the results of choleography and radioscintigraphy to evaluate the extrahepatic biliary ducts

    Energy Technology Data Exchange (ETDEWEB)

    Zubovskij, G.A.; Popova, Z.P.; Ogneva, T.V.; Sycheva, N.A.; Mikhajlova, N.A.; Medvedeva, Eh.S. (Nauchno-Issledovatel' skij Inst. Rentgenologii i Radiologii, Moscow (USSR))

    A great share of hepatic and bile cyst diseases among gastrointestinal diseases necessitates attempts to collect the most complete information on the state of the above organs while using an optimum complex of examination methods. The authors present the results of a multimodality study of 98 patients including i.v. cholecystography and computerized hepatobiliscintigraphy with sup(99m)Tc-HIDA. A detailed analysis of coincidences and divergences in diagnosis is provided. A conclusion has been made as to the great informative value of the x-ray methods for detection of organic defects of the biliary ducts and the advantages of radionuclide study in the evaluation of functional disorders in the liver and biliary tract.

  10. Diseases of the gastrointestinal tract in individuals diagnosed as children with atypical autism

    DEFF Research Database (Denmark)

    Mouridsen, Svend Erik Birkebæk; Isager, Torben; Rich, Bente

    2013-01-01

    The purpose of this study is to compare the prevalence and types of diseases (International Classification of Mental and Behavioural Disorders, 10th Edition codes K20-K93) relating to the gastrointestinal tract in a clinical sample of 89 individuals diagnosed as children with atypical autism....../pervasive developmental disorder not otherwise specified with 258 controls from the general population. All participants were screened through the nationwide Danish National Hospital Register. The average observation time was 32.9 years, and mean age at the end of the observation period was 48.5 years. Among the 89 cases...... with atypical autism, a total of 22 (24.7%) were registered with at least one diagnosis of any disease of the gastrointestinal tract, against 47 of 258 (18.2%) in the comparison group (p = 0.22; odds ratio = 1.5; 95% confidence interval = 0.8-2.6). Without reaching statistical significance, the rate of...

  11. Upper Respiratory Tract Disease in the Gopher Tortoise Is Caused by Mycoplasma agassizii†

    OpenAIRE

    Brown, M B; McLaughlin, G. S.; Klein, P A; Crenshaw, B. C.; Schumacher, I M; Brown, D R; Jacobson, E R

    1999-01-01

    Upper respiratory tract disease (URTD) has been observed in a number of tortoise species, including the desert tortoise (Gopherus agassizii) and the gopher tortoise (Gopherus polyphemus). Clinical signs of URTD in gopher tortoises are similar to those in desert tortoises and include serous, mucoid, or purulent discharge from the nares, excessive tearing to purulent ocular discharge, conjunctivitis, and edema of the eyelids and ocular glands. The objectives of the present study were to determi...

  12. Bisphosphonates for osteoporosis in primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena; Giljaca, Vanja; Krstic, Miodrag N;

    2011-01-01

    Bisphosphonates are widely used for treatment of postmenopausal osteoporosis. Patients with primary biliary cirrhosis often have osteoporosis - either postmenopausal or secondary to the liver disease. No systematic review or meta-analysis has assessed the effects of bisphosphonates for osteoporosis...

  13. Relationship between cognitive impairment and white-matter alteration in Parkinson’s disease with dementia: tract-based spatial statistics and tract-specific analysis

    OpenAIRE

    Kamagata, Koji; Motoi, Yumiko; Tomiyama, Hiroyuki; Abe, Osamu; Ito, Kenji; Shimoji, Keigo; Suzuki, Michimasa; Hori, Masaaki; Nakanishi, Atsushi; Sano, Tamotsu; Kuwatsuru, Ryohei; Sasai, Keisuke; Aoki, Shigeki; Hattori, Nobutaka

    2013-01-01

    Objectives We investigated the relationship between white-matter alteration and cognitive status in Parkinson’s disease (PD) with and without dementia by using diffusion tensor imaging. Methods Twenty PD patients, 20 PDD (Parkinson’s disease with dementia) patients and 20 age-matched healthy controls underwent diffusion tensor imaging. The mean diffusivity and fractional anisotropy (FA) map of each patient group were compared with those of the control group by using tract-based spatial statis...

  14. Percutaneous Transhepatic Endobiliary Drainage of Hepatic Hydatid Cyst with Rupture into the Biliary System: An Unusual Route for Drainage

    International Nuclear Information System (INIS)

    The most common and serious complication of hydatid cyst of the liver is rupture into the biliary tract causing obstructive jaundice, cholangitis and abscess. The traditional treatment of biliary-cystic fistula is surgery and recently endoscopic sphincterotomy. We report a case of complex heterogeneous cyst rupture into the biliary tract causing biliary obstruction in which the obstruction and cyst were treated successfully by percutaneous transhepatic endobiliary drainage. Our case is the second report of percutaneous transbiliary internal drainage of hydatid cyst with rupture into the biliary duct in which the puncture and drainage were not performed through the cyst cavity

  15. Successful Endoscopic Ultrasound-Guided Transduodenal Biliary Drainage Through a Pre-Existing Duodenal Stent

    Directory of Open Access Journals (Sweden)

    Paul J Belletrutti

    2010-05-01

    Full Text Available Context When ERCP fails in the setting of combined biliary and duodenal obstruction, EUS-guided biliary drainage has emerged as an alternate method of biliary decompression. Case report We present a case of a 40-year-old man with advanced pancreatic cancer and a pre-existing duodenal wall stent who subsequently develops jaundice due to biliary obstruction. An ERCP was technically unsuccessful as the papilla was inaccessible despite probing within the duodenal stent. Transduodenal biliary drainage was achieved using EUS guidance to create a choledochoduodenostomy tract. A fully covered metal biliary stent was then deployed through the mesh of the duodenal wall stent. The patient’s jaundice and pruritus subsequently resolved. Conclusion This is the first report of successful transduodenal EUS-guided biliary drainage performed through an existing enteral wall stent and can still be considered as an alternate mode of biliary drainage in this setting.

  16. Hepatobiliary and pancreatic disorders in celiac disease

    Institute of Scientific and Technical Information of China (English)

    Hugh James Freeman

    2006-01-01

    A variety of hepatic and biliary tract disorders may complicate the clinical course of celiac disease. Some of these have been hypothesized to share common genetic factors or have a common immunopathogenesis, such as primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune forms of hepatitis or cholangitis. Other hepatic changes in celiac disease may be associated with malnutrition resulting from impaired nutrient absorption,including hepatic steatosis. In addition, celiac disease may be associated with rare hepatic complications, suchas hepatic T-cell lymphoma. Finally, pancreatic exocrine function may be impaired in celiac disease and represent a cause of treatment failure.

  17. Biliary scintigraphy in neonatal cytomegalovirus cholestasis

    International Nuclear Information System (INIS)

    Diagnostic value of hepatobiliary scintigraphy using mebrofenin-Te-99m was assessed in three newborns with cytomegalovirus (CMV) hepatitis and one baby with hepatitis B jaundice. All cases were affected by persistent jaundice with predominately conjugated bilirubin, alcoholic stools, anemia. One of this newborns (case number 1) was suspected of having biliary atresia due to the absence of intestinal excretion of the tracer. After three weeks intestinal passage was seen in scintiscan late after 24 h. Hepatobiliary scintigraphy represents a non-invasive diagnostic procedure which enables the detection of permeability of the biliary tract. (Author)

  18. Primary biliary cirrhosis.

    Science.gov (United States)

    Nguyen, Douglas L; Juran, Brian D; Lazaridis, Konstantinos N

    2010-10-01

    Primary biliary cirrhosis (PBC) is an idiopathic chronic autoimmune liver disease that primarily affects women. It is believed that the aetiology for PBC is a combination between environmental triggers in genetically vulnerable persons. The diagnosis for PBC is made when two of the three criteria are fulfilled and they are: (1) biochemical evidence of cholestatic liver disease for at least 6 month's duration; (2) anti-mitochondrial antibody (AMA) positivity; and (3) histologic features of PBC on liver biopsy. Ursodeoxycholic acid (UDCA) is the only FDA-approved medical treatment for PBC and should be administered at a recommended dose of 13-15 mg/kg/day. Unfortunately despite adequate dosing of UDCA, approximately one-third of patients does not respond adequately and may require liver transplantation. Future studies are necessary to elucidate the role of environmental exposures and overall genetic impact not only in the development of PBC, but on disease progression and variable clinical response to therapy. PMID:20955967

  19. 胆道感染患者的病原菌分布及耐药性分析%Distribution and drug resistance of Pathogenic bacteria in patients with biliary tract infection

    Institute of Scientific and Technical Information of China (English)

    杨培; 马春华; 罗华

    2012-01-01

    OBJECTIVE To study the microbiologed distribution of biliary tract infection in patients with resistant strains so as to guide rational drug use. METHODS There were 275 cases with submission sample. The isolation and culture of bacteria and drug susceptibility test were executed according to'National Clinical Laboratory Operating Procedures' (third edition) standards using automated microbial (VITEK-32, France) analyzer. KB method was used for drug susceptibility testing and the results were judged by Clinical Laboratory Standards (CLSI) standards. RESULTS A total of 183 strains were detected from 275 samples, with the detection rate of 66. 55%. They included 95 strains of gram-negative bacteria accounting for 51. 91%, 63 strains of gram-positive bacteria accounting for 34. 43% and 12 strains of fungi accounting for 6. 56%. The resistance rates of the major bacteria Escherichia coli and Klebsiella pneumoniae to imipenem/cilastatin was 0, and the resistance rate of Enterococcus faecalis, Enterococci feces, Staphylococcus aureus to quinolones was low. CONCLUSION The biliary system is widely distributed with microbial infections, and some strains may cause multidrug resistance. We suggest clinicians emphasize the monitoring of the dynamic distribution of pathogenic bacteria and changes in drug susceptibility to guide rational antibiotics use.%目的 了解胆道感染患者的病原菌分布及耐药性特点,指导合理用药.方法 送检标本275例,菌种分离培养和药物敏感试验执行《全国临床检验操作规程》(第3版)标准;分析仪器采用全自动微生物(VITEK-32法国)分析仪鉴定,用K-B法进行药物敏感试验,操作规程执行《全国临床检验操作规程》,结果判断执行美国临床实验室标准化研究所(CLSI)标准.结果 送检标本275份,检出病原菌183株,检出率为66.55%;其中革兰阴性菌95株,占51.91%,革兰阳性菌63株,占34.43%,真菌12株,占6.56%;大肠埃希菌、肺炎克

  20. Endocannabinoids and the Digestive Tract and Bladder in Health and Disease.

    Science.gov (United States)

    Izzo, Angelo A; Muccioli, Giulio G; Ruggieri, Michael R; Schicho, Rudolf

    2015-01-01

    Components of the so-called endocannabinoid system, i.e., cannabinoid receptors, endocannabinoids, as well as enzymes involved in endocannabinoid synthesis and degradation, have been identified both in the gastrointestinal and in the urinary tract. Evidence suggests that the endocannabinoid system is implicated in many gastrointestinal and urinary physiological and pathophysiological processes, including epithelial cell growth, inflammation, analgesia, and motor function. A pharmacological modulation of the endocannabinoid system might be beneficial for widespread diseases such as gastrointestinal reflux disease, irritable bowel syndrome, inflammatory bowel disease, colon cancer, cystitis, and hyperactive bladder. Drugs that inhibit endocannabinoid degradation and raise the level of endocannabinoids, non-psychotropic cannabinoids (notably cannabidiol), and palmitoylethanolamide, an acylethanolamide co-released with the endocannabinoid anandamide, are promising candidates for gastrointestinal and urinary diseases. PMID:26408170

  1. Diagnosis and treatment of arteriobiliary hemorrhage occurring after percutaneous biliary drainage

    International Nuclear Information System (INIS)

    Hemorrhage due to arteriobiliary communication occurred in 15 of 500 patients after percutaneous biliary drainage (PBD). Hemorrhage produced a distinct clinical syndrome and occurred sooner after PBD in patients with benign disease (eight patients, mean of 1.5 weeks) than in patients with neoplastic obstruction (seven patients, mean of 11.5 weeks). In eight patients the author identified the bleeding vessel by contrast agent injection into the transhepatic tract, and in four we were able to embolize this vessel via the transhepatic tract. Eleven patients underwent hepatic arteriography, which identified contrast agent extravasation or arterial abnormality. Angiographic embolization was possible in eight of the 11. Embolization via the transhepatic tube tract should be attempted first, with angiographic embolization as a backup

  2. GWAS in Primary Biliary Cirrhosis

    OpenAIRE

    Gulamhusein, Aliya F.; Juran, Brian D.; Lazaridis, Konstantinos N.

    2015-01-01

    Genome wide association studies (GWAS) have been a significant technological advance in our ability to evaluate the genetic architecture of complex diseases such as Primary Biliary Cirrhosis (PBC). To date, six large-scale studies have been performed which identified 27 non-HLA risk loci associated with PBC. The identified risk variants emphasize important disease concepts; namely, that disturbances in immunoregulatory pathways are important in the pathogenesis of PBC and that such perturbati...

  3. Causes and counter measures of reoperation for biliary diseases%胆道再次手术的原因与对策

    Institute of Scientific and Technical Information of China (English)

    梁力建; 胡文杰

    2012-01-01

    The reoperation for biliary diseases is usually unplanned, and the major reasons leading to this situation include:(1) The initial operation was performed under emergency situation and radical procedure could not be carried out.(2) The surgical procedure was inadequate.( 3 ) The operator was unqualified for the operation. In order to avoid repeated operations,the following principles must be obeyed strictly.Firstly,once the initial operation was failed,the patients must be transferred to large medical center and the reoperation must be performed by hepatobiliary specialists.Secondly,the operator must realize that most of the patients were in poor condition because of the previous operation,and they needed careful evaluation of organ function and adequate supportive treatment before reoperation.Thirdly,various measures must be taken to avoid unplanned operation and ensure the successful implement of radical operation at a time:( 1 ) Operator must learn all the details of previous operation,which include operation procedure,findings during operation and postoperative complications.( 2 ) Cholangiogram of the whole biliary tree is important for surgical planning,ultrasonography,computed tomography (CT),endoscopic retrograde cholangiopancreatography,magnetic resonance cholangiopancreatography, percutaneous transhepatic cholangiography (PTC),or PTC-CT should be performed solely or comprehensively to determine the nature and location of lesions.For bile duct injury,additional examination including CT angiography,magnetic resonance angiography or digital subtraction angiography is necessary to ascertain the accompanied vessel injury.(3) Making individual surgical procedure according to patien's condition and distribution of lesions.

  4. Peroral direct cholangioscopy by freehand intubation using routine straight-view endoscope for diagnosis and therapy of biliary diseases%徒手直接经口胆道镜在胆道疾病中的初步应用

    Institute of Scientific and Technical Information of China (English)

    高道键; 胡冰

    2013-01-01

    Objective To evaluate the feasibility and safety of peroral direct cholangioscopy (PDCS) by freehand intubation using routine straight-view endoscope for diagnosis and therapy of biliary diseases.Methods Patients with bile duct dilation underwent standard ERCP and native papilla was dilated using EST and/or endoscopic papillary large balloon dilation,according to the size of the papilla.Then peroral direct cholangioscopy was performed by freehand intubation using routine straight-view endoscope.General data of patients,procedure of ERCP,diagnosis of PDCS and complications were recorded.Results A total of 5 patients underwent PDCS.Indications included common bile duct stones (n =2),intraductal papillary neoplasm of bile buct (n =2) and benign biliary stricture after removable metal stent placement (n =1).The diameter of common bile duct ranges from 1.2 cm to 2.4 cm.EST or/and EPLBD was required in 3/5 patients to facilitate PDCS.Freehand PDCS intubation of the bile duct was successful in all procedures (1 case into distal common bile duct,4 cases into proximal common bile duct).Complications were cholangitis managed with intavenous antibiotics (n =1).No procedure related death occurred.Conclusion Freehand PDCS is technically feasible and safe,and may be clinically useful for diagnostic and therapeutic purposes in managing select biliary tract diseases.%目的 探讨胃镜和鼻胃镜徒手直接经口胆道镜在胆道疾病诊治中的安全性及可行性.方法 对5例胆管扩张患者先行ERCP,并根据十二指肠乳头开口大小决定是否进行扩张,扩张完成后退出十二指肠镜,然后采用胃镜或鼻胃镜进行徒手直接经口胆道镜检查,记录患者一般资料、ERCP诊治情况、胆道检查结果以及并发症发生情况.结果 ERCP诊断胆总管结石2例、胆管内乳头状产黏蛋白肿瘤2例、胆管良性狭窄可回收金属支架置入术后1例,胆总管直径在1.2~2.4 cm,有3例行乳头括约肌中切

  5. Percutaneous biliary drainage and stenting

    International Nuclear Information System (INIS)

    Full text: Percutaneous transhepatic cholangiography (PTC) is an X-ray or US guided procedure that involves the injection of a contrast material directly into the bile ducts inside the liver to produce pictures of them. If a blockage or narrowing is found, additional procedures may be performed: 1. insertion of a catheter to drain excess bile out of the body or both - internal and external; 2. plastic endoprothesis placement; 3. self-expandable metal stents placement to help open bile ducts or to bypass an obstruction and allow fluids to drain. Current percutaneous biliary interventions include percutaneous transhepatic cholangiography (PTC) and biliary drainage to manage benign and malignant obstructions. Internal biliary stents are either plastic or metallic, and various types of each kind are available. Internal biliary stents have several advantages. An external tube can be uncomfortable and have a psychological disadvantage. An internal stent prevents the problems related to external catheters, for example, pericatheter leakage of bile and the need for daily flushing. The disadvantages include having to perform endoscopic retrograde cholangiopancreatography (ERCP) or new PTC procedures to obtain access in case of stent obstruction. Better patency rates are reported with metallic than with plastic stents in cases of malignant obstruction, though no effect on survival is noted. Plastic internal stents are the cheapest but reportedly prone to migration. Metallic stents are generally not used in the treatment of benign disease because studies have shown poor long-term patency rates. Limited applications may include the treatment of patients who are poor surgical candidates or of those in whom surgical treatment fails. Most postoperative strictures are treated surgically, though endoscopic and (less commonly) percutaneous placement of nonmetallic stents has increasingly been used in the past few years. Now there are some reports about use of biodegradable biliary

  6. Percutaneous transhepatic removal of biliary stones: Clinical analysis of 16 cases

    International Nuclear Information System (INIS)

    Percutaneous transhepatic biliary drainage (PTBD) is widely used to control cholangitis, sepsis, or jaundice caused by biliary tree obstruction. The PTBD tract can be used in percutaneous biliary stone extraction in pre- or post-operative state when ERCP is failed or operation is contraindicated. We performed 16 cases of percutaneous transhepatic biliary stone removal. Locations of biliary stones are combined intrahepatic and extrahepatic in 8 cases(50%), only extrahepatic in 7 cases (44%), and only intrahepatic in 1 cases(6%). The number of stones was single in 6 cases and multiple in 10 cases. Over all success rate was 81% (13/16), 93% (14/15) in extrahepatic stones and 78% (7/9) in intrahepatic stones. In 5 of 6 caes, complete stone removed was impossible due to marked tortuosity of T-tube tract or peripherally located stones, complete removal of biliary stones was achieved via a new PTBD tract. No significant pre- or post-procedure complication was occurred. Percutaneous removal of biliary stones via PTBD tract is an effective and safe alternative method in difficult cases in the management of biliary tract stones

  7. Percutaneous transhepatic removal of biliary stones: Clinical analysis of 16 cases

    Energy Technology Data Exchange (ETDEWEB)

    Ryeom, Hun Kyu; Sim, Jae In; Park, Auh Whan; Kim, Yong Joo [Kyungpook National University College of Medicine, Taegu (Korea, Republic of); Kim, Hee Jin [Taegu Fatima Hospital, Taegu (Korea, Republic of)

    1993-11-15

    Percutaneous transhepatic biliary drainage (PTBD) is widely used to control cholangitis, sepsis, or jaundice caused by biliary tree obstruction. The PTBD tract can be used in percutaneous biliary stone extraction in pre- or post-operative state when ERCP is failed or operation is contraindicated. We performed 16 cases of percutaneous transhepatic biliary stone removal. Locations of biliary stones are combined intrahepatic and extrahepatic in 8 cases(50%), only extrahepatic in 7 cases (44%), and only intrahepatic in 1 cases(6%). The number of stones was single in 6 cases and multiple in 10 cases. Over all success rate was 81% (13/16), 93% (14/15) in extrahepatic stones and 78% (7/9) in intrahepatic stones. In 5 of 6 caes, complete stone removed was impossible due to marked tortuosity of T-tube tract or peripherally located stones, complete removal of biliary stones was achieved via a new PTBD tract. No significant pre- or post-procedure complication was occurred. Percutaneous removal of biliary stones via PTBD tract is an effective and safe alternative method in difficult cases in the management of biliary tract stones.

  8. Suggestions on the guidelines for percutaneous transhepatic biliary drainage

    International Nuclear Information System (INIS)

    Percutaneous transhepatic biliary drainage (PTBD) is an effective therapeutic option for obstructive jaundice. With various novel puncture instruments being created, the manipulating technique being improved and medical idea being updated, PTBD has been widely employed in clinical practice for alleviating the biliary tract obstruction. In order to standardize this technique this paper aims to make some suggestions for the PTBD guidelines concerning the indications, contraindications, operative skill, postoperative management, complications and their preventions, points for attention, etc. (authors)

  9. Heterogeneity of the intrahepatic biliary epithelium

    Institute of Scientific and Technical Information of China (English)

    Shannon Glaser; Heather Francis; Sharon DeMorrow; Gene LeSage; Giammarco Fava; Marco Marzioni; Julie Venter; Gianfranco Alpini

    2006-01-01

    The objectives of this review are to outline the recent findings related to the morphological heterogeneity of the biliary epithelium and the heterogeneous pathophysiological responses of different sized bile ducts to liver gastrointestinal hormones and peptides and liver injury/toxins with changes in apoptotic, proliferative and secretory activities. The knowledge of biliary function is rapidly increasing because of the recognition that biliary epithelial cells (cholangiocytes) are the targets of human cholangiopathies, which are characterized by proliferation/damage of bile ducts within a small range of sizes. The unique anatomy, morphology, innervation and vascularization of the biliary epithelium are consistent with function of cholangiocytes within different regions of the biliary tree. The in vivo models [e.g., bile duct ligation (BDL), partial hepatectomy, feeding of bile acids,carbon tetrachloride (CCl4) or α-naphthylisothiocyanate (ANIT)] and the in vivo experimental tools [e.g., freshly isolated small and large cholangiocytes or intrahepatic bile duct units (IBDU) and primary cultures of small and large murine cholangiocytes] have allowed us to demonstrate the morphological and functional heterogeneity of the intrahepatic biliary epithelium.These models demonstrated the differential secretory activities and the heterogeneous apoptotic and proliferative responses of different sized ducts. Similar to animal models of cholangiocyte proliferation/injury restricted to specific sized ducts, in human liver diseases bile duct damage predominates specific sized bile ducts.Future studies related to the functional heterogeneity of the intrahepatic biliary epithelium may disclose new pathophysiological treatments for patients with cholangiopathies.

  10. Antibodies against p53 protein in serum of patients with benign or malignant pancreatic and biliary diseases.

    OpenAIRE

    Laurent-Puig, P.; Lubin, R; Semhoun-Ducloux, S; Pelletier, G.; Fourre, C; Ducreux, M.; Briantais, M J; Buffet, C; Soussi, T

    1995-01-01

    Specific markers for pancreatic or biliary cancer have been developed in the past few years. Ca 19-9 has a good sensitivity but it is also increased in benign cholestasis. Mutations in the p53 gene are commonly reported in pancreatic cancer and can be detected by a serological analysis. The aim of this work was to find out the sensitivity and specificity of this new assay in diagnosing cancer of the pancreas or of the bile ducts. The presence of antibodies against p53 was determined by an enz...

  11. Interactions between Cytokines, Congenital Anomalies of Kidney and Urinary Tract and Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Ana Cristina Simões e Silva

    2013-01-01

    Full Text Available Fetal hydronephrosis is the most common anomaly detected on antenatal ultrasound, affecting 1–5% of pregnancies. Postnatal investigation has the major aim in detecting infants with severe urinary tract obstruction and clinically significant urinary tract anomalies among the heterogeneous universe of patients. Congenital uropathies are frequent causes of pediatric chronic kidney disease (CKD. Imaging techniques clearly contribute to this purpose; however, sometimes, these exams are invasive, very expensive, and not sufficient to precisely define the best approach as well as the prognosis. Recently, biomarkers have become a focus of clinical research as potentially useful diagnostic tools in pediatric urological diseases. In this regard, recent studies suggest a role for cytokines and chemokines in the pathophysiology of CAKUT and for the progression to CKD. Some authors proposed that the evaluation of these inflammatory mediators might help the management of postnatal uropathies and the detection of patients with high risk to developed chronic kidney disease. Therefore, the aim of this paper is to revise general aspects of cytokines and the link between cytokines, CAKUT, and CKD by including experimental and clinical evidence.

  12. Diagnostic imaging of digestive tract involvement in cystic fibrosis. Part 2: pancreatic and gastrointestinal disease

    International Nuclear Information System (INIS)

    Cystic fibrosis (CF) is the most common fatal, autosomal recessive disease among the white population. Although recurrent pulmonary infections and pulmonary insufficiency are the major causes of morbidity and mortality, gastrointestinal symptoms generally present earlier and may suggest the diagnosis in the newborn or even prior to birth. The changes are attributed to the secretion of an abnormally thick mucous into the intestinal lumen, leading to the hallmark of diseases of the digestive tract: obstruction. This can be detected at birth in the form of mecanium ileus, ileal atresia, mecanium peritonitis and mecomiun plug, or present later on in childhood and adolescence as distal bowel obstruction syndrome or fibrosing colonopathy. This thick mucous can also trigger intussusception or acute appendicitis. Pancreatic insufficiency or pancreatic enzyme replacement therapy is the direct cause of most of these disorders. Plain radiography is of the utmost utility in assessing the digestive tract in CF. When the disease is detected in a newborn, the recommended approach is to perform plain abdominal X-ray, followed by barium enema, always accompanied by ultrasound. In older children and adolescents, enema and ultrasound are usually sufficient, although computed tomography and magnetic resonance may sometimes be necessary. (Author) 52 refs

  13. Intra-biliary contrast-enhanced ultrasound for evaluating biliary obstruction during percutaneous transhepatic biliary drainage: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Er-jiao [Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630 (China); Zheng, Rong-qin, E-mail: zhengrq@mail.sysu.edu.cn [Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630 (China); Su, Zhong-zhen; Li, Kai; Ren, Jie; Guo, Huan-yi [Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630 (China)

    2012-12-15

    Objectives: The aimed of this study was to investigate the value of intra-biliary contrast-enhanced ultrasound (IB-CEUS) for evaluating biliary obstruction during percutaneous transhepatic biliary drainage (PTBD). Materials and methods: 80 patients with obstructive jaundice who underwent IB-CEUS during PTBD were enrolled. The diluted ultrasound contrast agent was injected via the drainage catheter to perform IB-CEUS. Both conventional ultrasound and IB-CEUS were used to detect the tips of the drainage catheters and to compare the detection rates of the tips. The obstructive level and degree of biliary tract were evaluated by IB-CEUS. Fluoroscopic cholangiography (FC) and computer tomography cholangiography (CTC) were taken as standard reference for comparison. Results: Conventional ultrasound displayed only 43 tips (43/80, 53.8%) of the drainage catheters within the bile ducts while IB-CEUS identified all 80 tips (80/80, 100%) of the drainage catheters including 4 of them out of the bile duct (P < 0.001). IB-CEUS made correct diagnosis in 44 patients with intrahepatic and 36 patients with extrahepatic biliary obstructions. IB-CEUS accurately demonstrated complete obstruction in 56 patients and incomplete obstruction in 21 patients. There were 3 patients with incomplete obstruction misdiagnosed to be complete obstruction by IB-CEUS. The diagnostic accuracy of biliary obstruction degree was 96.3% (77/80). Conclusion: IB-CEUS could improve the visualization of the drainage catheters and evaluate the biliary obstructive level and degree during PTBD. IB-CEUS may be the potential substitute to FC in the PTBD procedure.

  14. Intra-biliary contrast-enhanced ultrasound for evaluating biliary obstruction during percutaneous transhepatic biliary drainage: A preliminary study

    International Nuclear Information System (INIS)

    Objectives: The aimed of this study was to investigate the value of intra-biliary contrast-enhanced ultrasound (IB-CEUS) for evaluating biliary obstruction during percutaneous transhepatic biliary drainage (PTBD). Materials and methods: 80 patients with obstructive jaundice who underwent IB-CEUS during PTBD were enrolled. The diluted ultrasound contrast agent was injected via the drainage catheter to perform IB-CEUS. Both conventional ultrasound and IB-CEUS were used to detect the tips of the drainage catheters and to compare the detection rates of the tips. The obstructive level and degree of biliary tract were evaluated by IB-CEUS. Fluoroscopic cholangiography (FC) and computer tomography cholangiography (CTC) were taken as standard reference for comparison. Results: Conventional ultrasound displayed only 43 tips (43/80, 53.8%) of the drainage catheters within the bile ducts while IB-CEUS identified all 80 tips (80/80, 100%) of the drainage catheters including 4 of them out of the bile duct (P < 0.001). IB-CEUS made correct diagnosis in 44 patients with intrahepatic and 36 patients with extrahepatic biliary obstructions. IB-CEUS accurately demonstrated complete obstruction in 56 patients and incomplete obstruction in 21 patients. There were 3 patients with incomplete obstruction misdiagnosed to be complete obstruction by IB-CEUS. The diagnostic accuracy of biliary obstruction degree was 96.3% (77/80). Conclusion: IB-CEUS could improve the visualization of the drainage catheters and evaluate the biliary obstructive level and degree during PTBD. IB-CEUS may be the potential substitute to FC in the PTBD procedure.

  15. The potential of methylxanthine-based therapies in pediatric respiratory tract diseases.

    Science.gov (United States)

    Oñatibia-Astibia, Ainhoa; Martínez-Pinilla, Eva; Franco, Rafael

    2016-03-01

    Caffeine, theophylline and theobromine are the most known methylxanthines as they are present in coffee, tea and/or chocolate. In the last decades, a huge experimental effort has been devoted to get insight into the variety of actions that these compounds exert in humans. From such knowledge it is known that methylxanthines have a great potential in prevention, therapy and/or management of a variety of diseases. The benefits of methylxanthine-based therapies in the apnea of prematurity and their translational potential in pediatric affections of the respiratory tract are here presented. PMID:26880379

  16. Laproscopic Management of Wandering Biliary Ascariasis

    OpenAIRE

    Umesh Jethwani; G. J. Singh; Sarangi, P; Vipul Kandwal

    2012-01-01

    Ascariasis is one of the most common helminthic diseases in humans, occurring mostly in countries with low standards of public health and hygiene, thereby making ascariasis highly endemic in developing countries. In endemic areas, 30% of adults and 60–70% of children harbour the adult worm. Biliary ascariasis is a rare cause of obstructive jaundice. Conventional management involves endoscopic extraction of worm. We are reporting a rare case of ascaris which induced extrahepatic biliary obstru...

  17. Biliary ascariasis: radiological clue to diagnosis.

    Science.gov (United States)

    Sundriyal, Deepak; Bansal, Satish; Kumar, Naveen; Sharma, Navneet

    2015-03-01

    Ascariasis is caused by Ascaris lumbricoides. It is the most common helminthic infection seen worldwide. Ascariasis is an endemic disease in our country. This is due to the prevailing poor sanitary conditions and low level of education. Biliary ascariasis is an uncommon cause of obstructive jaundice. We report a case of biliary ascariasis in a young labourer who presented with acute abdominal pain. PMID:26634136

  18. Persistent high serum bilirubin level after percutaneous transhepatic biliary drainage: analysis of 32 cases

    Energy Technology Data Exchange (ETDEWEB)

    Choo, In Wook; Choi, Byung Ihn; Park, Jae Hyung; Han, Man Chung; Kim, Chu Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-12-15

    The aim of percutaneous transhepatic biliary drainage (PTBD) is to decrease serum bilirubin level and promote liver function in patient with biliary tract disease, especially obstruction by malignant disease. But some patients showed persistent high serum bilirubin level or higher than pre-PTBD level. Percutaneous transhepatic biliary drainage was performed in 341 patients of obstructive jaundice for 5 years form July, 1981 to July, 1986 at department of radiology, Seoul National University Hospital. Follow up check of the serum bilirubin level was possible in 188 patients. Among them the authors analysed 32 patients who showed persistent high serum bilirubin level after PTBD. The results were as follows: 1. The male to female ratio was 3.4:1 and the age ranged from 33 to 75. 2. The causes of obstructive jaundice included 30 malignant diseases and 2 benign diseases. Malignant disease were 16 cases of bile duct carcinoma, 7 cases of pancreatic cancer and 7 cases of metastasis from stomach, colon and uterine cervix. Benign disease were 1 case of common hepatic duct stone and 1 case of intrahepatic duct stones. 3. The most common level of obstruction was trifurcation in 17 cases. 4. The most common indication of PTBD was palliative drainage of obstruction secondary to malignant tumor in 28 cases. 5. Change of serum bilirubin level ratio (post-PTBD level/pre-PTBD level) was 1.28, 1.22, 1.38, 1.51 in serial period of 1-3 days, 4-6 days, 1-2 week 2-3 week after PTBD. 6. Causes of persistent high serum bilirubin level after PTBD were 12 cases of partial drainage of intrahepatic bile, 13 cases of hepatic dysfunction including 9 cases of metastatic nodule, 2 cases of biliary cirrhosis, 2 cases of multiple liver abscess, and 7 cases of poor function of catheter including 4 cases of hemobilia, 1 case of multiple intrahepatic stones, pyobilia and intrahepatic Clonorchis sinensis.

  19. Persistent high serum bilirubin level after percutaneous transhepatic biliary drainage: analysis of 32 cases

    International Nuclear Information System (INIS)

    The aim of percutaneous transhepatic biliary drainage (PTBD) is to decrease serum bilirubin level and promote liver function in patient with biliary tract disease, especially obstruction by malignant disease. But some patients showed persistent high serum bilirubin level or higher than pre-PTBD level. Percutaneous transhepatic biliary drainage was performed in 341 patients of obstructive jaundice for 5 years form July, 1981 to July, 1986 at department of radiology, Seoul National University Hospital. Follow up check of the serum bilirubin level was possible in 188 patients. Among them the authors analysed 32 patients who showed persistent high serum bilirubin level after PTBD. The results were as follows: 1. The male to female ratio was 3.4:1 and the age ranged from 33 to 75. 2. The causes of obstructive jaundice included 30 malignant diseases and 2 benign diseases. Malignant disease were 16 cases of bile duct carcinoma, 7 cases of pancreatic cancer and 7 cases of metastasis from stomach, colon and uterine cervix. Benign disease were 1 case of common hepatic duct stone and 1 case of intrahepatic duct stones. 3. The most common level of obstruction was trifurcation in 17 cases. 4. The most common indication of PTBD was palliative drainage of obstruction secondary to malignant tumor in 28 cases. 5. Change of serum bilirubin level ratio (post-PTBD level/pre-PTBD level) was 1.28, 1.22, 1.38, 1.51 in serial period of 1-3 days, 4-6 days, 1-2 week 2-3 week after PTBD. 6. Causes of persistent high serum bilirubin level after PTBD were 12 cases of partial drainage of intrahepatic bile, 13 cases of hepatic dysfunction including 9 cases of metastatic nodule, 2 cases of biliary cirrhosis, 2 cases of multiple liver abscess, and 7 cases of poor function of catheter including 4 cases of hemobilia, 1 case of multiple intrahepatic stones, pyobilia and intrahepatic Clonorchis sinensis.

  20. Infectious Agents in the Pathogenesis of Primary Biliary Cirrhosis

    Directory of Open Access Journals (Sweden)

    Oscar-Danilo Ortega-Hernandez

    2010-01-01

    Full Text Available Primary biliary cirrhosis (PBC is a chronic progressive cholestatic liver disease which is characterized by the breakdown of self-tolerance to the highly conserved pyruvate dehydrogenase complex, specially the pyruvate dehydrogenase E2 complex (PDC-E2. The breakdown of the tolerance to such antigens leads to an autoimmune process characterized by portal inflammation and immune-mediated destruction of the intrahepatic bile ducts. Epidemiological studies have suggested that infections agents can trigger or even exacerbate the disease. Among other gram negative bacteria, Escherichia Coli, and Nosphingobium aromaticivorans are the most associated agents reported hitherto. Epidemiological and molecular evidence points towards molecular mimicry between some components of these microorganisms and specific amino-acid sequences that are present in proteins on normal cells of the biliary tract. In this review, we revisit all reports suggesting that infectious agents might be associated with the autoimmune pathogenesis of PBC. We also retrieve the immune molecular mimicry mechanisms that are likely involved with the autoimmune process in PBC.

  1. Fine-mapping analysis revealed complex pleiotropic effect and tissue-specific regulatory mechanism of TNFSF15 in primary biliary cholangitis, Crohn's disease and leprosy.

    Science.gov (United States)

    Sun, Yonghu; Irwanto, Astrid; Toyo-Oka, Licht; Hong, Myunghee; Liu, Hong; Andiappan, Anand Kumar; Choi, Hyunchul; Hitomi, Yuki; Yu, Gongqi; Yu, Yongxiang; Bao, Fangfang; Wang, Chuan; Fu, Xian; Yue, Zhenhua; Wang, Honglei; Zhang, Huimin; Kawashima, Minae; Kojima, Kaname; Nagasaki, Masao; Nakamura, Minoru; Yang, Suk-Kyun; Ye, Byong Duk; Denise, Yosua; Rotzschke, Olaf; Song, Kyuyoung; Tokunaga, Katsushi; Zhang, Furen; Liu, Jianjun

    2016-01-01

    Genetic polymorphism within the 9q32 locus is linked with increased risk of several diseases, including Crohn's disease (CD), primary biliary cholangitis (PBC) and leprosy. The most likely disease-causing gene within 9q32 is TNFSF15, which encodes the pro-inflammatory cytokine TNF super-family member 15, but it was unknown whether these disparate diseases were associated with the same genetic variance in 9q32, and how variance within this locus might contribute to pathology. Using genetic data from published studies on CD, PBC and leprosy we revealed that bearing a T allele at rs6478108/rs6478109 (r(2) = 1) or rs4979462 was significantly associated with increased risk of CD and decreased risk of leprosy, while the T allele at rs4979462 was associated with significantly increased risk of PBC. In vitro analyses showed that the rs6478109 genotype significantly affected TNFSF15 expression in cells from whole blood of controls, while functional annotation using publicly-available data revealed the broad cell type/tissue-specific regulatory potential of variance at rs6478109 or rs4979462. In summary, we provide evidence that variance within TNFSF15 has the potential to affect cytokine expression across a range of tissues and thereby contribute to protection from infectious diseases such as leprosy, while increasing the risk of immune-mediated diseases including CD and PBC. PMID:27507062

  2. Photodynamic therapy--1994: treatment of benign and malignant upper aerodigestive tract disease

    Science.gov (United States)

    Schweitzer, Vanessa G.

    1995-03-01

    From 1983 to 1994 Phase II and III clinical studies at Henry Ford Hospital demonstrated complete or partial responses in 46 of 47 patients treated with hematoporphyrin-derivative photodynamic therapy (HPD-PDT) for a variety of benign and malignant upper aerodigestive tract disease: (1) superficial `condemned mucosa' or `field cancerization' of the oral cavity; (2) stage III/IV head and neck cancer; (3) mucocutaneous AIDS-related Kaposi's sarcoma of the upper aerodigestive tract; (4) recurrent laryngotracheal papillomatosis; (5) severe dysplasia/adenocarcinoma in situ in Barrett's esophagus; (6) partial or completely obstructing terminal esophageal cancer. HPD-PDT produced complete responses in 19 patients (follow up 6 months to 8 years) with `field cancerization' (CIS, T1) of the oral cavity and larynx (6), adenocarcinoma in situ in Barrett's esophagus (2), mucocutaneous Kaposi's sarcoma (9), obstructing esophageal carcinoma (1), and stage IV squamous cell carcinoma of the nasopharynx (1). PDT treatment protocols, results, complications, and application as adjunct or primary oncologic therapy for head and neck disease are reviewed.

  3. Functional Self-Expandable Metal Stents in Biliary Obstruction

    OpenAIRE

    Kwon, Chang-Il; Ko, Kwang Hyun; Hahm, Ki Baik; Kang, Dae Hwan

    2013-01-01

    Biliary stents are widely used not only for palliative treatment of malignant biliary obstruction but also for benign biliary diseases. Each plastic stent or self-expandable metal stent (SEMS) has its own advantages, and a proper stent should be selected carefully for individual condition. To compensate and overcome several drawbacks of SEMS, functional self-expandable metal stent (FSEMS) has been developed with much progress so far. This article looks into the outcomes and defects of each st...

  4. Gonad doses in biliary tract examinations (cholecystography)

    International Nuclear Information System (INIS)

    622 single measurements of gonad doses were performed during cholecystography in patients of either sex (intravaginally in women). In oral cholecystography on an average 13 mR were revealed for men and 149 mR for women, resp. According to a minimum, medium, or maximum extent of examination, in intravenous cholecystography the data for men were 11, 17, and 24 mR, while the corresponding data for women were 93, 185, and 278 mR. Based on about 400,000 cholegraphic examinations per year in the GDR the contribution to the total gonad dose caused by radiological examinations is 6-8%. (author)

  5. The observation and nursing of patients receiving interventional management for biliary complications occurred after liver transplantation

    International Nuclear Information System (INIS)

    Objective: To discuss the perioperative nursing norm for patients who are suffering from biliary complications occurred after liver transplantation and who will receive interventional management to treat the complications. Methods: Interventional therapies were performed in 20 patients with biliary complications due to liver transplantation. The interventional procedures performed in 20 cases included percutaneous biliary drainage (n = 13), percutaneous biliary balloon dilatation (n = 5) and biliary stent implantation (n = 7). The clinical results were observed and analyzed. Results: Biliary tract complications occurred after liver transplantation were seen frequently. Proper interventional management could markedly improve the successful rate of liver transplantation and increase the survival rate of the patients. In accordance with the individual condition, proper nursing measures should be taken promptly and effectively. Conclusion: Conscientious and effective nursing can contribute to the early detection of biliary complications and, therefore, to improve the survival rate of both the transplanted liver and the patients. (authors)

  6. Ursodeoxycholic acid for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Gong, Y.; Huang, Z.B.; Christensen, Erik;

    2008-01-01

    references of identified studies. The last search was performed in January 2007. SELECTION CRITERIA: Randomised clinical trials evaluating UDCA versus placebo or no intervention in patients with primary biliary cirrhosis. DATA COLLECTION AND ANALYSIS: The primary outcomes were mortality and mortality or......, trial duration, and patient's severity of primary biliary cirrhosis. We also used Bayesian meta-analytic approach to estimate the UDCA effect as sensitivity analysis. MAIN RESULTS: Sixteen randomised clinical trials evaluating UDCA against placebo or no intervention were identified. Data from three......BACKGROUND: Primary biliary cirrhosis is an uncommon autoimmune liver disease with unknown aetiology. Ursodeoxycholic acid (UDCA) has been used for primary biliary cirrhosis, but the effects remain controversial. OBJECTIVES: To evaluate the benefits and harms of UDCA on patients with primary...

  7. Progress in pediatrics in 2013: choices in allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses

    OpenAIRE

    Caffarelli, Carlo; Santamaria, Francesca; Vottero, Alessandra; Dascola, Carlotta Povesi; Mirra, Virginia; Sperli, Francesco; Bernasconi, Sergio

    2014-01-01

    This review will provide new information related to pathophysiology and management of specific diseases that have been addressed by selected articles published in the Italian Journal of Pediatrics in 2013, focusing on allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses in children. Recommendations for interpretation of skin prick test to foods in atopic eczema, management of allergic conjunctivitis,...

  8. Colon Cancer Metastatic to the Biliary Tree.

    Science.gov (United States)

    Strauss, Alexandra T; Clayton, Steven B; Markow, Michael; Mamel, Jay

    2016-04-01

    Metastasis of colon adenocarcinoma is commonly found in the lung, liver, or peritoneum. Common bile duct (CBD) tumors related to adenomas from familial adenomatous polyposis metastasizing from outside of the gastrointestinal tract have been reported. We report a case of biliary colic due to metastatic colon adenocarcinoma to the CBD. Obstructive jaundice with signs of acalculous cholecystitis on imaging in a patient with a history of colon cancer should raise suspicion for metastasis to CBD. PMID:27144209

  9. Disease-specific structural changes in thalamus and dentatorubrothalamic tract in progressive supranuclear palsy

    International Nuclear Information System (INIS)

    The aim of this study is to identify disease-specific changes of the thalamus, basal ganglia, pons, and midbrain in patients with progressive supranuclear palsy (PSP), Parkinson's disease (PD), and multiple system atrophy with predominant parkinsonism (MSA-P) using diffusion tensor imaging and volumetric analysis. MRI diffusion and volumetric data were acquired in a derivation of 30 controls and 8 patients with PSP and a validation cohort comprised of controls (n = 21) and patients with PSP (n = 27), PD (n = 10), and MSA-P (n = 11). Analysis was performed using regions of interest (ROI), tract-based spatial statistic (TBSS), and tractography and results compared between diagnostic groups. In the derivation cohort, we observed increased mean diffusivity (MD) in the thalamus, superior cerebellar peduncle, and the midbrain in PSP compared to controls. Furthermore, volumetric analysis showed reduced thalamic volumes in PSP. In the validation cohort, the observations of increased MD were replicated by ROI-based analysis and in the thalamus by TBSS-based analysis. Such differences were not found for patients with PD in any of the cohorts. Tractography of the dentatorubrothalamic tract (DRTT) showed increased MD in PSP patients from both cohorts compared to controls and in the validation cohort in PSP compared to PD and MSA patients. Increased MD in the thalamus and along the DRTT correlated with disease stage and motor function in PSP. Patients with PSP, but not PD or MSA-P, exhibit signs of structural abnormalities in the thalamus and in the DRTT. These changes are associated with disease stage and impaired motor function. (orig.)

  10. Disease-specific structural changes in thalamus and dentatorubrothalamic tract in progressive supranuclear palsy

    Energy Technology Data Exchange (ETDEWEB)

    Surova, Yulia; Hall, Sara; Widner, Haakan [Lund University, Department of Clinical Sciences, Lund (Sweden); Skaane University Hospital, Department of Neurology, Lund (Sweden); Nilsson, Markus [Lund University, Lund University Bioimaging Center, Lund (Sweden); Laett, Jimmy [Skaane University Hospital, Center for Medical Imaging and Physiology, Lund (Sweden); Lampinen, Bjoern [Lund University, Department of Medical Radiation Physics, Lund (Sweden); Lindberg, Olof [Malmoe, Lund University, Department of Clinical Sciences, Malmoe (Sweden); Nilsson, Christer [Skaane University Hospital, Department of Neurology, Lund (Sweden); Malmoe, Lund University, Department of Clinical Sciences, Malmoe (Sweden); Westen, Danielle van [Lund University, Department of Clinical Sciences, Lund (Sweden); Skaane University Hospital, Center for Medical Imaging and Physiology, Lund (Sweden); Hansson, Oskar [Malmoe, Lund University, Department of Clinical Sciences, Malmoe (Sweden); Skaane University Hospital, Memory Clinic, Lund (Sweden)

    2015-11-15

    The aim of this study is to identify disease-specific changes of the thalamus, basal ganglia, pons, and midbrain in patients with progressive supranuclear palsy (PSP), Parkinson's disease (PD), and multiple system atrophy with predominant parkinsonism (MSA-P) using diffusion tensor imaging and volumetric analysis. MRI diffusion and volumetric data were acquired in a derivation of 30 controls and 8 patients with PSP and a validation cohort comprised of controls (n = 21) and patients with PSP (n = 27), PD (n = 10), and MSA-P (n = 11). Analysis was performed using regions of interest (ROI), tract-based spatial statistic (TBSS), and tractography and results compared between diagnostic groups. In the derivation cohort, we observed increased mean diffusivity (MD) in the thalamus, superior cerebellar peduncle, and the midbrain in PSP compared to controls. Furthermore, volumetric analysis showed reduced thalamic volumes in PSP. In the validation cohort, the observations of increased MD were replicated by ROI-based analysis and in the thalamus by TBSS-based analysis. Such differences were not found for patients with PD in any of the cohorts. Tractography of the dentatorubrothalamic tract (DRTT) showed increased MD in PSP patients from both cohorts compared to controls and in the validation cohort in PSP compared to PD and MSA patients. Increased MD in the thalamus and along the DRTT correlated with disease stage and motor function in PSP. Patients with PSP, but not PD or MSA-P, exhibit signs of structural abnormalities in the thalamus and in the DRTT. These changes are associated with disease stage and impaired motor function. (orig.)

  11. Endoscopic ultrasound guided biliary drainage

    OpenAIRE

    2012-01-01

    Endoscopic retrograde cholangio-pancreatography is the most appropriate technique for treating common bile duct and pancreatic duct stenosis secondary to benign and malignant diseases. Even if the procedure is performed by skillful endoscopist, there are patients in whom endoscopic stent placement is not possible. Common causes of failure include complex peri-papillary diverticula, prior surgery procedures, tumor involvement of the papilla, biliary sphincter stenosis, and impacted stones. Per...

  12. Fatores de risco e conduta nas complicações do trato biliar no transplante hepático Risk factors and management of biliary tract complications in liver transplantation

    Directory of Open Access Journals (Sweden)

    Alexandre Coutinho Teixeira de Freitas

    2000-12-01

    Full Text Available A reconstrução biliar é um dos pontos vulneráveis do transplante hepático apresentando incidência de complicações biliares, variando de 10 a 35%, nos diversos estudos da literatura. Esse trabalho tem por objetivo apresentar a experiência do nosso serviço em relação à incidência e ao manejo das complicações biliares no transplante de fígado. Foram incluídos no estudo 147 transplantes hepáticos ortotópicos, com idade média de 37,3 anos, correspondendo a 88 procedimentos em pacientes do sexo masculino e 59 do sexo feminino. Complicações biliares ocorreram em 27 transplantes (18,36% em 25 pacientes (dois retransplantes. A presença de rejeição celular e de complicações vasculares foi identificada como fator de risco para as complicações biliares. A idade, o sexo, a etiologia da cirrose e a técnica utilizada na reconstrução biliar não foram fatores de risco. No total, foram empregados 52 cursos terapêuticos: tratamento cirúrgico em 23 vezes; tratamento endoscópico em 15 vezes; retransplante em sete vezes; drenagem biliar transparieto-hepática em seis vezes e um paciente está em lista de espera para retransplante. Conclui-se deste estudo que as complicações biliares são freqüentes após o transplante hepático e que as vasculares e a rejeição celular são fatores de risco.Biliary reconstruction is a vulnerable step of liver transplantation, presenting an incidence of biliary complications between 10 to 35% in many studies. Our aim is to present our incidence and treatment of biliary complications, in a total of 147 orthotopic liver transplantations, 88 males and 59 females, with an mean age of 37 years. Biliary complications occurred in 27 transplants (18,36% performed in 25 patients (two retransplants. Cellular rejection and vascular complications were identified as risk factors for biliary complications. Age, sex, etiology of cirrhosis and biliary reconstruction technique were not risk factors. Fifty

  13. Percutaneous Transhepatic Cholangiography and Biliary Drainage After Liver Transplantation: A Five-Year Experience

    OpenAIRE

    Zajko, Albert B.; Bron, Klaus M.; Campbell, William L.; Behal, Rajan; VAN THIEL, DAVID H.; Starzl, Thomas E.

    1987-01-01

    Evaluation of the biliary tract by percutaneous transhepatic cholangiography (PTC) is often required in liver transplant patients with an abnormal postoperative course. Indications for PTC include failure of liver enzyme levels to return to normal postoperatively, an elevation of serum bilirubin or liver enzyme levels, suspected bile leak, biliary obstructive symptoms, cholangitis, and sepsis.

  14. Improved Accuracy of Percutaneous Biopsy Using “Cross and Push” Technique for Patients Suspected with Malignant Biliary Strictures

    International Nuclear Information System (INIS)

    PurposeVarious methods have been used to sample biliary strictures, including percutaneous fine-needle aspiration biopsy, intraluminal biliary washings, and cytological analysis of drained bile. However, none of these methods has proven to be particularly sensitive in the diagnosis of biliary tract malignancy. We report improved diagnostic accuracy using a modified technique for percutaneous transluminal biopsy in patients with this disease.Materials and MethodsFifty-two patients with obstructive jaundice due to a biliary stricture underwent transluminal forceps biopsy with a modified “cross and push” technique with the use of a flexible biopsy forceps kit commonly used for cardiac biopsies. The modification entailed crossing the stricture with a 0.038-in. wire leading all the way down into the duodenum. A standard or long sheath was subsequently advanced up to the stricture over the wire. A Cook 5.2-Fr biopsy forceps was introduced alongside the wire and the cup was opened upon exiting the sheath. With the biopsy forceps open, within the stricture the sheath was used to push and advance the biopsy cup into the stricture before the cup was closed and the sample obtained. The data were analysed retrospectively.ResultsWe report the outcomes of this modified technique used on 52 consecutive patients with obstructive jaundice secondary to a biliary stricture. The sensitivity and accuracy were 93.3 and 94.2 %, respectively. There was one procedure-related late complication.ConclusionWe propose that the modified “cross and push” technique is a feasible, safe, and more accurate option over the standard technique for sampling strictures of the biliary tree

  15. Improved Accuracy of Percutaneous Biopsy Using “Cross and Push” Technique for Patients Suspected with Malignant Biliary Strictures

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Prashant, E-mail: p.patel@bham.ac.uk [University of Birmingham, School of Cancer Sciences, Vincent Drive (United Kingdom); Rangarajan, Balaji; Mangat, Kamarjit, E-mail: kamarjit.mangat@uhb.nhs.uk, E-mail: kamarjit.mangat@nhs.net [University Hospital Birmingham NHS Trust, Department of Radiology (United Kingdom)

    2015-08-15

    PurposeVarious methods have been used to sample biliary strictures, including percutaneous fine-needle aspiration biopsy, intraluminal biliary washings, and cytological analysis of drained bile. However, none of these methods has proven to be particularly sensitive in the diagnosis of biliary tract malignancy. We report improved diagnostic accuracy using a modified technique for percutaneous transluminal biopsy in patients with this disease.Materials and MethodsFifty-two patients with obstructive jaundice due to a biliary stricture underwent transluminal forceps biopsy with a modified “cross and push” technique with the use of a flexible biopsy forceps kit commonly used for cardiac biopsies. The modification entailed crossing the stricture with a 0.038-in. wire leading all the way down into the duodenum. A standard or long sheath was subsequently advanced up to the stricture over the wire. A Cook 5.2-Fr biopsy forceps was introduced alongside the wire and the cup was opened upon exiting the sheath. With the biopsy forceps open, within the stricture the sheath was used to push and advance the biopsy cup into the stricture before the cup was closed and the sample obtained. The data were analysed retrospectively.ResultsWe report the outcomes of this modified technique used on 52 consecutive patients with obstructive jaundice secondary to a biliary stricture. The sensitivity and accuracy were 93.3 and 94.2 %, respectively. There was one procedure-related late complication.ConclusionWe propose that the modified “cross and push” technique is a feasible, safe, and more accurate option over the standard technique for sampling strictures of the biliary tree.

  16. Real-time ultrasonographic findings of biliary ascariasis

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Seong Ku; Sung, Dong Wook; Ko, Young Tae; Kim, Ho Kyun; Kim, Soon Yong [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1983-06-15

    Although the ultrasonography has been regarded as a main procedure in the diagnosis of bile duct and gallbladder diseases, a few reports concerning the ultrasonographic findings of biliary ascariasis appeared in the literature. Seven cases of real-time ultrasonographic diagnosis of biliary ascariasis were made in our hospital during last 15 months. In six, the diagnosis was confirmed by surgery or radiographic examination. The results were as follows: 1. The characteristic long, thick, highly reflective echo without distal acoustic shadowing in the extra- and/or intra-hepatic ducts were seen in all six proven cases. 2. The echogenic, nonshadowing images of the worms were seen as single stripe in five cases (containing a central, longitudinal, anechoic tube, suggesting its digestive tract in three cases) or multiple stripes in one case. But so-called coiled appearance or amorphous fragments were not seen in our cases. 3. Associated findings were as follows: mild to moderate dilatation of the extrahepatic duct in all six proven cases, mild dilatation of the intrahepatic ducts in 3 cases, mild dilatation of the pancreatic duct in 1 case, intrahepatic stone in 1 case, contracted gallbladder containing single stone in 1 case and evidence of cholecystitis in 4 cases. 4. One false positive diagnosis of ascariasis in the gallbladder is considered due to reverberation artefact. No false negative was seen.

  17. Real-time ultrasonographic findings of biliary ascariasis

    International Nuclear Information System (INIS)

    Although the ultrasonography has been regarded as a main procedure in the diagnosis of bile duct and gallbladder diseases, a few reports concerning the ultrasonographic findings of biliary ascariasis appeared in the literature. Seven cases of real-time ultrasonographic diagnosis of biliary ascariasis were made in our hospital during last 15 months. In six, the diagnosis was confirmed by surgery or radiographic examination. The results were as follows: 1. The characteristic long, thick, highly reflective echo without distal acoustic shadowing in the extra- and/or intra-hepatic ducts were seen in all six proven cases. 2. The echogenic, nonshadowing images of the worms were seen as single stripe in five cases (containing a central, longitudinal, anechoic tube, suggesting its digestive tract in three cases) or multiple stripes in one case. But so-called coiled appearance or amorphous fragments were not seen in our cases. 3. Associated findings were as follows: mild to moderate dilatation of the extrahepatic duct in all six proven cases, mild dilatation of the intrahepatic ducts in 3 cases, mild dilatation of the pancreatic duct in 1 case, intrahepatic stone in 1 case, contracted gallbladder containing single stone in 1 case and evidence of cholecystitis in 4 cases. 4. One false positive diagnosis of ascariasis in the gallbladder is considered due to reverberation artefact. No false negative was seen

  18. Risk of Flood-Related Diseases of Eyes, Skin and Gastrointestinal Tract in Taiwan: A Retrospective Cohort Study.

    Science.gov (United States)

    Huang, Ling-Ya; Wang, Yu-Chun; Wu, Chin-Ching; Chen, Yi-Chun; Huang, Yu-Li

    2016-01-01

    Floods are known to cause serious environmental damage and health impacts. Studies on flood-related diseases have been primarily on individual events, and limited evidence could be drawn on potential health impacts from floods using large population data. This study used reimbursement records of one million people of the Taiwan National Health Insurance program to compare incident diseases of the eyes, skin and gastrointestinal (GI) tract associated with floods. Incidence rates for the selected diseases were calculated according to outpatient/emergency visit data. The incidence rates were evaluated by flood status: in 10 days before floods, during floods and within 10 days after the floods receded. Outpatient/emergency visit rates for the eye, skin and GI tract diseases were highest after floods and lowest during floods. Results from multivariate Poisson regression analyses showed that, when compared with the incidence in 10 days before floods, the incidence rate ratios (IRR) of diseases within 10 days after floods were 1.15 (95% confidence interval (CI) = 1.10-1.20) for eyes, 1.08 (95% C.I. = 1.05-1.10) for skin, and 1.11 (95% CI = 1.08-1.14) for GI tract, after controlling for covariates. All risks increased with ambient temperature. V-shaped trends were found between age and eye diseases, and between age and GI tract diseases. In contrast, the risk of skin diseases increased with age. In conclusion, more diseases of eyes, skin and GI tract could be diagnosed after the flood. PMID:27171415

  19. Risk of Flood-Related Diseases of Eyes, Skin and Gastrointestinal Tract in Taiwan: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Ling-Ya Huang

    Full Text Available Floods are known to cause serious environmental damage and health impacts. Studies on flood-related diseases have been primarily on individual events, and limited evidence could be drawn on potential health impacts from floods using large population data. This study used reimbursement records of one million people of the Taiwan National Health Insurance program to compare incident diseases of the eyes, skin and gastrointestinal (GI tract associated with floods. Incidence rates for the selected diseases were calculated according to outpatient/emergency visit data. The incidence rates were evaluated by flood status: in 10 days before floods, during floods and within 10 days after the floods receded. Outpatient/emergency visit rates for the eye, skin and GI tract diseases were highest after floods and lowest during floods. Results from multivariate Poisson regression analyses showed that, when compared with the incidence in 10 days before floods, the incidence rate ratios (IRR of diseases within 10 days after floods were 1.15 (95% confidence interval (CI = 1.10-1.20 for eyes, 1.08 (95% C.I. = 1.05-1.10 for skin, and 1.11 (95% CI = 1.08-1.14 for GI tract, after controlling for covariates. All risks increased with ambient temperature. V-shaped trends were found between age and eye diseases, and between age and GI tract diseases. In contrast, the risk of skin diseases increased with age. In conclusion, more diseases of eyes, skin and GI tract could be diagnosed after the flood.

  20. Risk of Flood-Related Diseases of Eyes, Skin and Gastrointestinal Tract in Taiwan: A Retrospective Cohort Study

    Science.gov (United States)

    Huang, Ling-Ya; Wang, Yu-Chun; Wu, Chin-Ching

    2016-01-01

    Floods are known to cause serious environmental damage and health impacts. Studies on flood-related diseases have been primarily on individual events, and limited evidence could be drawn on potential health impacts from floods using large population data. This study used reimbursement records of one million people of the Taiwan National Health Insurance program to compare incident diseases of the eyes, skin and gastrointestinal (GI) tract associated with floods. Incidence rates for the selected diseases were calculated according to outpatient/emergency visit data. The incidence rates were evaluated by flood status: in 10 days before floods, during floods and within 10 days after the floods receded. Outpatient/emergency visit rates for the eye, skin and GI tract diseases were highest after floods and lowest during floods. Results from multivariate Poisson regression analyses showed that, when compared with the incidence in 10 days before floods, the incidence rate ratios (IRR) of diseases within 10 days after floods were 1.15 (95% confidence interval (CI) = 1.10–1.20) for eyes, 1.08 (95% C.I. = 1.05–1.10) for skin, and 1.11 (95% CI = 1.08–1.14) for GI tract, after controlling for covariates. All risks increased with ambient temperature. V-shaped trends were found between age and eye diseases, and between age and GI tract diseases. In contrast, the risk of skin diseases increased with age. In conclusion, more diseases of eyes, skin and GI tract could be diagnosed after the flood. PMID:27171415

  1. Ultrasound monitoring of structural urinary tract disease in Schistosoma haematobium infection

    Directory of Open Access Journals (Sweden)

    King Charles H

    2002-01-01

    Full Text Available A major advance in our understanding of the natural history of Schistosoma haematobium-related morbidity has come through the introduction of the portable ultrasound machines for non-invasive examination of the kidneys and bladder. With the use of generators or battery packs to supply power in non-clinical field settings, and with the use of instant photography or miniaturized thermal printers to record permanent images, it is possible to examine scores of individuals in endemic communities every day. Broad-based ultrasound screening has allowed better definition of age-specific disease risks in urinary schistosomiasis. Results indicate that urinary tract abnormalities are common (18% overall prevalence in S. haematobium transmission areas, with a 2-4% risk of either severe bladder abnormality or advanced ureteral obstruction. In longitudinal surveys, ultrasound studies have shown that praziquantel and metrifonate therapy are rapidly effective in reversing urinary tract abnormalities among children. The benefits of treating adults are less well known, but research in progress should help to define this issue. Similarly, the prognosis of specific ultrasound findings needs to be clarified, and the ease of sonographic examination will make such long-term follow-up studies feasible. In summary, the painless, quick, and reproducible ultrasound examination has become an essential tool in the study of urinary schistosomiasis.

  2. Clinical application of Patlak plot CT-GFR in animals with upper urinary tract disease.

    Science.gov (United States)

    Alexander, Kate; Dunn, Marilyn; Carmel, Eric Norman; Lavoie, Jean-Pierre; Del Castillo, Jérôme R E

    2010-01-01

    Glomerular filtration rate (GFR), an important parameter of renal function, is difficult to assess clinically. Serum creatinine and blood urea nitrogen measurements lack sensitivity, whereas radionuclide determination of GFR is not always available and requires postinjection patient isolation. GFR can be determined using computed tomography (CT), most commonly via Patlak plot analysis. Four adult cats, two adult dogs, and a foal underwent abdominal CT under general anesthesia for various diseases of the upper urinary tract. CT-GFR was measured with a single-slice dynamic acquisition and Patlak plot analysis. In five animals, the total CT-GFR appeared to be below normal, corresponding with mild (two animals) and moderate (two animals) increases of serum creatinine in four. In the two animals with normal or increased CT-GFR, serum creatinine was within the reference values. A significant negative logarithmic relationship was found between CT-GFR and serum creatinine values (P = 0.008; r2 = 0.75). No complications occurred during or following CT-GFR. CT examination provided clinically relevant information in 3/5 patients with possible ureteral obstruction and in 3/3 patients with suspected ureteral calculi. Single-slice dynamic CT-GFR was practical and provided clinically useful information in this small series of patients undergoing CT of the upper urinary tract. There was a significant relationship between CT-GFR and serum creatinine values, which supports the clinical potential of CT-GFR and justifies further investigation of this technique. PMID:20806874

  3. Unusual Development of Iatrogenic Complex, Mixed Biliary and Duodenal Fistulas Complicating Roux-en-Y Antrectomy for Stenotic Peptic Disease of the Supraampullary Duodenum Requiring Whipple Procedure: An Uncommon Clinical Dilemma

    Directory of Open Access Journals (Sweden)

    Francesco A. Polistina

    2010-10-01

    Full Text Available Complex fistulas of the duodenum and biliary tree are severe complications of gastric surgery. The association of duodenal and major biliary fistulas occurs rarely and is a major challenge for treatment. They may occur during virtually any kind of operation, but they are more frequent in cases complicated by the presence of difficult duodenal ulcers or cancer, with a mortality rate of up to 35%. Options for treatment are many and range from simple drainage to extended resections and difficult reconstructions. Conservative treatment is the choice for well-drained fistulas, but some cases require reoperation. Very little is known about reoperation techniques and technical selection of the right patients. We present the case of a complex iatrogenic duodenal and biliary fistula. A 42-year-old Caucasian man with a diagnosis of postoperative peritonitis had been operated on 3 days earlier; an antrectomy with a Roux-en-Y reconstruction for stenotic peptic disease was performed. Conservative treatment was attempted with mixed results. Two more operations were required to achieve a definitive resolution of the fistula and related local complications. The decision was made to perform a pancreatoduodenectomy with subsequent reconstruction on a double jejunal loop. The patient did well and was discharged on postoperative day 17. In our experience pancreaticoduodenectomy may be an effective treatment of refractory and complex iatrogenic fistulas involving both the duodenum and the biliary tree.

  4. Biliary Atresia - Translational Research on Key Molecular Processes Regulating Biliary Injury and Obstruction

    Directory of Open Access Journals (Sweden)

    Jorge A. Bezerra

    2006-06-01

    Full Text Available Biliary atresia is the most common cause of pathologic jaundice in young infants andresults from the obstruction of the extrahepatic bile ducts by an inflammatory and fibroobliterativeprocess. Although the pathogenesis of the disease is multifactorial, recentpatient- and animal-based studies began deciphering the molecular pathways involved in biliaryinjury and duct obstruction. Using large-scale genomics and immunostaining of liversfrom children with biliary atresia, investigators have discovered unique molecular signaturesof dominant proinflammatory cytokines at the time of diagnosis. To study hypotheses generatedfrom these patient-based studies, the anatomical and inflammatory profiles of a mousemodel of rotavirus-induced biliary atresia were analyzed and found to share striking similaritieswith the human profiles. Then, using these mice in mechanistic studies, interferongamma(IFNγ has been shown to regulate the biliary tropism of lymphocytes to the biliarysystem, and to play a critical role in the inflammatory obstruction of extrahepatic bile ducts.The ability to combine human studies with a laboratory model of neonatal biliary injury andobstruction opens a new era of opportunities to advance the field of biliary atresia, and todevelop new therapeutic strategies to improve long-term outcome with the native liver ofchildren with biliary atresia.

  5. Biliary duct obstruction treatment with aid of percutaneous transhepatic biliary drainage

    OpenAIRE

    Daniel Knap; Natalia Orlecka; Renata Judka; Aleksandra Juza; Michał Drabek; Maciej Honkowicz; Tomasz Kirmes; Bartosz Kadłubicki; Dominik Sieroń; Jan Baron

    2016-01-01

    Introduction: Percutaneous Transhepatic Biliary Drainage (PTBD) is a procedure indicated in patients with non-operative lesions, when endoscopic application of prosthesis is impossible due to anatomic reasons, complications or severe general condition of patient. Most often it is a palliative procedure, aiming for live-quality improvement, although not altering prognosis of basic disease. Aim: This study presents own experience in biliary drainage with the aid of percutaneous transhepatic ...

  6. Biliary stenosis in the radiologist's eyes: A review

    International Nuclear Information System (INIS)

    The authors discuss the epidemiology, etiology, morphology, and staging of biliary stenoses and coexisting diseases. The best known classification of biliary stenosis, based on anatomic relationships and cholangiographic images, is described. Diagnostic approach, including both historical methods and modern imaging techniques such as ultrasound, computed tomography, endoscopic procedures, and magnetic resonance, are also presented. (author)

  7. Interventional radiology of the biliary system and pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Teplick, S.K.; Haskin, P.H.; Matsumoto, T.; Wolferth, C.C. Jr.; Pavlides, C.A.; Gain, T.

    1984-02-01

    In recent years, newer techniques have become available to the clinician for the diagnosis and treatment of biliary and pancreatic disease. This article emphasizes interventional procedures through the liver, such as percutaneous transhepatic cholangiography, percutaneous transhepatic biliary drainage, and ancillary techniques. Also discussed are the nonsurgical management of bile duct calculi and the diagnosis and treatment of pancreatic tumors, abscesses, and pseudocysts.

  8. Biliary cholesterol secretion: More than a simple ABC

    Institute of Scientific and Technical Information of China (English)

    Arne; Dikkers; Uwe; JF; Tietge

    2010-01-01

    Biliary cholesterol secretion is a process important for 2 major disease complexes, atherosclerotic cardiovascular disease and cholesterol gallstone disease. With respect to cardiovascular disease, biliary cholesterol secretion is regarded as the f inal step for the elimination of cholesterol originating from cholesterol-laden macrophage foam cells in the vessel wall in a pathway named reverse cholesterol transport. On the other hand, cholesterol hypersecretion into the bile is considered the main pathophys...

  9. Alterations and diseases of the gastrointestinal tract caused by old age

    International Nuclear Information System (INIS)

    The dissertation reviews the publications on 'The gastrointestinal tract in old age' since 1941. As in the 1941 publication by Heinrich, particular interest is taken in diagnostic radiology. The lower age limit of the cases described was set at 55 to 60 years. Oesophageal changes ranged from functional disturbances (e.g. atonia, changes in peristalsis, or dilatation) to chronic inflammation, displacement caused by the surrounding organs, and tumours (mainly carcinoma). Formation of diverticula takes an intermediate position. Of the gastric and duodenal changes, hiatal hermia and chronic atrophic gastritis were the most frequent. Ulcers caused by old age differ from 'common' ulcers in some respects, and the symptoms may be confused with those of gastric carcinoma. Early gastric carcinoma is another disease whose incidence increases with age. Thoracic and spinal changes may cause impressions on the stomach. The effects of old age on the time of passage of contrast media, on gastric tone, and on the shape of the stomach remain unclear. Changes caused by old age in the small and large intestine range from formation of diverticula and vascular diseases (e.g. ischaemic colitis and obstruction of the mesenteric vessels) to the frequent carcinoma of the large intestine and rectum. According to this study it has to be supposed that the degenerative atrophic processes of aging and previous diseases occurring increasingly in old age, favour the provocation of ratrogenic injuries. (orig./MG)

  10. Secretin-stimulated magnetic resonance cholangiopancreatography of patients with unclear disease in the pancreaticobiliary tract

    Energy Technology Data Exchange (ETDEWEB)

    Hellund, J.C.; Skattum, J.; Buanes, T.; Geitung, J.T. [Depts. of Radiology and Gastrointestinal Surgery, Ullevaal Univ. Hospital, Oslo (Norway)

    2007-02-15

    Purpose: To explore the usefulness of secretin-stimulated magnetic resonance cholangiopancreatography (S-MRCP) on different pathological entities in the pancreaticobiliary tract (PBT) Material and Methods: Sixty-two patients with unclear disease in the PBT were examined with S-MRCP as the final radiological procedure. Nine groups of referral diagnoses were identified, and clinical outcome was evaluated. Results: In five patients with suspected pancreatic duct injury after blunt abdominal trauma, a negative predictive value of 100% was found after a median of 3.5 months of follow-up. In 22 patients with residual pain after cholecystectomy, investigated for sphincter of Oddi dysfunction (SOD), delayed dilatation of the PD and pain were documented in four patients. Three of these were treated with endoscopic papillotomy (EPT), and no recurrences were found during an average of 13.6 months of follow-up. Five cases of pancreas divisum not previously seen were identified, and of 12 patients with suspected postoperative stenosis, five were successfully treated after being identified with S-MRCP. Useful information was obtained in most of the patients, i.e., findings not observed in previous radiological examinations or clarifying uncertain previous findings. Nine patients were referred to other non-radiological examinations, identifying that the origin of disease was outside the PBT. Conclusion: S-MRCP has the potential to become the final part of diagnostic workup in difficult PBT diseases, but further investigation of usefulness regarding different referral reasons is mandatory.

  11. Microbial Communities in the Upper Respiratory Tract of Patients with Asthma and Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Park, HeeKuk; Shin, Jong Wook; Park, Sang-Gue; Kim, Wonyong

    2014-01-01

    Respiratory infections are well-known triggers of chronic respiratory diseases. Recently, culture-independent tools have indicated that lower airway microbiota may contribute to pathophysiologic processes associated with asthma and chronic obstructive pulmonary disease (COPD). However, the relationship between upper airway microbiota and chronic respiratory diseases remains unclear. This study was undertaken to define differences of microbiota in the oropharynx of asthma and COPD patients relative to those in healthy individuals. To account for the qualitative and quantitative diversity of the 16S rRNA gene in the oropharynx, the microbiomes of 18 asthma patients, 17 COPD patients, and 12 normal individuals were assessed using a high-throughput next-generation sequencing analysis. In the 259,572 total sequence reads, α and β diversity measurements and a generalized linear model revealed that the oropharynx microbiota are diverse, but no significant differences were observed between asthma and COPD patients. Pseudomonas spp. of Proteobacteria and Lactobacillus spp. of Firmicutes were highly abundant in asthma and COPD. By contrast, Streptococcus, Veillonella, Prevotella, and Neisseria of Bacteroidetes dominated in the healthy oropharynx. These findings are consistent with previous studies conducted in the lower airways and suggest that oropharyngeal airway microbiota are important for understanding the relationships between the various parts of the respiratory tract with regard to bacterial colonization and comprehensive assessment of asthma and COPD. PMID:25329665

  12. 改良经皮肝穿刺胆道引流术及经皮胆道支架置入治疗恶性梗阻性黄疸%Management of malignant obstructive jaundice by Improved PTCD and percutaneous biliary tract stents placement

    Institute of Scientific and Technical Information of China (English)

    刘会春; 李宗狂; 周磊; 鲁贻民; 周少波

    2008-01-01

    Objective To investigate the clinical value of improved percutaneous tramhepatic cholangiographic drainage(PTCD)and percutaneous placement of biliary metallic stents on the treatment of malignant obstructive jaundice.Methods Thirty three patients with malignant biliary obstruction were treated by the improved PTCD guided by ultrasound followed by pereutaneous placement of biliary tract metallic stcnts 1~3 weeks later.Results Improved PTCD WaS succeeded in all the patients,30 patients(90.9%)accepted percutaneous placement of biliary metallic stents successfully,3 patients who failed in stents placement accepted PTCD again for palliative management of iallndice.Thofle who failed in stent placement were found to have bleeding from the PTCD tube,but recovered several days later.Jaundice alleviated in all the patients.The patients were followed up for 1~29 months,medium follow-up period is 14.8 months.Six cases were found lever and jaundice,among that,two ageepted improved PTCD again,one recovered after antibioic treatment,the remaining 3 patients failed in further treatment due to the metastasis of the tumor.Condusion Pereutaneous placement of biliary metallic stents after improved PTCD is a safe and effeetive method to relieve malignant biliary obstruction,it can improve life quality,prolong survival time.This method could be a good choice for treating the patients with mnlignant biliary obstruction without operation.%目的 探讨改良经皮肝穿刺胆道引流术(PTCD)及经皮胆道支架置入在恶性梗阻性黄疸中的治疗价值.方法 33例恶性胆道梗阻患者,采用改良PTCD,并在当时或1~3周后行经皮胆道可膨式金属支架置入.结果 改良PTCD成功率100%,支架置入成功率90.9%(30/33).随访1~29个月,中位生存14.8个月.6例随访期间出现发热、黄疸,其中1例重置PTCD后症状缓解,1例抗炎、利胆治疗后症状消失,1例重置PTCD管后黄疸短暂消失,渐出现混合性黄疸,另3例因肿瘤广

  13. Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study

    NARCIS (Netherlands)

    Bouwman, Inge I.; Blanker, Marco H.; Schouten, Boris W. V.; Bohnen, Arthur M.; Nijman, Rien J. M.; van der Heide, Wouter K.; Bosch, J. L. H. Ruud

    2015-01-01

    PURPOSE: To describe the association between lower urinary tract symptoms (LUTS) and cardiovascular diseases (CVD), with adjustment for age and other confounders. We were specifically interested in the possible predictive value of LUTS to the incidence of CVD in the future in the general population.

  14. Biliary obstruction caused by intra-biliary tumor growth from recurred hepatocellular carcinoma after radiofrequency ablation: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Ji Hyun; Kim, Jae Won [Dept. of Radiology, Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2014-04-15

    A 59-year-old man with a known central hepatocellular carcinoma (HCC) underwent a trans-arterial-chemo-embolization (TACE) and a post-TACE percutaneous radiofrequency ablation (PRFA). Two months after the PRFA, the patient presented jaundice and an abdominal computed tomography was obtained. An arterial enhancing mass adjacent to the ablated necrotic lesion with a continuously coexisting mass inside the right hepatic duct, suggestive of a HCC recurrence with a direct extension to the biliary tract was found. Finally a biliary tumor obstruction has been developed and a percutaneous transhepatic biliary drainage was performed. This case of biliary obstruction caused by directly invaded recurred HCC after PRFA will be reported because of its rare occurrence.

  15. Biliary fascioliasis--an uncommon cause of recurrent biliary colics: report of a case and brief review.

    Science.gov (United States)

    Al Qurashi, Hesham; Masoodi, Ibrahim; Al Sofiyani, Mohammad; Al Musharaf, Hisham; Shaqhan, Mohammed; All, Gamal Nasr Ahmed Abdel

    2012-01-01

    Biliary parasitosis is one of the important causes of biliary obstruction in endemic areas, however due to migration and travel the disease is known to occur in non endemic zones as well. The spectrum of biliary fascioliasis ranges from recurrent biliary colics to acute cholangitis. The long term complications are gall stones, sclerosing cholangitis and biliary cirrhosis. We describe fascioliasis as a cause of recurrent biliary colics in a young male necessitating multiple hospitalizations over a period of four years. Investigative profile had been non-contributory every time he was hospitalized for his abdominal pain prior to the current presentation. He never had cholangitis due to the worm in the common bile duct. It was only at endoscopic retrograde cholangiopancreatography (ERCP) biliary fascioliasis was discovered to be the cause of his recurrent biliary colics. After removal of the live Fasciola hepatica from the common bile duct he became symptom free and is attending our clinic for last 11 months now. Clinical spectrum of biliary fascioliasis is discussed in this report. PMID:22566787

  16. Contemporary Management of Acute Biliary Pancreatitis

    Directory of Open Access Journals (Sweden)

    Orhan Ozkan

    2014-03-01

    Full Text Available Acute biliary pancreatitis is one of the major causes of acute pancreatitis.Gallstones, biliary sludge and microlithiasis, especially in pancreatitis without detectable reason, can be the cause of acute pancreatitis. Acute biliary pancreatitis has many controversions in the literature, and its classification and guidelines are being updated very frequently. Atlanta classifications which determine the definitions and guidelines about acute pancreatitis were renewed and published in 2013. It has various clinical aspects, ranging from a mild form which is easily treated, to a severe form that causes complications leading to mortality. The pathogenesis of this disease has not been fully elucidated and several theories have been suggested. New scoring systems and laboratory methods such as proteomics have been suggested for both diagnosis and to predict disease severity, and research on these topics is still in progress. Novel therapeutic approaches with technological developments such as ERCP, ES, MRCP, and EUS are also suggested.

  17. Percutaneous transhepatic biliary drainage

    International Nuclear Information System (INIS)

    Percutaneous transhepatic biliary drainage was successfully made 20 times on 17 patients of obstructive jaundice for recent 1 year since June 1981 at Department of Radiology in Seoul National University Hospital. The causes of obstructive jaundice was CBD Ca in 13 cases, metastasis in 2 cases, pancreatic cancer in 1 case and CBD stone in 1 case. Percutaneous transhepatic biliary drainage is a relatively ease, safe and effective method which can be done after PTC by radiologist. It is expected that percutaneous transhepatic biliary drainage should be done as an essential procedure for transient permanent palliation of obstructive jaundice

  18. The upper respiratory tract microbiome and its potential role in bovine respiratory disease and otitis media

    Science.gov (United States)

    Lima, Svetlana F.; Teixeira, Andre Gustavo V.; Higgins, Catherine H.; Lima, Fabio S.; Bicalho, Rodrigo C.

    2016-01-01

    The upper respiratory tract (URT) hosts a complex microbial community of commensal microorganisms and potential pathogens. Analyzing the composition and nature of the healthy URT microbiota and how it changes over time will contribute to a better understanding of the pathogenesis of pneumonia and otitis. A longitudinal study was conducted including 174 Holstein calves that were divided in four groups: healthy calves, calves diagnosed with pneumonia, otitis or both diseases. Deep pharyngeal swabs were collected on days 3, 14, 28, and 35 of life, and next-generation sequencing of the 16S rRNA gene as well as quantitative PCR was performed. The URT of Holstein dairy calves aged 3 to 35 days revealed to host a highly diverse bacterial community. The relative abundances of the bacterial genera Mannheimia, Moraxella, and Mycoplasma were significantly higher in diseased versus healthy animals, and the total bacterial load of newborn calves at day 3 was higher for animals that developed pneumonia than for healthy animals. Our results corroborate the existing knowledge that species of Mannheimia and Mycoplasma are important pathogens in pneumonia and otitis. Furthermore, they suggest that species of Moraxella can potentially cause the same disorders (pneumonia and otitis), and that high neonatal bacterial load is a key contributor to the development of pneumonia. PMID:27363739

  19. Hemangioblastoma of the optic nerve producing bilateral optic tract edema in a patient with von Hippel-Lindau disease

    OpenAIRE

    Staub, Blake N.; Livingston, Andrew D.; Patricia Chévez-Barrios; Baskin, David S.

    2014-01-01

    Background: The authors present a novel case of a hemangioblastoma of the optic nerve producing bilateral optic tract edema in a patient with von Hippel-Lindau disease (VHL). This is the only case in the literature documenting optic tract edema secondary to a hemangioblastoma of the optic nerve. Case Description: The patient was a 34-year-old female in whom this lesion was causing retro-orbital pain and proptosis. She had previously lost vision in the symptomatic eye secondary to a retina...

  20. Upper respiratory tract diseases in captive orangutans (Pongo abelii, Pongo pygmaeus): prevalence in 20 European zoos and possible predisposing factors

    OpenAIRE

    Zimmermann, N.

    2011-01-01

    Chronic upper respiratory tract diseases are severe problems in captive orangutans (Pongo abelii, P. pygmaeus), but the etiology and pathogenesis are unknown. This study recorded the prevalence of such diseases in captive European orangutans (201 animals; 20 zoos) and investigated possible predisposing factors. Bornean orangutans (P. pygmaeus) showed chronic respiratory signs (13.8% of all animals) significantly more often than Sumatran (P. abelii; 3.6%), and male animals more often (15.8%) t...

  1. Cholesterol gallstone disease: focusing on the role of gallbladder.

    Science.gov (United States)

    Chen, Yongsheng; Kong, Jing; Wu, Shuodong

    2015-02-01

    Gallstone disease (GSD) is one of the most common biliary tract diseases worldwide in which both genetic and environmental factors have roles in its pathogenesis. Biliary cholesterol supersaturation from metabolic defects in the liver is traditionally seen as the main pathogenic factor. Recently, there have been renewed investigative interests in the downstream events that occur in gallbladder lithogenesis. This article focuses on the role of the gallbladder in the pathogenesis of cholesterol GSD (CGD). Various conditions affecting the crystallization process are discussed, such as gallbladder motility, concentrating function, lipid transport, and an imbalance between pro-nucleating and nucleation inhibiting proteins. PMID:25502177

  2. Acceptable Toxicity After Stereotactic Body Radiation Therapy for Liver Tumors Adjacent to the Central Biliary System

    Energy Technology Data Exchange (ETDEWEB)

    Eriguchi, Takahisa; Takeda, Atsuya; Sanuki, Naoko; Oku, Yohei; Aoki, Yousuke [Radiation Oncology Center, Ofuna Chuo Hospital, Kanagawa (Japan); Shigematsu, Naoyuki [Department of Radiology, Keio University School of Medicine, Tokyo (Japan); Kunieda, Etsuo, E-mail: kunieda-mi@umin.ac.jp [Department of Radiation Oncology, Tokai University, Kanagawa (Japan)

    2013-03-15

    Purpose: To evaluate biliary toxicity after stereotactic body radiation therapy (SBRT) for liver tumors. Methods and Materials: Among 297 consecutive patients with liver tumors treated with SBRT of 35 to 50 Gy in 5 fractions, patients who were irradiated with >20 Gy to the central biliary system (CBS), including the gallbladder, and had follow-up times >6 months were retrospectively analyzed. Toxicity profiles, such as clinical symptoms and laboratory and radiologic data especially for obstructive jaundice and biliary infection, were investigated in relation to the dose volume and length relationship for each biliary organ. Results: Fifty patients with 55 tumors were irradiated with >20 Gy to the CBS. The median follow-up period was 18.2 months (range, 6.0-80.5 months). In the dose length analysis, 39, 34, 14, and 2 patients were irradiated with >20 Gy, >30 Gy, >40 Gy, and >50 Gy, respectively, to >1 cm of the biliary tract. Seven patients were irradiated with >20 Gy to >20% of the gallbladder. Only 2 patients experienced asymptomatic bile duct stenosis. One patient, metachronously treated twice with SBRT for tumors adjacent to each other, had a transient increase in hepatic and biliary enzymes 12 months after the second treatment. The high-dose area >80 Gy corresponded to the biliary stenosis region. The other patient experienced biliary stenosis 5 months after SBRT and had no laboratory changes. The biliary tract irradiated with >20 Gy was 7 mm and did not correspond to the bile duct stenosis region. No obstructive jaundice or biliary infection was found in any patient. Conclusions: SBRT for liver tumors adjacent to the CBS was feasible with minimal biliary toxicity. Only 1 patient had exceptional radiation-induced bile duct stenosis. For liver tumors adjacent to the CBS without other effective treatment options, SBRT at a dose of 40 Gy in 5 fractions is a safe treatment with regard to biliary toxicity.

  3. Mechanisms of biliary carcinogenesis and growth.

    Science.gov (United States)

    Wise, Candace; Pilanthananond, Metaneeya; Perry, Benjamin-F; Alpini, Gianfranco; McNeal, Michael; Glaser, Shannon-S

    2008-05-21

    Cholangiocarcinoma is a rare cancer originating from the neoplastic transformation of the epithelial cells (i.e. cholangiocytes) that line the biliary tract. The prognosis for patients with cholangiocarcinoma is grim due to lack of viable treatment options. The increase in world-wide incidence and mortality from cholangiocarcinoma highlights the importance of understanding the intracellular mechanisms that trigger the neoplastic transformation of cholangiocytes and the growth of biliary cancers. The purpose of the following review is to address what has been learned over the past decade concerning the molecular basis of cholangiocarcinogenesis. The material presented is divided into two sections: (1) mechanisms regulating neoplastic transformation of cholangiocytes; and (2) factors regulating cholangiocarcinoma growth. An understanding of the growth regulatory mechanisms of cholangiocarcinoma will lead to the identification of therapeutic targets for this devastating cancer. PMID:18494047

  4. Hepatic and biliary ascariasis

    Directory of Open Access Journals (Sweden)

    Anup K Das

    2014-01-01

    Full Text Available Ascariasis mainly contributes to the global helminthic burden by infesting a large number of children in the tropical countries. Hepato-biliary ascariasis (HBA is becoming a common entity now than in the past owing to the frequent usage of ultrasonograms and endoscopic diagnostic procedures in the clinical practice. There are a variety of manifestations in HBA and diagnosis depends on a high index of suspicion in endemic areas coupled with subsequent confirmation by sonographic or endoscopic demonstration of the worm. Most of them present with acute abdomen and jaundice. Oriental or recurrent pyogenic cholangiopathy is possibly the result of HBA, commonly encountered in South-East Asian countries. Conservative treatment with anthelminthic agents is used in the majority. Failure to respond to medical therapy usually indicates the need for endoscopic or surgical interventions. Overall, mortality is low and prognosis is good, but many epidemiological and immunological aspects of Ascaris infection are unclear, meaning our understanding the disease and infection still remains incomplete. Therefore, it is difficult to definitely put down a fixed modality of treatment for HBA. This underscores the need for further studies as ascariasis has the potential to adversely affect the national socio-economy by compromising the health of children and adults alike with its sheer number.

  5. Stenting in Malignant Biliary Obstruction.

    Science.gov (United States)

    Almadi, Majid A; Barkun, Jeffrey S; Barkun, Alan N

    2015-10-01

    Decompression of the biliary system in patients with malignant biliary obstruction has been widely accepted and implemented as part of the care. Despite a wealth of literature, there remains a significant amount of uncertainty as to which approach would be most appropriate in different clinical settings. This review covers stenting of the biliary system in cases of resectable or palliative malignant biliary obstruction, potential candidates for biliary drainage, technical aspects of the procedure, as well as management of biliary stent dysfunction. Furthermore, periprocedural considerations including proper mapping of the location of obstruction and the use of antibiotics are addressed. PMID:26431598

  6. Biliary acute pancreatitis: a review

    Institute of Scientific and Technical Information of China (English)

    Osvaldo M. Tiscomia; Susana Hamamura; Enriqueta S. de Lehmann; Graciela Otero; Hipólito Waisman; Patricia Tiscornia-Wasserman; Simmy Bank

    2000-01-01

    @@INTRODUCTION It is axiomatic that the most effective and soundly based plan of treatment of any disorder is one aimed at the mechanism or mechanisms responsible for its development[1]. This basic notion, coupled with recent reports[2- 11] in which, surprisingly there is a total lack of reference to the probable involvement of autonomic-arc-reflexes in the physiopathogenesis of biliary acute pancreatitis have prompted this presentation. Undoubtedly, this disease entity has numerous causes, an obscure physiopathology, few effective remedies, and, often, an unpredictable outcome. At the turn of the century, Opie[12,13] brought to light the association between gallstone migration and acute pancreatitis.

  7. Acute biliary pancreatitis: Diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Hazem Zakaria

    2009-01-01

    Full Text Available Gallstones are the commonest cause of acute pancreatitis (AP, a potentially life-threatening condition, worldwide. The pathogenesis of acute pancreatitis has not been fully understood. Laboratory and radiological investigations are critical for diagnosis as well prognosis prediction. Scoring systems based on radiological findings and serologic inflammatory markers have been proposed as better predictors of disease severity. Early endoscopic retrograde cholangiopancreatography (ERCP is beneficial in a group of patients with gallstone pancreatitis. Laparoscopic cholecystectomy with preoperative endoscopic common bile duct clearance is recommended as a treatment of choice for acute biliary pancreatitis. The timing of cholecystectomy, following ERCP, for biliary pancreatitis can vary markedly depending on the severity of pancreatitis

  8. Laproscopic Management of Wandering Biliary Ascariasis

    Directory of Open Access Journals (Sweden)

    Umesh Jethwani

    2012-01-01

    Full Text Available Ascariasis is one of the most common helminthic diseases in humans, occurring mostly in countries with low standards of public health and hygiene, thereby making ascariasis highly endemic in developing countries. In endemic areas, 30% of adults and 60–70% of children harbour the adult worm. Biliary ascariasis is a rare cause of obstructive jaundice. Conventional management involves endoscopic extraction of worm. We are reporting a rare case of ascaris which induced extrahepatic biliary obstruction in a young male who presented with acute cholangitis. The ascaris was removed by laparoscopic exploration of the common bile duct. Postoperative period was uneventful.

  9. PERCUTAENOUS BILIARY DRAINAGE IN MALIGNANT OBSTRUCTIVE JAUNDICE

    Directory of Open Access Journals (Sweden)

    V. Fotea

    2008-10-01

    Full Text Available In patients with malignant obstructive jaundice for whom surgery is not indicated the treatment of choice is palliative biliary drainage either endoscopic or percutaneous. We present our experience with percutaneous drainage. Although percutaneous placement of an endoprosthesis is preferred, the patients are seldom candidates for such a procedure because of locally advanced disease, and even when successful survival is not significantly affected but merely the patients’ quality of life. For this patients internal-external catheter drainage or external biliary drainage might still be of help provided that a proper care and periodical catheter change is ensured.

  10. Fibrate treatment for primary biliary cirrhosis

    NARCIS (Netherlands)

    Cuperus, F.J.C.; Halilbasic, E.; Trauner, M.

    2014-01-01

    PURPOSE OF REVIEW: Primary biliary cirrhosis (PBC) can lead to end-stage liver disease and death. Ursodeoxycholic acid (UDCA) treatment can normalize serum liver enzymes in PBC, and such UDCA-responsive patients have a similar life expectancy as age and sex-matched controls. Nearly up to 50% of the

  11. Azithromycin does not improve disease course in hospitalized infants with respiratory syncytial virus (RSV) lower respiratory tract disease : A randomized equivalence trial

    NARCIS (Netherlands)

    Kneyber, Martin C. J.; van Woensel, Job B. M.; Uijtendaal, Esther; Uiterwaal, Cuno S. P. M.; Kimpen, Jan L. L.

    2008-01-01

    Background: Nearly halt of all hospitalized infants with respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) are treated with (parenteral) antibiotics. The present study was designed to test our hypothesis that the use of antibiotics would not lead to a reduced duration of hospi

  12. Pathology of upper respiratory tract disease of gopher tortoises in Florida.

    Science.gov (United States)

    McLaughlin, G S; Jacobson, E R; Brown, D R; McKenna, C E; Schumacher, I M; Adams, H P; Brown, M B; Klein, P A

    2000-04-01

    Between August 1993 and September 1995, 24 gopher tortoises (Gopherus polyphemus) were received for pathological evaluations from various locations in Florida (USA). All tortoises were examined for clinical signs of upper respiratory tract disease (URTD) including nasal and ocular discharge, palpebral edema, and conjunctivitis. Of the 24 tortoises, 10 had current or previously observed clinical signs of URTD and 14 did not. A blood sample was drawn for detection of anti-mycoplasma antibodies by ELISA, and nasal lavage samples were collected for culture and detection of Mycoplasma agassizii gene sequences by polymerase chain reaction (PCR). Of the 14 clinically healthy tortoises, eight were sero-, culture- and PCR-negative, and six were seropositive for antibodies against M. agassizii. Of those six, five were culture- and/or PCR-positive for M. agassizii, and one was culture- and PCR-negative. Of the 10 ill tortoises, nine were seropositive by the ELISA and one was in the suspect range. Nine of the ill tortoises, including the suspect tortoise, were culture- and/or PCR-positive for M. agassizii, and one was culture- and PCR-negative. For histologic evaluation and discussion, the eight sero-, culture-, and PCR-negative tortoises were designated URTD-negative, and the other 16 were classified as URTD-positive. Histologic evaluation of the upper respiratory tract (URT) indicated the presence of mild to severe inflammatory, hyperplastic, or dysplastic changes in 14 URTD-positive tortoises. Seven of eight URTD-negative tortoises had normal appearing nasal cavities; one had mild inflammatory changes. Transmission electron microscopy revealed an organism consistent with Mycoplasma spp. on the nasal mucosal surface of tortoises with clinical signs and lesions of URTD. Additionally, gram-negative bacteria were isolated more frequently from the nasal cavities of URTD-positive tortoises than URTD-negative tortoises. Because clinical signs of URTD were never observed in six of

  13. Upper respiratory tract disease, force of infection, and effects on survival of gopher tortoises.

    Science.gov (United States)

    Ozgul, Arpat; Oli, Madan K; Bolker, Benjamin M; Perez-Heydrich, Carolina

    2009-04-01

    Upper respiratory tract disease (URTD) caused by Mycoplasma agassizii has been hypothesized to contribute to the decline of some wild populations of gopher tortoises (Gopherus polyphemus). However, the force of infection (FOI) and the effect of URTD on survival in free-ranging tortoise populations remain unknown. Using four years (2003-2006) of mark-recapture and epidemiological data collected from 10 populations of gopher tortoises in central Florida, USA, we estimated the FOI (probability per year of a susceptible tortoise becoming infected) and the effect of URTD (i.e., seropositivity to M. agassizii) on apparent survival rates. Sites with high (> or = 25%) seroprevalence had substantially higher FOI (0.22 +/- 0.03; mean +/- SE) than low (tortoises had higher apparent survival (0.99 +/- 0.0001) than seronegatives (0.88 +/- 0.03), possibly because seropositive tortoises represent individuals that survived the initial infection, developed chronic disease, and experienced lower mortality during the four-year span of our study. However, two lines of evidence suggested possible effects of mycoplasmal URTD on tortoise survival. First, one plausible model suggested that susceptible (seronegative) tortoises in high seroprevalence sites had lower apparent survival rates than did susceptible tortoises in low seroprevalence sites, indicating a possible acute effect of infection. Second, the number of dead tortoise remains detected during annual site surveys increased significantly with increasing site seroprevalence, from approximately 1 to approximately 5 shell remains per 100 individuals. If (as our results suggest) URTD in fact reduces adult survival, it could adversely influence the population dynamics and persistence of this late- maturing, long-lived species. PMID:19425439

  14. Micromachined polymerase chain reaction system for multiple DNA amplification of upper respiratory tract infectious diseases.

    Science.gov (United States)

    Liao, Chia-Sheng; Lee, Gwo-Bin; Wu, Jiunn-Jong; Chang, Chih-Ching; Hsieh, Tsung-Min; Huang, Fu-Chun; Luo, Ching-Hsing

    2005-01-15

    This paper presents a micro polymerase chain reaction (PCR) chip for the DNA-based diagnosis of microorganism genes and the detection of their corresponding antibiotic-resistant genes. The micro PCR chip comprises cheap biocompatible soda-lime glass substrates with integrated thin-film platinum resistors as heating/sensing elements, and is fabricated using micro-electro-mechanical-system (MEMS) techniques in a reliable batch-fabrication process. The heating and temperature sensing elements are made of the same material and are located inside the reaction chamber in order to ensure a uniform temperature distribution. This study performs the detection of several genes associated with upper respiratory tract infection microorganisms, i.e. Streptococcus pneumoniae, Haemopilus influenze, Staphylococcu aureus, Streptococcus pyogenes, and Neisseria meningitides, together with their corresponding antibiotic-resistant genes. The lower thermal inertia of the proposed micro PCR chip relative to conventional bench-top PCR systems enables a more rapid detection operation with reduced sample and reagent consumption. The experimental data reveal that the high heating and cooling rates of the system (20 and 10 degrees C/s, respectively) permit successful DNA amplification within 15 min. The micro PCR chip is also capable of performing multiple DNA amplification, i.e. the simultaneous duplication of multiple genes under different conditions in separate reaction wells. Compared with the large-scale PCR system, it is greatly advantageous for fast diagnosis of multiple infectious diseases. Multiplex PCR amplification of two DNA segments in the same well is also feasible using the proposed micro device. The developed micro PCR chip provides a crucial tool for genetic analysis, molecular biology, infectious disease detection, and many other biomedical applications. PMID:15590288

  15. Association between respiratory tract diseases and secondhand smoke exposure among never smoking flight attendants: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Murawski Judith

    2007-09-01

    Full Text Available Abstract Background Little is known about long-term adverse health consequences experienced by flight attendants exposed to secondhand smoke (SHS during the time smoking was allowed on airplanes. We undertook this study to evaluate the association between accumulated flight time in smoky airplane cabins and respiratory tract diseases in a cohort of never smoking flight attendants. Methods We conducted a mailed survey in a cohort of flight attendants. Of 15,000 mailed questionnaires, 2053 (14% were completed and returned. We excluded respondents with a personal history of smoking (n = 748 and non smokers with a history of respiratory tract diseases before the age of 18 years (n = 298. The remaining 1007 respondents form the study sample. Results The overall study sample was predominantly white (86% and female (89%, with a mean age of 54 years. Overall, 69.7% of the respondents were diagnosed with at least one respiratory tract disease. Among these respondents, 43.4% reported a diagnosis of sinusitis, 40.3% allergies, 30.8% bronchitis, 23.2% middle ear infections, 13.6% asthma, 13.4% hay fever, 12.5% pneumonia, and 2.0% chronic obstructive pulmonary disease. More hours in a smoky cabin were observed to be significantly associated with sinusitis (OR = 1.21; p = 0.024, middle ear infections (OR = 1.30; p = 0.006, and asthma (OR = 1.26; p = 0.042. Conclusion We observed a significant association between hours of smoky cabin exposure and self-reported reported sinusitis, middle ear infections, and asthma. Our findings suggest a dose-response between duration of SHS exposure and diseases of the respiratory tract. Our findings add additional evidence to the growing body of knowledge supporting the need for widespread implementation of clean indoor air policies to decrease the risk of adverse health consequences experienced by never smokers exposed to SHS.

  16. Meta-analysis of propylthiouracil for alcoholic liver disease--a Cochrane Hepato-Biliary Group Review

    DEFF Research Database (Denmark)

    Rambaldi, A; Gluud, C

    2001-01-01

    The aim of this review was to determine the benefits and adverse effects of propylthiouracil for patients with alcoholic liver disease.......The aim of this review was to determine the benefits and adverse effects of propylthiouracil for patients with alcoholic liver disease....

  17. The role of cholescintigraphy in the diagnosis of acute cholecystitis and other biliary tract emergencies; Place de la scintigraphie des voies biliaires dans la cholecystite aigue et les autres urgences bilio-digestives

    Energy Technology Data Exchange (ETDEWEB)

    Delcourt, A.

    1996-12-31

    Patients suspected of having acute cholecystitis can present a difficult diagnostic problem. Cholescintigraphy using {sup 99m}Tc-labeled analogues of imino-diacetic acid (IDA) is a sensitive and specific test for the early diagnosis of acute cholecystitis. The radiopharmaceutical enters the bilirubin metabolic pathway and follows the hepatic bile flow. A cystic duct obstruction is suspected if the gall-bladder does not take up the tracer 40 to 60 min after the injection, provided that the radiotracer is seen the small intestine. At that moment, morphine sulfate can be given intravenously. Acute cholecystitis is deemed present if the gall-bladder is still unseen 30 min after morphine injection or 4 hours after the radiotracer administration if morphine is contraindicated. Cholescintigraphy proves also useful in diagnosing post-surgical or post-traumatic biliary injuries. This test conveys complementary information to ultrasonography and computed tomography in cases of bile leakage, collected or free in the peritoneal cavity, in confirming the biliary origin of the collection. (author). 88 refs.

  18. Biliary ascariasis: Report of a complicated case and literature review

    OpenAIRE

    Sanai F; Al-Karawi M

    2007-01-01

    Invasion of the Ascaris worm into the biliary system leads to a wide variety of clinical syndromes. Most of the descriptions of the disease have originated from the developing world, where due to the environmental factors there is a high level of parasitism. An increased incidence of biliary ascariasis borne out of population migration and increased facilities for diagnosis has led to a renewal of interest in this disease in the developed world. Significant morbidity and mortality is associat...

  19. Primary biliary cirrhosis: geographical clustering and symptomatic onset seasonality.

    OpenAIRE

    Hamlyn, A. N.; Macklon, A F; James, O

    1983-01-01

    Patients with primary biliary cirrhosis (primary non-suppurative destructive cholangitis) in the north east region of England were studied over a five year period and, to evaluate epidemicity, compared with two contemporaneous disease series of known occurrence. These were: terminal renal failure, all causes (low or absent epidemicity n = 106) and an outbreak of echovirus 19 disease (high epidemicity n = 201). Eight primary biliary cirrhosis-affected men and 109 women from an estimated catchm...

  20. Detection of antibodies to a pathogenic mycoplasma in desert tortoises (Gopherus agassizii) with upper respiratory tract disease.

    OpenAIRE

    Schumacher, I M; Brown, M B; Jacobson, E R; Collins, B R; Klein, P A

    1993-01-01

    Mycoplasma agassizii (proposed species novum) is the etiologic agent of an upper respiratory tract disease in the desert tortoise (Gopherus agassizii), which is threatened in most of its range. An enzyme-linked immunosorbent assay (ELISA) for the detection of M. agassizii-specific antibodies in desert tortoises was developed with a monoclonal antibody with specificity for desert tortoise immunoglobulin light chain. Plasma samples from one group of tortoises were tested immediately before and ...

  1. Autochthonous Chagas' disease in Santa Catarina State, Brazil: report of the first case of digestive tract involvement

    Directory of Open Access Journals (Sweden)

    Maegawa Felipe Antonio Boff

    2003-01-01

    Full Text Available We report the first case of digestive tract pathology (megaesophagus determined by Trypanosoma cruzi infection in Santa Catarina State, southern Brazil. A 63-year- old female had presumptive clinical diagnosis of Chagas' disease, which was confirmed by imaging (endoscopy and esophagogram and immunological methods. Further molecular diagnosis was carried out with esophagus and blood samples collected during corrective surgery. Polymerase chain reaction tested positive for Trypanosoma cruzi in both esophagus and buffy coat samples.

  2. Endoscopic laser surgery of patients with pretumoral diseases and tumors of the organs of respiration and gastro-intestinal tract

    Science.gov (United States)

    Poddubny, Boris K.; Ungiadze, G. V.; Kuvshinov, Yury P.; Efimov, Oleg N.; Mazurov, S. T.

    1996-01-01

    The result of treatment of 566 patients with precancerous diseases, cancer and benign tumors of respiratory and gastro-intestinal tract are presented. The `Raduga-1' as a source of laser radiation has been used. The wavelength of radiation 1060 nm. The maximum of basic radiation at the end of lightguide is 50 W. It is shown that the method of endoscopic laser destruction is a highly effective one and may be recommended for radical treatment.

  3. Tuberculosis DALY-Gap: Spatial and Quantitative Comparison of Disease Burden Across Urban Slum and Non-slum Census Tracts.

    Science.gov (United States)

    Marlow, Mariel A; Maciel, Ethel Leonor Noia; Sales, Carolina Maia Martins; Gomes, Teresa; Snyder, Robert E; Daumas, Regina Paiva; Riley, Lee W

    2015-08-01

    To quantitatively assess disease burden due to tuberculosis between populations residing in and outside of urban informal settlements in Rio de Janeiro, Brazil, we compared disability-adjusted life years (DALYs), or "DALY-gap." Using the 2010 Brazilian census definition of informal settlements as aglomerados subnormais (AGSN), we allocated tuberculosis (TB) DALYs to AGSN vs non-AGSN census tracts based on geocoded addresses of TB cases reported to the Brazilian Information System for Notifiable Diseases in 2005 and 2010. DALYs were calculated based on the 2010 Global Burden of Disease methodology. DALY-gap was calculated as the difference between age-adjusted DALYs/100,000 population between AGSN and non-AGSN. Total TB DALY in Rio in 2010 was 16,731 (266 DALYs/100,000). DALYs were higher in AGSN census tracts (306 vs 236 DALYs/100,000), yielding a DALY-gap of 70 DALYs/100,000. Attributable DALY fraction for living in an AGSN was 25.4%. DALY-gap was highest for males 40-59 years of age (501 DALYs/100,000) and in census tracts with <60% electricity (12,327 DALYs/100,000). DALY-gap comparison revealed spatial and quantitative differences in TB burden between slum vs non-slum census tracts that were not apparent using traditional measures of incidence and mortality. This metric could be applied to compare TB burden or burden for other diseases in mega-cities with large informal settlements for more targeted resource allocation and evaluation of intervention programs. PMID:25840553

  4. Bezafibrate for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N;

    2012-01-01

    Treatment of primary biliary cirrhosis is complicated. There are studies suggesting that bezafibrate, alone or in combination with ursodeoxycholic acid (UDCA), is effective in the treatment of primary biliary cirrhosis, but no systematic review has summarised the evidence yet.......Treatment of primary biliary cirrhosis is complicated. There are studies suggesting that bezafibrate, alone or in combination with ursodeoxycholic acid (UDCA), is effective in the treatment of primary biliary cirrhosis, but no systematic review has summarised the evidence yet....

  5. Biliary Infection May Exacerbate Biliary Cystogenesis Through the Induction of VEGF in Cholangiocytes of the Polycystic Kidney (PCK) Rat

    OpenAIRE

    Ren, Xiang Shan; Sato, Yasunori; Harada, Kenichi; Sasaki, Motoko; Yoneda, Norihide; Lin, Zhen Hua; Nakanuma, Yasuni

    2011-01-01

    Cholangitis arising from biliary infection dominates the prognosis in Caroli's disease. To clarify the influences of bacterial infection on the biliary cystogenesis, in vivo and in vitro studies were performed using the polycystic kidney (PCK) rat as an animal model of Caroli's disease. Cholangitis became a frequent histological finding in aged PCK rats, and neovascularization around the bile ducts also increased in aged PCK rats. Immunohistochemistry revealed that expression of vascular endo...

  6. Percutaneous Transcatheteral Biliary Biopsy (PTBB)

    OpenAIRE

    Kim, Dae Ghon; Song, Suck Hyun; Jang, Hyun Cheol; Kim, Jung Gweon; Ahn, Hong Suck; Ahn, Deuk Soo; Kim, Jong Soo; Han, Yeung Min

    1989-01-01

    In two patients with obstructive jaundice, percutaneous transhepatic cholangiography (PTC) and percutaneous transhepatic biliary drainage (PTBD) were performed. During PTBD, the percutaneous transcatheteral biliary biopsy (PTBB) with the biopsy forceps of the gastrofiberscope was performed through the biliary stent catheter. Biopsy specimens were successfully obtained and histopathologic findings were satisfactory in both cases.

  7. Relationship between occult pancreaticobiliary reflux and biliary diseases%隐匿性胰液反流与胆道疾病间的相关性

    Institute of Scientific and Technical Information of China (English)

    杨慧慧; 李会兵; 刘爽; 刘贤英

    2016-01-01

    Objective To investigate the relationship between occult pancreaticobiliary reflux (OPR) and biliary diseases.Methods Forty-four patients with primary biliary diseases was enrolled,and serum amylase level was determined,and the bile in common bile duct (CBD) was collected to measure the amylase level,then the △ amylase was calculated,which equals bile amylase level minus serum amylase level.OPR was confirmed if bile amylase level was higher than serum amylase level,otherwise it would be defined as the control group.Results Among the 44 patients with primary biliary diseases,the incidence of OPR was 72.7% (n =32).The bile and serum amylase activity of patients with OPR were (1 513 ± 2 725),(44 ± 21)U/L;and they were (18 ± 14) and (38 ± 17) U/L in the control group.The bile amylase level in OPR group was significantly higher than that in the control group,and the difference was statistically significant (P < 0.05),while there was no significant difference in serum amylase activity between the two groups.The incidence of OPR in patients with CBD stones was 100%,and the bile amylase activity was (1 048 ± 1 317) IU/L,and the △ bile amylase activity was (996 ± 1 322) U/L;the incidence of OPR in patients with choledocholithiasis and cholecystolithiasis was 75%,and the bile amylase activity was (2 457 ± 3 312),the △ amylase activity was (2 412 ± 3 320)IU/L;and the corresponding values in patients with gallbladder stones were 80%,(95 ± 82),(57 ± 76)IU/L;and the corresponding values in patients with bile duct cancer were 50%,(73 ± 51),(40 ± 37)U/L.Conclusions The occurrence of OPR is closely related to CBD stones only,CBD stones and gallbladder stones,and it may be one of the main pathogenic factors of bile duct stones.%目的 探讨隐匿性胰液反流(OPR)与胆道疾病间的相关性.方法 收集44例原发性胆道疾病患者,取血检测血清淀粉酶活性,收集胆总管胆汁,测定胆汁淀粉酶活性,计算胆总管的△胆汁

  8. Sulphoxidation and sulphation capacity in patients with primary biliary cirrhosis.

    Science.gov (United States)

    Davies, M H; Ngong, J M; Pean, A; Vickers, C R; Waring, R H; Elias, E

    1995-05-01

    We have previously reported an association of impaired S-oxidation with primary biliary cirrhosis. In order to confirm and further define this relationship, we retested S-oxidation capacity via three metabolic pathways and sulphation capacity via a fourth pathway. Metabolism of S-carboxymethyl-L-cysteine is polymorphic -20% of healthy individuals being poor S-oxidisers. We found 26% with primary biliary cirrhosis were poor S-oxidisers, compared with 36% with other liver disease and 25% of healthy controls. Differences were not statistically significant. S-oxidation of ranitidine is dependent upon flavin mono-oxygenases. We showed a non-significant trend toward less S-oxide in primary biliary cirrhosis and other liver disease, compared with healthy controls, with no significant difference between disease groups. Conversion of cysteine to sulphate depends predominantly on cysteine dioxygenase. Impaired activity may be reflected by decreased plasma sulphate and elevated cysteine. We found that the plasma cysteine: sulphate ratio was significantly elevated not only in primary biliary cirrhosis (p < 0.0001), but also in other liver disease (p < 0.0001), compared with healthy individuals. Sulphation capacity was studied by analysing paracetamol metabolism. Paracetamol sulphate and sulphate: glucuronide ratio were reduced in primary biliary cirrhosis compared with normal individuals, (p < 0.05). A trend towards less sulphate in primary biliary cirrhosis compared other liver disease was not significant (p = 0.42). We conclude that although sulphation and some sulphoxidation pathways are impaired in primary biliary cirrhosis, we can currently find no evidence to substantiate the hypothesis that primary biliary cirrhosis is a disease specifically associated with poor S-oxidation, as assessed via these metabolic pathways. PMID:7650336

  9. Attach importance to the speciality in the diagnosis and treatment of diseases in biliary-pancreatic-duodenal junction%提高对胆胰肠结合部疾病诊断和治疗特殊性的认识

    Institute of Scientific and Technical Information of China (English)

    王坚

    2012-01-01

    Biliary-pancreatic-duodenal junction is a special region in the human body.It is difficult to diagnose and treat diseases in this region because of the complicated anatomy,the limitation of diagnosing methods,the variety of disease,the high risks of operation and the severity of complications. We should pay more attention to the pathophysiology aspects and the laboratory researches of diseases in this region.Proper diagnosis and combination of different diagnosing methods could improve the rate of early diagnosis and identify the characteristics of the disease. Individualized operation should be considered to deal with iatrogenic injury of biliary-pancreatic-duodenal junction according to different patients' condition.The principle of operation is to control damage firstly and to preserve the function of biliary-pancreatic-duodenal junction and the physiological passway of bile and pancreatic juice to the greatest extent.

  10. Percutaneous transhepatic biliary drainage

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M. J.; Kim, K. W.; Lee, J. T.; Lee, Y. H.; Park, C.Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1983-12-15

    Percutaneous transhepatic biliary drainage (PTBD) was performed 27 times in 24 patients with obstructive jaundice, from May, 1981 to October, 1982 at Department of Radiology Severance Hospital, Yonsei University, College of Medicine. Internal drainage was performed in 5 cases and external drainage in 19 cases. Daily drainage amount was corrected with the decline of serum bilirubin level. Six patients with sepsis were all improved after PTBD. This procedure effectively decompress the sevely obstructed biliary tree prior to surgery, palliates the clinical problems in patient with unresectable malignant obstruction and controls sepsis effectively.

  11. Percutaneous transhepatic biliary drainage

    International Nuclear Information System (INIS)

    Percutaneous transhepatic biliary drainage (PTBD) was performed 27 times in 24 patients with obstructive jaundice, from May, 1981 to October, 1982 at Department of Radiology Severance Hospital, Yonsei University, College of Medicine. Internal drainage was performed in 5 cases and external drainage in 19 cases. Daily drainage amount was corrected with the decline of serum bilirubin level. Six patients with sepsis were all improved after PTBD. This procedure effectively decompress the sevely obstructed biliary tree prior to surgery, palliates the clinical problems in patient with unresectable malignant obstruction and controls sepsis effectively

  12. Extrahepatic biliary obstruction; postoperative morbidity and mortality

    International Nuclear Information System (INIS)

    The objectives of this study are to evaluate the surgical management, both definitive and palliative, in selected patients with biliary obstruction and to find out the postoperative morbidity and mortality in these patients. Duration of the study is two years conducted from June 2002 to May 2004. The study was carried out at. the surgical. unit 4 of the Combined Military Hospital and surgical department of the Military Hospital. Thirty eight cases of biliary obstruction were included. A convenient sampling technique was followed. Data analyzed by using SPSS version 10.0 for windows on computer. Descriptive statistics like frequency, percentage, average etc were computed for data presentation. Any inferential test-was not found to be applicable for this descriptive type case series. We selected 38 patients with features of extrahepatic biliary obstruction. Out of these (n 38) 15 patients (39.5%) suffered from benign diseases while those having malignant diseases were 23 (60.5%). 19 (50%) patients died within two years of follow up while 19 (50%) were the survivors. Mortality was maximum for the malignant cases. In benign cases only one patient died. Maximum deaths 6 (31.6%) occurred in the period of up to one month of operation. 20 patients had one or another complication of operation and hence the morbidity came out to be 52%. According to our results the mortality and morbidity related to extrahepatic biliary obstruction in our patients was higher compared to other studies which can only be reduced by early detection and treatment. (author)

  13. Management of benign biliary strictures: current status and perspective.

    Science.gov (United States)

    Kaffes, Arthur J

    2015-09-01

    Benign biliary strictures are common and occur either from hepato-biliary surgery or from diseases including chronic pancreatitis and primary sclerosing cholangitis, among others. The treatment of many such strictures is endoscopic with evolving new approaches especially with fully covered metal stents. The only classification system available is for postoperative strictures with the intention to guide surgical correction. There is no useful classification system to guide both assessment and management of benign biliary strictures. This proposed classification is relevant to patient care in assisting diagnosis and endoscopic management. PMID:26147976

  14. Spectrum of biliary complications following live donor livertransplantation

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Liver transplantation is the optimal treatment formany patients with advanced liver disease, includingdecompensated cirrhosis, hepatocellular carcinomaand acute liver failure. Organ shortage is the maindeterminant of death on the waiting list and hence livingdonor liver transplantation (LDLT) assumes importance.Biliary complications are the most common post operativemorbidity after LDLT and occur due to anatomical andtechnical reasons. They include biliary leaks, stricturesand cast formation and occur in the recipient as well asthe donor. The types of biliary complications after LDLTalong with their etiology, presenting features, diagnosisand endoscopic and surgical management are discussed.

  15. The clinical application of static-fluid MRU and enhanced MRU for the diagnosis of upper urinary tract disease

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical utility of heavy T2-weighted MR urography (static-fluid MRU) and gadolinium-enhanced T1-weighted MR urography (enhanced MRU) for the diagnosis of upper urinary tract disease. Methods: Eleven patients were examined with static-fluid MRU and enhanced MRU. The images of static-fluid MRU and enhanced MRU were ranked and diagnosed by two radiologists. And the results were compared later. Results: The ranked image quality was analyzed with a Wilcoxon sign-rank test. The difference between two kinds of MRU images was not significant (P>0.05). The number of correct diagnosis of static-fluid MRU was 19(86.4%) by observer A and 18 (81.8%) by observer B; of enhanced MRU was 21 (95.5%) by observer A and 19 (86.4%) by observer B. Conclusion: With static-fluid MRU, the intraluminal anatomy of urinary tract can be displayed, but the function of kidney can not be evaluated. With enhanced MRU, the intraluminal anatomy can be displayed, and the function of kidney can be evaluated as well. Most of upper urinary tract disease could be diagnosed by static-fluid MRU or enhanced MRU. (authors)

  16. Percutaneous transhepatic cholangiography and drainage for treatment of biliary complications after liver transplantation

    International Nuclear Information System (INIS)

    Objective: To evaluate the value of interventional biliary drainage for the treatment of biliary complications after liver transplantation (LT). Methods: The clinical data of 6 patients with biliary complications after LT from October 1999 to October 2005 were retrospectively analyzed, including common bile duct stenosis (n=2), common bile duct with fistula (n=1), bile leaks (n=1), biloma (n=2). Results: Percutaneous transhepatic cholangiography and drainage in 5 cases and 1 case of stent placement were identified as biliary tract complications after LT. The procedures were successful with clinical symptomatic improvement of the patients. Conclusion: Interventional therapy is an effective modality for biliary complications after LT with reduction of reoperation and improvement of the living quality and survival rate. The short term effects were satisfied. (authors)

  17. Imaging findings of biliary hamartomas

    Institute of Scientific and Technical Information of China (English)

    Rong-Qin Zheng; Bo Zhang; Masatoshi Kudo; Hirokazu Onda; Tatsuo Inoue

    2005-01-01

    AIM: To evaluate the imaging findings of biliary hamartomas (von Meyenburg complexes, VMCs) and discuss the differential diagnosis with other related diseases.METHODS: Imaging findings of biliary hamartomas on ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), MR cholangiopancreatography (MRCP)and hepatobiliary scintigraphy were retrospectively analyzed in six patients.RESULTS: On ultrasound images, five of the six cases showed multiple small hyper- and hypo-echoic lesions with comet-tail echoes, especially when magnified by US with the usage of zoom function. In all the six cases,multiple tiny hypodense lesions less than 10 mm in diameter were revealed as scattered throughout the liver with no enhancement on CT. These tiny lesions were demonstrated to be hyper- and hypo-intensity on T2- and TI-weighed images, respectively, in three patients who underwent MRI examinations. MRCP was performed in two patients, and clearly showed multiple tiny irregular- and round-shaped hyper-intensity lesions.MRCP and hepatobiliary scintigraphy showed normal appearances of intra- and extra-hepatic bile ducts in two and one patients, respectively.CONCLUSION: Imaging modalities are useful in the diagnosis and differential diagnosis of VMCs. A correct diagnosis might be obtained when typical imaging findings are present even without a histological confirmation.

  18. Upper Respiratory Tract Disease in the Gopher Tortoise Is Caused by Mycoplasma agassizii†

    Science.gov (United States)

    Brown, M. B.; McLaughlin, G. S.; Klein, P. A.; Crenshaw, B. C.; Schumacher, I. M.; Brown, D. R.; Jacobson, E. R.

    1999-01-01

    Upper respiratory tract disease (URTD) has been observed in a number of tortoise species, including the desert tortoise (Gopherus agassizii) and the gopher tortoise (Gopherus polyphemus). Clinical signs of URTD in gopher tortoises are similar to those in desert tortoises and include serous, mucoid, or purulent discharge from the nares, excessive tearing to purulent ocular discharge, conjunctivitis, and edema of the eyelids and ocular glands. The objectives of the present study were to determine if Mycoplasma agassizii was an etiologic agent of URTD in the gopher tortoise and to determine the clinical course of the experimental infection in a dose-response infection study. Tortoises were inoculated intranasally with 0.5 ml (0.25 ml/nostril) of either sterile SP4 broth (control group; n = 10) or 108 color-changing units (CCU) (total dose) of M. agassizii 723 (experimental infection group; n = 9). M. agassizii caused clinical signs compatible with those observed in tortoises with natural infections. Clinical signs of URTD were evident in seven of nine experimentally infected tortoises by 4 weeks postinfection (p.i.) and in eight of nine experimentally infected tortoises by 8 weeks p.i. In the dose-response experiments, tortoises were inoculated intranasally with a low (101 CCU; n = 6), medium (103 CCU; n = 6), or high (105 CCU; n = 5) dose of M. agassizii 723 or with sterile SP4 broth (n = 10). At all time points p.i. in both experiments, M. agassizii could be isolated from the nares of at least 50% of the tortoises. All of the experimentally infected tortoises seroconverted, and levels of antibody were statistically higher in infected animals than in control animals for all time points of >4 weeks p.i. (P tortoises in both experiments did not show clinical signs, did not seroconvert, and did not have detectable M. agassizii by either culture or PCR at any point in the study. Histological lesions were compatible with those observed in tortoises with natural infections

  19. Upper respiratory tract disease in the gopher tortoise is caused by Mycoplasma agassizii.

    Science.gov (United States)

    Brown, M B; McLaughlin, G S; Klein, P A; Crenshaw, B C; Schumacher, I M; Brown, D R; Jacobson, E R

    1999-07-01

    Upper respiratory tract disease (URTD) has been observed in a number of tortoise species, including the desert tortoise (Gopherus agassizii) and the gopher tortoise (Gopherus polyphemus). Clinical signs of URTD in gopher tortoises are similar to those in desert tortoises and include serous, mucoid, or purulent discharge from the nares, excessive tearing to purulent ocular discharge, conjunctivitis, and edema of the eyelids and ocular glands. The objectives of the present study were to determine if Mycoplasma agassizii was an etiologic agent of URTD in the gopher tortoise and to determine the clinical course of the experimental infection in a dose-response infection study. Tortoises were inoculated intranasally with 0.5 ml (0.25 ml/nostril) of either sterile SP4 broth (control group; n = 10) or 10(8) color-changing units (CCU) (total dose) of M. agassizii 723 (experimental infection group; n = 9). M. agassizii caused clinical signs compatible with those observed in tortoises with natural infections. Clinical signs of URTD were evident in seven of nine experimentally infected tortoises by 4 weeks postinfection (p.i.) and in eight of nine experimentally infected tortoises by 8 weeks p.i. In the dose-response experiments, tortoises were inoculated intranasally with a low (10(1) CCU; n = 6), medium (10(3) CCU; n = 6), or high (10(5) CCU; n = 5) dose of M. agassizii 723 or with sterile SP4 broth (n = 10). At all time points p.i. in both experiments, M. agassizii could be isolated from the nares of at least 50% of the tortoises. All of the experimentally infected tortoises seroconverted, and levels of antibody were statistically higher in infected animals than in control animals for all time points of >4 weeks p.i. (P tortoises in both experiments did not show clinical signs, did not seroconvert, and did not have detectable M. agassizii by either culture or PCR at any point in the study. Histological lesions were compatible with those observed in tortoises with natural

  20. Long-term results of endoscopic balloon dilatation of lower GI tract strictures in Crohn's disease

    International Nuclear Information System (INIS)

    Over the last few years there have been several reports on endoscopic balloon dilatation of Crohn's strictures of the lower gastrointestinal (GI) tract. However, to date, long-term results are not available. Our objective is to examine the long-term results of endoscopic treatment in a prospective study conducted over a period of 10 years, 1997 to January 2007. Here, we report our initial findings. A total of 25 patients (20 female and five male: aged 18-75 years) with at least one symptom of stricture, with the standard colonoscopy not able to be passed and with a scarred Crohn's stricture of the lower GI were included in the study. The main symptom was abdominal pain. The endoscopic balloon dilatation was performed with an 18 mm balloon under endoscopic and radiological control. Eleven strictures were located in the colon, 13 at the anastomosis after ileocoecal resection, three at the Bauhin valve and four in the ileum. Four patients had two strictures and one patient had three strictures. Of the 31 strictures, in 30 was balloon dilatation successful in a single endoscopic session, so that eventually the strictures could be passed easily with the standard colonoscopy. In one patient with a long stricture of the ileum involving the Bauhin valve and an additional stricture of the ileum which were 15 cm apart, sufficient dilatation was not possible. This patient therefore required surgery. Improvement of abdominal symptoms was achieved in all cases with technically successful balloon dilatation. Although in one case, perforation occurred after dilatation of a recurrent stricture. Available follow-up was in the range 54-118 months (mean of 81 months). The relapse rate over this period was 46% but 64% of relapsing strictures could be successfully dilated again. Only in four patients was surgery required during this followup period. We conclude from these initial results that endoscopic balloon dilatation especially for short strictures in Crohn's disease, can be

  1. 损伤控制理念指导老年胆道系统疾病诊治体会%Application of damage control in the treatment of biliary system diseases in elderly patients

    Institute of Scientific and Technical Information of China (English)

    张诚; 杨玉龙; 林美举; 史力军; 张洪威; 李婧伊

    2012-01-01

    目的 探讨损伤控制(DC)理念及损伤控制手术(DCS)在老年胆道系统疾病诊治中的应用价值.方法 回顾性分析2008年10月至2012年2月采取DC理念治疗的99例老年胆道系统结石患者的临床资料,其中急性梗阻性化脓性胆管炎(AOSC) 46例、急性胆源性胰腺炎(ABP) 12例、急性结石性胆囊炎(结石嵌顿)24例、肝内胆管结石伴急性胆管炎15例、肝脓肿4例.结果 99例患者均行DCS,手术方式包括内镜下乳头括约肌切开术(EST/EPT)、经内镜鼻胆/胰管引流术(ENBD/ENPD)、经内镜胆管塑料支架内引流术(ERBD)、经皮经肝穿刺胆管引流术(PTCD)、经皮经肝穿刺胆囊引流术(PTGBD).所有患者均度过急性期,后续治疗采取“个体化”治疗原则,行开腹胆囊切开取石、胆道探查取石、经皮经肝胆道镜(PTCS)以及胆道镜下取石、等离子碎石、狭窄部位球囊扩张/电切治疗.治愈92例(92.9%),好转7例(7.1%),无死亡病例.结论 以DC理念为指导,对高危老年胆道系统疾病患者实施DCS治疗,能分解手术风险,达到缓解甚至治愈疾病的目的.%Objective To investigate the application value of damage control (DC) concept and damage control surgery (DCS) in the treatment of biliary diseases in eldery patients. Methods The clinical data of 99 cases with severe biliary diseases who treated with the concept of DC from Oct. 2008 to Feb. 2012 were analyzed retrospectively, of whom, 46 eases of acute obstructive suppurative cholangitis (AOSC), 12 rases of acute biliary pancreatitis (ABP). 24 crases of acute obstructive cholecystitis, 15 cases of acute cholangitis with intrahepatic bile duct stones, and 4 cases of iatrogenie bile leakage. Results Nintvnine patients underwent DCS. The surgical procedures included endo~ scopio sphinctemtomy (EST/EPT), endoseopie naso biliary/pancreatic drainage (ENBD/ENPD), endoscopic retro" grade biliary drainage (ERBD), percutaneous transhepatic eholangiography

  2. The effect of biliary decompression on bacterial translocation in jaundiced rats

    OpenAIRE

    Jin Wen Ding; Roland Andersson; Vasile Soltesz; Roger Willén; Steffen Loft; Poulsen, Henrik E; Håkan Pärsson; Kjell Olsson; Stig Bengmark

    1993-01-01

    Patients with obstructive jaundice are prone to septic complications after biliary tract operations. Restoring bile flow to the intestine may help to decrease the complication rate. The present study is aimed at evaluating the effect of biliary decompression on bacterial translocation in jaundiced rats. Sixty-six male Sprague-Dawley rats were randomly allocated to six groups subjected to common bile duct ligation (CBDL) and transection (groups 2-6) or sham operation (group 1). In groups 1 and...

  3. Management of Simultaneous Biliary and Duodenal Obstruction: The Endoscopic Perspective

    OpenAIRE

    Baron, Todd H

    2010-01-01

    Obstructive jaundice often develops in patients with unresectable malignancy in and around the head of the pancreas. Duodenal obstruction can also occur in these patients, and usually develops late in the disease course. Palliation of both malignant biliary and duodenal obstruction is traditionally performed with surgical diversion of the bile duct and stomach, respectively. With the advent of nonsurgical palliation of biliary obstruction using endoscopic transpapillary expandable metal stent...

  4. Techniques of biliary drainage for acute cholangitis: Tokyo Guidelines

    OpenAIRE

    Tsuyuguchi, Toshio; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Wada, Keita; Nagino, Masato; Mayumi, Toshihiko; Yoshida, Masahiro; Miura, Fumihiko; Tanaka, Atsushi; Yamashita, Yuichi; Hirota, Masahiko; Hirata, Koichi; Yasuda, Hideki; Kimura, Yasutoshi

    2007-01-01

    Biliary decompression and drainage done in a timely manner is the cornerstone of acute cholangitis treatment. The mortality rate of acute cholangitis was extremely high when no interventional procedures, other than open drainage, were available. At present, endoscopic drainage is the procedure of first choice, in view of its safety and effectiveness. In patients with severe (grade III) disease, defined according to the severity assessment criteria in the Guidelines, biliary drainage should be...

  5. SPONTANEOUS DUODENO-BILIARY FISTULA CAUSED BY DUODENAL PEPTIC ULCER

    Directory of Open Access Journals (Sweden)

    N. Danila

    2005-07-01

    Full Text Available Spontaneous duodeno-biliary fistula represents a rare complication of chronic duodenal peptic ulcer. The authors present two cases with this pathology and also the particularities of surgical approach. Spontaneous duodeno-biliary fistula caused by chronic peptic ulcer is often a surprising diagnostic in the era of H2 blockers. The difficulties and the complexity of the diagnosis associated with the particularities of surgical technique represent the key of this rare disease.

  6. The Impact of Intensified Hemodialysis on Pruritus in an End Stage Renal Disease Patient with Biliary Ductopenia

    Directory of Open Access Journals (Sweden)

    Sandra Chomicki

    2015-01-01

    Full Text Available We report a unique observation characterized by the coexistence of idiopathic adulthood ductopenia (IAD, a rare cholestatic disease, and end stage renal failure treated by conventional hemodialysis in a patient awaiting double renal and liver transplantation. As pruritus gradually worsened, we hypothesized that intensified dialysis could alleviate the symptoms. Conventional hemodialysis following 3 hours/3 times a week regimen was initiated in December 2013. Due to increasing pruritus not responding to standard medical therapy, intensified hemodialysis following 2.5 hours/5 times a week regimen was started in May 2014. During two weeks, a temporary decrease in bilirubin levels was observed. No major changes on other liver function tests and inflammatory markers occurred. Nevertheless, a persistent improvement on pruritus and general wellbeing was obtained during the four weeks’ study period. The pathogenesis of itch encompasses multiple factors, and, in our case, both uremic and cholestatic pruritus are involved, although the latter is likely to account for a greater proportion. By improving itch intensity, through better clearance of uremic and cholestatic toxins which we detail further, intensive dialysis appears to be an acceptable short-term method for patients with hepatic cholestasis and moderate pruritus not responding to conventional therapy. Additional studies are needed to assess and differentiate precisely factors contributing to pruritus of both origins.

  7. Surgical treatment of congenital biliary duct cyst

    Directory of Open Access Journals (Sweden)

    Wang De-chun

    2012-03-01

    Full Text Available Abstract Background It is acknowledged that total cyst excision is a safe and ideal surgical treatment for congenital biliary duct cyst, compared to simple internal drainage. The aim of this study was to determine the optimal operation occasion and the effect of laparoscopy on congenital biliary duct cyst based upon total cyst excision. Methods From January 2002 to January 2011, 217 patients were admitted to Southwest Hospital for congenital biliary duct cyst. To determine the optimal surgery occasion, we divided these subjects into three groups, the infant group (age ≤ 3 years, the immaturity group (3 18 years, and then evaluated the feasibility, risk and long-term outcome after surgery in the three groups. To analyze the effect of laparoscopic technique on congenital biliary duct cyst, we divided the patients into the laparoscopy and the open surgery groups. Results Among the three groups, the morbidity from cholangiolithiasis before surgical treatment had obvious discrepancy (p 0.05. Similarly, no significant discrepancy was observed in the morbidity from postoperative complications or long-term postoperative complications (p > 0.05 between the laparoscopic and the open surgery groups. Conclusions We conclude that total cyst excision should be performed as early as possible. The optimal treatment occasion is the infant period, and laparoscopic resection may be a new safe and feasible minimally invasive surgery for this disease.

  8. Studies on the usefulness of negative contrast medium for CT-fatty emulsion-in diseases of the gastrointestinal tract

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, Tsuneo; Kameda, Kyoko; Tanaka, Koji; Nishimura, Shigeru; Higashide, Toshiaki (Osaka Police Hospital (Japan))

    1983-09-01

    Investigation was made on the usefulness of negative contrast medium for CT-fatty emulsion-, which is applicable to the whole area of the gastrointestinal tract, in diagnoses of diseases of the stomach, pancreas, colon and the organs adjacent to the three. After the administration of the drug, CT was performed and the thickness of the walls were measured for the normal upper gastrointestinal tract in 50 patients and for the normal colon in 25. The normal gastric walls did not exceed 5 mm and the walls of the colon measured about 2.1 mm. Gastric tumors were projected at 80.4%. Especially, the drug was useful for the early diagnosis of schirrus. The pancreas was more clearly projected in 88.4% of the patients. The reconstruction method using the present drug was useful for the investigation of the relationship between the two organs, the stomach and the duodenum, and the pancreas. When CT was performed on a patient laying this right side on the bed, invasion of pancreatic cancer and gastric antrum cancer into the circumferntial organs could be diagnosed. The drug was useful for the identification of tumors in the colon and intrapelvic lesions. The medium was also given to four patients with colitis ulcerosa and the obtained findings on the wall features were same as those obtained by barium enema. The present drug was little associated with side effects and is considered to be an excellent negative contrast medium for all the gastrointestinal tracts.

  9. Endoscopic ultrasound-guided biliary drainage as an alternative to percutaneous drainage and surgical bypass.

    Science.gov (United States)

    Prachayakul, Varayu; Aswakul, Pitulak

    2015-01-16

    Endoscopic retrograde cholangiopancreatography had been a treatment modality of choice for both benign and malignant biliary tract obstruction for more than half century, with a very high clinical success rate and low complications. But in certain circumstances, such as advanced and locally advanced pancreatobiliary malignancies (pancreatic cancer, cholangiocarcinoma, ampullary tumor) and tight benign strictures, endoscopic retrograde cholangiopancreatography (ERCP) fails. Up to this point, the only alternative interventions for these conditions were percutaneous transhepatic biliary drainage or surgery. Endoscopic ultrasound guided interventions was introduced for a couple decades with the better visualization and achievement of the pancreatobiliary tract. And it's still in the process of ongoing development. The inventions of new techniques and accessories lead to more feasibility of high-ended procedures. Endoscopic ultrasound guided biliary drainage was a novel treatment modality for the patient who failed ERCP with the less invasive technique comparing to surgical bypass. The technical and clinical success was high with acceptable complications. Regarded the ability to drain the biliary tract internally without an exploratory laparotomy, this treatment modality became a very interesting procedures for many endosonographers, worldwide, in a short period. We have reviewed the literature and suggest that endoscopic ultrasound-guided biliary drainage is also an option, and one with a high probability of success, for biliary drainage in the patients who failed conventional endoscopic drainage. PMID:25610532

  10. Management of complications during percutaneous implementation of biliary stents

    International Nuclear Information System (INIS)

    Objective: To retrospectively analyze the complications and management of complications during percutaneous implementation of biliary stents in 17 patients. Methods: Percutaneous biliary drainage and implementation of biliary stents for malignant biliary obstruction under fluoroscopic guidance was performed in 64 patients. 17 cases developed complications. Bradycardia and hypotension was seen in 5 cases, slipping of the stent into the duodenum in 1, bile duct perforation in 2, the fine guidewire broken in the hepatic parenchyma in 2, malposition of the stent in 3, hepato-renal failure leading to hemorrhage in 2, exchanging guidewire broken in the duodenum in 1, and balloon broken leading to stent dislocation in 1, respectively. Results: Bradycardia and hypotension in the 5 cases was treated medically and the procedure was interrupted. Slipping of the stent into the duodenum was passed off spontaneously. Broken of the fine guidewire in the liver did not present any complaints until the death of the patients. Perforation of bile duct was treated conservatively with a clinical successful outcome. Malposition of the stent was treated by reimplementation of shorter stents. The broken exchanging guidewire in the duodenum during implementation was removed with the gastroscope. The hepato-renal failure leading to hemorrhage had poor prognosis. The broken balloon caused stent dislocation was treated by reimplementation of stent. Conclusion: Percutaneous implementation of stent is effective and safe for elderly patients with proximal stenosis of the biliary tract. However, one must be very careful to avoid the complications

  11. Antimicrobial agents of plant origin for the treatment of phlogistic-infectious diseases of the lower female genital tract

    Directory of Open Access Journals (Sweden)

    Francesco Gon

    2012-12-01

    Full Text Available The phlogistic-infectious diseases of the lower female genital tract are one of the most widespread obstetricgynecologic issues, due to treatment failures that cause frequent relapses and to the adverse effects of some commonly used drugs.The most common vaginal syndromes are due to uncontrolled growth of bacteria or fungi which replace the normal vaginal flora, causing phlogistic and infectious based diseases. These infections are treated with anti-inflammatory and antibiotic therapy; however, the emergence of resistant strains and the ability of many microorganisms to grow inside biofilms severely reduce the repertoire of useful agents.Thus, in the last years increasing interest has been focused toward compounds of plant origin with anti-microbial properties. In the present work, we studied the antimicrobial activity of fractions obtained from endemic plants of Sardinia towards microorganisms that frequently are involved in vaginal infectious diseases: Streptococcus agalactiae, Gardnerella vaginalis and Candida albicans.

  12. Progress in pediatrics in 2011. Choices in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy and respiratory tract illnesses

    Directory of Open Access Journals (Sweden)

    Caffarelli Carlo

    2012-06-01

    Full Text Available Abstract Main progresses in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy, and respiratory tract illnesses selected from articles published in The Italian Journal of Pediatrics in 2011 were reviewed. Risk factors for gastroenteritis and appendicitis in developing countries may be useful in improving our understanding of these diseases. Childhood hearing impairment is a world-wide problem which continues to have an high prevalence in newborns. Among the mechanisms of diseases, obese children often have asthma and high hepcidin levels that may reduce serum iron concentrations. In cystic fibrosis, 18q distal deletion has been described as a novel mutation. Hypothyroidism in children with central nervous system infections may increase mortality rates. Infrared tympanic thermometer (IRTT in oral mode for the measurement of body temperature may be useful in fever screening in a busy setup. In newborns, the transmission of CMV infection through breast milk may be prevented through freezing or pasteurization. Recent advances in treatment of constipation, urinary tract infections, leukemia, pain in children with cancer, neonates with sepsis or difficult weaning from mechanical ventilation will likely contribute towards optimizing management of these common disorders. The work of the Family Pediatricians Medicines for Children Research Network aims to develop competence, infrastructure, networking and education for pediatric clinical trials.

  13. Biliary Ascariasis Mimicking Colonic Tumor Infiltration of the Biliary System.

    Science.gov (United States)

    Sundriyal, Deepak; Mittal, Gyanendra; Kumar, Sushil; Manjunath, Suraj; Sharma, Navneet; Gupta, Mahesh

    2015-09-01

    Ascariasis is a common problem in developing countries with poor hygiene and sanitation. It is endemic in India and usually seen in the northern states. Biliary ascariasis is an uncommon cause of obstructive jaundice. We present a case of carcinoma of hepatic flexure of colon in which the patient developed biliary ascariasis and posed a diagnostic challenge as it mimicked tumor infiltration of the biliary system. PMID:27217679

  14. Quantitative evaluation of changes in the selected white matter tracts using diffusion tensor imaging in patients with Alzheimer's disease and mild cognitive impairment.

    Science.gov (United States)

    Zimny, A; Szewczyk, P; Bladowska, J; Trypka, E; Wojtynska, R; Leszek, J; Sasiadek, M

    2012-07-01

    This study evaluated the damage to the extensive range of white matter tracts in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Thirty-four patients with AD (mean age 71.5 yrs, MMSE 17.6), 23 patients with MCI (mean age 66 yrs, MMSE 27.4) and 15 normal controls (mean age 69 yrs, MMSE 29.8) were enrolled. Diffusion tensor imaging (DTI) was performed in 25 directions on 1.5 T MR scanner. Fractional anisotropy (FA) values were obtained with a small ROI method in several association tracts including posterior cingulum fibers, in commissural tracts (genu and splenium of corpus callosum) and projection tracts (middle cerebellar peduncles and posterior limbs of internal capsules). In MCI significant reductions of FA were found in the inferior longitudinal fascicles, left superior longitudinal fascicle and posterior cingulum fibers compared to normal controls. In AD significantly decreased FA values were detected in the same fascicles as in MCI and additionally in inferior fronto-occipital tracts and commissural tracts. In both AD and MCI the most severe changes were found within posterior cingulum fibers. No abnormalities were detected in projection tracts in both groups. Accuracy of DTI in detecting AD and MCI reached 0.95 and 0.79, respectively. FA measurements strongly correlated with neuropsychological tests. DTI is capable of depicting microstructural changes within white matter fiber tracts in dementia and may aid the differential diagnosis of AD and MCI. PMID:24028982

  15. Expansion of PROMININ-1-expressing cells in association with fibrosis of biliary atresia

    OpenAIRE

    Mavila, Nirmala; James, David; Shivakumar, Pranavkumar; Nguyen, Marie V.; Utley, Sarah; Mak, Katrina; Wu, Allison; Zhou, Shengmei; Wang, Larry; Vendyres, Christopher; Groff, Megan; Asahina, Kinji; Wang, Kasper S

    2014-01-01

    Biliary atresia (BA), the most common cause of end-stage liver disease and the leading indication for pediatric liver transplantation, is associated with intrahepatic ductular reactions within regions of rapidly expanding periportal biliary fibrosis. While the extent of such biliary fibrosis is a negative predictor of long-term transplant-free survival, the cellular phenotypes involved in the fibrosis are not well established. Using a Rhesus rotavirus (RRV)-induced mouse model of BA, we demon...

  16. Percutaneous transhepatic biliary drainage and stenting for malignant obstructive jaundice: A report of two cases

    OpenAIRE

    SHAO, JIN-HUI; FANG, HAI-XING; Li, Guo-Wei; HE, JIA-SHENG; Wang, Bao-Quan; Sun, Jun-Hui

    2015-01-01

    Malignant obstructive jaundice comprises a group of diseases that can be caused by primary biliary and extra-biliary carcinomas. Generally, surgical resection is the primary treatment for malignant obstructive jaundice; however, for the patients that are unable to undergo surgery, urgent treatment is required to improve hepatic function. Percutaneous transhepatic biliary drainage (PTBD) and stenting are emerging alternative treatments for malignant obstructive jaundice. PTBD and stenting have...

  17. Congenital upper urinary tract abnormalities: new images of the same diseases

    Energy Technology Data Exchange (ETDEWEB)

    Maranhao, Carol Pontes de Miranda; Santos, Carla Jotta dos [Clinica de Medicina Nuclear e Radiologia de Maceio (MedRadiUS), AL (Brazil); Miranda, Christiana Maia Nobre Rocha de; Farias, Lucas de Padua Gomes de; Padilha, Igor Gomes, E-mail: maiachristiana@globo.com [Universidade Federal de Alagoas (UFAL), Maceio, AL (Brazil)

    2013-01-15

    Congenital upper urinary tract abnormalities imply a variable clinical spectrum of morphofunctional changes ranging from asymptomatic conditions to renal failure and incompatibility with life. Computed tomography, which has overcome excretory urography imaging, has been playing a key role in the diagnosis of congenital anomalies, serving as a better guidance in the therapeutic and surgical decision-making process, besides acting as an essential tool in the identification of associated complications and aiding in the performance of minimally invasive surgery techniques. (author)

  18. Clinical Significance of Cerebrovascular Biomarkers and White Matter Tract Integrity in Alzheimer Disease

    OpenAIRE

    Wu, Ming-Kung; Lu, Yan-Ting; Huang, Chi-Wei; Lin, Pin-Hsuan; Chen, Nai-Ching; Lui, Chun-Chung; Chang, Wen-Neng; Lee, Chen-Chang; Chang, Ya-Ting; Chen, Sz-Fan; Chang, Chiung-Chih

    2015-01-01

    Abstract Cerebrovascular risk factors and white matter (WM) damage lead to worse cognitive performance in Alzheimer dementia (AD). This study investigated WM microstructure using diffusion tensor imaging in patients with mild to moderate AD and investigated specific fiber tract involvement with respect to predefined cerebrovascular risk factors and neurobehavioral data prediction cross-sectionally and after 18 months. To identify the primary pathoanatomic relationships of risk biomarkers to f...

  19. The application of biliary catheter folding technique in the treatment of hilar nonanastomotic biliary strictures after orthotopic liver transplantation

    International Nuclear Information System (INIS)

    Objective: To introduce a newly-designed percutaneous single catheter folding technique, by which bilateral biliary drainage and stenting can be completed through single access, and to assess the effectiveness and safety of this technique in treating hilar nonanastomotic strictures occurred after orthotopic liver transplantation. Methods: A total of 10 patients with nonanastomotic strictures, who were encountered during the period from July 2000 to July 2010 in authors' hospital, were enrolled in this study. Balloon dilatation was used for the biliary tract stenosis. After the placement of biliary drainage tube, the catheter was folded into 'Y' shape within the biliary duct at hepatic portal region, and triaxial supporting drainage, i.e. the left hepatic duct, the right hepatic duct and the common hepatic duct, was established. The technical success rate, the clinical efficacy, the complications and the recurrence were documented and analyzed. Results: Technical success rate was 100% (10/10). In 9 patients, the clinical symptoms were obviously relieved, the biochemical indexes were gradually restored to normal and the imaging findings were markedly improved. During the follow-up lasting 26 months (median), no recurrence was seen. Minor complications occurred in two cases. One patient died after he received second orthotopic liver transplantation because of failure to respond to initial treatment. Conclusion: Percutaneous transhepatic biliary catheter folding technique is technically feasible. The results of this study indicate that this technique carries satisfactory success rate and is very effective and safe for the treatment of hilar nonanastomotic strictures occurred after orthotopic liver transplantation. (authors)

  20. Incidence of port-site metastasis after undergoing robotic surgery for biliary malignancies

    Institute of Scientific and Technical Information of China (English)

    Quan-Da Liu; Jun-Zhou Chen; Xiao-Ya Xu; Tao Zhang; Ning-Xin Zhou

    2012-01-01

    AIM:To investigate the incidence of clinically detected port-site metastasis (PSM) in patients who underwent robotic surgery for biliary malignancies.METHODS:Using a prospective database,the patients undergoing fully robotic surgery for biliary malignancies between January 2009 and January 2011 were included.Records of patients with confirmed malignancy were reviewed for clinicopathological data and information about PSM.RESULTS:Sixty-four patients with biliary tract cancers underwent robotic surgery,and sixty patients met the inclusion criteria.The median age was 67 year (range:40-85 year).During a median 15-mo follow-up period,two female patients were detected solitary PSM after robotic surgery.The incidence of PSM was 3.3%.Patient 1 underwent robotic anatomatic left hemihepatectomy and extraction of biliary tumor thrombi for an Klatskin tumor.She had a subcutaneous mass located at the right lateral abdominal wall near a trocar scar.Patient 2 underwent robotic pancreaticoduodenectomy for distal biliary cancer.She had two metachronous subcutaneous mass situated at the right lateral abdominal wall under a same trocar scar at 7 and 26 mo.The pathology of the excised PSM masses confirmed metastatic biliary adenocarcinoma.COMCLUSION:The incidence of PSMs after robotic surgery for biliary malignancies is relatively low,and biliary cancer can be an indication of robotic surgery.

  1. 3 T MR cholangiopancreatography appearances of biliary ascariasis

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Z.X., E-mail: hangzhoudzx73@126.co [Department of Radiology, Zhejiang Provincial People' s Hospital, Hangzhou (China); Yuan, J.H. [Department of Radiology, Zhejiang Provincial People' s Hospital, Hangzhou (China); Chong, V. [Department of Diagnostic Imaging, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore (Singapore); Zhao, D.J. [Department of Hepatobiliary Surgery, Zhejiang Provincial People' s Hospital, Hangzhou (China); Chen, F.H.; Li, Y.M. [Department of Radiology, Zhejiang Provincial People' s Hospital, Hangzhou (China)

    2011-03-15

    Aim: To evaluate the 3 T MR cholangiopancreatography (MRCP) appearances of biliary ascariasis. Materials and methods: Nine patients with a MRCP diagnosis of biliary ascariasis were reviewed. All patients had endoscopic retrograde cholangiopancreatography (ERCP) or surgical confirmation of the disease. Results: On thin-slab MRCP imaging, Ascaris worms are clearly demarcated within the biliary tree. All the identified worms demonstrated a characteristic three-parallel-lines appearance. The middle high-signal intensity line is sandwiched between two low-signal intensity lines and they are in turn surrounded by high signal bile. On thick-slab MRCP the worms also show the three-line sign but with less clarity. However, thick-slab MRCP has the advantage of providing three-dimensional ERCP-like images of the pancreaticobiliary system. Conclusion: The 'three-line' sign appears to be a characteristic sign of biliary ascariasis on 3 T MRCP.

  2. 3 T MR cholangiopancreatography appearances of biliary ascariasis

    International Nuclear Information System (INIS)

    Aim: To evaluate the 3 T MR cholangiopancreatography (MRCP) appearances of biliary ascariasis. Materials and methods: Nine patients with a MRCP diagnosis of biliary ascariasis were reviewed. All patients had endoscopic retrograde cholangiopancreatography (ERCP) or surgical confirmation of the disease. Results: On thin-slab MRCP imaging, Ascaris worms are clearly demarcated within the biliary tree. All the identified worms demonstrated a characteristic three-parallel-lines appearance. The middle high-signal intensity line is sandwiched between two low-signal intensity lines and they are in turn surrounded by high signal bile. On thick-slab MRCP the worms also show the three-line sign but with less clarity. However, thick-slab MRCP has the advantage of providing three-dimensional ERCP-like images of the pancreaticobiliary system. Conclusion: The 'three-line' sign appears to be a characteristic sign of biliary ascariasis on 3 T MRCP.

  3. Role of stents and laser therapy in biliary strictures

    Science.gov (United States)

    Chennupati, Raja S.; Trowers, Eugene A.

    2001-05-01

    The most frequent primary cancers causing malignant obstructive jaundice were pancreatic cancer (57%), hilar biliary cancer (19% including metastatic disease), nonhilar biliary cancer (14%) and papillary cancer (10%). Endoscopic stenting has widely replaced palliative surgery for malignant biliary obstruction because of its lower risk and cost. Self-expandable metal stents are the preferred mode of palliation for hilar malignancies. Plastic stents have a major role in benign biliary strictures. Major complications and disadvantages associated with metallic stents include high cost, cholangitis. malposition, migration, unextractability, and breakage of the stents, pancreatitis and stent dysfunction. Dysfunction due to tumor ingrowth can be relieved by thermal methods (argon plasma coagulator therapy). We present a concise review of the efficacy of metallic stents for palliation of malignant strictures.

  4. Biliary ascariasis. A case report.

    Science.gov (United States)

    Sarihan, H; Gürkök, S; Sari, A

    1995-01-01

    Ascaris lumbricoides is a worldwide intestinal infestation that may cause various complications. Biliary ascariasis, however, is a rare condition. We describe a child with biliary ascariasis. The patient's clinical symptoms were pain, vomiting and abdominal tenderness, and she was thought to have acute appendicitis. However, laboratory examination revealed high serum alkaline phosphatase and amylase levels, and ultrasonography and percutaneous cholangiography demonstrated biliary ascariasis. The patient was successfully treated with mebendazole and antispasmolytic drugs. PMID:8560608

  5. Pulmonary involvement in primary biliary cirrhosis.

    OpenAIRE

    Rodriguez-Roisin, R.; Pares, A; Bruguera, M; Coll, J; Picado, C.; Agusti-Vidal, A; Burgos, F.; Rodes, J

    1981-01-01

    The association of pulmonary fibrosis and primary biliary cirrhosis (PBC) remains controversial. To determine the frequency of pulmonary fibrosis in PBC, a carefully selected series of 14 PBC patients, seven patients with Sicca complex, and 14 control subjects have been studied. Seven of the 14 patients with PBC had Sjögren's syndrome, four of whom had some clinical evidence of pulmonary disease. Evaluation of ventilatory capacity, gas transfer factor, arterial blood gases, and lung mechanics...

  6. Hepatic and Biliary Ascariasis

    OpenAIRE

    Anup K Das

    2014-01-01

    Ascariasis mainly contributes to the global helminthic burden by infesting a large number of children in the tropical countries. Hepato-biliary ascariasis (HBA) is becoming a common entity now than in the past owing to the frequent usage of ultrasonograms and endoscopic diagnostic procedures in the clinical practice. There are a variety of manifestations in HBA and diagnosis depends on a high index of suspicion in endemic areas coupled with subsequent confirmation by sonographic or endoscopic...

  7. GWAS in Primary Biliary Cirrhosis

    Science.gov (United States)

    Gulamhusein, Aliya F.; Juran, Brian D.

    2015-01-01

    Genome wide association studies (GWAS) have been a significant technological advance in our ability to evaluate the genetic architecture of complex diseases such as Primary Biliary Cirrhosis (PBC). To date, six large-scale studies have been performed which identified 27 non-HLA risk loci associated with PBC. The identified risk variants emphasize important disease concepts; namely, that disturbances in immunoregulatory pathways are important in the pathogenesis of PBC and that such perturbations are shared among a diverse number of autoimmune diseases – suggesting the risk architecture may confer a generalized propensity to autoimmunity not necessarily specific to PBC. Furthermore, the impact of non-HLA risk variants, particularly in genes involved with IL-12 signaling, and ethnic variation in conferring susceptibility to PBC have been highlighted. While GWAS have been a critical stepping-stone in understanding common genetic variation contributing to PBC, limitations pertaining to power, sample availability, and strong linkage disequilibrium across genes have left us with an incomplete understanding of the genetic underpinnings of disease pathogenesis. Future efforts to gain insight into this missing heritability, the genetic variation that contributes to important disease outcomes and the functional consequences of associated variants will be critical if practical clinical translation is to be realized. PMID:26676814

  8. Urinary Tract Infections in Children

    Science.gov (United States)

    ... Disease Organizations​​ . (PDF, 345 KB) Alternate Language URL Urinary Tract Infections in Children Page Content On this page: What ... Points to Remember Clinical Trials What is a urinary tract infection (UTI)? A UTI is an infection in the ...

  9. 导丝介入法在胆道梗阻患者内镜下鼻胆管引流术中的应用%Application of interventional guidewire in endoscopic nasal biliary drainage in patients with ;obstruction of biliary tract

    Institute of Scientific and Technical Information of China (English)

    黄茵; 曾婷

    2014-01-01

    目的:探讨导丝介入法经内镜下鼻胆管引流术中的应用价值。方法2014年1月至2015年1月将120例因胆道梗阻行内镜下鼻胆管引流术的住院患者,随机分为观察组(n =60)和对照组(n =60)。观察组采用导丝从咽后壁牵引拉出牵引管再将鼻胆管引出鼻腔固定;对照组采用手术者食、中指伸至患者咽后壁夹出牵引管方法。分别比较两组临床结果和并发症。结果观察组与对照组相比较,观察组的总成功率(P <0.05),一次成功率优于对照组(P <0.01);鼻胆管远端脱出率(P <0.05);口腔内打折率(P <0.01);术者手指被咬伤率(P <0.01)。结论采用导丝从咽部牵引出牵引管将鼻胆管自口经鼻引出固定法,具有简便、易操作,患者反应轻、副作用少,成功率高等优点。%Objective To discuss the application and the value of inventional guidewire in endoscopic nasal biliary drainage.Methods A total of 120 patients who underwent nasal biliary drainage admitted during the period from January 2014 to January 2015 were randomly divided into observational group (n =60)and control group (n =60).The patients in the observation group were applied with guide wire from the posterior pharyngeal wall pulling nasobiliary and then leading nasal tube fixed.The surgeons used forefingers and middle fingers to clip out the traction from the patients′pharyngeal tube in the control group. The clinical results and complications of both groups were compared.Results The success rate in the observational group was higher than that in the control group (P <0.05);especially the one-time pass rate was higher than that in the control group (P <0.01 );nasobiliary distal prolapse rate (P <0.05 );oral discount rate (P <0.01 );finger′s bitten rate of surgeons (P <0.01 ).Conclusion The application of guidewire tube via pharynx to pull out nose duct from mouth is convenient and easy

  10. Radionuclide uroflowmetry and urethral caliper in girls with urinary tract disease

    International Nuclear Information System (INIS)

    In a group of 178 girls aged 4 to 15 years suffering from various inflammations of the urinary tract a clinical and laboratory examinations were made, calibration of the urethra and radionuclide uroflowmetry (UFM). The methods are described of calibration of the urethra and uroflowmetry. Presented are normal and pathological values of both examinations and the evaluation of the relationship between calibration values of the urethra and parameters of UFM. No correlation was found between the results of these examinations. In the group of girls with urinary tract infections impaired urodynamics were found in 26 to 34%. Higher incidence was not revealed of impaired urodynamics in more serious conditions, i.e. pyelonephritis. A bladder residue was significantly more frequent in impaired urodynamics. This was not the case in vesiculoureteral reflux. In girls with enuresis a significantly higher incidence of impaired urodynamics was observed. Calibration of the urethra and uroflowmetry are complementary examination methods which cannot replace each other. (author). 3 figs., 2 tabs., 18 refs

  11. Role of Toll-like receptors in health and diseases of gastrointestinal tract

    Institute of Scientific and Technical Information of China (English)

    Greg Harris; Rhonda KuoLee; Wangxue Chen

    2006-01-01

    The human gastrointestinal (GI) tract is colonized by non-pathogenic commensal microflora and frequently exposed to many pathogenic organisms.For the maintenance of GI homeostasis, the host must discriminate between pathogenic and non-pathogenic organisms and initiate effective and appropriate immune and inflammatory responses. Mammalian toll-like receptors (TLRs) are members of the pattern-recognition receptor (PRR) family that plays a central role in the initiation of innate cellular immune responses and the subsequent adaptive immune responses to microbial pathogens. Recent studies have shown that gastrointestinal epithelial cells express almost all TLR subtypes characterized to date and that the expression and activation of TLRs in the GI tract are tightly and coordinately regulated. This review summarizes the current understanding of the crucial dual roles of TLRs in the development of host innate and adaptive immune responses to GI infections and the maintenance of the immune tolerance to commensal bacteria through down-regulation of surface expression of TLRs in intestinal epithelial cells.

  12. Hepatobiliary scintigraphy in the assessment of long-term complication after biliary-enteric anastomosis: role in the diagnosis of post-operative segmental or total biliary obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Moon, Dae Hyuk; Lee, Sung Gyu; Lee, Yung Joo; Park, Kwang Min; Shin, Jung Woo; Ryu, Jin Sook; Lee, Hee Kyung [Asan Medicial Center, Seoul (Korea, Republic of)

    1998-07-01

    The purpose of this study was to investigate the accuracy of hepatobiliary scintigraphy (HBS) in the diagnosis of segmental or total biliary obstruction during long-term follow-up period after curative radical surgery with biliary-enteric anastomosis. The study population included 80 patients who underwent biliary-enteric anastomoses for benign (n=33) or malignant (n=47) biliary disease. Fifty-six of these 80 patients also underwent curative hepatic resection. Ninety eight hepatobiliary scintigrams using {sup 99m}Tc-DISIDA were performed at least 1 month after surgery (median 9 month). The scintigraphic criteria of total biliary obstruction we used were intestinal excretion beyond one hour or delayed hepatobiliary washout despite the presence of intestinal excretion. Segmental biliary obstruction was defined as delayed segmental excretion. The accuracy for biliary obstruction was evaluated according to different clinical situations. There were 9 instances with total biliary obstruction and 23 with segmental bile duct obstruction. Diagnosis of biliary obstruction was confirmed by percutaneous transhepatic cholangiography or surgery in 13, and follow-up clinical data for at least 6 months in 19 instances. Among the 32 instances with biliary symptoms and abnormal liver function, HBS allowed correct diagnosis in all 32(9 total, 14 segmental obstruction and 9 non-obstruction). Of the 40 with nonspecific symptom or isolated elevation of serum alkaline phosphatase, HBS diagnosed 8 of the 9 segmental biliary obstruction and 30 of the 31 non-obstruction. There were no biliary obstruction and no false positive result of scintigraphy in 26 instances which had no clinical symptom or signs of biliary obstruction. Diagnostic sensitivity of HBS was 100% (9/9) for total biliary obstruction, and 96%(22/23) for segmental bile obstruction. Specificity was 98%(39/40) in patients who had abnormal symptom or sign. Hepatobiliary scintigraphy is a highly accurate modality in the

  13. Silymarin attenuated hepatic steatosis through regulation of lipid metabolism and oxidative stress in a mouse model of nonalcoholic fatty liver disease (NAFLD)

    OpenAIRE

    Ni, Xunjun; Wang, Haiyan

    2016-01-01

    Silymarin, which derived from the milk thistle plant (silybum marianum), has been used for centuries as a natural remedy for diseases of the liver and biliary tract. Considering the therapeutic potential to liver disease, we tested efficacy of silymarin on hepatic steatosis with a high fat diet (HFD)-induced mouse model of non-alcoholic fatty liver disease (NAFLD), and investigated possible effects on lipid metabolic pathways. In our study, silymarin could attenuate the hepatic steatosis, whi...

  14. Methotrexate for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Giljaca, Vanja; Poropat, Goran; Stimac, Davor;

    2010-01-01

    Methotrexate has been used to treat patients with primary biliary cirrhosis as it possesses immunosuppressive properties. The previously prepared version of this review from 2005 showed that methotrexate seemed to significantly increase mortality in patients with primary biliary cirrhosis. Since...... that last review version, follow-up data of the included trials have been published....

  15. Colchicine for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Gong, Yan; Gluud, Christian

    2005-01-01

    Colchicine is used for patients with primary biliary cirrhosis due to its immunomodulatory and antifibrotic potential. The results from randomized clinical trials have, however, been inconsistent. We conducted a systematical review to evaluate the effect of colchicine for primary biliary cirrhosis....

  16. Azathioprine for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Gong, Yanzhang; Christensen, E; Gluud, C

    Azathioprine is used for patients with primary biliary cirrhosis, but the therapeutic responses in randomised clinical trials have been conflicting.......Azathioprine is used for patients with primary biliary cirrhosis, but the therapeutic responses in randomised clinical trials have been conflicting....

  17. Long-term effects of forgotten biliary stents: a case series and literature review.

    Science.gov (United States)

    Odabasi, Mehmet; Arslan, Cem; Akbulut, Sami; Abuoglu, Haci Hasan; Ozkan, Erkan; Yildiz, Mehmet Kamil; Eris, Cengiz; Gunay, Emre; Tekesin, Kemal; Muftuoglu, Tolga

    2014-01-01

    There are many studies about the biliary stents, however there is a little information about the long-term stayed forgotten biliary stents except a few case reports. We have reported the results of a number of cases with biliary stents that were forgotten or omitted by the patient and the endoscopist. During February 2010 to May 2013, five patients were referred to the general surgery clinic of Haydarpasa Numune Training and Research Hospital, Istanbul Turkey. Past history and medical documents submitted by the patient did not indicate a replacement of the biliary stent in 3 patients. Two patients knew that they had biliary stents. We also conducted a literature review via the PubMed and Google Scholar databases of English language studies published until March 2014 on forgotten biliary stent. There were 3 men and 2 women ranging in age from 22 to 68 years (mean age 41.6 years). Patients presented with pain in the upper abdomen, jaundice, fever, abnormal liver function tests or dilatation of the biliary tract alone or in combination. Patients' demographic findings are presented in Table 1. A review of three cases reported in the English medical literature also discussed. The mean duration of the patency of the stent is about 12 months. The biliary stenting is performed either with plastic or metal stents, studies recommending their replacement after 3-6 months. Patients with long stayed forgotten biliary stents are inevitably treated with surgical intervention. We recommend for all endoscopic retrograde cholangiopancreatography units provide a stent registry system that the stents placed for various therapeutic procedures are not forgotten both by the patient as well as the physician. There should be a deadline for biliary stents in the registry system for each patient. PMID:25232385

  18. Long-term effects of forgotten biliary stents: a case series and literature review

    Science.gov (United States)

    Odabasi, Mehmet; Arslan, Cem; Akbulut, Sami; Abuoglu, Haci Hasan; Ozkan, Erkan; Yildiz, Mehmet Kamil; Eris, Cengiz; Gunay, Emre; Tekesin, Kemal; Muftuoglu, Tolga

    2014-01-01

    There are many studies about the biliary stents, however there is a little information about the long-term stayed forgotten biliary stents except a few case reports. We have reported the results of a number of cases with biliary stents that were forgotten or omitted by the patient and the endoscopist. During February 2010 to May 2013, five patients were referred to the general surgery clinic of Haydarpasa Numune Training and Research Hospital, Istanbul Turkey. Past history and medical documents submitted by the patient did not indicate a replacement of the biliary stent in 3 patients. Two patients knew that they had biliary stents. We also conducted a literature review via the PubMed and Google Scholar databases of English language studies published until March 2014 on forgotten biliary stent. There were 3 men and 2 women ranging in age from 22 to 68 years (mean age 41.6 years). Patients presented with pain in the upper abdomen, jaundice, fever, abnormal liver function tests or dilatation of the biliary tract alone or in combination. Patients’ demographic findings are presented in Table 1. A review of three cases reported in the English medical literature also discussed. The mean duration of the patency of the stent is about 12 months. The biliary stenting is performed either with plastic or metal stents, studies recommending their replacement after 3-6 months. Patients with long stayed forgotten biliary stents are inevitably treated with surgical intervention. We recommend for all endoscopic retrograde cholangiopancreatography units provide a stent registry system that the stents placed for various therapeutic procedures are not forgotten both by the patient as well as the physician. There should be a deadline for biliary stents in the registry system for each patient. PMID:25232385

  19. Percutaneous transluminal biopsy using 7F forceps for diagnosing malignant biliary obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Bahn, Young Eun; Kim, Young Hwan; An, Eun Jung; Kim, See Hyung [Keimyung Univ. College of Medicine, Daegu (Korea, Republic of)

    2012-07-15

    To evaluate the usefulness of the percutaneous transluminal biopsy using 7-F forceps for diagnosing malignant biliary obstruction. One hundred and seven consecutive patients with obstructive jaundice underwent transluminal forceps biopsy. The lesions involved the common bile duct (n = 33), common hepatic duct (n = 13), hilum (n = 17), right or left intrahepatic bile duct (n = 32), multiple sites (extra and intrahepatic ducts, n = 7), or anastomotic sites (n = 5). In each patient, an average of three specimens was taken with 7F biopsy forceps through a transhepatic biliary drainage tract. The final diagnosis was confirmed with pathologic findings, or a clinical and radiologic follow up. The final diagnoses showed malignancies in 75 patients and benign biliary obstructions in 32 patients. Pathologic classifications of malignancies established by forceps biopsy included 67 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 hepatocelluar carcinoma. There were 6 false-negative diagnoses. The diagnostic performance of transluminal forceps biopsy in malignant biliary obstruction had a sensitivity of 92%, specificity of 100%, positive predictive value of 100%, a negative predictive value of 84.2%, and an accuracy of 94.2%. Percutaneous transluminal forceps biopsy is a safe procedure that is easy to perform through a transhepatic biliary drainage tract. It is a highly accurate technique for diagnosing malignant biliary obstructions.

  20. Percutaneous transluminal biopsy using 7F forceps for diagnosing malignant biliary obstruction

    International Nuclear Information System (INIS)

    To evaluate the usefulness of the percutaneous transluminal biopsy using 7-F forceps for diagnosing malignant biliary obstruction. One hundred and seven consecutive patients with obstructive jaundice underwent transluminal forceps biopsy. The lesions involved the common bile duct (n = 33), common hepatic duct (n = 13), hilum (n = 17), right or left intrahepatic bile duct (n = 32), multiple sites (extra and intrahepatic ducts, n = 7), or anastomotic sites (n = 5). In each patient, an average of three specimens was taken with 7F biopsy forceps through a transhepatic biliary drainage tract. The final diagnosis was confirmed with pathologic findings, or a clinical and radiologic follow up. The final diagnoses showed malignancies in 75 patients and benign biliary obstructions in 32 patients. Pathologic classifications of malignancies established by forceps biopsy included 67 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 hepatocelluar carcinoma. There were 6 false-negative diagnoses. The diagnostic performance of transluminal forceps biopsy in malignant biliary obstruction had a sensitivity of 92%, specificity of 100%, positive predictive value of 100%, a negative predictive value of 84.2%, and an accuracy of 94.2%. Percutaneous transluminal forceps biopsy is a safe procedure that is easy to perform through a transhepatic biliary drainage tract. It is a highly accurate technique for diagnosing malignant biliary obstructions

  1. A Comparison of Preoperative Biliary Drainage Methods for Perihilar Cholangiocarcinoma: Endoscopic versus Percutaneous Transhepatic Biliary Drainage

    OpenAIRE

    Kim, Kwang Min; Park, Ji Won; Lee, Jong Kyun; Lee, Kwang Hyuck; Lee, Kyu Taek; Shim, Sang Goon

    2015-01-01

    Background/Aims Controversy remains over the optimal approach to preoperative biliary drainage in patients with resectable perihilar cholangiocarcinoma. We compared the clinical outcomes of endoscopic biliary drainage (EBD) with those of percutaneous transhepatic biliary drainage (PTBD) in patients undergoing preoperative biliary drainage for perihilar cholangiocarcinoma. Methods A total of 106 consecutive patients who underwent biliary drainage before surgical treatment were divided into two...

  2. Endoscopicmanagementofpostcholecystectomy biliary leakage

    Institute of Scientific and Technical Information of China (English)

    Virendra Singh; Gurpreet Singh; Ganga R Verma; Rajesh Gupta

    2010-01-01

    BACKGROUND: Biliary leak is an uncommon but signiifcant complication following cholecystectomy. Endotherapy is an established method of treatment. However, the optimal intervention is not known. METHOD: Eighty-ifve patients with postcholecystectomy biliary leaks from July 2000 to March 2009 were retrospectively evaluated. RESULTS: The study population was 20 males and 65 females with a mean age of 42.47 years. Patients presented with abdominal pain (46), jaundice (23), fever (23), abdominal distension (42), or bilious abdominal drain (67). Endoscopic retrograde cholangiopancreatography detected a leak at the cystic duct stump in 45 patients, stricture with middle common bile duct leak in 4, leak from the right hepatic duct in 3, and a ligated common bile duct in 32. Twelve also had bile duct stones. One had a broken T-tube with stones. Endotherapy was possible in 53 patients. Three patients with stones, one with a broken T-tube with stones, and 4 with stricture of the common bile duct with a leak were managed with sphincterotomy and stenting. Eight patients with a cystic duct stump leak with stones were managed with sphincterotomy and stone extraction. Three outpatients and 12 inpatients with a cystic duct stump leak were managed with sphincterotomy and stent and sphincterotomy and nasobiliary drain, respectively. Five patients with a cystic duct stump leak were managed with stenting. Sixteen with coagulopathy were managed with only nasobiliary drain (9) or stent (7). Leak closure was achieved in 100%patients. Four developed mild pancreatitis which improved with conservative treatment. CONCLUSIONS: Endoscopic intervention is a safe and effective method of treatment of postcholecystectomy biliary leaks. However, management should be individualized based on factors such as outpatients or inpatients, presence of stone, stricture, ligature, or coagulopathy.

  3. Treatment of malignant biliary obstruction by combined percutaneous transhepatic biliary drainage with local tumor treatment

    Institute of Scientific and Technical Information of China (English)

    Xiao-Jun Qian; Ren-You Zhai; Ding-Ke Dai; Ping Yu; Li Gao

    2006-01-01

    AIM: To evaluate the utility of local tumor therapy combined with percutaneous transhepatic biliary drainage (PTBD) for malignant obstructive biliary disease.METHODS: A total of 233 patients with malignant biliary obstruction were treated in our hospital with PTBD by placement of metallic stents and/or plastic tubes. After PTBD, 49 patients Accepted: brachytherapy or extraradiation therapy or arterial infusion chemotherapy. The patients were followed up with clinical and radiographic evaluation. The survival and stent patency rate were calculated by Kaplan-Meier survival analysis.RESULTS: Twenty-two patients underwent chemotherapy (11 cases of hepatic carcinoma, 7 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy), and 14 patients received radiotherapy (10 cases of cholangiocarcinoma, 4 cases of pancreatic carcinoma), and 13patients Accepted: brachytherapy (7 cases of cholangiocarcinoma, 3 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy). The survival rate of the local tumor treatment group at 1, 3, 6, and 12 months was 97.96%, 95.92%, 89.80%, and 32.59% respectively,longer than that of the non treatment group. The patency rate at 1, 3, 6, and 12 months was 97.96%, 93.86%,80.93%, and 56.52% respectively. The difference of patency rate was not significant between treatment group and non treatment group.CONCLUSION: Our results suggest that local tumor therapy could prolong the survival time of patients with malignant biliary obstruction, and may improve stent patency.

  4. Hormone replacement for osteoporosis in women with primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N;

    2011-01-01

    Women with primary biliary cirrhosis often suffer from postmenopausal osteoporosis due to their age, or osteoporosis secondary to their liver disease, or treatments provided for their liver disease. Hormone replacement increases bone mineral density and reduces fractures in postmenopausal women. On...

  5. Cholangiocyte anion exchange and biliary bicarbonate excretion

    Institute of Scientific and Technical Information of China (English)

    Jesús M Banales; Jesús Prieto; Juan F Medina

    2006-01-01

    Primary canalicular bile undergoes a process of fluidization and alkalinization along the biliary tract that is influenced by several factors including hormones, innervation/neuropeptides, and biliary constituents. Theexcretion of bicarbonate at both the canaliculi and the bile ducts is an important contributor to the generation of the so-called bile-salt independent flow. Bicarbonate is secreted from hepatocytes and cholangiocytes through parallel mechanisms which involve chloride efflux through activation of Cl- channels, and further bicarbonate secretion via AE2/SLC4A2-mediated Cl-/HCO3-exchange. Glucagon and secretin are two relevant hormones which seem to act very similarly in their target cells (hepatocytes for the former and cholangiocytes for the latter). These hormones interact with their specific G protein-coupled receptors, causing increases in intracellular levels of cAMP and activation of cAMP-dependent Cl- and HCO3- secretory mechanisms. Both hepatocytes and cholangiocytes appear to have cAMP-responsive intracellular vesicles in which AE2/SLC4A2 colocalizes with cell specific Cl- channels (CFTR in cholangiocytes and not yet determined in hepatocytes) and aquaporins (AQP8 in hepatocytes and AQP1 in cholangiocytes). cAMP-induced coordinated trafficking of these vesicles to either canalicular or cholangiocyte lumenal membranes and further exocytosis results in increased osmotic forces and passive movement of water with net bicarbonate-rich hydrocholeresis.

  6. An Approach for Treating the Hepatobiliary Disease of Cystic Fibrosis by Somatic Gene Transfer

    Science.gov (United States)

    Yang, Yiping; Raper, Steven E.; Cohn, Jonathan A.; Engelhardt, John F.; Wilson, James M.

    1993-05-01

    Cystic fibrosis (CF) is an inherited disease of epithelial cell ion transport that is associated with pathology in multiple organ systems, including lung, pancreas, and liver. As treatment of the pulmonary manifestations of CF has improved, management of CF liver disease has become increasingly important in adult patients. This report describes an approach for treating CF liver disease by somatic gene transfer. In situ hybridization and immunocytochemistry analysis of rat liver sections indicated that the endogenous CFTR (cystic fibrosis transmembrane conductance regulator) gene is primarily expressed in the intrahepatic biliary epithelial cells. To specifically target recombinant genes to the biliary epithelium in vivo, recombinant adenoviruses expressing lacZ or human CFTR were infused retrograde into the biliary tract through the common bile duct. Conditions were established for achieving recombinant gene expression in virtually all cells of the intrahepatic bile ducts in vivo. Expression persisted in the smaller bile ducts for the duration of the experiment, which was 21 days. These studies suggest that it may be feasible to prevent CF liver disease by genetically reconstituting CFTR expression in the biliary tract, using an approach that is clinically feasible.

  7. Effects of mycoplasmal upper respiratory tract disease on morbidity and mortality of gopher tortoises in northern and central Florida.

    Science.gov (United States)

    Berish, Joan E Diemer; Wendland, Lori D; Kiltie, Richard A; Garrison, Elina P; Gates, Cyndi A

    2010-07-01

    Gopher tortoise (Gopherus polyphemus) populations on four tracts of public lands in northern and central Florida were studied from 1998 to 2001 to assess the effects of mycoplasmal upper respiratory tract disease (URTD). Adult gopher tortoises (n=205) were marked for identification, serum and nasal flush samples were obtained for mycoplasmal diagnostic assays, and clinical signs of URTD (nasal discharge, ocular discharge, palpebral edema, and conjunctivitis) were evaluated. A subset of tortoises (n=68) was radio-instrumented to facilitate repeated sampling and document potential mortality. Presence of serum antibody to Mycoplasma agassizii was determined by enzyme-linked immunosorbent assay (ELISA), and mollicutes species were detected in nasal flushes by polymerase chain reaction (PCR). Antibody prevalence varied among sites and years but was highest in 1998, exceeding 70% at two sites. Only 11 tortoises (5%) were positive by PCR, and three species (M. agassizii, M. testudineum, and a nonpathogenic Acholeplasma) were identified in nasal flush specimens. Nasal discharge, though rare (6% of tortoises), was significantly correlated with higher ELISA ratios, study site, and positive PCR status. Mortality events (n=11) occurred on two of the three M. agassizii-positive sites; no mortality was observed on the M. agassizii-negative control site. However, none of the tested variables (ELISA result, study site, year, sex, presence of clinical signs, or carapace length) showed significant ability to predict the odds of death. Mycoplasmal URTD is believed to be a chronic disease with high morbidity but low mortality, and follow-up studies are needed to detect long-term effects. PMID:20688675

  8. Resección hepática en enfermedad de Caroli localizada Hepatic resection in localized Caroli disease

    OpenAIRE

    Ricardo Espinoza G; Sergio San Martín R; Felipe Court A; Emilio Vera P; Rodrigo Ferreira S; Héctor Croxatto A

    2003-01-01

    Caroli disease is a cystic congenital malformation of the intrahepatic biliary tract, frequently associated with lithiasis. Commonly, cystic dilatations are bilateral and infrequently they affect only one hepatic lobule or segment. We report six patients with localized Caroli disease, three in the right and three in the left hepatic lobule, that were subjected to a hepatic resection. There were no postoperative complications or mortality. After 28 months of follow up, patients are asymptomati...

  9. CONSENSUS EXPERT RECOMMENDATIONS FOR THE DIAGNOSIS AND MANAGEMENT OF AUTOSOMAL RECESSIVE POLYCYSTIC KIDNEY DISEASE: REPORT OF AN INTERNATIONAL CONFERENCE

    OpenAIRE

    Guay-Woodford, Lisa M.; Bissler, John J.; Braun, Michael C.; Bockenhauer, Detlef; Cadnapaphornchai, Melissa A.; Dell, Katherine M.; Kerecuk, Larissa; Liebau, Max C; Alonso-Peclet, Maria H.; Shneider, Benjamin; Emre, Sukru; Heller, Theo; Kamath, Binita M.; Murray, Karen F.; Moise, Kenneth

    2014-01-01

    Autosomal recessive polycystic kidney disease (ARPKD; MIM 263200) is a severe, typically early onset form of cystic disease that primarily involves the kidneys and biliary tract. Phenotypic expression and age at presentation can be quite variable1. The incidence of ARPKD is 1 in 20,000 live births2, and its pleotropic manifestations are potentially life-threatening. Optimal care requires proper surveillance to limit morbidity and mortality, knowledgeable approaches to diagnosis and treatment,...

  10. Malignant biliary obstruction

    International Nuclear Information System (INIS)

    This paper assesses the value of CT in predicting surgical resectability of tumors in patients with malignant biliary obstruction. A retrospective analysis was performed on 320 consecutive patients with malignant biliary obstruction over a 3-1/2-year period. Most patients were treated nonoperatively. Fifty-one patients fulfilled the selection criteria of surgical exploration, pathological confirmation of malignancy, and prepoperative CT scans available for review. The CT scans were reviewed by a blinded reader and assessed for surgical resectability of tumors. There were 32 patients with pancreatic adenocarcinoma, 6 with ampullary carcinoma, 5 with cholangiocarcinoma, 2 with gallbladder carcinoma, and 6 with other pathologic diagnoses. Of 36 patients thought to have unresectable tumors based on CT findings, 32 were found to have surgically unresectable tumors (positive predictive value, 89%). Of 15 patients thought to have resectable tumors based on CT findings, 11 had surgically resectable tumors (positive predictive value, 73%). CT missed positive duodenal lymph nodes in 2 patients, portal vein infiltration in 1 patient, and small liver metastases in 1 patient

  11. IATROGENIC BILIARY LESIONS

    Directory of Open Access Journals (Sweden)

    J. M. Schiappa

    2007-10-01

    Full Text Available Iatrogenic bile duct injury carries a high rate of morbidity. After the introduction of laparoscopiccholecystectomy the incidence of these injuries has at least doubled, and even after the learningcurve, the incidence has remained of about 0.5%. Etiology of the iatrogenic biliary injuries is theresult of the anatomical conditions (biliary or vascular anomalies, pathology (acute cholecystitis,adhesions, technical equipment, surgeon (the lerning curve. The type of the injuries, thediagnostic procedures and therapeutic approach are discussed. Most of the minor bile duct injuries,including cystic duct leaks and bile duct strictures, are well treatable with endoscopic techniques,whereas most of the major injuries require operative treatment, which at optimal circumstancesgives good results. Interdisciplinary cooperation and early referral to an experienced center iscrucial in the management of these iatrogenic lesions. The best „treatment” for this iatrogenicpathology is prevention: surgical access adapted to morphology, good exposure of the hepatoduodenalspace, good identification of structures before tying, appropriate dissection, selectivecholangiography, great care with the use of electrosurgery.

  12. Initial clinical experience on improved percutaneous transhepatic biliary drainage in the treatment of malignant obstruction of the proximal biliary

    International Nuclear Information System (INIS)

    ±159) ml/d, t=1.930, P>0.05], decrease of the serum total bilirubin after the procedures [experimental group (87±51) μmol/L, control group (105±66) μmol/L (t=1.061 , P>0.05)] and the median survival time (experimental group 7.7 months, control group 6.9 months, χ2= 0.610, P>0.05) of the patients showed no statistically significant difference between two groups. The mean WBC amount of patients was higher after the traditional procedure [(10.9±5.2) × 109/L] than before the procedure [(7.8±2.9) × 109/L] in the control group (t=3.606, P9/L], post-procedure [(7.4±2.6) × 109/L] (t=2.649, P<0.05). No reflux of duodenal juice was observed in all patients of the experimental group, and 1 patient had infection of biliary tract. The reflux was observed in 11 patients of the control group after conventional PTBIED. Of them, 8 patients had infection of biliary tract. Incidence rate of infection of biliary tract in the control group was higher than that in the experimental group (±2=5.381, P<0.05). Conclusions: Improved PTBIED is convenient and feasible, and compared with traditional PTBIED, it can reduce the complications of infection of biliary tract. (authors)

  13. the Application of Low dose MDCT Urinary Tract Imaging in Urinary Tract Disease%低剂量多层螺旋CT尿路成像在泌尿系疾病中的应用

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

     Objective To investigate low dose MDCT urinary tract imaging (CTU) to urinary tract disease clinical application value. Methods 36 cases of clinical quasi urinary tract disease patients, the use of furosemide, low dose multilayer spiral CT scan, line multiplanar reconstruction (MPR) and surface recombination (CPR) and volume reproduction technology (VR), analysis the cause of the disease. Results 36 patients with urinary tract patients, 2 cases of renal cell carcinoma, pyelonephritis (3 cases), renal abscess 1 cases of ureteral calculi, eighteen cases, urinary congenital malformation in 5 cases, 4 cases of ureteral inflammation, 2 cases of ureteral carcinoma, uterine fibroids in 1, and all cases were confirmed by clinical or surgical pathology.Conclusion MDCT urinary tract imaging can not only clear visual display urinary tract lesion location, size and nature, but also can show around the lesions, help clinical rational treatment.%  目的探讨低剂量多层螺旋CT尿路造影(CTU)对泌尿系疾病的临床应用价值。方法对36例临床拟泌尿系病变患者,使用呋塞米后,低剂量多层螺旋CT扫描后,行多平面重建(MPR)、曲面重组(CPR)及容积再现技术(VR),分析病变的原因。结果36例泌尿系患者中,肾癌2例,肾盂肾炎3例,肾脓肿1例,输尿管结石18例、泌尿系先天畸形5例、输尿管炎症4例、输尿管癌2例、子宫肌瘤1例,所有病例均经临床或手术病理证实。结论多层螺旋CT尿路成像不仅可清楚直观显示泌尿系病变位置、大小和性质,还能显示周围的病变,有助于临床制定合理的治疗方案。

  14. Development of Biliary and Enteral Stents by the Korean Gastrointestinal Endoscopists

    OpenAIRE

    Shim, Chan Sup; Kim, Jin Hong; Bok, Gene Hyun

    2016-01-01

    Stenting in the gastrointestinal tract is a common procedure used for palliation of obstruction in the enteral and biliary tract. Today, stenting of malignant and benign strictures is performed at almost every major tertiary hospital in Korea. Moreover, Korea has become a major global supplier of cutting edge technology in the field of self-expanding metal stents. However, the history of stenting in Korea is relatively short and was far behind that of other nations such as Japan and Germany. ...

  15. Endoscopic Extraction of Biliary Fascioliasis Diagnosed Using Intraductal Ultrasonography in a Patient with Acute Cholangitis.

    Science.gov (United States)

    Ha, Ji Su; Choi, Hyun Jong; Moon, Jong Ho; Lee, Yun Nah; Tae, Jae Woong; Choi, Moon Han; Lee, Tae Hoon; Cha, Sang-Woo

    2015-11-01

    Fasciola hepatica infection may result in biliary obstruction with or without cholangitis in the chronic biliary phase. Because clinical symptoms and signs of F. hepatica are similar to other biliary diseases that cause bile duct obstruction, such as stones or bile duct malignancies, that are, in fact, more common, this condition may not be suspected and diagnosis may be overlooked and delayed. Patients undergoing endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the evaluation of bile duct obstruction may be incidentally detected with the worm, and diagnosis can be confirmed by extraction of the leaf-like trematode from the bile duct. Intraductal ultrasonography (IDUS) can provide high-resolution cross-sectional images of the bile duct, and is useful in evaluating indeterminate biliary diseases. We present a case of biliary fascioliasis that was diagnosed using IDUS and managed endoscopically in a patient with acute cholangitis. PMID:26668810

  16. Isolated Biliary Granulocytic Sarcoma Followed by Acute Myelogeneous Leukemia with Multilineage Dysplasia: A Case Report and Literature Review

    OpenAIRE

    Sung, Chang Ohk; Ko,Young Hyeh; Park, Cheol Keun; Jang, Kee Taek; Heo, Jin Seok

    2006-01-01

    Granulocytic sarcoma is a rare extramedullary tumor composed of myeloid progenitor cells. Primary involvement of the biliary tract without evidence of leukemia is exceedingly rare. Here, we report an isolated biliary granulocytic sarcoma in a 30-yr-old man who presented with jaundice, fever, and chill without any evidence of leukemia. However, five months after the diagnosis, he developed acute myelogenous leukemia with multilineage dysplasia and chromosomal abnormality. A rare possibility of...

  17. Endoscopic ultrasound-guided biliary drainage as an alternative to percutaneous drainage and surgical bypass

    OpenAIRE

    Prachayakul, Varayu; Aswakul, Pitulak

    2015-01-01

    Endoscopic retrograde cholangiopancreatography had been a treatment modality of choice for both benign and malignant biliary tract obstruction for more than half century, with a very high clinical success rate and low complications. But in certain circumstances, such as advanced and locally advanced pancreatobiliary malignancies (pancreatic cancer, cholangiocarcinoma, ampullary tumor) and tight benign strictures, endoscopic retrograde cholangiopancreatography (ERCP) fails. Up to this point, t...

  18. The relationships between clinical variables and renal parenchymal disease in pediatric clinically suspected urinary tract infection

    Directory of Open Access Journals (Sweden)

    Jung Lim Byun

    2010-02-01

    Full Text Available Purpose : To evaluate the significance of clinical signs and laboratory findings as predictors of renal parenchymal lesions and vesicoureteral reflux (VUR in childhood urinary tract infection (UTI. Methods : From July 2005 to July 2008, 180 patients admitted with a first febrile UTI at the Pediatric Department of Konkuk University Hospital were included in this study. The following were the clinical variables: leukocytosis, elevated C-reactive protein (CRP, positive urine nitrite, positive urine culture, and fever duration both before and after treatment. We evaluated the relationships between clinical variables and dimercaptosuccinic acid (DMSA scan and voiding cystourethrography (VCUG results. Results : VCUG was performed in 148 patients; of them, 37 (25.0% had VUR: 18 (12.2% had low-grade (I-II VUR, and 19 (10.5% had high-grade (III-V VUR. Of the 95 patients who underwent DMSA scanning, 29 (30.5% had cortical defects, of which 21 (63.6% had VUR: 10 (30.3%, low-grade (I-II VUR; and 11 (33.3%, high-grade VUR. Of the 57 patients who were normal on DMSA scan, 8 (14.0% had low-grade VUR and 6 (10.5% had high-grade VUR. The sensitivity, specificity, and positive and negative predictive values of the DMSA scan in predicting high-grade VUR were 64.7%, 69.9%, 33.3%, and 89.5%, respectively. Leukocytosis, elevated CRP, and prolonged fever (?#243;6 hours after treatment were significantly correlated with the cortical defects on DMSA scans and high-grade VUR. Conclusion : Clinical signs, including prolonged fever after treatment, elevated CRP, and leukocytosis, are positive predictors of acute pyelonephritis and high-grade VUR.

  19. Markedly Elevated Liver Enzymes in Choledocholithiasis in the absence of Hepatocellular Disease

    Science.gov (United States)

    Tetangco, Eula Plana; Shah, Natasha; Arshad, Hafiz Muhammad Sharjeel; Raddawi, Hareth

    2016-01-01

    Liver enzyme levels are commonly obtained in the evaluation of many conditions. Elevated alanine transaminase and aspartate transaminase have traditionally been considered a “hepatocellular” pattern concerning for ischemic, viral, or toxic hepatitis. Elevations in these levels pose a diagnostic dilemma in patients without a clinical picture consistent with liver disease. On the other hand, elevated alkaline phosphatase historically represents a “cholestatic” pattern concerning for gallbladder and biliary tract disease. Often, patients present with a “mixed” picture of elevation in all 3 liver enzymes, further confounding the clinical scenario. We present 4 cases of women with severe upper abdominal pain and markedly elevated transaminases. Three of the patients had accompanying jaundice. A higher rise in enzyme levels was seen in those who had greater bile duct dilation. All patients saw a rapid decrease in transaminases after biliary decompression, along with a fall in alkaline phosphatase and total bilirubin levels. No evidence of liver disease was found, nor were there any signs of hepatocellular disease on imaging. The patients were ultimately found to have choledocholithiasis on endoscopic retrograde cholangiopancreatography with no hepatocellular disease. Furthermore, our cases show that severe abdominal pain in the setting of elevated liver enzymes is likely associated with biliary disease rather than a primary hepatic process. Recognition of this rare pattern of markedly elevated transaminases in isolated biliary disease can aid in avoiding unnecessary evaluation of primary hepatic disease and invasive surgical interventions such as liver biopsy. PMID:27408902

  20. Contrast-enhanced ultrasound in the biliary system: Potential uses and indications

    OpenAIRE

    Hui-Xiong Xu

    2009-01-01

    Conventional ultrasound (US) is the first-line imaging investigation for biliary diseases. However, it is lack of the ability to depict the microcirculation of some lesions which may lead to failure in diagnosis for some biliary diseases. The use of contrast-enhanced US (CEUS) has reached the field of bile duct disease in recent years and promising results have been achieved. In this review, the methodology, image interpretation, enhancement pattern, clinical usefulness, and indications for C...