Cholangitis (Total 19171 Papers Found)

Since its publication in 2007, the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) have been widely adopted. The validation of TG07 conducted in terms of clinical practice has shown that the diagnostic criteria for acute cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. Discussion by the Tokyo Guidelines Revision Committee concluded that acute cholecystitis should be suspected when Murphy's sign, local inflammatory fin ...
UNLABELLED Primary sclerosing cholangitis (PSC) is an incurable cholangiopathy of unknown etiopathogenesis. Here we tested the hypothesis that cholangiocyte senescence is a pathophysiologically important phenotype in PSC. We assessed markers of cellular senescence and senescence-associated secretory phenotype (SASP) in livers of patients with PSC, primary biliary cirrhosis, hepatitis C, and in normals by fluorescent in situ hybridization (FISH) and immunofluorescence microscopy (IFM). We tested ...
What can be said with certainty regarding endotherapy for biliary injuries associated with laparoscopic or conventional cholecystectomy? On the one hand, ongoing cystic duct and most bile duct leaks close rapidly after sphincterotomy or placement of a stent or both. Such therapy does not preclude the need for drainage of sizable bilomas. On the other hand, acute and ultimate success of endotherapy appears to be contingent on the degree and perhaps the cause of injury. Although ERCP is useful in ...
BACKGROUND AND STUDY AIM To date, only a few reports with small numbers of patients have described double stenting (biliary and duodenal), in particular endoscopic ultrasound (EUS)-guided biliary drainage, for patients with obstructive jaundice. In addition, no reports have sought to determine which EUS-guided biliary drainage route has better outcomes. The aim of the current study was to investigate adverse events and stent patency in patients who underwent EUS-guided biliary drainage and duode ...
OBJECTIVE To review the treatment and outcome of patients with common bile duct (CBD) stones who underwent cholecystectomy. DESIGN Prospective series of 700 consecutive laparoscopic cholecystectomies, with a mean follow-up of 22 months. SETTING University-affiliated community hospital. PATIENTS Eighty patients with documented CBD stones during a 42-month period (July 1990 to January 1994). INTERVENTIONS Laparoscopic CBD exploration (LCBDE) was performed with either choledochotomy and T t ...
  • Romain Potier, Olivier Reineau,
  • Journal of zoo and wildlife medicine : official publication of the American Association of Zoo Veterinarians
  • 2015
A 14.5-yr-old female kinkajou (Potos flavus) was diagnosed with cholelithiasis after an episode of vomiting; diagnostics included biochemical analysis and abdominal ultrasound exam. Despite antimicrobial treatment, cholelithiasis led to cholecystitis. A cholecystotomy was performed to remove choleliths and inspissated bile. Morphological and spectroscopic properties of the choleliths were similar to those of gallstones from the brown pigment family and Streptococcus sp. and Escherichia coli were ...
The article generalizes experience (1986-1991) in the treatment of 246 patients with choledocholithiasis with the performance of endoscopic papillosphincterotomy. Most patients (61%) were over 60 years of age, many had serious concomitant diseases. Among patients with occlusion of the bile ducts, 53.6% had obstructive purulent cholangitis, 53.6% had acute biliary pancreatitis, and 30.9% had acute cholecystitis. Typical as well as atypical cannulation EPST was applied. To exclude an X-ray load on ...
PURPOSE Cholangiocarcinoma (CCA) is a malignancy of the bile ducts. The purpose of this discovery study was to identify effective serum markers for surveillance of cholangiocarcinoma. EXPERIMENTAL DESIGN Using a glycomic method, patients with CCA were determined to have increased levels of alpha-1,3 and alpha-1,6 linked fucosylated glycan. Proteomic analysis of the serum fucosylated proteome identified proteins such as alpha-2-macroglobulin, kininogen, hemopexin, fetuin-A, alpha-1 anti-trypsin ...
BACKGROUND Sclerosing encapsulating peritonitis (Abdominal cocoon) is an uncommon cause of intestinal obstruction and tuberculosis is an important etiology. Appropriate management of this entity is still uncertain. METHODS We did a retrospective analysis of patients with abdominal cocoon who were seen over a two year period at a tertiary care center in North India. We included patients with tubercular abdominal cocoon (TAC) who were managed primarily with antitubercular therapy in the present ...
A 67-year-old woman was admitted to our hospital for surgical management of cancer of the ascending colon. On admission, she had cholangitis due to choledocholithiasis. Abdominal computed tomography, ultrasonography, and magnetic resonance showed cholelithiasis, choledocholithiasis, and multiple liver tumors. Colonoscope showed advanced cancer of the ascending colon. Because of acute obstructive suppurative cholangitis, endoscopic sphincterotomy was performed. During the procedure, periampullary ...
Endoscopic retrograde cholangiography (ERC) was performed in 28 patients with hepatobiliary disease associated with ulcerative colitis. The films were reviewed and correlated with diagnoses at liver biopsy. Thirteen patients with extrahepatic as well as intrahepatic bile duct abnormalities had characteristic cholangiographic findings compatible with sclerosing cholangitis, together with cholangiocarcinoma in one patient. Six patients had intrahepatic bile duct involvement only, and the cholangio ...
Endoscopic transpapillary gallbladder stent (ETGS) placement is a proposed minimally invasive alternative to cholecystectomy in high-risk patients with symptomatic gallbladder disease. To describe the safety and efficacy of ETGS placement in 29 consecutive patients without cirrhosis. A retrospective analysis of consecutive ETGS cases from 2005 to 2013 at a referral center was undertaken. The mean age was 70 years (range 40–91), and 62 % were hospitalized. The most common indication for ETGS ...
Thirty infants were diagnosed with extrahepatic biliary atresia (EBA) from July 1978 to July 1989; 28 have undergone a Kasai or Lilly-Altman modification of the Kasai portoenterostomy; 2 were excluded from surgery because they presented after 3 months of age and had advanced biliary cirrhosis. Immediate postoperative drainage (>30 ml/day was achieved in 24 patients (86%), with 14 (50%) surviving free of jaundice. The average follow-up was 2.25 years (range 3 months to 10 years); the longest s ...
  • John Gatewood Ham,
  • HPB surgery : a world journal of hepatic, pancreatic and biliary surgery
  • 1990
In order to identify risk factors in patients with acute cholangitis, 140 clinical, biochemical, etiologic and pathologic variables of 449 attacks of acute cholangitis seen in one center over a 20-year period were analyzed. Simple regression revealed 24 factors with prognostic significance but multivariate analysis detected only seven factors with independent significance in predicting mortality (acute renal failure, cholangitis associated with liver abscesses or liver cirrhosis, cholangitis sec ...
Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune liver disease characterized by progressive destruction of small intrahepatic bile ducts. If left untreated, PBC may eventually result in end-stage liver disease. For better management of PBC and optimal allocation of medical resources, it is pivotal to accurately estimate the prognosis of patients with PBC. This article will briefly review the models that predict long-term outcome of PBC patients, ...
Berichtet wird über die schwierige Differenzialdiagnose eines Leberbefalls im Rahmen einer Langerhans-Zell-Histiozytose (LCH). Bei einer 18-jährigen Patientin waren 3 Jahre nach Chemotherapie eines eosinophilen Granuloms unklare Oberbauchbeschwerden und serologische Zeichen einer Cholestase aufgetreten. Histologisch fanden sich in der Leberbiopsie Veränderungen, die als chronische nichteitrige Cholangitis gedeutet wurden. Zwei Jahre später bestand ein Ikterus mit massiven Leberfunktionsstö ...
Hyper IgM (HIGM) syndrome is an immunodeficiency that can lead to liver disease in more than 80% of affected males by an age of 20 years. Hepatitis, sclerosing cholangitis, and hepatocellular malignancies are common among them. We encountered two cases in children of less than 12 years who presented with typical manifestations of liver abscess and were later detected to have a concomitant underlying HIGM syndrome. ...
  • ,
  • Prescrire international
  • 2002
(1) In 1996 the evidence, though limited, suggested that the hydrophilic bile acid ursodeoxycholic acid slowed the progression of primary biliary cirrhosis. Given the absence of an effective alternative, we considered that the treatment was "A real advance" in this setting. (2) The file is far bulkier now. A meta-analysis of 11 randomised placebo-controlled trials of ursodeoxycholic acid in the treatment of primary biliary cirrhosis did not show efficacy. Histologically, the data suggest that th ...
A German shepherd dog was diagnosed with sclerosing encapsulating peritonitis after an episode of peritonitis caused by a free intra-abdominal foreign body (stick). The foreign body had initially been treated by surgical removal and abdominal lavage. Postoperatively, peritoneal effusion persisted despite the use of methylprednisolone for 1 month and a second surgical exploration and abdominal lavage. After a third surgery at our institution (to breakdown abdominal adhesions) followed by open abd ...
BACKGROUND The marked increase in the incidence of biliary tract infections due to antimicrobial-resistant pathogens in recent years is of great concern, as patients infected by these isolates might initially receive antibiotics ineffective against the responsible pathogens. METHODS A retrospective cohort study including 556 episodes of bacteremic biliary tract infection was designed to evaluate the impact of inappropriate initial antimicrobial therapy on the clinical outcomes of patients with ...
The role of the surgeon in the management of patients with autoimmune sclerosing pancreatitis (ASP) is controversial and in evolution.1–17 On the one extreme are those who believe that surgical intervention or resection for this entity is not indicated, as there are data to suggest that this is a nonsurgical disease. On the other extreme are those who believe that surgical intervention for ASP can benefit patients by unquestionably providing a definitive diagnosis and excellent symptom palliat ...
Patients with primary sclerosing cholangitis (PSC) and associated inflammatory bowel disease (IBD) have an increased risk of colorectal cancer (CRC). We estimated the pooled incidence of CRC after liver transplantation (LT) in patients with PSC as well as in a subset of patients with associated IBD (PSC-IBD). Through a systematic review of major bibliographic databases up to April 1, 2013, we identified cohort studies reporting the incidence of de novo CRC after LT for PSC. The main outcome meas ...
BACKGROUND & AIMS The management of acute biliary diseases often involves endoscopic retrograde cholangiopancreatography (ERCP), but it is not clear whether this technique reduces mortality. We investigated whether mortality from acute biliary diseases that require ERCP has been reduced over time and explored factors associated with mortality. METHODS We conducted a cohort study using the Nationwide Inpatient Sample (1998-2008). We identified hospitalizations for choledocholithiasis, cholangit ...
Endoscopic retrograde cholangiopancreatography is a valuable tool in the diagnosis and management of pancreaticobiliary diseases. The diagnostic sensitivity of brush cytology is reported as between 18% and 70% for malignant bile duct or pancreatic duct strictures. We report our findings in 74 patients with pancreaticobiliary strictures who underwent ERCP. Brush cytology was performed on 55 bile duct specimens and 19 pancreatic duct specimens. No complications related to the procedure occurred; 4 ...
In 185 patients (August 1974 to December 1986), aged 19–85 years (median 66 years), with indwelling T-tube drains, endoscopic sphincterotomy was performed for residual biliary concrements. EST and stone extraction both had a success rate of 93%. All complications (9.3%) responded to conservative therapy. Lethality was 0% for EST and 1.8% for open biliary revision. At the time of EST, 34% were under 50 years of age. Follow-up at an interval of 2.5–9 years after EST indicated no pain in 95%, e ...
The relapse of icterus may be a sign of serious postoperative complication after hepatic portoenterostomy for biliary atresia. To analyse the cause of such icteric flare-up, a retrospective study was made on 27 patients. A total of 38 episodes of icteric flare-up occurred in 19 patients. An accompanying disease, which had not directly involved the biliary tract, was assumed to be the cause in 11 episodes (29%). Fourteen episodes (37%) were due to biliary tract infection caused by the cyst formed ...
Primary biliary cholangitis (PBC) is an immunological condition that causes a significant health disturbance and dramatically reduces the quality of life for those affected with the disease. It is a potentially fatal disease that can lead to multiple hepatic and extrahepatic complications. Having adequate therapeutic interventions that can improve the course of the disease is imperative in reducing the associated morbidity and mortality. Ursodeoxycholic acid (UDCA) is the gold standard therapy. ...
BACKGROUND Detection of cholangiocarcinoma (CC) remains a diagnostic challenge particularly in patients with primary sclerosing cholangitis (PSC). We recently established diagnostic peptide marker models in bile and urine to detect CC. Our aim was to combine both models to reach a higher diagnostic accuracy of CC diagnosis. METHODS Bile (BPA) and urine (UPA) proteome analysis by capillary electrophoresis mass spectrometry was performed in a case-control phase II study on 87 patients (36 CC inc ...