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Biomed Res Int 2018 4;2018:8305927. Epub 2018 Nov 4.

Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center and Postgraduate School Molecular Medicine, Rotterdam, Netherlands.

[This corrects the article DOI: 10.1155/2018/6751952.]. Read More

Int J Mol Sci 2018 Dec 4;19(12). Epub 2018 Dec 4.

School of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, 20900 Monza, Italy.

The cholangipathies are a class of liver diseases that specifically affects the biliary tree. These pathologies may have different etiologies (genetic, autoimmune, viral, or toxic) but all of them are characterized by a stark inflammatory infiltrate, increasing overtime, accompanied by an excess of periportal fibrosis. The cellular types that mount the regenerative/reparative hepatic response to the damage belong to different lineages, including cholagiocytes, mesenchymal and inflammatory cells, which dynamically interact with each other, exchanging different signals acting in autocrine and paracrine fashion. Read More

PLoS Genet 2018 Dec 3;14(12):e1007833. Epub 2018 Dec 3.

Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.

Primary Biliary Cholangitis (PBC) is a chronic autoimmune liver disease characterised by progressive destruction of intrahepatic bile ducts. The strongest genetic association is with HLA-DQA1*04:01, but at least three additional independent HLA haplotypes contribute to susceptibility. We used dense single nucleotide polymorphism (SNP) data in 2861 PBC cases and 8514 controls to impute classical HLA alleles and amino acid polymorphisms using state of the art methodologies. Read More

Liver Int 2018 Dec 2. Epub 2018 Dec 2.

Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden.

Background And Aims: Detection of early cholangiocarcinoma (CCA) in primary sclerosing cholangitis (PSC) is challenging. The aim of this study was to evaluate the diagnostic accuracy of a stepwise approach to biliary brush cytology with sequential use of fluorescence in-situ hybridization (FISH) for the detection of biliary malignancy in PSC.

Method: We retrospectively studied consecutive patients with PSC who underwent biliary brushings at Karolinska University Hospital between 2009 and 2015 (n = 208). Read More

Med Mycol Case Rep 2019 Mar 12;23:23-25. Epub 2018 Nov 12.

Department of Medicine, Jersey Shore University Medical Center, 1945 State Route 33, Neptune, NJ 07750, United States.

Saccharomyces cerevisiae has recently been used as an ingredient in probiotic supplements. Invasive Saccharomyces infection have been documented, and multiple predisposing risk factors have been identified including critical illness, ICU admission, antibiotics use, central venous catheters, probiotics use, and immunosuppression. We report a case of a 74-year-old man admitted for acute cholangitis taking a probiotic supplement containing the subtype Saccharomyces boulardii. Read More

Nutr Metab Cardiovasc Dis 2018 Sep 26. Epub 2018 Sep 26.

Department of Medicine, University of Padua, Italy. Electronic address:

Aims: To review the formation, catabolism, and the possible atherogenic properties of Lp-X.

Data Synthesis: The conversion of cholesterol to bile acids is regulated by several mechanisms including cholesterol 7 alpha hydroxylase, fibroblast growth factor 19, and farnesoid X receptors. During cholestasis these mechanisms are altered and there is an accumulation of bile acids and cholesterol in plasma. Read More

J Surg Res 2019 Jan 26;233:8-19. Epub 2018 Jul 26.

Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Background: Transferred emergency general surgery (EGS) patients have increased morbidity, mortality, and costs, yet little is known about the characteristics of such transfers. Increasing specialization and a decreasing general surgery workforce have led to concerns about access to care, which may lead to increased transfers. We sought to evaluate the reasons for and timing of transfers for EGS diagnoses. Read More

J Surg Res 2019 Jan 10;233:368-375. Epub 2018 Sep 10.

Department of General surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.

Background: Laparoscopic Kasai portoenterostomy (LKPE) is generally regarded to have a poorer outcome for surgical treatment of uncorrectable biliary atresia. We herein described our initial experience of some modifications to make LKPE easier in the treatment of type III biliary atresia (BA).

Methods: During the period July 2012-October 2016, a total of 25 infants with type III BA were treated with a modified LKPE technique. Read More

Dig Liver Dis 2018 Nov 3. Epub 2018 Nov 3.

Pediatric Hepatology and Liver Transplantation, ISMETT UPMC Palermo, Palermo, Italy; Section of Pediatrics, Department of Medical Sciences, University of Ferrara, University Hospital Arcispedale Sant'Anna, Ferrara, Italy. Electronic address:

Background: Cyclosporine (CSA) is an alternative treatment for autoimmune hepatitis (AIH), however, its unknown long-term safety and efficacy have limited its use.

Aims: Examine the long-term outcome of children and young adults with AIH treated with CSA for at least 4 years.

Methods: Twenty patients were included in this retrospective study: 15 with classical AIH and 5 with autoimmune hepatitis/autoimmune sclerosing cholangitis overlap syndrome (ASC). Read More

J Pediatr Surg 2018 Nov 6. Epub 2018 Nov 6.

Department of Paediatric Surgery, "Spedali Civili" Children's Hospital, 25123, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, 25123, Brescia, Italy.

Introduction: Biliary atresia (BA) represents the leading indication for liver transplantation in childhood. Only few studies reported the outcome of patients who survived more than 20 years on their native liver, and up to date there are no Italian data available. We reported our 40-year single centre experience with long-term follow-up of BA patients. Read More

Scand J Gastroenterol 2018 Dec 5:1-7. Epub 2018 Dec 5.

a Department of Medicine , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.

Objectives: The American Society for Gastrointestinal Endoscopy (ASGE) guidelines offered the risk-stratified approach in suspected choledocholithiasis. Previous studies have raised concern about the insufficient accuracy of the guideline, especially in high probability group. The purposes of this study were to authenticate the stratification and clinical predictors of the guidelines for suspected choledocholithiasis with no visible choledocholithiasis on computed tomography (CT) and to make clear the clinical strategy of endoscopic ultrasonography (EUS). Read More

Surgery 2018 Dec 1. Epub 2018 Dec 1.

Pediatric Liver and Gut Research Group and Section of Pediatric Surgery, Children's Hospital, Helsinki University Hospital, Finland. Electronic address:

Background: Progression of fibrosis and ensuing complications determine the postoperative course of patients operated on for biliary atresia. We evaluated predictors of the progression of fibrosis in the native liver after operative treatment.

Methods: Among patients whose bilirubin decreased to <34 µmol/L after portoenterostomy (n = 41), predictors of follow-up cirrhosis and the progression of fibrosis were analyzed with logistic regression and survival of their native liver was evaluated with the Kaplan-Meier method. Read More

J Autoimmun 2018 Dec 25;95:124-132. Epub 2018 Oct 25.

Division Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital, Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy. Electronic address:

Primary biliary cholangitis (PBC) is an autoimmune liver disease with a striking female preponderance. The mechanisms behind this predominance are still to be elucidated, although multiple theories have been postulated and investigated. Among the proposed involved factors, sex hormones have been the first to be studied, but unfortunately data have been inconclusive or conflicting. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13431

Department of Hepatology, First Hospital of Jilin University, Jilin University.

Primary biliary cholangitis (PBC) is a chronic disease that is increasingly being recognized in recent years. In this study, we sought to identify noninvasive markers of the severity of cirrhosis in patients with PBC based on routinely investigated laboratory parameters.Ninety-four patients with histologically-confirmed PBC based on liver biopsy performed between January 2013 and December 2017 at the First Hospital of Jilin University were divided into 2 groups: early-stage cirrhosis (fibrosis stage F1 and F2; n = 74) and advanced-stage cirrhosis (fibrosis stage F3 and F4; n = 20). Read More

J Pediatr Gastroenterol Nutr 2018 Nov 27. Epub 2018 Nov 27.

Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.

Objectives: Available data indicate that liver involvement is present in a significant proportion of children with celiac disease (CD) at the diagnosis (elevated transaminases 15-57%, autoimmune liver disease 1-2%). We sought to evaluate prevalence, clinical course, and risk factors for liver involvement in a large cohort of children with CD.

Methods: Children (age 0-18 years) diagnosed with CD from March 2010 to April 2016 were enrolled. Read More

ANZ J Surg 2018 Nov 29. Epub 2018 Nov 29.

Hepato-Pancreato-Biliary and Transplantation Unit, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.

J Hepatobiliary Pancreat Sci 2018 Nov 29. Epub 2018 Nov 29.

Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Japan.

Purpose: Multicenter study was undertaken to analyze the results of laparoscopic and open Kasai portoenterostomy.

Methods: Subjects were infants with type III biliary atresia who underwent open operation (n=106) or laparoscopic operation (n=21) between January 2012 and December 2015. Clinical data were compared between open and laparoscopic operations (2016-0534). Read More

Dig Dis Sci 2018 Nov 28. Epub 2018 Nov 28.

Division of Cardiology, Faculty of Medicine and Psychology, University of Rome "Sapienza," Sant'Andrea Hospital, Rome, Italy.

World J Gastrointest Endosc 2018 Nov;10(11):354-366

Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Huntsman Cancer Center, Salt Lake City, UT 84132, United States.

Aim: To investigate indications and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhotics, especially adverse events. Patients with cirrhosis undergoing ERCP are believed to have increased risk. However, there is a paucity of literature describing the indications and outcomes of ERCP procedures in patients with cirrhosis, especially focusing on adverse events. Read More

World J Gastroenterol 2018 Nov;24(43):4939-4949

Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague 140 21, Czech Republic.

Aim: To evaluate risk factors for primary sclerosing cholangitis (PSC) recurrence (rPSC) after orthotopic liver transplantation (OLT) in patients with well-preserved colons.

Methods: We retrospectively evaluated the medical records of all patients transplanted for PSC in our center between July 1994 and May 2015 and selected 47 with follow-up of at least 60 mo for further analysis based on strict inclusion and exclusion criteria. rPSC was confirmed by magnetic resonance or endoscopic retrograde cholangiopancreatography and liver biopsy. Read More

BMC Surg 2018 Nov 29;18(1):111. Epub 2018 Nov 29.

Department of Hepatobiliary Surgery, Dongyang People's Hospital, 60 West Wuning Road, 322100, Dongyang, Zhejiang, China.

Background: The timing of laparoscopic cholecystectomy (LC) performed after the mild acute biliary pancreatitis (MABP) is still controversial. We conducted a review to compare same-admission laparoscopic cholecystectomy (SA-LC) and delayed laparoscopic cholecystectomy (DLC) after mild acute biliary pancreatitis (MABP).

Methods: We systematically searched several databases (PubMed, EMBASE, Web of Science, and the Cochrane Library) for relevant trials published from 1 January 1992 to 1 June 2018. Read More

Semin Respir Crit Care Med 2018 Oct 28;39(5):578-587. Epub 2018 Nov 28.

Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Infections remain a leading cause of morbidity and mortality among patients with liver failure. A number of factors, including relative immune dysfunction and systemic inflammation, bacterial translocation, gut dysbiosis, small intestine bacterial overgrowth, altered bile acid pools, and changes in pH due to acid suppression, contribute to the high rates of infection in this population. Though a range of infections can complicate the course of cirrhotic patients, spontaneous bacterial peritonitis (SBP), cholangitis, and cholecystitis in addition to other infections (i. Read More

Am J Surg 2018 Sep 29. Epub 2018 Sep 29.

Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. Electronic address:

Background: We sought to examine whether preoperative endoscopic retrograde cholangio-pancreatography (ERCP) increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy.

Methods: Patients admitted to an academic hospital from 2010 to 2016, who were older than 18 and had a laparoscopic or a laparoscopic converted to open cholecystectomy for complicated biliary tract disease were included. We compared those who had a preoperative ERCP to those who did not. Read More

Ann Rheum Dis 2018 Nov 24. Epub 2018 Nov 24.

Inflammation-Immunopathology-Biotherapy Department (i2B), AP-HP, Pitié-Salpêtrière Hospital, Paris, France

Objective: Regulatory T cells (Tregs) prevent autoimmunity and control inflammation. Consequently, any autoimmune or inflammatory disease reveals a Treg insufficiency. As low-dose interleukin-2 (ld-IL2) expands and activates Tregs, it has a broad therapeutic potential. Read More

Hepatol Res 2018 Nov 24. Epub 2018 Nov 24.

Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan.

Aims: A noninvasive biomarker for patients with primary biliary cholangitis (PBC) is needed. The association between leucine-rich alpha 2 glycoprotein (LRG) and PBC has not been investigated. We aimed to assess the predictive value of LRG for the development of cirrhosis-related conditions in PBC. Read More

Strahlenther Onkol 2018 Nov 23. Epub 2018 Nov 23.

Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Marchioninistraße 15, 81377, München, Germany.

Objective: Image-guided high-dose-rate interstitial brachytherapy (iBT) with iridium-192 is an effective treatment option for patients with liver malignancies. Little is known about long-term radiation effects on the bile duct system when central hepatic structures are exposed to iBT. This retrospective analysis investigates the occurrence of posthepatic cholestasis (PHC) and associated complications in patients undergoing iBT. Read More

Med Clin (Barc) 2018 Nov 20. Epub 2018 Nov 20.

Servicio de Medicina Interna, Hospital México, San José, Costa Rica.

Hautarzt 2018 Nov 22. Epub 2018 Nov 22.

Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Rostock, Rostock, Deutschland.

Background: The PAPA syndrome, an acronym for pyogenic sterile arthritis, pyoderma gangraenosum and acne, is an autosomal dominant hereditary disease which is caused by a mutation in the PSTPIP1 ("proline-serine-threonine phosphatase interacting protein 1") gene located on chromosome 15 and encodes the proline-serine-threonine phosphatase-interacting protein 1. An association with Crohn's disease (CD), autoimmune diseases of the liver and PAPA syndrome has not yet been reported in the literature.

Objective: To thoroughly investigate a family with three affected members (mother and 2 children) with newly diagnosed PAPA syndrome and intestinal and hepatobiliary symptoms. Read More

Gut Liver 2018 11;12(6):613-614

Center for Liver Cancer, National Cancer Center, Goyang, Korea.

Semin Liver Dis 2018 Nov 22. Epub 2018 Nov 22.

Research and Development Unit, Tavistock Centre, Tavistock and Portman NHS Foundation Trust, London, United Kingdom.

Primary sclerosing cholangitis (PSC) is a chronic liver disease resulting from the inflammation and scarring of an individual's hepatic bile ducts. With no curative treatment available and a risk of potentially severe complications and death, it is likely that those diagnosed with the illness may experience impairments in their psychological wellbeing. The aim of this scoping review is to locate, chart, and summarize all available literature on how PSC affects mental health and psychological wellbeing, as well as the factors that may or may not impact on the psychological wellbeing of those who have this diagnosis. Read More

Curr Oncol 2018 Oct 31;25(5):e430-e435. Epub 2018 Oct 31.

Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON.

Background: In 2010, a multicentre randomized controlled trial reported increased postoperative complications in pancreaticoduodenectomy (pde) patients undergoing preoperative biliary decompression (pbd). We evaluated the effect of that publication on rates of pbd at the population level.

Methods: This retrospective observational cohort study identified patients undergoing pde for malignancy, 2005-2013, linking them with administrative health care databases covering medical services for a population of 13. Read More

J Surg Res 2018 Dec 25;232:492-496. Epub 2018 Jul 25.

Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China. Electronic address:

Background: A 30-40 cm Roux loop is widely accepted in Kasai portoenterostomy in infants with Ohi Type III biliary atresia (BA), regardless of patient's size, to avoid reflux cholangitis. However, the redundant length of the jejunal limb may lead to complications; hence, we compared the outcome of a shorter Roux loop with the standard loop length in Kasai portoenterostomy in infants with Ohi Type III BA.

Methods: There were 166 patients with Ohi Type III BA who underwent the Kasai procedure and were prospectively randomized into two groups: (1) the long Roux loop group (LRLG) contained 91 patients, where a standard 30-40 cm Roux loop was used regardless of the child's size and (2) the short Roux loop group (SRLG) included 75 patients in which the Roux loop length was based on the distance between hepatic hilum and umbilicus. Read More

Transplantation 2018 Nov 19. Epub 2018 Nov 19.

Institute of Liver Studies, King's College Hospital, London, UK.

Background: Young people born with biliary atresia are an emerging population for adult hepatologists with 40-45% of children entering adolescence with their native liver intact. For those requiring liver transplantation during adolescence, disparity on the waiting list and post liver transplantation outcome for young adults compared to younger and older age groups has stimulated discussion regarding the optimal timing of listing. In this study we review our experience of young people with biliary atresia requiring liver transplantation during adolescence and young adulthood. Read More

Am J Dermatopathol 2018 Nov 15. Epub 2018 Nov 15.

Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA.

Linear IgA bullous dermatosis (LABD) is a rare autoimmune blistering disorder seen in the pediatric and adult populations that is often linked to a medication, infection, or underlying gastrointestinal, hepatobiliary, or autoimmune disease. In this study, we describe the case of a 23-year-old white man whose presentation and diagnosis of LABD ultimately led to the discovery of underlying primary sclerosing cholangitis (PSC) and ulcerative colitis (UC). His dermatitis resolved with topical steroids and dapsone, and he is undergoing systemic treatment for his UC and PSC. Read More

Turk J Gastroenterol 2018 Nov 20. Epub 2018 Nov 20.

Department of Gastroenterology, Ege University School of Medicine, İzmir, Turkey.

Background/aims: Patients with ulcerative colitis (UC) are at increased risk of colorectal cancer (CRC). High-grade dysplasia (HGD) and low-grade dysplasia (LGD) are premalignant conditions. The aim of this study is to evaluate the risk of CRC/dysplasia in patients with UC, and the related risk factors. Read More

Ann Gastroenterol Surg 2018 Nov 17;2(6):442-450. Epub 2018 Sep 17.

Department of Gastroenterological Surgery (Surgery II) Nagoya University Graduate School of Medicine Nagoya Japan.

Objectives: The aim of this dual-center randomized controlled trial was to determine the optimal duration of antimicrobial prophylaxis in patients treated with pancreaticoduodenectomy (PD) who underwent preoperative biliary drainage (PBD) but were without cholangitis.

Background: Some reports showed that PBD in patients undergoing pancreatectomy increased the rate of perioperative complications. However, no clinical trial has evaluated the optimal duration of antimicrobial prophylaxis with a focus on patients who underwent PD following PBD. Read More

Turk J Gastroenterol 2018 Nov 16. Epub 2018 Nov 16.

Department of Diagnostic Radiology, University of Pamukkale, Denizli, Turkey.

Front Physiol 2018 5;9:1530. Epub 2018 Nov 5.

Department of Medicine, University of Padova, Padova, Italy.

Patients with Primary Biliary Cholangitis (PBC) exhibit delayed sleep-wake habits, disturbed night sleep and daytime sleepiness/fatigue. Such combination of symptoms is reminiscent of delayed sleep-wake phase disorder (DSPD), which benefits from morning light treatment. The aim of the present pilot study was to test the effect of morning light treatment in a group of 13 well-characterized patients with PBC [all females; (mean ± SD) 53 ± 10 years]. Read More

Front Immunol 2018 2;9:2534. Epub 2018 Nov 2.

Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.

There is considerable interest in expanding B cell-targeted therapies in human autoimmune diseases. However, clinical trials in human primary biliary cholangitis (PBC) using a chimeric antibody against human CD20 (hCD20) have showed limited efficacy. Two potential explanations for these disappointing results are the appearance of anti-drug antibodies (ADAs) and the high frequency of patients with moderate PBC or patients who had failed ursodeoxycholic acid treatment. Read More

Intern Med 2018 Nov 19. Epub 2018 Nov 19.

Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Japan.

Objective The efficacy and safety of concomitant use of antithrombin (AT) with recombinant soluble human thrombomodulin (rTM) for acute cholangitis-induced disseminated intravascular coagulation (AC-induced DIC) remains unclear. This study was conducted to investigate the efficacy of AT combined with rTM as anticoagulant therapy for AC-induced DIC. Methods One hundred patients with AC-induced DIC received anticoagulant therapy using rTM from April 2010 to December 2017. Read More

Clin Gastroenterol Hepatol 2018 Nov 15. Epub 2018 Nov 15.

Department of Medicine Huddinge, Unit of Gastroenterology and Rheumatology, Karolinska Institutet, Stockholm, Sweden; Division of Hepatology, Department of Upper GI Disease, Karolinska University Hospital, Stockholm, Sweden. Electronic address:

Background & Aims: There is increasing evidence that statins can benefit patients with chronic liver diseases, but their effects have not been studied in patients with primary sclerosing cholangitis (PSC). We performed a nationwide study in Sweden to determine the effects of exposure to drugs, including statins, in patients with PSC.

Methods: We studied a population-based cohort of patients in Sweden with PSC and concomitant ulcerative colitis or Crohn´s disease from 2005 through 2014 (n=2914), followed through 2016. Read More

Dig Liver Dis 2018 Oct 29. Epub 2018 Oct 29.

Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.

Background: It is still not clear whether primary biliary cholangitis (PBC) is associated with abnormalities of the cardiovascular system. We aimed to assess the relationship between PBC and coronary flow reserve (CFR).

Methods: Our inclusion criterion was a diagnosis of PBC with no clinical evidence of heart disease or metabolic syndrome. Read More

J Immunol 2018 Nov 16. Epub 2018 Nov 16.

I. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, 20246 Hamburg, Germany;

Inflammatory bowel disease is associated with extraintestinal diseases such as primary sclerosing cholangitis in the liver. Interestingly, it is known that an imbalance between Foxp3 regulatory T cells (Treg) and Th17 cells is involved in inflammatory bowel disease and also in primary sclerosing cholangitis. To explain these associations, one hypothesis is that intestinal inflammation and barrier defects promote liver disease because of the influx of bacteria and inflammatory cells to the liver. Read More

Gastroenterology 2018 Nov 13. Epub 2018 Nov 13.

Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany. Electronic address:

Background: &Aims: Cholangiocyte proliferation and ductular reaction contribute to onset and progression of liver diseases. Little is known about the role of the transcription factor NF-kB in this process. We investigated the activities of the RELB proto-oncogene NF-kB subunit (RELB) in human cholangiocytes and in mouse models of liver disease characterized by a ductular reaction. Read More

Adv Parasitol 2018 10;102:73-95. Epub 2018 Sep 10.

School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.

Human liver fluke infection caused by Opisthorchis viverrini is a major public health problem in Mekong countries such as Thailand, Laos, Cambodia, Vietnam, and Myanmar with over 10 million infected through consumption of fish containing infective metacercariae. With no tissue migration phase and living entirely within the larger secondary (intrahepatic) bile ducts, liver flukes are only exposed to a biliary mucosal immune response, while their excretory and secretory products also stimulate chronic inflammation of biliary epithelium. Neither mucosal nor tissue immune responses appear to cause parasite death or protect against newly established flukes, as evidenced by the persistence of infection for decades in the body and rapid reinfection following treatment. Read More

PLoS One 2018 15;13(11):e0206694. Epub 2018 Nov 15.

Division of Gastroenterology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.

Background: Most patients with distal extrahepatic cholangiocarcinoma have developed jaundice or cholangitis at the time of initial diagnosis, which can delay surgery. We aim to evaluate the actual EB-RFA ablation volume and validated the clinical feasibility of preoperative endobiliary radiofrequency ablation (EB-RFA) for resectable distal extrahepatic cholangiocarcinoma.

Methods: The medical records of patients who underwent EB-RFA from July 2016 to June 2017 at a single tertiary academic medical center were reviewed. Read More

Medicine (Baltimore) 2018 Nov;97(46):e13080

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu.

Laparoscopic left hemihepatectomy (LLH) followed by biliary tract exploration is used to treat left-sided hepatolithiasis (LSH). The purpose of this study was to compare the efficacy of 2 methods of biliary tract exploration in LLH:biliary tract exploration through a common bile duct (CBD) incision (with T-tube drainage) or through the left hepatic duct (LHD) stump (without T-tube drainage).LSH patients (113 patients) were recruited retrospectively in our hospital from December 2008 to January 2016. Read More

Hepatol Int 2018 Nov 14;12(6):510-519. Epub 2018 Nov 14.

Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.

Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease of the biliary tree of unknown etiology leading to stricturing and dilation. There is currently no effective medical therapy for PSC and liver transplantation (LT) remains the ultimate treatment for severe disease defined as repeated episodes of cholangitis, decompensated biliary cirrhosis or in exceptional cases, cholangiocarcinoma (CCA). Patients often present with a "dominant" stricture and the therapeutic endoscopist plays an important role in management to improve biliary patency using a variety of techniques that involve sampling, balloon dilation and temporary stenting. Read More

Radiologe 2018 Dec;58(12):1099-1114

Kinderradiologie im Dr. von Haunerschen Kinderspital der Radiologischen Klinik und Poliklinik, Ludwig-Maximilian-Universität München, München, Deutschland.

Upper abdominal pain, icterus and cholestasis are the symptoms leading to evaluation of the biliary tract. Together with its complications biliary stone disease is the main reason for inflammation of the biliary system. A distinction is made between acute and chronic variants. Read More

Am J Gastroenterol 2018 Nov 14. Epub 2018 Nov 14.

NYU Langone Health, New York, NY, 10016, USA.

Primary biliary cholangitis (PBC) is a chronic, cholestatic, autoimmune disease with a variable progressive course. PBC can cause debilitating symptoms including fatigue and pruritus and, if left untreated, is associated with a high risk of cirrhosis and related complications, liver failure, and death. Recent changes to the PBC landscape include a name change, updated guidelines for diagnosis and treatment as well as new treatment options that have recently become available. Read More