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Surg Infect (Larchmt) 2022 May 17. Epub 2022 May 17.

Department of General Surgery, Tan Tock Seng Hospital, Singapore.

J Hepatobiliary Pancreat Sci 2022 May 18. Epub 2022 May 18.

Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.

Purpose: To evaluate long-term outcomes of endoscopic double stenting using anti-reflux metal stents (ARMS) for combined malignant biliary and duodenal obstruction.

Methods: Consecutive patients with advanced pancreatic cancer who received endoscopic double stenting with self-expandable metal stents (SEMS) for combined malignant biliary and duodenal obstruction at our institution between July 2014 and March 2021 were evaluated. Patients were divided into the ARMS group, endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) group, and covered metal stent-transpapillary (CMS-transpapillary) groups. Read More

World J Gastroenterol 2022 Apr;28(14):1430-1443

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milan, Italy.

Primary biliary cholangitis and primary sclerosing cholangitis (PSC) are the most common cholestatic liver diseases (CLD) in adults and are both characterized by an immune pathogenesis. While primary biliary cholangitis is a model autoimmune disease, with over 90% of patients presenting very specific autoantibodies against mitochondrial antigens, PSC is considered an immune mediated disease. Osteoporosis is the most common bone disease in CLD, resulting in frequent fractures and leading to significant morbidity. Read More

World J Hepatol 2022 Mar;14(3):495-503

Department of Gastroenterology and Hepatology, The University of Texas Medical Branch, Galveston, TX 77555, United States.

The natural history, associations with inflammatory bowel disease (IBD), and long-term outcomes of large duct primary sclerosing cholangitis (ldPSC) have been well documented. Small duct primary sclerosing cholangitis (sdPSC) is a much less common and relatively more benign variant. The natural history of sdPSC has been difficult to characterize given the limited number of studies in the literature especially with regards to the subset of patients who progress to large duct involvement. Read More

Gastroenterology 2022 May 14. Epub 2022 May 14.

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757, Aasahimachi-Dori, Chuo-Ku, Niigata, Japan.

Am Surg 2022 May 16:31348221102610. Epub 2022 May 16.

Deptartment of Surgical Gastroenterology, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

The Immunoglobulin G4-related disease (IgG4-RD) is a multisystem inflammatory condition. Pancreaticobiliary manifestations often present as mass lesions that mimic malignancies. The diagnosis is confirmed by histopathological examination, that shows lymphoplasmacytic infiltration, storiform fibrosis, obliterative phlebitis, and positive immunohistochemistry for IgG4. Read More

Cureus 2022 Apr 13;14(4):e24097. Epub 2022 Apr 13.

Infectious Diseases, University of Florida College of Medicine, Jacksonville, USA.

Strongyloidiasis is endemic to socioeconomically disadvantaged tropics and subtropics, primarily as an asymptomatic carriage. It is seen in developed nations among the underprivileged. We describe a case of an Asian immigrant with eosinophilia, common bile duct stricture, cholangitis, and pancreatitis with  spp found on duodenal biopsy in the setting of steroid exposure. Read More

Intern Med 2022 May 14. Epub 2022 May 14.

Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan.

A 76-year-old man presented with liver dysfunction and intrahepatic bile duct dilatation. Imaging studies showed two large stones that had become impacted in the common hepatic duct, which was fused with the gallbladder. The patient was diagnosed with Mirizzi syndrome type IV. Read More

Gastroenterol Hepatol 2022 May 12. Epub 2022 May 12.

Departamento de Gastroenterología, Hospital Universitario de Fuenlabrada, Madrid, España.

Abdom Radiol (NY) 2022 May 14. Epub 2022 May 14.

Department of Radiology, Mayo Clinic, Rochester, MN, USA.

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by biliary ductal inflammation and fibrosis causing both intrahepatic and extrahepatic biliary strictures and dilatation. There is currently no effective medical treatment and the disease leads to cirrhosis and liver failure, with patients often requiring liver transplantation in end-stage disease. Liver fibrosis is one of the most important factors in determining patient outcome in PSC, and the diagnosis and monitoring of fibrosis are vital to patient care. Read More

J Clin Med 2022 Apr 28;11(9). Epub 2022 Apr 28.

Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.

The soluble urokinase-type plasminogen activator receptor (suPAR) has evolved as a useful biomarker for different entities of chronic liver disease. However, its role in patients with primary sclerosing cholangitis (PSC) is obscure. We analyzed plasma levels of suPAR in 84 patients with PSC and compared them to 68 patients with inflammatory bowel disease (IBD) without PSC and to 40 healthy controls. Read More

Cancers (Basel) 2022 Apr 24;14(9). Epub 2022 Apr 24.

Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.

Perihilar cholangiocarcinoma is a rare hepatobiliary malignancy that requires thoughtful, multidisciplinary evaluation in the preoperative setting to ensure optimal patient outcomes. Comprehensive preoperative imaging, including multiphase CT angiography and some form of cholangiographic assessment, is key to assessing resectability. While many staging systems exist, the Blumgart staging system provides the most useful combination of resectability assessment and prognostic information for use in the preoperative setting. Read More

Cancers (Basel) 2022 Apr 24;14(9). Epub 2022 Apr 24.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA.

Background: Primary sclerosing cholangitis (PSC) is a major risk factor for cholangiocarcinoma (CCA). We investigated biliary and fecal microbiota to determine whether specific microbes in the bile or stool are associated with PSC or CCA.

Methods: Bile was obtained from 32 patients with PSC, 23 with CCA with PSC, 26 with CCA without PSC, and 17 controls. Read More

Int J Mol Sci 2022 Apr 28;23(9). Epub 2022 Apr 28.

Department of Medical Biology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.

Deficient mismatch repair (MMR) proteins may lead to DNA damage and microsatellite instability. Primary sclerosing cholangitis (PSC) is a risk factor for colitis-associated colon cancer. MiR-155 is suggested to act as a key regulating node, linking inflammation and tumorigenesis. Read More

Int J Mol Sci 2022 Apr 28;23(9). Epub 2022 Apr 28.

Division of Gastroenterology, Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.

Primary Biliary Cholangitis (PBC) is a rare autoimmune disease of the liver, affecting mostly females. There is evidence that epigenetic changes have a pathogenic role in PBC. Epigenetic modifications are related to methylation of CpG DNA islands, post-translational modifications of histone proteins, and non-coding RNAs. Read More

Langenbecks Arch Surg 2022 May 13. Epub 2022 May 13.

Department of General Surgery, Hefei Second People's Hospital, Anhui Medical University, Hefei, 230011, Anhui Province, People's Republic of China.

Background: The safety and feasibility of primary closure after laparoscopic common bile duct exploration (LCBDE) have been confirmed in elective settings. However, the suitability of primary closure after LCBDE in the treatment of patients with non-severe acute cholangitis in emergency settings remains unclear. The aim of the present study was to explore the safety and feasibility of LCBDE with primary closure in patients with non-severe acute cholangitis. Read More

J Hepatobiliary Pancreat Sci 2022 May 13. Epub 2022 May 13.

University of Yamanashi, Faculty of Medicine Graduate School of Medicine, First Department of Internal medicine.

Background/purpose: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) has many associated adverse events. We evaluated the clinical efficacy and safety of the laser-cut fully covered self-expandable metallic stent (FCSEMS) for this procedure.

Methods: This single-center, retrospective study included cases where EUS-HGS with a laser-cut FCSEMS was performed for malignant biliary obstruction. Read More

Vet Med Sci 2022 May 13. Epub 2022 May 13.

Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy.

Mucocele and cholecystitis were diagnosed in a 10 year-old Shetland-sheepdog presenting aspecific clinical signs. Blood examinations and ultrasonography investigation were performed before to surgical approach, which allowed to collect biopsies and samples for bacteriological analyses. In addition, the patient was subjected to cholecystectomy. Read More

Inflamm Bowel Dis 2022 May 11. Epub 2022 May 11.

Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.

Background: Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) run a 10-fold increased risk of developing colorectal cancer (CRC) compared to patients with IBD only. The aim of this study was to perform an extensive screen of known carcinogenic genomic alterations in patients with PSC-IBD, and to investigate whether such changes occur already in nondysplastic mucosa.

Methods: Archival cancer tissue and nondysplastic mucosa from resection specimens of 19 patients with PSC-IBD-CRC were characterized, determining DNA copy-number variations, microsatellite instability (MSI), mutations on 48 cancer genes, and CpG island methylator phenotype (CIMP). Read More

Langenbecks Arch Surg 2022 May 13. Epub 2022 May 13.

Hepatobiliary and Pancreatic Surgery and Liver Transplant Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK.

Aims: To compare outcomes of interrupted (IS) and continuous (CS) suturing techniques for Roux-en-Y hepaticojejunostomy and duct-to-duct choledochocholedochostomy.

Methods: The study protocol was prospectively registered in PROSPERO (registration number: CRD42021286294). A systematic search of MEDLINE, CENTRAL, and Web of Science and bibliographic reference lists were conducted (last search: 14th March 2022). Read More

Cureus 2022 Apr 8;14(4):e23956. Epub 2022 Apr 8.

Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, IRN.

Background: The CT findings of cirrhosis caused by primary sclerosing cholangitis (PSC) differ from cryptogenic cirrhosis. PSC could become complicated with biliary cirrhosis and cholangiocarcinoma. This study aimed at augmenting the information on the role of the three-phasic-abdominopelvic CT scan in PSC. Read More

Zhonghua Yi Xue Za Zhi 2022 May;102(18):1326-1329

Cholelithiasis Center, Tongji University Affiliated Shanghai East Hospital, Shanghai 200120, China.

The confluence of pancreaticobiliary ducts refers to the area between the end of common bile duct, the opening of main pancreatic duct and duodenal papilla. Those confluence diseases of pancreaticobiliary ducts will cause obstruction of biliary and pancreatic outflow tract, cholestasis, pancreatic juice deposition or pancreaticobiliary reflux, and thus induce gallstones, cholangitis, pancreatitis and other diseases. Endoscopic ampullary sphincterotomy is an important way to treat biliary and pancreatic diseases, but the length of incision is determined by the anatomy of Oddi sphincter. Read More

Zhonghua Gan Zang Bing Za Zhi 2022 Apr;30(4):419-425

Department of Critical Hepatology, Beijing You'an Hospital Affiliated to Capital Medical University, Beijing 100069, China.

To analyze the clinical characteristics and prognostic value of liver function in a large samples of patients with anti-glycoprotein 210 (gp210 antibody) positive primary biliary cholangitis (PBC). A retrospective study was performed on 931 PBC cases in Beijing You'an Hospital affiliated to Capital Medical University from 2010 to 2019. According to the detection of gp210 antibody, 318 cases were divided into gp210 antibody positive group (positive group) and 613 cases were divided into gp210 antibody negative group (negative group). Read More

Support Care Cancer 2022 May 11. Epub 2022 May 11.

Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France.

Background: Palliative biliary drainage in patients with unresectable malignant biliary obstruction (MBO) frequently leads to biliary stent infection (BI), which could impact medical care. The aim of this study was to assess the risk factors for BI occurrence in patients after stenting procedure and the impact of BI on patient survival.

Methods: All consecutive patients hospitalized from 2014 to 2018 for MBO and biliary stenting were retrospectively included. Read More

Semin Immunopathol 2022 May 10. Epub 2022 May 10.

Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany.

Autoimmune liver diseases are a group of immune-mediated liver diseases with three distinct entities, including autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis. The interplay of genetic and environmental factors leads to the breakdown of self-tolerance, resulting in hyper-responsiveness, and auto-aggressive immune activation. Emerging evidence links autoimmune liver diseases with alterations of the commensal microbiome configuration and aberrant immune system activation by microbial signals, mainly via the gut-liver axis. Read More

Liver Int 2022 May 10. Epub 2022 May 10.

Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway.

Background & Aims: Evidence for the benefit of scheduled imaging for early detection of hepatobiliary malignancies in primary sclerosing cholangitis (PSC) is limited. We aimed to compare different follow-up strategies in PSC with the hypothesis that regular imaging improves survival.

Methods: We collected retrospective data from 2975 PSC patients from 27 centres. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):617-624. Epub 2021 Sep 4.

Yashoda Hospitals, Secunderabad, India.

Fatigue is a common symptom in patients with liver disease and has a significant impact on the health-related quality of life (HR-QoL). Its pathogenesis is poorly understood and is considered multifactorial. The liver is central in the pathogenesis of fatigue because it uniquely regulates much of the production, storage, and release of substrate for energy generation. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):287-292. Epub 2021 Sep 10.

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Background: There is limited literature on the role of percutaneous transhepatic biliary drainage (PTBD) as an adjunct to endoscopic retrograde cholangiopancreatography (ERCP). This study evaluates the role of PTBD in patients with failed ERCP or post-ERCP cholangitis.

Methods: Retrospective evaluation of clinical and intervention records of patients with biliary obstruction referred for PTBD following failed ERCP or post-ERCP cholangitis was performed. Read More

Front Immunol 2022 22;13:885229. Epub 2022 Apr 22.

Department of Gastroenterology, Hepatology and Clinical Oncology Centre of Postgraduate Medical Education, Warsaw, Poland.

Background And Aims: Metalloproteinases (MMPs) are involved in many distinct processes in the liver. Matrix metalloproteinase-3 (MMP-3) plays an important role in connective tissue remodeling, degradation of collagen (types II, III, IV, IX, and X), proteoglycans, fibronectin, laminin, and elastin. In addition, MMP-3 can also activate other MMPs such as MMP-1, MMP-7, and MMP-9. Read More

Case Rep Gastroenterol 2022 Jan-Apr;16(1):186-194. Epub 2022 Mar 28.

Department of Gastroenterology and Endoscopic Services, Western Health, Melbourne, Victoria, Australia.

Iatrogenic Stapfer type-1 duodenal perforations during endoscopic retrograde cholangiopancreatography (ERCP) typically necessitate surgical management and carry significant morbidity and mortality risk. Here, we present a case of a large duodenal perforation during ERCP managed endoscopically with an over-the-scope clip (OTSC) and describe the subsequent post-procedural management. An 80-year-old woman presented to the emergency department with acute cholangitis. Read More