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[PMID]:29465584
[Au] Autor:Fan X; He L; Khadaroo PA; Zhou D; Lin H
[Ad] Endereço:Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
[Ti] Título:Duplication of the extrahepatic bile duct: A case report and review of the literatures.
[So] Source:Medicine (Baltimore);97(8):e9953, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Duplication of the extrahepatic bile duct is an extremely rare congenital anomaly of the biliary system. PATIENT CONCERNS: A 44-year-old woman presented with a history of continuous upper abdominal pain and vomiting. DIAGNOSES: Magnetic resonance cholangiopancreatography (MRCP) disclosed diffuse dilatation of the intrahepatic and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) showed the presence of two extrahepatic bile ducts with calculus at the distal end of the CBD. INTERVENTIONS: Laparoscopic cholecystectomy (LC) was performed after an ERCP. Choledochoscopy, performed during the operation, showed duplicated common bile duct and the cystic duct was seen opening at the right side of the extrahepatic duct. OUTCOMES: The patient was doing well after 6 months of follow-up. LESSONS: We reported a case of a double common duct with choledocholithiasis and gallstone. This rare anomaly may lead to cholangitis, common bile duct injury during surgery, malignancy occurrence, and should be treated with extreme care.
[Mh] Termos MeSH primário: Doenças dos Ductos Biliares/congênito
Ductos Biliares Extra-Hepáticos/anormalidades
Ducto Colédoco/anormalidades
[Mh] Termos MeSH secundário: Adulto
Colangiopancreatografia Retrógrada Endoscópica
Colangiopancreatografia por Ressonância Magnética
Colecistectomia Laparoscópica
Coledocolitíase/congênito
Feminino
Cálculos Biliares/congênito
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009953


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[PMID]:29275776
[Au] Autor:Al-Zahir MZ; AlAmeel T
[Ad] Endereço:Department of Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia.
[Ti] Título:Extrahepatic cholangiocarcinoma with prolonged survival: a case report.
[So] Source:J Med Case Rep;11(1):357, 2017 Dec 25.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cholangiocarcinoma has poor prognosis and short term-survival. Here, we report the case of a patient with unusually prolonged survival. CASE PRESENTATION: Our patient was a 56-year-old Arab man with a 6-month history of obstructive jaundice. A computed tomography scan of his abdomen revealed a mass at the confluence of the hepatic ducts with suspected malignant strictures on endoscopy. A positive tissue diagnosis was achieved more than 18 months after commencement of his symptoms. He remained functional throughout this period despite recurrent episodes of cholangitis. CONCLUSIONS: Cholangiocarcinoma is a presumably fatal disease, especially because patients tend to present late with unresectable disease. Many patient-related and disease-related factors may alter survival.
[Mh] Termos MeSH primário: Neoplasias dos Ductos Biliares/diagnóstico por imagem
Ductos Biliares Extra-Hepáticos/diagnóstico por imagem
Tumor de Klatskin/diagnóstico por imagem
[Mh] Termos MeSH secundário: Neoplasias dos Ductos Biliares/complicações
Neoplasias dos Ductos Biliares/patologia
Ductos Biliares Extra-Hepáticos/patologia
Colangiocarcinoma/complicações
Colangiocarcinoma/diagnóstico por imagem
Colangiocarcinoma/patologia
Colangiopancreatografia Retrógrada Endoscópica
Colangite/etiologia
Seres Humanos
Icterícia Obstrutiva/etiologia
Tumor de Klatskin/complicações
Tumor de Klatskin/patologia
Masculino
Meia-Idade
Taxa de Sobrevida
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171226
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1519-5


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[PMID]:29187494
[Au] Autor:Okabayashi T; Shima Y; Iwata J; Morita S; Sumiyoshi T; Sui K; Shimada Y; Iiyama T
[Ad] Endereço:Department of Gastroenterological Surgery at Kochi Health Sciences Center, Kochi, Japan tokabaya@gmail.com.
[Ti] Título:Characterization of Prognostic Factors and the Efficacy of Adjuvant S-1 Chemotherapy in Patients with Post-surgery Extrahepatic Bile Duct Cancer.
[So] Source:Anticancer Res;37(12):7049-7056, 2017 12.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIM: There is no clear consensus on the type of adjuvant therapy that should be used for patients with extrahepatic bile duct cancer. PATIENTS AND METHODS: Two hundred and seventy-one patients that had undergone surgical resection for extrahepatic bile duct cancer composed the study cohort. Demographics, treatments, and relationships between the potential prognostic factors and survival rates were analyzed. RESULTS: The overall 3-year and 5-year survival rates for post-surgery extrahepatic bile duct cancer patients were 49.0% and 35.4%, respectively. Multivariate analysis revealed that regional lymph node metastasis was an independent negative prognostic factor. We observed a significant correlation between node-positive extrahepatic bile duct cancer and postoperative local recurrence, liver metastasis, peritoneal dissemination, and post-surgery lymph node metastasis. Adjuvant S-1 chemotherapy showed a favorable hazard ratio in patients with lymph node metastases or positive vascular invasion. CONCLUSION: We recommend the use of adjuvant S-1 therapy in patients with lymph node metastases or microvascular invasion.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias dos Ductos Biliares/tratamento farmacológico
Ductos Biliares Extra-Hepáticos/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Neoplasias dos Ductos Biliares/cirurgia
Ductos Biliares Extra-Hepáticos/cirurgia
Quimioterapia Adjuvante
Feminino
Seguimentos
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Análise Multivariada
Recidiva Local de Neoplasia
Ácido Oxônico/administração & dosagem
Prognóstico
Estudos Retrospectivos
Tegafur/administração & dosagem
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
1548R74NSZ (Tegafur); 5VT6420TIG (Oxonic Acid)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:27777211
[Au] Autor:Shi HD; Shi XJ; Lv SC; Ma HX; Liang YR; Zhou L; Shi Y
[Ad] Endereço:Department of Hepatobiliary Surgery, General Hospital of PLA, Beijing 100853, China. E-mail: shihaida0211@163.com.
[Ti] Título:[Development of laparoscopic technology in biliary surgery in the past 23 years: a single-center experience].
[So] Source:Nan Fang Yi Ke Da Xue Xue Bao;36(10):1429-1434, 2016 Oct 20.
[Is] ISSN:1673-4254
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To summarize the 23-year experience of laparoscopic biliary surgery in General Hospital of PLA and evaluate the application of laparoscopic surgery in the treatment of biliary diseases. METHODS: We retrospectively analyzed the clinical data of 11 419 consecutive patients with biliary diseases undergoing laparoscopic surgery from April, 1992 and December, 2014. The disease spectrum was compared between patients treated before December 31, 2003 and those treated after the time point. RESULTS: The 11419 patients receiving laparoscopic surgery accounted for 56.3% of the total patients undergoing biliary surgeries during the 23 years, including 4701 male and 6718 female patients with a mean age of 50.9∓13.2 years (6-93 years). Most (80.83%) of the patients received laparoscopic surgery for gallbladder stones, and 12.53% patients had the operation for gallbladder polyps. The laparoscopic operation rate was 84.81% in patients with gallbladder stones and 34.91% in patients with extrahepatic bile duct stones, but remained low in patients with biliary carcinoma. In laparoscopic operations, laparoscopic cholecystectomy was the most frequent (96.18%) followed by operations for extrahepatic bile duct stones, in which primary suture accounted for 1.38%, traditional T tube drainage for 0.90% and laparoscopic transcystic duct exploration for 0.72%. For malignant tumors, laparoscopic technique was used mainly for the purpose of exploration (0.34%). The application of laparoscopic technique in biliary surgery tended to increase after the year 2004, especially for benign gallbladder diseases and extrahepatic bile duct stones (P<0.05). CONCLUSION: Laparoscopic technique in biliary surgery is gradually replacing the traditional open operation and becomes the gold standard for the treatment of benign biliary diseases.
[Mh] Termos MeSH primário: Neoplasias dos Ductos Biliares/cirurgia
Doenças da Vesícula Biliar/cirurgia
Cálculos Biliares/cirurgia
Laparoscopia/tendências
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Ductos Biliares Extra-Hepáticos
Criança
Colecistectomia Laparoscópica
Drenagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:28684159
[Au] Autor:Yokoyama Y; Mizuno T; Sugawara G; Asahara T; Nomoto K; Igami T; Ebata T; Nagino M
[Ad] Endereço:Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: yyoko@med.nagoya-u.ac.jp.
[Ti] Título:Profile of preoperative fecal organic acids closely predicts the incidence of postoperative infectious complications after major hepatectomy with extrahepatic bile duct resection: Importance of fecal acetic acid plus butyric acid minus lactic acid gap.
[So] Source:Surgery;162(4):928-936, 2017 Oct.
[Is] ISSN:1532-7361
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To investigate the association between preoperative fecal organic acid concentrations and the incidence of postoperative infectious complications in patients undergoing major hepatectomy with extrahepatic bile duct resection for biliary malignancies. METHODS: The fecal samples of 44 patients were collected before undergoing hepatectomy with bile duct resection for biliary malignancies. The concentrations of fecal organic acids, including acetic acid, butyric acid, and lactic acid, and representative fecal bacteria were measured. The perioperative clinical characteristics and the concentrations of fecal organic acids were compared between patients with and without postoperative infectious complications. RESULTS: Among 44 patients, 13 (30%) developed postoperative infectious complications. Patient age and intraoperative bleeding were significantly greater in patients with postoperative infectious complications compared with those without postoperative infectious complications. The concentrations of fecal acetic acid and butyric acid were significantly less, whereas the concentration of fecal lactic acid tended to be greater in the patients with postoperative infectious complications. The calculated gap between the concentrations of fecal acetic acid plus butyric acid minus lactic acid gap was less in the patients with postoperative infectious complications (median 43.5 vs 76.1 µmol/g of feces, P = .011). Multivariate analysis revealed that an acetic acid plus butyric acid minus lactic acid gap <60 µmol/g was an independent risk factor for postoperative infectious complications with an odds ratio of 15.6; 95% confidence interval 1.8-384.1. CONCLUSION: The preoperative fecal organic acid profile (especially low acetic acid, low butyric acid, and high lactic acid) had a clinically important impact on the incidence of postoperative infectious complications in patients undergoing major hepatectomy with extrahepatic bile duct resection.
[Mh] Termos MeSH primário: Ácido Acético/metabolismo
Neoplasias dos Ductos Biliares/cirurgia
Ductos Biliares Extra-Hepáticos
Ácido Butírico/metabolismo
Hepatectomia/efeitos adversos
Infecção da Ferida Cirúrgica/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Neoplasias dos Ductos Biliares/metabolismo
Estudos de Coortes
Fezes/química
Feminino
Seres Humanos
Incidência
Ácido Láctico/metabolismo
Masculino
Meia-Idade
Valor Preditivo dos Testes
Infecção da Ferida Cirúrgica/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
107-92-6 (Butyric Acid); 33X04XA5AT (Lactic Acid); Q40Q9N063P (Acetic Acid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE


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[PMID]:28671689
[Au] Autor:Sampaziotis F; Justin AW; Tysoe OC; Sawiak S; Godfrey EM; Upponi SS; Gieseck RL; de Brito MC; Berntsen NL; Gómez-Vázquez MJ; Ortmann D; Yiangou L; Ross A; Bargehr J; Bertero A; Zonneveld MCF; Pedersen MT; Pawlowski M; Valestrand L; Madrigal P; Georgakopoulos N; Pirmadjid N; Skeldon GM; Casey J; Shu W; Materek PM; Snijders KE; Brown SE; Rimland CA; Simonic I; Davies SE; Jensen KB; Zilbauer M; Gelson WTH; Alexander GJ; Sinha S; Hannan NRF; Wynn TA; Karlsen TH; Melum E; Markaki AE; Saeb-Parsy K; Vallier L
[Ad] Endereço:Wellcome Trust-Medical Research Council Stem Cell Institute, Cambridge Stem Cell Institute, Anne McLaren Laboratory, University of Cambridge, Cambridge, UK.
[Ti] Título:Reconstruction of the mouse extrahepatic biliary tree using primary human extrahepatic cholangiocyte organoids.
[So] Source:Nat Med;23(8):954-963, 2017 Aug.
[Is] ISSN:1546-170X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The treatment of common bile duct (CBD) disorders, such as biliary atresia or ischemic strictures, is restricted by the lack of biliary tissue from healthy donors suitable for surgical reconstruction. Here we report a new method for the isolation and propagation of human cholangiocytes from the extrahepatic biliary tree in the form of extrahepatic cholangiocyte organoids (ECOs) for regenerative medicine applications. The resulting ECOs closely resemble primary cholangiocytes in terms of their transcriptomic profile and functional properties. We explore the regenerative potential of these organoids in vivo and demonstrate that ECOs self-organize into bile duct-like tubes expressing biliary markers following transplantation under the kidney capsule of immunocompromised mice. In addition, when seeded on biodegradable scaffolds, ECOs form tissue-like structures retaining biliary characteristics. The resulting bioengineered tissue can reconstruct the gallbladder wall and repair the biliary epithelium following transplantation into a mouse model of injury. Furthermore, bioengineered artificial ducts can replace the native CBD, with no evidence of cholestasis or occlusion of the lumen. In conclusion, ECOs can successfully reconstruct the biliary tree, providing proof of principle for organ regeneration using human primary cholangiocytes expanded in vitro.
[Mh] Termos MeSH primário: Ductos Biliares Extra-Hepáticos/fisiologia
Células Epiteliais/citologia
Vesícula Biliar/fisiologia
Organoides/fisiologia
Regeneração/fisiologia
Engenharia Tecidual/métodos
[Mh] Termos MeSH secundário: Animais
Ductos Biliares Extra-Hepáticos/citologia
Ductos Biliares Extra-Hepáticos/lesões
Sistema Biliar/citologia
Sistema Biliar/lesões
Sistema Biliar/fisiologia
Transplante de Células
Regulador de Condutância Transmembrana em Fibrose Cística/metabolismo
Células Epiteliais/efeitos dos fármacos
Células Epiteliais/metabolismo
Vesícula Biliar/lesões
Seres Humanos
Técnicas In Vitro
Queratina-19/metabolismo
Queratina-7/metabolismo
Camundongos
Organoides/citologia
Organoides/efeitos dos fármacos
Organoides/metabolismo
Secretina/farmacologia
Somatostatina/farmacologia
Tecidos Suporte
gama-Glutamiltransferase/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Nm] Nome de substância:
0 (Keratin-19); 0 (Keratin-7); 126880-72-6 (Cystic Fibrosis Transmembrane Conductance Regulator); 1393-25-5 (Secretin); 51110-01-1 (Somatostatin); EC 2.3.2.2 (gamma-Glutamyltransferase)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170704
[St] Status:MEDLINE
[do] DOI:10.1038/nm.4360


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[PMID]:28601317
[Au] Autor:Maddah G; Rajabi Mashhadi MT; Parvizi Mashhadi M; Nooghabi MJ; Hassanpour M; Abdollahi A
[Ad] Endereço:Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
[Ti] Título:Iatrogenic injuries of the extrahepatic biliary system.
[So] Source:J Surg Res;213:215-221, 2017 Jun 01.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Iatrogenic traumatic extrahepatic biliary tract injuries though rarely occur; they can lead to exceedingly morbid complications. The aim of this study was to evaluate the management strategies and outcomes of patients presented with iatrogenic bile duct injuries. METHODS: This is a retrospective study. Over 19 y, 124 patients were managed for iatrogenic biliary injuries at our institution. The data related to the etiology of biliary tract injury, symptoms of injury, laboratory and radiologic studies, injury-to-diagnosis time, type of biliary tract injury, injury management, hospitalization time, and postoperative complications were reviewed. RESULTS: The main clinical presentations were jaundice or recurrent cholangitis in 64 (51.61%) patients, followed by bile peritonitis in 34 (56.67%) and biliary fistula in 26 (43.33%) patients. Only in 23 (18.54%) cases, the injury was recognized intraoperatively. The most frequent surgical procedure was open cholecystectomy in 81 (65.32%) of 124 patients. The remaining patients were operated on laparoscopically. Good results were achieved in 99 of 101 patients with direct suture repair including hepaticojejunostomy, choledocoduodenostomy, and choledochocholedochostomy (98.02% success rate) at the first attempt. Three cases (2.97%) of biliary strictures after direct suture technique and four (3.96%) cases of postoperative mortalities were detected. The mortality rate was mostly affected by male gender, advanced age, and existence of bile peritonitis. Totally, 111 (89.52%) patients are still alive with a mean follow-up time of 78 ± 38 (2-230) mo. CONCLUSIONS: Biliary injuries can be sometimes life-threatening complications. A successful repair may provide patients with a lifelong relief from symptoms, whereas a failed repair may result in recurrent biliary obstruction, reoperation, and even death.
[Mh] Termos MeSH primário: Ductos Biliares Extra-Hepáticos/lesões
Colecistectomia/efeitos adversos
Complicações Intraoperatórias
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Seres Humanos
Complicações Intraoperatórias/diagnóstico
Complicações Intraoperatórias/etiologia
Complicações Intraoperatórias/mortalidade
Complicações Intraoperatórias/terapia
Masculino
Meia-Idade
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/mortalidade
Complicações Pós-Operatórias/terapia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170612
[St] Status:MEDLINE


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[PMID]:28447209
[Au] Autor:Kim SW; Noh OK; Kim JH; Chun M; Oh YT; Kang SY; Lee HW; Park RW; Yoon D
[Ad] Endereço:Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
[Ti] Título:Adjuvant concurrent chemoradiotherapy with low-dose daily cisplatin for extrahepatic bile duct cancer.
[So] Source:Cancer Chemother Pharmacol;79(6):1161-1167, 2017 Jun.
[Is] ISSN:1432-0843
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: We aimed to present the clinical outcomes of adjuvant concurrent chemoradiotherapy (CCRT) with low-dose daily cisplatin regimen compared to the conventional 5-fluorouracil (5-FU)-based regimen for extrahepatic bile duct cancer (EHBDC). METHODS: From October 1994 to April 2013, 41 patients received adjuvant CCRT with low-dose daily regimen or 5-FU-based regimens. Nineteen patients received low-dose of cisplatin just before every delivery of radiation therapy, and 21 patients received two cycles of 5-FU-based regimen during radiotherapy. We compared the clinical outcomes between two adjuvant CCRT regimens. RESULTS: Adjuvant CCRT with low-dose daily cisplatin showed comparable toxicity profiles compared with that of a 5-FU-based regimen. The median follow-up time was 33 months (range, 5-205), and the 5-year overall survival (OS), locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) were 34.2, 50.8, and 49.7%, respectively. Univariable analyses showed no significant differences in OS, LRRFS, and DMFS between the groups with two regimens. In multivariable analyses, chemotherapeutic regimen was a significant prognostic factor for OS, favoring the low-dose daily cisplatin regimen (HR = 2.491, p = 0.036) over 5-FU-based regimen, though not for LRRFS (p = 0.642) and DMFS (p = 0.756). CONCLUSIONS: Adjuvant CCRT with low-dose daily cisplatin regimen showed acceptable toxicities and survivals compared to those of the 5-FU-based regimen. Low-dose daily cisplatin can be one of the feasible regimens for adjuvant CCRT for EHBDC.
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Neoplasias dos Ductos Biliares/terapia
Quimiorradioterapia Adjuvante/métodos
Cisplatino/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Antimetabólitos Antineoplásicos/uso terapêutico
Antineoplásicos/administração & dosagem
Antineoplásicos/efeitos adversos
Neoplasias dos Ductos Biliares/tratamento farmacológico
Neoplasias dos Ductos Biliares/radioterapia
Ductos Biliares Extra-Hepáticos
Cisplatino/administração & dosagem
Cisplatino/efeitos adversos
Terapia Combinada/efeitos adversos
Comorbidade
Feminino
Fluoruracila/uso terapêutico
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Análise de Sobrevida
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimetabolites, Antineoplastic); 0 (Antineoplastic Agents); Q20Q21Q62J (Cisplatin); U3P01618RT (Fluorouracil)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1007/s00280-017-3312-y


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[PMID]:28234108
[Au] Autor:Jian Y; Haisu T; Chihua F; Yingfang F; Nan X; Ning Z; Jun L; Wen Z
[Ad] Endereço:Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong, People's Republic of China.
[Ti] Título:Clinical Applications of Three-Dimensional Visualization Model of Arteries Supplying the Extrahepatic Bile Duct for Patients with Biliary Obstruction.
[So] Source:Am Surg;83(1):8-15, 2017 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to assess distribution characteristics and digital typing of arteries supplying the extrahepatic bile duct for patients with biliary obstruction, and evaluate the three-dimensional (3D) model in surgical decision-making. Forty-one patients with biliary obstruction were retrospectively evaluated. Clinical data obtained by 64-slice multidetector CT angiography scanning were introduced into Medical Image Three-Dimensional Visualization System; then, 3D model of extrahepatic bile duct and its supplying arteries were reconstructed. Based on the 3D model, the origination and bifurcations of the bile duct artery were observed, and the digital types established. Afterwards, plans for preoperative procedures were formulated. Finally, postoperative observations were performed and the biliary complications recorded in detail. The 3D model clearly displayed the origin, course, and distribution of individualized arteries supplying the extrahepatic bile duct, as well as variations. According to 3D model characteristics, the digital types were established. Blood supply to the superior segment of the extrahepatic bile duct encompassed 6 (14.6%), 17 (41.5%), 12 (29.3%), and 6 (14.6%) cases of Types IA, IB, IC, and II, respectively; meanwhile, blood supply to the inferior segment comprised 13 (31.7%), 13 (31.7%), 4 (9.8%), 7 (17.0%), and 4 (9.8%) cases of Types IA, IB, IC, II, and III, respectively. This classification helped in preoperative surgical planning and corroborated intraoperative findings. No postoperative biliary complications were recorded. The 3D model reconstructed using Medical Image Three-Dimensional Visualization System displayed individualized anatomical structures of the extrahepatic bile duct and associated blood supplying arteries, and could contribute to preoperative surgical planning.
[Mh] Termos MeSH primário: Artérias/diagnóstico por imagem
Ductos Biliares Extra-Hepáticos/irrigação sanguínea
Colestase/diagnóstico por imagem
Imagem Tridimensional
Tomografia Computadorizada Multidetectores
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Angiografia/métodos
Ductos Biliares Extra-Hepáticos/diagnóstico por imagem
Coledocolitíase/diagnóstico por imagem
Coledocolitíase/cirurgia
Colestase/cirurgia
Duodeno
Feminino
Seres Humanos
Masculino
Ilustração Médica
Meia-Idade
Tratamentos com Preservação do Órgão
Neoplasias Pancreáticas/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170310
[Lr] Data última revisão:
170310
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE


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[PMID]:28224425
[Au] Autor:Gao Y; Li M; Song ZF; Cui L; Wang BR; Lou XD; Zhou T; Zhang Y; Zheng QC
[Ad] Endereço:Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
[Ti] Título:Mechanism of dynamic near-infrared fluorescence cholangiography of extrahepatic bile ducts and applications in detecting bile duct injuries using indocyanine green in animal models.
[So] Source:J Huazhong Univ Sci Technolog Med Sci;37(1):44-50, 2017 Feb.
[Is] ISSN:1672-0733
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:Fluorescence intraoperative cholangiography (IOC) is a potential alternative for identifying anatomical variation and preventing iatrogenic bile duct injuries by using the near-infrared probe indocyanine green (ICG). However, the dynamic process and mechanism of fluorescence IOC have not been elucidated in previous publications. Herein, the optical properties of the complex of ICG and bile, dynamic fluorescence cholangiography and iatrogenic bile duct injuries were investigated. The emission spectrum of ICG in bile peaked at 844 nm and ICG had higher tissue penetration. Extrahepatic bile ducts could fluoresce 2 min after intravenous injection, and the fluorescence intensity reached a peak at 8 min. In addition, biliary dynamics were observed owing to ICG excretion from the bile ducts into the duodenum. Quantitative analysis indicated that ICG-guided fluorescence IOC possessed a high signal to noise ratio compared to the surrounding peripheral tissue and the portal vein. Fluorescence IOC was based on rapid uptake of circulating ICG in plasma by hepatic cells, excretion of ICG into the bile and then its interaction with protein molecules in the bile. Moreover, fluorescence IOC was sensitive to detect bile duct ligation and acute bile duct perforation using ICG in rat models. All of the results indicated that fluorescence IOC using ICG is a valid alternative for the cholangiography of extrahepatic bile ducts and has potential for measurement of biliary dynamics.
[Mh] Termos MeSH primário: Doenças dos Ductos Biliares/diagnóstico por imagem
Ductos Biliares Extra-Hepáticos/lesões
Colangiografia/métodos
Corantes Fluorescentes/administração & dosagem
Verde de Indocianina/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Doenças dos Ductos Biliares/etiologia
Ductos Biliares Extra-Hepáticos/diagnóstico por imagem
Ductos Biliares Extra-Hepáticos/cirurgia
Colecistectomia Laparoscópica/efeitos adversos
Modelos Animais de Doenças
Doença Iatrogênica
Injeções Intravenosas
Período Intraoperatório
Ratos
Razão Sinal-Ruído
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fluorescent Dyes); IX6J1063HV (Indocyanine Green)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171104
[Lr] Data última revisão:
171104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1007/s11596-017-1692-1



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