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[PMID]:29320821
[Au] Autor:Choi JH; Seo M
[Ad] Endereço:Division of Gastroenterology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan 31116, Korea.
[Ti] Título:A Case of Biliary Ascariasis in Korea.
[So] Source:Korean J Parasitol;55(6):659-660, 2017 Dec.
[Is] ISSN:1738-0006
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Biliary ascariasis is still the leading cause of surgical complication of ascariasis, though its incidence has been dramatically reduced. Herein, we report a case of biliary ascariasis for the purpose of enhancing awareness of parasitic infections as a possible cause. A 72-year-old male visited the emergency room of Dankook University Hospital on 12 July 2015, complaining of right-upper-quadrant pain. By endoscopic retrograde cholangiopancreatography (ERCP), a tubular filling defect in the right hepatic duct was detected. The defect was endoscopically removed and diagnosed as an adult female of Ascaris lumbricoides worm, of 30 cm length. Upon removal of the worm, the pain subsided, and the patient was discharged without any complication. When treating cases of biliary colic, physicians should not neglect biliary ascariasis as the possible cause.
[Mh] Termos MeSH primário: Ascaríase/parasitologia
Ascaríase/cirurgia
Ascaris lumbricoides/isolamento & purificação
Doenças dos Ductos Biliares/parasitologia
Doenças dos Ductos Biliares/cirurgia
[Mh] Termos MeSH secundário: Dor Abdominal/etiologia
Idoso
Animais
Ascaríase/complicações
Ascaríase/diagnóstico por imagem
Doenças dos Ductos Biliares/complicações
Doenças dos Ductos Biliares/diagnóstico por imagem
Colangiopancreatografia Retrógrada Endoscópica
Ducto Hepático Comum/diagnóstico por imagem
Ducto Hepático Comum/parasitologia
Ducto Hepático Comum/cirurgia
Seres Humanos
Masculino
República da Coreia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.3347/kjp.2017.55.6.659


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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]:27778170
[Au] Autor:Roy M; Dip F; Nguyen D; Simpfendorfer CH; Menzo EL; Szomstein S; Rosenthal RJ
[Ad] Endereço:Section of Minimally Invasive Surgery, Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA.
[Ti] Título:Fluorescent incisionless cholangiography as a teaching tool for identification of Calot's triangle.
[So] Source:Surg Endosc;31(6):2483-2490, 2017 Jun.
[Is] ISSN:1432-2218
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Intraoperative incisionless fluorescent cholangiogram (IOIFC) has been demonstrated to be a useful tool to increase the visualization of Calot's triangle. This study evaluates the identification of extrahepatic biliary structures with IOIFC by medical students and surgery residents. METHODS: Two pictures were taken, one with xenon light and one with near-infrared (NIR) light, at the same stage during dissection of Calot's triangle in ten different cases of laparoscopic cholecystectomy (LC). All twenty pictures were organized in a random fashion to remove any imagery bias. Twenty students and twenty residents were asked to identify the biliary anatomy. RESULTS: Medical students were able to accurately identify the cystic duct on an average 33.8 % under the xenon light versus 86 % under NIR light (p = 0.0001), the common hepatic duct (CHD) on an average 19 % under the xenon light versus 88.5 % under NIR light (p = 0.0001), and the junction on an average 24 % under xenon light versus 80.5 % under NIR light (p = 0.0001). Surgery residents were able to accurately identify the cystic duct on an average 40 % under the xenon light versus 99 % under NIR light (p = 0.0001), the CHD on an average 35 % under the xenon light versus 96 % under NIR light (p = 0.0001), and the junction on an average 24 % under the xenon light versus 95.5 % under NIR light (p = 0.0001). CONCLUSIONS: IOIFC increases the visualization of Calot's triangle structures when compared to xenon light. IOIFC may be a useful teaching tool in residency programs to teach LC.
[Mh] Termos MeSH primário: Artérias/diagnóstico por imagem
Doenças dos Ductos Biliares/cirurgia
Colangiografia/métodos
Ducto Cístico/diagnóstico por imagem
Fluoroscopia/métodos
Ducto Hepático Comum/diagnóstico por imagem
Imagem Óptica/métodos
[Mh] Termos MeSH secundário: Colecistectomia Laparoscópica
Corantes/administração & dosagem
Ducto Cístico/irrigação sanguínea
Seres Humanos
Cuidados Intraoperatórios
Iluminação/métodos
Erros Médicos/prevenção & controle
Xenônio
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Coloring Agents); 3H3U766W84 (Xenon)
[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:161026
[St] Status:MEDLINE
[do] DOI:10.1007/s00464-016-5250-x


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[PMID]:29245291
[Au] Autor:Liu Y; Wu L; Chen Y; Li D; Jiang J; Zhong W; Cao Y
[Ad] Endereço:aDepartment of Emergency Medicine, West China Hospital, Sichuan University, ChengdubDepartment of Emergency MedicinecDepartment of Hepatobiliary Surgery, Affiliated Hospital of Southwest Medical UniversitydDepartment of Gastroenterology, Luzhou People's HospitaleDepartment of Vascular Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China.
[Ti] Título:Delayed diagnosis of abdominal pain in patient with situs inversus totalis in emergency department: A case report.
[So] Source:Medicine (Baltimore);96(49):e9028, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Abdominal pain is one of the most common complaints for patients in emergency department. It's difficult to make an accurate diagnosis by emergency physician in time, especially in patients with situs inversus totalis. PATIENT CONCERNS: A patient with acute exacerbation of chronic left upper quadrant abdominal pain.DIAGNOSES:: cholangiolithiasis with situs inversus totalis. INTERVENTIONS: laparoscopic cholecystectomy and laparoscopic exploration of common bile duct. OUTCOMES: The patient had an uneventful recovery. LESSONS: High suspicion and adequate evaluation are important for diagnosis in patients with abdominal pain and situs inversus totalis in emergency department, and physical examination, electrocardiogrphy and radiological investigations are necessary.
[Mh] Termos MeSH primário: Dor Abdominal/etiologia
Doenças dos Ductos Biliares/complicações
Litíase/complicações
Situs Inversus/complicações
Situs Inversus/diagnóstico
[Mh] Termos MeSH secundário: Doenças dos Ductos Biliares/cirurgia
Diagnóstico Tardio
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Litíase/cirurgia
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009028


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[PMID]:28930036
[Au] Autor:Gupta V; Jayaraman S
[Ad] Endereço:From the Division of General Surgery, University of Toronto, Toronto, Ont.
[Ti] Título:Role for laparoscopy in the management of bile duct injuries.
[So] Source:Can J Surg;60(5):300-304, 2017 Sep.
[Is] ISSN:1488-2310
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury; this literature has not been reviewed. We reviewed the literature on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this review with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries. Intraoperatively, CBD injury can be prevented in the case of short cystic duct with the use of a loop ligature or transfixing suture, and it can be diagnosed using intraoperative cholangiography or other visualization techniques. When CBD injury is suspected postoperatively, repeat laparoscopy can be used to control sepsis with abdominal washout; as a diagnostic tool to guide management; and, in some settings, as a therapeutic tool for suturing small duct leaks, drain insertion and postoperative endoscopic retrograde cholangiopancreatography with sphincterotomy. Definitive laparoscopic repair is possible when certain criteria are met. Open surgery should be considered when the CBD is small, the injury occurred more than 72 hours previously, injury or anatomy are complex, port positioning is awkward for repair, or local experience is limited with laparoscopic management. There is an emerging role for laparoscopy in the management of CBD injuries. More case reports and series are needed to show the safety and efficacy of this technique, encourage its wider adoption, and allow outcomes assessment on a larger scale.
[Mh] Termos MeSH primário: Doenças dos Ductos Biliares/diagnóstico
Doenças dos Ductos Biliares/terapia
Ductos Biliares/lesões
Laparoscopia/métodos
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/terapia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170921
[St] Status:MEDLINE


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[PMID]:28885366
[Au] Autor:Zhao Z; Bao L; Yu X; Zhu C; Xu J; Wang Y; Yin M; Li Y; Li W
[Ad] Endereço:aDepartment of Infectious Disease, Third Liver Unit bDepartment of Ear-Nose-Throat, Anhui Provincial Hospital, Anhui Medical University, Hefei cDepartment of Infectious Disease, Jiangsu Provincial Hospital, Nanjing Medical University, Nanjing dDepartment of Infectious Disease, Intensive Care Unit, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
[Ti] Título:Acute vanishing bile duct syndrome after therapy with cephalosporin, metronidazole, and clotrimazole: A case report.
[So] Source:Medicine (Baltimore);96(36):e8009, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Vanishing bile duct syndrome (VBDS) consists of a series of diseases characterized by the loss of >50% bile duct in portal areas. Many factors are associated with VBDS including infections, neoplasms, and drugs. Antibiotic is one of the most frequently reported causes of VBDS. PATIENT CONCERNS: A 29-year-old female was admitted because of liver injury for over 3 months. Tests for viruses that can cause hepatitis and autoantibodies were all negative. She was prescribed with antibiotics approximately a week before liver injury while there was no history of alcohol consumption. DIAGNOSES: Liver biopsy demonstrated a loss of intrahepatic bile duct in most of the portal tracts. INTERVENTIONS: This patient was treated with ursodeoxycholic acid, polyene phosphatidylcholine, and bicyclol. Most importantly, the treatments in our hospital were proved by the ethics committee of Department of Infectious Disease, Anhui Provincial Hospital. OUTCOMES: The symptoms were improved. She is still under treatment. LESSONS: VBDS is rare but can be severe. A liver biopsy offers an important evidence for the diagnosis of VBDS, especially for those with a history of susceptible drugs taking.
[Mh] Termos MeSH primário: Antibacterianos/efeitos adversos
Doenças dos Ductos Biliares/induzido quimicamente
Ductos Biliares Intra-Hepáticos/efeitos dos fármacos
Cefalosporinas/efeitos adversos
Clotrimazol/efeitos adversos
Metronidazol/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/uso terapêutico
Doenças dos Ductos Biliares/patologia
Ductos Biliares Intra-Hepáticos/patologia
Cefalosporinas/uso terapêutico
Clotrimazol/uso terapêutico
Quimioterapia Combinada
Feminino
Seres Humanos
Metronidazol/uso terapêutico
Síndrome
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cephalosporins); 140QMO216E (Metronidazole); G07GZ97H65 (Clotrimazole)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008009


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[PMID]:28859949
[Au] Autor:Fujiki M; Hashimoto K; Palaios E; Quintini C; Aucejo FN; Uso TD; Eghtesad B; Miller CM
[Ad] Endereço:Department of General Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH. Electronic address: fujikim@ccf.org.
[Ti] Título:Probability, management, and long-term outcomes of biliary complications after hepatic artery thrombosis in liver transplant recipients.
[So] Source:Surgery;162(5):1101-1111, 2017 Nov.
[Is] ISSN:1532-7361
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hepatic artery thrombosis after liver transplantation is a devastating complication associated with ischemic cholangiopathy that can occur even after successful revascularization. This study explores long-term outcomes after hepatic artery thrombosis in adult liver transplantation recipients, focusing on the probability, risk factors, and resolution of ischemic cholangiopathy. METHODS: A retrospective chart review of 1,783 consecutive adult liver transplantations performed between 1995 and 2014 identified 44 cases of hepatic artery thrombosis (2.6%); 10 patients underwent immediate retransplantation, and 34 patients received nontransplant treatments, involving revascularization (n = 19) or expectant nonrevascularization management (n = 15). RESULTS: The 1-year graft survival after nontransplant treatment was favorable (82%); however, 16 of the 34 patients who received a nontransplant treatment developed ischemic cholangiopathy and required long-term biliary intervention. A Cox regression model showed that increased serum transaminase and bilirubin levels at the time of hepatic artery thrombosis diagnosis, but not nonrevascularization treatment versus revascularization, were risk factors for the development of ischemic cholangiopathy. Ischemic cholangiopathy in revascularized grafts was less extensive with a greater likelihood of resolution within 5-years than that in nonrevascularized grafts (100% vs 17%). Most liver abscesses without signs of liver failure also were reversible. Salvage retransplantation after a nontransplant treatment was performed in 8 patients with a 1-year survival rate equivalent to immediate retransplantation (88% vs 80%). CONCLUSION: Selective nontransplant treatments for hepatic artery thrombosis resulted in favorable graft survival. Biliary intervention can resolve liver abscess and ischemic cholangiopathy that developed in revascularized grafts in the long-term; salvage retransplantation should be considered for ischemic cholangiopathy in nonrevascularized grafts because of a poor chance of resolution.
[Mh] Termos MeSH primário: Doenças dos Ductos Biliares/terapia
Artéria Hepática
Falência Hepática/cirurgia
Transplante de Fígado/efeitos adversos
Trombose/terapia
[Mh] Termos MeSH secundário: Adulto
Doenças dos Ductos Biliares/etiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Reoperação
Estudos Retrospectivos
Trombose/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE


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[PMID]:28823571
[Au] Autor:Bhalla A; Mann SA; Chen S; Cummings OW; Lin J
[Ad] Endereço:Indiana University, Department of Pathology and Laboratory Medicine, Indianapolis, IN, USA. 46202.
[Ti] Título:Histopathological evidence of neoplastic progression of von Meyenburg complex to intrahepatic cholangiocarcinoma.
[So] Source:Hum Pathol;67:217-224, 2017 Sep.
[Is] ISSN:1532-8392
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Von Meyenburg complex (VMC) is generally thought to be benign, although its preneoplastic potential for intrahepatic cholangiocarcinoma (iCC) has been a subject of contention. We retrospectively reviewed 86 hepatectomy specimens with a diagnosis of iCC. Morphologically, an association between iCC and VMC was appreciated in 35% of cases that illustrated a gradual neoplastic progression from benign VMC to dysplasia and then to iCC. Among them, 24 cases had VMC lined by epithelial cells with low-grade biliary dysplasia and 13 with high-grade biliary dysplasia. VMC-associated iCCs were smaller in size and well to moderately differentiated, with features of anastomosing glandular architecture, ductal carcinoma in situ-like growth pattern, peritumoral lymphocytic infiltrate, central fibrous scar, and complete pushing border. They often presented as T1 tumors. In contrast, non-VMC-associated iCCs were moderately to poorly differentiated with solid, cribriform or papillary growth patterns. They likely exhibited necrosis, perineural invasion, positive surgical margin, lymphovascular invasion, and high T stage. Additionally, Ki67 and p53 immunostains support the continuing neoplastic evolution from benign VMC to dysplasia and then to iCC. VMC could become neoplastic, serving as an in situ carcinoma lesion to transform to iCC. The underlying molecular alteration and clinical implication of this neoplastic transformation deserves further investigation.
[Mh] Termos MeSH primário: Doenças dos Ductos Biliares/patologia
Neoplasias dos Ductos Biliares/patologia
Carcinoma in Situ/patologia
Transformação Celular Neoplásica/patologia
Colangiocarcinoma/patologia
Lesões Pré-Cancerosas/patologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doenças dos Ductos Biliares/cirurgia
Neoplasias dos Ductos Biliares/química
Neoplasias dos Ductos Biliares/cirurgia
Biomarcadores Tumorais/análise
Biópsia
Carcinoma in Situ/química
Carcinoma in Situ/cirurgia
Diferenciação Celular
Proliferação Celular
Transformação Celular Neoplásica/química
Colangiocarcinoma/química
Colangiocarcinoma/cirurgia
Progressão da Doença
Feminino
Hepatectomia
Seres Humanos
Imuno-Histoquímica
Masculino
Meia-Idade
Gradação de Tumores
Estadiamento de Neoplasias
Lesões Pré-Cancerosas/química
Lesões Pré-Cancerosas/cirurgia
Estudos Retrospectivos
Carga Tumoral
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170822
[St] Status:MEDLINE


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[PMID]:28526690
[Au] Autor:Fabris L; Spirli C; Cadamuro M; Fiorotto R; Strazzabosco M
[Ad] Endereço:Department of Molecular Medicine, University of Padua School of Medicine, Padua, Italy; luca.fabris@unipd.it.
[Ti] Título:Emerging concepts in biliary repair and fibrosis.
[So] Source:Am J Physiol Gastrointest Liver Physiol;313(2):G102-G116, 2017 Aug 01.
[Is] ISSN:1522-1547
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Chronic diseases of the biliary tree (cholangiopathies) represent one of the major unmet needs in clinical hepatology and a significant knowledge gap in liver pathophysiology. The common theme in cholangiopathies is that the target of the disease is the biliary tree. After damage to the biliary epithelium, inflammatory changes stimulate a reparative response with proliferation of cholangiocytes and restoration of the biliary architecture, owing to the reactivation of a variety of morphogenetic signals. Chronic damage and inflammation will ultimately result in pathological repair with generation of biliary fibrosis and clinical progression of the disease. The hallmark of pathological biliary repair is the appearance of reactive ductular cells, a population of cholangiocyte-like epithelial cells of unclear and likely mixed origin that are able to orchestrate a complex process that involves a number of different cell types, under joint control of inflammatory and morphogenetic signals. Several questions remain open concerning the histogenesis of reactive ductular cells, their role in liver repair, their mechanism of activation, and the signals exchanged with the other cellular elements cooperating in the reparative process. This review contributes to the current debate by highlighting a number of new concepts derived from the study of the pathophysiology of chronic cholangiopathies, such as congenital hepatic fibrosis, biliary atresia, and Alagille syndrome.
[Mh] Termos MeSH primário: Doenças dos Ductos Biliares/patologia
Hepatopatias/patologia
[Mh] Termos MeSH secundário: Animais
Sistema Biliar/patologia
Fibrose/patologia
Seres Humanos
Fígado/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170521
[St] Status:MEDLINE
[do] DOI:10.1152/ajpgi.00452.2016


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[PMID]:28403110
[Au] Autor:Imanishi M; Ogura T; Kurisu Y; Onda S; Takagi W; Okuda A; Miyano A; Amano M; Nishioka N; Masuda D; Higuchi K
[Ad] Endereço:aSecond Department of Internal Medicine, Osaka Medical College bDepartment of Pathology, Osaka Medical College, Osaka Japan.
[Ti] Título:A feasibility study of digital single-operator cholangioscopy for diagnostic and therapeutic procedure (with videos).
[So] Source:Medicine (Baltimore);96(15):e6619, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recently, the novel SpyGlass DS Direct Visualization system (SPY DS) has become available. This system offers several advantages over the conventional SPYGlass system. This study evaluated the clinical feasibility and efficacy of diagnostic and therapeutic procedures for biliary disorder using SPY DS.In this retrospective study, consecutive patients who had biliary disorder were enrolled between November 2015 and February 2016. All patients could not be diagnosed or treated by standard endoscopic retrograde cholangiopancreatography in our hospital or at another hospital.A total of 28 consecutive patients (21 men and 7 women; median age, 73 years; age range, 55-87 years) were retrospectively enrolled in this study. Among them, diagnostic procedure was performed in 20 patients, and 8 patients underwent therapeutic procedures. The technical success rate for diagnostic procedures was 100% (20/20). Diagnostic accuracy was 100% (19/19). The technical success rate for therapeutic procedures was 88% (7/8). Among these 8 patients, 4 patients with common bile duct stones underwent electrohydraulic lithotripsy. One patient successfully underwent guidewire insertion to remove a migrated plastic stent. The 3 remaining patients underwent SPY DS to insert a guidewire for left bile duct obstruction and for posterior bile duct branch. In the patient who underwent guidewire insertion for left hepatic bile duct obstruction cause by primary sclerosing cholangitis, we could not advance the guidewire into the left hepatic bile duct. No adverse events were seen. Median SPY DS insertion time was 21 min (range, 8-32 min).Single-operator cholangioscopy using SPY DS was feasible and had a marked clinical impact in patients with biliary disease. Additional case reports and prospective studies are needed to examine further applications of this system.
[Mh] Termos MeSH primário: Doenças dos Ductos Biliares/diagnóstico
Doenças dos Ductos Biliares/cirurgia
Procedimentos Cirúrgicos do Sistema Biliar/instrumentação
Colangiografia/instrumentação
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Ductos Biliares/cirurgia
Procedimentos Cirúrgicos do Sistema Biliar/métodos
Colangiografia/métodos
Desenho de Equipamento
Estudos de Viabilidade
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170430
[Lr] Data última revisão:
170430
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006619



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