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[PMID]:28399849
[Au] Autor:Wiggers JK; van Golen RF; Verheij J; Dekker AM; van Gulik TM; Heger M
[Ad] Endereço:Department of Surgery, Surgical Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. jim.wiggers@gmail.com.
[Ti] Título:Atorvastatin does not protect against ischemia-reperfusion damage in cholestatic rat livers.
[So] Source:BMC Surg;17(1):35, 2017 Apr 11.
[Is] ISSN:1471-2482
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Extrahepatic cholestasis sensitizes the liver to ischemia/reperfusion (I/R) injury during surgery for perihilar cholangiocarcinoma. It is associated with pre-existent sterile inflammation, microvascular perfusion defects, and impaired energy status. Statins have been shown to protect against I/R injury in normal and steatotic mouse livers. Therefore, the hepatoprotective properties of atorvastatin were evaluated in a rat model of cholestatic I/R injury. METHODS: Male Wistar rats were subjected to 70% hepatic ischemia (during 30 min) at 7 days after bile duct ligation. Rats were randomized to atorvastatin treatment or vehicle-control in three test arms: (1) oral treatment with 5 mg/kg during 7 days after bile duct ligation; (2) intravenous treatment with 2.5, 5, or 7.5 mg/kg at 24 h before ischemia; and (3) intravenous treatment with 5 mg/kg at 30 min before ischemia. Hepatocellular damage was assessed by plasma alanine aminotransferase (ALT) and histological necrosis. RESULTS: I/R induced severe hepatocellular injury in the cholestatic rat livers (~10-fold increase in ALT at 6 h after I/R and ~30% necrotic areas at 24 h after I/R). Both oral and intravenous atorvastatin treatment decreased ALT levels before ischemia. Intravenous atorvastatin treatment at 5 mg/kg at 24 h before ischemia was the only regimen that reduced ALT levels at 6 h after reperfusion, but not at 24 h after reperfusion. None of the tested regimens were able to reduce histological necrosis at 24 h after reperfusion. CONCLUSION: Pre-treatment with atorvastatin did not protect cholestatic livers from hepatocellular damage after I/R. Clinical studies investigating the role of statins in the protection against hepatic I/R injury should not include cholestatic patients with perihilar cholangiocarcinoma. These patients require (pharmacological) interventions that specifically target the cholestasis-associated hepatopathology.
[Mh] Termos MeSH primário: Atorvastatina Cálcica/uso terapêutico
Colestase Extra-Hepática/complicações
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
Fígado/patologia
Complicações Pós-Operatórias/prevenção & controle
Substâncias Protetoras/uso terapêutico
Traumatismo por Reperfusão/prevenção & controle
[Mh] Termos MeSH secundário: Administração Oral
Animais
Ductos Biliares/cirurgia
Esquema de Medicação
Injeções Intravenosas
Ligadura
Masculino
Necrose/etiologia
Necrose/prevenção & controle
Complicações Pós-Operatórias/etiologia
Distribuição Aleatória
Ratos
Ratos Wistar
Traumatismo por Reperfusão/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Protective Agents); 48A5M73Z4Q (Atorvastatin Calcium)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170522
[Lr] Data última revisão:
170522
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1186/s12893-017-0235-9


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[PMID]:27741030
[Au] Autor:Walter D; van Boeckel PG; Groenen MJ; Weusten BL; Witteman BJ; Tan G; Brink MA; Nicolai J; Tan AC; Alderliesten J; Venneman NG; Laleman W; Jansen JM; Bodelier A; Wolters FL; van der Waaij LA; Breumelhof R; Peters FT; Scheffer RC; Steyerberg EW; May AM; Leenders M; Hirdes MM; Vleggaar FP; Siersema PD
[Ad] Endereço:aDepartment of Gastroenterology and Hepatology bJulius Center for Health Sciences and Primary Care, University Medical Center cDepartment of Gastroenterology and Hepatology, Diakonessen Hospital, Utrecht dDepartment of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem eDepartment of Gastroenterology and Hepatology, St Antonius Hospital, Nieuwegein fDepartment of Gastroenterology and Hepatology, Gelderse Vallei Hospital, Ede gDepartment of Gastroenterology and Hepatology, Zorg Groep Twente, Hengelo hDepartment of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort iDepartment of Gastroenterology and Hepatology, Haga Hospital, Den Haag jDepartment of Gastroenterology and Hepatology, Canisius Wilhelmina Hospital, Nijmegen kDepartment of Gastroenterology and Hepatology, Albert Schweitzer Hospital, Dordrecht lDepartment of Gastroenterology and Hepatology, Medisch Spectrum Twente, Enschede mDepartment of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam nDepartment of Gastroenterology and Hepatology, Amphia Hospital, Breda oDepartment of Gastroenterology and Hepatology, VieCuri Hospital, Venlods pDepartment of Gastroenterology and Hepatology, Martini Hospital qDepartment of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen rDepartment of Gastroenterology and Hepatology, Jeroen Bosch Hospital, Den Bosch sDepartment of Decision Analysis, Erasmus University Medical Center, Rotterdam, The Netherlands tDepartment of Gastroenterology and Hepatology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.
[Ti] Título:Higher quality of life after metal stent placement compared with plastic stent placement for malignant extrahepatic bile duct obstruction: a randomized controlled trial.
[So] Source:Eur J Gastroenterol Hepatol;29(2):231-237, 2017 Feb.
[Is] ISSN:1473-5687
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: For palliation of extrahepatic bile duct obstruction, self-expandable metal stents (SEMS) are superior to plastic stents in terms of stent patency and occurrence of stent dysfunction. We assessed health-related quality of life (HRQoL) after stent placement to investigate whether this also results in a difference in HRQoL between patients treated with a plastic stent or SEMS. PATIENTS AND METHODS: This randomized multicenter trial included 219 patients who were randomized to receive plastic stent (n=73) or SEMS [uncovered (n=75) and covered (n=71); n=146] placement. HRQoL was assessed with two general questionnaires (EQ-5D-3L and QLQ-C30) and one disease-specific questionnaire (PAN-26). Scores were analyzed using linear mixed model regression and included all patients with baseline and at least one follow-up measurement. RESULTS: HRQoL data were available in 140 of 219 patients (64%); 71 patients (32%) declined participation and in eight patients (4%) only baseline questionnaires were available. On the QLQ-C30, the interaction between follow-up time and type of stent was significantly different on two of five functional scales [physical functioning (P=0.004) and emotional functioning (P=0.01)] in favor of patients with a SEMS. In addition, patients with SEMS reported significantly less frequent symptoms of fatigue (P=0.01), loss of appetite (P=0.02), and nausea and vomiting (0.04) over time. The EQ-VAS score decreased with time in both treatment groups, indicating a statistically significant decrease in HRQoL over time. CONCLUSION: In patients with inoperable malignant extrahepatic bile duct obstruction, SEMS placement results in better scores for general and disease-specific HRQoL over time compared with plastic stent placement.
[Mh] Termos MeSH primário: Colangiopancreatografia Retrógrada Endoscópica/métodos
Colestase Extra-Hepática/cirurgia
Plásticos
Qualidade de Vida
Stents Metálicos Autoexpansíveis
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Colestase Extra-Hepática/etiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Cuidados Paliativos
Neoplasias Pancreáticas/complicações
Neoplasias Pancreáticas/patologia
Stents
Inquéritos e Questionários
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Plastics)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161015
[St] Status:MEDLINE
[do] DOI:10.1097/MEG.0000000000000762


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[PMID]:27566055
[Au] Autor:Choi JH; Kim HW; Lee JC; Paik KH; Seong NJ; Yoon CJ; Hwang JH; Kim J
[Ad] Endereço:Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
[Ti] Título:Percutaneous transhepatic versus EUS-guided gallbladder drainage for malignant cystic duct obstruction.
[So] Source:Gastrointest Endosc;85(2):357-364, 2017 Feb.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has been proposed as an alternative management strategy for acute cholecystitis caused by malignant cystic duct obstruction in patients for whom surgery is not an option. This study aimed to compare the results of EUS-GBD with those of percutaneous transhepatic gallbladder drainage (PTGBD) for palliative management of malignant cystic duct obstruction with acute cholecystitis or symptomatic gallbladder hydrops. METHODS: Between November 2013 and November 2015, 14 patients with acute cholecystitis or symptomatic gallbladder hydrops as a result of malignant cystic duct obstruction underwent EUS-GBD with covered metal stents. Nineteen patients with acute cholecystitis as a result of malignant cystic duct obstruction who received PTGBD served as a control group. Patients' medical records were reviewed retrospectively. RESULTS: The technical and clinical success rates of EUS-GBD were 85.7% (12/14) and 91.7% (11/12) and of PTGBD were 100% (19/19) and 86.4% (17/19), respectively. The groups had similar adverse event rates (28.5% and 21.1%, respectively). The average duration of stent patency in patients with EUS-GBD was 130.3 ± 35.3 days, and no patient required an additional procedure before death. In 6 of 17 patients (35.3%) with clinically successful PTGBD, the catheter was not removed until the end stage of life. CONCLUSIONS: EUS-GBD is a feasible, safe, and effective modality for the treatment of malignant cystic duct obstruction in patients who are not indicated for surgery. It enables improved long-term quality of life in patients with advanced-stage cancer.
[Mh] Termos MeSH primário: Colecistite Aguda/cirurgia
Colestase Extra-Hepática/cirurgia
Ducto Cístico
Drenagem/métodos
Vesícula Biliar/cirurgia
Stents
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Neoplasias dos Ductos Biliares/complicações
Carcinoma Hepatocelular/complicações
Colangiocarcinoma/complicações
Colecistite Aguda/etiologia
Colestase Extra-Hepática/etiologia
Neoplasias do Ducto Colédoco/complicações
Endossonografia
Feminino
Neoplasias da Vesícula Biliar/complicações
Seres Humanos
Tumor de Klatskin/complicações
Neoplasias Hepáticas/complicações
Masculino
Meia-Idade
Neoplasias Pancreáticas/complicações
Estudos Retrospectivos
Cirurgia Assistida por Computador
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160828
[St] Status:MEDLINE


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[PMID]:27795771
[Au] Autor:Badji N; Akpo G; Deme H; Toure MH; Ly M; Ndong B; Niang EH
[Ad] Endereço:Service de Radiologie Générale du CHU Aristide Le Dantec, Dakar, Sénégal.
[Ti] Título:[Role of biliary MRI in etiological diagnosis of cholestatic icteruses in Dakar].
[Ti] Título:Place de la bili-IRM dans le diagnostic etiologique des icteres cholestatiques à Dakar..
[So] Source:Pan Afr Med J;24:174, 2016.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Biliary MRI is a relatively new diagnostic test in the arsenal of exploration techniques in biliopancreatic pathology. This is a reproducible and reliable non invasive technique for direct visualization of biliary and pancreatic ducts. This study aims to evaluate the morphological features of major abnormalities and the role of biliary MRI in the etiological diagnosis of cholestatic icteruses. This is a retrospective study of 17 patients conducted in the Imaging Unit of the University Hospital of Fann and of the Principal hospital of Dakar over a period of 4 years and six months (January 2008 at July 2012). All patients underwent MRI (1.5T) according to the standardized protocols for the explored pathology. Only medical records of patients whose diagnosis was established based on laboratory tests and who underwent biliary MRI and surgical exploration were retained. The study involved 5 women and 12 men with a sex ratio of 2.4. The average age of patients was 58 years, ranging between 35 and 81 years. Klatskin tumors were found in 7 patients with infiltrative form in 71% of cases and exophytic form was found in 28% of cases. Cancers of the gallbladder were found in 28% of cases. Cancers in the head of the pancreas accounted for 28% of cases. Major bile duct lithiasis was detected in 5 patients, choledocholithiasis in 60% of cases and a single lithiasis in 40% of cases. All these lesions were responsible for an expansion of intrahepatic bile duct (IHBD). One case of intra and extrahepatic bile ducts dilatation was found without biliopancreatic cause. Biliary MRI is the test of choice for the exploration of cholestatic icteruses. It should be recommended as first-line examination when residual lithiasis is suspected and as second-line examination after ultrasound, when the latter shows a suspected bile ducts tumoral obstruction. Its association with CT scan is the best combination of screening tests for etiologic diagnosis and pre-operative assessment of tumoral biliary obstructions.
[Mh] Termos MeSH primário: Colestase Extra-Hepática/diagnóstico por imagem
Colestase Intra-Hepática/diagnóstico por imagem
Icterícia Obstrutiva/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Neoplasias dos Ductos Biliares/diagnóstico por imagem
Neoplasias dos Ductos Biliares/patologia
Colestase Extra-Hepática/patologia
Colestase Intra-Hepática/patologia
Feminino
Neoplasias da Vesícula Biliar/diagnóstico por imagem
Neoplasias da Vesícula Biliar/patologia
Seres Humanos
Icterícia Obstrutiva/etiologia
Icterícia Obstrutiva/patologia
Tumor de Klatskin/diagnóstico por imagem
Tumor de Klatskin/patologia
Masculino
Meia-Idade
Neoplasias Pancreáticas/diagnóstico por imagem
Neoplasias Pancreáticas/patologia
Estudos Retrospectivos
Senegal
[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:161101
[St] Status:MEDLINE


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[PMID]:27664884
[Au] Autor:Sen A; Ozkan S; Recebova K; Cevik O; Ercan F; Kervancioglu Demirci E; Bitis L; Sener G
[Ad] Endereço:Department of Pharmacognosy, School of Pharmacy, Marmara University, Istanbul, Turkey.
[Ti] Título:Effects of Myrtus communis extract treatment in bile duct ligated rats.
[So] Source:J Surg Res;205(2):359-367, 2016 Oct.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of our study was to investigate the antifibrotic and antioxidant effects of Myrtus communis subsp. communis (MC) extract against liver injury and fibrosis occurring in rats with biliary obstruction. MATERIALS AND METHODS: The rats were randomized into four groups (n = 8). Control group (C), MC-administrated group (MC), the bile duct ligation (BDL), and BDL + MC groups. MC was administered at a dose of 50 mg/kg a day orally for 28 days. In blood samples, total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase levels, tumor necrosis factor-α, and interleukin-1ß measurement were measured. Oxidative injury was examined by measuring luminol and lucigenin chemiluminescence, malondialdehyde and glutathione levels, superoxide dismutase and myeloperoxidase activities. Transforming growth factor-beta and hydroxyproline levels were measured for analyzing fibrosis. The hepatic injury was also analyzed microscopically. RESULTS: Plasma total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase, tumor necrosis factor-α, and interleukin-1ß levels were found significantly high in the BDL group, while these values significantly decreased in the BDL group treated with MC. On the other hand, the glutathione and superoxide dismutase values significantly decreased in the BDL group compared to the control group but increased markedly in BDL + MC group compared to the BDL group. Malondialdehyde levels, myeloperoxidase activity, tissue luminol, lucigenin, transforming growth factor-beta, and hydroxyproline levels when compared with the control group increased dramatically in the BDL group and reduced the MC + BDL group. CONCLUSIONS: Our results suggest that MC protects the liver tissues against oxidative damage following BDL via its radical scavenging and antioxidant activities, which appear to involve the inhibition of tissue neutrophil infiltration.
[Mh] Termos MeSH primário: Colestase Extra-Hepática/complicações
Insuficiência Hepática/prevenção & controle
Cirrose Hepática/prevenção & controle
Myrtus
Fitoterapia
Extratos Vegetais/uso terapêutico
Substâncias Protetoras/uso terapêutico
[Mh] Termos MeSH secundário: Administração Oral
Animais
Ductos Biliares Extra-Hepáticos/cirurgia
Biomarcadores/metabolismo
Esquema de Medicação
Insuficiência Hepática/etiologia
Ligadura
Fígado/efeitos dos fármacos
Fígado/metabolismo
Fígado/patologia
Cirrose Hepática/etiologia
Cirrose Hepática/patologia
Infiltração de Neutrófilos/efeitos dos fármacos
Estresse Oxidativo/efeitos dos fármacos
Extratos Vegetais/farmacologia
Substâncias Protetoras/farmacologia
Distribuição Aleatória
Ratos
Ratos Wistar
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Plant Extracts); 0 (Protective Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170806
[Lr] Data última revisão:
170806
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160925
[St] Status:MEDLINE


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[PMID]:27383832
[Au] Autor:Yuan ZQ; Li KW
[Ad] Endereço:Department of Biliary-Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
[Ti] Título:Role of farnesoid X receptor in cholestasis.
[So] Source:J Dig Dis;17(8):501-509, 2016 Aug.
[Is] ISSN:1751-2980
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:The nuclear receptor farnesoid X receptor (FXR) plays an important role in physiological bile acid synthesis, secretion and transport. Defects of FXR regulation in these processes can cause cholestasis and subsequent pathological changes. FXR regulates the synthesis and uptake of bile acid via enzymes. It also increases bile acid solubility and elimination by promoting conjugation reactions and exports pump expression in cholestasis. The changes in bile acid transporters are involved in cholestasis, which can result from the mutations of transporter genes or acquired dysfunction of transport systems, such as inflammation-induced intrahepatic cholestasis. The modulation function of FXR in extrahepatic cholestasis is not identical to that in intrahepatic cholestasis, but the discrepancy may be reduced over time. In extrahepatic cholestasis, increasing biliary pressure can induce bile duct proliferation and bile infarcts, but the absence of FXR may ameliorate them. This review provides an update on the function of FXR in the regulation of bile acid metabolism, its role in the pathophysiological process of cholestasis and the therapeutic use of FXR agonists.
[Mh] Termos MeSH primário: Colestase/metabolismo
Receptores Citoplasmáticos e Nucleares/fisiologia
[Mh] Termos MeSH secundário: Ácidos e Sais Biliares/metabolismo
Colestase/tratamento farmacológico
Colestase Extra-Hepática/tratamento farmacológico
Colestase Extra-Hepática/metabolismo
Colestase Intra-Hepática/tratamento farmacológico
Colestase Intra-Hepática/metabolismo
Seres Humanos
Terapia de Alvo Molecular/métodos
Receptores Citoplasmáticos e Nucleares/agonistas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Bile Acids and Salts); 0 (Receptors, Cytoplasmic and Nuclear); 0 (farnesoid X-activated receptor)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170502
[Lr] Data última revisão:
170502
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160708
[St] Status:MEDLINE
[do] DOI:10.1111/1751-2980.12378


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[PMID]:27363632
[Au] Autor:Liu X; Yang Z; Tan H; Shao C; Liu L; Si S; Xu L; Sun Y
[Ad] Endereço:Department of Hepatobiliary Surgery, China-Japan Friendship Hospital, Beijing, China.
[Ti] Título:Differentiation of benign and malignant hilar bile duct stenosis.
[So] Source:J Surg Res;203(2):275-82, 2016 Jun 15.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Failure to differentiate benign and malignant hilar bile duct stenosis may lead to inappropriate treatment. We retrospectively analyzed the methods for differentiation. MATERIALS AND METHODS: A total of 53 patients with hilar bile duct stenosis were included, comprising 41 malignant cases (hilar cholangiocarcinoma) and 12 benign cases (six primary sclerosing cholangitis and six IgG4-associated sclerosing cholangitis). Data of clinical histories, laboratory tests, imaging studies, and liver pathologies were collected, and comparison was made between benign and malignant groups. RESULTS: Compared with malignant group, patients in the benign group were more likely to have multiorgan involvement of clinical histories (P < 0.001). There was no difference on bilirubin, liver enzyme, and serum tumor marker between the two groups, whereas serum IgG4 levels were higher in the benign group (P = 0.003). Patients in the benign group were more likely to have pancreatic changes (P < 0.001) and multiple-segmental bile duct stenosis (P < 0.001) on imaging. Compared with the malignant group, patients in the benign group were more likely to show severe periportal inflammation in noninvolved liver (P < 0.001), fibrosis around intrahepatic bile duct (P < 0.001), and more IgG4-positive plasma cells (P < 0.001) on liver pathology. CONCLUSIONS: Benign lesion should be considered for patients with history of multiorgan involvement, pancreas changes, or multiple-segmental bile duct stenosis on imaging. Liver biopsy could be helpful for differential diagnosis before surgery.
[Mh] Termos MeSH primário: Neoplasias dos Ductos Biliares/diagnóstico
Ductos Biliares Extra-Hepáticos
Colangite Esclerosante/diagnóstico
Colestase Extra-Hepática/etiologia
Tumor de Klatskin/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias dos Ductos Biliares/complicações
Colangite Esclerosante/complicações
Diagnóstico Diferencial
Feminino
Seres Humanos
Tumor de Klatskin/complicações
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170621
[Lr] Data última revisão:
170621
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160702
[St] Status:MEDLINE


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[PMID]:27106653
[Au] Autor:Hu Z; Patel N; Butani D
[Ad] Endereço:Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642.
[Ti] Título:External Biliary Conduit for Occlusion of an Endobiliary Stent in Malignant Biliary Obstruction: A Nonsurgical Solution.
[So] Source:J Vasc Interv Radiol;27(5):770-3, 2016 May.
[Is] ISSN:1535-7732
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Neoplasias dos Ductos Biliares/secundário
Carcinoma de Células Escamosas/secundário
Colestase Extra-Hepática/terapia
Drenagem/instrumentação
Neoplasias Primárias Desconhecidas/patologia
Falha de Prótese
Stents
[Mh] Termos MeSH secundário: Neoplasias dos Ductos Biliares/complicações
Carcinoma de Células Escamosas/complicações
Colestase Extra-Hepática/diagnóstico por imagem
Colestase Extra-Hepática/etiologia
Seres Humanos
Masculino
Meia-Idade
Retratamento
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170327
[Lr] Data última revisão:
170327
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160424
[St] Status:MEDLINE


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[PMID]:27097771
[Au] Autor:Rew SJ; Lee DH; Park CH; Jeon J; Kim HS; Choi SK; Rew JS
[Ad] Endereço:Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
[Ti] Título:Comparison of intraductal ultrasonography-directed and cholangiography-directed endoscopic retrograde biliary drainage in patients with a biliary obstruction.
[So] Source:Korean J Intern Med;31(5):872-9, 2016 Sep.
[Is] ISSN:2005-6648
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIMS: Endoscopic retrograde biliary drainage (ERBD) has become a standard procedure in patients with a biliary obstruction. Intraductal ultrasonography (IDUS) has emerged as a new tool for managing extrahepatic biliary diseases. IDUS-directed ERBD can be performed without conventional cholangiography (CC). The goal of this study was to assess the effectiveness and safety of IDUS-directed ERBD compared to CC-directed ERBD in patients with an extrahepatic biliary obstruction. METHODS: A total of 210 patients who had undergone IDUS-directed ERBD (IDUS-ERBD, n = 105) and CC-directed ERBD (CC-ERBD, n = 105) between October 2013 and April 2014 were analyzed retrospectively. The primary outcome measure was the procedural success rate. Secondary outcome measures included clinical outcomes, total procedure time, radiation exposure time, and overall complication rates. RESULTS: The total technical success rate of ERBD was 100% (105/105) in the IDUS-ERBD and CC-ERBD groups. Mean procedure time was slightly prolonged in the IDUS-ERBD group than that in the CC-ERBD group (32.1 ± 9.9 minutes vs. 28.4 ± 11.6 minutes, p = 0.023). Mean radiation exposure time was one-third less in the IDUS-ERBD group than that in the CC-ERBD group (28.0 ± 49.3 seconds vs. 94.2 ± 57.3 seconds, p < 0.001). No significant differences in complication rates were detected between the groups. CONCLUSIONS: IDUS-ERBD was equally effective and safe as CC-ERBD in patients with an extrahepatic biliary obstruction. Although IDUS-ERBD increased total procedure time, it significantly decreased radiation exposure.
[Mh] Termos MeSH primário: Colestase Extra-Hepática/diagnóstico por imagem
Colestase Extra-Hepática/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Colangiografia
Colangiopancreatografia Retrógrada Endoscópica
Drenagem/métodos
Endossonografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160422
[St] Status:MEDLINE
[do] DOI:10.3904/kjim.2015.291


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Fotocópia
[PMID]:27059976
[Au] Autor:Tomoda T; Tsutsumi K; Kato H; Mizukawa S; Yabe S; Akimoto Y; Seki H; Uchida D; Matsumoto K; Yamamoto N; Horiguchi S; Okada H
[Ad] Endereço:Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama, 700-8558, Japan. tomotake79@yahoo.co.jp.
[Ti] Título:Outcomes of management for biliary stricture after living donor liver transplantation with hepaticojejunostomy using short-type double-balloon enteroscopy.
[So] Source:Surg Endosc;30(12):5338-5344, 2016 Dec.
[Is] ISSN:1432-2218
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: To evaluate the outcomes of management for biliary stricture (BS) after living donor liver transplantation (LDLT) using short-type double-balloon enteroscopy. METHODS: This study retrospectively evaluated 20 patients who underwent endoscopic retrograde cholangiography using short-type double-balloon enteroscopy (sDB-ERC) upon suspicion of BS after LDLT with hepaticojejunal (HJ) reconstruction at Okayama University Hospital. RESULTS: Scope insertion to the HJ site and sDB-ERC succeeded in 85 % (17/20) and 82.4 % (14/17) of patients, respectively. Of 14 patients who required treatment for BS, 11 were successfully treated using sDB-ERC, and 3 were successfully treated using sDB-ERC and rendezvous procedures. Adverse events occurred in 2.9 % of all sessions (2/68). After resolution of BS, 7 patients (50 %) experienced a recurrence. Of these, 6 (85.7 %) were treated with only balloon dilation, and 1 (14.3 %) was treated with both balloon dilation and stent deployment (P = 0.029). CONCLUSIONS: sDB-ERC is a useful procedure for diagnosis and treatment for BS after LDLT with HJ reconstruction. Balloon dilation combined with stent deployment might be recommended for definite resolution of BS.
[Mh] Termos MeSH primário: Colestase Extra-Hepática/terapia
Enteroscopia de Duplo Balão/métodos
Ducto Hepático Comum/cirurgia
Jejuno/cirurgia
Transplante de Fígado/métodos
Doadores Vivos
Complicações Pós-Operatórias/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Anastomose Cirúrgica
Criança
Pré-Escolar
Colestase Extra-Hepática/etiologia
Enteroscopia de Duplo Balão/instrumentação
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Recidiva
Estudos Retrospectivos
Stents
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160410
[St] Status:MEDLINE



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