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Role of Plant-Based Medicines for Gallstones
Published in Megh R. Goyal, Preeti Birwal, Durgesh Nandini Chauhan, Herbs, Spices, and Medicinal Plants for Human Gastrointestinal Disorders, 2023
Vivek Kumar, Anju Dhiman, Pooja Chawla, Viney Chawla
Almost 75% of the gallstones are composed of cholesterol and rest of these are of black and brown pigments. The brown pigmented (5%) stones are composed of calcium bilirubinate, mucin glycoproteins and calcium soaps (such as calcium palmitate and calcium stearate). Soft and greasy type gallstones generally occur in bile ducts due to infections, such as biliary obstruction and biliary tract infestation (such as Ascaris, Opisthorchis viverrini and Clinor chussinesis).31,32 The black pigmented (20%) stones are composed of bilirubin pigment mixed with calcium carbonate, phosphate, and cholesterol.
Hepatic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Ghassan M. Hammoud, Jamal A. Ibdah
The incidence of gallstones during pregnancy is estimated to be 3% to 12%; however, symptomatic gallstones occur in only 1.2% of these pregnancies (58). Hormonal changes during pregnancy, altered gallbladder motility, and increased cholesterol secretion are major predisposing factors for the development of gallstones and biliary sludge. The commonest clinical presentations are biliary pain and gallstone pancreatitis and the least common is acute cholecystitis. The management of symptomatic uncomplicated biliary tract disease is usually conservative. In patients with symptomatic choledocholithiasis, endoscopic management using endoscopic retrograde cholangiopancreatography (ERCP) is an alternative option. Since fluoroscopy poses a radiation risk to the fetus, abdominal shield to the pregnant patient should be provided. Laparoscopic cholecystectomy can be performed safely during pregnancy with no maternal mortality, although spontaneous abortions and preterm labor have been reported.
Liver Diseases
Published in George Feuer, Felix A. de la Iglesia, Molecular Biochemistry of Human Disease, 2020
George Feuer, Felix A. de la Iglesia
Our present knowledge of the mechanism of bile secretion is still limited due to the wide anatomic variations of the biliary tract and marked differences in bile composition and flow.168,545 Nevertheless, some diseases show causal relationship with the loss of hepatic secretory function.297 Jaundice is a manifestation of hepatic disease due to the failure of bile secretory activity. Changes in bile secretion and composition as caused by liver injury produce various types of jaundice. These changes are also important in the pathogenesis of gallstones.
Emerging treatment strategies in hepatobiliary cancer
Published in Expert Review of Anticancer Therapy, 2023
Deniz Can Guven, Hasan Cagri Yildirim, Elvin Chalabiyev, Fatih Kus, Feride Yilmaz, Serkan Yasar, Arif Akyildiz, Burak Yasin Aktas, Suayib Yalcin, Omer Dizdar
Cholangiocarcinoma arises from the biliary tract epithelium. Primary sclerosing cholangitis, biliary stone disease, and biliary tract infections are recognized risk factors for cholangiocarcinoma [7]. According to their location, they can be categorized as intrahepatic or extrahepatic. The most prevalent type is extrahepatic. Extrahepatic tumors are further classified as hilar (pCCA) (sometimes referred to as Klatskin tumors), and distal extrahepatic cholangiocarcinoma (dCCA) [8,9]. In contrast to GBC, the eCCA presents with obstructive jaundice earlier in the disease course [6], while iCCA is generally diagnosed very late due to nonspecific symptoms. Patients with iCCA have higher rates of FGFR fusions and IDH-1 mutations, while HER2/3 amplifications are more frequent in eCCAs [6].
Type 1 Choledochal Cyst with Ectopic Pancreas and Septate Gallbladder
Published in Fetal and Pediatric Pathology, 2022
Amir-Hossein Akbari, Juan Putra
Choledochal cysts (CCs) are cystic dilatation of the biliary tract which result from congenital developmental abnormalities of the bile duct system (1). The frequency on CCs is 1 in 100,000–150,000 live births in western population (1). They are 4 times more common in females than males (1). CCs are classified based on the anatomical location of biliary duct dilation into 5 types (I–V) (2). The most common type is type I (50–80%), followed by types IV (15–35%), V (20%), III (4.5%) and II (2%) (2). Clinically, CCs present as right upper quadrant mass, abdominal pain and occasionally jaundice (3). Complications include pancreatitis, cholangitis, spontaneous rupture of cyst and cholangiocarcinoma (reported in 5–10% of the cases) (4, 5). The mainstay of treatment is complete surgical resection (5). CCs are associated with a myriad of different developmental anomalies such as colonic atresia, duodenal atresia, multiseptated gallbladder, and pancreatic divisum (6–11). To our knowledge there is only one published case of co-occurrence of CCs with ectopic pancreas and septate gallbladder (8). Here we present the clinicopathologic findings of another case demonstrating this co-occurrence.
The effect of cholecystectomy on the risk of acute myocardial infarction in patients with gallbladder stones
Published in Postgraduate Medicine, 2021
Chien-Hua Chen, Cheng-Li Lin, Chia-Hung Kao
Gallbladder stones (GBS) account for the most common disease of outpatient visits in gastrointestinal department globally, and it has been reported that about 85% of the patients with biliary tract stones harbor gallbladder stones (GBS) [6]. Moreover, the epidemiological studies have reported that prevalence of GBS for adult Taiwanese ranges between 5% and 10% [7,8]. Prophylactic cholecystectomy is not clinically indicated since approximately 80% of patients with GBS will remain asymptomatic in their lifetimes and only 1.5% of patients with symptomatic GBS will develop biliary complications, such as cholecystitis, cholangitis, and pancreatitis [9,10]. In addition to biliary complications, GBS has been reportedly related to the development of CAD through the pathogenesis of shared risk factors, common pathophysiology of cholesterol accumulation, dysbiosis with the resultants of lithogenic bile acid secretion and vascular inflammation, or the oxidative stress imposed by GBS [11,12]. However, debate remains to determine whether GBS is a causal factor or an epiphenomenon of CAD [13].