China
Africa
Explore chapters and articles related to this topic
Liver, Biliary Tract and Pancreatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Liver histology, rarely required to make a diagnosis, shows a lymphocytic infiltration around damaged middle-sized intrahepatic bile ducts or their remnants. It is useful where there is doubt about the diagnosis (e.g. when AMA and other PBC-specific antibodies are negative) or when there is suspicion of an overlap syndrome (as with RBC/autoimmune hepatitis [AIH] overlap).
Paper 1
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
An abdominal ultrasound in a 5 year old girl finds hepatomegaly with increased periportal echogenicity and reversal of hepatic venous flow. There are dilated intrahepatic bile ducts. The gallbladder and pancreas have normal appearances. The spleen is enlarged. The kidneys are enlarged bilaterally and echogenic with reduction in corticomedullary differentiation.
ABC Transporters, Organic Solute Carriers and Drug Metabolising Enzymes in Bile Duct Epithelial Cells
Published in Gianfranco Alpini, Domenico Alvaro, Marco Marzioni, Gene LeSage, Nicholas LaRusso, The Pathophysiology of Biliary Epithelia, 2020
Intrahepatic bile ducts are not simple conduits for the bile that is produced by the hepatocytes. In fact, bile composition is significandy modified in the intrahepatic bile ducts. Here, water and bicarbonate are added and glucose, various amino acids, bile salts and drugs are reabsorbed. This reabsorption of biliary constituents contributes to the efficiency with which the organism deals with its substrates. Reabsorption of glucose conserves energy and reabsorption of glutamate conserves an amino acid for resynthesis to glutathione.1
Open hepatic artery flow with portal vein clamping protects against bile duct injury compared to pringles maneuver
Published in Scandinavian Journal of Gastroenterology, 2023
Siliang Zhang, Pingli Cao, Pinduan Bi, Fu Yang, Ming Wu, Ding Luo, Bin Yang
Immunohistochemistry was performed in 4 μm thick sections. The sections were deparaffinized and endogenous peroxidase activity was blocked by a 30-min incubation in methanolic hydrogen peroxide (2.5%). Later, the endogenous biotin was blocked by a biotin blocking system (MXB Biotechnologies, China) according to the manufacturer’s instructions. The sections were then hydrated in graded alcohol and rinsed in 1× PBS (pH 7.4) before applying the selected primary antibody. Sections were incubated overnight at 4 °C with primary antibodies including rabbit polyclonal anti-Ki67 (1:200, 27309, Proteintech, China), rabbit polyclonal anti-caspase 3 (1:200, 19677, Proteintech, China). The following day, samples were rinsed with PBS for 5 min, then followed the manufacturer’s instructions of using MaxvisionTM2 HRP-Polymer anti-Mouse/Rabbit IHC Kit (MXB Biotechnologies, China). Negative controls were performed for all immunoreactions to confirm the specificity of immunoreaction. At least 10 different portal areas (from 3 different sections) were evaluated. The intrahepatic bile duct was evaluated using light microscopy (DM6000B, Leica, Germany).
Efficacy of a dedicated plastic stent in endoscopic ultrasound-guided hepaticogastrostomy during the learning curve: cumulative multi-center experience
Published in Scandinavian Journal of Gastroenterology, 2023
Koh Kitagawa, Akira Mitoro, Ryuki Minami, Shinsaku Nagamatsu, Takahiro Ozutsumi, Yukihisa Fujinaga, Norihisa Nishimura, Yasuhiko Sawada, Tadashi Namisaki, Takemi Akahane, Kosuke Kaji, Fumimasa Tomooka, Shohei Asada, Miki Kaneko, Hitoshi Yoshiji
Transpapillary drainage via endoscopic retrograde cholangiopancreatography (ERCP) is performed to relieve biliary obstructions [1–3]. However, even at high-volume centers, there are a certain number of failed ERCP procedures. For example, in cases where the gastro-duodenal tract is stenotic because of pancreatic–biliary neoplasms, it may not be possible to perform ERCP given that the scope cannot reach the duodenal papilla. Additionally, although ERCP with a balloon-assisted endoscope is useful [4–8], surgically altered anatomy cases require expertise. Endoscopic ultrasound-guided biliary drainage (EUS-BD) [9] has been reported to be useful for difficult ERCP cases [9–14]. The anastomosis of the stomach to the intrahepatic bile duct (IHBD) via EUS-BD is called EUS-guided hepaticogastrostomy (EUS-HGS) [10,11]. However, the rate of adverse events (AEs) is high at non-expert centers [15]; hence, extra care is needed when learning EUS-HGS [16]. There are few reports on the learning curve of EUS-HGS, and challenges remain in terms of the safe introduction of the procedure.
Pharmaceutical suspensions of ursodeoxycholic acid for pediatric patients: in vitro and in vivo studies
Published in Pharmaceutical Development and Technology, 2021
Oriana Boscolo, Leandro Salvo, Cecilia Dobrecky, Eliana N. Fissore, Fabian Buontempo, Valeria Tripodi, Silvia E. Lucangioli
Ursodeoxycholic acid (UDCA) (3α, 7β-dihydroxy-5β-cholan-24-oic acid), or ursodiol is approved as therapeutic agent for hepatobiliary disorders. Treatment with oral UDCA ameliorates histological features of liver diseases and restores the biochemical parameters in preschoolers and children with a diversity of cholestatic disorders (Setchell et al. 2005), such as benign recurrent intrahepatic cholestasis, progressive familiar intrahepatic cholestasis, biliary atresia, Alagille syndrome, bile acid synthesis impairment causing cholestasis inborn, long-term parenteral nutrition and cystic fibrosis-associated liver disease. Primary biliary cholangitis pathology (Melchor-Mendoza et al. 2017; Lindor et al. 2019) is an autoimmune type disease in which the progressive destruction of the intrahepatic bile ducts that can cause biliary cirrhosis, portal inflammation and finally liver failure. Up to 2016, UDCA was the only drug granted approval by the U.S. Food and Drug Administration for treatment of primary biliary cholangitis. In this case, UDCA administration improves survival without transplantation and is consequently the preliminary drug of choice for this pathology (Melchor-Mendoza et al. 2017; Lindor et al. 2019).