The channels that collect and transport the bile secretion from the BILE CANALICULI, the smallest branch of the BILIARY TRACT in the LIVER, through the bile ductules, the bile ducts out the liver, and to the GALLBLADDER for storage.
Passages within the liver for the conveyance of bile. Includes right and left hepatic ducts even though these may join outside the liver to form the common hepatic duct.
The largest bile duct. It is formed by the junction of the CYSTIC DUCT and the COMMON HEPATIC DUCT.
An emulsifying agent produced in the LIVER and secreted into the DUODENUM. Its composition includes BILE ACIDS AND SALTS; CHOLESTEROL; and ELECTROLYTES. It aids DIGESTION of fats in the duodenum.
Tumors or cancer of the BILE DUCTS.
Diseases in any part of the ductal system of the BILIARY TRACT from the smallest BILE CANALICULI to the largest COMMON BILE DUCT.
Passages external to the liver for the conveyance of bile. These include the COMMON BILE DUCT and the common hepatic duct (HEPATIC DUCT, COMMON).
Impairment of bile flow due to injury to the HEPATOCYTES; BILE CANALICULI; or the intrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC).
Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones.
A malignant tumor arising from the epithelium of the BILE DUCTS.
Impairment of bile flow due to obstruction in small bile ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS).
Diseases of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
A type of surgical portasystemic shunt to reduce portal hypertension with associated complications of esophageal varices and ascites. It is performed percutaneously through the jugular vein and involves the creation of an intrahepatic shunt between the hepatic vein and portal vein. The channel is maintained by a metallic stent. The procedure can be performed in patients who have failed sclerotherapy and is an additional option to the surgical techniques of portocaval, mesocaval, and splenorenal shunts. It takes one to three hours to perform. (JAMA 1995;273(23):1824-30)
A benign tumor of the intrahepatic bile ducts.
An imaging test of the BILIARY TRACT in which a contrast dye (RADIOPAQUE MEDIA) is injected into the BILE DUCT and x-ray pictures are taken.
Solid crystalline precipitates in the BILIARY TRACT, usually formed in the GALLBLADDER, resulting in the condition of CHOLELITHIASIS. Gallstones, derived from the BILE, consist mainly of calcium, cholesterol, or bilirubin.
Fiberoptic endoscopy designed for duodenal observation and cannulation of VATER'S AMPULLA, in order to visualize the pancreatic and biliary duct system by retrograde injection of contrast media. Endoscopic (Vater) papillotomy (SPHINCTEROTOMY, ENDOSCOPIC) may be performed during this procedure.
Predominantly extrahepatic bile duct which is formed by the junction of the right and left hepatic ducts, which are predominantly intrahepatic, and, in turn, joins the cystic duct to form the common bile duct.
Ducts that collect PANCREATIC JUICE from the PANCREAS and supply it to the DUODENUM.
Impairment of bile flow in the large BILE DUCTS by mechanical obstruction or stricture due to benign or malignant processes.
Tumor or cancer of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances.
The duct that is connected to the GALLBLADDER and allows the emptying of bile into the COMMON BILE DUCT.
Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS).
Inflammation of the biliary ductal system (BILE DUCTS); intrahepatic, extrahepatic, or both.
Any surgical procedure performed on the biliary tract.
Jaundice, the condition with yellowish staining of the skin and mucous membranes, that is due to impaired BILE flow in the BILIARY TRACT, such as INTRAHEPATIC CHOLESTASIS, or EXTRAHEPATIC CHOLESTASIS.
The largest lymphatic vessel that passes through the chest and drains into the SUBCLAVIAN VEIN.
Diseases in any part of the BILIARY TRACT including the BILE DUCTS and the GALLBLADDER.
Application of a ligature to tie a vessel or strangulate a part.
Excision of the gallbladder through an abdominal incision using a laparoscope.
Surgical removal of the GALLBLADDER.
A storage reservoir for BILE secretion. Gallbladder allows the delivery of bile acids at a high concentration and in a controlled manner, via the CYSTIC DUCT to the DUODENUM, for degradation of dietary lipid.
A short thick vein formed by union of the superior mesenteric vein and the splenic vein.
Presence or formation of GALLSTONES in the COMMON BILE DUCT.
Incision of Oddi's sphincter or Vater's ampulla performed by inserting a sphincterotome through an endoscope (DUODENOSCOPE) often following retrograde cholangiography (CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE). Endoscopic treatment by sphincterotomy is the preferred method of treatment for patients with retained or recurrent bile duct stones post-cholecystectomy, and for poor-surgical-risk patients that have the gallbladder still present.
Minute intercellular channels that occur between liver cells and carry bile towards interlobar bile ducts. Also called bile capillaries.
Non-invasive diagnostic technique for visualizing the PANCREATIC DUCTS and BILE DUCTS without the use of injected CONTRAST MEDIA or x-ray. MRI scans provide excellent sensitivity for duct dilatation, biliary stricture, and intraductal abnormalities.
FIBROSIS of the hepatic parenchyma due to obstruction of BILE flow (CHOLESTASIS) in the intrahepatic or extrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC; BILE DUCTS, EXTRAHEPATIC). Primary biliary cirrhosis involves the destruction of small intra-hepatic bile ducts and bile secretion. Secondary biliary cirrhosis is produced by prolonged obstruction of large intrahepatic or extrahepatic bile ducts from a variety of causes.
Tumors or cancer of the LIVER.
Any of the ducts which transport saliva. Salivary ducts include the parotid duct, the major and minor sublingual ducts, and the submandibular duct.
Excision of all or part of the liver. (Dorland, 28th ed)
A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum.
Progressive destruction or the absence of all or part of the extrahepatic BILE DUCTS, resulting in the complete obstruction of BILE flow. Usually, biliary atresia is found in infants and accounts for one third of the neonatal cholestatic JAUNDICE.
Pathological processes of the LIVER.
Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN.
Abnormal passage in any organ of the biliary tract or between biliary organs and other organs.
A condition characterized by the formation of CALCULI and concretions in the hollow organs or ducts of the body. They occur most often in the gallbladder, kidney, and lower urinary tract.
Tumors or cancer in the BILIARY TRACT including the BILE DUCTS and the GALLBLADDER.
A congenital anatomic malformation of a bile duct, including cystic dilatation of the extrahepatic bile duct or the large intrahepatic bile duct. Classification is based on the site and type of dilatation. Type I is most common.
An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic.
Linear TETRAPYRROLES that give a characteristic color to BILE including: BILIRUBIN; BILIVERDIN; and bilicyanin.
A dilation of the duodenal papilla that is the opening of the juncture of the COMMON BILE DUCT and the MAIN PANCREATIC DUCT, also known as the hepatopancreatic ampulla.
A tool for the study of liver damage which causes bile stasis and hyperbilirubinemia acutely and bile duct hyperplasia and biliary cirrhosis chronically, with changes in hepatocyte function. It may cause skin and kidney damage.
Gastrointestinal agents that stimulate the flow of bile into the duodenum (cholagogues) or stimulate the production of bile by the liver (choleretic).
A clinical manifestation of HYPERBILIRUBINEMIA, characterized by the yellowish staining of the SKIN; MUCOUS MEMBRANE; and SCLERA. Clinical jaundice usually is a sign of LIVER dysfunction.
Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules.
The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
A pair of excretory ducts of the middle kidneys (MESONEPHROI) of an embryo, also called mesonephric ducts. In higher vertebrates, Wolffian ducts persist in the male forming VAS DEFERENS, but atrophy into vestigial structures in the female.
Surgical formation of an opening (stoma) into the COMMON BILE DUCT for drainage or for direct communication with a site in the small intestine, primarily the DUODENUM or JEJUNUM.
Chronic inflammatory disease of the BILIARY TRACT. It is characterized by fibrosis and hardening of the intrahepatic and extrahepatic biliary ductal systems leading to bile duct strictures, CHOLESTASIS, and eventual BILIARY CIRRHOSIS.
A bile pigment that is a degradation product of HEME.
The product of conjugation of cholic acid with taurine. Its sodium salt is the chief ingredient of the bile of carnivorous animals. It acts as a detergent to solubilize fats for absorption and is itself absorbed. It is used as a cholagogue and cholerectic.
The sphincter of the hepatopancreatic ampulla within the duodenal papilla. The COMMON BILE DUCT and main pancreatic duct pass through this sphincter.
Tumors or cancer of the gallbladder.
Adenocarcinoma of the common hepatic duct bifurcation. These tumors are generally small, sharply localized, and seldom metastasizing. G. Klatskin's original review of 13 cases was published in 1965. Once thought to be relatively uncommon, tumors of the bifurcation of the bile duct now appear to comprise more than one-half of all bile duct cancers. (From Holland et al., Cancer Medicine, 3d ed, p1457)
The transference of a part of or an entire liver from one human or animal to another.
A pair of ducts near the WOLFFIAN DUCTS in a developing embryo. In the male embryo, they degenerate with the appearance of testicular ANTI-MULLERIAN HORMONE. In the absence of anti-mullerian hormone, mullerian ducts give rise to the female reproductive tract, including the OVIDUCTS; UTERUS; CERVIX; and VAGINA.
Veins which drain the liver.
Retrograde bile flow. Reflux of bile can be from the duodenum to the stomach (DUODENOGASTRIC REFLUX); to the esophagus (GASTROESOPHAGEAL REFLUX); or to the PANCREAS.
The circulation of BLOOD through the LIVER.
INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis.
Surgical formation of an opening through the ABDOMINAL WALL into the JEJUNUM, usually for enteral hyperalimentation.
Any fluid-filled closed cavity or sac that is lined by an EPITHELIUM. Cysts can be of normal, abnormal, non-neoplastic, or neoplastic tissues.
A primary malignant neoplasm of epithelial liver cells. It ranges from a well-differentiated tumor with EPITHELIAL CELLS indistinguishable from normal HEPATOCYTES to a poorly differentiated neoplasm. The cells may be uniform or markedly pleomorphic, or form GIANT CELLS. Several classification schemes have been suggested.
The main structural component of the LIVER. They are specialized EPITHELIAL CELLS that are organized into interconnected plates called lobules.
Congenital cystic dilatation of the intrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC). It consists of 2 types: simple Caroli disease is characterized by bile duct dilatation (ectasia) alone; and complex Caroli disease is characterized by bile duct dilatation with extensive hepatic fibrosis and portal hypertension (HYPERTENSION, PORTAL). Benign renal tubular ectasia is associated with both types of Caroli disease.
The condition of an anatomical structure's being dilated beyond normal dimensions.
Blood tests that are used to evaluate how well a patient's liver is working and also to help diagnose liver conditions.
A system of vessels in which blood, after passing through one capillary bed, is conveyed through a second set of capillaries before it returns to the systemic circulation. It pertains especially to the hepatic portal system.
Surgical venous shunt between the portal and systemic circulation to effect decompression of the portal circulation. It is performed primarily in the treatment of bleeding esophageal varices resulting from portal hypertension. Types of shunt include portacaval, splenorenal, mesocaval, splenocaval, left gastric-caval (coronary-caval), portarenal, umbilicorenal, and umbilicocaval.
A major primary bile acid produced in the liver and usually conjugated with glycine or taurine. It facilitates fat absorption and cholesterol excretion.
Experimentally induced chronic injuries to the parenchymal cells in the liver to achieve a model for LIVER CIRRHOSIS.
Infection of the biliary passages with CLONORCHIS SINENSIS, also called Opisthorchis sinensis. It may lead to inflammation of the biliary tract, proliferation of biliary epithelium, progressive portal fibrosis, and sometimes bile duct carcinoma. Extension to the liver may lead to fatty changes and cirrhosis. (From Dorland, 27th ed)
The 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholanic acid family of bile acids in man, usually conjugated with glycine or taurine. They act as detergents to solubilize fats for intestinal absorption, are reabsorbed by the small intestine, and are used as cholagogues and choleretics.
A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones.
A bile acid formed from chenodeoxycholate by bacterial action, usually conjugated with glycine or taurine. It acts as a detergent to solubilize fats for absorption and is itself absorbed. It is used as cholagogue and choleretic.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
A Y-shaped surgical anastomosis of any part of the digestive system which includes the small intestine as the eventual drainage site.
Straight tubes commencing in the radiate part of the kidney cortex where they receive the curved ends of the distal convoluted tubules. In the medulla the collecting tubules of each pyramid converge to join a central tube (duct of Bellini) which opens on the summit of the papilla.
The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is LITHOTRIPSY, LASER.
Histochemical localization of immunoreactive substances using labeled antibodies as reagents.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body.
Instruments for the visual examination of interior structures of the body. There are rigid endoscopes and flexible fiberoptic endoscopes for various types of viewing in ENDOSCOPY.
Tomography using x-ray transmission and a computer algorithm to reconstruct the image.
A tubular duct that conveys TEARS from the LACRIMAL GLAND to the nose.
Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.
Diseases of the GALLBLADDER. They generally involve the impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, neoplasms, or other diseases.
The condition of an anatomical structure's being constricted beyond normal dimensions.
Inflammation of the GALLBLADDER; generally caused by impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, or other diseases.
A condition in which the hepatic venous outflow is obstructed anywhere from the small HEPATIC VEINS to the junction of the INFERIOR VENA CAVA and the RIGHT ATRIUM. Usually the blockage is extrahepatic and caused by blood clots (THROMBUS) or fibrous webs. Parenchymal FIBROSIS is uncommon.
Paired ducts in the human male through which semen is ejaculated into the urethra.
An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones.
A radiopharmaceutical used extensively in cholescintigraphy for the evaluation of hepatobiliary diseases. (From Int Jrnl Rad Appl Inst 1992;43(9):1061-4)
A bile acid formed by bacterial action from cholate. It is usually conjugated with glycine or taurine. Deoxycholic acid acts as a detergent to solubilize fats for intestinal absorption, is reabsorbed itself, and is used as a choleretic and detergent.
Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.
Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment.
Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.
Surgery of the smooth muscle sphincter of the hepatopancreatic ampulla to relieve blocked biliary or pancreatic ducts.
The venous pressure measured in the PORTAL VEIN.
A benign neoplasm derived from glandular epithelium, in which cystic accumulations of retained secretions are formed. In some instances, considerable portions of the neoplasm, or even the entire mass, may be cystic. (Stedman, 25th ed)
Examination of the portal circulation by the use of X-ray films after injection of radiopaque material.
The excision of the head of the pancreas and the encircling loop of the duodenum to which it is connected.
Endoscopic examination, therapy or surgery of the luminal surface of the duodenum.
Elements of limited time intervals, contributing to particular results or situations.
The act of dilating.
The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers.
A bile salt formed in the liver by conjugation of deoxycholate with taurine, usually as the sodium salt. It is used as a cholagogue and choleretic, also industrially as a fat emulsifier.
A bile salt formed in the liver by conjugation of chenodeoxycholate with taurine, usually as the sodium salt. It acts as detergent to solubilize fats in the small intestine and is itself absorbed. It is used as a cholagogue and choleretic.
A nodular organ in the ABDOMEN that contains a mixture of ENDOCRINE GLANDS and EXOCRINE GLANDS. The small endocrine portion consists of the ISLETS OF LANGERHANS secreting a number of hormones into the blood stream. The large exocrine portion (EXOCRINE PANCREAS) is a compound acinar gland that secretes several digestive enzymes into the pancreatic ductal system that empties into the DUODENUM.
Accumulation or retention of free fluid within the peritoneal cavity.
Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL).
Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body.
A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.
Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.
Recycling through liver by excretion in bile, reabsorption from intestines (INTESTINAL REABSORPTION) into portal circulation, passage back into liver, and re-excretion in bile.
An enzyme that catalyzes the conversion of L-alanine and 2-oxoglutarate to pyruvate and L-glutamate. (From Enzyme Nomenclature, 1992) EC
A subfamily of transmembrane proteins from the superfamily of ATP-BINDING CASSETTE TRANSPORTERS that are closely related in sequence to P-GLYCOPROTEIN. When overexpressed, they function as ATP-dependent efflux pumps able to extrude lipophilic drugs, especially ANTINEOPLASTIC AGENTS, from cells causing multidrug resistance (DRUG RESISTANCE, MULTIPLE). Although P-Glycoproteins share functional similarities to MULTIDRUG RESISTANCE-ASSOCIATED PROTEINS they are two distinct subclasses of ATP-BINDING CASSETTE TRANSPORTERS, and have little sequence homology.
Pathological processes of the PANCREAS.
A subclass of ORGANIC ANION TRANSPORTERS whose transport of organic anions is driven either directly or indirectly by a gradient of sodium ions.
Liver disease caused by infections with parasitic flukes of the genus FASCIOLA, such as FASCIOLA HEPATICA.
The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils.
Endoscopic examination, therapy or surgery of the digestive tract.
One or more layers of EPITHELIAL CELLS, supported by the basal lamina, which covers the inner or outer surfaces of the body.
Fragmentation of CALCULI, notably urinary or biliary, by LASER.
A type II keratin found associated with KERATIN-19 in ductal epithelia and gastrointestinal epithelia.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
A species of trematode flukes of the family Opisthorchidae. Many authorities consider this genus belonging to Opisthorchis. It is common in China and other Asiatic countries. Snails and fish are the intermediate hosts.
The narrow tube connecting the YOLK SAC with the midgut of the EMBRYO; persistence of all or part of it in post-fetal life produces abnormalities, of which the commonest is MECKEL DIVERTICULUM.
The first alpha-globulins to appear in mammalian sera during FETAL DEVELOPMENT and the dominant serum proteins in early embryonic life.
The glycine conjugate of CHOLIC ACID. It acts as a detergent to solubilize fats for absorption and is itself absorbed.
Ultrasonography of internal organs using an ultrasound transducer sometimes mounted on a fiberoptic endoscope. In endosonography the transducer converts electronic signals into acoustic pulses or continuous waves and acts also as a receiver to detect reflected pulses from within the organ. An audiovisual-electronic interface converts the detected or processed echo signals, which pass through the electronics of the instrument, into a form that the technologist can evaluate. The procedure should not be confused with ENDOSCOPY which employs a special instrument called an endoscope. The "endo-" of endosonography refers to the examination of tissue within hollow organs, with reference to the usual ultrasonography procedure which is performed externally or transcutaneously.
An adenocarcinoma containing finger-like processes of vascular connective tissue covered by neoplastic epithelium, projecting into cysts or the cavity of glands or follicles. It occurs most frequently in the ovary and thyroid gland. (Stedman, 25th ed)
A nontoxic radiopharmaceutical that is used in RADIONUCLIDE IMAGING for the clinical evaluation of hepatobiliary disorders in humans.
Establishment of an opening into the gallbladder either for drainage or surgical communication with another part of the digestive tract, usually the duodenum or jejunum.
Severe inability of the LIVER to perform its normal metabolic functions, as evidenced by severe JAUNDICE and abnormal serum levels of AMMONIA; BILIRUBIN; ALKALINE PHOSPHATASE; ASPARTATE AMINOTRANSFERASE; LACTATE DEHYDROGENASES; and albumin/globulin ratio. (Blakiston's Gould Medical Dictionary, 4th ed)
Cells that line the inner and outer surfaces of the body by forming cellular layers (EPITHELIUM) or masses. Epithelial cells lining the SKIN; the MOUTH; the NOSE; and the ANAL CANAL derive from ectoderm; those lining the RESPIRATORY SYSTEM and the DIGESTIVE SYSTEM derive from endoderm; others (CARDIOVASCULAR SYSTEM and LYMPHATIC SYSTEM) derive from mesoderm. Epithelial cells can be classified mainly by cell shape and function into squamous, glandular and transitional epithelial cells.
Infection with flukes of the genus Opisthorchis.
INFLAMMATION of the LIVER in non-human animals.
A peptide hormone of about 27 amino acids from the duodenal mucosa that activates pancreatic secretion and lowers the blood sugar level. (USAN and the USP Dictionary of Drug Names, 1994, p597)
A malignant neoplasm derived from glandular epithelium, in which cystic accumulations of retained secretions are formed. The neoplastic cells manifest varying degrees of anaplasia and invasiveness, and local extension and metastases occur. Cystadenocarcinomas develop frequently in the ovaries, where pseudomucinous and serous types are recognized. (Stedman, 25th ed)
Interference with the secretion of tears by the lacrimal glands. Obstruction of the LACRIMAL SAC or NASOLACRIMAL DUCT causing acute or chronic inflammation of the lacrimal sac (DACRYOCYSTITIS). It is caused also in infants by failure of the nasolacrimal duct to open into the inferior meatus and occurs about the third week of life. In adults occlusion may occur spontaneously or after injury or nasal disease. (Newell, Ophthalmology: Principles and Concepts, 7th ed, p250)
Radiography of the gallbladder after ingestion of a contrast medium.
The part of the membranous labyrinth that traverses the bony vestibular aqueduct and emerges through the bone of posterior cranial fossa (CRANIAL FOSSA, POSTERIOR) where it expands into a blind pouch called the endolymphatic sac.
Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA).
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
A multisystem disorder that is characterized by aplasia of intrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC), and malformations in the cardiovascular system, the eyes, the vertebral column, and the facies. Major clinical features include JAUNDICE, and congenital heart disease with peripheral PULMONARY STENOSIS. Alagille syndrome may result from heterogeneous gene mutations, including mutations in JAG1 on CHROMOSOME 20 (Type 1) and NOTCH2 on CHROMOSOME 1 (Type 2).
A strongly basic anion exchange resin whose main constituent is polystyrene trimethylbenzylammonium Cl(-) anion.
Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM.
Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.
A syndrome characterized by central nervous system dysfunction in association with LIVER FAILURE, including portal-systemic shunts. Clinical features include lethargy and CONFUSION (frequently progressing to COMA); ASTERIXIS; NYSTAGMUS, PATHOLOGIC; brisk oculovestibular reflexes; decorticate and decerebrate posturing; MUSCLE SPASTICITY; and bilateral extensor plantar reflexes (see REFLEX, BABINSKI). ELECTROENCEPHALOGRAPHY may demonstrate triphasic waves. (From Adams et al., Principles of Neurology, 6th ed, pp1117-20; Plum & Posner, Diagnosis of Stupor and Coma, 3rd ed, p222-5)
Operation for biliary atresia by anastomosis of the bile ducts into the jejunum or duodenum.
Organic or functional motility disorder involving the SPHINCTER OF ODDI and associated with biliary COLIC. Pathological changes are most often seen in the COMMON BILE DUCT sphincter, and less commonly the PANCREATIC DUCT sphincter.
A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.
Acute inflammation of the GALLBLADDER wall. It is characterized by the presence of ABDOMINAL PAIN; FEVER; and LEUKOCYTOSIS. Gallstone obstruction of the CYSTIC DUCT is present in approximately 90% of the cases.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
FIBROSIS of the hepatic parenchyma due to chronic excess ALCOHOL DRINKING.
The return of a sign, symptom, or disease after a remission.
A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain.
The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum.
Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept.
Hemorrhage in or through the BILIARY TRACT due to trauma, inflammation, CHOLELITHIASIS, vascular disease, or neoplasms.
A membrane-bound cytochrome P450 enzyme that catalyzes the 7-alpha-hydroxylation of CHOLESTEROL in the presence of molecular oxygen and NADPH-FERRIHEMOPROTEIN REDUCTASE. This enzyme, encoded by CYP7, converts cholesterol to 7-alpha-hydroxycholesterol which is the first and rate-limiting step in the synthesis of BILE ACIDS.
An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC
Pathological conditions in the DUODENUM region of the small intestine (INTESTINE, SMALL).
The visualization of deep structures of the body by recording the reflections or echoes of ultrasonic pulses directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz.
An enzyme, sometimes called GGT, with a key role in the synthesis and degradation of GLUTATHIONE; (GSH, a tripeptide that protects cells from many toxins). It catalyzes the transfer of the gamma-glutamyl moiety to an acceptor amino acid.
A onecut transcription factor that regulates expression of GENES involved in EMBRYONIC DEVELOPMENT of the PANCREAS and LIVER.
A malignant epithelial tumor with a glandular organization.
Solitary or multiple collections of PUS within the liver as a result of infection by bacteria, protozoa, or other agents.
A class of fibrous proteins or scleroproteins that represents the principal constituent of EPIDERMIS; HAIR; NAILS; horny tissues, and the organic matrix of tooth ENAMEL. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms a coiled-coil alpha helical structure consisting of TYPE I KERATIN and a TYPE II KERATIN, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. alpha-Keratins have been classified into at least 20 subtypes. In addition multiple isoforms of subtypes have been found which may be due to GENE DUPLICATION.
Yellow discoloration of the SKIN; MUCOUS MEMBRANE; and SCLERA in the NEWBORN. It is a sign of NEONATAL HYPERBILIRUBINEMIA. Most cases are transient self-limiting (PHYSIOLOGICAL NEONATAL JAUNDICE) occurring in the first week of life, but some can be a sign of pathological disorders, particularly LIVER DISEASES.
RNA sequences that serve as templates for protein synthesis. Bacterial mRNAs are generally primary transcripts in that they do not require post-transcriptional processing. Eukaryotic mRNA is synthesized in the nucleus and must be exported to the cytoplasm for translation. Most eukaryotic mRNAs have a sequence of polyadenylic acid at the 3' end, referred to as the poly(A) tail. The function of this tail is not known for certain, but it may play a role in the export of mature mRNA from the nucleus as well as in helping stabilize some mRNA molecules by retarding their degradation in the cytoplasm.
A solvent for oils, fats, lacquers, varnishes, rubber waxes, and resins, and a starting material in the manufacturing of organic compounds. Poisoning by inhalation, ingestion or skin absorption is possible and may be fatal. (Merck Index, 11th ed)
Functional KIDNEY FAILURE in patients with liver disease, usually LIVER CIRRHOSIS or portal hypertension (HYPERTENSION, PORTAL), and in the absence of intrinsic renal disease or kidney abnormality. It is characterized by intense renal vasculature constriction, reduced renal blood flow, OLIGURIA, and sodium retention.
Surgical portasystemic shunt between the portal vein and inferior vena cava.
Presence or formation of GALLSTONES in the GALLBLADDER.
Perisinusoidal cells of the liver, located in the space of Disse between HEPATOCYTES and sinusoidal endothelial cells.
A family of MEMBRANE TRANSPORT PROTEINS that require ATP hydrolysis for the transport of substrates across membranes. The protein family derives its name from the ATP-binding domain found on the protein.
Repair or renewal of hepatic tissue.
Genetically identical individuals developed from brother and sister matings which have been carried out for twenty or more generations or by parent x offspring matings carried out with certain restrictions. This also includes animals with a long history of closed colony breeding.
Enzymes of the transferase class that catalyze the conversion of L-aspartate and 2-ketoglutarate to oxaloacetate and L-glutamate. EC
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
A genus of trematode liver flukes of the family Opisthorchidae. It consists of the following species: O. felineus, O. noverca (Amphimerus noverca), and O. viverrini. The intermediate hosts are snails, fish, and AMPHIBIANS.
The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.

Lobar decrease in 99mTc-GSA accumulation in hilar cholangiocarcinoma. (1/1066)

Hilar cholangiocarcinoma can obstruct hepatic ducts and involve the portal veins. Both biliary stasis and decrease in portal venous flow are known to reduce 99mTc-diethylenetriamine pentaacetic acid-galactosyl human serum albumin (GSA) accumulation. The specific relationship between these pathological conditions due to hilar cholangiocarcinomas and 99mTc-GSA accumulation has never been clarified. METHODS: Sixteen patients with hilar cholangiocarcinomas who underwent 99mTc-GSA liver scintigraphy were reviewed. The relationship between significant decrease in 99mTc-GSA accumulation and lobar biliary stasis, or decrease in the portal venous flow, was evaluated. Average counts of region of interest placed in both right and left lobes were compared in the same transaxial SPECT section. Count ratios of right and left lobes were calculated. RESULTS: Significant lobar decrease in 99mTc-GSA accumulation was observed in 6 of the 16 patients. Ipsilateral portal venous stenosis or obstruction was seen in all these 6 patients, whereas ipsilateral portal venous stenosis or obstruction was seen in only 1 of the other 10 patients. Symmetric bile duct dilatation was seen in 13 patients, and asymmetric bile duct dilatation was seen in 3. Lobar decrease in 99mTc-GSA accumulation correlated well with decrease in ipsilateral portal venous flow (P < 0.0005). The count ratio was significantly reduced when unilateral portal venous flow decreased (P < 0.05). CONCLUSION: Using 99mTc-GSA liver scintigraphy, we can predict lobar decrease in ipsilateral portal venous flow and monitor hepatic functional lateralities in patients with hilar cholangiocarcinomas.  (+info)

ANIT-induced disruption of biliary function in rat hepatocyte couplets. (2/1066)

alpha-Naphthylisothiocyanate (ANIT) induces intrahepatic cholestasis in rats, involving damage to biliary epithelial cells; our study aims to investigate whether disruption of biliary function in hepatocytes can contribute to early stages of ANIT-induced intrahepatic cholestasis. Isolated rat hepatocyte couplets were used to investigate biliary function in vitro by canalicular vacuolar accumulation (cVA) of a fluorescent bile acid analogue, cholyl-lysyl-fluorescein (CLF), within the canalicular vacuole between the two cells. After a 2-h exposure to ANIT, there was a concentration-dependent inhibition of cVA (cVA-IC50; 25 microM), but no cytotoxicity (LDH leakage or [ATP] decline) within this ANIT concentration range. There was no loss of cellular [GSH] at low ANIT concentrations, but, at 50 microM ANIT, a small but significant loss of [GSH] had occurred. Diethylmaleate (DEM) partially depleted cellular [GSH], but addition of 10 microM ANIT had no further effect on GSH depletion. Reduction in cVA was seen in DEM-treated cells; addition of ANIT to these cells reduced cVA further, but the magnitude of this further reduction was no greater than that caused by ANIT alone, indicating that glutathione depletion does not enhance the effect of ANIT. F-actin distribution (by phalloidin-FITC staining) showed an increased frequency of morphological change in the canalicular vacuoles but only a small, non-significant (0.05 < p < 0.1) increase in proportion of the F-actin in the region of the pericanalicular web. The results are in accord with a disruption of hepatocyte canalicular secretion within two h in vitro, at low, non-cytotoxic concentrations of ANIT, and the possible involvement of a thiocabamoyl-GSH conjugate of ANIT (GS-ANIT) in this effect.  (+info)

Lymph node metastasis in intrahepatic cholangiocarcinoma. (3/1066)

BACKGROUND: Lymph node metastasis is a significant prognostic factor in intrahepatic cholangiocarcinoma. This study was aimed at investigating lymph node metastasis in intrahepatic cholangiocarcinoma and to examine whether the extent of metastasis affects outcomes after surgery. METHODS: From 1980 through 1996, 70 patients with intrahepatic cholangiocarcinoma underwent hepatectomy, with a 50% curative resection rate. Lymph node dissection was performed in 51 patients, and the presence of lymph node metastasis was examined microscopically. The metastatic nodes were divided into groups N1, N2 or N3 using the classification proposed by the Liver Cancer Study Group of Japan. RESULTS: Twenty-three patients had lymph node metastasis. Metastasis was to N1 nodes in 10 patients, to N2 nodes in nine patients and to N3 nodes in four patients. Nineteen patients had metastatic nodes in the hepatoduodenal ligament, which was the most common metastatic site regardless of tumor location. The five-year survival rate in patients with lymph node metastasis (0%) was significantly lower (p < 0.0001) than that in patients without lymph node metastasis (51 %); however, five-year survival rates did not differ between patients with metastases to N1, N2 and N3 nodes. CONCLUSIONS: Lymph nodes in the hepatoduodenal ligament may be sentinel nodes for intrahepatic cholangiocarcinoma, and outcomes after surgery for patients with lymph node metastasis are poor regardless of the sites of nodal metastasis.  (+info)

Promoting effects of 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone on rat glandular stomach carcinogenesis initiated with N-methyl-N'-nitro-N-nitrosoguanidine. (4/1066)

The modifying effects of 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone (MX), a mutagenic by-product in chlorinated water, on the development of glandular stomach cancers were investigated in Wistar rats. A total of 120 males, 6 weeks of age, were divided into six groups. After initiation with 100 ppm N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) solution and 5% NaCl diet for 8 weeks, 30 rats each in groups 1-3 were given MX in the drinking water at concentrations of 30, 10, or 0 ppm for the following 57 weeks. Ten animals each in groups 4-6 were administered the MX without prior carcinogen exposure. There were no statistical significant differences in final body weights between the groups. The incidences and multiplicities of adenocarcinomas in the glandular stomachs were significantly higher (P < 0.05) in the initiated 30 ppm MX group than those in the MNNG/NaCl group. The incidences of atypical hyperplasias in the glandular stomachs were also significantly increased (P < 0.05 or 0.01) by the MX treatments. With their multiplicity, the effects were clearly dose dependent. Interestingly, the 30 ppm MX alone itself induced atypical hyperplasias in the pylorus, although the incidences and severity were low. Moreover, MX showed a tendency to enhance the development of intrahepatic cholangiocellular tumors and thyroid follicular cell tumors in the MNNG-treated animals. The results of the present study thus indicate that MX exerts promoting effects when given during the postinitiation phase of two-stage glandular stomach carcinogenesis in rats.  (+info)

Acute carbon tetrachloride feeding induces damage of large but not small cholangiocytes from BDL rat liver. (5/1066)

Bile duct damage and/or loss is limited to a range of duct sizes in cholangiopathies. We tested the hypothesis that CCl4 damages only large ducts. CCl4 or mineral oil was given to bile duct-ligated (BDL) rats, and 1, 2, and 7 days later small and large cholangiocytes were purified and evaluated for apoptosis, proliferation, and secretion. In situ, we measured apoptosis by morphometric and TUNEL analysis and the number of small and large ducts by morphometry. Two days after CCl4 administration, we found an increased number of small ducts and reduced number of large ducts. In vitro apoptosis was observed only in large cholangiocytes, and this was accompanied by loss of proliferation and secretion in large cholangiocytes and loss of choleretic effect of secretin. Small cholangiocytes de novo express the secretin receptor gene and secretin-induced cAMP response. Consistent with damage of large ducts, we detected cytochrome P-4502E1 (which CCl4 converts to its radicals) only in large cholangiocytes. CCl4 induces selective apoptosis of large ducts associated with loss of large cholangiocyte proliferation and secretion.  (+info)

Expression of p73, a novel protein related to the p53 tumour suppressor p53, and apoptosis in cholangiocellular carcinoma of the liver. (6/1066)

p73, the first homologue of the tumour suppressor protein p53, was recently discovered on chromosome 1p36 and has been shown to induce apoptosis in a p53-like manner. The present study was performed with the aim of investigating the expression of p53, its new homologue p73 and the occurrence of apoptosis in cholangiocellular carcinoma. Protein levels of p73 were examined in 41 patients with curatively (R0-) resected cholangiocellular carcinomas with an antiserum, raised against a peptide in the N-terminal domain of p73. The incidence of mutations in the p53 gene was analysed by direct sequencing and also immunohistochemically. Apoptotic cell death was assessed using in-situ end-labelling (ISEL) technique in combination with morphological criteria. The results obtained were correlated with patient survival. Immunostaining of p73 protein was detected in 17/41 carcinomas examined (41%). The immunoreactivity was confined to the cell nucleus. In 15/41 patients (37%), mutations of the p53 gene were observed. Eleven out of these 15 patients stained also positive for p73. In contrast, out of 26 patients without any detectable p53 mutation, only six exhibited p73 immunostaining. We failed to observe a correlation between p73 expression or p53 and apoptosis within a given tumour. Survival analysis including the parameters stage and grade of disease, p73 and p53, and also apoptosis, showed that tumour stage and grade as well as p53 and p73 were significantly related to prognosis. In Cox regression survival analysis, however, only extent of primary tumour and lymph node status had an independent prognostic impact. Our results with a high prevalence of p73 within tumours harbouring mutated p53 gene suggest that p73 could compensate for p53 function. We failed to establish p73 or p53 as independent prognostic factors in cholangiocellular carcinoma of the liver.  (+info)

Intrahepatic peripheral cholangiocarcinoma: CT features in 18 pathologically proven cases. (7/1066)

OBJECTIVE: To determine the morphological features of 18 pathologically proven intrahepatic peripheral cholangiocarcinoma (IHPCC) cases in computerized tomography (CT) image. METHODS: All 18 patients had CT, using Picker I.Q.T/C and taking pre-contrast continuous 10-mm sections throughout the liver and post-contrast continuous 10-mm sections throughout the focuses. RESULTS: The disease was characterized in CT image by the following: all focuses were found in the periphery of the liver and shown as a lobulated or fused hypodense space-occupying mass; there were one or more divergent or confluent, circular or irregular cystic areas with much lower density, in the majority. All focuses could be enhanced slightly and most revealed a dim edge. Dilated bile ducts around the focus were found frequently; the dilated bile ducts especially seemed to encircle the focus (33.3%, 6/18). This phenomenon were referred to as "encysted sign of dilated bile ducts". CONCLUSIONS: CT scanning should be one of the most important investigative methods for IHPCC due to the disease characteristics identified in CT image, especially "encysted sign of dilated bile ducts" which possesses specificity in diagnosing the disease.  (+info)

Long-lasting sonographic and histopathological findings in cured clonorchiasis of rabbits. (8/1066)

To ascertain residual sonographic and histopathological findings of clonorchiasis after treatment, the present study evaluated sonographic findings in rabbits which were infected with 500 metacercariae of C. sinensis every 6 months for 18 months after treatment with praziquantel. The sonographic findings were analyzed in terms of intrahepatic bile duct dilatation and periductal echogenicity, and histopathological findings were observed after the last sonographic examination. Compared with the sonographic findings before treatment, dilatation of the intrahepatic bile ducts became mild to some degree in four of the seven cases and increased periductal echogenicity resolved in four of them. The histopathological specimens after 18 months showed that periductal inflammation has almost resolved but moderate dilatation of the intrahepatic ducts and mucosal hyperplasia persisted. The periductal fibrosis minimally resolved. The long-lasting sonographic findings in cured clonorchiasis make sonography less specific.  (+info)

TY - JOUR. T1 - Expression of matrix proteinases during human intrahepatic bile duct development. T2 - A possible role in biliary cell migration. AU - Terada, T.. AU - Okada, Y.. AU - Nakanuma, Y.. PY - 1995/1/1. Y1 - 1995/1/1. N2 - Primitive biliary cells are known to migrate from the ductal plate into the mesenchyme during human intrahepatic bile duct development, and this migration process is essential for normal development of intrahepatic bile ducts. However, its molecular mechanism is unknown. Matrix proteinases play an important role in cell migration during cancer invasion and organ development. In this study, we therefore investigated in situ expression of matrix metalloproteinases (MMP) and tissue inhibitors of MMP (TIMP) during human intrahepatic bile duct development, using 32 human fetal livers. We also examined in situ expression of trypsinogen/trypsin, chymotrypsinogen/chymotrypsin, and cathepsin B, which are matrix proteinases and activators of MMP. MMP-1 expression was noted in ...
Libbrecht, Louis ; Desmet, Valeer ; Roskams, Tania. Stages of normal and aberrant intrahepatic bile duct development in a mixed hepatoblastoma.. In: Histopathology, Vol. 42, no.6, p. 618-20 (2003 ...
Human intrahepatic biliary epithelial cells were isolated from the livers of patients with primary biliary cirrhosis and from normal livers and established in primary culture. The in vitro expression of intercellular adhesion molecule-1, HLA class I, and HLA class II on biliary epithelial cells was studied in response to tumour necrosis factor-alpha (0-500 U/ml), interferon-gamma (0-500 U/ml), and interleukin-1 (0-5 U/ml) by immunohistochemical staining and a semiquantitative scoring system validated by spectrophotometry and previously validated by laser confocal microscopy. The non-stimulated expression of intercellular adhesion molecule-1 and HLA class II was higher on cells derived from the primary biliary cirrhosis liver than on cells from normal liver, a difference not seen with HLA class I expression. A statistically significant increase in intercellular adhesion molecule-1 expression was seen with all three cytokines in cells derived from both primary biliary cirrhosis and normal liver. ...
This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patients clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician ...
This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patients clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician ...
Cholangiocyte cytokines stimulate inducible nitric oxide synthase (NOS2) to produce nitric oxide (NO), a known DNA mutagen linked to malignant transformation (5, 13). The generation of NO is also important for bile duct development because it induces Notch1 expression (14, 15). The four Notch genes identified in mammals (Notch 1-4) are expressed in a wide variety of cells and play a significant role in cellular differentiation. The activation of Notch by cell-to-cell interaction causes a transcriptional silencing effect that inhibits differentiation in some cells but not in others (16-18). While the Notch pathway is known to be associated with pancreatic carcinogenesis in rats and humans (19), this same pathway may also have a role in cholangiocarcinogenesis via NOS2.. Cyclooxygenase-2 (prostaglandin-endoperoxide synthase 2, PTGS2) is also implicated in the initiation of malignant cholangiocytes (20). PTGS2 is up-regulated in murine and rat models of biliary adenocarcinoma, while the antisense ...
Hepatitis C virus (HCV) is a variable RNA virus that can readily establish persistent infection. Cellular immune responses are important in the early control of the virus. Evidence from animal models suggests that mutation in epitopes recognized by CD8+ T lymphocytes may play an important role in the establishment of persistence but in human persistent infection, equivalent evidence is lacking. We investigated this by analysing a unique resource: viruses from a set of chronically HCV-infected individuals in whom the CD8+ T-cell responses in liver had previously been accurately mapped. Virus was sequenced in seven individuals at 10 epitopes restricted by 10 human leucocyte antigen (HLA) molecules. Two main patterns emerged: in the majority of epitopes sequenced, no variation was seen. In three epitopes, mutations were identified which were compatible with immune escape as assessed using phylogenetic and/or functional studies. These data suggest that - even where specific intrahepatic T cells are
Hepatitis C virus (HCV) is a variable RNA virus that can readily establish persistent infection. Cellular immune responses are important in the early control of the virus. Evidence from animal models suggests that mutation in epitopes recognized by CD8+ T lymphocytes may play an important role in the establishment of persistence but in human persistent infection, equivalent evidence is lacking. We investigated this by analysing a unique resource: viruses from a set of chronically HCV-infected individuals in whom the CD8+ T-cell responses in liver had previously been accurately mapped. Virus was sequenced in seven individuals at 10 epitopes restricted by 10 human leucocyte antigen (HLA) molecules. Two main patterns emerged: in the majority of epitopes sequenced, no variation was seen. In three epitopes, mutations were identified which were compatible with immune escape as assessed using phylogenetic and/or functional studies. These data suggest that - even where specific intrahepatic T cells are
Hepatitis C virus (HCV) is a variable RNA virus that can readily establish persistent infection. Cellular immune responses are important in the early control of the virus. Evidence from animal models suggests that mutation in epitopes recognized by CD8+ T lymphocytes may play an important role in the establishment of persistence but in human persistent infection, equivalent evidence is lacking. We investigated this by analysing a unique resource: viruses from a set of chronically HCV-infected individuals in whom the CD8+ T-cell responses in liver had previously been accurately mapped. Virus was sequenced in seven individuals at 10 epitopes restricted by 10 human leucocyte antigen (HLA) molecules. Two main patterns emerged: in the majority of epitopes sequenced, no variation was seen. In three epitopes, mutations were identified which were compatible with immune escape as assessed using phylogenetic and/or functional studies. These data suggest that - even where specific intrahepatic T cells are
INTRODUCTION: The liver is a multi-purposeful organ, susceptible to injury. Following acute injury, cells such as hepatocytes, regenerate, while latent hepatic progenitor cell (HPC) become active after chronic liver injury. Some studies suggest Fibroblast growth factors (FGF) may activate HPCs similarly to embryonic liver stem cells. In addition, Notch signaling is critical in bile duct development and injury. With progenitor cell transplantation as an alternative to tissue transplantation, we hypothesize that FGF and Notch signaling pathways induce proliferation of HPC after chronic liver injury.; MATERIALS AND METHODS: Wild-type mice were fed either regular or 0.1% 3,5-diethoxycarbonyl dihydrocollidine (DDC) chow to induce injury. Transgenic, dominant-negative RosartTA;tet(o)sFGFR2b+/- mice were given doxycycline 2 days prior and throughout DDC injury. mRNA and immunostaining of FGF and Notch receptors and ligands were performed. Cells isolated from transgenic mice were fluoresecently sorted ...
in Acta Gastro-Enterologica Belgica (2014, March), 77(1), 16. Aim: Results of donation after circulatory death (DCD) liver transplantation (LT) are impaired by ischemic bile duct lesions caused by procurement warm ischemia. Donor age is a risk factor in deceased ... [more ▼]. Aim: Results of donation after circulatory death (DCD) liver transplantation (LT) are impaired by ischemic bile duct lesions caused by procurement warm ischemia. Donor age is a risk factor in deceased donor LT, and particularly in DCD-LT. At the authors institute, age is not an absolute exclusion criterion to discard DCD liver grafts, controlled DCD donors receive comfort therapy before withdrawal, and cold ischemia is minimized. The aim of the present study was to report on the results of the first 10 years of this experience, and particularly on graft survival and the rate of post-transplant biliary complications, according to DCD donor age. Methods: The authors retrospectively studied a consecutive series of 70 DCD-LT ...
Background:. Alcohol consumption is one of the most important known causes of human cancer after tobacco smoking.. Aim:. This study aims to estimate cancer incidence attributable to alcohol use in Brazil. The proportion of cancer cases that could be attributable to alcohol exposure was estimated for lip; oral cavity; nasopharynx and other pharynx; larynx; esophagus; colorectum; female breast; and liver and intrahepatic bile ducts. Methods:. The proportion of exposed cases and the association between alcohol and cancer was based on data made available by the Cancer Hospital Registries. The cancer incidence was obtained from the estimates produced by GLOBOCAN. We multiplied population aetiologic fraction (PAF) by the number of cases for each type of cancer by sex group and summed them. This study was approved by the Brazilian National Cancer Institute Ethics Committee.. Results:. In 2012 there were 437,592 new cancer cases in Brazil. Of these, alcohol drinking was responsible for 5.2% of all new ...
Lung scarring can be a highly dangerous condition and is usually caused by inhaling dangerous chemicals or by infections. Lung scarring is generally defined by which area of the lung is injured, with the perihilar area, which is the major entrance for the major veins and arteries of the lungs, being the most common.
CoCC shows a variable histological morphology depending on the extent of the associated ICC/HCC components. Such an inherent histological heterogeneity potentially complicates the pathologic diagnosis of CoCC. Komuta et al. proposed that CoCC is defined as when the proportion of CoCC accounts for more than 90% of the entire tumor [8]. According to this strict definition, CoCC with a significant proportion of ICC or HCC components may be considered to be an ordinary ICC or HCC, respectively [4]. The authors also reported immunohistochemical findings of a positive EMA at the apical membrane [6, 8, 9], positive NCAM (a marker of hepatic progenitor cells), and negative S100P (a marker of intrahepatic large bile ducts) [8]. As described, we made an incorrect initial diagnosis of ordinary ICC in the present patient, primarily because a lack of knowledge of CoCC led us not to consider the possibility of CoCC. There may be a concern that pathological diagnosis of the recurrent lesions treated with RFA ...
Congenital cystic dilatation of the intrahepatic biliary ducts, until recently, has been infrequently recognized. Three patients with this anomaly have been tre
Request for sample pages of the report: Intrahepatic Cholangiocarcinoma (ICCA) Emerging Therapies:. 1. Pemazyre (Pemigatinib): Incyte Corporation. 2. Rozlytrek (Entrectinib): Roche. 3. Melphalan/HDS: Delcath Systems. 4. Derazantinib: Basilea Pharmaceutica. Intrahepatic Cholangiocarcinoma (ICCA) Market Outlook. Intrahepatic cholangiocarcinoma (ICCA) is the type of CCA that forms in the bile ducts inside the liver. The commonly available modalities for the treatment of ICCA include surgery and radiation therapies for curative intent and systemic therapies, including chemotherapy and chemoradiotherapy, for the surgery of ineligible patients.. Surgical resection is the mainstay for the treatment of ICCA. The main goal of the surgery is the hepatic resection with negative margins. Since this type of cancer occurs in the bile ducts inside the liver, surgery may include removing the section or wedge of the liver, and ...
TY - JOUR. T1 - Combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma. T2 - Outcome after liver transplantation. AU - Maganty, Kishore. AU - Levi, David. AU - Moon, Jang. AU - Bejarano, Pablo A.. AU - Arosemena, Leopoldo. AU - Tzakis, Andreas. AU - Martin, Paul. PY - 2010/12/1. Y1 - 2010/12/1. N2 - Background: Combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma is a rare hepatobiliary malignancy incorporating components derived from both hepatocyte and intrahepatic bile duct epithelium. The natural history, treatment, and prognosis of this distinct cancer differ from hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC) and are not completely understood. There is considerable controversy about the classification, treatment, and survival, which in turn is related to the rarity of the condition. Treatment options include surgical resection and the prognosis is believed to be better than CC but worse than HCC alone. Methods: We report a single-center liver ...
TY - JOUR. T1 - Neuropeptide Y inhibits cholangiocarcinoma cell growth and invasion. AU - DeMorrow, Sharon. AU - Onori, Paolo. AU - Venter, Julie. AU - Invernizzi, Pietro. AU - Frampton, Gabriel. AU - White, Mellanie. AU - Franchitto, Antonio. AU - Kopriva, Shelley. AU - Bernuzzi, Francesca. AU - Francis, Heather. AU - Coufal, Monique. AU - Glaser, Shannon. AU - Fava, Giammarco. AU - Meng, Fanyin. AU - Alvaro, Domenico. AU - Carpino, Guido. AU - Gaudio, Eugenio. AU - Alpini, Gianfranco. PY - 2011/5. Y1 - 2011/5. N2 - No information exists on the role of neuropeptide Y (NPY) in cholangiocarcinoma growth. Therefore, we evaluated the expression and secretion of NPY and its subsequent effects on cholangiocarcinoma growth and invasion. Cholangiocarcinoma cell lines and nonmalignant cholangiocytes were used to assess NPY mRNA expression and protein secretion. NPY expression was assessed by immunohistochemistry in human liver biopsies. Cell proliferation and migration were evaluated in vitro by MTS ...
Cholangiocarcinoma cells are dependent on antiapoptotic signaling for survival and resistance to death stimuli. to contribute to the effects of embelin on cholangiocarcinoma cells. Instead, embelin caused inhibition of cell proliferation and cell cycle analysis indicated that embelin increased the number of cells in S and G2/M phase. Our results demonstrate that embelin decreased VD2-D3 proliferation in cholangiocarcinoma cell lines. Embelin treatment resulted in decreased XIAP protein expression, but did not induce or enhance apoptosis. Thus, in cholangiocarcinoma cells the mechanism of action of embelin is probably not reliant on apoptosis. Introduction Cholangiocarcinoma can be a liver organ tumor with mobile top features of bile duct epithelial cells and may be the second most common major liver cancers. Biliary tract swelling predisposes to cholangiocarcinoma, although most individuals dont have identified underlying liver disease at the proper time of diagnosis. Chemotherapy offers been ...
TY - JOUR. T1 - Comparative effectiveness of hepatic artery based therapies for unresectable intrahepatic cholangiocarcinoma. AU - Boehm, Lucas M.. AU - Jayakrishnan, Thejus T.. AU - Miura, John T.. AU - Zacharias, Anthony J.. AU - Johnston, Fabian M.. AU - Turaga, Kiran K.. AU - Gamblin, T. Clark. PY - 2015/2/1. Y1 - 2015/2/1. N2 - Background: Hepatic artery based therapies (HAT) are offered for patients with unresectable intrahepatic cholangiocarcinoma (ICC). We aimed to evaluate the comparative effectiveness of HAT-hepatic arterial infusion (HAI), transcatheter arterial chemoembolization (TACE), drug-eluting bead TACE (DEB-TACE), and Yttrium90 radioembolization (Y-90) for unresectable ICC. Methods: A meta-analysis was performed using a prospectively registered search strategy at PROSPERO (CRD42013004830) that utilized PubMed (2003-2013). Primary outcome was median overall survival (OS), and secondary outcomes were tumor response to therapy and toxicity. Results: A total of 20 articles (of ...
Lymphoepithelioma-like carcinoma (LELC) of the liver is extremely rare. To our knowledge, only 16 cases of pure LELC or LELC with ordinary adenocarcinoma arising in the hepatobiliary tract have been reported in the English literature.1-7 Most of these tumours (68%, 11/16) were positive for Epstein-Barr virus (EBV) by EBV-encoded small non-polyadenylated RNA (EBER-1) in situ hybridisation.1-6 However, association of intrahepatic cholangiocarcinoma bearing an intense lymphoplasmacytic infiltration with EBV infection has not been reported. We were the first to present two cases of intrahepatic cholangiocarcinoma with dense lymphoplasmacytic infiltration from Southern China, an area that is well known for and has a high-incidence of nasopharyngeal carcinoma, showing EBV infection, but one case of LELC was associated with EBV infection as well. ...
The original observations of this study relate to inflammation, NO production, DNA damage, and inhibition of DNA repair as related mechanisms for the development and/or progression of cholangiocarcinoma. Our results directly demonstrate the following: (a) human cholangiocarcinomas express the iNOS protein; (b) proinflammatory cytokines stimulate iNOS message and protein expression and the production of NO in cholangiocarcinoma cell lines; (c) the magnitude of NO produced is sufficient to cause single-stranded, double-stranded, and oxidative DNA lesions in the malignant cell lines; and (d) stimulated NO generation is associated with impaired global DNA repair activity in the cholangiocarcinoma cell lines. These data suggest that NO generated in response to inflammation may initiate malignant transformation of biliary epithelia and/or promote progression of established cholangiocarcinoma. Each of these observations is discussed in greater detail below.. iNOS expression with NO generation has been ...
TY - JOUR. T1 - Characterization and growth regulation of a rat intrahepatic bile duct epithelial cell line under hormonally defined, serum-free conditions. AU - De Groen, Piet C.. AU - Vroman, Ben. AU - Laakso, Karen. AU - Larusso, Nicholas F.. N1 - Funding Information: We are indebted to Ms. Sue Kuntz for valuable help in electron microscopy, Ms. Pare Tietz for animal surgeries, and Dr. Vanda Lennon and Mn James Thorenson for performing the nude mouse experiments. This research was supported by grants from the NIH (DK24031) and Mayo Foundation.. PY - 1998. Y1 - 1998. N2 - Bile duct epithelial cells, or cholangiocytes, proliferate in vivo under a number of pathologic (i.e., partial hepatectomy) and pathophysiologic (i.e., bile duct ligation, malignant transformation) conditions. However, little is known about the possible growth factors that modulate these proliferative responses, in part because an in vitro model to study proliferation of nontransformed, normal cholangiocytes is not available. ...
TY - JOUR. T1 - The impact of portal vein resection on outcomes for hilar cholangiocarcinoma. T2 - A multi-institutional analysis of 305 cases. AU - De Jong, Mechteld C.. AU - Marques, Hugo. AU - Clary, Bryan M.. AU - Bauer, Todd W.. AU - Marsh, J. Wallis. AU - Ribero, Dario. AU - Majno, Pietro. AU - Hatzaras, Ioannis. AU - Walters, Dustin M.. AU - Barbas, Andrew S.. AU - Mega, Raquel. AU - Schulick, Richard D.. AU - Choti, Michael A.. AU - Geller, David A.. AU - Barroso, Eduardo. AU - Mentha, Gilles. AU - Capussotti, Lorenzo. AU - Pawlik, Timothy M.. PY - 2012/10/1. Y1 - 2012/10/1. N2 - BACKGROUND. Surgical strategy for hilar cholangiocarcinoma often includes hepatectomy, but the role of portal vein resection (PVR) remains controversial. In this study, the authors sought to identify factors associated with outcome after surgical management of hilar cholangiocarcinoma and examined the impact of PVR on survival. METHODS: Three hundred five patients who underwent curative-intent surgery for hilar ...
Surgical resection remains the mainstay of curative treatment for intrahepatic cholangiocarcinoma (ICC). Prognosis after surgery is unsatisfactory despite improvements in treatment and post-operative clinical management. Despite developments in the molecular profiling of ICC, the preoperative prediction of prognosis remains a challenge. This study aimed to identify clinical prognostic indicators by investigating the molecular profiles of ICC and evaluating the preoperative imaging data of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET). A retrospective analysis was performed on 50 consecutive patients with ICC who underwent curative hepatectomy after 18F-FDG-PET examination. To evaluate the molecular profiles of ICC, KRAS mutation status was assessed in resected specimens. For the assessment of glucose uptake, we observed the expression of glucose transporter-1 (GLUT-1) by immunohistochemistry. The data of 18F-FDG-PET were re-evaluated as follows: maximum standardized uptake value,
Background: The aim of the present study was to analyze whether Homer1 is a potential prognostic markerfor intrahepatic cholangiocarcinoma (ICC). Materials and Methods: The expression of Homer1 in ICC tissuewas detected with immunohistochemistry and levels of protein in ICC and paratumor tissues were evaluated byWestern blotting. Survival analysis by the Kaplan-Meier method was performed to assess prognostic significance.Results: Homer1 expression was high in 67.4% (58/86) of ICC samples, and there was significant differencebetween ICC and adjacent noncancerous tissues (p|0.001); high expression was associated with poor histologicdifferentiation (p=0.019), TNM stage (p=0.014), lymph node metastasis (p=0.040), and lymphatic invasion(p=0.025). On Kaplan-Meier analysis, a comparison of survival curves of low versus high expressors of Homer1revealed a highly significant difference in OS (p=0.001) and DFS (p=0.006), indicating that high expressionof Homer1 was linked with a worse prognosis. Multivariate
Overview: In view of the increasing morbidity and mortality rates of Intrahepatic Cholangiocarcinoma (ICC) and the high risk of lymph node metastasis,..
Few studies have evaluated the risk of cancers other than hepatocellular carcinoma associated with hepatitis B virus (HBV) infection. This study aimed to estimate incidence rates of intrahepatic cholangiocarcinoma (ICC) and non-Hodgkin lymphoma (NHL) and its major subtypes in a nationwide cohort of parous women and to assess their associations with chronic HBV infection. We conducted a cohort study including 1,782,401 pregnant Taiwanese women whose HBV serostatus was obtained from the National Hepatitis B Vaccination Registry. Newly diagnosed ICCs and NHLs were ascertained through data linkage with the National Cancer Registry. Risks of ICC and NHL were assessed using Cox proportional hazards regression models. After a mean of 6.91 years of follow-up, there were 18 cases of ICC and 192 cases of NHL, including 99 cases of diffuse large B-cell lymphoma (DLBCL). Incidence rates of ICC were 0.09 and 0.43 per 100,000 person-years, respectively, among women who were hepatitis B surface antigen ...
The aim of this study was to compare the enhancement pattern of intrahepatic cholangiocarcinoma (ICC) on contrast-enhanced ultrasound (CEUS) with that on contrast-enhanced computed tomography (CECT). 40 pathologically proven ICC lesions in 40 patients were evaluated retrospectively with both CEUS and CECT. The enhancement level and pattern in the dynamic phases on both CEUS and CECT were analysed. The diagnostic results of CEUS and CECT before pathological examination were also recorded. During arterial phases, the number of lesions that appeared as (i) peripheral irregular rim-like hyperenhancement, (ii) diffuse heterogeneous hyperenhancement, (iii) diffuse homogeneous hyperenhancement and (iv) diffuse heterogeneous hypoenhancement were 19 (47.5%), 9 (22.5%), 5 (12.5%) and 7 (17.5%), respectively, on CEUS, and 22 (55.0%), 3 (7.5%), 2 (5.0%) and 13 (32.5%), respectively, on CECT (p = 0.125). In the portal phase, the number of lesions showing hyperenhancement and hypoenhancement were 1 (2.5%) and ...
Intrahepatic cholangiocarcinoma (ICC) is an aggressive, highly lethal tumors and lacks of effective chemo and targeted therapies. Cell lines and animal models, even partially reflecting tumor characteristics, have limits to study ICC biology and drug response. In this work, we created and characterized a novel ICC patient-derived xenograft (PDX) model of Italian origin. Seventeen primary ICC tumors derived from Italian patients were implanted into NOD (Non-Obese Diabetic)/Shi-SCID (severe combined immunodeficient) mice. To verify if the original tumor characteristics were maintained in PDX, immunohistochemical (cytokeratin 7, 17, 19, and epithelial membrane antigen) molecular (gene and microRNA expression profiling) and genetic analyses (comparative genomic hybridization array, and mutational analysis of the kinase domain of EGFR coding sequence, from exons 18 to 21, exons 2 to 4 of K-RAS, exons 2 to 4 of N-RAS, exons 9 and 20 of PI3KCA, and exon 15 of B-RAF) were performed after tumor stabilization.
TY - JOUR. T1 - The Impact of Intraoperative Re-Resection of a Positive Bile Duct Margin on Clinical Outcomes for Hilar Cholangiocarcinoma. AU - Zhang, Xu Feng. AU - Squires, Malcolm H.. AU - Bagante, Fabio. AU - Ethun, Cecilia G.. AU - Salem, Ahmed. AU - Weber, Sharon M.. AU - Tran, Thuy. AU - Poultsides, George. AU - Son, Andre Y.. AU - Hatzaras, Ioannis. AU - Jin, Linda. AU - Fields, Ryan C.. AU - Weiss, Matthew J. AU - Scoggins, Charles. AU - Martin, Robert C.G.. AU - Isom, Chelsea A.. AU - Idrees, Kamron. AU - Mogal, Harveshp D.. AU - Shen, Perry. AU - Maithel, Shishir K.. AU - Schmidt, Carl R.. AU - Pawlik, Timothy M.. PY - 2018/2/22. Y1 - 2018/2/22. N2 - Background: The impact of re-resection of a positive intraoperative bile duct margin on clinical outcomes for resectable hilar cholangiocarcinoma (HCCA) remains controversial. We sought to define the impact of re-resection of an initially positive frozen-section bile duct margin on outcomes of patients undergoing surgery for HCCA. ...
Postoperative Mortality after Liver Resection for Perihilar Cholangiocarcinoma: Development of a Risk Score and Importance of Biliary Drainage of the Future Liver Remnant.
Hepatitis C virus (HCV) infects the liver and hepatocytes are the major cell type supporting viral replication. Hepatocytes and cholangiocytes derive from a common hepatic progenitor cell that proliferates during inflammatory conditions, raising the possibility that cholangiocytes may support HCV replication and contribute to the hepatic reservoir. We screened cholangiocytes along with a panel of cholangiocarcinoma-derived cell lines for their ability to support HCV entry and replication. While primary cholangiocytes were refractory to infection and lacked expression of several entry factors, two cholangiocarcinoma lines, CC-LP-1 and Sk-ChA-1, supported efficient HCV entry; furthermore, Sk-ChA-1 cells supported full virus replication. In vivo cholangiocarcinomas expressed all of the essential HCV entry factors; however, cholangiocytes adjacent to the tumour and in normal tissue showed a similar pattern of receptor expression to ex vivo isolated cholangiocytes, lacking SR-BI expression, explaining their
The purpose of this project is to evaluate the role of gadoxetate (Eovist) enhanced dual-energy CT in better evaluating perihilar cholangiocarcinoma, by exploiting the combination of the physiologic behavior of gadoxetate in liver tissue combined with the advantageous mass attenuation coefficient of Gadolinium achievable through dual energy technique. This combination of unique CT imaging sensitivity, high resolution and differential enhancement potentially allows improved visualization and detection of tumor relative to enhancing surrounding hepatic parenchyma and ductal anatomy in the hepatobiliary phase, due to the biliary excretion of the agent.. Cholangiocarcinoma is a hepatic adenocarcinoma that arises from the bile duct epithelium and is the second most prevalent liver cancer after hepatocellular carcinoma. The hilar intrahepatic variety of cholangiocarcinoma can present as an infiltrative, exophytic, or polypoid lesion. Most extra-hepatic cholangiocarcinomas are infiltrative, causing a ...
Cholangiocarcinomas are a heterogeneous group of malignancies arising from a number of cells of origin along the biliary tree. Although most cases in Western countries are sporadic, large population-based studies have identified a number of risk factors. This review summarises the evidence behind reported risk factors and current understanding of the molecular pathogenesis of cholangiocarcinoma, with a focus on inflammation and cholestasis as the driving forces in cholangiocarcinoma development. Cholestatic liver diseases (e.g. primary sclerosing cholangitis and fibropolycystic liver diseases), liver cirrhosis, and biliary stone disease all increase the risk of cholangiocarcinoma. Certain bacterial, viral or parasitic infections such as hepatitis B and C and liver flukes also increase cholangiocarcinoma risk. Other risk factors include inflammatory disorders (such as inflammatory bowel disease and chronic pancreatitis), toxins (e.g. alcohol and tobacco), metabolic conditions (diabetes, obesity and non
MeSH-minor] Adenoma, Liver Cell / mortality. Adenoma, Liver Cell / pathology. Adenoma, Liver Cell / surgery. Adrenal Gland Neoplasms / mortality. Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / surgery. Adult. Bile Duct Neoplasms / mortality. Bile Duct Neoplasms / pathology. Bile Duct Neoplasms / surgery. Breast Neoplasms / mortality. Breast Neoplasms / pathology. Breast Neoplasms / surgery. Carcinoma, Hepatocellular / mortality. Carcinoma, Hepatocellular / pathology. Carcinoma, Hepatocellular / surgery. Cholangiocarcinoma / mortality. Cholangiocarcinoma / pathology. Cholangiocarcinoma / surgery. Colorectal Neoplasms / mortality. Colorectal Neoplasms / pathology. Colorectal Neoplasms / surgery. Female. Focal Nodular Hyperplasia / mortality. Focal Nodular Hyperplasia / pathology. Focal Nodular Hyperplasia / surgery. Hemangioma / mortality. Hemangioma / pathology. Hemangioma / surgery. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / ...
Cholangiocarcinoma (CCA), cancer of the bile duct, is the first cause of cancer death of the people in the northeast of Thailand. The incidence of CCA in this region is highest not only in the country but in the world. CCA is a slow growing but highly metastatic tumor. At present, there is no standard chemotherapy or effective treatment for CCA. Most of the patients have short survival after diagnosis. Strong evidences from in vitro, animal and clinical studies indicate that vitamin D can prevent and control growth of cancer. Our preclinical studies in CCA cell lines, animal and patient tissue culture indicate that vitamin D effectively reduce growth of CCA. Supplementation of vitamin D to chemotherapeutic drugs enhance drug toxicity and better response. At present, there are several clinical trials in USA on supplementation of vitamin D or its analogs to cancer patients. The side effect or toxicity of using vitamin D supplementation is low, some patients had stable disease and some had good ...
Kinetics, histological and biochemical characteristics of transplantable cholangiocellular RS-1 carcinoma were studied after intrahepatic and subcutaneous
Cholangiocarcinoma (CCA) is the second most common liver cancer and it is associated with a poor prognosis. CCA can be divided into intrahepatic, hilar and distal. Despite the subtype, the median survival is 12-24 months without treatment. Liver transplantation (LT) is worldwide recognized as a curative option for hepatocellular carcinoma. On the other hand, the initial results for LT for CCA were very poor mainly due to a lack of adequate patient selection. In the last two decades, improvement has been made in the management of unresectable hilar CCA, and the results of LT after neoadjuvant chemoradiation have been shown to be promising ...
Hilar cholangiocarcinoma (HCC) remains one of the most difficult tumors to stage and treat. The aim of the study was to assess the diagnostic efficiency of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computer tomography (PET/CT) in evaluating the resectability of HCC. A systematic search was performed of the PubMed, EMBASE, and Cochrane databases. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for individual studies and pooled data as well as test for heterogeneity and public bias. Our data showed that CT had the highest pooled sensitivity at 95% (95% CI: 91–97), whereas PET/CT had the highest pooled specificity at 81% (95% CI: 69–90). The area under the curve (AUC) of CT, MRI, and PET/CT was 0.9269, 0.9194, and 0.9218, respectively. In conclusion, CT is the most frequently used imaging modality to assess HCC resectability with a good
Hepatocellular carcinoma (liver cell cancer) is the most common type of primary liver cancer. It is relatively rare in the United States but very common in Southeast Asia, especially China. The tumor predominantly affects males who are over 50 years of age, although it may arise in younger individuals or even children. The liver is also the primary site for cholangiocarcinomas (intrahepatic bile duct cancers) that are relatively rare and account for 10-20% of all primary liver cancers. These tumors occur in older individuals, usually after the age of 60. The overall median survival for hepatocellular carcinoma is 4 months and the overall 5-year survival rate is 3%. Cholangiocarcinomas have an overall mean survival time of less than 2 years. Several predisposing factors are thought to play a role in hepatocellular carcinoma. These include infection with hepatotropic viruses such as hepatitis B and C viruses, liver cirrhosis, liver cell dysplasia, exposure to aflatoxins and inborn errors of ...
시각화 및 마우스 간문맥 정맥 또는 intrahepatic의 담즙 덕트의 3 차원 구조를 정량화하는 방법이 설명되어 있습니다. 이 수지 주조 기술은 다른 ductal이나 혈관 시스템에 적용이 가능 할 수 있습니다...
Cholangiocarcinoma: A malignant tumor arising from the intrahepatic bile duct epithelium. It is composed of ducts lined by cuboidal or columnar cells that do not contain bile, with abundant stroma. (From Holland et al., Cancer Medicine, 3d ed, p1455; Stedman, 25th ed)
Histamine regulates functions via four receptors (HRH1, HRH2, HRH3, and HRH4). The d-myo-inositol 1,4,5-trisphosphate (IP3)/Ca2+/protein kinase C (PKC)/mitogen-activated protein kinase pathway regulates cholangiocarcinoma growth. We evaluated the role of HRH3 in the regulation of cholangiocarcinoma growth. Expression of HRH3 in intrahepatic and extrahepatic cell lines, normal cholangiocytes, and human tissue arrays was measured. In Mz-ChA-1 cells stimulated with (R)-(α)-(−)-methylhistamine dihydrobromide (RAMH), we measured (a) cell growth, (b) IP3 and cyclic AMP levels, and (c) phosphorylation of PKC and mitogen-activated protein kinase isoforms. Localization of PKCα was visualized by immunofluorescence in cell smears and immunoblotting for PKCα in cytosol and membrane fractions. Following knockdown of PKCα, Mz-ChA-1 cells were stimulated with RAMH before evaluating cell growth and extracellular signal-regulated kinase (ERK)-1/2 phosphorylation. In vivo experiments were done in BALB/c ...
Prognosis of ICC with lymph node metastasis is poor. And the feasibility of operation is uncertain, which is a contraindication in NCCN guidelines. In addition, in the neoadjuvant therapy of ICC, the role of immunotherapy is not clear. We describe a case of ICC with lymph node metastasis was s...
Background: iCCA is the 2nd most common liver malignancy and with a poor patient prognosis. The ABC-02 study established gemcitabine+cisplatin (gem-cis) as the standard of care (SOC) in 1st line (1L) systemic chemotherapy (CT). The objective was to examine the treatment (tx) patterns and time trends in the tx received by patients (pts) with iCCA in the United States before and after ABC-02 study was published. Methods: Retrospective data from the Optum Research Database, which included commercial and Medicare Advantage health plan members between January 1, 2006 and June 30, 2018, were used. Eligible pts were aged ≥ 18 years; had ≥ 2 nondiagnostic claims of primary iCCA diagnosis (International Classification of Disease [ICD]-9: 155.1 or ICD-10: C22.1) in the identification period (July 01, 2006-March 31, 2018); and had 6 months continuous enrollment prior to and ≥ 3 months follow-up (or less due to death) from the date of first diagnosis. Tx patterns in the periods before and after ABC-02 ...
In the west, the exact cause of cholangiocarcinoma is unclear. It is likely that this cancer arises due to a combination of factors, including other illnesses that cause chronic damage to the liver and/or bile ducts, certain toxins and possibly a small genetic predisposition, although it is not believed to be a directly inherited disease. Although most cases of cholangiocarcinoma are in people over 60 years of age, it appears to be increasing across all age groups including younger people. The cause of this ongoing rise is currently unknown.. In Southeast Asia, especially Thailand, which has the worlds highest incidence of cholangiocarcinoma, associated risk factors include eating raw fish infected with liver fluke and chronic typhoid, neither of which occurs in the western world.. ...
Sigma-Aldrich offers abstracts and full-text articles by [Maiko Terada, Kenichi Horisawa, Shizuka Miura, Yasuo Takashima, Yasuyuki Ohkawa, Sayaka Sekiya, Kanae Matsuda-Ito, Atsushi Suzuki].
A110 Cholangiocarcinoma (CCA), a malignant tumor of the bile duct epithelium, is one of the major of cancers in Northeast Thailand. This disease is difficult to diagnose and has a high mortality rate, thus posing an important public health problem in this region. Generally, cancer arises from dysregulation of tumor suppressor genes and oncogenes. c-Met, hepatocyte growth factor (HGF) receptor, and its ligand, HGF, regulate diverse biological responses including proliferation, migration and invasion, key features of metastatic cancer. Overexpression of c-Met has frequently been found in cholangiocarcinoma especially of well-differentiated type suggesting the role of c-Met in cholangiocarcinogenesis. In this study the role of HGF in invasiveness of cholangiocarcinoma was investigated using the human CCA cell line, KKU-213, in which c- Met expression is high when compare to immortalized cholangiocyte, H-69. Activation of c-Met by HGF induced KKU-213 cell proliferation, invasion and motility. ...
The Hippo pathway effector Yes-associated protein (YAP) is localized to the nucleus and transcriptionally active in a number of tumor types, including a majority of human cholangiocarcinomas. YAP activity has been linked to chemotherapy resistance and has been shown to rescue KRAS and BRAF inhibition in RAS/RAF-driven cancers; however, the underlying mechanisms of YAP-mediated chemoresistance have yet to be elucidated. Herein, we report that the tyrosine phosphatase SHP2 directly regulates the activity of YAP by dephosphorylating pYAPY357 even in the setting of RAS/RAF mutations, and that diminished SHP2 phosphatase activity is associated with chemoresistance in cholangiocarcinomas. A screen for YAP-interacting tyrosine phosphatases identified SHP2, and characterization of cholangiocarcinomas cell lines demonstrated an inverse relationship between SHP2 levels and pYAPY357. Human sequencing data demonstrated lower SHP2 levels in cholangiocarcinomas tumors as compared with normal liver. Cell lines ...
TT-00420, a multi-target novel kinase inhibitor that can conveniently taken via once daily oral administration, has proven to be safe and well tolerated in the Phase I clinical study. In addition, TT-00420 has shown promising clinical benefit potential in adult patients with advanced cholangiocarcinoma who received TT-00420 at different dose levels ranged from 8 mg to 12 mg. In this webinar, Dr. Javle, a leading key opinion leader in cholangiocarcinoma innovative drug development, will review the two cases of advanced CCA patients who achieved partial responses in TT-00420 Phase I study. Dr. Javle will further share more scientific background about TT-00420, especially the tumor grown inhibition shown in nonclinical PDX study for CCA without FGFR alternations. TT-00420 is developed by TransThera Biosciences, who is dedicatedly working on the late phase development of TT-00420 in CCA in the U.S., so to offer more effective treatment options to CCA patients.. ...
The biliary tree consists of intrahepatic and extrahepatic bile ducts and is lined by biliary epithelial cells (or cholangiocytes). There are also peribiliary glands around the intrahepatic large bile ducts and extrahepatic bile ducts. The biliary tr
BACKGROUND Intrahepatic cholangiocarcinoma is a rare condition which typically occurs in males between 50 and 70 years of age, and presents with symptoms related to biliary obstruction including jaundice, pruritus, and dark urine. Other common symptoms at presentation include abdominal pain, weight loss, and fever. CASE REPORT We present a case of a 67-year-old female initially presenting with chest pain at rest, found to have a lung nodule on diagnostic imaging at the time of admission. On further imaging, a 9 cm liver lesion was incidentally discovered, initially suspicious for hepatocellular carcinoma on imaging, with initial biopsy staining CK7 positive, and CK20 negative ...
TY - JOUR. T1 - SOX17 regulates cholangiocyte differentiation and acts as a tumor suppressor in cholangiocarcinoma. AU - Merino-Azpitarte, Maite. AU - Lozano, Elisa. AU - Perugorria, María J.. AU - Esparza-Baquer, Aitor. AU - Erice, Oihane. AU - Santos-Laso, Álvaro. AU - ORourke, Colm J.. AU - Andersen, Jesper B.. AU - Jiménez-Agüero, Raúl. AU - Lacasta, Adelaida. AU - DAmato, Mauro. AU - Briz, Óscar. AU - Jalan-Sakrikar, Nidhi. AU - Huebert, Robert C.. AU - Thelen, Kristen M.. AU - Gradilone, Sergio A.. AU - Aransay, Ana M.. AU - Lavín, José L.. AU - Fernández-Barrena, Maite G.. AU - Matheu, Ander. AU - Marzioni, Marco. AU - Gores, Gregory J.. AU - Bujanda, Luis. AU - Marin, José J.G.. AU - Banales, Jesús M.. PY - 2017/7/1. Y1 - 2017/7/1. N2 - Background & Aims Cholangiocarcinoma (CCA) is a biliary malignancy linked to genetic and epigenetic abnormalities, such as hypermethylation of SOX17 promoter. Here, the role of SOX17 in cholangiocyte differentiation and ...
Sigma-Aldrich offers abstracts and full-text articles by [Papavee Samatiwat, Auemduan Prawan, Laddawan Senggunprai, Veerapol Kukongviriyapan].
In the transverse image, the common bile duct (red arrowheads) is anterior to the portal vein (PV) and the gallbladder (red arrow) is also visualized.. Exam Begin with the patient in the left posterior oblique position. Patient may also be placed in the supine position. Obtain longitudinal and transverse views of right and left lobe of liver and include longitudinal images of liver/diaphragm interface. Measure intrahepatic bile duct, common hepatic duct (CHD), and CBD as far distal as possible. Acquire longitudinal view of bile duct in pancreatic head and take measurement. Document patency in portal veins, hepatic veins, and hepatic artery. Sonographic Findings: 1) Shotgun sign intrahepatic biliary ducts (IHBD) become tortuous and their diameter exceeds 2 mm or exceeds 40% of the diameter of the adjacent PV. Color Doppler is used to confirm the absence of blood flow in the enlarged biliary tubes.. ...
Cholangiocellular Carcinoma in Dogs Bile duct carcinoma is a malignant cancer that typically arises from the the epithelia, the cellular lining of the hepatic (
Looking for biliary system? Find out information about biliary system. The complex of canaliculi, or microscopic bile ducts, that empty into the larger intrahepatic bile ducts Explanation of biliary system
Discussion This is the first study that demonstrates the effects of glyphosate on cholangiocarcinoma cells, and provides a better understanding of the possible mechanisms related to its effects. The low concentrations of glyphosate tested in this study are relevant to the range of levels that have been reported in the environment and detected in humans (Acquavella et al., 2004; Bai and Ogbourne, 2016; Kongtip et al., 2017). Previous studies have reported that E2 induces cell proliferation in an ERα expressing CCA, HuH28 cell line (Alvaro et al., 2006). It was reported that E2 also induced the expression levels of several proteins, including ERα, VEGF, VEGFR, IGF-1, and IGF-1R, as well as downstream signaling proteins associated to cell proliferation. In this study, we found that 10−11 to 10−5 M of glyphosate and E2 induced cell proliferation in HuCCA-1 cells under estrogen withdrawal conditions and the inductive effects were inhibited by ER antagonists. This study also demonstrated the ...
TY - JOUR. T1 - Elevated expression of tyrosine kinase DDR2 in primary biliary cirrhosis. AU - Mao, Tin K.. AU - Kimura, Yasunori. AU - Kenny, Thomas P.. AU - Branch, Andrea. AU - Gish, Robert G.. AU - Van de Water, Judith A. AU - Kung, Hsing-Jien. AU - Friedman, Scott L.. AU - Gershwin, M. Eric. PY - 2002/12. Y1 - 2002/12. N2 - Background: Primary biliary cirrhosis (PBC) is characterized by chronic progressive destruction of small intrahepatic bile ducts with portal inflammation and cholestasis, leading to fibrosis. Methods: We utilized a novel restriction analysis system to profile the expression of tyrosine kinases (TKs). This methodology targets a conserved sequence present in the majority of human TKs, and exploits the known restriction map of the TK cDNA sequences. We isolated mRNA from biliary epithelial cell (BEC)-enriched cell fractions, amplified the TK transcripts using degenerative primers, and identified specific TKs by restriction enzyme digest analysis and then performed in situ ...
Case History-A 60 yr old woman presenting with abnormal liver blood tests.Primary biliary cirrhosis is a chronic, cholestatic liver disease in which the biliary epithelial cells lining the small intrahepatic bile ducts are the target for immune-mediated damage leading to progressive ductopenia. The cause is unknown, but presumed to be autoimmune....
de Jong, I. E. M., Matton, A. P. M., van Praagh, J. B., van Haaften, W. T., Wiersema-Buist, J., van Wijk, L. A., Oosterhuis, D., Iswandana, R., Suriguga, S., Overi, D., Lisman, T., Carpino, G., Gouw, A. S. H., Olinga, P., Gaudio, E. & Porte, R. J., Aug-2019, In : Transplantation. 103, 8, p. 3-3 1 p.. Research output: Contribution to journal › Meeting Abstract › Academic ...
Malignant neoplasm of liver and intrahepatic bile ducts. The most frequent forms are metastatic malignant neoplasm of liver) ... bile duct) spasm of sphincter of Oddi biliary cyst biliary atresia ICD-10 codes K70-K77: Liver Diseases [1] (Diseases of liver ... of liver malignant neoplasm of the gallbladder malignant neoplasm of other parts of biliary tract extrahepatic bile duct ...
In terms of mortality, the 5-year survival rate for liver and intrahepatic bile duct cancers in the United States is 19.6%. In ... In the United States there were 42,810 new cases of liver and intrahepatic bile duct cancer in 2020, which represents 2.4% of ... "SEER Stat Fact Sheets: Liver and Intrahepatic Bile Duct Cancer". NCI. Archived from the original on 2017-07-28. World Cancer ... "Cancer of the Liver and Intrahepatic Bile Duct - Cancer Stat Facts". SEER. Retrieved 2021-02-23. Wikimedia Commons has media ...
"Etiological Causes of Intrahepatic and Extrahepatic Bile Duct Dilatation" (PDF). International Journal of New Technology and ...
"The role of notch signaling in the development of intrahepatic bile ducts". Gastroenterology. 127 (6): 1775-1786. doi:10.1053/j ... When Hes1 expression is low, hepatocytes form normally, but bile ducts are completely absent. This phenotype resembles Alagille ...
Liver abscesses may be seen even without dilatation of intrahepatic bile ducts. While normally asymptomatic, most pathological ... The free metacercariae penetrate the intestinal mucosa and enter the bile ducts. Migration into the bile ducts takes 1-2 days. ... In humans, it infects the common bile duct and gall bladder, feeding on bile. It was discovered by British physician James ... bile duct obstruction, and even liver cirrhosis, cholangiocarcinoma, and hepatic carcinoma. As a major causative agent of bile ...
This species had produced megaloschizonts in the intrahepatic bile ducts and portal veins. The presence of these ...
Liver Liver Liver Liver Liver Liver Liver Liver Liver Liver Liver Liver Liver Liver Gallbladder Gallbladder Bile duct Bile duct ... No intrahepatic biliary ductal dilatation. Portal Vein: Patent main portal vein. Gallbladder: No stones, wall thickening, or ... Common Bile Duct: Nondilated measuring 1.3 mm at the level of the porta hepatis. Pancreas: Visualized portions unremarkable. ... gallbladder or bile duct diseases, or a tumor in the liver. Ultrasonography of liver tumors involves two stages: detection and ...
Vital and scaffolding structures (like large blood vessels, urethra or intrahepatic bile ducts) are conserved. The electrically ... portal veins and intrahepatic bile ducts were all preserved. In IRE the cell death is mediated by apoptosis. Structures mainly ... June 2020). Hepatic IRE appears to be safe, even when performed near vessels and bile ducts with an overall complication rate ...
"Jagged1 in the portal vein mesenchyme regulates intrahepatic bile duct development: insights into Alagille syndrome". ...
When the intrahepatic bile duct wall has protrusions, it is clearly seen as central dots or a linear streak. Caroli disease is ... bile ducts due to ectasia. Using an ultrasound, tubular dilation of the bile ducts can be seen. On a CT scan, Caroli disease ... He described it as "nonobstructive saccular or fusiform multifocal segmental dilatation of the intrahepatic bile ducts"; ... 2007). "Bile duct cyst type V (Caroli's disease): surgical strategy and results". HPB (Oxford). 9 (4): 281-4. doi:10.1080/ ...
Biliary cystadenoma and cystadenocarcinoma constitute less than 5% of intrahepatic cysts originating from the bile duct. ... Ahmad Z, Uddin N, Memon W, Abdul-Ghafar J, Ahmed A (November 2017). "Intrahepatic biliary cystadenoma mimicking hydatid cyst of ...
Tumors occurring in the bile ducts within the liver are referred to as intrahepatic, those occurring in the ducts outside the ... Cholangiocarcinoma, also known as bile duct cancer, is a type of cancer that forms in the bile ducts. Symptoms of ... American Cancer Society Detailed Guide to Bile Duct Cancer. Patient information on extrahepatic bile duct tumors, from the ... Intrahepatic cholangiocarcinomas (those arising from the bile ducts within the liver) are usually treated with partial ...
Obstruction of the bile ducts by gallstones (choledocholithiasis), primary sclerosing cholangitis, liver damage (intrahepatic ... The absence of bile secretion can cause the feces to turn gray or pale. Bile is responsible for the brownish color of feces. ... Possible causes include exocrine pancreatic insufficiency, with poor digestion from lack of lipases, loss of bile salts, which ...
Where formation of stones are not strictly in gallbladder, hence not fibrotic, but in the intrahepatic bile ducts). To ... Double gallstones with one falling and blocking the common bile duct (responsible for jaundice) and one at the cystic duct ( ... The exceptions to the law are stones that dislodge and acutely block the duct distally to the hepatic/cystic duct junction: ... in the case of recurrent pyogenic cholangitis complicated by calcium bilirubinate stone dislodging to the common bile duct ...
... involving saccular or fusiform dilatation of a portion or entire common bile duct (CBD) with normal intrahepatic duct. Type II ... Choledochal cysts (a.k.a. bile duct cyst) are congenital conditions involving cystic dilatation of bile ducts. They are ... inflammation within the bile ducts caused by the spread of bacteria from the intestine into the bile ducts). Inflammation of ... Multiple dilatations involving only the extrahepatic bile ducts. Type V: Cystic dilatation of intrahepatic biliary ducts ...
... involving bile duct injury), or vanishing bile duct syndrome (loss of intrahepatic bile ducts).: 17 Bland cholestasis occurs ... Bile canaliculi dynamics refers to the contractile motion of bile canaliculi (ducts) required for bile flow. Cholestasis can ... and inflammation of intrahepatic or extrahepatic bile ducts, leading to reduced bile flow or formation (i.e., cholestasis). The ... which in turn joins the cystic duct from the gall bladder, to give the common bile duct. This duct then enters the duodenum at ...
... cystic duct MeSH A03. - common hepatic duct MeSH A03.159.183.158 - intrahepatic bile ducts MeSH A03.159.183.158. ... MeSH A03.159.183.079 - extrahepatic bile ducts MeSH A03. - common bile duct MeSH A03. - ... salivary ducts MeSH A03.556.500.760.650 - minor salivary glands MeSH A03.556.500.760.687 - sublingual gland MeSH A03.556. ... bile canaliculi MeSH A03.734.414.065 - glucagon-secreting cells MeSH A03.734.414.131 - insulin-secreting cells MeSH A03.734. ...
... genetic defect resulting in hypoplastic intrahepatic bile ducts) Progressive familial intrahepatic cholestasis Pyknocytosis ( ... is caused by a blockage of bile ducts that transport bile containing conjugated bilirubin out of the liver for excretion. This ... which leads to increased conjugated bilirubin and bile salts there. In complete obstruction of the bile duct, conjugated ... If a bile duct blockage is present, surgery is typically required; otherwise, management is medical. Medical management may ...
... is seen due to portal hypertension caused by compression of portal veins by the proximate sclerosed intrahepatic bile ducts, ... The resulting scarring of the bile ducts obstructs the flow of bile, which further perpetuates bile duct and liver injury. ... The bile duct scarring that occurs in PSC narrows the ducts of the biliary tree and impedes the flow of bile to the intestines ... infection within the bile ducts) can be seen due to impaired drainage of the bile ducts, which increases the risk of infection ...
... common bile duct neoplasms MeSH C06.130.320.120 - bile duct neoplasms MeSH C06.130.320.120.280 - common bile duct neoplasms ... intrahepatic MeSH C06. - alagille syndrome MeSH C06. - liver cirrhosis, biliary MeSH ... MeSH C06.130.120.120 - bile duct neoplasms MeSH C06. - common bile duct neoplasms MeSH C06.130.120.123 - biliary ... bile duct neoplasms MeSH C06.301.120.250.250 - common bile duct neoplasms MeSH C06.301.120.401 - gallbladder neoplasms MeSH ...
... but also the so-called intra-hepatic stones from the bile ducts of the liver by this procedure. There are different sets of ...
Anatomical Observation of Normal Human Intrahepatic Bile Duct and Hepatic Artery(《正常人肝内胆管和肝动脉的解剖学观察》)etc., and constructed a ... By this time, he had figured out the layout of hepatic artery, hepatic vein, portal vein and bile duct in livers. He also had a ... theory in 1960 for the first time and published Observation on Intrahepatic Anatomy of Normal People in China(《我国正常人肝内解剖的观察》), ... and established a new anatomical theory based on vascular distributions in livers
Progressive familial intrahepatic cholestasis, bile duct paucity, Alagille syndrome, alpha 1-antitrypsin deficiency, and other ... Cystic fibrosis Dubin-Johnson syndrome Rotor syndrome Drugs Total parenteral nutrition Idiopathic Biliary atresia or bile duct ...
It results from a slow, progressive destruction of the small bile ducts of the liver, causing bile and other toxins to build up ... with the intralobular ducts and the canals of Hering (intrahepatic ductules) being affected early in the disease. Most people ... small duct PSC, adult idiopathic ductopenia. Stage 1 - portal stage: Normal-sized triads, portal inflammation, subtle bile duct ... In the new system of Nakanuma, the stage of disease is based on fibrosis, bile duct loss, and features of cholestasis, i.e. ...
... intrahepatic - intrahepatic bile ducts - intrahepatic infusion - intralesional - intraluminal intubation and dilation - ... common bile duct - comorbidity - compassionate use trial - complementary and alternative medicine - complete blood count (CBC ... bile duct - biliary - bilirubin - binding agent - bioavailable - biochanin A - biochemical reactions - biological response ... pancreatic duct - pancreatic enzyme - pancreatic juice - pancreatitis - PAP, same as Pap smear - Pap smear - Pap test, same as ...
... a freshwater catfish Malignant neoplasms of liver and intrahepatic bile ducts ICD-10 code Centre Municipal Airport FAA LID This ...
155 Malignant neoplasm of liver and intrahepatic bile ducts 156 Malignant neoplasm of gallbladder and extrahepatic bile ducts ... 237 Neoplasm of uncertain behavior of endocrine glands and nervous system 237.0 Pituitary gland and craniopharyngeal duct ...
... where they merge to form bile ducts. Within the liver, these ducts are termed intrahepatic bile ducts, and once they exit the ... The cystic duct from the gallbladder joins with the common hepatic duct to form the common bile duct. The biliary system and ... They are cuboidal epithelium in the small interlobular bile ducts, but become columnar and mucus secreting in larger bile ducts ... or is temporarily stored in the gallbladder via the cystic duct. The common bile duct and the pancreatic duct enter the second ...
In these infants, the bile is not able to drain normally from the small bile ducts within the liver into the larger bile ducts ... the fibrous tissue of the porta hepatis and thus provide direct connection with the intrahepatic ductule system to allow bile ... the area of the liver from which bile should drain) by radical excision of all bile duct tissue up to the liver capsule and ... The rationale for this approach is that minute residual bile duct remnants may be present in ...
... duct the sphincterotome is then placed in the pancreatic duct and used to cut the septum between the pancreatic duct and bile ... Extraction of choledocholithiasis and/or intrahepatic stones: choledocholithiasis is the presence of gallstones within the ... common bile duct. They can be either primary (formed within the duct) or secondary (entering the duct from the gallbladder). ... Biliary endoscopic sphincterotomy is a procedure where the sphincter of Oddi and the segment of the common bile duct where it ...
Discrete localized enlargements of normal structures (ureters, blood vessels, intrahepatic or extrahepatic biliary ducts, ... Bile acids, at high levels in the colons of humans eating a high fat diet, also cause DNA damage and contribute to colon cancer ... "Carcinogenicity of deoxycholate, a secondary bile acid". Arch. Toxicol. 85 (8): 863-71. doi:10.1007/s00204-011-0648-7. PMC ...
In case of hyperbilirubinemia due to intrahepatic or extrahepatic bile ducts blockage, e.g. gallstone, the name is given as ... and be excreted into bile canaliculi by way of C-MOAT and MRP2 as normal human bile along with a little amount of unconjugated ... Note that biliary duct blockage can also lead to conjugated hyperbilirubinemia but the pathophysiology is that backflow of ... That means up to 96%-99% of bilirubin in the bile are conjugated. Normally, there is just a little conjugated bilirubin escapes ...
... association with high serum bile acids, advanced pathology, and bile duct abnormalities". Digestive Diseases and Sciences. 42 ( ... Progressive intrahepatic cholestasis Treatment Schedule: 3 to 5 eight-hour treatment sessions on consecutive days Continuous ... Progressive intrahepatic cholestasis Treatment Schedule: 3 to 5 eight-hour treatment sessions on consecutive days Continuous ... Saich, R; Collins, P; Ala, A; Standish, R; Hodgson, H (May 2005). "Benign recurrent intrahepatic cholestasis with secondary ...
... interlobular bile ductsintrahepatic bile ducts → left and right hepatic ducts merge to form → common hepatic duct exits ... Drainage in Patients with Nondilated Intrahepatic Bile Ducts Compared with Patients with Dilated Intrahepatic Bile Ducts". ... A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. Bile is ... The top half of the common bile duct is associated with the liver, while the bottom half of the common bile duct is associated ...
... including bile plugs and bile infarcts), duct hypoplasia, hepatocellular injury, and Zone 3 fibrosis. Giant cell change and ... The free or "unchaperoned" bile acids in bile of patients with MDR3 deficiency cause a cholangitis. Biochemically, this is of ... the gene that codes for the bile salt export pump, or BSEP. Retention of bile salts within hepatocytes, which are the only cell ... Biochemical markers include a normal GGT for PFIC-1 and -2, with a markedly elevated GGT for PFIC-3. Serum bile acid levels are ...
FREM1 Bile acid malabsorption, primary; 613291; SLC10A2 Bile acid synthesis defect, congenital, 2; 235555; AKR1D1 Bile acid ... DCTN1 Persistent Mullerian duct syndrome, type I; 261550; AMH Persistent Mullerian duct syndrome, type II; 261550; AMHR2 ... benign recurrent intrahepatic; 243300; ATP8B1 Cholestasis, familial intrahepatic, of pregnancy; 147480; ABCB4 Cholestasis, ... progressive familial intrahepatic 2; 601847; ABCB11 Cholestasis, progressive familial intrahepatic 3; 602347; ABCB4 Cholestasis ...
... intrahepatic bile ductule (in portal tracts / triads) >> interlobular bile ducts >> left and right hepatic ducts These merge to ... The common bile duct, commonly abbreviated CBD, is formed by the union of the cystic duct and common hepatic duct, and it later ... Bile is secreted by the liver into small ducts that join to form the common hepatic duct. Between meals, secreted bile is ... gallbladder and bile ducts, and how they work together to make, store and secrete bile. Bile consists of water, electrolytes, ...
... veins and bile ducts. While bile is made in the liver and stored in the gallbladder, the bile eventually passes into the GI ... A transjugular intrahepatic portosystemic shunt (TIPS) is a procedure an interventional radiologist performs to create a shunt ... cystic and common bile ducts. Any condition that prevents the normal flow of bile from the liver, through these bile vessels ... through the bile duct system and into the GI tract, essentially restoring the normal flow of bile. If the patient's GI tract ...
Ultrasonography always detects dilatation of the bile ducts, but more rarely the tumor itself.Magnetic resonance ... and CA 125 are abnormally high in the bloodstreams of patients with intrahepatic cholangiocarcinoma and Klatskin tumor. The ... Tannapfel A, Wittekind C (2004). "[Gallbladder and bile duct carcinoma. Biology and pathology]". Internist (Berlin) (in German ... occurring at the confluence of the right and left hepatic bile ducts. The disease was named after Gerald Klatskin, who in 1965 ...
... a bile acid-sensitive ion channel highly expressed in bile ducts". FASEB J. 26 (10): 4122-30. doi:10.1096/fj.12-207043. PMID ... Pusl T, Beuers U (2007). "Intrahepatic cholestasis of pregnancy". Orphanet J Rare Dis. 2: 26. doi:10.1186/1750-1172-2-26. PMC ... The bile acid pool size is between 4-6 g, which means that bile acids are recycled several times each day. About 95% of bile ... These conjugated bile acids are often referred to as bile salts. The pKa of the unconjugated bile acids are between 5 and 6.5, ...
Rarely are diseases of the bile ducts, such as primary sclerosing cholangitis, causes of cirrhosis. Imaging of the bile ducts, ... Sellers CM, Nezami N, Schilsky ML, Kim HS (April 2019). "Transjugular intrahepatic portosystemic shunt as a bridge to liver ... In primary biliary cholangitis, there is fibrosis around the bile duct, the presence of granulomas and pooling of bile. Lastly ... Ursodiol may be useful if the disease is due to blockage of the bile duct. Other medications may be useful for complications ...
... , sold under the brand name Truseltiq, is an anti-cancer medication used to treat cholangiocarcinoma (bile duct ... an investigational agent for the treatment of FGFR-altered intrahepatic cholangiocarcinoma". Expert Opinion on Investigational ... bile duct cancer) with a fibroblast growth factor receptor 2 (FGFR2) fusion or other rearrangement as detected by an FDA- ...
In purified form, it has been used to treat or prevent several diseases of the liver or bile ducts. It is available as a ... UDCA has been used for intrahepatic cholestasis of pregnancy. UDCA lessens itching in the mother and may reduce the number of ... primary bile acids can be metabolized into secondary bile acids by intestinal bacteria. Primary and secondary bile acids help ... UDCA has also been in effective in non-alcoholic fatty liver disease, in liver bile duct-paucity syndromes. It is ...
Discrete localized enlargements of normal structures (ureters, blood vessels, intrahepatic or extrahepatic biliary ducts, ... Bile acids, at high levels in the colons of humans eating a high fat diet, also cause DNA damage and contribute to colon cancer ... a secondary bile acid". Arch. Toxicol. 85 (8): 863-71. doi:10.1007/s00204-011-0648-7. PMC 3149672. PMID 21267546. Katsurano M, ...
... carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other ... Intrahepatic cholestasis of pregnancy List of cutaneous conditions Rapini RP, Bolognia JL, Jorizzo JL (2007). Dermatology: 2- ... which stores the bile), or biliary tract (also known as the biliary tree, the conduit that allows the bile to leave the liver ... the liver conjugates the bile to make it water-soluble and because the bile has already been processed by the liver, when it ...
They tend to be friable concretions of various shapes and sizes within the biliary tree, and their associated bile is often ... Digby, Kenelm (1930). "Common‐duct stones of liver origin". The British Journal of Surgery. 17 (68): 578. doi:10.1002/bjs. ... Caroli, J. (1973-01-01). "Diseases of the intrahepatic biliary tree". Clinics in Gastroenterology. 2 (1): 147-161. ISSN 0300- ... In humans, the majority of bilirubin is excreted in the bile as bilirubin glucuronide.[citation needed] Hepatolithiasis is ...
Biliary atresia, or inflammation and destruction of the bile ducts, may lead to jaundice. Vomiting and swelling of the ... Vascular abnormalities: Interrupted inferior vena cava, Bilateral superior or inferior venae cavae Intrahepatic interruption of ... In this surgery, a Y-shaped shunt is used to passage bile from the liver directly to the intestine. If this is unsuccessful, ... A majority of left atrial isomeric patients have defects throughout the biliary tree, which is responsible for bile production ...
Interlobular bile ducts (between the interlobar ducts and the lobules) - simple columnar epithelium. Intralobular bile ducts ( ... Intrahepatic bile ducts compose the outflow system of exocrine bile product from the liver. They can be divided into: Lobar ... Interlobar ducts (between the main hepatic ducts and the interlobular ducts) - pseudostratified columnar epithelium. ... ducts (right and left hepatic ducts) - stratified columnar epithelium. ...
They are small ducts that distinctly enter the gallbladder bed, or small tributaries of minor intrahepatic radicals of the ... Originating from the hepatic parenchyma the accessory bile duct may enter a large bile duct or the gallbladder at any location ... An accessory bile duct is a conduit that transports bile and is considered to be supernumerary or auxiliary to the biliary tree ... Often diagnosed by HIDA scan, a bile leak from an accessory bile duct post-op can be treated with a temporary biliary stent[ ...
Interlobular bile ducts (between the interlobar ducts and the lobules) - simple columnar epithelium. Intralobular bile ducts ( ... Intrahepatic bile ducts compose the outflow system of exocrine bile product from the liver. They can be divided into: Lobar ... Interlobar ducts (between the main hepatic ducts and the interlobular ducts) - pseudostratified columnar epithelium. ... ducts (right and left hepatic ducts) - stratified columnar epithelium. ...
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Centers RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.. ...
Intrahepatic Bile Duct Carcinoma , Adenocarcinoma , Malignant Adenoma , TACE Combined With Tislelizumab in Patients With ... Intrahepatic Bile Duct Carcinoma, Adenocarcinoma, Malignant Adenoma, Intrahepatic Cholangiocarcinoma Treatment. TACE, ... Not sure for Participants must have unresectable or metastatic histologically or cytologically confirmed intrahepatic ... Yes for Participants must have unresectable or metastatic histologically or cytologically confirmed intrahepatic ...
... USCS data brief, no 5. Atlanta, GA: Centers for Disease ... Title : Liver and intrahepatic bile duct cancer, United States-2006-2015 Corporate Authors(s) : National Center for Chronic ... In 2015, 32,908 new liver and intrahepatic bile duct cancer cases and 25,760 deaths were reported in the United States. • ...
Start fundraising to fight Liver And Intrahepatic Bile Duct in Union City today. No technical skill required, keep 100% of all ... Fundraising To Fight Liver and Intrahepatic Bile Duct In Union City. How Many People Have Liver and Intrahepatic Bile Duct It ... 2013 it is estimated that 22,720 men will be diagnosed with Liver and Intrahepatic Bile Duct. Liver and Intrahepatic Bile Duct ... 2013 it is estimated that 7,921 women will be diagnosed with Liver and Intrahepatic Bile Duct. Liver and Intrahepatic Bile Duct ...
Amoebic liver abscess communicating with intrahepatic bile duct. Tropical Gastroenterology. 1995 Oct-Dec; 16(4): 47-9. ...
Variations of intrahepatic and proximal extrahepatic bile ducts ... Variations of intrahepatic and proximal extrahepatic bile ducts ... Morda vas bo zanimalo: Variations of intrahepatic and proximal extrahepatic bile ducts ... intrahepatic and extrahepatic bile ducts. The aim of this study was to find biliary variations, especially o na segmental and ... Background/Aims: The modern segmental concept of the liver with a segmental bile duct distribution is of practical importance ...
Liver and intrahepatic bile ducts. 277. (5.6%). (1.0%). Stomach. 228. (4.6%). (0.8%). ...
... and cancer can result in bile duct problems. Discover the types, causes, symptoms, and treatment of bile duct diseases. ... your gallbladder pushes the bile into tubes called bile ducts. They carry the bile to your small intestine. The bile helps ... Different diseases can block the bile ducts and cause a problem with the flow of bile:. *Gallstones, which can increase ... Progressive familial intrahepatic cholestasis: MedlinePlus Genetics (National Library of Medicine) Clinical Trials ...
A. Damage to Intrahepatic Bile Ducts or Portal Tracts. Viral hepatitis A-E ... shows sludge within the gallbladder and the lower common bile duct (arrow). A diagnosis of acalculous cholecystitis was ... Bile duct cancers. Developmental disorders of the bile ducts (eg, Caroli disease) ...
14-day fever, headache, jaundice, RUQ pain, myalgia, 8-cm hepatomegaly; abdominal CT suggested tumor of intrahepatic bile ducts ...
Liver and intrahepatic bile duct cancers are the fifth most common cause of cancer deaths in men in the US, and the seventh ... The common bile duct gives off the cystic duct and becomes the hepatic duct. The hepatic duct then divides into two or three ... For 2022, the American Cancer Society (ACS) estimates that 41,260 new cases of liver cancer (including intrahepatic bile duct ... 27] According to Surveillance, Epidemiology, and End Results (SEER) program data, liver and intrahepatic bile duct cancers ...
Liver and Intrahepatic Bile Duct 21071 Liver 21072 Intrahepatic Bile Duct 21080 Gallbladder 21090 Other Biliary 21100 Pancreas ...
... intrahepatic bile ducts; 5) pancreas; 6) trachea, bronchus, and lung; 7) ovary; 8) brain; 9) tumors of the hemopoietic/ ... cancer of the gallbladder and extrahepatic ducts. These increased risks were not limited to cancers only but were also observed ...
Categories: Bile Ducts, Intrahepatic Image Types: Photo, Illustrations, Video, Color, Black&White, PublicDomain, ...
... perihilar bile duct tumors, and distal bile duct tumors. Gallbladder cancer staging Table. ... intrahepatic bile duct tumors, perihilar bile duct tumors, and distal bile duct tumors. [1, 2] ... Intrahepatic bile duct tumor staging. Table. Intrahepatic bile duct tumor staging (Open Table in a new window) ... Perihilar bile duct tumor staging. Table. Perihilar bile duct tumor staging (Open Table in a new window) ...
... confirmed the recurrence of CoCC in the intrahepatic bile duct. Although extended right lobectomy with extrahepatic bile duct ... We reported a case of IG-type recurrence in the bile duct, which is an unusual pattern of intrahepatic recurrence, after ... The patient was treated with repeat hepatectomy with bile duct reconstruction. The patient was a 76-year-old man with a history ... Computed tomography revealed a tumor occupying the right hepatic duct (B5-8) to B4 and the junction of the cystic duct. ...
Important information from Karmanos Cancer Institute about bile duct cancer, its causes, risk factors, diagnosis and treatment. ... Intrahepatic bile duct cancer: This type of cancer forms in the bile ducts inside the liver. Only a small number of bile duct ... What is bile duct cancer?. Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts. Bile ... Intrahepatic bile duct cancers are also called intrahepatic cholangiocarcinomas.. *Extrahepatic bile duct cancer: This type of ...
Repopulation of intrahepatic bile ducts in engineered rat liver grafts. Technology (Singap World Sci). 2019 Mar-Jun;7(1-2):46- ... Post-hepatectomy liver regeneration in the context of bile acid homeostasis and the gut-liver signaling axis. J Clin Transl Res ...
Liver & Intrahepatic Bile Duct. Both Sexes. 6.6. 6.2. 8.4. 10.6. 9.1. 9.3. 5.8. 6.8. 6.3. 8.0. 9.2. 9.3. 9.5. 5.7. ...
Liver / intrahepatic bile duct. 8.2. 4.9. 3.4-6.8. 5.6. 7.8. 5.0-11.6. 2.6. 2.4. 1.3-4.4. ...
Tumors of the liver and intrahepatic bile ducts. Atlas of tumor pathology. Washington, D.C.: Armed Forces Institute of ...
Neurites are present in the liver before bile duct tubulogenesis, and in other organs, innervation can instruct tubulogenesis. ... the signal initiating tubulogenesis of bile ducts therein remains to be identified. ... I will test the hypothesis that intrahepatic innervation initiates biliary tubulogenesis. First, I will apply 3D staining and ... While liver development is well-studied, the signal initiating tubulogenesis of bile ducts therein remains to be identified. ...
This study is looking at derazantinib for bile duct cancer that cant be removed with surgery and has certain changes in the ... It is open to people with bile duct cancer that started inside of the liver (intrahepatic bile duct cancer) and has spread. ... Research shows that derazantinib might help people with intrahepatic bile duct cancer that has certain changes in the FGFR2 ... There are changes in this gene in many different cancers including intrahepatic bile duct cancer. ...
Bile Duct Neoplasms. 3. 2002. 563. 0.040. Why? Bile Ducts, Intrahepatic. 2. 2002. 269. 0.040. Why? ...
Endoscopic Management of Liver Abscesses and Cysts that Communicate with Intrahepatic Bile Ducts * Full Text ... Effect on Deep Common Bile Duct Cannulation Time * Full Text ... Multiple Stenting of Refractory Pancreatic Duct Strictures in ...
  • The distal region is made up of the common bile duct which passes through the pancreas and ends in the small intestine. (
  • Abnormal bile duct junctures that may allow juices from the pancreas to reflux up into the bile ducts. (
  • Gastroenterology and Hepatology is the first journal to cover the latest advances in pathology of the gastrointestinal tract, liver, pancreas, and bile ducts, making it an indispensable tool for gastroenterologists, hepatologists, internists and general practitioners. (
  • The most commonly affected organs are: the pancreas, bile duct, major salivary glands, lacrimal glands, retroperitoneum and lymphatic ducts. (
  • Dilatation of extra- and intrahepatic bile ducts and heterogeneity of the head of the pancreas are visible. (
  • There was evidence of biliary obstruction at the level of the liver hilum with marked dilatation of the intrahepatic biliary ducts and a hypervascular lesion in the head of the pancreas. (
  • Two ducts, the main pancreatic duct and a smaller accessory pancreatic duct , run through the body of the pancreas, joining with the common bile duct near a small ballooning called the ampulla of Vater . (
  • In this case, the presence of an ampullary mass caused DDI with sub mucosal elongation of the common bile duct and obstructive jaundice in a patient with pancreas divisum. (
  • Due to the presence of Pancreas Divisum, no pancreatic duct was encountered within the ampulla, which was advantageous (Figure 3). (
  • Vanishing bile duct syndrome (VBDS) is a rare acquired disorder associated with progressive destruction and disappearance of intrahepatic bile ducts which eventually leads to cholestasis. (
  • Elevated ALP indicates cholestasis (elevated GGT confirms liver source) and normal bile ducts on ultrasound therefore INTRAHEPATIC CHOLESTASIS. (
  • Albireo is developing A4250 to treat progressive familial intrahepatic cholestasis (PFIC), among other conditions. (
  • ALP levels in plasma will rise in the presence of a large bile duct obstruction, intrahepatic cholestasis, or liver infiltrative disease. (
  • To study the incidence and peculiarities of intrahepatic cholestasis (IHC) syndrome in patients with toxic liver damage in acute and chronic intoxications with pesticides and to substantiate rational methods of diagnosis and treatment. (
  • Chemical substances released during the biotransformation by the liver in the bile often cause the formation of intrahepatic cholestasis (IHC), especially in individuals with individual genetic characteristics of the body[1-6, 8-11]. (
  • Cholestasis in the absence of obstruction is an intra-hepatic process and is caused by impaired bile synthesis or transport in hepatocytes or in the canalicular system (or by combining these mechanisms) [1-8, 32, 36]. (
  • In accordance with this, the following IHC variants are identified: intralobular cholestasis caused by hepatocyte damage (hepatocellular mainly affecting membranes or transport proteins), as well as canaliculi damage (canalicular mainly affecting cholangiocyte membranes or their transport proteins) and extralobular (ductular) caused by damage of intrahepatic bile ducts [4, 6, 8, 32, 36]. (
  • Primary biliary cholangitis) The primary biliary cirrhosis (PBC) is an autoimmune liver disease with progressive destruction of intrahepatic bile ducts, which may lead to the development of cholestasis, cirrhosis and ultimately liver failure. (
  • Liver cancer includes two major types: hepatocellular carcinoma (HCC) and intrahepatic bile duct cancer. (
  • The efficacy of adjuvant photodynamic therapy (PDT) using the new photosensitizer, talaporfin sodium (TPS), was assessed in 7 patients with bile duct carcinoma (BDC). (
  • As a result of the improvements in early diagnosis, the number of cases with resectable bile duct carcinoma (BDC) has increased and the patients survival has improved in recent years ( 1 - 3 ). (
  • Strikingly, patients with the same predisposition or liver damaging risk factors either develop hepatocellular carcinoma or intrahepatic cholangiocellular carcinoma. (
  • Precancerous cells, in whose environment cells died due to necroptosis, led to intrahepatic cholangiocellular carcinoma. (
  • In the treatment of HCC with chemoembolization, it has already been observed that a part of the original liver cancer can turn into a bile duct carcinoma. (
  • METHODS: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) among 467,336 EPIC participants (median follow-up 14.9 years). (
  • Primary neuroendocrine carcinoma of the liver is a rare tumour, probably arising from scattered neuroendocrine cells of the bile duct. (
  • Primary liver cancer, the most common histologic types of which are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), is the second leading cause of cancer death worldwide. (
  • After a mean 7.5 mean years of follow-up, 121 hepatocellular carcinoma (HCC), 34 intrahepatic bile duct (IHBC) and 131 gallbladder and biliary tract (GBTC) cases were identified and matched to 2 controls each. (
  • 1 Primary liver cancer includes hepatocellular carcinoma (HCC) (75%-85% of primary liver cancers) and intrahepatic cholangiocarcinoma or bile duct cancer (10%-15% of primary liver cancers). (
  • Cholangiocarcinoma (CCA) is a heterogeneous malignant tumor containing intrahepatic and extrahepatic bile ducts and gallbladder carcinoma. (
  • Tumorigenesis and phenotypic characteristics of mucin-producing bile duct tumors: an immunohistochemical approach. (
  • Tumors or cancer of the BILE DUCTS. (
  • For purposes of staging, satellite nodules , multifocal primary cholangiocarcinomas, and intrahepatic metastases are not distinguished and are considered multiple tumors. (
  • The tumor-node-metastasis (TNM) staging classifications for biliary tract cancers are provided below, including those for biliary tract cancer, intrahepatic bile duct tumors, perihilar bile duct tumors, and distal bile duct tumors. (
  • Placement in biliary strictures caused by benign tumors, as the long-term effects of the stent in the bile duct is unknown. (
  • RESULTS: Of the 564 patients, 44 (8%) had intrahepatic, 281 (50%) had perihilar, and 239 (42%) had distal tumors. (
  • This study is intended to investigate the clinicopathological features of the intraductal papillary neoplasms of the intrahepatic bile duct (IPNB), especially focused on malignant changes. (
  • Bile Duct Neoplasms" is a descriptor in the National Library of Medicine's controlled vocabulary thesaurus, MeSH (Medical Subject Headings) . (
  • This graph shows the total number of publications written about "Bile Duct Neoplasms" by people in Harvard Catalyst Profiles by year, and whether "Bile Duct Neoplasms" was a major or minor topic of these publication. (
  • Below are the most recent publications written about "Bile Duct Neoplasms" by people in Profiles. (
  • Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts. (
  • We describe the clinical cases of four patients with malignant pleural mesothelioma (MPM), diffuse malignant peritoneal mesothelioma (DMPM), intrahepatic cholangiocarcinoma, and breast cancer (BC) who received supportive treatment (ST) according to an IM approach after the failure of standard cancer treatments or the appearance of serious adverse events caused by antiblastic chemotherapy. (
  • Etiologically, a distinction is made between benign and malignant bile duct stenoses, which require different diagnostic and therapeutic approaches. (
  • Cholangiocarcinoma (CCA) is a rare and heterogeneous malignant neoplasm with epithelial cell origin of the biliary duct and histologic and biochemical features of cholangiocyte differentiation. (
  • Comparison of Hepatic Arterial Infusion Pump Chemotherapy vs Resection for Patients With Multifocal Intrahepatic Cholangiocarcinoma. (
  • However, curative resection is often difficult because BDC spreads extensively along the bile duct beyond the lesion noted at the pre-operative diagnosis ( 1 ). (
  • In this study, a 32-year-old male patient with Bismuth Type IVa hilar cholangiocarcinoma underwent radical robotic resection of hepatic S4b, S5, and S1 (Taj Mahal hepatectomy) combined with regional lymphadenectomy, hilar bile duct reconstruction, and hepaticojejunostomy by the robotic surgical system. (
  • The Taj Mahal procedure comprises complete resection of S4b, S5, and S1 combined with regional lymphadenectomy, extrahepatic bile duct resection, hilar bile duct reconstruction, and hepaticojejunostomy 4 . (
  • Kim JH , Won HJ, Shin YM, Kim PN, Lee SG, Hwang S. Radiofrequency ablation for recurrent intrahepatic cholangiocarcinoma after curative resection. (
  • Percutaneous Radiofrequency Ablation for Recurrent Intrahepatic Cholangiocarcinoma After Curative Resection: Multivariable Analysis of Factors Predicting Survival Outcomes. (
  • Participants in this study comprised 220 consecutive patients who underwent intrahepatic cholangiojejunostomy following hepato-biliary resection for biliary malignancies between September 1998 and December 2010. (
  • Liver resection with intrahepatic cholangiojejunostomy for biliary malignancies is one of the most demanding surgeries and is associated with a high morbidity rate. (
  • The other indications included a biliary leakage at the resection margin after left hemihepatectomy with distal biliary narrowing (n = 1) as well as the implantation of the BMCL stent via a transgastric bile duct access (BPD stent) in the case of stenosis at the hepatic bifurcation area (n = 1, patient request for stent removability). (
  • A hepatic bile duct bifurcation resection was performed in the further course of the patient treatment with the stent inserted transgastrally. (
  • Patients who undergo liver resection with biliary duct reconstructon. (
  • Only a small number of bile duct cancers are intrahepatic. (
  • Intrahepatic bile duct cancers are also called intrahepatic cholangiocarcinomas. (
  • There are changes in this gene in many different cancers including intrahepatic bile duct cancer. (
  • No associations were observed with cancers of the intrahepatic and extrahepatic bile ducts. (
  • However, cancers of the bile ducts also occur outside the liver as distal cholangiocarcinomas and Klatskin tumours and are classified under code C24 according to the current classification system. (
  • This includes both intrahepatic and extrahepatic (inside and outside the liver) bile duct cancers. (
  • and liver and intrahepatic bile duct cancers 8.3 per 100,000. (
  • In the United States, 28,720 new cancers of the liver and intrahepatic bile duct are expected in 2012, with an estimated 20,550 deaths ( 2 ). (
  • MRCP confirms a number of stones within the gall bladder and common bile duct (at least 4 in the duct), with no intrahepatic duct dilatation. (
  • The liver cannot perform any of these functions properly if its bile ducts are clogged with deposits of hardened bile or " gallstones " (made of gall or bile). (
  • The gall-bladder and bile ducts laid open. (
  • Originating from the bile ducts which are the tubes that carry bile from the liver to the gall bladder, about ten to twenty per cent of the cases of primary liver cancer fall under this category. (
  • Approximately 65 percent of tumours within the liver (ICD-10 C22) develop from liver cells (hepatocellular carcinomas) and about 26 percent from cells of the bile ducts (intrahepatic cholangiocarcinomas). (
  • The following figure shows the distribution of hepatocellular carcinomas as well as all tumours of the bile ducts according to sex. (
  • Congenital choledochal cysts: new etiological concept based on anomalous relationships of the common bile duct and pancreatic bulb]. (
  • Cysts in the bile ducts (cysts block the flow of bile and can cause swollen bile ducts, inflammation, and infection). (
  • obstruction of bile ducts by intrahepatic cysts, rupture of cysts into the bile ducts and subsequent intrinsic obstruction caused by hydatid material, and, the rarest form, extrinsic compression of bile ducts by a hydatid cyst with or without accompnying liver cyst 2 - 5 . (
  • Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. (
  • Primary sclerosing cholangitis (a progressive disease in which the bile ducts become blocked by inflammation and scarring). (
  • Primary sclerosing cholangitis (PSC) is a fibroinflammatory disease of the bile ducts leading to cirrhosis and hepatic decompensation. (
  • Primary sclerosing cholangitis (PSC) is a rare inflammatory, fibrotic disease involving intrahepatic and extrahepatic bile ducts ( 1 ). (
  • Long-term damage to bile ducts that may result from chronic inflammation from stones in the bile duct or primary sclerosing cholangitis, an autoimmune disease that leads to bile duct scarring. (
  • Also, gallstones and inflammatory conditions of the digestive tract, such as ulcerative colitis or an associated condition called Primary Sclerosing Cholangitis (PSC), increase the risk of bile duct cancer. (
  • Primary biliary cholangitis (PBC) is a chronic liver disease resulting from progressive destruction of the intrahepatic bile ducts in the liver. (
  • [5] In this obstructed state, the duct is especially vulnerable to an infection called ascending cholangitis . (
  • The presence of intrahepatic bile duct ectasia with hepatolithiasis, predominantly affecting left lateral segment and parenchymal atrophy, fits the description of segmental cholangiectasia (i.e., recurrent pyogenic cholangitis ) of the liver. (
  • 65-year-old female who underwent ERCP for Jaundice, abnormal liver function test, acquired bile duct dilation and Cholangitis like symptoms. (
  • Following placement of the biliary stent, the bile leak improved, but hemobilia and cholangitis developed five days later. (
  • abdominal CT suggested tumor of intrahepatic bile ducts (cholangiocarcinoma? (
  • Perihilar bile duct cancer is also called a Klatskin tumor or perihilar cholangiocarcinoma. (
  • MICA/B-targeted antibody promotes NK cell-driven tumor immunity in patients with intrahepatic cholangiocarcinoma. (
  • Locally advanced tumor occluding bile duct was relieved by PDT and patency was maintained for 16 months. (
  • In recent years, in particular, the number of patients with the highly invasive intrahepatic cholangiocellular carcinomas increased noticeably, although both tumor types show overlaps regarding their risk factors. (
  • Differential diagnosis was obstructive jaundice secondary to common bile duct stone vs. periampullary tumor given the duration and the severity of jaundice clinically. (
  • Subsequently, an endoscopic retrograde cholangiopancreatography revealed a tumor within the biliary tree consistent with a Klatskin tumor, an adenocarcinoma located at the bifurcation of the common hepatic duct. (
  • tumor obstruction of the bile ducts. (
  • Liver and intrahepatic bile duct cancer. (
  • an estimated 24,120 new cases from liver and intrahepatic bile duct cancer in the united states are expected to occur during 2010, resulting in approximately 18,910 deaths. (
  • CRNM: Dilation of the intra- and extra-hepatic bile duct with images suggesting the presence of calculi from the intra-pancreatic portion to segment IV of the liver. (
  • It can also be caused by the intrahepatic bile ducts' dilation or stone formation. (
  • Rare deformities of the common bile duct are cystic dilations (4 cm), choledochoceles (cystic dilation of the ampula of Vater (3-8 cm)), and biliary atresia . (
  • Endoscopic ultrasound (EUS) confirmed a 27x25mm round homogeneous hypoechoic lesion, with well-defined contour, located in the pancreatic head, without upstream biliary or pancreatic duct dilation. (
  • Magnetic resonance cholangiopancreatography (MRCP) revealed CBD dilation with a maximal diameter of 14 mm and mild dilation of intra-hepatic bile ducts. (
  • Although there were no intraluminal lesions, the dilation appeared to end abruptly at the junction with main pancreatic duct (Fig. 1). (
  • A constriction in the bile duct that impairs the outflow of bile and leads to a consecutive dilation of the bile duct is called a bile duct stenosis. (
  • As a whole, cholangiocarcinoma is an aggressive cancer of the bile ducts. (
  • Saha studied intrahepatic cholangiocarcinoma, a cancer of the bile ducts. (
  • As a part of the digestive system, it functions as an exocrine gland secreting pancreatic juice into the duodenum through the pancreatic duct . (
  • A blockage in the bile duct prevents bile (bilirubin) from flowing into the duodenum, which aids digestion. (
  • ERCP is a method which plays the basic role in diagnosis and treatment of fistula between common bile duct and duodenum. (
  • The flow of bile from the ampulla of Vater into the duodenum is under the control of the sphincter of Oddi . (
  • When open, the stored and concentrated bile (now mixed with pancreatic secretions) exits into the duodenum and takes part in digestion . (
  • Choledochoduodenostomy - a surgical procedure to create a connection between the common bile duct (CBD) and an alternative portion of the duodenum. (
  • In 2 patients (recurrent stone discharge), the distal end of the stent in the duodenum was clearly obstructed after 3 to 4 months, whereby the bile drainage in these patients was ensured through the openings in the cover in direct front of the insertion portion point to the major papilla (Figure 2). (
  • It receives and stores bile, produced by the liver, via the common hepatic duct and releases it via the common bile duct into the duodenum , where the bile helps in the digestion of fats . (
  • The metacercariae of excyst in the duodenum, then migrate into hepatic bile ducts where the flukes adult into adult worms [3]. (
  • CT scan and MRI revealed that there is an intussusception, with the elongated common bile duct entering the duodenum to the left of the midline (Figure 2). (
  • The gallbladder is part of a network of structures known collectively as the biliary tree, which drains bile from the liver into the duodenum to facilitate digestion. (
  • 24] In these patients, a small distal CBD entered the pancreatic duct at 2-3.5 cm from the ampulla of Vater, whereas the normal common channel is 5 mm or less. (
  • It is formed by the confluence of the common hepatic duct and cystic duct and terminates by uniting with pancreatic duct , forming the ampulla of Vater . (
  • The patient underwent Exploratory laparotomy, cholecystectomy, exploration of common bile duct, excision of ampulla of Vater with reimplantation of common bile duct. (
  • Bile duct opening was not noted at this ampulla. (
  • The extrahepatic bile duct is made up of the hilum region and the distal region. (
  • Distal bile duct cancer is also called extrahepatic cholangiocarcinoma. (
  • Patients were divided into intrahepatic, perihilar, and distal groups. (
  • Cystic duct , 6. (
  • At the same time, the cystic duct can be drained through the openings that this stent provides. (
  • The gallbladder is shaped like a pear, with its tip opening into the cystic duct . (
  • The neck tapers and is continuous with the cystic duct , part of the biliary tree . (
  • [2] The gallbladder fossa, against which the fundus and body of the gallbladder lie, is found beneath the junction of hepatic segments IVB and V. [5] The cystic duct unites with the common hepatic duct to become the common bile duct . (
  • Lymphatic drainage of the gallbladder follows the cystic node which is located between cystic duct and common hepatic ducts. (
  • [2] Rarely, two or even three gallbladders may coexist, either as separate bladders draining into the cystic duct, or sharing a common branch that drains into the cystic duct. (
  • The biliary tree also includes the cystic duct, the right and left hepatic ducts, and the common hepatic and common bile ducts, as well as a series of microscopic biliary vessels. (
  • It consists of a rounded fundus, smooth body and tapering neck, which becomes contiguous with the cystic duct and attaches to the porta hepatis. (
  • The most common indication was therapy-refractory benign bile duct stenosis with recurrent stone discharge (n = 5) or with chronic pancreatitis (n = 4). (
  • Chronic bacterial infection of the intrahepatic bile ducts can induce inflammation and scarring, eventually leading to stenosis, proximal cholangiectasia, and hepatolithiasis. (
  • They carry the bile to your small intestine. (
  • The liver secretes bile into the small intestine via the biliary system, employing the gallbladder as a reservoir. (
  • In vertebrates, the gallbladder is a small hollow organ where bile is stored and concentrated before it is released into the small intestine . (
  • IBATs mediate the uptake of bile acids from the small intestine to the liver, a process known as enterohepatic circulation. (
  • The major function of the bile duct is to move a fluid called bile from the liver and gallbladder to the small intestine, where it helps digest the fats in food. (
  • Bile salts are produced by the liver and are essential for the digestion and absorption of fat in the small intestine. (
  • Cystic dilatation of the common bile duct (CBD), also known as choledochal cyst, is a fairly uncommon anomaly of the biliary tract. (
  • Choledochal cyst is a rare congenital dilatation of the common bile duct, often associated with a congenital or acquired dilatation of intra-hepatic ducts. (
  • Case of dilatation of the common bile duct. (
  • He has it in his bile duct liver bone in rib and lymph nodes. (
  • This autoimmune condition causes bile duct inflammation and scarring that leads to their narrowing and hardening, and gradual liver damage. (
  • PSC is an autoimmune disease in which the body's immune system attacks the bile ducts and causes scarring. (
  • Primary biliary cirrhosis (PBC) is characterized by the highly selective autoimmune injury of small intrahepatic bile ducts, despite widespread distribution of mitochondrial autoantigens. (
  • A diagnosis of autoimmune pancreatitis was confirmed, the bile duct stent removed, and an appropriate treatment plan was undertaken. (
  • Interlobar ducts (between the main hepatic ducts and the interlobular ducts) - pseudostratified columnar epithelium. (
  • We concluded that intrahepatic IPNB is a rare type of biliary neoplasm which includes a histological spectrum, ranging from benign disease to invasive malignancy. (
  • Intraductal papillary neoplasm of the bile duct associated with Clonorchis sinensis infection. (
  • Intraductal neoplasm of the intrahepatic bile duct: clinicopathological studyof 24 cases. (
  • KRAS mutation and immunohistochemical profile in intraductal papillary neoplasm of the intrahepatic bile ducts. (
  • Once the diagnosis of metastatic cholangiocarcinoma was established, palliative stenting of the biliary tree and hepatic ducts were done to alleviate the obstruction. (
  • Although most PSC involves entire biliary tree without a left segmental propensity, intrahepatic segmental PSC has been reported. (
  • They can be divided into: Lobar ducts (right and left hepatic ducts) - stratified columnar epithelium. (
  • It is a rare congenital anomaly that is characterized by nonobstructive saccular or fusiform dilatation of the intrahepatic bile ducts and is associated with bile stagnation and hepatolithiasis. (
  • This type of cyst occurs as a result of a congenital (born with it) malformation of a bile duct in which a fluid-filled sac forms in the bile duct. (
  • Congenital bile duct abnormalities. (
  • The choledochal cyst is a congenital disease which is characterized by extrahepatic bile duct dilatation. (
  • These are at birth or congenital abnormalities in your bile duct. (
  • Intrahepatic bile duct stones are one of the most common late complications of Roux-en-Y hepaticojejunostomy for congenital biliary dilatation. (
  • Todani T, Narusue M, Watanabe Y, Tabuchi K, Okajima K. Management of congenital choledochal cyst with intrahepatic involvement. (
  • A right upper quadrant ultrasound showed an enlarged liver with mild coarse echo texture and dilated intrahepatic bile ducts with a hypoechoic lesion in the right lobe of the liver. (
  • However, patients with extrahepatic lesions could be included if excision of intrahepatic lesion prolongs theirprognosis. (
  • The hormone cholecystokinin , when stimulated by a fatty meal, promotes bile secretion by increased production of hepatic bile, contraction of the gallbladder, and relaxation of the sphincter of Oddi. (
  • For extrahepatic bile duct cancer, the average age at diagnosis is 72.The number of new cases of bile duct cancer is increasing, mostly due to rising rates of intrahepatic bile duct cancer. (
  • Cancer that originates in sections of the duct outside the liver, then it is known as extrahepatic bile duct cancer. (
  • Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by destruction and disappearance of intrahepatic (inside the liver) bile ducts. (
  • As co-director of the Hutch's Pancreatic Cancer Program, Kugel hopes to develop effective therapies for pancreatic and bile duct cancer patients who now face a grim prognosis. (
  • The significant rise in the prevalence of bile duct and pancreatic cancer is the major factor driving the growth of global biliary stent market. (
  • Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease characterized by inflammatory destruction of the intrahepatic bile ducts. (
  • On top benign von Myenberg complex, below cholangiocarcinoma of intrahepatic bile ducts. (
  • Biliary hamartomas are rare benign bile duct malformations consisting of multiple collections of localized duct-like structures that are lined by biliary epithelium and embedded in a fibrous stroma. (
  • Laboratory examinations revealed elevated CA19-9 (31.48 U/mL) and total bilirubin (145.7 μmol/L). Severe obstruction with partial thickening of the hilar bile duct wall was observed in Magnetic Resonance Cholangiopancreatography (MRCP) ( Figure 1 ) and 3D reconstruction of MRI ( Figure 2 ). (
  • the liver's ability to synthesize enzymes and proteins, the liver's ability to process bilirubin and secrete bile, and the extent of liver damage. (
  • The liver converts bilirubin into a water-soluble form to be secreted into bile. (
  • A large number of toxic exogenous and endogenous compounds are released from the body with bile (bilirubin, cholesterol, metabolites of medicinal products, xenobiotics, etc. (
  • These findings suggest biliary cirrhosis associated with cholelithiasis, bacterial cholecystitis, bile plugs, and/or intrahepatic bile duct rupture with leakage of bile should be considered a top differential for green iguanas presenting with evidence of hepatobiliary disease. (
  • These stones, hardened pebble-like deposits of bile or cholesterol, can form in the gallbladder, causing inflammation or a blockage in the bile ducts. (
  • IHC is based on the dysfunction of the mechanisms of bile synthesis, secretion and outflow, which develops in the absence of obstruction of the bile ducts against the background of lesions in any area - from the basolateral membrane of the hepatocyte or cholangiocyte to the terminal sections of the intrahepatic bile ducts [1-3, 10-14]. (
  • Borderline of a dilated perihilar bile duct, measuring 8 mm. (
  • Many risk factors for gallbladder cancer are related to inflammation in the gallbladder or bile ducts, or are conditions that cause this inflammation. (
  • HealthDay)-Most people aren't aware of the signs of gallbladder or bile duct cancer, but the Rutgers Cancer Institute of New Jersey says they should be. (
  • Results: The types of confluence and their frequency were determined separately for the left, right, right anterior sectorial, right posterior sectorial and common hepatic ducts. (
  • Bile pigments are the end product of the breakdown of hemoglobin during the destruction of old red blood cells. (
  • Each year, an estimated 8,000 people in the United States are diagnosed with bile duct cancer. (
  • According to the American Cancer Society, Inc., about 8,000 people in the United States are diagnosed with bile duct cancer each year. (
  • The objective of this study is to evaluate the efficacy and safety of TACE combined with Tislelizumab in patients with advanced intrahepatic cholangiocarcinoma after progression on first-line systemic therapy. (
  • Therefore, this study aims to evaluate the efficacy and safety of TACE combined with anti-PD-1 antibody in patients in advanced intrahepatic cholangiocarcinoma. (
  • To evaluate morbimortality rates, evolution and handing of patients with cystic dilatation bile ducts in adults. (
  • Diffusion-weighted imaging as an imaging biomarker for assessing survival of patients with intrahepatic mass-forming cholangiocarcinoma. (
  • Futibatinib is indicated for use in adult patients with previously treated, unresectable, locally advanced, or metastatic intrahepatic cholangiocarcinoma harboring fibroblast growth factor receptor 2 (FGFR2) gene fusions or other rearrangements. (
  • Approximately 20% of patients diagnosed with cholangiocarcinoma have the intrahepatic form of the disease. (
  • In most patients the diagnosis can be confirmed by using ultrasound pictures or by injecting a radioactive substance and performing a tomography scan which gives an "image" of the abnormal duct. (
  • Is it safe to administer neoadjuvant chemotherapy to patients undergoing hepatectomy for intrahepatic cholangiocarcinoma? (
  • Choi WJ, Ivanics T, Claasen M, Gallinger S, Hansen B, and Sapisochin G. Is it safe to administer neoadjuvant chemotherapy to patients undergoing hepatectomy for intrahepatic cholangiocarcinoma? (
  • BACKGROUND: The use of neoadjuvant chemotherapy (NAC) in patients with intrahepatic cholangiocarcinoma (iCCA) is increasing. (
  • This study aimed to assess the efficacy and safety of SpyDS-assisted PTCS in patients with surgically altered anatomy, particularly those with a Roux-en-Y reconstruction. (
  • Thirteen patients (six women, median age 71.4 years [range, 53 to 83 years]) with surgically altered anatomy (four Roux-en-Y choledochojejunostomies, seven Roux-en-Y hepaticojejunostomies, and two Roux-en-Y esophagojejunostomies) who underwent SpyDS-assisted PTCS between January 2019 and August 2020 were included and the data was acquired by retrospectively reviewing electronic medical record. (
  • Laparoscopic cholecystectomy and common bile duct exploration are safe for older patients. (
  • OBJECTIVE: To assess long-term survival and prognostic factors in a large series of patients with bile duct cancer. (
  • METHODS: We studied 564 consecutive patients with bile duct cancer operated upon between 1973 and 2004. (
  • The purposes of the present study were, firstly, to evaluate the incidence of anastomotic insufficiency following intrahepatic cholangiojejunostomy and, secondly, to evaluate whether platelet depletion represents a risk factor for anastomotic insufficiency in intrahepatic cholangiojejunostomy. (
  • Precise determination of the incidence of, and risk factors for, anastomotic insufficiency after intrahepatic cholangiojejunostomy remains difficult. (
  • SUMMARY BACKGROUND DATA: The incidence of bile duct cancer is low but increasing. (
  • There is evidence that demonstrates greater effectiveness of the two-step approach with ERCP and subsequent laparoscopic cholecystectomy over the one-step approach, especially in the rate of bile leak and the incidence of retained stones. (
  • The one-step approach with bile duct exploration and laparoscopic cholecystectomy at the same time is safe, with a high success rate, low incidence of complications, shorter hospital stay, and lower costs. (
  • This can result in a build-up of bile in the liver, resulting in symptoms including jaundice, stomach pain, and nausea. (
  • Obstruction of the common bile duct and related jaundice has been documented since at least since the time of Erasistratus . (
  • AIP can appear as a common bile duct stricture in an endoscopic retrograde cholangiopancreatography. (
  • Placement of a fully covered or partially covered biliary stent across a branch duct or major bifurcation may result in complications due to blockage of flow from the branch duct and prevent endoscopic or transhepatic access for future procedures. (
  • Physicians may recommend a procedure-endoscopic retrograde cholangiopancreatography (ERCP)-to remove the stones remaining in the bile duct. (
  • Caddy G, Tham T: Symptoms, diagnosis and endoscopic management of common bile duct stones. (