Journal articles: 'Hepato-biliary and pancreatic diseases'

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Sunaga, Masahiko, Shintaro Kikkawa, and Fumio Nomura. "3. Digestive System Diseases 2) Hepato-biliary-pancreatic Diseases." Nihon Naika Gakkai Zasshi 97, no. 12 (2008): 2951–58. http://dx.doi.org/10.2169/naika.97.2951.

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Topala, M., V. Ionescu, A. Ion, R. Neamtu, S. Dragan, and C. Gheorghe. "P343 Pancreato-biliary disorders in patients with inflammatory bowel diseases – a single-centre report." Journal of Crohn's and Colitis 18, Supplement_1 (January 1, 2024): i738. http://dx.doi.org/10.1093/ecco-jcc/jjad212.0473.

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Abstract Background Inflammatory bowel diseases (IBD) are regarded as multisystemic disorders due to the high prevalence of extraintestinal symptoms. Hepato-pancreato-biliary involvement can be present in up to 50% of patients, due to IBD extraintestinal manifestations and complications. Our aim was to evaluate the prevalence of the pancreato-biliary diseases in patients diagnosed with IBD. Methods We conducted a single-centre retrospective study which included patients diagnosed with Crohn’s disease (CD) and ulcerative colitis (UC), admitted between 1 January 2018 and 1 August 2023 in the Gastroenterology and Surgery Departments of the Fundeni Clinical Institute (Romania). We analysed the medical history (including abdominal imaging - ultrasound, computed tomography or magnetic resonance imaging) of patients during hospital follow-up and we screened for pancreato-biliary disorders. Results We analysed 1736 patients, of which 303 patients (17%) associated pancreato-biliary involvement and 756 patients (44%) had no pancreato-biliary disorders, with both subgroups having at least one abdominal imaging scan during follow-up; 677 patients (39%) had neither history of pancreato-biliary disorders, nor abdominal imaging. 30 patients (1.72% of total; 56.6% CD, 77% male) had acute pancreatitis (93.3% mild), 66.67% being drug-induced (13 cases - azathioprine, six cases - 5-amynosalicilates, one case - metronidazole). Three patients were diagnosed with idiopathic chronic pancreatitis and one with type 2 autoimmune pancreatitis. In the subgroup that underwent abdominal imaging (1059 patients) we identified 124 patients (11.70%) with pancreatic steatosis, 11 patients (1.03%) with pancreatic cysts (one case of intraductal papillary mucinous neoplasm) and three patients (0.28%) with congenital pancreatic anomalies (two annular pancreases, one pancreas divisum). There were no patients diagnosed with pancreatic adenocarcinoma. We identified 14 patients (0.8% from total; 64.28% UC, 57.14% male) with primary sclerosing cholangitis, of which five underwent liver transplantation, one case of primary biliary cholangitis and three cases of cholangiocarcinoma. The subgroup with abdominal imaging included 46 patients (4.34%) with prior cholecystectomy and 147 patients (13.88%) with gallbladder lithiasis or sludge (59.86% CD; 53.06% male; 39.45% intestinal resection). Conclusion Up to one third of patients with IBD that underwent abdominal imaging associated pancreato-biliary involvement. The high risk of drug-induced acute pancreatitis in IBD has to be taken into consideration. Screening for possible extraintestinal manifestations and early diagnosis of extraintestinal complications might improve the IBD management.

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Anand, Madhur, Noor Topno, Ranendra Hajong, Anoop J. Baruah, Donkupar Khongwar, and Swati Agarwal. "Surgical manifestations and management of gastrointestinal and hepato-pancreato-biliary ascariasis: an observational study." International Surgery Journal 7, no. 11 (October 23, 2020): 3620. http://dx.doi.org/10.18203/2349-2902.isj20204660.

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Background: Ascaris lumbricoides is the largest intestinal nematode parasite of humans. This study describes different presentations and management patterns of gastrointestinal and hepato-pancreato-biliary ascariasis presenting to a tertiary centre of North-eastern India.Methods: This was a prospective observational study aimed to study the presentations and management patterns of Ascaris related surgical diseases including intestinal obstruction, pancreatitis and cholangitis in a tertiary centre of Northeast India. All consenting cases of gastrointestinal and hepato-pancreato- biliary ascariasis admitted in our hospital were included.Results: Ninty patients with Ascaris sequeale were included, which included biliary ascariasis without cholangitis: 36, pancreatitis: 30, cholangitis: 18 and sub-acute intestinal obstruction: 6. Ultrasound was the most useful diagnostic investigation followed by stool examination and endoscopy. Hepato-pancreato-biliary ascariasis was managed conservatively and the progress monitored with sonography. The surgical management choledocho-duodenostomy was done for three patients having biliary ascariasis with unresolving obstructive jaundice and recurrent cholangitis on conservative management and 6 patients underwent therapeutic endoscopic worm removal. There were no deaths. No patient needed ICU care.Conclusions: Sonography can be helpful in diagnosing the presence of worms, its complications and in evaluating response to treatment. Hepato-pancreato-biliary ascariasis can be managed conservatively for majority of the patients.

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Di Vincenzo, Federica, Alberto Nicoletti, Marcantonio Negri, Federica Vitale, Lorenzo Zileri Dal Verme, Antonio Gasbarrini, Francesca Romana Ponziani, and Lucia Cerrito. "Gut Microbiota and Antibiotic Treatments for the Main Non-Oncologic Hepato-Biliary-Pancreatic Disorders." Antibiotics 12, no. 6 (June 17, 2023): 1068. http://dx.doi.org/10.3390/antibiotics12061068.

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The gut microbiota is a pivotal actor in the maintenance of the balance in the complex interconnections of hepato-biliary-pancreatic system. It has both metabolic and immunologic functions, with an influence on the homeostasis of the whole organism and on the pathogenesis of a wide range of diseases, from non-neoplastic ones to tumorigenesis. The continuous bidirectional metabolic communication between gut and hepato-pancreatic district, through bile ducts and portal vein, leads to a continuous interaction with translocated bacteria and their products. Chronic liver disease and pancreatic disorders can lead to reduced intestinal motility, decreased bile acid synthesis and intestinal immune dysfunction, determining a compositional and functional imbalance in gut microbiota (dysbiosis), with potentially harmful consequences on the host’s health. The modulation of the gut microbiota by antibiotics represents a pioneering challenge with striking future therapeutic opportunities, even in non-infectious diseases. In this setting, antibiotics are aimed at harmonizing gut microbial function and, sometimes, composition. A more targeted and specific approach should be the goal to pursue in the future, tailoring the treatment according to the type of microbiota modulation to be achieved and using combined strategies.

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Amin, Arshad, Faiz Ur Rahman, Fazli Junaid, and Shahid Nisar. "Pattern of Surgical Cases and its Management in Bacha Khan Medical Complex Shahmansoor Swabi." Journal of Gandhara Medical and Dental Science 4, no. 1 (September 1, 2017): 8–12. http://dx.doi.org/10.37762/jgmds.4-1.26.

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OBJECTIVETo study the pattern of general surgery cases and their management in Bacha Khan Medical Complex Shahmansoor Swabi.METHODSThis descriptive cases-series study was conducted prospectively in general surgery department Bacha Khan Medical Complex Shahmansoor Swabi form jan, 2013 to Dec, 2015. There were 1200 patients in the series who were managed either conservatively or operated upon. All patients with symptoms suggesting a surgical disease and managed as a surgical case were included, while cases that were referred to other departments and those that left against medical advice were excluded.RESULTSMost of the patients had alimentary tract diseases 361(30%) followed by urinary tract diseases 264 (22%),superficial lumps 142 (11.8%), hernia 140 (11.7%), hepato-biliary-pancreatic diseases 116 (9.7%), breast diseases 55 (4.6%), scrotal diseases 41 (3.4%), thyroid diseases 28 (2.3%),salivary gland diseases 15 (1.3%), vascular diseases 8 (0.7%), thoracic diseases 2 (0.2%) and miscellaneous 28 (2.3%). A total of 604 (64.5%) patients were treated as elective cases and333 (35.5%). were treated as emergency cases. As many as 937 (74.08%) patient were treated by operations and 263 (21.92%) patients by conservative treatment, while 41 (3.41%) patients were referred. Seven patients expired, giving a mortality rate of 0.58%.CONCLUSIONThe commonest cause of seeking surgical care was alimentary tract diseases, followed by urinary tract diseases, superficial lumps, hernias, hepato-biliary-pancreatic diseases, breast diseases, scrotal diseases and thyroid diseases. Bacha Khan Medical Complex Shahmansoor Swabi is a newly established hospital catering to the needs of population of district Swabi and adjoining districts and areas.

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De, Uptal, M. Mukherjee, S. Das, and Rupesh Kumar. "Hepato-pancreatic ascariasis." Tropical Doctor 40, no. 4 (September 16, 2010): 227–29. http://dx.doi.org/10.1258/td.2010.090368.

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Shapey, Iestyn M., and Mustafa Sultan. "Machine learning for prediction of postoperative complications after hepato-biliary and pancreatic surgery." Artificial Intelligence Surgery 3, no. 1 (2023): 1–13. http://dx.doi.org/10.20517/ais.2022.31.

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Machine Learning (ML) relates to the use of computer-derived algorithms and systems to enhance knowledge in order to facilitate decision making. In surgery, ML has the potential to shape clinical decision making and the management of postoperative complications in three ways: (a) by using the predicted probability of postoperative complications or survival to determine and guide optimal treatment; (b) by identifying anomalous data and patterns representing high-risk physiological states during the perioperative period and taking measures to minimise the impact of the existing risks; (c) to facilitate post-hoc identification of physiological trends, phenotypic patient characteristics, morphological characteristics of diseases, and human factors that may help alert surgeons to relevant risk factors in future patients. The accuracy, validity and integrity of data that are input into ML predictive models are central to its future success. ML could reduce errors by drawing attention to known risks of complications through supervised learning, and gain greater insights by identifying previously under-appreciated aspects of care through unsupervised learning. The success of ML in enhancing patient care will be determined by the human potential to incorporate data science techniques into daily clinical practice.

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Faisal, Shah, Muhammad Imranullah, Muhammad Qammar Noshad, Arjan Kumar, Talha Rehman, and Ulas Khan. "Patients' Prognosis in a Pakistani Hepato-Biliary Unit Treating Acute Severe Necrotizing Pancreatitis." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1588–90. http://dx.doi.org/10.53350/pjmhs221651588.

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Objective: The outcomes of individuals who were admitted to a hepatobiliary unit suffering from acute severe necrotizing pancreatitis will be the focus of this research. Study Design: Observational/ Prospective study Place and Duration: Conducted at Department of Gastroenterology Hayatabad Medical Complex Peshawar, during from the period Jan, 2021 to June, 2021. Methods: There were 85 patients of both genders were presented in this study. Included patients were aged between 20-70 years. All the patients had severe necrotizing pancreatitis were included. Detailed demographics of enrolled cases included age,sex, body mass index, etiology and comorbidities were recorded after taking informed written consent. Outcomes were calculated in terms of complications, hospital stay, number of drains inserted and nutritional support among all cases. SPSS 22.0 was used to analyze all data. Results: Among 85 patients, majority of the cases were males 62 (72.9%) and the rest of the patients were females 23 (27.1%). Included patients had mean age 47.12±8.39 years and had mean BMI 26.2±6.25 kg/m2. Most common comorbidity was diabetes mellitus found in 18 (21.2%),followed by hypertension in 17 (20%) and ischemic heart disease in 9 (10.6%) cases. Gall stones were the most common etiology found in 35 (41.2%) followed by idiopathic in 16 (18.8%) and cigarette smoking in 13 (15.3%) patients. NG feed was the most common nutrition in 19 (22.4%) cases. 10 was the most common CTSI score in 43 (50.6%) cases. Mean hospital stay was 31.9±11.82 days and infected necrosis / peri-pancreatic collections was the most common complication.13 (15.3%) cases received EUS drainage and surgical necrosectomy was given to 8 (9.4%) cases. Frequency of deaths was 10 (11.8%). Conclusion: A specialized hepato-biliary unit with a multidisciplinary team approach improves survival with acute severe necrotizing pancreatitis. Percutaneous and EUS-guided draining of pancreatic collections helps prevent necrosectomy for infected pancreatic necrosis. Keywords: Disease outcome, Acute pancreatitis, Infected pancreatic necrosis, Necrosectomy Acute Necrotizing Pancreatitis

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Campeanu, Ionel. "The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases." Chirurgia 117, no. 4 (2022): 499. http://dx.doi.org/10.21614/chirurgia.2781.

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Aiba, Keisuke, Kazuo Tamura, Toshiaki Saeki, Hideo Baba, Yuko Kitagawa, Kazuhiro Yoshida, Junji Furuse, Yoshihiro Kakeji, and Go Wakabayashi. "Patterns and severity of chemotherapy-induced nausea (CIN) in patients with gastrointestinal cancers associated with highly to moderately emetogenic chemotherapy (HEC and MEC)." Journal of Clinical Oncology 33, no. 3_suppl (January 20, 2015): 24. http://dx.doi.org/10.1200/jco.2015.33.3_suppl.24.

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24 Background: Chemotherapy-induced nausea and vomiting (CINV) is well controlled recently thanks to novel antiemetic therapy, but the incidence of nausea remained high in patients receiving either HEC or MEC. The aim of the study is to investigate patterns and severity of CIN in cancer patients who are to receive chemotherapy for the first time. Methods: A nationwide survey on CINV was conducted by the CINV study group of Japan. A 7-day diary for CINV was provided to the patient prior to chemotherapy to record daily occurrence and severity of CINV. CIN was measured using visual analog scales(VAS) of 10cm length scales. Acute and delayed CINV were defined as nausea and vomiting which developed within or after 24 hours after the start of chemotherapy, respectively. Results: A total of 2,068 patients were registered and 1,910 patients were analyzed. A mean age was 62 (range:19-87) and there were 873 males and 1,037 females. MEC was given to 715 as was HEC to 1,195 patients. Underlying diseases were esophageal (192 patients), gastric (152), colorectal (90), hepato-biliary-pancreatic (100), lung (426) and breast cancer (429), and gynecological (214) and hematological malignancy (197). Comparing patients with various cancers treated with similar emetogenic agents or regimens, we easily could find that there are several patterns of CIN severity. Firstly, temporal profiles of CIN severity of esophageal, gastric and lung cancers were similar, having daily increased delayed nausea up to Day 7. The reason of this phenomenon seems due to a single high dose of CDDP. Colorectal and hepato-biliary-pancreatic cancer had a similar mild CIN pattern over 7days, probably due to mild emetogenic nature of oxaliplatin and moderate dose of CDDP. Conclusions: Temporal profile and severity of CIN patterns seem to be divided into several groups and delayed CIN remained to be high and needs further investigation.

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Xu, Jia, Shu Huang, Qiong Yan, Jiao Jiang, Nan Hu, Wei Zhang, Lei Shi, Mingming Deng, Xiaowei Tang, and Jingyuan Liao. "Causes of death and nomogram for patients with oncologic hepato-biliary-pancreatic disorders: A large-cohort study." Medicine 103, no. 8 (February 23, 2024): e37187. http://dx.doi.org/10.1097/md.0000000000037187.

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The improvement of digestive cancer survival results in increased morbidity of noncancerous comorbidities. This study aimed at clarifying causes of death (COD) and predicting overall survival (OS) in patients diagnosed with liver cancer, gallbladder cancer, cholangiocarcinoma, and pancreatic cancer. We used the Surveillance, Epidemic, and End Results database to extract information. Nomograms of multivariate Cox regression was used to predict OS of cancer patients. The models were evaluated using the concordance indexes (C-indexes), the receiver operating characteristic curves and calibration curves. Respectively 58,895, 15,324, 30,708, and 109,995 cases with cancer of liver, gallbladder, bile duct or pancreas were retrieved between 2000 and 2020. Approximately 80% deaths occurred within 1 years after cancer diagnosis. Sequence in noncancerous COD proportion was diverse, while diseases of heart always accounted for a great part. Risks of death from most noncancerous COD were significantly higher than that of the cancer-free population. Nomograms were developed by predictors of interest such as age, therapy and TNM stage. The concordance indexes of nomograms were 0.756, 0.729, 0.763, and 0.760 respectively, well-calibrating to the reality. The 0.5-, 1-, and 2-year areas under the receiver operating characteristic curve were about 0.800, indicating good reliability and accuracy. Noncancerous COD accounted for larger part in gallbladder cancer and cholangiocarcinoma. Noncancerous COD showed an upward trend as follow-up time extended and the majorities were diseases of heart, cerebrovascular disease, chronic liver disease and cirrhosis. The novel OS-nomograms can provide personalized prognosis information with satisfactory accuracy.

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Târcoveanu, E. "Recenzie carte The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases"." Jurnalul de Chirurgie 18, no. 4 (December 31, 2022): 343–45. http://dx.doi.org/10.7438/jsurg.2022.04.11.

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Sbeit, Wisam, Anas Kadah, Mahmud Mahamid, Rinaldo Pellicano, Amir Mari, and Tawfik Khoury. "A State-of-the-Art Review on the Evolving Utility of Endoscopic Ultrasound in Liver Diseases Diagnosis." Diagnostics 10, no. 8 (July 23, 2020): 512. http://dx.doi.org/10.3390/diagnostics10080512.

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Liver diseases are amongst the most common diseases worldwide and manifest as a parenchymatic and/or biliary injury due to several causes as well as focal liver lesions, ranging from benign to malignant ones. The diagnosis of liver diseases is based mainly on biochemical and advanced imaging studies and, when required, on liver biopsy. Endoscopic ultrasound (EUS), which combines endoscopy and ultrasonography, is one of the main examination techniques used in gastroenterology as it is applied to evaluate abnormalities in the lumen of the upper and lower gastrointestinal tract and to define pancreatic and hepato-biliary features, often in chronic patients. Given its high spatial resolution and its proximity to the liver, EUS is gaining popularity in the diagnostic work up of liver diseases. This is a comprehensive overview of the current literature on the diagnostic indications for EUS use in patients with liver diseases. We performed a MEDLINE\PubMed and Embase search, and all articles that were relevant, after reviewing abstracts, were assessed and the full text was analyzed to extract data regarding technical success, diagnostic yield, bioptic characteristics, and complications rate. EUS-guided imaging and biopsy techniques in liver diseases have shown consistent favorable promising results among the reports through the literature, with an excellent diagnostic yield and safety profile, especially in the context of focal lesions and portal hypertension. The application of EUS in the diagnosis of liver diseases is a promising technique and should be considered as a first-line therapeutic option in selected cases.

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Yuehu, Li, Gong Jianp, and Shu Dong. "Current status and research progress of endoscopic retrograde cholangiopancreatography in the diagnosis and treatment of biliary and pancreatic system diseases." International Surgery Journal 8, no. 9 (August 27, 2021): 2866. http://dx.doi.org/10.18203/2349-2902.isj20213637.

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Endoscopic retrograde cholangiopancreatography (ERCP) has been used clinically since the 1960s, after nearly half a century of development, it has become an important method for clinical diagnosis and treatment of biliary and pancreatic system diseases. In recent years, with the continuous updating of endoscopy equipment, the advancement of endoscopists’ technology, and the progress in understanding of biliary and pancreatic diseases, the application of ERCP in the diagnosis and treatment of biliary and pancreatic diseases has become more extensive, and the diagnosis and treatment procedures have become more standardized. At the same time, the diagnostic role of ERCP has declined slightly with the advancement of noninvasive imaging technology. But, its intervention role in treatment is more prominent, reducing dependence on traditional trauma therapy. The aim of the study was to summarize the application status of ERCP technology in biliary and pancreatic system diseases and the research progress in recent years.

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Marin-Jimenez, Ignacio, Guillermo Bastida, Ana Forés, Esther Garcia-Planella, Federico Argüelles-Arias, Pilar Sarasa, Ignacio Tagarro, et al. "Impact of comorbidities on anti-TNFα response and relapse in patients with inflammatory bowel disease: the VERNE study." BMJ Open Gastroenterology 7, no. 1 (March 2020): e000351. http://dx.doi.org/10.1136/bmjgast-2019-000351.

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ObjectiveTo evaluate the impact of comorbidities and extraintestinal manifestations of inflammatory bowel disease on the response of patients with inflammatory bowel disease to antitumour necrosis factor alpha (anti-TNFα) therapy.DesignData from 310 patients (194 with Crohn’s disease and 116 with ulcerative colitis) treated consecutively with the first anti-TNFα in 24 Spanish hospitals were retrospectively analysed. Univariate and multivariate logistic regression analyses were performed to assess the associations between inflammatory bowel disease comorbidities and extraintestinal manifestations with anti-TNFα treatment outcomes. Key clinical features, such as type of inflammatory bowel disease and concomitant treatments, were included as fixed factors in the model.ResultsMultivariate logistic regression analyses (OR, 95% CI) showed that chronic obstructive pulmonary disease (2.67, 1.33 to 5.35) and hepato-pancreato-biliary diseases (1.87, 1.48 to 2.36) were significantly associated with primary non-response to anti-TNFα, as was the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn’s disease). It was also found that myocardial infarction (3.30, 1.48 to 7.35) and skin disease (2.73, 1.42 to 5.25) were significantly associated with loss of response, along with the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn’s disease).ConclusionsOur results suggest that the presence of some comorbidities in patients with inflammatory bowel disease, such as chronic obstructive pulmonary disease and myocardial infarction, and of certain extraintestinal manifestations of inflammatory bowel disease, such as hepato-pancreato-biliary conditions and skin diseases, appear to be related to failure to anti-TNFα treatment. Therefore, their presence should be considered when choosing a treatment.Trial registration numberNCT02861118.

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Daniel, Philip, and Surinder S. Rana. "Biodegradable Pancreatic and Biliary Stents—Still Searching For Disappearing Wonder?" Journal of Digestive Endoscopy 11, no. 02 (June 2020): 173–76. http://dx.doi.org/10.1055/s-0040-1713712.

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AbstractBiodegradable stents hold considerable promise in the treatment of benign biliary or pancreatic diseases with the major advantage being avoidance of repeated interventions for stent removal or stent exchange. They have been confirmed to have good biocompatibility and current evidence shows acceptable rates of clinical efficacy and safety. In the current news and views, we discuss an interesting study that has evaluated a new type of biodegradable biliary and pancreatic stent (the Archimedes stent) in benign biliary and pancreatic diseases.

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Dayem Ullah, Abu Z. M., Lavanya Sivapalan, Hemant M. Kocher, and Claude Chelala. "COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London." BMJ Open 11, no. 4 (April 2021): e045077. http://dx.doi.org/10.1136/bmjopen-2020-045077.

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ObjectiveTo explore risk factors associated with COVID-19 susceptibility and survival in patients with pre-existing hepato–pancreato–biliary (HPB) conditions.DesignCross-sectional study.SettingEast London Pancreatic Cancer Epidemiology (EL-PaC-Epidem) Study at Barts Health National Health Service Trust, UK. Linked electronic health records were interrogated on a cohort of participants (age ≥18 years), reported with HPB conditions between 1 April 2008 and 6 March 2020.ParticipantsEL-PaC-Epidem Study participants, alive on 12 February 2020, and living in East London within the previous 6 months (n=15 440). The cohort represents a multi-ethnic population with 51.7% belonging to the non-White background.Main outcome measureCOVID-19 incidence and mortality.ResultsSome 226 (1.5%) participants had confirmed COVID-19 diagnosis between 12 February and 12 June 2020, with increased odds for men (OR 1.56; 95% CI 1.2 to 2.04) and Black ethnicity (2.04; 1.39 to 2.95) as well as patients with moderate to severe liver disease (2.2; 1.35 to 3.59). Each additional comorbidity increased the odds of infection by 62%. Substance misusers were at more risk of infection, so were patients on vitamin D treatment. The higher ORs in patients with chronic pancreatic or mild liver conditions, age >70, and a history of smoking or obesity were due to coexisting comorbidities. Increased odds of death were observed for men (3.54; 1.68 to 7.85) and Black ethnicity (3.77; 1.38 to 10.7). Patients having respiratory complications from COVID-19 without a history of chronic respiratory disease also had higher odds of death (5.77; 1.75 to 19).ConclusionsIn this large population-based study of patients with HPB conditions, men, Black ethnicity, pre-existing moderate to severe liver conditions, six common medical multimorbidities, substance misuse and a history of vitamin D treatment independently posed higher odds of acquiring COVID-19 compared with their respective counterparts. The odds of death were significantly high for men and Black people.

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Al-Dhahab, Hisham, Julia McNabb-Baltar, Said Al-Busafi, and Alan N. Barkun. "Immunoglobulin G4-Related Pancreatic and Biliary Diseases." Canadian Journal of Gastroenterology 27, no. 9 (2013): 523–30. http://dx.doi.org/10.1155/2013/180461.

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BACKGROUND: Autoimmune pancreatitis and autoimmune cholangitis are new clinical entities that are now recognized as the pancreaticobiliary manifestations of immunoglobulin (Ig) G4-related disease.OBJECTIVE: To summarize important clinical aspects of IgG4-related pancreatic and biliary diseases, and to review the role of IgG4 in the diagnosis of autoimmune pancreatitis (AIP) and autoimmune cholangitis (AIC).METHODS: A narrative review was performed using the PubMed database and the following keywords: “IgG4”, “IgG4 related disease”, “autoimmune pancreatitis”, “sclerosing cholangitis” and “autoimmune cholangitis”. A total of 955 articles were retrieved; of these, 381 contained relevant data regarding the IgG4 molecule, pathogenesis of IgG-related diseases, and diagnosis, management and long-term follow-up for patients with AIP and AIC. Of these 381 articles, 66 of the most pertinent were selected.RESULTS: The selected studies demonstrated the increasing clinical importance of both AIP and AIC, which can mimic pancreatic cancer and cholangiocarcinoma, respectively. IgG4 titration in tissue or blood cannot be used alone to diagnose all IgG4-related diseases; however, it is often a useful adjunct to clinical, radiological and histological features. AIP and AIC respond to steroids; however, relapse is common and long-term maintenance treatment often required.CONCLUSIONS: A review of the diagnosis and management of both AIC and AIP is timely and pertinent to clinical practice because the amount of information regarding these conditions has increased substantially in the past few years, resulting in significant impact on the clinical management of affected patients.

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McCartan, D., B. Dasari, J. Ahmad, C. Jones, L. McKie, M. A. Taylor, and T. Diamond. "OUTCOMES FOLLOWING OPEN BILIARY BYPASS FOR BENIGN BILIARY AND PANCREATIC DISEASES." Gut 62, Suppl 2 (June 8, 2013): A26.3—A27. http://dx.doi.org/10.1136/gutjnl-2013-305143.61.

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Steccanella, Francesca, Paolo Amoretti, Maria Rachele Barbieri, Fabio Bellomo, and Alessandro Puzziello. "Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery—A Systematic Review." Antibiotics 11, no. 2 (February 1, 2022): 194. http://dx.doi.org/10.3390/antibiotics11020194.

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Background: Surgical site infections (SSIs) are among the most important determinants of morbidity after HBP surgery. Their frequency after HPB surgery is variable, from 1–2% after elective cholecystectomy to 25% after PD. Methods: A systematic review was performed to assess the role of antimicrobial prophylaxis (AP) in HPB elective surgery. Articles published between 2015 and 2021 were obtained; those before 2015 were not included because they antedate the WHO guidelines on SSI prevention. We conducted three different research methods for liver resection, elective cholecystectomy and pancreatic and biliary surgery regarding patients requiring preoperative biliary drainage. Results: Hepatic surgery, improvement in surgical technique and perioperative management lead to a very low SSI. One preoperative 2 g cefazolin dose may be adequate for surgical prophylaxis. From preoperative biliary drainage, we can derive that patients’ homeostasis rather than AP plays a paramount role in reducing postoperative morbidity. The time from biliary drainage could be an essential element in decision making for surgical prophylaxis. In the case of low-risk cholecystectomy, it is not easy to draw definitive conclusions about the effect of AP. Data from the literature are inconsistent, and some risk factors cannot be predicted before surgery. Conclusion: in our opinion, a strict preoperative cefazolin dose strategy can be reasonable in HBP surgery until a large-scale, multicentric RCT brings definitive conclusions.

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Mesenas, Steven J. "Does the Advent of Endoscopic Ultrasound (EUS) Sound the Death Knell for Endoscopic Retrograde Cholangiopancreatography (ERCP)?" Annals of the Academy of Medicine, Singapore 35, no. 2 (February 15, 2006): 89–95. http://dx.doi.org/10.47102/annals-acadmedsg.v35n2p89.

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Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has been the premier diagnostic and therapeutic endoscopic procedure in the management of pancreatic and biliary diseases (PBD). The use of endoscopic ultrasound (EUS), including EUS-guided fine needle aspiration (FNA), of pancreatic and biliary tumours has become more widely available in the last decade and has gradually replaced diagnostic ERCP. Together with EUS, other imaging modalities like magnetic resonance cholangiopancreatography (MRCP) have resulted in a decrease in the number of ERCPs. With the advent of interventional EUS, ERCP is at risk of being completely eclipsed. Methods: A search of all relevant articles on EUS and ERCP from Medline and peer-reviewed journals. Results: This review article examines the exact place of ERCP and EUS and their relative contributions in the management algorithm of PBD. Conclusion: Although diagnostic EUS, including EUS-guided FNA, is well established in the evaluation of PBD, interventional EUS is still in its infancy and its true potential is unknown. Therefore, therapeutic ERCP still has a vital, albeit smaller role to play in the treatment of pancreatic and biliary diseases. Key words: Biliary diseases, Endoscopic retrograde cholangiopancreatography, Endosonography, Pancreatic

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Hirano, Kenji, Takao Kawabe, Natsuyo Yamamoto, Yousuke Nakai, Naoki Sasahira, Takeshi Tsujino, Nobuo Toda, Hiroyuki Isayama, Minoru Tada, and Masao Omata. "Serum IgG4 concentrations in pancreatic and biliary diseases." Clinica Chimica Acta 367, no. 1-2 (May 2006): 181–84. http://dx.doi.org/10.1016/j.cca.2005.11.031.

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Markelova, Nadezhda, and Lyudmila Kochetova. "Yury Semyonovich Vinnik - Professor, Honored Worker of Science of the Russian Federation, Honorary Professor of the Federal State Educational Establishment of the Russian Federation "Krasnoyarsk State Medical University named after Professor VF Voyno-Yasenetsky", Ministry of Health of Russia (on the occasion of his 70th birthday)." Vestnik of Experimental and Clinical Surgery 11, no. 1 (April 8, 2018): 80. http://dx.doi.org/10.18499/2070-478x-2018-11-1-80.

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The main field of scientific interests Yu.S. Vinnica - hepato-pancreatic-biliary surgery: acute pancreatitis, reconstructive biliary surgery, pancreatic injury, cholelithiasis and its complications; mechanical jaundice, surgery of the stomach and duodenum, herbiology with the use of reticular endoprostheses, surgery of the large intestine (x-ray endovascular surgery), purulent surgery, diabetic foot, frostbites (questions of the pathogenesis of cold trauma and the treatment of complications), immunodeficiency, cytokinotherapy, metabolic immunotherapy of surgical diseases, peritonitis; syndrome of systemic inflammatory response, use in surgery of new biopolymers - polyhydroxyalkanoates and medical products on their basis. Yu.S. Vinnik is the founder of the scientific school of abdominal and purulent surgery. Under the direction of Vinnik Yu.S. 47 candidate dissertations, 13 doctoral dissertations were defended. He is the author of more than 800 published works, 40 copyright patents of Russia, 37 monographs. Since 1995, he has been elected to the present time as a full member of the New York Academy of Sciences, since 1996 he has been an academician of the International Academy of Sciences on Ecology, Human and Nature Safety (MANEB), since 1999 - full member of the Russian Academy of Natural Sciences (RANS) since 2000 - Academician of the Russian Academy of Natural Sciences (RANS), Corresponding Member of the Russian Academy of Natural Sciences (RAE), Academician of the Petrovsky Academy of Sciences and Arts (PANI). Honored Doctor of the Russian Federation. Honored Worker of Science and Education of the Russian Federation. Member of the Editorial Board of the journals of the VAK "Annals of Surgical Hepatology", "Bulletin of Experimental and Clinical Surgery", "Surgery News", "Moscow Surgical Journal", "Siberian Medical Review", "Surgical Practice". Member of the Russian Society of Surgeons, the Russian Society of Surgeons-Hepatologists, the Russian Society of Surgeons-Gastroenterologists, the Russian Society of Herniologists, the Association of General Surgeons of the Russian Federation, the Russian Society of Endoscopic Surgeons.

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JONES, BRYONY A., and JOANNA C. GIRLING. "BILIARY AND PANCREATIC DISEASE IN PREGNANCY." Fetal and Maternal Medicine Review 21, no. 4 (September 17, 2010): 263–82. http://dx.doi.org/10.1017/s0965539510000094.

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Pregnancy is a physiological condition that affects all organs. Diseases unrelated to pregnancy may present coincidentally during pregnancy or may be exacerbated by pregnancy, and may increase maternal and/or fetal morbidity or mortality. Compared with many other systems, the changes within the biliary tree and pancreas are relatively minimal. However, pregnancy is associated with an increased likelihood of cholelithiasis, which can have significant implications for the parturient.

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Raza, Ali, and Kumar Krishnan. "Endoscopic Pancreato-Biliary Interventions." Digestive Disease Interventions 02, no. 04 (November 30, 2018): 336–45. http://dx.doi.org/10.1055/s-0038-1675756.

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AbstractEndoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) play a critical role in the diagnosis and management of benign and malignant pancreatobiliary diseases. In the last several years, role of ERCP has evolved from just a diagnostic procedure to mostly a therapeutic procedure. It plays a key role in the diagnosis of indeterminate biliary strictures and evaluation of bile leaks. Therapeutic ERCP utilizes various techniques for the extraction of biliary and pancreatic stones, management of bile leaks, and the treatment of malignant and benign strictures. EUS plays a central role in tissue acquisition for diagnostic purposes. Therapeutic applications of EUS have significantly increased in the recent years and include management of pancreatic fluid collections, pancreatic necrosis, drainage of the biliary obstruction, gall bladder drainage, and EUS-assisted ERCP. These procedures have good efficacy and acceptable side effect profile when performed by expert endoscopists at tertiary care medical centers.

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Ishchenko, I. K. "About concomitant lesions of the liver, gallbladder and pancreas in peptic ulcer disease." Kazan medical journal 43, no. 4 (November 16, 2021): 66–68. http://dx.doi.org/10.17816/kazmj87235.

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The anatomical proximity and functional connection of the stomach, duodenum, liver, gallbladder and pancreas create conditions such that the defeat of one of these organs contributes to the defeat of the other. Reflex influences (interoreceptive influences) also play a significant role. The existence of the relationship between diseases of these organs found expression in the works of N.I. Leporsky on the hepato-pancreatic-duodenal system.

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Jarari, Abdalla M., Abdelaziz MA AlFaydi, Nouh MH Aljarari, Saeid Omar Al Soaeiti, Ibtisam Cheith Kaziri, and Dhastagir Sultan Sheriff. "BIOCHEMICAL STUDIES RELATED TO ACUTE CHOLECYSTITIS IN LIBYAN SUBJECTS." International Journal of Research -GRANTHAALAYAH 8, no. 8 (August 29, 2020): 226–32. http://dx.doi.org/10.29121/granthaalayah.v8.i8.2020.1005.

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Acute cholecystitis and cholelithiasis are one of common health problems of Libyans. [1] Acute cholecystitis or bile gallbladder stones are one of the major surgical problems in the Libyan population and account for many hospital admissions and surgical interventions. This study was done to estimate causes and risk factors of AC among general population of Benghazi city in Libya. Reflux of pancreatic secretions into the biliary duct due to a defect in motility of gallbladder or biliary tree or spastic episodes of Sphincter Oddi may cause injury to gallbladder mucosa and biliary tract which may precipitate acute cholecystitis. Pancreatic biliary reflux (PBR) therefore may cause such reflux of pancreatic juice into gallbladder and biliary tract. This problem is probably related to obesity, cardiovascular disorders (CVD), metabolic syndrome, and dietary habits. Studies on gallstone composition carried out a close link with dietary habits and ethnicity. The biliary composition has been demonstrated by many researches for several years. Gallstone formation is relatively increased with consumption of dietary fats, age and gender.2-3 Estimation of pancreatic amylase in gallbladder bile as well as in serum of patients with acute cholecystitis (AC) may be considered as a biomarker of PB reflux. Serum and bile pancreatic amylase levels as marker for diagnosis of acute cholecystitis" by investigate biliary composition especial alpha amylase pancreatic, total amylase, liver enzymes estimation the correlation between (AST, ALT, ALP and Bilirubin total, C-RP and lipid profile in gallstone disease patients and estimate the correlation between (Cholesterol, HDL, LDL, VLDL) concentration in serum and biliary gallbladder, presence of gallstones, age, in both gender patient with gallbladder diseases.

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Chen, Po‐Ting, Dawei Chang, Tinghui Wu, Ming‐Shiang Wu, Weichung Wang, and Wei‐Chih Liao. "Applications of artificial intelligence in pancreatic and biliary diseases." Journal of Gastroenterology and Hepatology 36, no. 2 (February 2021): 286–94. http://dx.doi.org/10.1111/jgh.15380.

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TONAI, MAKOTO. "Hepatic, biliary tract and pancreatic diseases in farm villages." JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE 34, no. 3 (1985): 260–65. http://dx.doi.org/10.2185/jjrm.34.260.

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Schafer, Edwin. "THE ROLE OF CHOLANGIOSCOPY IN BILIARY AND PANCREATIC DISEASES." Gastroenterology Nursing 32, no. 2 (March 2009): 149. http://dx.doi.org/10.1097/01.sga.0000349598.32503.60.

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Gandolfi, Lionello, Francesco Torresan, Luigi Solmi, and Annalisa Puccetti. "The role of ultrasound in biliary and pancreatic diseases." European Journal of Ultrasound 16, no. 3 (February 2003): 141–59. http://dx.doi.org/10.1016/s0929-8266(02)00068-x.

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Katabathina, Venkata S., Erin M. Flaherty, Anil K. Dasyam, Christine O. Menias, Nicole D. Riddle, Narayan Lath, Kazuto Kozaka, Osamu Matsui, Yasuni Nakanuma, and Srinivasa R. Prasad. "“Biliary Diseases with Pancreatic Counterparts”: Cross-sectional Imaging Findings." RadioGraphics 36, no. 2 (March 2016): 374–92. http://dx.doi.org/10.1148/rg.2016150071.

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Qin, Xiu-Min, Fei-Hong Yu, Chuan-Kai Lv, Zhi-Min Liu, and Jie Wu. "Endoscopic retrograde cholangiopancreatography for diagnosing and treating pediatric biliary and pancreatic diseases." World Journal of Gastrointestinal Surgery 15, no. 10 (October 27, 2023): 2272–79. http://dx.doi.org/10.4240/wjgs.v15.i10.2272.

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Postcholecystectomy bile duct injury (BDI) remains a devastating iatrogenic complication that adversely impacts the quality of life with high healthcare costs. Despite a decrease in the incidence of laparoscopic cholecystectomy-related BDI, the absolute number remains high as cholecystectomy is a commonly performed surgical procedure. Open Roux-en-Y hepaticojejunostomy with meticulous surgical technique remains the gold standard surgical procedure with excellent long-term results in most patients. As with many hepatobiliary disorders, a minimally invasive approach has been recently explored to minimize access-related complications and improve postoperative recovery. Since patients with gallstone disease are often admitted for a minimally invasive cholecystectomy, laparoscopic and robotic approaches for repairing postcholecystectomy biliary stricture are attractive. While recent series have shown the feasibility and safety of minimally invasive post-cholecystectomy biliary stricture management, most are retrospective analyses with small sample sizes. Also, long-term follow-up is available only in a limited number of studies. The principles and technique of minimally invasive repair resemble open repair except for the extent of adhesiolysis and the suturing technique with continuous sutures commonly used in minimally invasive approaches. The robotic approach overcomes key limitations of laparoscopic surgery and has the potential to become the preferred minimally invasive approach for the repair of postcholecystectomy biliary stricture. Despite increasing use, lack of prospective studies and selection bias with available evidence precludes definitive conclusions regarding minimally invasive surgery for managing postcholecystectomy biliary stricture. High-volume prospective studies are required to confirm the initial promising outcomes with minimally invasive surgery.

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Vörös, K., T. Németh, T. Vrabély, F. Manczur, J. Tóth, Melinda Magdus, and Edina Perge. "Ultrasonography and surgery of canine biliary diseases." Acta Veterinaria Hungarica 49, no. 2 (April 2001): 141–54. http://dx.doi.org/10.1556/004.49.2001.2.3.

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Findings of hepatic and gallbladder ultrasonography were analyzed in 12 dogs with gallbladder and/or extrahepatic biliary tract obstruction and compared with the results of exploratory laparotomy. Hepatic ultrasonography demonstrated normal liver in 2 dogs and hepatic abnormalities in 10 animals. The following ultrasonographic diagnoses were established compared to surgical findings: gallbladder obstruction caused by bile sludge (correct/incorrect: 1/2, surgical diagnosis: choleliths in one case), gallbladder obstruction caused by neoplasm (0/1, surgical diagnosis: mucocele), gallbladder and extrahepatic biliary tract obstruction due to choleliths (3/3), extrahepatic biliary tract obstruction caused by pancreatic mass (1/1) and small intestinal volvulus (1/1). Bile peritonitis caused by gallbladder rupture (4/4) was correctly diagnosed by ultrasound, aided with ultrasonographically-guided abdominocentesis and peritoneal fluid analysis. Rupture of the gallbladder should be suspected in the presence of a small, echogenic gallbladder or in the absence of the organ together with free abdominal fluid during ultrasonography. Laparotomy was correctly indicated by ultrasonography in all cases. However, the direct cause of obstruction could not be determined in 2 of the 12 dogs by ultrasonography alone.

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Bansal, Rinkesh Kumar, Narendra S. Choudhary, Rajesh Puri, Zubin Sharma, Saurabh Patle, and Gaurav Kumar Patil. "Intraductal Ultrasonography in Pancreatobiliary Diseases." Journal of Digestive Endoscopy 08, no. 03 (July 2017): 115–18. http://dx.doi.org/10.4103/jde.jde_83_16.

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ABSTRACTIntraductal ultrasonography (IDUS) utilizes probe catheter and operates at a higher frequency (12–30 MHz). It can be passed down the biopsy channel of a side‑view endoscope during endoscopic retrograde cholangiopancreatography, and it provides real‑time, high‑quality imaging of pancreatobiliary ducts and the surrounding structures. IDUS has been used in defining choledocholithiasis, evaluating biliary as well as pancreatic strictures or thickening, and local staging of tumor. We shall discuss the utility of IDUS in the current review.

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Wang, Jian, and Wei Wang. "Diagnosis and treatment of diseases in biliary-pancreatic-duodenal junction." World Chinese Journal of Digestology 26, no. 22 (August 8, 2018): 1329–33. http://dx.doi.org/10.11569/wcjd.v26.i22.1329.

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Sharma, A., P. Dahiya, R. Khullar, V. Soni, M. Baijal, and P. K. Chowbey. "Single-Incision Laparoscopic Surgery (SILS) in Biliary and Pancreatic Diseases." Indian Journal of Surgery 74, no. 1 (November 29, 2011): 13–21. http://dx.doi.org/10.1007/s12262-011-0372-9.

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Kobashi, Yuko, Masateru Uchiyama, and Junichi Matsui. "The “K-Sign”—A Novel CT Finding Suggestive before the Appearance of Pancreatic Cancer." Cancers 13, no. 16 (August 22, 2021): 4222. http://dx.doi.org/10.3390/cancers13164222.

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Pancreatic invasive ductal adenocarcinoma (PDAC) has a poor prognosis, and the detection of PDAC during the early stage is thought to improve prognosis. In this study, we retrospectively investigated pancreatic morphological abnormalities that lead to the early diagnosis of PDAC with computed tomography (CT) imaging. In total, 41 out of 308 patients diagnosed with pancreatic cancer between 2011 and 2017 in our institution were enrolled. As a control group for the group with pancreatic cancer, 4277 patients without pancreato-biliary diseases were enrolled. We retrospectively reviewed and analyzed the clinical data including patient characteristics, the clinical course and preoperative CT imaging with pancreatic morphological features. Out of 41 patients, 24 patients (58.5%) showed local K-shaped constriction of the pancreatic parenchyma “K-sign” on preoperative CT images. Eight patients (19.5%) showed localized fatty change. Out of 4277 control patients, seven patients (0.16%) showed K-sign. “K-sign” may be used for the early diagnosis of PDAC by CT imaging.

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Overi, Diletta, Guido Carpino, Vincenzo Cardinale, Antonio Franchitto, Samira Safarikia, Paolo Onori, Domenico Alvaro, and Eugenio Gaudio. "Contribution of Resident Stem Cells to Liver and Biliary Tree Regeneration in Human Diseases." International Journal of Molecular Sciences 19, no. 10 (September 25, 2018): 2917. http://dx.doi.org/10.3390/ijms19102917.

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Two distinct stem/progenitor cell populations of biliary origin have been identified in the adult liver and biliary tree. Hepatic Stem/progenitor Cells (HpSCs) are bipotent progenitor cells located within the canals of Hering and can be differentiated into mature hepatocytes and cholangiocytes; Biliary Tree Stem/progenitor Cells (BTSCs) are multipotent stem cells located within the peribiliary glands of large intrahepatic and extrahepatic bile ducts and able to differentiate into hepatic and pancreatic lineages. HpSCs and BTSCs are endowed in a specialized niche constituted by supporting cells and extracellular matrix compounds. The actual contribution of these stem cell niches to liver and biliary tree homeostatic regeneration is marginal; this is due to the high replicative capabilities and plasticity of mature parenchymal cells (i.e., hepatocytes and cholangiocytes). However, the study of human liver and biliary diseases disclosed how these stem cell niches are involved in the regenerative response after extensive and/or chronic injuries, with the activation of specific signaling pathways. The present review summarizes the contribution of stem/progenitor cell niches in human liver diseases, underlining mechanisms of activation and clinical implications, including fibrogenesis and disease progression.

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Dorrell, Robert, Swati Pawa, and Rishi Pawa. "Endoscopic Management of Malignant Biliary Stricture." Diagnostics 10, no. 6 (June 10, 2020): 390. http://dx.doi.org/10.3390/diagnostics10060390.

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A biliary stricture is an area of narrowing in the extrahepatic or intrahepatic biliary system. The majority of biliary strictures are caused by malignancies, particularly cholangiocarcinoma and pancreatic adenocarcinoma. Most malignant biliary strictures are unresectable at diagnosis. Treatment of these diseases historically required surgical procedures, however, the development of endoscopic techniques has provided alternative minimally invasive treatment options to improve patient quality of life and survival with unresectable disease. While endoscopic retrograde cholangiopancreatography with stent placement has been the cornerstone of biliary drainage for decades, cutting edge endoscopic developments, including radiofrequency ablation and endoscopic ultrasound-guided biliary drainage, offer new therapy options to patients that historically have a poor quality of life and a grim prognosis. In this review, we explore the endoscopic techniques that have contributed to revolutionary advancements in the endoscopic management of malignant biliary strictures.

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Li, Chunsheng, Jinhong Chen, Jianping Zhang, Qi Zou, Jie Chen, and Zhijun Min. "Management of Biliary and Pancreatic Diseases Using a New Intraductal Endoscope." Journal of Laparoendoscopic & Advanced Surgical Techniques 24, no. 3 (March 2014): 130–33. http://dx.doi.org/10.1089/lap.2013.0348.

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Bornman, P. C. "ABC of diseases of liver, pancreas, and biliary system: Pancreatic tumours." BMJ 322, no. 7288 (March 24, 2001): 721–23. http://dx.doi.org/10.1136/bmj.322.7288.721.

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Bornman, P. C., and I. J. Beckingham. "ABC of diseases of liver, pancreas, and biliary system: Pancreatic tumours." BMJ 322, Suppl S5 (May 1, 2001): 0105149. http://dx.doi.org/10.1136/sbmj.0105149.

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44

Ambiru, S., A. Kato, F. Kimura, H. Shimizu, H. Yoshidome, M. Otsuka, and M. Miyazaki. "Poor postoperative blood glucose control increases surgical site infections after surgery for hepato-biliary-pancreatic cancer: a prospective study in a high-volume institute in Japan." Journal of Hospital Infection 68, no. 3 (March 2008): 230–33. http://dx.doi.org/10.1016/j.jhin.2007.12.002.

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Reddy, A. Dinakar, Anuroop Thota, and Vanga Devi Harsha. "Bactibilia-effect on postoperative course and outcome in patients with bilio-pancreatic diseases." International Surgery Journal 9, no. 1 (December 28, 2021): 27. http://dx.doi.org/10.18203/2349-2902.isj20214829.

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Background: Bactibilia is detrimental to the outcomes of biliary tract surgery. The present study was undertaken to determine the microbial flora of bile and their significance to post-operative infectious complications and morbidity.Methods: A retrospective study of patients with biliopancreatic diseases who underwent surgery from Jan 2017 to March 2020 in a tertiary care hospital were analyzed. The samples were assessed for bile microbiological flora, and a search for their possible link with post-operative infectious complications and morbidity was carried out.Results: A total of 90 bile samples were assessed. The mean age of the study group was 51.8 SD-13.6 years with male predominance. Bactibilia was found in 39 cases (43.3%), mostly in patients with malignant diseases, older than 50 years and females. Escherichia coli was the most common organism. Post-operative infectious complications were seen in twenty cases, thirteen of them in bactibilia-associated patients, showing statistical significance. Statistical significance was found between the presence of pre-operative biliary stent and bactibilia and between diabetes mellitus and bactibilia. Nine out of 24 patients with comorbidities had post-operative infectious complications. No significant relationship was found between pre-operative jaundice and comorbidities with bactibilia. Conclusions: The present study showed a statistically significant relationship between the presence of pre-operative biliary stent and bactibilia and also the incidence of post-operative infectious complications and bactibilia. Microbiological analysis of bile is a valuable tool in prognosticating the post-operative complications, thereby guiding us to provide adequate therapy and helps to establish local antibiotic guidelines.

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Dicheva, D. T., A. Yu Goncharenko, A. V. Zaborovsky, D. V. Privezentsev, and D. N. Andreev. "Functional disorders of the biliary tract: modern diagnostic criteria and principles of pharmacotherapy." Meditsinskiy sovet = Medical Council, no. 11 (August 8, 2020): 116–23. http://dx.doi.org/10.21518/2079-701x-2020-11-116-123.

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The review article presents current data on functional disorders of the biliary system, taking into account the latest recommendations of experts of the Rome Foundation (Rome Criteria IV, 2016) and the Russian Gastroenterological Association (specialized clinical recommendations, 2018). According to modern concepts, biliary dysfunction is a group of functional disorders of the biliary system caused by motor disorders and increased visceral sensitivity. According to the literature data, the prevalence of functional disorders of GB and OS is 10-15%, and violation of OS function is revealed in 30-40% of patients who underwent cholecystectomy (CE). The presence of biliary pain is an obligatory condition in the diagnosis of functional disorders of GB and OS. Bilirubin and serum transaminases (AST, ALT) levels may increase in biochemical blood analysis in patients with functional OS disorder of biliary type, and pancreatic amylase and lipase in case of functional OS disorder of pancreatic type. Ultrasound examination of abdominal organs is considered to be the priority among instrumental methods. This technique allows to exclude organic lesions of both the GB and visualized ducts, and adjacent organs (GSD, biliary tract, liver and pancreas neoplasms). Magnetic resonance cholangiopancreatography (MRCP) is used as a clarifying method, which allows to visualize the state of biliary ducts throughout. Ultrasonic cholecystography is used to assess the contractile activity of the GB. When duct dilation is detected and/or when liver/pancreatic enzyme levels are elevated in the absence of changes according to MRCP data, it is reasonable to perform an endoscopic ultrasound examination. According to the latest recommendations of the Russian Gastroenterological Association (2018), the foundation of pharmacotherapy for this group of diseases are antispasmodics and ursodeoxycholic acid (UDCA).

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Lassen, K., L. S. Nymo, H. Kørner, K. Thon, T. Grindstein, H. H. Wasmuth, T. Moger, et al. "The New National Registry for Gastrointestinal Surgery in Norway: NoRGast." Scandinavian Journal of Surgery 107, no. 3 (April 9, 2018): 201–7. http://dx.doi.org/10.1177/1457496918766697.

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Background and Aims: There is an increasing demand for high-quality data for the outcome of health care. Diseases of the gastro-intestinal tract involve large patient groups often presenting with serious or life-threatening conditions. Complications may affect treatment outcomes and lead to increased mortality or reduced quality of life. A continuous, risk-adjusted monitoring of major complications is important to improve the quality of health care to patients undergoing gastrointestinal resections. We present the development of the Norwegian Registry for Gastrointestinal Surgery, a national registry for colorectal, upper gastrointestinal, and hepato-pancreato-biliary resections in Norway. Materials and Methods: A narrative and qualitative presentation of the development and current state of the registry. Results: We present the variables and the analysis tools and provide examples for the potential in quality improvement and research. Core characteristics include a strictly limited set of variables to reflect important risk factors, the procedure performed, and the clinical outcomes. Conclusion: A registry with the potential to present complete national cohort data is a powerful tool for quality improvement and research.

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Lu, Yan, and Feifei Wang. "Effect of Programmed Nursing Plan Based on Thinking Map Guidance Mode on Hemodynamics and Intestinal Function Recovery of Patients Undergoing Endoscopic Retrograde Cholangiopancreatography." Emergency Medicine International 2022 (May 14, 2022): 1–7. http://dx.doi.org/10.1155/2022/6555150.

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ERCP is an effective method for the diagnosis and treatment of pancreatic and biliary diseases. With the improvement of endoscopes by researchers and the intubation and angiography technologies of medical workers, the role of ERCP in the diagnosis and treatment of pancreatic and biliary diseases has become increasingly important. Although ERCP is a minimally invasive diagnostic technique, it still falls into the category of surgery, and thus the physical and psychological dysfunction of patients undergoing ERCP caused by various factors such as surgery cannot be ignored. This study explored the effects of the procedural nursing plan based on the thinking map guidance mode on hemodynamics and intestinal function recovery of ERCP patients. The results showed that this plan could reduce the effects of ERCP on hemodynamics of patients, promote intestinal function recovery, relieve their bad psychology, reduce postoperative complications, and help to improve patients’ satisfaction with the nursing work, and it was worthy of promotion.

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Liao, Guolin, Huaqiang Ruan, Peng Peng, Shiquan Liu, Jianfu Qin, Zhihai Liang, Guodu Tang, Mengbin Qin, and Jie’an Huang. "Clonorchiasis in Patients with Biliary and Pancreatic Diseases: Diagnosis and Risk Factors." BioMed Research International 2020 (February 24, 2020): 1–9. http://dx.doi.org/10.1155/2020/2946541.

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Background. Many epidemiological studies have investigated the risk factors for clonorchiasis, but endoscopic findings of this disease in endoscopic retrograde cholangiopancreatography (ERCP) have not been well characterized. In this study, we evaluated clonorchiasis in ERCP in patients with biliary and pancreatic diseases. Methods. This was a retrospective two-center study in hospitalized patients who received ERCP between January 2012 and October 2018. All patients were divided into clonorchiasis and nonclonorchiasis groups. Data were analyzed using univariate analysis and multivariate analyses. Results. A total of 1119 patients were included, and clonorchiasis was diagnosed in 19.2% patients. Detection of Clonorchis sinensis eggs in bile samples was higher than that in fecal samples (85.9% vs. 58.7%; P=0.001). In multivariate analysis, male patients (95% confidence interval (CI): 1.945–4.249, P=0.0001), age≤60 years old (95% CI: 1.212–2.474, P=0.003), patients with papilla fistula (95% CI: 0.081–0.900, P=0.033), and patients with a common bile duct (CBD) diameter<12 mm (95% CI: 1.093–2.130, P=0.013) were associated with clonorchiasis incidence. Nonclonorchiasis endoscopic diagnosis did not significantly correlate with clonorchiasis incidence (P>0.05). Conclusions. The detection of C. sinensis eggs was significantly higher in bile than in fecal samples; thus, bile samples represent a preferable sample for the diagnosis of clonorchiasis in patients with biliary obstruction. We found that male, age≤60 years old, and CBD diameter<12 mm were independent risk factors for clonorchiasis, while papilla fistula was a protective factor.

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Fedail, Sulieman S., A. Alia Gaber, and Ikhals Sulieman. "Endoscopic Retrograde Cholangiopancreatography and Endoscopic Sphincterotomy: Experience in the Sudan." Tropical Doctor 23, no. 1 (January 1993): 20–23. http://dx.doi.org/10.1177/004947559302300110.

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Over a 5 year period 626 endoscopic retrograde cholangiopancreatography (ERCP) examinations were attempted in Khartoum, Sudan. The relevant duct was successfully cannulated and visualized in 94% of cases of biliary tract disease and in 73% of cases of pancreatic disease. This was due to the large number of cases with advanced pancreatic cancer. The commonest abnormal finding was stones in the biliary tree in 214 cases (35% of all cases). Cholangiocarcinoma was seen in 18 cases, pancreatic cancer in 64 cases, chronic pancreatitis in 48 cases and periampullary carcinoma in 20 cases. ERCP was considered normal in 100 cases. Endoscopic sphincterotomy (EST) was performed in 48 cases; 44 had common duct stones. ERCP and EST are feasible and useful procedures in a developing country. However they are expensive and should be carried out in referral centres.

Journal articles on the topic 'Hepato-biliary and pancreatic diseases'

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