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Seminars in Interventional Radiology Aug 2021Bile duct stone disease is the most common causes of nonmalignant bile duct obstructions. The range of common bile duct stone formation in patients with cholecystectomy... (Review)
Review
Bile duct stone disease is the most common causes of nonmalignant bile duct obstructions. The range of common bile duct stone formation in patients with cholecystectomy is 3 to 14.7%. Hepatolithiasis, although endemic in some parts of the world, is a rare disease that is difficult to manage. Endoscopic intervention is accepted as the first-line management of common bile duct stones. However, when the bile duct cannot be cannulated for various reasons, the endoscopic procedure fails. In this circumstance, percutaneous approach is an alternative technique for the nonsurgical treatment of bile duct stones. This article reviews the indications, technique, outcomes, and complications of the percutaneous treatment of bile duct stone disease.
PubMed: 34393345
DOI: 10.1055/s-0041-1731373 -
Progress in Retinal and Eye Research Sep 2023Primary acquired nasolacrimal duct obstruction, or PANDO, is a common adult lacrimal drainage disorder. The current treatment modality of dacryocystorhinostomy to bypass... (Review)
Review
Primary acquired nasolacrimal duct obstruction, or PANDO, is a common adult lacrimal drainage disorder. The current treatment modality of dacryocystorhinostomy to bypass the obstructed nasolacrimal duct has excellent outcomes. However, the understanding of the disease etiopathogenesis needs to be revisited. There are not many studies that specifically assessed any hypothesis or ones that convincingly put forth the presumed or confirmed interpretations regarding the PANDO pathogenesis or the mechanisms or pathways involved therein. Histopathological evidence points to recurrent inflammation of the nasolacrimal duct, subsequent fibrosis, and the resultant obstruction. The disease etiopathogenesis is considered multifactorial. Several implicated suspects include anatomical narrowing of the bony nasolacrimal duct, vascular factors, local hormonal imbalance, microbial influence, nasal abnormalities, autonomic dysregulation, surfactants, lysosomal dysfunction, gastroesophageal reflux, tear proteins, and deranged local host defenses. The present work reviewed the literature on the etiopathogenesis of primary acquired nasolacrimal duct obstruction (PANDO) to gain insights into the present state of the understanding and the high-value translational implications of precisely decoding the disease etiology.
Topics: Adult; Humans; Nasolacrimal Duct; Lacrimal Duct Obstruction; Dacryocystorhinostomy; Risk Factors; Inflammation
PubMed: 37394093
DOI: 10.1016/j.preteyeres.2023.101193 -
Indian Journal of Ophthalmology Oct 2017
Review
Topics: Child; Dacryocystorhinostomy; Endoscopy; Humans; Lacrimal Duct Obstruction; Nasolacrimal Duct
PubMed: 29044070
DOI: 10.4103/ijo.IJO_696_17 -
Bioscience Trends Sep 2017The management of bile duct injury (BDI) remains a considerable challenge in hepatobiliary surgery. BDI is mainly iatrogenic, and mostly occurs in cholecystectomy.... (Review)
Review
The management of bile duct injury (BDI) remains a considerable challenge in hepatobiliary surgery. BDI is mainly iatrogenic, and mostly occurs in cholecystectomy. Laparoscopic cholecystectomy (LC) has been performed widely, however, the incidence of BDI associated with LC increases 2-3 times compared to that in open cholecystectomy (OC). BDI also occurs in robotic cholecystectomy. In China, the evidence-based Practice Guideline for Diagnosis and Treatment of BDI was published by the Biliary Surgery Group of Surgery Branch of Chinese Medical Association, with the purpose of reducing the incidence of BDI as well as promoting its optimal diagnosis and treatment. Surgery remains the mainstay of treatment for BDI and traumatic bile duct stricture. The definitive repair involves a series of procedures including exposing the proximal and distal bile duct, anastomotic bile duct tissue preparation, minimally invasive tissue anastomoses, and so on. Successful management is a surgical challenge requiring great specialized experience and precise surgical skill. The application of precision biliary surgery is recommended for promoting standardized management of BDI.
Topics: Anastomosis, Surgical; Bile Ducts; Humans; Preoperative Care; Wound Healing
PubMed: 28824026
DOI: 10.5582/bst.2017.01176 -
World Journal of Gastroenterology Oct 2022Biliodigestive anastomosis between the extrahepatic bile duct and the intestine for bile duct disease is a gastrointestinal reconstruction that abolishes duodenal... (Review)
Review
Biliodigestive anastomosis between the extrahepatic bile duct and the intestine for bile duct disease is a gastrointestinal reconstruction that abolishes duodenal papilla function and frequently causes retrograde cholangitis. This chronic inflammation can cause liver dysfunction, liver abscess, and even bile duct cancer. Although research has been conducted for over 100 years to directly repair bile duct defects with alternatives, no bile duct substitute (BDS) has been developed. This narrative review confirms our understanding of why bile duct alternatives have not been developed and explains the clinical applicability of BDSs in the near future. We searched the PubMed electronic database to identify studies conducted to develop BDSs until December 2021 and identified studies in English. Two independent reviewers reviewed studies on large animals with 8 or more cases. Four types of BDSs prevail: Autologous tissue, non-bioabsorbable material, bioabsorbable material, and others (decellularized tissue, 3D-printed structures, ). In most studies, BDSs failed due to obstruction of the lumen or stenosis of the anastomosis with the native bile duct. BDS has not been developed primarily because control of bile duct wound healing and regeneration has not been elucidated. A BDS expected to be clinically applied in the near future incorporates a bioabsorbable material that allows for regeneration of the bile duct outside the BDS.
Topics: Animals; Bile Ducts; Bile Ducts, Extrahepatic; Bile Duct Diseases; Cholangitis; Anastomosis, Surgical; Constriction, Pathologic
PubMed: 36338889
DOI: 10.3748/wjg.v28.i39.5707 -
BMJ Case Reports May 2021A 35-year-old woman underwent left external dacryocystorhinostomy (DCR) following a recent bout of left acute dacryocystitis. She had a right DCR 14 years earlier. Her...
A 35-year-old woman underwent left external dacryocystorhinostomy (DCR) following a recent bout of left acute dacryocystitis. She had a right DCR 14 years earlier. Her relatively young age of presentation prompted suspicion of secondary nasolacrimal duct obstruction and, although the left lacrimal sac appeared macroscopically normal peroperatively, a lacrimal sac biopsy was taken. Histopathology revealed florid chronic inflammation, with abundant granular brown pigment and polarisable crystals suggestive of an exogenous material in the lacrimal sac mucosa compatible with mascara. After initial improvement, her epiphora has recurred 1-year postoperatively, but her ocular discharge has resolved. Mascara-induced conjunctival pigmentation is well established. However, there are very few published reports of nasolacrimal duct obstruction due to mascara. Since cosmetic application of mascara and kohl eyeliner is widespread, patients and practitioners should be aware of their potential to migrate into the lacrimal apparatus and cause chronic inflammation with secondary nasolacrimal duct obstruction.
Topics: Adult; Dacryocystitis; Dacryocystorhinostomy; Female; Humans; Lacrimal Duct Obstruction; Nasolacrimal Duct; Neoplasm Recurrence, Local
PubMed: 33962923
DOI: 10.1136/bcr-2020-240942 -
Asian Journal of Surgery Jul 2023
Topics: Humans; Thoracic Duct; Dilatation; Dilatation, Pathologic
PubMed: 37173246
DOI: 10.1016/j.asjsur.2023.03.194 -
Environmental Epigenetics Jul 2019Mammalian embryos initially develop progenitor tissues for both male and female reproductive tract organs, known as the Wolffian ducts and the Müllerian ducts,... (Review)
Review
Mammalian embryos initially develop progenitor tissues for both male and female reproductive tract organs, known as the Wolffian ducts and the Müllerian ducts, respectively. Ultimately, each individual develops a single set of male or female reproductive tract organs. Therefore, an essential step for sex differentiation is the regression of one duct and growth and differentiation of the other duct. In males, this requires Müllerian duct regression and Wolffian duct growth and differentiation. Müllerian duct regression is induced by the expression of , encoding anti-Müllerian hormone, from the fetal testes. Subsequently, receptor-mediated signal transduction in mesenchymal cells surrounding the Müllerian duct epithelium leads to duct elimination. The genes that induce transcription and the downstream signaling that results from activity form a pathway. However, the molecular details of this pathway are currently unknown. A set of essential genes for AMH pathway function has been identified. More recently, transcriptome analysis of male and female Müllerian duct mesenchyme at an initial stage of regression has identified new genes that may mediate elimination of the Müllerian system. The evidence taken together can be used to generate an initial gene regulatory network describing the pathway for Müllerian duct regression. An gene regulatory network will be a useful tool to study Müllerian duct regression, sex differentiation, and its relationship to environmental influences.
PubMed: 31579527
DOI: 10.1093/eep/dvz017 -
Open Access Macedonian Journal of... Jun 2018This study was designated to evaluate the frequency of anatomic variations of the pancreaticobiliary union.
AIM
This study was designated to evaluate the frequency of anatomic variations of the pancreaticobiliary union.
MATERIALS AND METHODS
Our research was observational, comparative and analytical. The investigation was conducted from January 2016-May 2017. This study included 63 patients from Clinic of Gastroenterology and Hepatology - Prishtina, assessed pancreaticobiliary union with Magnetic Resonance cholangiopancreatography.
RESULTS
Union of the common bile duct and the major pancreas was biliary-pancreatic type The angle between common bile duct and the major pancreas duct had different sizes average 35.6°. We did not distinguish significant statistical significance in the size of the pancreaticobiliary angle. In men, the union angle was from the average 36.9°, while in females was average 34.3°. No correlation between the age and size of the angle between common bile duct and the major pancreas duct.
CONCLUSIONS
The union of the common bile duct and the major pancreas duct was in most cases B-P Type. The common channel and angle between common bile duct and the major pancreas duct were normal in most cases.
PubMed: 29983789
DOI: 10.3889/oamjms.2018.196 -
Frontiers in Medicine 2022Intrahepatic cholangiocarcinoma (iCCA) is an aggressive primary liver malignancy with an increasing incidence worldwide. Recently, histopathologic classification of... (Review)
Review
Intrahepatic cholangiocarcinoma (iCCA) is an aggressive primary liver malignancy with an increasing incidence worldwide. Recently, histopathologic classification of small duct type and large duct type iCCA has been introduced. Both these types of tumors exhibit differences in clinicopathological features, mutational profiles, and prognosis. Small duct type iCCA is composed of non-mucin-producing cuboidal cells, whereas large duct type iCCA is composed of mucin-producing columnar cells, reflecting different cells of origin. Large duct type iCCA shows more invasive growth and poorer prognosis than small duct type iCCA. The background liver of small duct type iCCA often shows chronic liver disease related to hepatitis B or C viral infection, or alcoholic or non-alcoholic fatty liver disease/steatohepatitis, in contrast to large duct type iCCA that is often related to hepatolithiasis and liver fluke infection. Cholangiolocarcinoma is a variant of small duct type iCCA composed of naïve-looking cuboidal cells forming cords or ductule-like structures, and shows better prognosis than the conventional small duct type. Fibrous tumor stroma, one of the characteristic features of iCCA, contains activated fibroblasts intermixed with innate and adaptive immune cells. The types of stroma (mature versus immature) are related to tumor behavior and prognosis. Low tumor-infiltrating lymphocyte density, alteration, and chromosomal instability are related to immune-suppressive tumor microenvironments with resistance to programmed death 1/ programmed death ligand 1 blockade. Data from recent large-scale exome analyses have revealed the heterogeneity in the molecular profiles of iCCA, showing that small duct type iCCA exhibit frequent , hotspot mutations and fusion, in contrast to frequent mutations in , , and observed in large duct type iCCA. Multi-omics analyses have proposed several molecular classifications of iCCA, including inflammation class and proliferation class. The inflammation class is enriched in inflammatory signaling pathways and expression of cytokines, while the proliferation class has activated oncogenic growth signaling pathways. Diverse pathologic features of iCCA and its associated multi-omics characteristics are currently under active investigation, thereby providing insights into precision therapeutics for patients with iCCA. This review provides the latest knowledge on the histopathologic classification of iCCA and its associated molecular features, ranging from tumor microenvironment to genomic and transcriptomic research.
PubMed: 35433771
DOI: 10.3389/fmed.2022.857140