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Hepatology (Baltimore, Md.) Jul 2009
Topics: Humans; Liver Cirrhosis, Biliary
PubMed: 19554543
DOI: 10.1002/hep.22906 -
Seminars in Pediatric Surgery Aug 2020Nearly 20,000 pediatric patients undergo cholecystectomy annually, and abnormal gallbladder emptying ("biliary dyskinesia") has replaced cholelithiasis as the leading... (Review)
Review
Nearly 20,000 pediatric patients undergo cholecystectomy annually, and abnormal gallbladder emptying ("biliary dyskinesia") has replaced cholelithiasis as the leading indication for this operation in the USA. Nonetheless, patients with abnormal gallbladder emptying nuclear medicine scans do not uniformly benefit from cholecystectomy. This article reviews the available data on presentation, workup and treatment of patients with abnormally low and high rates of gallbladder emptying.
Topics: Biliary Dyskinesia; Cholecystectomy; Humans
PubMed: 32861451
DOI: 10.1016/j.sempedsurg.2020.150947 -
Techniques in Vascular and... Jun 2009Biliary tract interventions remain a tremendous technical challenge to the interventionalist and require appropriate clinical postprocedural management. The increased... (Review)
Review
Biliary tract interventions remain a tremendous technical challenge to the interventionalist and require appropriate clinical postprocedural management. The increased use of endoscopy for biliary tract evaluation and intervention has served to largely replace percutaneous techniques, resulting in a decreased number of patients requiring primary percutaneous transhepatic biliary interventions. However, those patients who do present for percutaneous biliary procedures often represent a more technically difficult subset. Thorough familiarity with normal and variant biliary tract anatomy, and experience with a variety of techniques, will allow for successful biliary tract interventions in complex situations. This article reviews the current role of percutaneous transhepatic interventions in the emergency evaluation and management of biliary tract disease.
Topics: Biliary Tract Diseases; Biliary Tract Surgical Procedures; Catheterization; Cholecystostomy; Drainage; Emergency Treatment; Humans; Minimally Invasive Surgical Procedures; Radiography, Interventional; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Interventional
PubMed: 19853234
DOI: 10.1053/j.tvir.2009.08.009 -
The Surgical Clinics of North America Apr 2019Biliary dyskinesia is a functional disorder of the gallbladder or sphincter of Oddi. While cholecystectomy for symptomatic cholelithiasis is widely accepted, debate... (Review)
Review
Biliary dyskinesia is a functional disorder of the gallbladder or sphincter of Oddi. While cholecystectomy for symptomatic cholelithiasis is widely accepted, debate remains regarding the clinical benefit of invasive procedures for biliary dyskinesia. This article will review current best evidence in the diagnosis and management of biliary dyskinesia.
Topics: Biliary Dyskinesia; Humans
PubMed: 30846030
DOI: 10.1016/j.suc.2018.11.004 -
Journal of Surgical Oncology Jul 2019Percutaneous biliary interventions have established their role in the management of benign and malignant biliary disease. There are limited data comparing procedures... (Review)
Review
Percutaneous biliary interventions have established their role in the management of benign and malignant biliary disease. There are limited data comparing procedures performed by gastroenterologists and interventional radiologists in managing malignant biliary obstruction. Endoscopic procedures performed by gastroenterologists are not completely benign with reported complications ranging from 2% to 15%. It is important that gastroenterologists and interventional radiologists collaborate to form algorithms for management of malignant biliary obstruction which provide safe and efficacious care to these patients.
Topics: Biliary Tract Neoplasms; Biliary Tract Surgical Procedures; Cholangiography; Cholestasis; Drainage; Endoscopy, Digestive System; Gastroenterology; Humans; Palliative Care; Perioperative Care; Prosthesis Implantation; Radiography, Interventional; Stents
PubMed: 30977913
DOI: 10.1002/jso.25471 -
Surgical Pathology Clinics Jun 2018Primary biliary cholangitis and autoimmune hepatitis are common autoimmune diseases of the liver. Both have typical clinical presentations, including certain... (Review)
Review
Primary biliary cholangitis and autoimmune hepatitis are common autoimmune diseases of the liver. Both have typical clinical presentations, including certain autoantibodies on serologic testing. Histologic features are also often typical: primary biliary cholangitis shows bile duct destruction (sometimes with granulomas), and autoimmune hepatitis shows prominent portal and lobular lymphoplasmacytic inflammation. Both have a wide differential diagnosis, including one another; they may also simultaneously occur within the same patient. Careful use of clinical and histologic criteria may be necessary for diagnosis. First-line therapy is immunosuppression for autoimmune hepatitis and ursodeoxycholic acid for primary biliary cholangitis. Both diseases may progress to cirrhosis.
Topics: Biopsy; Cholangitis; Diagnosis, Differential; Hepatitis, Autoimmune; Humans; Immunosuppressive Agents; Liver; Liver Cirrhosis, Biliary; Prognosis; Ursodeoxycholic Acid
PubMed: 29751878
DOI: 10.1016/j.path.2018.02.010 -
Seminars in Pediatric Surgery Nov 2000Although the prognosis of biliary atresia has been dramatically improved in the era of liver transplantation, the Kasai operation is still the first line of surgical... (Review)
Review
Although the prognosis of biliary atresia has been dramatically improved in the era of liver transplantation, the Kasai operation is still the first line of surgical treatment. Successful hepatic portoenterostomy depends on early diagnosis and surgery, adequate surgical technique, prevention of cholangitis, and precise postoperative management.
Topics: Biliary Atresia; Child; Cholangitis; Humans; Portoenterostomy, Hepatic; Reoperation
PubMed: 11112835
DOI: 10.1053/spsu.2000.18846 -
Gastroenterology Clinics of North... Jun 2011Primary biliary cirrhosis is a chronic autoimmune inflammatory disease of the liver with a striking female preponderance. It has an insidious onset and typically affects... (Review)
Review
Primary biliary cirrhosis is a chronic autoimmune inflammatory disease of the liver with a striking female preponderance. It has an insidious onset and typically affects middle-aged women. The disease manifests gradually with symptoms of fatigue, pruritis, and increased alkaline phosphatase levels on laboratory evaluation. The hallmark of the disease is the circulating antimitochondrial antibody. Histology is characterized by inflammation of the bile ducts, destruction of cholangiocytes, and subsequent cholestasis, progressing to biliary cirrhosis. The standard treatment for primary biliary cirrhosis is ursodeoxycholic acid, which improves survival, but the disease can still lead to cirrhosis and liver failure over decades.
Topics: Female; Humans; Liver Cirrhosis, Biliary; Male; Sex Factors
PubMed: 21601785
DOI: 10.1016/j.gtc.2011.03.008 -
Journal of Clinical Ultrasound : JCU Jun 2019Congenital anomalies of the biliary tract include a variety of pathologic conditions, such as biliary atresia, choledochal cysts, gallbladder agenesis, congenital... (Review)
Review
Congenital anomalies of the biliary tract include a variety of pathologic conditions, such as biliary atresia, choledochal cysts, gallbladder agenesis, congenital cholelithiasis, and gallbladder duplication. Although most of these malformations are rare and benign conditions, they may occasionally represent a major threat to extrauterine life. Visualization of a normal-sized gallbladder should be a mandatory component of the second-trimester anomaly ultrasound scan. Advances in prenatal sonography enable the detection of biliary tract congenital malformations. In this review, we discuss the detection rates, sonographic features, and prognosis of the most frequently prenatally diagnosed biliary tract malformations.
Topics: Biliary Tract; Biliary Tract Diseases; Digestive System Abnormalities; Female; Humans; Pregnancy; Prognosis; Ultrasonography, Prenatal
PubMed: 30729537
DOI: 10.1002/jcu.22705 -
The New England Journal of Medicine Oct 1999
Review
Topics: Biliary Tract; Biliary Tract Neoplasms; Cholangiography; Humans; Risk Factors; Tomography, X-Ray Computed
PubMed: 10536130
DOI: 10.1056/NEJM199910283411807