Pub Date : 2017-11-17DOI: 10.5348/IJHPD-2017-73-ED-9
N. Osna, Srivatsan Kidambi
Infection of liver with hepatotropic viruses is exacerbated by alcohol abuse. Toxic effects of alcohol on virally infected cells are induced not by alcohol per se, but by alcohol metabolism. To efficiently metabolize alcohol, cells should express ethanol-metabolizing enzymes, alcohol dehydrogenase (ADH) and cytochrome P450E1 (CYP2E1) that convert alcohol to acetaldehyde and generate reactive oxygen species (ROS). These enzymes are highly expressed in hepatocytes, making them the primary site of ethanol metabolism. All toxic effects of ethanol exposure to hepatocytes, which dose and time-dependently modulate viral replication, can be attributed to ethanol metabolism. Recently, we have shown that short-term exposure of HCV-infected cells to acetaldehyde enhances viral replication, while long-term exposure pushes cells to apoptosis [1, 2]. These effects were not observed if liver cells are unable to metabolize ethanol. Unfortunately, most of ethanol studies on HCVinfected and HBV-infected hepatocytes are performed on hepatoma cell lines (HepG2 and Huh7 cells), which serve as the surrogative in vitro hepatocyte models. Most of hepatoma cells do not express ADH and CYP2E1 and thus, are not affected by ethanol metabolism, making the obtained results questionable in terms of the effects of ethanol metabolism. Furthermore, human primary
{"title":"In vitro studies of alcohol-induced liver injury in virally-infected human hepatocytes: Advantages and limitations","authors":"N. Osna, Srivatsan Kidambi","doi":"10.5348/IJHPD-2017-73-ED-9","DOIUrl":"https://doi.org/10.5348/IJHPD-2017-73-ED-9","url":null,"abstract":"Infection of liver with hepatotropic viruses is exacerbated by alcohol abuse. Toxic effects of alcohol on virally infected cells are induced not by alcohol per se, but by alcohol metabolism. To efficiently metabolize alcohol, cells should express ethanol-metabolizing enzymes, alcohol dehydrogenase (ADH) and cytochrome P450E1 (CYP2E1) that convert alcohol to acetaldehyde and generate reactive oxygen species (ROS). These enzymes are highly expressed in hepatocytes, making them the primary site of ethanol metabolism. All toxic effects of ethanol exposure to hepatocytes, which dose and time-dependently modulate viral replication, can be attributed to ethanol metabolism. Recently, we have shown that short-term exposure of HCV-infected cells to acetaldehyde enhances viral replication, while long-term exposure pushes cells to apoptosis [1, 2]. These effects were not observed if liver cells are unable to metabolize ethanol. Unfortunately, most of ethanol studies on HCVinfected and HBV-infected hepatocytes are performed on hepatoma cell lines (HepG2 and Huh7 cells), which serve as the surrogative in vitro hepatocyte models. Most of hepatoma cells do not express ADH and CYP2E1 and thus, are not affected by ethanol metabolism, making the obtained results questionable in terms of the effects of ethanol metabolism. Furthermore, human primary","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"7 1","pages":"50-52"},"PeriodicalIF":0.1,"publicationDate":"2017-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47689400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-25DOI: 10.5348/IJHPD-2017-72-RA-8
S. Turbeville, C. Hornfeldt, M. Javle, E. Tran, Marion Schwartz
Cholangiocarcinoma (CCA) is a cancer arising from the epithelium of intrahepatic or extrahepatic bile ducts. Cholangiocarcinoma often has a poor prognosis due to late diagnosis and the incidence and mortality rate of intrahepatic CCA appear to be increasing. Current therapies include surgical resection, orthotopic liver transplantation, chemotherapy/ chemoradiation and palliative care. Depending on the location, the 5-year survival for CCA ranges from 27–60%. Emerging new therapies are currently being developed for treating CCA include immunotherapy, altering the tumor microenvironment, targeting growth factor gene mutations and signal pathways and that control tumor growth, and targeting gene therapy. The objective of this paper is to summarize the research that is currently ongoing for treating this challenging disease.
{"title":"Emerging therapies for the treatment of cholangiocarcinoma","authors":"S. Turbeville, C. Hornfeldt, M. Javle, E. Tran, Marion Schwartz","doi":"10.5348/IJHPD-2017-72-RA-8","DOIUrl":"https://doi.org/10.5348/IJHPD-2017-72-RA-8","url":null,"abstract":"Cholangiocarcinoma (CCA) is a cancer arising from the epithelium of intrahepatic or extrahepatic bile ducts. Cholangiocarcinoma often has a poor prognosis due to late diagnosis and the incidence and mortality rate of intrahepatic CCA appear to be increasing. Current therapies include surgical resection, orthotopic liver transplantation, chemotherapy/ chemoradiation and palliative care. Depending on the location, the 5-year survival for CCA ranges from 27–60%. Emerging new therapies are currently being developed for treating CCA include immunotherapy, altering the tumor microenvironment, targeting growth factor gene mutations and signal pathways and that control tumor growth, and targeting gene therapy. The objective of this paper is to summarize the research that is currently ongoing for treating this challenging disease.","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"7 1","pages":"36-49"},"PeriodicalIF":0.1,"publicationDate":"2017-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49507220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-29DOI: 10.5348/IJHPD-2017-71-CR-7
A. A.M., A. A.A., A. M.F., Alsareii S.A.
Endoscopic retrograde cholangiopancreatography (ERCP) is minimally invasive procedure commonly performed for biliary and pancreatic diseases. According to literature, the most common related complication are pancreatitis, post-sphincterotomy bleeding, perforation and cholangitis. This is rare and exceptional ERCP complication and only few cases have been reported. We report a case of rare post-ERCP complication, subcapsular liver hematoma that was diagnosed 16 hour post-ERCP in 28-year-old lady with intra-abdominal collection, ultrasound guided drainage of suspected bile leak was done, but the drained fluid was bloody (blood mixed with bile), with total amount of 900 ml in the first 36 hours. Patient received 2 units packed RBCs and she maintain her vital sign and hemoglobin 8.5 g/dl. Computed tomography scan of abdomen revealed a large left hepatic lobe subcapsular hematoma 16x7x12 cm with no active bleeding causing compression of the left hepatic vessels. On the basis of laboratory, clinical, and hemodynamic parameters the patient was hemodynamically stable. She was managed conservatively with only ultrasound Alzubaidi A.M.1, Alshadadi A.A.1, Atta M.F.1, Alsareii S.A.2 Affiliations: 1King Khalid Hospital – Najran/Gastroenterology, Saudi Arabia; 2Faculty of Medicine, Surgical Department – Najran University, Saudi Arabia. Corresponding Author: Dr. Ali Mothanna Saleh Al-zubaidi, Consultant Gastroenterology and Hepatology King Khalid hospital – Najran; Clinical Assistant Professor Faculty of Medicine/Najran University, Saudi Arabia; Email: dr_ali26@ yahoo.com Received: 24 March 2017 Accepted: 09 May 2017 Published: 30 August 2017 guided drained of abdominal collection and no any radiological or surgical intervention needed for the hematoma.
{"title":"Subcapsular left hepatic lobe hematoma: A potentially life-threatening post-ERCP complication","authors":"A. A.M., A. A.A., A. M.F., Alsareii S.A.","doi":"10.5348/IJHPD-2017-71-CR-7","DOIUrl":"https://doi.org/10.5348/IJHPD-2017-71-CR-7","url":null,"abstract":"Endoscopic retrograde cholangiopancreatography (ERCP) is minimally invasive procedure commonly performed for biliary and pancreatic diseases. According to literature, the most common related complication are pancreatitis, post-sphincterotomy bleeding, perforation and cholangitis. This is rare and exceptional ERCP complication and only few cases have been reported. We report a case of rare post-ERCP complication, subcapsular liver hematoma that was diagnosed 16 hour post-ERCP in 28-year-old lady with intra-abdominal collection, ultrasound guided drainage of suspected bile leak was done, but the drained fluid was bloody (blood mixed with bile), with total amount of 900 ml in the first 36 hours. Patient received 2 units packed RBCs and she maintain her vital sign and hemoglobin 8.5 g/dl. Computed tomography scan of abdomen revealed a large left hepatic lobe subcapsular hematoma 16x7x12 cm with no active bleeding causing compression of the left hepatic vessels. On the basis of laboratory, clinical, and hemodynamic parameters the patient was hemodynamically stable. She was managed conservatively with only ultrasound Alzubaidi A.M.1, Alshadadi A.A.1, Atta M.F.1, Alsareii S.A.2 Affiliations: 1King Khalid Hospital – Najran/Gastroenterology, Saudi Arabia; 2Faculty of Medicine, Surgical Department – Najran University, Saudi Arabia. Corresponding Author: Dr. Ali Mothanna Saleh Al-zubaidi, Consultant Gastroenterology and Hepatology King Khalid hospital – Najran; Clinical Assistant Professor Faculty of Medicine/Najran University, Saudi Arabia; Email: dr_ali26@ yahoo.com Received: 24 March 2017 Accepted: 09 May 2017 Published: 30 August 2017 guided drained of abdominal collection and no any radiological or surgical intervention needed for the hematoma.","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"7 1","pages":"32-35"},"PeriodicalIF":0.1,"publicationDate":"2017-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47309409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-21DOI: 10.5348/ijhpd-2017-70-CR-6
A. Perez, C. Yacapin
Introduction: Angiomyolipomas primarily arising from the liver are rare. Hepatic angiomyolipoma (HAML) is a rare tumor characterized by the presence of blood vessels, muscle tissue and adipose tissue with only about 300 reported cases to date. This is the first case reported in literature of a Filipino patient. Case Report: A 49-year-old Filipino female presented with a two-year history of recurrent epigastric pain. Abdominal magnetic resonance imaging revealed a fat-containing lesion in the left liver lobe. Serial follow-up revealed progressive enlargement on imaging studies. Serologic tests were negative for malignancy or infection. The patient underwent left hepatic lateral segmentectomy which revealed a 7.5x7 cm friable mass involving hepatic segments II and III. Histopathology showed mature fat cells with a few thick-walled blood vessels and spindled smooth muscle cells with no atypia. Homatropine methylbromide-45 test showed strong and diffused staining confirming angiomyolipoma. Conclusion: Clinical evaluation and a comprehensive analysis of ultrasonography, Anthony Relucio Perez1, Clarence Yacapin2 Affiliations: 1MD, MHA, Vice Chair for Training, Department of Surgery, UP College of Medicine and Philippine General Hospital, Section Chief, Hepatobiliary and Pancreatic Surgery Asian Hospital and Medical Center; 2MD, Clinical Fellow Section of Minimally Invasive Surgery, Department of Surgery Asian Hospital and Medical Center. Corresponding Author: Anthony Relucio Perez, 108 Dayap Street Ayala Alabang, Muntinlupa, NCR, Philippines, 1780; Email: tonyperez92@yahoo.com Received: 26 June 2017 Accepted: 26 July 2017 Published: 21 August 2017 computed tomography scan and magnetic resonance imaging scan are essential for correct preoperative diagnosis. Symptoms, malignant potential and inability to distinguish from liver malignancies may indicate surgical resection as the best treatment option.
{"title":"Hepatic angiomyolipoma presenting with chronic epigastric pain: A case report","authors":"A. Perez, C. Yacapin","doi":"10.5348/ijhpd-2017-70-CR-6","DOIUrl":"https://doi.org/10.5348/ijhpd-2017-70-CR-6","url":null,"abstract":"Introduction: Angiomyolipomas primarily arising from the liver are rare. Hepatic angiomyolipoma (HAML) is a rare tumor characterized by the presence of blood vessels, muscle tissue and adipose tissue with only about 300 reported cases to date. This is the first case reported in literature of a Filipino patient. Case Report: A 49-year-old Filipino female presented with a two-year history of recurrent epigastric pain. Abdominal magnetic resonance imaging revealed a fat-containing lesion in the left liver lobe. Serial follow-up revealed progressive enlargement on imaging studies. Serologic tests were negative for malignancy or infection. The patient underwent left hepatic lateral segmentectomy which revealed a 7.5x7 cm friable mass involving hepatic segments II and III. Histopathology showed mature fat cells with a few thick-walled blood vessels and spindled smooth muscle cells with no atypia. Homatropine methylbromide-45 test showed strong and diffused staining confirming angiomyolipoma. Conclusion: Clinical evaluation and a comprehensive analysis of ultrasonography, Anthony Relucio Perez1, Clarence Yacapin2 Affiliations: 1MD, MHA, Vice Chair for Training, Department of Surgery, UP College of Medicine and Philippine General Hospital, Section Chief, Hepatobiliary and Pancreatic Surgery Asian Hospital and Medical Center; 2MD, Clinical Fellow Section of Minimally Invasive Surgery, Department of Surgery Asian Hospital and Medical Center. Corresponding Author: Anthony Relucio Perez, 108 Dayap Street Ayala Alabang, Muntinlupa, NCR, Philippines, 1780; Email: tonyperez92@yahoo.com Received: 26 June 2017 Accepted: 26 July 2017 Published: 21 August 2017 computed tomography scan and magnetic resonance imaging scan are essential for correct preoperative diagnosis. Symptoms, malignant potential and inability to distinguish from liver malignancies may indicate surgical resection as the best treatment option.","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"7 1","pages":"28-31"},"PeriodicalIF":0.1,"publicationDate":"2017-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44037794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-04DOI: 10.5348/ijhpd-2017-69-OA-5
Soubia Akhter, Z. Khan, B. Ahmed, F. Ahmed, Z. Memon
Aims: The aim of this study was to determine the complications of acute pancreatitis in tertiary care hospital. Methods: Hundred patients diagnosed with acute pancreatitis were analyzed in this prospective cohort study from July 2015 to July 2016. Complications were studied. Cholelithiasis was found to be the most common cause of acute pancreatitis in our setting. Results: Acute pancreatitis is defined as reversible inflammation of pancreatic parenchyma which is characterized by the presence of interstitial edema, acute inflammatory cell infiltrate and varying degree of cellular apoptosis, necrosis and hemorrhage. Cholelithiasis and alcohol were found to be the most common causes of acute pancreatitis. Alcohol, Smoking, some medications are the major risk factors. The major complications of acute pancreatitis are pseudocyst, pleural effusion, sepsis, shock or internal bleeding, fluid collection, ascites. Conclusion: Acute pancreatitis is one of the most common gastrointestinal ailments with high morbidity and mortality worldwide and at our set up too. Like any other disease occurrence of complications may worsen the prognosis of acute pancreatitis. Acute fluid collection around pancreas came out to be the common complication. Soubia Akhter1, Zaeem UR Rehman Khan1, Bilal Ahmed1, Farah Ahmed1, Zahid Ali Memon1 Affiliation: 1Dow University of health and sciences, Karachi, Pakistan. Corresponding Author: Farah Ahmed, Dow University of health and sciences, Karachi 74200, Pakistan; Email: farahahmed153@gmail.com Received: 07 January 2017 Accepted: 29 April 2017 Published: 04 July 2017
目的：本研究旨在确定三级护理医院急性胰腺炎的并发症。方法：对2015年7月至2016年7月期间诊断为急性胰腺炎的100名患者进行前瞻性队列研究。对并发症进行了研究。在我们的环境中，胆结石被发现是急性胰腺炎最常见的原因。结果：急性胰腺炎是指胰腺实质的可逆性炎症，其特征是存在间质水肿、急性炎症细胞浸润和不同程度的细胞凋亡、坏死和出血。胆结石和酒精是急性胰腺炎最常见的病因。酒精、吸烟和一些药物是主要的危险因素。急性胰腺炎的主要并发症有假性囊肿、胸腔积液、败血症、休克或内出血、积液、腹水。结论：急性胰腺炎是世界范围内最常见的胃肠道疾病之一，发病率和死亡率都很高。与任何其他疾病一样，并发症的发生可能会恶化急性胰腺炎的预后。胰腺周围急性积液是常见的并发症。Soubia Akhter1、Zaeem UR Rehman Khan1、Bilal Ahmed1、Farah Ahmed1和Zahid Ali Mem1隶属关系：1巴基斯坦卡拉奇，多哈卫生与科学大学。通讯作者：Farah Ahmed，陶氏卫生与科学大学，巴基斯坦卡拉奇74200；电子邮件：farahahmed153@gmail.com接收日期：2017年1月7日接收日期：2019年4月29日发布日期：2017
{"title":"Complications of acute pancreatitis in tertiary care hospital","authors":"Soubia Akhter, Z. Khan, B. Ahmed, F. Ahmed, Z. Memon","doi":"10.5348/ijhpd-2017-69-OA-5","DOIUrl":"https://doi.org/10.5348/ijhpd-2017-69-OA-5","url":null,"abstract":"Aims: The aim of this study was to determine the complications of acute pancreatitis in tertiary care hospital. Methods: Hundred patients diagnosed with acute pancreatitis were analyzed in this prospective cohort study from July 2015 to July 2016. Complications were studied. Cholelithiasis was found to be the most common cause of acute pancreatitis in our setting. Results: Acute pancreatitis is defined as reversible inflammation of pancreatic parenchyma which is characterized by the presence of interstitial edema, acute inflammatory cell infiltrate and varying degree of cellular apoptosis, necrosis and hemorrhage. Cholelithiasis and alcohol were found to be the most common causes of acute pancreatitis. Alcohol, Smoking, some medications are the major risk factors. The major complications of acute pancreatitis are pseudocyst, pleural effusion, sepsis, shock or internal bleeding, fluid collection, ascites. Conclusion: Acute pancreatitis is one of the most common gastrointestinal ailments with high morbidity and mortality worldwide and at our set up too. Like any other disease occurrence of complications may worsen the prognosis of acute pancreatitis. Acute fluid collection around pancreas came out to be the common complication. Soubia Akhter1, Zaeem UR Rehman Khan1, Bilal Ahmed1, Farah Ahmed1, Zahid Ali Memon1 Affiliation: 1Dow University of health and sciences, Karachi, Pakistan. Corresponding Author: Farah Ahmed, Dow University of health and sciences, Karachi 74200, Pakistan; Email: farahahmed153@gmail.com Received: 07 January 2017 Accepted: 29 April 2017 Published: 04 July 2017","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"7 1","pages":"23-27"},"PeriodicalIF":0.1,"publicationDate":"2017-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46150603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-27DOI: 10.5348/ijhpd-2017-68-CS-4
A. Gupta, A. Choraria, Shantanu Tiwari, H. Dubey, R. Agrawal, Sourabh Nandi, Vivek Chaudhary
Introduction: Nowadays laparoscopic surgery is a very common form of treatment strategy for digestive diseases and these ‘keyhole’ surgeries provide many benefits to the patients. However, controversy exists when the laparoscopic surgery is done for early gallbladder cancer. The aim of our study was to report two such cases to see feasibility and safety of laparoscopic radical cholecystectomy with lymph node dissection. Case Series: Two patients underwent laparoscopic radical cholecystectomy with lymph node dissection for gallbladder carcinoma. Both patients were preoperatively diagnosed. Mean operative time was 172 minutes, and average estimated blood loss was 225 ml. There was no intraoperative complication. The liver dissection was done by Harmonic in one case and by Waterjet in the other case. Average hospital stay after surgery was four days. Postoperative morbidity included minimal bile leak in one patient only and no bile leak in patient operated with Waterjet system. Postoperative histopathology revealed adenocarcinoma of gallbladder with no lymph node invasion T2N0M0 (Stage II) in both patients. The mean lymph node retrieval was 5.5. Both patients received adjuvant chemotherapy with gemcitabine and carboplatin. Conclusion: We conclude that laparoscopic radical cholecystectomy with lymph node dissection is safe and beneficial for the patients with T1b/T2 gallbladder carcinoma and is useful in selected patients with a preoperative suspicion of early-stage gallbladder cancer by sparing them the necessity of a second-stage open procedure.
{"title":"Laparoscopic radical cholecystectomy for carcinoma gallbladder: A case series","authors":"A. Gupta, A. Choraria, Shantanu Tiwari, H. Dubey, R. Agrawal, Sourabh Nandi, Vivek Chaudhary","doi":"10.5348/ijhpd-2017-68-CS-4","DOIUrl":"https://doi.org/10.5348/ijhpd-2017-68-CS-4","url":null,"abstract":"\u0000 \u0000 \u0000 Introduction: Nowadays laparoscopic surgery is a very common form of treatment strategy for digestive diseases and these ‘keyhole’ surgeries provide many benefits to the patients. However, controversy exists when the laparoscopic surgery is done for early gallbladder cancer. The aim of our study was to report two such cases to see feasibility and safety of laparoscopic radical cholecystectomy with lymph node dissection.\u0000 Case Series: Two patients underwent laparoscopic radical cholecystectomy with lymph node dissection for gallbladder carcinoma. Both patients were preoperatively diagnosed. Mean operative time was 172 minutes, and average estimated blood loss was 225 ml. There was no intraoperative complication. The liver dissection was done by Harmonic in one case and by Waterjet in the other case. Average hospital stay after surgery was four days. Postoperative morbidity included minimal bile leak in one patient only and no bile leak in patient operated with Waterjet system. Postoperative histopathology revealed adenocarcinoma of gallbladder with no lymph node invasion T2N0M0 (Stage II) in both patients. The mean lymph node retrieval was 5.5. Both patients received adjuvant chemotherapy with gemcitabine and carboplatin.\u0000 Conclusion: We conclude that laparoscopic radical cholecystectomy with lymph node dissection is safe and beneficial for the patients with T1b/T2 gallbladder carcinoma and is useful in selected patients with a preoperative suspicion of early-stage gallbladder cancer by sparing them the necessity of a second-stage open procedure. \u0000 \u0000","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49603529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-19DOI: 10.5348/IJHPD-2017-67-ED-3
N. Osna
{"title":"Demethylase JMJD6 as a regulator of innate immunity in HCV-associated liver injury","authors":"N. Osna","doi":"10.5348/IJHPD-2017-67-ED-3","DOIUrl":"https://doi.org/10.5348/IJHPD-2017-67-ED-3","url":null,"abstract":"","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"7 1","pages":"15-17"},"PeriodicalIF":0.1,"publicationDate":"2017-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41899946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-01DOI: 10.5348/IJHPD-2017-66-CR-2
M. Bleszynski, D. Schaeffer, M. Segedi
Introduction: Neuroendocrine tumors (NETs) formally known as carcinoids tumors are neoplasms that arise from enterochromaffin cells. The NETs most commonly occur in the gastro-intestinal tract and predominately within the ileum. Symptomatic ileal NETs have most likely metastasized to the liver at the time of diagnosis. Pancreatic metastasis from ileal NETs are exceptionally rare. Case Report: A 76-year-old female with a primary ileal carcinoid underwent right hemi-colectomy secondary to bowel obstruction. One-year post bowel resection, the patient presented with carcinoid syndrome, imaging revealed a singular hepatic metastasis (segment 2) and a pancreatic tail mass. After radiologic workup with an abdominal CT, PET and octreotide scan a presumed diagnosis of recurrent metastatic NET was made. Multi-disciplinary rounds discussed the case. Laparoscopic distal pancreatectomy, splenectomy and radiofrequency ablation of the liver tumor were performed. Surgical pathology of the pancreatic mass was consistent with primary ileal carcinoid tumor. Conclusion: Ileal NET metastasis to the pancreas is a rare Michael Sean Bleszynski1, David F. Schaeffer2, Maja Segedi1 Affiliations: 1Department of General Surgery, University of British Columbia, Vancouver, Canada; 2Department of Pathology, University of British Columbia, Vancouver, Canada. Corresponding Author: Michael Bleszynski, MD, The University of British Columbia Faculty of Medicine, Department of Surgery, Division of General Surgery, Vancouver General Hospital Rm 3100 – Jim Pattison Pavillion North, 950 West 10th Avenue, Vancouver, BC, V5Z 1M9 Canada; E-mail: mbleszyn@gmail.com Received: 27 November 2016 Accepted: 07 February 2017 Published: 07 March 2017 phenomenon. Metastatic NET management should be discussed with a multi-disciplinary team. R0 resection of primary and metastatic NETs offers the only chance of cure. Locoregional, systemic therapies, and surgical debulking can offer a survival benefit in unresectable disease or in cases where resection incurs a high perioperative risk.
引言：神经内分泌肿瘤（NETs）正式名称为类癌，是由肠嗜铬细胞引起的肿瘤。NETs最常见于胃肠道，主要发生在回肠内。有症状的回肠NETs在诊断时最有可能转移到肝脏。回肠NETs的胰腺转移异常罕见。病例报告：一位76岁的女性原发性回肠类癌患者接受了继发于肠梗阻的右半结肠切除术。肠切除术后一年，患者出现类癌综合征，影像学显示有一个单一的肝转移（第2节）和胰腺尾部肿块。经过腹部CT、PET和奥曲肽扫描的放射学检查，推测诊断为复发性转移性NET。多学科轮番讨论了此案。对肝肿瘤进行腹腔镜胰远端切除术、脾切除术和射频消融术。胰腺肿块的外科病理与原发性回肠类癌一致。结论：Ileal NET向胰腺转移是罕见的，Michael Sean Bleszynski1，David F.Schaeffer2，Maja Segedi 1所属单位：1加拿大温哥华不列颠哥伦比亚大学普通外科；2加拿大温哥华不列颠哥伦比亚大学病理学系。通讯作者：Michael Bleszynski，医学博士，不列颠哥伦比亚大学医学院普通外科外科，温哥华综合医院3100室-Jim Pattison Pavilion North，950 West 10th Avenue，温哥华，加拿大，V5Z 1M9；电子邮件：mbleszyn@gmail.com接收时间：2016年11月27日接受时间：2017年2月7日发布时间：2017月7日现象。转移性NET管理应与多学科团队讨论。原发性和转移性NETs的R0切除术是唯一的治愈机会。局部、系统治疗和手术减阻可以在不可切除的疾病或切除术围手术期风险较高的情况下提供生存益处。
{"title":"Ileal neuroendocrine tumor metastasis to pancreas and liver: A case report","authors":"M. Bleszynski, D. Schaeffer, M. Segedi","doi":"10.5348/IJHPD-2017-66-CR-2","DOIUrl":"https://doi.org/10.5348/IJHPD-2017-66-CR-2","url":null,"abstract":"Introduction: Neuroendocrine tumors (NETs) formally known as carcinoids tumors are neoplasms that arise from enterochromaffin cells. The NETs most commonly occur in the gastro-intestinal tract and predominately within the ileum. Symptomatic ileal NETs have most likely metastasized to the liver at the time of diagnosis. Pancreatic metastasis from ileal NETs are exceptionally rare. Case Report: A 76-year-old female with a primary ileal carcinoid underwent right hemi-colectomy secondary to bowel obstruction. One-year post bowel resection, the patient presented with carcinoid syndrome, imaging revealed a singular hepatic metastasis (segment 2) and a pancreatic tail mass. After radiologic workup with an abdominal CT, PET and octreotide scan a presumed diagnosis of recurrent metastatic NET was made. Multi-disciplinary rounds discussed the case. Laparoscopic distal pancreatectomy, splenectomy and radiofrequency ablation of the liver tumor were performed. Surgical pathology of the pancreatic mass was consistent with primary ileal carcinoid tumor. Conclusion: Ileal NET metastasis to the pancreas is a rare Michael Sean Bleszynski1, David F. Schaeffer2, Maja Segedi1 Affiliations: 1Department of General Surgery, University of British Columbia, Vancouver, Canada; 2Department of Pathology, University of British Columbia, Vancouver, Canada. Corresponding Author: Michael Bleszynski, MD, The University of British Columbia Faculty of Medicine, Department of Surgery, Division of General Surgery, Vancouver General Hospital Rm 3100 – Jim Pattison Pavillion North, 950 West 10th Avenue, Vancouver, BC, V5Z 1M9 Canada; E-mail: mbleszyn@gmail.com Received: 27 November 2016 Accepted: 07 February 2017 Published: 07 March 2017 phenomenon. Metastatic NET management should be discussed with a multi-disciplinary team. R0 resection of primary and metastatic NETs offers the only chance of cure. Locoregional, systemic therapies, and surgical debulking can offer a survival benefit in unresectable disease or in cases where resection incurs a high perioperative risk.","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"7 1","pages":"11-14"},"PeriodicalIF":0.1,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42517300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-23DOI: 10.5348/ijhpd-2017-65-OA-1
S. Tanveer, H. Mukarram, Hashmi Shoaib Nayyar, Mustafa Qurat Ul Ain, Shaheen Neelofar
Aims: To determine frequency of incidental gallbladder cancer (IGBC) in Pakistani population, its demographic/histopathological features and type of surgical resections performed. Methods: This observational study was conducted at Combined Military Hospital (CMH)/Armed Forces Institute of Pathology (AFIP) Rawalpindi, Pakistan from July 2009 to July 2015. Clinical as well as pathological records of all patients who underwent laparoscopic cholecystectomy (LC) / open cholecystectomy (OC) were reviewed and data was obtained regarding IGBC and benign gallbladder pathology. Patients diagnosed Sajid Muhammad Tanveer1, Hussain Syed Mukarram2, Hashmi Shoaib Nayyar3, Mustafa Qurat Ul Ain4, Shaheen Neelofar5 Affiliations: 1MBBS, FCPS, Assistant Professor & Classified Surgical Specialist, Department of General and Laparoscopic surgery, Combined Military Hospital Rawalpindi, Punjab, Pakistan; 2MBBS, FCPS, Associate Professor & Head of Department, Department of General and Laparoscopic Surgery, Combined Military Hospital Rawalpindi, Punjab, Pakistan; 3MBBS, FCPS, FRCP, Professor & Head of Department, Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan; 4MBBS, Senior Registrar, Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan; 5MBBS, Senior Medical Officer, Department of General and Laparoscopic Surgery, Combined Military Hospital Rawalpindi, Punjab, Pakistan. Corresponding Author: Muhammad Tanveer Sajid, C/o Hafiz Ghulam Mustafa Ezzy traders Hakeem jee building Jinnah road Abbottabad, KPK, Pakistan, 22010; Email: doc_tanveersajid@hotmail.com Received: 02 April 2016 Accepted: 22 June 2016 Published: 23 February 2017 with cancer underwent staging investigations and were offered definitive surgery. Overall frequency and clinicopathological features of IGBC were studied. Results: One hundred sixtyfour patients out of 10,549 had IGBC (1.55%). Mean age of presentation in IGBC and benign gallbladder pathology patients was 59.23±12.17 and 45.73±13.11 years respectively (p-value <0.001). Cancer patients had significantly more comorbid (73.17% versus 39.43%, p-value <0.001) and larger stones (p-value <0.001). Histopathology revealed adenocarcinoma in 148 (90.24%), adenosquamous carcinoma in 08 (4.88%), undifferentiated in 04 (2.44%), squamous cell carcinoma in 02 (1.22%), sarcoma and melanoma in one patient each (0.61%). Most of the tumors were well differentiated (36.59%) and liver was most commonly infiltrated organ (52.44%). Thirty-four patients had stage I, 38 patients had stage II, 49 patients had stage III and 43 patients had stage IV cancer (20.73%, 23.17%, 29.88%, 26.22% respectively). Surgical resection included no further treatment in 31 patients as cholecystectomy proved adequate vis-à-vis stage, extended cholecystectomy in three patients (1.83%), radical cholecystectomy in 17 (10.37%), pancreaticoduodenectomy (Whipple) in 6 (3.66%), palliation/symptomatic management in 42 (25.61%)
目的：确定巴基斯坦人群中偶然发生癌症（IGBC）的频率、其人口统计学/组织病理学特征和手术切除类型。方法：本观察性研究于2009年7月至2015年7月在巴基斯坦拉瓦尔品第联合军事医院（CMH）/武装部队病理学研究所（AFIP）进行。回顾了所有接受腹腔镜胆囊切除术（LC）/开放式胆囊切除术的患者的临床和病理记录，并获得了关于IGBC和良性胆囊病理的数据。患者诊断为Sajid Muhammad Tanveer1、Hussain Syed Mukarram2、Hashmi Shoaib Nayyar3、Mustafa Qurat Ul Ain4、Shaheen Neelofar5附属机构：1MBBS、FCPS、巴基斯坦旁遮普省拉瓦尔品第联合军事医院普通和腹腔镜外科助理教授和分类外科专家；2MBBS，FCPS，巴基斯坦旁遮普省拉瓦尔品第联合军事医院普通和腹腔镜外科副教授兼系主任；3MBBS，FCPS，FRCP，巴基斯坦拉瓦尔品第武装部队病理学研究所组织病理学系教授兼系主任；4MBBS，巴基斯坦拉瓦尔品第武装部队病理学研究所化学病理学系高级注册官；5MBBS，巴基斯坦旁遮普省拉瓦尔品第联合军事医院普通和腹腔镜外科高级医务官。通讯作者：Muhammad Tanveer Sajid，C/o Hafiz Ghulam Mustafa Ezzy traders Hakeem jee building Jinnah road Abbottabad，KPK，巴基斯坦，22010；电子邮件：doc_tanveersajid@hotmail.com接收日期：2016年4月2日接受日期：2016月22日发表日期：2017年2月23日癌症患者接受分期调查并接受最终手术。研究了IGBC的总体发病率和临床病理特征。结果：10549例患者中有164例患有IGBC（1.55%）。IGBC和胆囊良性病变患者的平均发病年龄分别为59.23±12.17和45.73±13.11岁（p值<0.001）。癌症患者的合并症（73.17%对39.43%，p值<001）和较大结石（p值小于0.001）显著增多。组织病理学显示148例（90.24%）为腺癌，腺鳞癌08例（4.88%），未分化04例（2.44%），鳞状细胞癌02例（1.22%），肉瘤和黑色素瘤各1例（0.61%）。大多数肿瘤分化良好（36.59%），肝脏是最常见的浸润器官（52.44%）。34例为I期，38例为II期，癌症III期49例，IV期43例（分别为20.73%、23.17%、29.88%、26.22%）。31名患者的手术切除不包括进一步治疗，因为胆囊切除术在分期上证明是适当的，3名患者（1.83%）的扩大胆囊切除术，17名患者（10.37%）的根治性胆囊切除术、6名患者（3.66%）的胰十二指肠切除术，42名患者（25.61%）的缓解/症状管理，65名患者（39.63%）拒绝手术。只有50名（30.49%）患者进行了充分的淋巴结切除术，而44名（26.83%）患者的切除率为阳性。结论：胆囊切除术中应注意IGBC，每个标本均应进行常规组织病理学检查。在精心选择的病例中，应提供根治性手术，并可能改善结果。
{"title":"Incidental gallbladder cancer: Missing links in Pakistani population","authors":"S. Tanveer, H. Mukarram, Hashmi Shoaib Nayyar, Mustafa Qurat Ul Ain, Shaheen Neelofar","doi":"10.5348/ijhpd-2017-65-OA-1","DOIUrl":"https://doi.org/10.5348/ijhpd-2017-65-OA-1","url":null,"abstract":"Aims: To determine frequency of incidental gallbladder cancer (IGBC) in Pakistani population, its demographic/histopathological features and type of surgical resections performed. Methods: This observational study was conducted at Combined Military Hospital (CMH)/Armed Forces Institute of Pathology (AFIP) Rawalpindi, Pakistan from July 2009 to July 2015. Clinical as well as pathological records of all patients who underwent laparoscopic cholecystectomy (LC) / open cholecystectomy (OC) were reviewed and data was obtained regarding IGBC and benign gallbladder pathology. Patients diagnosed Sajid Muhammad Tanveer1, Hussain Syed Mukarram2, Hashmi Shoaib Nayyar3, Mustafa Qurat Ul Ain4, Shaheen Neelofar5 Affiliations: 1MBBS, FCPS, Assistant Professor & Classified Surgical Specialist, Department of General and Laparoscopic surgery, Combined Military Hospital Rawalpindi, Punjab, Pakistan; 2MBBS, FCPS, Associate Professor & Head of Department, Department of General and Laparoscopic Surgery, Combined Military Hospital Rawalpindi, Punjab, Pakistan; 3MBBS, FCPS, FRCP, Professor & Head of Department, Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan; 4MBBS, Senior Registrar, Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan; 5MBBS, Senior Medical Officer, Department of General and Laparoscopic Surgery, Combined Military Hospital Rawalpindi, Punjab, Pakistan. Corresponding Author: Muhammad Tanveer Sajid, C/o Hafiz Ghulam Mustafa Ezzy traders Hakeem jee building Jinnah road Abbottabad, KPK, Pakistan, 22010; Email: doc_tanveersajid@hotmail.com Received: 02 April 2016 Accepted: 22 June 2016 Published: 23 February 2017 with cancer underwent staging investigations and were offered definitive surgery. Overall frequency and clinicopathological features of IGBC were studied. Results: One hundred sixtyfour patients out of 10,549 had IGBC (1.55%). Mean age of presentation in IGBC and benign gallbladder pathology patients was 59.23±12.17 and 45.73±13.11 years respectively (p-value <0.001). Cancer patients had significantly more comorbid (73.17% versus 39.43%, p-value <0.001) and larger stones (p-value <0.001). Histopathology revealed adenocarcinoma in 148 (90.24%), adenosquamous carcinoma in 08 (4.88%), undifferentiated in 04 (2.44%), squamous cell carcinoma in 02 (1.22%), sarcoma and melanoma in one patient each (0.61%). Most of the tumors were well differentiated (36.59%) and liver was most commonly infiltrated organ (52.44%). Thirty-four patients had stage I, 38 patients had stage II, 49 patients had stage III and 43 patients had stage IV cancer (20.73%, 23.17%, 29.88%, 26.22% respectively). Surgical resection included no further treatment in 31 patients as cholecystectomy proved adequate vis-à-vis stage, extended cholecystectomy in three patients (1.83%), radical cholecystectomy in 17 (10.37%), pancreaticoduodenectomy (Whipple) in 6 (3.66%), palliation/symptomatic management in 42 (25.61%)","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"7 1","pages":"1-10"},"PeriodicalIF":0.1,"publicationDate":"2017-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43183207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-23DOI: 10.5348/IJHPD-2016-64-CR-20
Qian Chen, Yun Wang, Jinglin Wang, W. Hou, B. Zou, Bin Cheng
Introduction: Pancreatic cystic lymphangioma (PCL) is an extremely rare benign tumor of lymphatic origin. Traditionally, it is diagnosed at surgery performed on a patient with a retroperitoneal cyst of unclear etiology. However, recently a few single case reports showed PCL was successfully diagnosed by endoscopic ultrasound with fine-needle aspiration (EUS-FNA). Case Report: We present a new case of PCL in an 11-year-old boy who came to our hospital for swelling of the body. A contrast-enhanced computed tomography scan revealed a 7.7×4.5 cm cystic lesion involving head and neck of the pancreas. EUS-FNA was subsequently performed and diagnosis of PCL was made based on result of cytological examination and measurement of aspirate. Conclusion: In agreement with previous reports, we show that EUS-FNA confirmed the cystic lesion in pancreas and further provided the gross, biochemical and cytological features supporting accurate diagnosis of PCL.
{"title":"Diagnosis of pancreatic cystic lymphangioma in an 11-year-old boy with endoscopic ultrasound-guided fine needle aspiration: A case report","authors":"Qian Chen, Yun Wang, Jinglin Wang, W. Hou, B. Zou, Bin Cheng","doi":"10.5348/IJHPD-2016-64-CR-20","DOIUrl":"https://doi.org/10.5348/IJHPD-2016-64-CR-20","url":null,"abstract":"\u0000 \u0000 Introduction: Pancreatic cystic lymphangioma (PCL) is an extremely rare benign tumor of lymphatic origin. Traditionally, it is diagnosed at surgery performed on a patient with a retroperitoneal cyst of unclear etiology. However, recently a few single case reports showed PCL was successfully diagnosed by endoscopic ultrasound with fine-needle aspiration (EUS-FNA).\u0000 Case Report: We present a new case of PCL in an 11-year-old boy who came to our hospital for swelling of the body. A contrast-enhanced computed tomography scan revealed a 7.7×4.5 cm cystic lesion involving head and neck of the pancreas. EUS-FNA was subsequently performed and diagnosis of PCL was made based on result of cytological examination and measurement of aspirate.\u0000 Conclusion: In agreement with previous reports, we show that EUS-FNA confirmed the cystic lesion in pancreas and further provided the gross, biochemical and cytological features supporting accurate diagnosis of PCL.\u0000","PeriodicalId":40532,"journal":{"name":"International Journal of Hepatobiliary and Pancreatic Diseases","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2016-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71033406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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