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Cholestatic liver diseases:An era of emerging therapies

World Journal of Clinical Cases 2019年第13期7卷 1571-1581页

作者： Hrishikesh Samant wuttiporn manatsathit David Dies Hosein Shokouh-Amiri Gazi Zibari Moheb Boktor Jonathan Steve Alexander Division of Gastroenterology and Hepatology Department of medicine LSU health Shreveport LA 71103 United States John C McDonald Transplant Center Willis Knighton Medical Center Shreveport LA 71103 United States Division of Gastroenterology and Hepatology University of Nebraska Omaha NE 68194 United States Department of Molecular and Cellular Physiology Louisiana State University School of Medicine Shreveport LA 71103 United States

Recently the field of cholestasis has expanded enormously reflecting an improved understanding of the molecular mechanisms underlying bile secretion and its perturbation in chronic cholestatic disease. Novel anti-cholestatic therapeutic options have been developed for patients not favorably responding to ursodeoxycholic acid (UDCA), the current standard treatment for cholestatic liver disease. Important novel treatment targets now also include nuclear receptors involved in bile acid (BA) homoeostasis like farnesoid X receptor and G proteincoupled receptors e.g., the G-protein-coupled BA receptor “transmembrane G coupled receptor 5”. Fibroblast growth factor-19 and enterohepatic BA transporters also deserve attention as additional drug targets as does the potential treatment agent norUDCA. In this review, we discuss recent and future promising therapeutic agents and their potential molecular mechanisms in cholestatic liver disorders.

关键词： Bile acids Drug therapy Cholestatic liver disease Nuclear receptor agonists

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Role of preoperative endoscopic ultrasound-guided fine-needle tattooing of a pancreatic head insulinoma

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World Journal of Gastrointestinal Endoscopy 2014年第10期6卷 506-509页

作者： Pornchai Leelasinjaroen wuttiporn manatsathit Richard Berri Mohammed Barawi Frank G Gress Department of Medicine St.John Hospital and Medical CenterDetroitMI 48236United States Department of Surgery St.John Hospital and Medical CenterDetroitMI 48236United States Division of Gastroenterology Department of MedicineSt.John Hospital and Medical CenterDetroit MI 48236United States Division of Digestive Diseases Columbia University Medical CenterNew YorkNY 10032United States

Although insulinomas are rare, they are the most com-mon pancreatic neuroendocrine tumor, with an inci-dence of four cases per million population. Insulinomas are generally benign indolent intrapancreatic tumors. Surgical resection remains the main option for treat-ment. However, up to 67% of a pancreatic head insu-linomas are nonpalpable, thus surgical resection of the nonplapable insulinoma in this area could become prob-lematic resulting in prolonged surgical time, increased risk of pancreatic duct injury and need for pancreati-coduodenectomy. Endoscopic ultrasound-guided fine- needle tattooing(EUS-FNT), has been shown to have a crucial role for localization of pancreatic body and tail lesions, facilitating laparoscopic distal pancreatectomyand helping surgeons identify the location of the tumor. EUS-FNT might have a role for preoperative localiza-tion of pancreatic head insulinomas which are likely to be nonpalpable. We report a case of preoperative EUS-FNT for localization of a nonplapable pancreatic head insulinoma. This report demonstrates that EUS-FNT of pancreatic head insulinomas may facilitate surgical resection, reduce operative time and decrease surgical complications.

关键词： Insulinoma Endosonography Endoscopic ultrasound-guided fine-needle tattooing Pancreas Neuroendocrine tumors

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