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Transjugular intrahepatic portosystemic shunt for recompensating decompensated cirrhosis?

World Journal of Gastroenterology 2024年第20期30卷 2621-2623页

作者： dimitrios s karagiannakis Academic Department of Gastroenterology and Hepatology Medical School of National and Kapodistrian University of AthensGeneral Hospital of Athens“Laiko”Athens 11527Greece

Transjugular intrahepatic portosystemic shunt(TIPs)is a medical procedure that has been used to manage variceal bleeding and ascites in patients with *** can prevent further decompensation and improve the survival of high-risk decompensated *** research indicates that TIPs could increase the possibility of recompensation of decompensated cirrhosis when it is combined with adequate suppression of the causative factor of liver ***,the results of the studies have been based on retrospective analysis,and further validation is required by conducting randomized controlled *** this context,we highlight the limitations of the current studies and emphasize the issues that must be addressed before TIPs can be recommended as a potential recompensating tool.

关键词： Decompensated cirrhosis Liver recompensation Baveno VII Transjugular intrahepatic portosystemic shunt

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Percutaneous transhepatic cholangiography:An effective option for endo-biliary radiofrequency ablation before stent insertion in unresectable biliary cancer?

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World Journal of Clinical Cases 2024年第30期12卷 6413-6416页

作者： dimitrios s karagiannakis Academic Department of Gastroenterology Medical School of the National and Kapodistrian University of Athens"Laiko"General HospitalAthens 11527Greece

Biliary cancer is a highly aggressive disease that is typically diagnosed at advanced stages when surgical removal is no longer an *** these cases,palliative care and mechanical widening of the blocked biliary system are *** insertion of a stent is often necessary to prevent the recurrence of blockages caused by cancer *** to stent placement,endo-biliary radiofrequency ablation(EB-RFA)appears to result in longer-lasting stent effectiveness without increasing the risk of severe ***,its impact on overall survival is not yet ***,while endoscopic retrograde cholangiopancreatography is the most common method for performing EB-RFA,percutaneous transhepatic cholangiodrainage seems to be a safe and potentially more efficient alternative,particularly for long,angulated,or significantly narrowed bile ducts.

关键词： Biliary cancer Cholangiocarcinoma Pancreatic cancer Percutaneous transhepatic cholangiodrainage Radiofrequency ablation

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serum zonulin levels in patients with liver cirrhosis:Prognostic implications

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World Journal of Hepatology 2021年第10期13卷 1394-1404页

作者： Theodoros A Voulgaris dimitrios karagiannakis E Hadziyannis spilios Manolakopoulos Georgios P Karamanolis George Papatheodoridis John Vlachogiannakos Academic Department of Gastroenterology and Hepatology Medical School of National and Kapodistrian University of AthensGeneral Hospital of Athens“Laiko”Athens 11527Greece Academic Department of Medicine Hippokrat General HospitalNational and Kapodistrian University of AthensAthens 11527Greece

BACKGROUND Increased gut permeability and bacterial translocation play an important role in liver *** is a recently recognized protein involved in the disintegration of the intestinal *** To investigate possible differences in serum zonulin levels among patients with different cirrhosis stages and their potential prognostic *** Consecutive cirrhotic patients who attended our liver clinic were included in the *** zonulin levels,clinical,radiological and biochemical data were collected at *** who accepted participation in a regular surveillance program were followed-up for at least 12 *** We enrolled 116 cirrhotics[mean Child-Turcotte-Pugh(CTP)score:6.2±1.6;model for end-stage liver disease score:11±3.9].The causes of cirrhosis were viral hepatitis(39%),alcohol(30%),non-alcoholic fatty liver disease(17%),and other(14%).At baseline,53% had decompensated cirrhosis,48% had ascites,and 32% had history of hepatic *** zonulin levels were significantly higher in patients with CTP-B class than CTP-A class(4.2±2.4 ng/dL vs 3.5±0.9 ng/dL,P=0.038),with than without ascites(P=0.006),and with than without history of encephalopathy(P=0.011).Baseline serum zonulin levels were independently associated with the probability of decompensation at 1 year(P=0.039),with an area under the receiving operating characteristic of 0.723 for predicting hepatic *** CTP score(P=0.021)and portal vein diameter(P=0.022)were independent predictors of *** serum zonulin levels are higher in patients with more advanced chronic liver disease and have significant prognostic value in identifying patients who will develop decompensation.

关键词： Zonulin Cirrhosis Intestinal barrier Bacterial translocation Decompensation Permeability

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