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World Journal of Clinical Cases 2018年第16期6卷 1217-1222页

作者： Bu-Shan Xie Jia-Wei Zhong An-Jiang Wang Zhen-Dong Zhang Xuan Zhu Gui-Hai Guo Department of Gastroenterology the First Affiliated Hospital of Nanchang University Department of Pathology the First Affiliated Hospital of Nanchang University

BACKGROUND Duodenal varices are a lesser-known complication with non-cirrhotic portal hypertension. We report a circuitous route from missed diagnosis of duodenal varices to correction. An extremely rare case of duodenal variceal bleeding secondary to idiopathic portal hypertension(IPH) is expounded in this study, which was controlled by transjugular intra-hepatic porto-systemic shunt(TIPS) plus embolization. CASE SUMMARY A 46-year-old woman with anemia for two years was frequently admitted to the local hospital. Upon examination, anemia was attributed to gastrointestinal tract bleeding, which resulted from duodenal variceal bleeding detected by repeated esophagogastroduodenoscopy. At the end of a complete workup, IPH leadingto duodenal varices was diagnosed. Portal venography revealed that the remarked duodenal varices originated from the proximal superior mesenteric vein. TIPS plus embolization with coils and Histoacryl was performed to obliterate the rupture of duodenal varices. The anemia resolved, and the duodenal varices completely vanished by 2 mo after the initial operation. CONCLUSION TIPS plus embolization may be more appropriate to treat the bleeding of large duodenal varices.

关键词： Idiopathic portal hypertension Anemia Duodenal variceal bleeding Transjugular intra-hepatic porto-systemic shunt Embolization Case report

intra-hepatic and extra-hepatic cholangiocarcinoma:New insight into epidemiology and risk factors

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World Journal of Gastrointestinal Oncology 2010年第11期2卷 407-416页

作者： Vincenzo Cardinale Rossella Semeraro Alessia Torrice Manuela Gatto Cristina Napoli Maria Consiglia Bragazzi Raffaele Gentile Domenico Alvaro Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche Sapienza University of Rome00185 RomeItaly

Cholangiocarcinoma(CCA) is a malignant tumour that arises from biliary epithelium at any portion of the biliary *** is currently classified as intra-hepatic or extra-hepatic CCA(EH-CCA).Recent evidences suggest that intra-hepatic CCA(IH-CCA) and EH-CCA are biologically different cancers,giving further support to a number of recent epidemiological studies showing large differences in terms of incidence,mortality and risk *** purpose of this manuscript is to review recent literature dealing with the descriptive epidemiology and risk factors of CCA with a special effort to compare IH-with EH-CCA.

关键词： Liver flukes Viral hepatitis Liver stem cells Peribiliary glands Epidemiology Extra-hepatic cholangiocarcinoma Risk factors Primary sclerosing cholangitis intra-hepatic cholangiocarcinoma Liver cirrhosis

Anatomic variations of the intra-hepatic biliary tree in the Caribbean:A systematic review

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World Journal of Gastrointestinal Endoscopy 2021年第6期13卷 170-183页

作者： Shamir O Cawich Alexander Sinanan Rahul R Deshpande Michael T Gardner Neil W Pearce Vijay Naraynsingh Department of Clinical Surgical Sciences University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom Department of Anatomy University of the West IndiesKingston KIN7Jamaica Department of Surgery Southampton University NHS TrustSouthampton SO16DPSouthamptonUnited Kingdom

BACKGROUND In the classic descriptions of the human liver,the common hepatic duct forms at the confluence of left and right hepatic *** authors have documented variations in the intra-hepatic ductal system,but to the best of our knowledge there has been no report on bile duct variations in Caribbean *** To evaluate the variations in bile duct anatomy using magnetic resonance cholangiography(MRC)in unselected patients at a major hepatobiliary referral centre in the Eastern *** of the intra-hepatic biliary anatomy is important to optimize service delivery for any physician treating liver and biliary *** This study was carried out at a tertiary referral hospital for hepatobiliary diseases in the Eastern *** retrospectively evaluated magnetic resonance cholangiograms in 152 consecutive patients at this facility over a two-year period from April 1,2017 to March 31,*** consultant radiologists experienced in MRC interpretation reviewed all scans and described biliary anatomy according to the Huang’s classification.A systematic review of published studies was performed and relevant data were extracted in order to calculate the global prevalence of each biliary *** variants in our population were compared to the global *** There were 152 MRCs evaluated in this study in 86 males and 66 *** were 109(71.7%)persons with“classic”biliary anatomy(type A1)and variants were present in 43(28.3%)*** was no statistical relationship between the presence of anatomic variants and gender or *** encountered the following variants:29(19.1%)type A2,7(4.6%)type A3,6(3.95%)type A4,0 type A5 and a single variant(quadrification)that did not fit the classification *** to the global prevalence,our population had a significantly greater occurrence of A1 anatomy(71.7%vs 62.6%;P=0.0227)and A2 trifurcations(19.1%vs 11.5%;P=0.0069),but a significantly lower incidence of A3 varian

关键词： Liver Variant Biliary Duct intra-hepatic Aberrant Trifurcation,Bifurcation

Impact of machine perfusion of the liver on post-transplant biliary complications: A systematic review

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World Journal of Transplantation 2018年第6期8卷 220-231页

作者： Yuri L Boteon Amanda PCS Boteon Joseph Attard Lorraine Wallace Ricky H Bhogal Simon C Afford Liver Unit Queen Elizabeth Hospital University Hospitals Birmingham NHS Foundation Trust Centre for Liver and Gastrointestinal Research Institute of Immunology and Immunotherapy College of Medical and Dental Sciences University of Birmingham National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre University of Birmingham and University Hospitals Birmingham NHS Foundation Trust

AIM To review the clinical impact of machine perfusion(MP) of the liver on biliary complications post-transplantation, particularly ischaemic-type biliary lesions(ITBL). METHODS This systematic review was performed in accordance with the Preferred Reporting Systematic Reviews and MetaAnalysis(PRISMA) protocol. The following databases were searched: PubMed, MEDLINE and Scopus. The keyword "liver transplantation" was used in combination with the free term "machine perfusion". Clinical studies reporting results of transplantation of donor human livers following ex situ or in situ MP were analysed. Details relating to donor characteristics, recipients, technique of MP performed and post-operative biliary complications(ITBL, bile leak and anastomotic strictures) were critically *** Fifteen articles were considered to fit the criteria for this review. Ex situ normothermic MP was used in 6 studies, ex situ hypothermic MP in 5 studies and the other 4 studies investigated in situ normothermic regional perfusion(NRP) and controlled oxygenated rewarming. MP techniques which have per se the potential to alleviate ischaemia-reperfusion injury: Such as hypothermic MP and NRP, have also reported lower rates of ITBL. Other biliary complications, such as biliary leak and anastomotic biliary strictures, are reported with similar incidences with all MP techniques. There is currently less clinical evidence available to support normothermic MP as a mitigator of biliary complications following liver transplantation. On the other hand, restoration of organ to full metabolism during normothermic MP allows assessment of hepatobiliary function before transplantation, although universally accepted criteria have yet to be *** MP of the liver has the potential to have a positive impact on post-transplant biliary complications, specifically ITBL, and expand extended criteria donor livers utilisation.

关键词： Liver transplantation Ex situ machine perfusion of the liver Donation after circulatory death Non-anastomotic intra-hepatic stricture Ischemic-type biliary lesions Extended criteria donors

intrahepatic therapy for liver-dominant metastatic colorectal cancer

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World Journal of Gastrointestinal Oncology 2015年第9期7卷 148-152页

作者： Kerlijne De Groote Hans Prenen Department of Gastroenterology University Hospitals Leuven

In patients with metastatic colorectal cancer, the liver is the most common site of metastatic disease. In patients with liver-dominant disease, consideration needs to be given to locoregional treatments such as hepatic arterial infusion chemotherapy, transarterial chemoembolisation and selective internal radiation therapy because hepatic metastases are a major cause of liver failure especially in chemorefractory disease. In this review we provide insights on the published literature for locoregional treatment of liver metastases in metastatic colorectal cancer.

关键词： Colorectal cancer Liver metastases intra-hepatic t