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Profile of hepatocyte apoptosis and bile lakes before and after bile duct decompression in severe obstructive jaundice patients

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Hepatobiliary & Pancreatic Diseases International 2010年第5期9卷 520-523页

作者： Toar JM Lalisang Raden Sjamsuhidajat Nurjati C Siregar Akmal Taher Department of Surgery Department of Anatomical Pathology Faculty of Medicine University of Indonesia Department of Urology Cipto Mangunkusumo Hospital

BACKGROUND:Excessive hepatocyte apoptosis and bile lakes in severe obstructive jaundice might impair liver *** decompression of the bile duct has been reported to improve liver functions in animal studies,the mechanism of obstruction differs from that in *** study aimed to determine the profiles of hepatocyte apoptosis and bile lakes following bile duct decompression in patients with severe obstructive jaundice in the clinical ***:We conducted a 'before and after study' on severe obstructive jaundice patients as a model of inhibition of the excessive process by bile duct *** of liver biopsies were taken before and after decompression of the bile duct and then stained by terminal deoxynucleotide transferase-mediated dUTP nick end-labeling(TUNEL) to identify hepatocyte apoptosis and by hematoxilin-eosin(HE) to identify bile *** measurements were independently done by 2 ***:Twenty-one severe obstructive jaundice patients were *** all patients,excessive hepatocyte apoptosis and bile lakes were *** decompression,the hepatocyte apoptosis index decreased from 53.1(SD 105) to 11.7(SD 13.6)(Pbile lakes from 23.6(SD 14.8) to 10.9(SD 6.9)(Pbile duct decompression improves hepatocyte apoptosis and bile lakes in cases of severe obstructive jaundice,similar to the findings in animal studies.

关键词： hepatocyte apoptosis bile lakes TUNEL obstructive jaundice bile duct decompression

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Effectiveness of a new approach to minimally invasive surgery in palliative treatment of patients with distal malignant biliary obstruction

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World Journal of Gastrointestinal Surgery 2023年第4期15卷 698-711页

作者： Yaroslav M Susak Leonid L Markulan Serhii M Lobanov Roman Y Palitsya Mariia P Rudyk Larysa M Skivka Department of Surgery with the Course of Emergency and Vascular Surgery O.O.Bogomolets National Medical UniversityKyiv 01601Ukraine Department of Abdominal Surgery National Military Medical Clinical Centre“Main Military Clinical Hospital”Kyiv 01133Ukraine Department of Microbiology and Immunology Taras Shevchenko National University of KyivKyiv 01033Ukraine

BACKGROUND Palliative endoscopic biliary drainage is the primary treatment option for the management of patients with jaundice which results from distal malignant biliary obstruction(DMBO).In this group of patients,decompression of the bile duct(BD)allows for pain reduction,symptom relief,chemotherapy administration,improved quality of life,and increased survival *** reduce the unfavorable effects of BD decompression,minimally invasive surgical techniques require continuous *** To develop a technique for internal-external biliary-jejunal drainage(IEBJD)and assess its effectiveness in comparison to other minimally invasive procedures in the palliative treatment of patients with *** A retrospective analysis of prospectively collected data was performed,which included 134 patients with DMBO who underwent palliative BD ***-jejunal drainage was developed to divert bile from the BD directly into the initial loops of the small intestine to prevent duodeno-biliary *** was carried out using percutaneous transhepatic *** transhepatic biliary drainage(PTBD),endoscopic retrograde biliary stenting(ERBS),and internal-external transpapillary biliary drainage (IETBD) were used for the treatment of studypatients. Endpoints of the study were the clinical success of the procedure, the frequency andnature of complications, and the cumulative survival *** were no significant differences in the frequency of minor complications between the studygroups. Significant complications occurred in 5 (17.2%) patients in the IEBJD group, in 16 (64.0%)in the ERBS group, in 9 (47.4%) in the IETBD group, and in 12 (17.4%) in the PTBD *** was the most common severe complication. In the IEBJD group, the course ofcholangitis was characterized by a delayed onset and shorter duration as compared to other studygroups. The cumulative survival rate of patients who underwent IEBJD was 2.6 times higher incomparison t

关键词： Distal malignant biliary obstruction Obstructive jaundice bile duct decompression Palliative endoscopic biliary drainage Internal-external biliary-jejunal drainage

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