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Triglyceride levels and apolipoprotein E polymorphism in patients with acute pancreatitis

Hepatobiliary & Pancreatic Diseases International 2012年第1期11卷 96-101页

作者： Radka Ivanova Susana Puerta Alfonso Garrido Ignacio Cueto Ana Ferro María José Ariza Andrés Cobos Pedro González-Santos Pedro Valdivielso Division of Internal Medicine Hospital Universitario "Virgen de la Victoria" Division of Gastroenterology Hospital Universitario "Virgen de la Victoria" CIMES Department of Medicine & Dermatology University of Malaga Division of Laboratory Hospital Universitario "Virgen de la Victoria"

BACKGROUND:Hypertriglyceridemia is an unusual cause of acute pancreatitis and sometimes considered to be an *** study aimed to investigate the clinical and analytical features and the APOE genotypes in patients with acute pancreatitis and severe ***:We undertook a one-year,prospective study of patients with acute pancreatitis whose first laboratory analysis on admission to the emergency department included measurement of serum *** APOE genotype was determined and the patients answered an established questionnaire within the first 24 hours concerning their alcohol consumption,the presence of co-morbidities and any medications being *** patients’ progression,etiological diagnosis,hospital stay and clinical and radiological severity were all ***:Hypertriglyceridemia was responsible for 7 of 133 cases of pancreatitis (5%);the remaining cases were of biliary (53%),idiopathic (26%),alcoholic (11%) or other (5%) *** with these remaining cases,the patients with hypertriglyceridemia were significantly younger,had more relapses,and more often had diabetes *** usually consumed alcohol or consumed it excessively on the days before ***,the ε4 allele of the APOE gene was more common in this group (P<0.05).CONCLUSION:One of 20 episodes of acute pancreatitis is caused by hypertriglyceridemia and it is linked to genetic (ε4 allele) and comorbid factors such as diabetes and,especially,alcohol consumption.

关键词： acute pancreatitis hypertriglyceridemia apolipoprotein E alcohol biliary lithiasis

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Diagnosis and management of choledocholithiasis in the golden age of imaging, endoscopy and laparoscopy

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World Journal of Gastroenterology 2014年第37期20卷 13382-13401页

作者： Renato Costi Alessandro Gnocchi Francesco Di Mario Leopoldo Sarli Dipartimento di Scienze Chirurgiche Università di ParmaAzienda Ospedaliero-Universitaria di Parma Dipartimento Materno Infantile Unità Operativa di Gastroenterologia ed Endoscopia DigestivaAzienda Ospedaliero-Universitaria di Parma Dipartimento di Medicina Clinica e Sperimentale Università di ParmaAzienda Ospedaliero-Universitaria di Parma

biliary lithiasis is an endemic condition in both Western and Eastern countries, in some studies affecting 20% of the general population. In up to 20% of cases, gallbladder stones are associated with common bile duct stones (CBDS), which are asymptomatic in up to one half of cases. Despite the wide variety of examinations and techniques available nowadays, two main open issues remain without a clear answer: how to cost-effectively diagnose CBDS and, when they are finally found, how to deal with them. CBDS diagnosis and management has radically changed over the last 30 years, following the dramatic diffusion of imaging, including endoscopic ultrasound (EUS) and magnetic resonance cholangiography (MRC), endoscopy and laparoscopy. Since accuracy, invasiveness, potential therapeutic use and cost-effectiveness of imaging techniques used to identify CBDS increase together in a parallel way, the concept of “risk of carrying CBDS” has become pivotal to identifying the most appropriate management of a specific patient in order to avoid the risk of “under-studying” by poor diagnostic work up or “over-studying” by excessively invasive examinations. The risk of carrying CBDS is deduced by symptoms, liver/pancreas serology and ultrasound. “Low risk” patients do not require further examination before laparoscopic cholecystectomy. Two main “philosophical approaches” face each other for patients with an “intermediate to high risk” of carrying CBDS: on one hand, the “laparoscopy-first” approach, which mainly relies on intraoperative cholangiography for diagnosis and laparoscopic common bile duct exploration for treatment, and, on the other hand, the “endoscopy-first” attitude, variously referring to MRC, EUS and/or endoscopic retrograde cholangiography for diagnosis and endoscopic sphincterotomy for management. Concerning CBDS diagnosis, intraoperative chol

关键词： biliary lithiasis Choledocholithiasis Laparoscopy Endoscopy Diagnosis Management

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Does bilioenteric anastomosis impair results of liver resection in primary intrahepatic lithiasis?

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World Journal of Gastroenterology 2010年第27期16卷 3423-3426页

作者： Paulo Herman Marcos V Perini Vincenzo Pugliese Julio Cesar Pereira Marcel Autran C Machado William A Saad Luiz AC D'Albuquerque Ivan Cecconello Department of Gastroenterology Hospital Das Clínicas-University of So Paulo Medical SchoolSo Paulo-SP-CEP 05403-000BrazilPaulo HermanPraa Santos Coimbra10So Paulo-SP-CEP 05614-050Brazil

AIM:To evaluate the long-term results of liver resection for the treatment of primary intrahepatic *** factors,especially the impact of bilioenteric anastomosis on recurrence of symptoms were ***:Forty one patients with intrahepatic stones and parenchyma fibrosis/atrophy and/or biliary stenosis were submitted to liver *** was associated with a Roux-en-Y hepaticojejunostomy in all patients with bilateral stones and in those with unilateral disease and dilation of the extrahepatic biliary duct(>2 cm).Late results and risk factors for recurrence of symptoms or stones were ***:There was no operative *** a mean follow-up of 50.3 mo,good late results were observed in 82.9% of patients;all patients submitted to liver resection alone and 58.8% of those submitted to liver resection and hepaticojejunostomy were free of symptoms(P=0.0006).Patients with unilateral and bilateral disease showed good late results in 94.1% and 28.6%,respectively(P<0.001).CONCLUSION:Recurrence of symptoms in patients with hepaticojejunostomy showed that this may not be the ideal *** studies are needed to establish the best treatment for patients with bilateral stones or unilateral disease and a dilated extrahepatic duct.

关键词： biliary lithiasis Bilioenteric anastomosis Cholangitis Intrahepatic lithiasis Liver resection

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Staged Surgery for Bronchobiliary Fistula and Incidental Finding of Mitral Valve Disease

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World Journal of Cardiovascular Surgery 2016年第9期6卷 105-111页

作者： Hazem Aljasem Nizar Abbas Younes Suliman Ali Khaddam Ahmad Al Khaddour Damascus University Hospital Damascus Syria

Bronchobiliary fistula (BBF) is defined as abnormal passage between bronchial system and the bile tree which often manifests as presence of bile in the sputum (biloptysis). BBF is a serious complication which requires early diagnosis and well-planned management strategy to avoid the high morbidity and mortality rate. The hydatid cystic disease is still the leading cause of the BBF. In this paper we present a case of 32-year-old man with BBF who was incidentally found to have a mitral valve disease for which he underwent mitral valve replacement during his management course.

关键词： Biloptysis Mitral Valve Replacement Hydatid Disease biliary lithiasis Cholecystitis Endoscopic Retrograde Cholangiopancreatography (ERCP) Computed Tomography (CT) Magnetic Resonance Cholangiography (MRC) Scintigraphy

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