检索结果-内蒙古大学图书馆

WORLD JOURNAL OF SURGERY 1984年第6期8卷 963-968页

作者： KINOSHITA, H HIROHASHI, K IGAWA, S NAGATA, E SAKAI, K OSAKA CITY UNIV SCH MEDDEPT SURGDIV 21-5-7 ASAHIMACHI ABENO KU OSAKA 545 JAPAN

Comparative study of the clinical features of 125 cases of acute cholangitis revealed that acute obstructive suppurative cholangitis (AOSC, 19 cases) was characterized by leukocytosis, high transaminase levels, bilirubinemia and a marked thrombocytopenia. Most species of bacilli isolated from the purulent bile were gram-negative and, in 9 of 12 cases of AOSC that we checked, the same species were found in the blood as in the bile. In 12 of the 19 cases of AOSC, plasma endotoxin levels were assayed by the Limulus test and found to be elevated. Of the 22 cases of cholangitis other than AOSC, only 5 showed transitory positive results. Bile duct laparotomy decompression in 8 patients with AOSC resulted in 4 deaths from postoperative complications. However, 7 of the 11 patients placed on emergency percutaneous transhepatic cholangio-drainage (PTCD) recovered from shock and underwent successful surgery later. In an experimental study the initiation of cholangiovenous reflux in mongrel dogs was confirmed. The cholangiovenous reflux of bacteria or endotoxin seems to induce the state of shock in patients with AOSC. Emergency decompression of the biliary tract even from AOSC patients in shock should be performed by a procedure less risky than laparotomy, such as PTCD.

关键词： cholangitis Endotoxin Level Acute cholangitis Plasma Endotoxin Suppurative cholangitis

来源：评论

学校读者我要写书评

暂无评论

Unique sterol metabolite shifts in inflammatory bowel disease and primary sclerosing cholangitis

引用

JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY 2025年 245卷 106621页

作者： Matysik, Silke Elger, Tanja Huss, Muriel Liebisch, Gerhard Hoering, Marcus Loibl, Johanna Kandulski, Arne Mueller, Martina Tews, Hauke Christian Buechler, Christa Univ Hosp Regensburg Inst Clin Chem & Lab Med D-93053 Regensburg Germany Univ Hosp Regensburg Dept Internal Med Gastroenterol Hepatol Endocrinol D-93053 Regensburg Germany

Inflammatory bowel disease (IBD) triggers chronic intestinal inflammation and is linked to primary sclerosing cholangitis (PSC). Cholesterol homeostasis, tightly regulated under normal conditions, becomes disrupted in both inflammation and chronic liver disease. We analyzed fecal and serum levels of cholesterol synthesis precursors, oxysterols, and phytosterols in 87 patients with IBD (81 for serum analysis) including patients with Crohn's disease (CD) and ulcerative colitis (UC), 11 patients with PSC, 21 patients with PSC-IBD (18 for serum analysis), and 16 healthy controls (17 for serum analysis). Cholesterol was analysed by flow injection analysis on a high- resolution hybrid quadrupole-Orbitrap mass spectrometer and further serum sterols and all fecal sterols were analysed by a gas chromatograph mass spectrometer. Serum levels of lanosterol, 7-dehydrocholesterol, 7-betahydroxycholesterol, 27-hydroxycholesterol, and the plant sterols campesterol, stigmasterol, and sitosterol were similar across control and patient groups. Notably, serum lathosterol was elevated in CD patients compared to those with UC, PSC, PSC-IBD, and healthy controls. All other serum and fecal sterols showed no differences between CD and UC. Cholesterol synthesis precursors in serum, serum cholesterol levels, and both serum and fecal plant sterol levels decreased with increasing IBD severity. Consequently, serum cholesterol, campesterol, sitosterol, and fecal 5-beta sitostanol and 5-alpha sitostanol were negatively correlated with C-reactive protein and fecal calprotectin. The conversion of cholesterol to coprostanol in feces was impaired in IBD, PSC, and PSCIBD, independent of bowel inflammation severity or liver disease extent. Patients with PSC, and to a lesser extent PSC-IBD, had elevated serum plant sterol levels, positively correlating with liver disease markers. In conclusion, in patients with IBD, cholesterol biosynthetic precursors, serum cholesterol levels, and fecal plant sterols de

关键词： Calprotectin Cholesterol Inflammation cholangitis

来源：评论

学校读者我要写书评

暂无评论

National analysis of outcomes in timing of cholecystectomy for acute cholangitis

引用

AMERICAN JOURNAL OF SURGERY 2025年 239卷 115851-115851页

作者： Ng, Ayesha P. Seo, Young-Ji Ali, Konmal Coaston, Troy Mallick, Saad de Virgilio, Christian Benharash, Peyman UCLA Dept Surg David Geffen Sch Med Los Angeles CA 90095 USA Harbor UCLA Med Ctr Dept Surg Torrance CA USA

Background: The present study aimed to compare outcomes between cholecystectomy on index versus delayed admission for acute cholangitis. Methods: The 2011-2020 Nationwide Readmissions Database was used to identify adult patients admitted for acute cholangitis who underwent cholecystectomy. Study cohorts were defined based on timing of surgery. Multivariable regressions and Royston-Parmar time-adjusted analysis were used to evaluate the association of cholecystectomy timing and outcomes. Results: Of 65,753 patients, 82.0 % received surgery on Index and 18.0 % on Delayed admissions. Following adjustment, Delayed operation was associated with significantly increased odds of mortality (AOR 1.67 [95 % CI 1.10-2.54]), complications (1.25 [1.13-1.40]), repair of bile duct injury (1.66 [1.15-2.41]), conversion to open (1.69 [1.48-1.93]), and 30-day readmission (3.52 [3.21-3.86]). The Delayed cohort experienced a & thorn;$14,200 increment in hospitalization costs relative to Index. Conclusions: Delayed cholecystectomy for acute cholangitis is significantly associated with adverse postoperative outcomes, suggesting that index cholecystectomy may be safe to perform.

关键词： cholangitis Cholecystectomy Acute care surgery Outcomes Quality

来源：评论

学校读者我要写书评

暂无评论

Prognostic significance of clinical scoring systems for large-duct primary sclerosing cholangitis in Japanese patients

引用

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2025年第0期 2025 Feb 27页

作者： Takahashi, Koji Horio, Ryosuke Ohyama, Hiroshi Kan, Motoyasu Ouchi, Mayu Nagashima, Hiroki Okitsu, Kohichiroh Ohno, Izumi Kato, Naoya Chiba Univ Grad Sch Med Dept Gastroenterol 1-8-1 InohanaChuo ku Chiba 2608670 Japan Chiba Univ Grad Sch Med Dept Med Oncol Chiba Japan

Purpose This study aimed to identify the significant factors associated with liver transplant-free survival time in Japanese patients with large-duct primary sclerosing cholangitis (PSC) by evaluating the association between various parameters and clinical scores at PSC diagnosis. Methods This single-center retrospective study investigated factors influencing liver transplant-free survival in Japanese large-duct PSC patients. Univariate analysis using log-rank tests identified significant clinical parameters and scoring systems, which were further analyzed with multivariate Cox proportional hazards models to determine independent predictors of liver transplant-free survival. Results A total of 77 patients with large-duct PSC were included. The univariate analysis identified that age (p < .001), serum albumin level (p = .024), Child-Pugh score (p = .0012), albumin-bilirubin score (p = .0083), Amsterdam-Oxford PSC score (p < .001), and revised Mayo risk score (p < .001) were significant predictors of liver transplant-free survival time. However, the multivariate analysis revealed that only the Amsterdam-Oxford PSC score remained as an independent factor significantly associated with liver transplant-free survival time (hazard ratio: 12.90, 95% confidence interval: 2.78-59.81, p = .0011). Conclusions This study underscored the importance of utilizing the Amsterdam-Oxford PSC score in clinical practice to assess disease prognosis and guide patient management in Japanese patients with large-duct PSC.

关键词： cholangitis liver transplantation prognosis risk assessment survival analysis

来源：评论

学校读者我要写书评

暂无评论

Navigating antibiotic therapy in acute cholangitis: Best practices and new insights

引用

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2025年第1期32卷 44-57页

作者： Masuda, Sakue Imamura, Yoshinori Jinushi, Ryuhei Kimura, Karen Ryozawa, Shomei Koizumi, Kazuya Shonan Kamakura Gen Hosp Dept Gastroenterol Med Ctr Kamakura Kanagawa Japan Univ Fukui Hosp Canc Care Promot Ctr Fukui Japan Saitama Med Univ Dept Gastroenterol Int Med Ctr Saitama Japan

Globally, antibiotic resistance is linked to increased morbidity, mortality, and healthcare costs, which necessitates further research on optimal antibiotic usage. Acute cholangitis (AC), a common cause of community-acquired bacteremia, often requires antimicrobial therapy. Therefore, studying the appropriate use of antibiotics for AC is considered crucial for suppressing the emergence of resistant bacteria and reducing adverse antibiotic-associated events. The Tokyo Guidelines 2018 (TG18) recommend 4-7days of antibiotics post-biliary drainage. However, this lacks strong evidence and is based primarily on various evidence and expert opinions. Recent retrospective studies advocate for a shorter 1-3-day antibiotic course for AC, thereby prompting a need to reassess the treatment duration to balance therapeutic efficacy and minimize resistance and adverse effects. Choosing the appropriate duration and antibiotics based on susceptibility to pathogens causing cholangitis is important. Awareness of local resistance patterns and understanding patients' risks of resistant pathogens are prerequisite for effective treatment. We must explore the applicability of these guidelines in specific scenarios such as severe AC, positive blood cultures, fever, or hilar biliary obstructions due to malignancy. This comprehensive review considers both the duration and type of antibiotics and aims to enhance treatment outcomes while reducing the risk of resistant bacterial infections.

关键词： antimicrobial resistance antimicrobial stewardship cholangitis duration of antimicrobial therapy endoscopic retrograde cholangiopancreatography

来源：评论

学校读者我要写书评

暂无评论

Patient Reported Outcomes in Primary Sclerosing cholangitis: An Australian Perspective

引用

ALIMENTARY PHARMACOLOGY & THERAPEUTICS 2025年第10期61卷 1612-1621页

作者： Tan, Natassia Zampogna, Christopher Lynch, Kate Hannah, Nicholas Sood, Siddharth Collins, Kate Majumdar, Avik Coulshed, Andrew Liu, Ken Sawhney, Rohit Bloom, Stephen Lubel, John Kemp, William Roberts, Stuart Majeed, Ammar Nicoll, Amanda J. The Alfred Dept Gastroenterol & Hepatol Melbourne Australia Monash Univ Sch Translat Med Melbourne Australia Eastern Hlth Dept Gastroenterol & Hepatol Melbourne Australia Royal Adelaide Hosp Dept Gastroenterol & Hepatol Adelaide Australia Melbourne Hlth Dept Gastroenterol & Hepatol Melbourne Australia Univ Melbourne Melbourne Australia Austin Hlth Dept Gastroenterol & Hepatol Melbourne Australia Royal Prince Alfred Hosp AW Morrow Gastroenterol & Liver Ctr Sydney Australia

Background and Aims Primary sclerosing cholangitis (PSC) is a rare, cholestatic liver condition that has a significant association with inflammatory bowel disease (IBD) and impaired health-related quality of life (HRQOL). We aimed to characterise and compare validated PSC and IBD patient-reported outcomes (PRO) and determine if PRO correlated with the severity of liver disease. Methods We conducted a multicentre, prospective cohort study in Australia enrolling adult patients with PSC from December 2019 to August 2023. Consecutive patients completed a baseline validated PSC PRO questionnaire and a short IBD questionnaire (SIBDQ) if they had concomitant IBD. Linear regression was used to explore factors associated with poor HRQOL and the association between each HRQOL domain and the severity of liver disease. Results A total of 55 PSC patients were included. Most patients were male (32/55, 58%) with a median age of 44 years and a median 7 years of follow-up from PSC diagnosis. Mental and physical fatigue were the most prominent PSC symptoms. All HRQOL domain scores except PSC symptoms were significantly associated with liver disease severity. Decompensated cirrhosis and a history of cholangitis were associated with reduced HRQOL in various domains, whereas older age was protective against emotional distress (p = 0.01). IBD bowel symptoms and emotional impact had a positive correlation with PSC symptoms and emotional impact within the same patient. Conclusion This is the first Australian study describing PSC and IBD PRO in a well-characterised prospective cohort. We have demonstrated that PSC-related PRO is significantly associated with liver disease severity. Further large-scale studies are required to further interrogate these findings.

关键词： cholangitis cirrhosis decompensated cirrhosis fatigue health-related quality of life inflammatory bowel disease patient-reported outcomes primary sclerosing cholangitis

来源：评论

学校读者我要写书评

暂无评论

Mutational Analysis of Bile Cell-Free DNA in Primary Sclerosing cholangitis: A Pilot Study

引用

LIVER INTERNATIONAL 2025年第4期45卷 e70049页

作者： Arechederra, Maria Bik, Emil Rojo, Carla Elurbide, Jasmin Elizalde, Maria Kruk, Beata Krasnodebski, Maciej Pertkiewicz, Jan Koziel, Slawomir Grat, Michal Raszeja-Wyszomirska, Joanna Rullan, Maria Alkorta-Aranburu, Gorka Oyon, Daniel Fernandez-Barrena, Maite G. Candels, Lena S. Bialek, Andrzej Krupa, Lukasz Schneider, Kai M. Urman, Jesus Strnad, Pavel Trautwein, Christian Milkiewicz, Piotr Krawczyk, Marcin Avila, Matias A. Berasain, Carmen Univ Navarra Solid Tumors Program Hepatol Lab CIMACCUN Pamplona Spain Navarra Inst Hlth Res IdiSNA Pamplona Spain Carlos III Hlth Inst Natl Inst Study Liver & Gastrointestinal Dis CIBERehd Madrid 28029 Spain Med Univ Warsaw Liver & Internal Med Unit Dept Gen Transplant & Liver Surg Warsaw Poland Med Univ Warsaw Lab Metab Liver Dis Dept Gen Transplant & Liver Surg Warsaw Poland Med Univ Warsaw Dept Gen Transplant & Liver Surg Warsaw Poland Navarra Univ Hosp Dept Gastroenterol & Hepatol Pamplona Spain Univ Navarra CIMA LAB Diagnost Pamplona Spain Hosp Gen Univ Gregorio Maranon Dept Gastroenterol & Hepatol Madrid Spain European Reference Network ERN Rare Liver Med Clin Gastroenterol Metab Dis & Intens Care 3 Aachen Germany Pomeranian Med Univ Dept Gastroenterol Szczecin Poland Teaching Hosp 1 Rzeszow Dept Gastroenterol & Hepatol Internal Dis Unit Rzeszow Poland Univ Rzeszow Med Dept Rzeszow Poland Tech Univ TU Univ Hosp Carl Gustav Carus Dresden Med Clin & Polyclin 1 Dresden Germany Tech Univ TU Ctr Regenerat Therapies Dresden CRTD Dresden Germany TUD Dresden Univ Technol Med Fac Carl Gustav Carus Else Kroener Fresenius Ctr Digital Hlth Dresden Germany Univ Hosp RWTH Aachen Dept Med 3 Aachen Germany Leibniz Res Ctr Working Environm & Human Factors I Dept Toxicol Dortmund Germany Pomeranian Med Univ Translat Med Grp Szczecin Poland Univ Duisburg Essen Med Fac Dept Gastroenterol Hepatol & Transplant Med Essen Germany

BackgroundPrimary sclerosing cholangitis (PSC) is a chronic liver disease characterised by inflammation and fibrosis of the bile ducts, conferring an increased risk of cholangiocarcinoma (CCA). However, detecting CCA early in PSC patients remains challenging due to the limited sensitivity of conventional diagnostic methods, including imaging or bile duct brush cytology during endoscopic retrograde cholangiopancreatography (ERCP). This study aims to evaluate the potential of bile cell-free DNA (cfDNA) mutational analysis, termed the Bilemut assay, as a tool for CCA detection in PSC patients. MethodsSixty-three PSC patients undergoing ERCP due to biliary strictures were prospectively recruited. Bile samples were collected, and cfDNA was extracted and analysed using the Oncomine Pan-Cancer Cell-Free assay. Twenty healthy liver donors were included for comparison. Samples with a mutant allele frequency (MAF) >= 0.1% were considered positive. Correlations between mutational status and clinical characteristics were assessed. ResultscfDNA mutational analysis was successful in all bile samples. Mutations predominantly in KRAS, GNAS, and TP53 were detected in 36.5% (23/63) of PSC patients, compared to 10% (2/20) of healthy donors (p = 0.0269). The clinical characteristics of Bilemut-positive and -negative patients were comparable, though there was a trend towards a lower prevalence of inflammatory bowel disease in the Bilemut-positive group. Among PSC patients diagnosed with CCA during follow-up, 75% were Bilemut-positive, suggesting an association between mutational status and malignancy risk. ConclusionsMutational analysis of cfDNA obtained from bile collected from PSC patients undergoing ERCP is feasible. Implementing the Bilemut assay may help identify patients needing closer surveillance and further imaging studies.

关键词： bile cfDNA cholangiocarcinoma cholangitis chronic liver disease liquid biopsy mutations PSC

来源：评论

学校读者我要写书评

暂无评论

Acute cholangitis caused by coinfection with zoonotic pathogens of Gallibacterium anatis and Enterococcus cecorum : A case report

引用

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES 2025年 150卷 107292-107292页

作者： Kodana, Masahiro Imai, Kazuo Takayama, Tetsuyoshi Suzuki, Masaomi Kawamura, Toru Omachi, Ryuha Asano, Hiroshi Maeda, Takuya Saitama Med Univ Hosp Dept Clin Lab Saitama Japan Saitama Med Univ Dept Clin Lab Med Saitama Japan Saitama Med Univ Dept Gen Surg Saitama Japan

Background: Gallibacterium anatis and Enterococcus cecorum are considered to be emerging infectious pathogens in poultry, particularly in the European Union. These bacteria are isolated on rare occasions from immunocompromised hosts and cause opportunistic infections associated with the ingestion of contaminated food. Here, we report the first case of G. anatis and E. cecorum coinfection in an immunocompetent host and clarify the genomic characteristics of these bacteria. Case presentation: A 78-year-old Japanese man diagnosed with acute cholangitis as a result of a common bile duct stone was hospitalized in 2021. He was treated with endoscopic papillary large-balloon dilation and antibiotics. His blood culture was positive for G. anatis and E. cecorum . Whole-genome sequencing identified that our isolate of G. anatis belongs to a highly virulent biovar haemolytica strain and our isolate of E. cecorum had multidrug resistance genes, which have commonly been found in U.S. strains. Conclusion: A common bile duct stone that impairs bile flow is a risk factor for G. anatis and E. cecorum infection in an immunocompetent host. This report indicates the need for further surveillance of G. anatis and E. cecorum in animals as well as for investigation of their pathogenesis in humans. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://***/licenses/by-nc-nd/4.0/ )

关键词： cholangitis WGS G. anatis E. cecorum

来源：评论

学校读者我要写书评

暂无评论

A case of cholangitis with Vibrio fluvialis bacteremia possibly related to frequent consumption of supermarket sushi in a Japanese woman with a gallbladder-duodenal fistula

引用

JOURNAL OF INFECTION AND CHEMOTHERAPY 2025年第3期31卷 102594-102594页

作者： Itoh, Naoya Akazawa-Kai, Nana Okumura, Nobumasa Sato, Ryo Nagoya City Univ Grad Sch Med Sci Dept Infect Dis Nagoya Aichi Japan Nagoya City Univ Grad Sch Med Sci Dept Clin Infect Dis Nagoya Aichi Japan Nagoya City Univ East Med Ctr Dept Infect Dis Nagoya Aichi Japan Nagoya City Univ East Med Ctr Dept Gastroenterol Nagoya Aichi Japan

Vibrio fluvialis is a halophilic, motile, flagellated, gram-negative bacterium commonly associated with acute gastroenteritis. However, extraintestinal infections are rare. We describe an unusual case of V. fluvialis cholangitis complicated by bacteremia in a 78-year-old woman with diabetes mellitus and a gallbladder-duodenal fistula. The patient presented with fever and altered mental status, with a history of frequent sushi consumption. Blood cultures yielded V. fluvialis, identified through matrix-assisted laser desorption/ionization time-offlight mass spectrometry with the MALDI Biotyper (Bruker Daltonics Co., Ltd., Yokohama, Japan) and biochemical properties. The patient was successfully treated with 7 days of intravenous ceftriaxone. There was no recurrence of fever for 6 days from the completion of antimicrobial treatment to discharge. This case underscores the need for heightened awareness of V. fluvialis as a potential pathogen in patients with predisposing conditions and dietary habits involving raw seafood. Further research is warranted to elucidate the mechanisms underlying its extraintestinal manifestations.

关键词： Vibrio fluvialis cholangitis Bacteremia Case report

来源：评论

学校读者我要写书评

暂无评论

"Post-Kasai Portoenterostomy cholangitis: What Have We Learnt So Far?"

引用

JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY 2025年第3期15卷 102471-102471页

作者： Samanta, Arghya Sarma, Moinak S. Sanjay Gandhi Postgrad Inst Med Sci Dept Pediat Gastroenterol Raebareli Rd Lucknow 226014 India

Post-Kasai portoenterostomy (KPE) cholangitis is one of the most common complications that has a negative impact on liver function and native liver survival. Early diagnosis and judicious empiric antimicrobial management are, therefore, important to prevent further liver damage and decompensation. However, there is no consensus regarding the standard definition of post-KPE cholangitis, and established guidelines on evaluation and management are also lacking. Metagenomic next-generation sequencing, a new molecular diagnostic technique, has the potential for detecting broader spectrum of pathogens, especially in blood culture-negative patients. Antibiotic prophylaxis to prevent cholangitis has been widely used, but questions over the choice of antibiotics, route of administration, and optimal duration remain unsettled. The available evidence on the efficacy of antibiotic prophylaxis in preventing cholangitis has shown conflicting results. This review offers a summary of the current research on advances in diagnostic approaches, including molecular techniques, and therapeutic challenges in managing intractable cholangitis. ( J O LIN E XP H EPATOL 2025;15:102471)

关键词： cholangitis antibiotic prophylaxis biliary atresia Kasai portoenterostomy intractable cholangitis

来源：评论

学校读者我要写书评

暂无评论

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案：

请选择收藏分类：

通借通还

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：