Incidence, Risk Factors, and Complications of Cholelithiasis in Patients with Home Parenteral Nutrition

Dray, Xavier; Joly, Francisca; Reijasse, Didier; Attar, Alain; Alvès, Arnaud; Panís, Yves; Valleur, Patrice; Messing, Bernard

doi:10.1016/j.jamcollsurg.2006.09.008

Cited by 56 publications

(31 citation statements)

References 28 publications

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“…For instance, the reported depletion of ICC in patients with Crohn's disease and the increased risk of pigment gallstone formation have apparently not been correlated. Similarly, it could be of interest to assess the gallbladder ICLC population in patients with home parenteral nutrition showing a high rate of cholelithiasis (Dray et al 2007). In this context, as pure speculation, a (more) generalized decrease in the global ICC pool might be hypothesized as a new mechanism of disease, too.…”

Section: Discussionmentioning

confidence: 99%

Interstitial Cajal-like cells in human gallbladder

et al. 2007

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We describe here an interstitial Cajal-like cell type (ICLC) in human gallbladder, resembling the archetypal enteric interstitial cells of Cajal. Gallbladder ICLC were demonstrated in fresh preparations (tissue cryosections) using methylene-blue, and fixed specimens in Epon semi-thin sections stained with toluidine blue or transmission electron microscopy (TEM). The positive diagnosis of gallbladder ICLC was further verified by immunohistochemistry: CD117/c-kit, CD34, and another 16 antigens: vimentin, desmin, nestin, alpha-smooth muscle actin, NK-1, S-100, PGP-9.5, tau protein, chromogranin A, NSE, GFAP, CD1a, CD62-P, CD68, estrogen and progesterone receptors. Double immunostaining was performed for CD117, CD34 and CD117 and nestin, respectively. In fresh specimens, the spatial density of gallbladder ICLC was 100-110 cells/mm(2). ICLC mainly appeared beneath the epithelium and in muscularis (about 7%, and approximately 5%, respectively). In toto, ICLC represent in gallbladder approximately 5.5% of subepithelial cells. TEM showed that diagnostic criteria were fulfilled by ICLC. Moreover, TEM indicated that the main ultrastructural distinctive feature for ICLC, the cell processes, develop into the characteristic shape at a relatively early stage of development. It remains to be established if, in humans, ICLC are involved in gallbladder (dis)functions (e.g. pace-making, secretion (auto-, juxta- and/or paracrine), intercellular signaling, or stone formation).

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Section: Discussionmentioning

confidence: 99%

Interstitial Cajal-like cells in human gallbladder

et al. 2007

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“…This may lead to biliary obstruction in a small proportion of patients. A French group found a 7.6% incidence of biliary complications in 2 years with 38% of HPN patients developing cholelithiasis in that time period [57]. …”

Section: Home Parenteral Nutritionmentioning

confidence: 99%

Parenteral Nutrition and Intestinal Failure

Bielawska

Allard

2017

Nutrients

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Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient’s home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes.

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“…The infection rate was 0.93/1,000 days. Although liver failure is uncommon in adults receiving long-term parenteral nutrition (15), Case 1 showed mild liver dysfunction and biliary sludge (16) under supplementation with necessary fatty acids. In this circumstance, reducing the number of calories in the infusion may improve liver dysfunction; namely a change from 1,160 kcal to 860 kcal a day normalized the liver dysfunction in Case 1.…”

Section: Discussionmentioning

confidence: 99%

Home Parenteral Nutrition Therapy in Seven Patients with Anorexia Nervosa: The Role and Indications

Hotta

Araki

Urano³

et al. 2014

Intern. Med.

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Home parenteral nutrition (HPN) is a well-established intervention to sustain life in malnourished patients at home. Because it is difficult for patients with anorexia nervosa (AN) to gain weight or stop purging, such patients require repeated hospitalizations. Although HPN has not been commonly used for AN patients in Japan, we utilized this approach to treat seven AN patients. We herein present the clinical course and outcome of these seven patients, the application criteria for HPN in our institution, and the potential problems associated with HPN. Despite its complications, HPN may be a useful measure to help patients with persistent AN avoid multiple hospitalizations.

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Incidence, Risk Factors, and Complications of Cholelithiasis in Patients with Home Parenteral Nutrition

Cited by 56 publications

References 28 publications

Interstitial Cajal-like cells in human gallbladder

Interstitial Cajal-like cells in human gallbladder

Parenteral Nutrition and Intestinal Failure

Home Parenteral Nutrition Therapy in Seven Patients with Anorexia Nervosa: The Role and Indications

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