Significance of Controlling Chronic Proliferative Cholangitis in the Treatment of Hepatolithiasis

Li, Fu Yu; Cheng, Nan; Mao, Hui; Jiang, Li; Cheng, Jing; Li, Quan Sheng; Munireddy, Sanjay

doi:10.1007/s00268-009-0154-8

Cited by 26 publications

(17 citation statements)

References 62 publications

(167 reference statements)

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“…In addition, bacterial lipopolysaccharide (LPS) increases mucin 5AC (MUC5AC) by tumor necrosis factor- α converting enzyme (TACE)/transforming growth factor- α (TGF- α )/growth factor receptor (EGFR) pathway in intrahepatic biliary epithelial cells also involved in the formulation and development of intrahepatic stone [5]. Meanwhile, bacterial infection will aggravate cholestasis and cholangitic stenosis to form a vicious circle, continuously stimulating the formation and growth of stones [6]. Lately, Helicobacter pylori ( H. pylori ) has been found to be related with the occurrence of intrahepatic stone as well [7].…”

Section: Infectionmentioning

confidence: 99%

Four Major Factors Contributing to Intrahepatic Stones

Ran

Yin

2017

Gastroenterology Research and Practice

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Intrahepatic stone is prevalent in Asian countries; though the incidence declines in recent years, the number of patients is still in a large quantity. Because of multiple complications, high recurrence rates, serious systemic damage, and a lack of extremely effective procedure for the management, it is more important to find out the etiology and pathogenesis of intrahepatic stones to prevent the disease from happening and developing rather than curing. A number of factors contribute to the development of the disease, such as cholestasis, infection, and anatomic abnormity of bile duct and bile metabolic defect. The four factors and possible pathogenesis will be discussed in detail in the review.

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Section: Infectionmentioning

confidence: 99%

Four Major Factors Contributing to Intrahepatic Stones

Ran

Yin

2017

Gastroenterology Research and Practice

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“…A vicious cycle exists between the presence of intrahepatic calculi and chronic proliferative cholangitis . In the later stages of inflammation, a stricture of the duct may occur when inflammation and fibrosis are localized within a short segment of the duct .…”

Section: Discussionmentioning

confidence: 99%

“…23 A vicious cycle exists between the presence of intrahepatic calculi and chronic proliferative cholangitis. 24 In the later stages of inflammation, a stricture of the duct may occur when inflammation and fibrosis are localized within a short segment of the duct. 25 An increase in connective tissues causes the wall of the duct to thicken and to show signs of fibrosis, proliferation of mucous and serous glands, and inflammatory cell infiltration at the wall and the periductal tissue.…”

Section: Discussionmentioning

confidence: 99%

Choledochoscopic high‐frequency needle‐knife electrotomy as an effective treatment for intrahepatic biliary strictures

Yang

Zhang

Zhao

et al. 2015

J of Gastro and Hepatol

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“…Repeated episodes of CPC leads to stone formation, thus forming a vicious cycle of CPC and stone formation. 2,19 Therefore, treatment of hepatolithiasis must include clearance of stones, correction of biliary stricture and elimination of CPC. Presently, traditional hepatectomy remains the only treatment of choice for hepatolithiasis.…”

Section: Discussionmentioning

confidence: 99%

“…The degree of biliary stricture is directly proportional to the frequency of stone recurrence. 2 This is further associated with gradual worsening of the…”

Section: Introductionmentioning

confidence: 99%

Chemical bile duct embolization for chemical hepatectomy, long term efficacy and feasibility in rats

et al. 2016

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Background:Hepatolithiasis is the presence of calculi within the intrahepatic bile ducts. It represents a significant problem in hepatobiliary surgery because of its high recurrence rate and the associated intra-operative and post-operative risks. This study was designed to explore the long-term efficacy of chemical biliary duct embolization (CBDE) to treat recurrent hepatolithiasis and to explain the mechanism of CBDE. Aims and Objectives: To investigate the long term efficacy of chemical bile duct embolization (CBDE) on the targeted hepatic lobe and to explain the mechanism of CBDE to achieve chemical hepatectomy. Materials and Methods: The median biliary duct of rats were embolized with phenol and N-butylcyanoacrylate. The short-term (6 weeks) and long-term (12 weeks) effects of chemical bile duct embolization were compared by observing the degree of atrophy, fibrosis, and proliferation of collagen fibers and apoptosis of hepatocytes of the embolized hepatic lobe. The feasibility and effectiveness of chemical hepatectomy were analyzed by histology, Western blot analysis of collagen I fibers and assessment of hydroxyproline content. Results: After 6 weeks of the procedure, destruction of hepatocytes, fibrosis and "self-cut" was seen only in the periphery of the targeted hepatic lobe. Whereas after 12 weeks, complete destruction of hepatocytes, and replacement with proliferative bile ductules and collagen fibers leading to complete fibrosis and "self-cut" phenomenon in the whole targeted hepatic lobe was seen. Collagen I expression in the 6-weeks treatment group and 12-weeks treatment groups were 4 times and 12 times higher than that in the Sham operated (SO) group respectively (P<0.05). In addition, there was increase in hepatic hydroxyproline content (HYP) approximately by sevenfold in 6-weeks treatment group and twentyfold in 12-weeks treatment group after CBDE, when compared to that in the SO group (P<0.05). Conclusion: Chemical bile duct embolization can achieve ideal effect of chemical hepatectomy in the whole targeted lobe.

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Significance of Controlling Chronic Proliferative Cholangitis in the Treatment of Hepatolithiasis

Cited by 26 publications

References 62 publications

Four Major Factors Contributing to Intrahepatic Stones

Four Major Factors Contributing to Intrahepatic Stones

Choledochoscopic high‐frequency needle‐knife electrotomy as an effective treatment for intrahepatic biliary strictures

Chemical bile duct embolization for chemical hepatectomy, long term efficacy and feasibility in rats

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