The role of the content (decreased level of apolipoprotein A1) and of the container (bile duct stricture, sectorial dilatation of the ducts determining bile stasis) in the pathogenesis of hepatolithiasis, either pigment or cholesterol

Cetta, Francesco; Lombardo, Francesco; Cariati, Andrea

doi:10.1002/hep.1840190637

Cited by 15 publications

(3 citation statements)

References 9 publications

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“…The majority of gallstones of hepatolithiasis are brown pigment stones (calcium bilirubinate stones) (31), which differ from cholesterol and black pigment stones in their composition (32) and etiology (33,34). Previous studies have suggested that bacterial infection (35) and bile stasis caused by bile duct strictures (36) are thought to be of pathogenetic importance of hepatolithiasis. However, the etiological process would be more complicated and may be governed by multiple factors, e.g., ethnics and environments, bacterial and parasitic infection, cholangitis and bile stasis, and biochemical/metabolic defects in the liver, all of which may affect the rheology of bile flow within the intrahepatic biliary tree as well as the formation and secretion of lithogenic hepatic bile.…”

Section: Pathogenesis Of Hepatolithiasismentioning

confidence: 99%

Hepatolithiasis-epidemiology and pathogenesis update

Shoda¹

2003

Front Biosci

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Hepatolithiasis or intrahepatic calculi are prevalent in East Asia, including Japan, but occurs much less frequently in Western countries. Hepatolithiasis appears mostly as brown pigment stones (calcium bilirubinate stones) but contain more cholesterol in composition. The disease is characterized by its intractable nature and frequent recurrence, requiring multiple operative interventions, in distinct contrast to gallbladder cholesterol or black pigment stones. Moreover, the most unfavorable complication of the disease is an intrahepatic cholangiocarcinoma. In view of the lack of information on the pathogenesis, a multidisciplinary approach has been carried out through the Hepatolithiasis Research Group organized by the Ministry of Health and Welfare of Japan. In this review, the up-to-date data on the epidemiology and pathogenesis of hepatolithiasis are introduced and discussed. Furthermore, potential medical treatments targeting pathogenetic molecules, which may be important for the etiological process of gallstone formation, are introduced as future therapeutic options for the disease.

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Section: Pathogenesis Of Hepatolithiasismentioning

confidence: 99%

Hepatolithiasis-epidemiology and pathogenesis update

Shoda¹

2003

Front Biosci

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“…11 From the view of pathogenesis, metabolic problems, bacterial infection, and bile stasis with bile duct strictures cause this disease. 12 Parasitic infestations (eg, Ascaris lumbricoides and Clonorchis sinensis ) have been cited as a cause of biliary complication. 13–15 However, worms and ova are found rarely in cases with hepatolithiasis.…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic Duct Stones Harboring Ascariasis Ova

Lee

et al. 2016

Medicine

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Ascariasis lumbricoides is one of the most common helminthic infestations in humans. Despite the fact that the prevalence of ascariasis in developed countries has been decreasing, biliary ascariasis can cause serious complications, such as acute cholangitis, pancreatitis, and liver abscess. Here we presented a rare ascariasis-related complication—hepatolithiasis.A 60-year-old female patient had symptoms of recurrent cholangitis. Abdominal computed tomography scan revealed left intrahepatic duct stones with left liver lobe atrophy. Endoscopic retrograde cholangiopancreatography was performed, but the stones could not be removed due to left main intrahepatic duct stenosis. The patient was treated with left hemi-hepatectomy. Unexpectedly, Ascaris ova were found on the histopathological examination. She received antihelminthic therapy orally and was on regular follow-up without any complications.Our study indicates that clinicians should be aware of biliary ascariasis in patients with hepatolithiasis, though not living in endemic areas.

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“…Cystic artery and duct is most frequently occluded by simple metallic clips. Common problems include common bile duct (CBD) stone formation due to the migration of suture materials, 3 bile leak due to the inappropriate clip placement or slippage of clips, 4,5 lateral injury to bile duct and/or vessels from heat of monopolar cautery, 6 and possibility of visceral organ injury due to the need for frequent instrumental exchange. [6][7][8] Ultrasound shear is the vessel and duct sealing device which tackles the issue related to clips, suture, and lateral thermal injury.…”

Section: Introductionmentioning

confidence: 99%

Clipless Laparoscopic Cholecystectomy: Ultrasonic Dissection vs Conventional Method

Pandit¹,

Awale²,

Adhikary³

2019

World Journal of Laparoscopic Surgery With DVD

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Introduction: Laparoscopic cholecystectomy (LC) is now the gold standard treatment of gallstone disease, but with advancement in technology, there is always a scope for improvement. Ultrasonic shears has been shown to seal the duct and small-size vessel adequately but the fear of complication and sleepless nights has always hindered its use as the sole instrument for LC. Proper use of ultrasonic shears can provide improvement or refinement in LC. Materials and methods: It is a randomized controlled trial conducted at BP Koirala Institute of Health Sciences, Dharan, Nepal, from 2015 to 2016 (1 year). All the patients with symptomatic gallstone disease were assessed thoroughly and randomized into the harmonic scalpel [clipless laparoscopic cholecystectomy (CLC)] or conventional laparoscopic group (CL). Results: Over a period of 1 year, 112 patients were enrolled into CLC (53) and CL (59) groups. The demography of the patients in both the groups including age, sex, history of previous surgery, comorbid conditions, and history of acute cholecystitis was comparable. The mean operative time in our study was 38.65 ± 13.28 minutes. The operative time in the CLC group (35.91 ± 11.66 minutes vs 41.12 ± 14.23 minutes) was less though it was not statistically significant (p 0.054). However, when the "gallbladder (GB) was not perforated, " the operative time was significantly less in the CLC group (34.30 ± 9.30 minutes vs 38.70 ± 10.76 minutes, p 0.03). In our study, three (2.6%) patients required conversion to open cholecystectomy. One (1.85%) in CLC and 2 (3.2%) in the CL group (p 0.63). The visual analog score (VAS) for pain in the first 12 hours and median fall in hemoglobin was significantly less in the CLC group. In our study group, a total of seven (6.25%) patients had morbidity and there was no mortality. Conclusion: With the development of ultrasonic energy source and its ability to seal the vessel and cystic duct safely, it can be utilized during LC without the need of clips.

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The role of the content (decreased level of apolipoprotein A1) and of the container (bile duct stricture, sectorial dilatation of the ducts determining bile stasis) in the pathogenesis of hepatolithiasis, either pigment or cholesterol

Cited by 15 publications

References 9 publications

Hepatolithiasis-epidemiology and pathogenesis update

Hepatolithiasis-epidemiology and pathogenesis update

Intrahepatic Duct Stones Harboring Ascariasis Ova

Clipless Laparoscopic Cholecystectomy: Ultrasonic Dissection vs Conventional Method

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