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Strasberg severity predicts 30-day loss of bile duct patency after ERCP in post-cholecystectomy bile duct injury.

AIM: This study evaluated the prognostic value of Strasberg classification on 30-day bile duct patency and explored relevant clinical and procedural factors. BACKGROUND: Bile duct injury (BDI) is a serious complication of cholecystectomy that may influence early outcomes after endoscopic retrograde cholangiopancreatography (ERCP). METHODS: We retrospectively reviewed 33 patients with BDI treated with ERCP at Dr. Moewardi Hospital from January 2023 to May 2025. Data included demographics, laboratory results, cholecystectomy type, timing of diagnosis and repair, and injury severity (minor: A-C…

Fenestrating Versus Reconstituting Subtotal Cholecystectomy: Systematic Review and Meta-Analysis on Bile Leak, Bile Duct Injury, and Outcomes.

Symptoms of gallstone disease are the most common reason for cholecystectomy. Fenestration reduces the likelihood of severe inflammation or scarring after normal treatments are used, and it also enhances control over bile outflow. The goal of reconstituted cholecystectomy is to lessen symptoms like pain and jaundice without undergoing the high-risk procedures associated with more invasive procedures. The reconstituted and fenestrated procedures were assessed by a meta-analysis and systematic review. Of the five studies, 189 (34.2%) had a reconstituted subtotal cholecystectomy, and 363 (65.8%) …

Laparoscopic cholecystectomy plus common bile duct exploration for extrahepatic bile duct stones and postoperative recurrence-associated risk factors.

BACKGROUND: There remain controversies regarding the surgical treatment of extrahepatic bile duct stones (EHBDSs) in clinical practice. AIM: To explore the curative effect of laparoscopic cholecystectomy (LC) plus common bile duct exploration (CBDE) for the surgical treatment of EHBDSs and to analyze the risk factors that affect postoperative stone recurrence. METHODS: Eighty-two patients with EHBDSs admitted between March 2017 and March 2023 were selected. Among them, patients treated with open choledocholithotomy plus LC or open cholecystectomy (OC) were set as the control group (n = 40), …

Bile Acid Overload Induced by Bile Duct and Portal Vein Ligation Improves Survival after Staged Hepatectomy in Rats.

OBJECTIVE: Compared to portal vein ligation (PVL), simultaneous bile duct and portal vein ligation (BPL) can significantly enhance hypertrophy of the intact liver. This study aimed to investigate whether BPL could improve survival after extended hepatectomy independently of an increased remnant liver. METHODS: We adopted rat models of 90% BPL or 90% PVL. To investigate the role of bile acids (BAs) the BA pools in the PVL and BPL groups were altered by the diet. Staged resection preserving 10% of the estimated liver weight was performed 3 days after BPL; PVL; or sham operation. Histology, cana…

Comparison of Laparoscopic Common Bile Duct Exploration with Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct Stones After Cholecystectomy.

Background: Few studies have focused on the treatment of common bile duct (CBD) stones after cholecystectomy, for which optimal treatment options remain unclear. Aims: To compare the safety and efficacy of laparoscopic common bile duct exploration (LCBDE) versus endoscopic retrograde cholangiopancreatography (ERCP) for CBD stone treatment after cholecystectomy. Materials and Methods: A total of 201 patients were enrolled in this retrospective cohort study, of whom 134 with ≤3 stones and a maximum stone diameter of <15 mm were classified as subgroup 1, and 67 with >3 stones or a maximum stone d…

Bile cytology diagnosis in challenging cases: Validation of diagnostic bile cytology criteria and extensive study for immunocytochemical markers.

BACKGROUND: Bile cytology is useful in diagnosing biliary tract lesions, albeit often challenging due to equivocal findings. To achieve better diagnoses for clinical decisions, we conducted cytomorphological and immunocytochemical studies of bile cytology cases. MATERIALS AND METHODS: We re-evaluated 40 bile cytology cases with initial equivocal diagnoses, taken from the cytology records of Jichi Medical University Hospital, including 1778 bile cytology specimens. First, we assessed the cases by the diagnostic bile cytology criteria of the Japanese Society of Clinical Cytology. Second, we sea…

Secondary bile acid ursodeoxycholic acid alters weight, the gut microbiota, and the bile acid pool in conventional mice.

Ursodeoxycholic acid (commercially available as ursodiol) is a naturally occurring bile acid that is used to treat a variety of hepatic and gastrointestinal diseases. Ursodiol can modulate bile acid pools, which have the potential to alter the gut microbiota community structure. In turn, the gut microbial community can modulate bile acid pools, thus highlighting the interconnectedness of the gut microbiota-bile acid-host axis. Despite these interactions, it remains unclear if and how exogenously administered ursodiol shapes the gut microbial community structure and bile acid pool in convention…

Administration of r-VEGF-A prevents hepatic artery ligation-induced bile duct damage in bile duct ligated rats.

The hepatic artery, through the peribiliary plexus, nourishes the intrahepatic biliary tree. During obstructive cholestasis, the nutritional demands of intrahepatic bile ducts are increased as a consequence of enhanced proliferation; in fact, the peribiliary plexus (PBP) displays adaptive expansion. The effects of hepatic artery ligation (HAL) on cholangiocyte functions during cholestasis are unknown, although ischemic lesions of the biliary tree complicate the course of transplanted livers and are encountered in cholangiopathies. We evaluated the effects of HAL on cholangiocyte functions in e…

Intraductal papillary neoplasm of the bile duct.

BACKGROUND: Intraductal papillary neoplasm of the bile duct (IPNB) was formally adopted in the 2010 WHO classification as a distinct clinical and pathological entity. We herein review the concept, clinical and pathologic features, as well as the prognosis of IPNB. METHODS: A comprehensive review was conducted using MEDLINE/PubMed, Google Scholar, Cochrane Library, and the Web of Science, which were accessed between 2004 and 2025. The main search focused on "Intraductal papillary neoplasm of the bile duct." RESULTS: IPNB often present with intermittent right upper quadrant abdominal pain, rec…

[Diagnosis and treatment of bile acid diarrhea].

This review concerns the diagnosis and therapy of bile acid diarrhea, a common type of chronic diarrhea which is considered underdiagnosed with a presumed prevalence of approximately 1%. A simple blood test, S-7-OH-cholestenone/cholesterol ratio, reflecting the bile acid synthesis rate, is a cost-effective analysis to diagnose most patients. Results above 25 nmol/mmol supports the diagnosis, while results <15 nmol/mmol are considered normal. Supplementary 75SeHCAT test may be required for results occurring in the grey zone (15-25 nmol/mmol). The latter investigation is more expensive and utili…

Новые роли кислых кислот в нейроинфламмации.

Подлые кислоты, которые когда-то считались простыми пищеварительными моющими веществами, появились в качестве многогранных сигнальных молекул с системным влиянием, выходящим далеко за пределы желудочно-кишечного тракта. Недавние открытия показывают их способность к модуляции иммунной реакции, пересечь мозговой барьер и взаимодействовать с клетками центральной нервной системы (КНС) через их рецепторы. Нейроинфламмация, ключевая движущая сила нейродегенеративных и нейроиммунных расстройств, все больше связана с путями подачи сигналов о желчных кислотах, которые регулируют глиальную активацию, пр

Совпадение в аннотации оригинала
Bile acids, once considered mere digestive detergents, have emerged as multifaceted signaling molecules with systemic influence extending far beyond the gastrointestinal tract. Recent discoveries reveal their capacity to modulate immune responses, cross the blood-brain barrier, and interact with central nervous system (CNS) cells through their receptors. Neu…

Liver and bile duct organoids and tumoroids.

Organoids refer to 3D cultures established to recapitulate histology, pathology, architecture, and genetic traits of various organs and tissues in the body, thereby replacing 2D cell cultures, xenograft, and animal models. Organoids form a 3D in vitro mimic of original tissues like the liver and are derived from embryonic or adult tissue stem cells. Liver and bile duct tumor organoids, also called, tumoroids capture genetic diversity, cellular, and pathophysiological properties of original tumors. Moreover, co-culture techniques along with genetic modulation of organoids allow for using tumoro…