scholarly journals Su1467 Direct PerOral Cholangioscopic Diagnosis of Bile Duct Lesions by Computed Virtual Chromoendoscopy Using I-Scan; Preliminary Study

2011 ◽  
Vol 73 (4) ◽  
pp. AB274
Author(s):  
Jong Ho Moon ◽  
Hyun Jong Choi ◽  
Jong Chan Lee ◽  
Seul Ki Min ◽  
Bong Min Ko ◽  
...  
Keyword(s):  
Bile Duct ◽  
Preliminary Study ◽  
Bile Duct Lesions ◽  
Virtual Chromoendoscopy

Direct peroral cholangioscopy for diagnosis of bile duct lesions using an I-SCAN ultraslim endoscope: a pilot study

Endoscopy ◽  
2017 ◽  
Vol 49 (07) ◽  
pp. 675-681 ◽  
Author(s):  
Yun Lee ◽  
Jong Moon ◽  
Hyun Choi ◽  
Tae Lee ◽  
Moon Choi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Clinical Trial Registration ◽  
Peroral Cholangioscopy ◽  
Microvascular Architecture ◽  
Mucosal Lesions ◽  
Bile Duct Lesions ◽  
Virtual Chromoendoscopy ◽  
Visual Diagnosis ◽  
Direct Peroral Cholangioscopy

Abstract Background and study aims I-SCAN is a computed virtual chromoendoscopy (CVC) system designed to enhance surface and vascular patterns. In this study, we evaluated the usefulness of direct peroral cholangioscopy (POC) using I-SCAN compared with a conventional white-light image (WLI) to diagnose bile duct lesions. Patients and methods Patients with mucosal lesions in the bile duct detected during direct POC were enrolled prospectively. The quality of endoscopic visualization and the visual diagnosis were assessed using I-SCAN and WLI modes, respectively, during direct POC. Results A total of 20 patients (9 malignant and 11 benign lesions) underwent I-SCAN to evaluate lesions in the bile duct using direct POC. The quality of endoscopic visualization using direct POC with I-SCAN was significantly higher than that of WLI for surface structure (P = 0.04), surface microvascular architecture (P = 0.01), and margins (P = 0.02). Overall diagnostic accuracy of the visual diagnosis was not different between I-SCAN and WLI (90.0 % vs. 75.0 %; P = 0.20). Conclusion Direct POC using CVC by I-SCAN seems to be helpful for evaluating mucosal lesions of the bile duct, without the interference from bile.Clinical trial registration: UMIN000021009

Long-term outcomes in the repair of intrahepatic iatrogenic bile duct lesions using a combined intraglissonian and extraglissonian approach

2021 ◽  
Author(s):  
Víctor Lopez-Lopez ◽  
David Ferreras ◽  
Asuncion Lopez-Conesa ◽  
Roberto Brusadin ◽  
Jose Cutillas ◽  
...  
Keyword(s):  
Bile Duct ◽  
Long Term Outcomes ◽  
Bile Duct Lesions

Pathology and Immunopathology of Primary Biliary Cirrhosis With Emphasis On Bile Duct Lesions: Recent Progress

1995 ◽  
Vol 15 (04) ◽  
pp. 313-328 ◽  
Author(s):  
Yasuni Nakanuma ◽  
Koichi Tsuneyama ◽  
M. Gershwin ◽  
Mitsue Yasoshima
Keyword(s):  
Bile Duct ◽  
Primary Biliary Cirrhosis ◽  
Recent Progress ◽  
Biliary Cirrhosis ◽  
Bile Duct Lesions

Immunopathology of Bile Duct Lesions of Primary Biliary Cirrhosis

2017 ◽  
pp. 73-84
Author(s):  
Hayato Baba ◽  
Ayumi Sugitani ◽  
Ryusei Takahashi ◽  
Kouki Kai ◽  
Yuki Moritoki ◽  
...  
Keyword(s):  
Bile Duct ◽  
Primary Biliary Cirrhosis ◽  
Biliary Cirrhosis ◽  
Bile Duct Lesions

Bile Acids and Deregulated Cholangiocyte Autophagy in Primary Biliary Cholangitis

2017 ◽  
Vol 35 (3) ◽  
pp. 210-216 ◽  
Author(s):  
Motoko Sasaki ◽  
Yasuni Nakanuma
Keyword(s):  
Bile Duct ◽  
Er Stress ◽  
Bile Acids ◽  
Cellular Senescence ◽  
Primary Biliary Cholangitis ◽  
Biliary Cirrhosis ◽  
Chemical Chaperone ◽  
Abnormal Expression ◽  
Bile Duct Lesions ◽  
Mitochondrial Antigens

Background: Primary biliary cholangitis (PBC) is characterized by a high prevalence of serum anti-mitochondrial antibodies against the E2 subunit of the pyruvate dehydrogenase complex and bile duct lesions called chronic non-suppurative destructive cholangitis (CNSDC) in small bile ducts, eventually followed by extensive bile duct loss and biliary cirrhosis. Macroautophagy (a major type of autophagy) is a process of cellular self-digestion that plays a critical role in energy homeostasis and in the cytoprotection to various stresses. Deregulated autophagy is thought to be associated with various human diseases. Key Messages: Accumulating evidences suggest that deregulated autophagy may be a central player in the pathogenesis of PBC. Damaged cholangiocytes involved in CNSDC show vesicular expression of autophagy marker LC3 and accumulation of p62/sequestosome-1, suggesting deregulated autophagy. Deregulated autophagy may be involved in the autoimmune process via the abnormal expression of mitochondrial antigens and also in cholangiocyte senescence in bile duct lesions in PBC. In vitro study showed that hydrophobic bile acids, such as glycochenodeoxycholic acid (GCDC), as well as serum deprivation and oxidative stress, cause autophagy, deregulated autophagy and abnormal expression of mitochondrial antigens followed by cellular senescence in cholangiocytes. Although exact mechanisms of deregulated autophagy remain to be clarified, endoplasmic reticulum (ER) stress may be a plausible cause of deregulated autophagy induced by GCDC in cholangiocytes. Impaired ‘biliary bicarbonate umbrella' may further exacerbate the toxicity of GCDC to cholangiocytes. Interestingly, pretreatment with ursodeoxycholic acid (UDCA) and tauro-UDCA, which is a chemical chaperone enhancing the adaptive capacity of the ER, significantly suppressed ER stress, deregulated autophagy and cellular senescence induced by GCDC and other stresses in cholangiocytes. Conclusions: GCDC may play a role in the occurrence of deregulated autophagy and cellular senescence at least partly through the induction of ER stress in PBC. Deregulated autophagy and cellular senescence can be a promising therapeutic target in PBC.

S1312 Ultrasonographic Imaging of Bile Duct Lesions in Autoimmune Pancreatitis

2008 ◽  
Vol 134 (4) ◽  
pp. A-224
Author(s):  
Rikako Koyama ◽  
Yuko Koizumi ◽  
Tsunao Imamura ◽  
Chikao Okuda ◽  
Kazuo Takeuchi
Keyword(s):  
Bile Duct ◽  
Autoimmune Pancreatitis ◽  
Bile Duct Lesions

scholarly journals A simple and novel marking method for correctly identifying the precutting direction to achieve safe and efficacious precut sphincterotomy (with video)

2019 ◽  
Vol 07 (01) ◽  
pp. E3-E8
Author(s):  
Kazumasa Nagai ◽  
Akio Katanuma ◽  
Kuniyuki Takahashi ◽  
Kei Yane ◽  
Toshifumi Kin ◽  
...  
Keyword(s):  
Bile Duct ◽  
Technical Success ◽  
Tertiary Referral ◽  
Endoscopic Retrograde ◽  
Incision Length ◽  
Tertiary Referral Center ◽  
Preliminary Study ◽  
Needle Knife ◽  
The Right ◽  
Precut Sphincterotomy

Abstract Background and study aims Failure to recognize the right direction and precise incision length during precutting has been reported. To address these concerns, we developed a marking method that places a marking on the cutting endpoint before starting precutting. This preliminary study aimed to assess the effectiveness and safety of precut sphincterotomy using our new marking method. Patients and methods Between April 2015 and May 2017, 21 patients from our tertiary referral center were included in this study. Precut sphincterotomy using our marking method was employed for difficult common bile duct cannulation cases. Before starting precutting, a marking was placed slightly before the upper margin of the bulge of the papilla in the 11- to 12-o’clock direction as a cutting endpoint by cauterization with a needle knife. Results Technical success was obtained in all 21 procedures. There were no post-endoscopic retrograde cholangiopancreatography (ERCP) complications except for one mild case of post-ERCP pancreatitis. Conclusion Our new marking method before precutting enabled precise incision and quick bile duct cannulation without causing severe complications.

scholarly journals What Are the Precursor and Early Lesions of Peripheral Intrahepatic Cholangiocarcinoma?

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Yasuni Nakanuma ◽  
Akemi Tsutsui ◽  
Xiang Shan Ren ◽  
Kenichi Harada ◽  
Yasunori Sato ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
Precursor Lesions ◽  
Intraductal Papillary Neoplasm ◽  
Combined Hepatocellular Cholangiocarcinoma ◽  
Biliary Adenofibroma ◽  
Bile Duct Lesions ◽  
Large Bile Duct ◽  
Papillary Neoplasm ◽  
Bile Duct Adenoma

Cholangiocarcinoma (CC) is divided into distal, perihilar, and intrahepatic CCs (ICCS), and are further subdivided into large bile duct ICC and peripheral ICC. In distal and perihilar CC and large duct ICC, biliary intraepithelial neoplasm (BilIN) and intraductal papillary neoplasm (IPN) have been proposed as precursor lesions. Peripheral ICC, bile duct adenoma (BDA), biliary adenofibroma (BAF), and von Meyenburg complexes (VMCs) are reportedly followed by development of ICCs. Herein, we surveyed these candidate precursor lesions in the background liver of 37 cases of peripheral ICC and controls (perihilar CC, 34 cases; hepatocellular carcinoma, 34 cases and combined hepatocellular cholangiocarcinoma, 25 cases). In the background liver of peripheral ICC, BDA and BAF were not found, but there were not infrequently foci of BDA-like lesions and atypical bile duct lesions involving small bile ducts (32.4% and 10.8%, resp.). VMCs were equally found in peripheral CCs and also control CCs. In conclusion, BDA, BAF, and VMCs are a possible precursor lesion of a minority of peripheral CCs, and BDA-like lesions and atypical bile duct lesions involving small bile ducts may also be related to the development of peripheral ICC. Further pathologic studies on these lesions are warranted for analysis of development of peripheral ICCs.

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