Perioperative Management in Patients with Biliary Tract and Liver Disease

2016 ◽  
pp. 842-842
Author(s):  
Ankur Garg ◽  
Sanjay Negi
Keyword(s):  
Liver Disease ◽  
Biliary Tract ◽  
Perioperative Management

scholarly journals Analysis of the Serum Bile Acid Composition for Differential Diagnosis in Patients with Liver Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Tomonori Sugita ◽  
Katsushi Amano ◽  
Masanori Nakano ◽  
Noriko Masubuchi ◽  
Masahiro Sugihara ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Liver Disease ◽  
Bile Acid ◽  
Viral Hepatitis ◽  
Healthy Volunteers ◽  
Biliary Tract ◽  
Liver Diseases ◽  
Biliary Tract Disease ◽  
Serum Bile Acid ◽  
Biliary Tract Diseases

Objectives. We determined the serum bile acid (BA) composition in patients with liver diseases and healthy volunteers to investigate the relationship between the etiologies of liver disease and BA metabolism.Material and Methods. Sera from 150 patients with liver diseases and 46 healthy volunteers were obtained. The serum concentrations of the 16 different BAs were determined according to the LC-MS/MS method and were compared between the different liver diseases.Results. A total of 150 subjects, including patients with hepatitis C virus (HCV) (n=44), hepatitis B virus (HBV) (n=23), alcoholic liver disease (ALD) (n=21), biliary tract disease (n=20), nonalcoholic fatty liver disease (NAFLD) (n=13), and other liver diseases (n=29), were recruited. The levels of UDCA and GUDCA were significantly higher in the ALD group, and the levels of DCA and UDCA were significantly lower in the biliary tract diseases group than in viral hepatitis group. In the UDCA therapy (−) subgroup, a significantly lower level of TLCA was observed in the ALD group, with lower levels of CDCA, DCA, and GLCA noted in biliary tract diseases group compared to viral hepatitis group.Conclusions. Analysis of the BA composition may be useful for differential diagnosis in liver disease.

Liver disease and biliary tract abnormalities in cystic fibrosis

The Lancet ◽  
1990 ◽  
Vol 335 (8685) ◽  
pp. 357 ◽  
Author(s):  
D. Bilton ◽  
R. Fox ◽  
A.K. Webb
Keyword(s):  
Cystic Fibrosis ◽  
Liver Disease ◽  
Biliary Tract

scholarly journals Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient

2017 ◽  
Vol 3 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Alexander A. Vitin ◽  
Leonard Azamfirei ◽  
Dana Tomescu ◽  
John D. Lang
Keyword(s):  
Liver Disease ◽  
Lactic Acidosis ◽  
Perioperative Management ◽  
Treatment Options ◽  
Disease Patient ◽  
Lactate Production ◽  
Current Treatment ◽  
Multiple Organ ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Lactic acidosis (LA) in end-stage liver disease (ESLD) patients has been recognized as one of the most complicated clinical problems and is associated with increased morbidity and mortality. Multiple-organ failure, associated with advanced stages of cirrhosis, exacerbates dysfunction of numerous parts of lactate metabolism cycle, which manifests as increased lactate production and impaired clearance, leading to severe LA-induced acidemia. These problems become especially prominent in ESLD patients, that undergo partial hepatectomy and, particularly, liver transplantation. Perioperative management of LA and associated severe acidemia is an inseparable part of anesthesia, post-operative and critical care for this category of patients, presenting a wide variety of challenges. In this review, lactic acidosis applied pathophysiology, clinical implications for ESLD patients, diagnosis, role of intraoperative factors, such as anesthesia- and surgery-related, vasoactive agents impact, and also current treatment options and modalities have been discussed.

Operative Considerations for the General Surgeon in Patients with Chronic Liver Disease

2019 ◽  
Vol 85 (2) ◽  
pp. 234-244
Author(s):  
Dylan T. Adamson ◽  
Matthew C. Bozeman ◽  
Matthew V. Benns ◽  
Alison Burton ◽  
Eric G. Davis ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Perioperative Management ◽  
Surgical Techniques ◽  
Chronic Liver ◽  
General Surgeon ◽  
Preoperative Diagnostic ◽  
Operative Strategies ◽  
Surgical Conditions ◽  
Review Current

Chronic liver disease remains a prevalent and challenging comorbidity in the American population at large. Scarring and fibrosis cause physical and physiological changes that may prove challenging in both medical and surgical management. However, because there has been relevant improvements in preoperative diagnostic, perioperative hepatologic, and intensive care management, as well as in surgical techniques, patients with cirrhosis can safely be operated on but patient selection remains vital. Patients with chronic liver disease may present to a general surgeon for evaluation of a number of elective or emergent surgical conditions. Here, we review current literature on the perioperative management and operative strategies of seemingly routine general surgery issues and provide a review of the pathophysiology associated with chronic liver disease.

scholarly journals Hepatobiliary continuum: non-alcoholic fatty liver disease, cholelithiasis ... what else?

2021 ◽  
pp. 68-76
Author(s):  
A. O. Bueverov
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Biliary Tract ◽  
Fatty Liver Disease ◽  
Gallstone Disease ◽  
Bacterial Overgrowth ◽  
Farnesoid X Receptor ◽  
Alcoholic Fatty Liver ◽  
Increased Risk ◽  
Alcoholic Fatty Liver Disease

The relationship between metabolic non-alcoholic fatty liver disease (NAFLD) and gallstone disease (GSD) is complex and seemingly interrelated. There is no doubt that there is an increased risk of cholelithiasis in patients with NAFLD, which is primarily associated with general pathogenetic mechanisms. These include central and peripheral insulin resistance, changes in the expression of transcription factors (hepatic X-receptor, farnesoid X-receptor (FXR) and membrane bile acid receptors (TGR5)). At the same time, the effect of gallstone disease on the course of NAFLD is assumed, although the pathogenetic factors of this association are still insufficient. There are accumulating data on an increased risk of other pathologies of the biliary tract in patients with NAFLD, in particular, of gallbladder polyps and tumors of the biliary tract. Recently there have been convincing data on the role of cholecystectomy in the progression of NAFLD, which may be due to disruption of endocrine balance and signaling function of  bile acids, as well as the  development of  bacterial overgrowth in  the  small intestine. General therapeutic approaches to the treatment of interrelated hepatobiliary pathology may include new generation insulinsensitizers, FXR agonists, and ursodeoxycholic acid. The link between NAFLD and the pathology of the biliary tract is complex and multifaceted, and its further study opens up prospects for the development of new methods of treatment.

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