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Results for “BILIARY TRACT”

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At least 19 recordsLinked to original sources
PubMed2001

Photodynamic therapy in the biliary tract.

Biliary tract cancers are rare malignancies usually characterized by slow growth and a low propensity for metastasis. Despite the relatively localized nature of these cancers, the only therapeutic measure with curative potential to date is surgical intervention. Because symptoms occur late, the diagnosis is rarely made at an early stage, and therefore only about half of the patients can have curative surgery. Patients with advanced disease face a dismal prognosis because palliative treatment options are limited. This review outlines recent advances in treatment of biliary cancer. Encouraging results from prospective, single-arm phase II trials of photodynamic therapy in nonresectable cholangiocarcinoma suggest considerable promise for this new palliative treatment modality. However, the apparent benefit of photodynamic therapy on survival, jaundice, and quality of life must be confirmed in a randomized multicenter trial.

Bile Ducts, Extrahepatic↗
PubMed1981

[Biliary tract carcinomas. II. Biliary tract cancer].

The authors discuss the biliary tract carcinoma in the second paper on biliary tract carcinomas. It ranks second as regards frequency, being responsible for 4 per cent of the biliary operations. The analysis is based on 48 observations during the period 1952-1979 at the Chair of Abdominal Surgery - 31 males and 17 females (2:1). Morbidity rate is the highest among the patients aged from 40 to 60. The patients are admitted for operation up to the 1-2 months since the beginning of their complaints, mostly due to the lasting jaundice, present in all the patients (100%). Regardless of the application of the present methods, biliary ducts carcinoma remains a serious diagnostic and surgical problem. Those methods, however, are the only possible ones, for an earlier detection of the tumors, hence, for the improvement of the unsatisfactory, so far, operability, lethality and survival.

Adenocarcinoma↗
PubMed1996

Biliary excretion of ciprofloxacin and piperacillin in the obstructed biliary tract.

Biliary excretion of ciprofloxacin and piperacillin was determined in cholestatic patients who had undergone endoscopic cholangiography. The median concentration of ciprofloxacin (n = 9) was 2.36 micrograms/ml (range, 0.29 to 19.8 micrograms/ml) in bile compared with 1.66 micrograms/ml (range, 0.73 to 2.69 micrograms/ml) in serum. The median concentration of piperacillin (n = 7) was < 5 micrograms/ml (range, < 5 to 26) in bile compared with 14.3 micrograms/ml (range, 5.3 to 80) in serum. Ciprofloxacin, but not piperacillin, can be actively excreted into bile in the presence of a biliary tract obstruction.

Adult↗
PubMed1976

Susceptibility of the liver and biliary tract to anaerobic infection in extrahepatic biliary tract obstruction. II. Liver function and morphology of the liver and biliary tract--an experimental study in rabbits.

Biliary tract infection with anaerobic bacteria (B. fragilis or Fusobacterium mortiferum) was produced in rabbits by common duct ligation (c.d.l.) 3 days prior to intravenous bacterial inoculation. Animals were investigated 1, 4 or 7 days after inoculation. Histopathological investigations included the liver, the common duct, and the gallbladder, while liver function was evaluated by bilirubin, alkaline phosphatase (AP), and L-alanine aminotransferase (GPT) in serum. Rabbits with c.d.l. and biliary tract infection were compared to rabbits with c.d.l. in which bacterial inoculation failed to produce infection, to inoculated rabbits without c.d.l., and to uninoculated rabbits with c.d.l. Anaerobic biliary tract infection in rabbits with c.d.l. caused a significant increase in liver abscesses, a significant increased infiltration with granulocytes in the gallbladder, and a significant increase in serum levels of bilirubin, AP, and GPT, but failed to produce signs of cholangitis in the liver and intramural abscesses in the gallbladder. A material is presented of normal values for bilirubin, AP, and GPT in serum in rabbits.

Alkaline Phosphatase↗
PubMed2001

Trypsinogen-1, -2 and tumour-associated trypsin-inhibitor in bile and biliary tract tissues from patients with biliary tract diseases and pancreatic carcinomas.

The bile concentrations of trypsinogen-1, -2 and tumour-associated trypsin-inhibitor (TATI) were determined in 23 patients with benign biliary tract disease, two with biliary tract cancer, and in 15 with pancreatic cancer. We also examined the trypsinogen and TATI expression by immunohistochemistry in tissue specimens from biliary tract cancer and non-neoplastic extrahepatic biliary tract. High levels of trypsinogen-1, trypsinogen-2, and TATI occur in bile of most patients. In contrast to the trypsinogens, the levels of TATI were significantly higher in patients with malignant disease than in those with benign diseases (p=0.04). There was no significant correlation between trypsinogen-2 and amylase (r=0.13, p=0.40), indicating that the occurrence of trypsinogen in bile is not a result of reflux of pancreatic fluid into the bile duct. Immunohistochemically, trypsinogen-2 was detected in five and TATI in 12 out of 15 non-neoplastic biliary tract specimens, and in four and seven out of 11 cholangiocarcinomas, respectively. High concentrations of trypsinogen-1, trypsinogen-2 and TATI occur in the bile of patients with non-neoplastic and malignant biliary tract disease and in patients with pancreatic cancer. At least part of the trypsinogen-2 and TATI found in bile appears to be derived from the biliary epithelium itself.

Bile↗
PubMed1991

[Atypical anatomical variants and anomalies of the biliary tract in patients with biliary tract and pancreatic diseases. II. Endoscopic treatment].

Results are reported of endoscopic treatment of 79 patients with atypical anatomical variants and anomalies of the bile ducts: common bile duct calculosis (54), stenosing papillo-odditis (8), indurative pancreatitis (2) and bile duct cancer (15). The following endoscopic manipulations have been performed: endoscopic sphincterotomy (72); hydrostatic balloon extraction of calculi (27); hydrostatic balloon dilatation of constricted segments (29); mechanical lithotripsy (15); nasolabial drainage (17) and endoprosthesis (15). Much more difficult was the extraction of calculi from the common bile in the event of atypical anatomical variants and anomalies of the distal portion of the common bile duct (chi 2 = 14.55; p less than 0.001). Treatment resulted in significant reduction of the bilirubin levels (t = 4.13; p less than 0.001), of AP (t = 4.47; p less than 0.001), GGTP (t = 4.07; p less than 0.001); AcAT (t = 5.75; p less than 0.001) and AlAT (t = 5.63; p less than 0.001). Complications occurred in 6 per cent of the patients (acute pancreatitis, cholangitis, hemorrhage). Mortality from endoscopic treatment was 1.3 per cent. Endoscopic methods for treatment are advised as alternative to operative treatment for patients in advanced age and high operative risk.

Adult↗
PubMed1994

[Papillomatous lesions of the biliary tract].

Biliary papillomatosis is a rare entity, characterized by single or multiple lesions arising from the biliary epithelium, leading to relapsing attacks of obstructive jaundice and cholangitis. Usually considered a benign disease, progression to malignancy has though been reported. In this paper the case of a 72 year old patient, with a single papilloma of the left hepatic duct treated by left hepatectomy, is discussed. The main histological, clinical and therapeutic aspects of this unusual pathology are then examined, with a complete review of the Literature.

Aged↗
PubMed1990

[Atypical anatomical variants and anomalies of the biliary tract in patients with biliary tract and pancreatic diseases. I. The incidence according to ERCP].

Of 570 patients with clinical manifestations of bile duct and pancreas diseases, examined by ERCP, 122 had different atypical anatomical variants (142 in 114 patients) and anomalies of the biliary passages (8 patients). The incidence of the individual atypical anatomical variants of the bile ducts was, as follows: 1. variants in the entry of the common bile duct in the duodenum--3.3 per cent (19 of 570 patients); 2. variants in the entry of ductus cysticus in the common bile duct--11.1 per cent (63 of 570 patients); 3. variants of the ramifications of the hepatic canals--10.5 per cent (60 of 570 patients). Of the bile duct anomalies, choledochocele was the most common--in 5 of the 8 patients in this group. In addition, there was a double gall bladder, gall bladder atresia and cysts of the intrahepatic bile ducts in one case each. High was the incidence of choledocholithiasis (63 per cent) and especially of primarily formed calculi in the common bile duct (20 per cent), as well as bile duct cancer (11 per cent). Cancer of the biliary passages was significantly commoner in atypical anatomical variants of ductus hepaticus (18 per cent) vs. 8 per cent in atypical variants of ductus cysticus and none in the common bile duct variants (chi 2 = 4.06; p less than 0.05). Cancer of the common bile duct was found also in 1 of the eight patients with anomalies of the biliary passages.

Age Factors↗
PubMed1982

The effect of elevated biliary tract pressure on biliary lipid metabolism and bile flow in nonhuman primates.

The effects of low (control), moderate, and high biliary tract pressures on biliary lipid metabolism and bile flow were studied in six rhesus monkeys and two baboons. Moderate pressures did not influence bile flow or biliary lipid metabolism. High biliary tract pressures produced significant reductions in bile flow and the secretion rates of bile salts, phospholipids, and cholesterol, but cholesterol saturation in bile improved. High pressure also completely inhibited bile salt synthesis, and the bile salt pool size decreased slightly due to continuing small losses in urine and bile samples. During the high pressure period bile salts accumulated in the liver and peripheral tissues. After pressure had been returned to control levels, bile flow and biliary lipid secretion rates returned to normal levels. Bile salt secretion recovered more slowly than secretion of the other lipids and bile became more saturated with cholesterol than in the control period. Bile salt synthesis resumed approximately 10 hr after pressure had been returned to control levels. The high biliary tract pressures induced in these studies are no known to occur in about 25% of normal human subjects. (J Lab Clin Med 99:342, 1982.)

Animals↗
PubMed1976

Susceptibility of the liver and biliary tract to anaerobic infection in extrahepatic biliary tract obstruction. III. Possible synergistic effect between anaerobic and aerobic bacteria. An experimental study in rabbits.

The pathogenicity of single anaerobic, single aerobic, and mixed anaerobic and aerobic bacterial inocula was studied in 3 groups of 12 rabbits with biliary tract obstruction. B. fragilis, ss. fragilis and E. coli serotype 01: K1: H7 were used. The investigation was made 7 days after bacterial inoculation and included bacteriological studies of the liver and bile as well as studies of liver function and morphology of the liver and biliary tract. Inoculation of 10(5)-10(6) E. coli did not cause biliary tract infection, liver abscesses or death. Inoculation of 10(9) B. fragilis caused biliary tract infection in 83% and liver abscesses in 17% of the animals inoculated, without any mortality. Combined inoculation with B. fragilis and E. coli in reduced doses significantly increased mortality (42%) and frequency of liver abscesses in surviving animals (86%). All abscesses, however, yielded pure culture of B. fragilis only. 84% of the animals inoculated with B. fragilis alone or with B. fragilis in combination with E. coli developed biliary tract infection with B. fragilis, the bile yielding from 10(7)-10(9) B. fragilis per ml, gallbladder bile yielding significantly higher bacterial counts than common duct bile. E coli was never recovered from bile in surviving animals but from both bile and blood in animals not surviving the experimental period.

Alanine Transaminase↗
PubMed1975

Susceptibility of the liver and biliary tract to anaerobic infection in extrahepatic biliary tract obstruction. Bacteriological investigations - an experimental study in rabbits.

The influence of common duct occlusion on susceptibility to infection with anaerobic gram-negative rods was investigated in rabbits. Intravenous inoculation was performed with three B. fragilis strains isolated from human infections and with a stock culture of Fusobacterium mortiferum. Liver tissue, gallbladder, bile, and blood were investigated. Anaerobic culture procedures were based on the use of a 'glove-box' with an oxygen-free atmosphere and pre-reduced, anaerobically sterilized media. Anaerobic transport was based on flushing of samples with oxygen-free carbon dioxide and transport-time less than 30 minutes. In regard to two B. fragilis strains (ss. fragilis) and in regard to Fusobacterium mortiferum, common duct occlusion significantly increased the number of infected animals compared to a control group of inoculated animals without common duct occlusion. Spontaneous infection did not arise in a control group of animals with common duct ligation. It is concluded that: 1) in biliary tract occlusion, anaerobic bacteria are able to invade the biliary tract from the blood stream, and 2) biliary tract occlusion produces sufficient anaerobic conditions for obligate anaerobic bacteria to multiply in the bile.

Animals↗