Billiary System/Pancreas Pubmed Results

CONCLUSION: We demonstrated the real-world genomic characteristics of BTC patients, which may have promising implications for the development and application of precision medicine in the future. Well-designed prospective studies are mandatory to validate the predictive role of significant genomic alterations observed in our study.

We explored the possibility of antioxidant and antifibrotic effects of panthenol (PL) associated with modulation of coenzyme A (CoA) biosynthesis in the liver in a rat model of chronic obstructive cholestasis induced by bile duct ligation (BDL). We found that PL increased alcohol dehydrogenase (ADH) activity in the liver of BDL rats. PL and its analog pantethine increased pantothenate kinase (PANK) activity, restored hepatic CoA levels reduced by BDL, lowered protein-bound CoA, and normalized...

Gallbladder cancer (GBC) is an aggressive malignancy with limited treatment options. ω-3PUFAs have known anticancer activity, but their role in GBC remains unclear. The anti-GBC effects of ω-3PUFAs (DHA/EPA) were evaluated using in vitro assays and mouse xenograft models. Epigenetic changes were analyzed by RRBS, MSP, and MethyLight PCR. Downstream mechanisms were explored via proteomics, Co-IP, and Western blot. This study demonstrates that ω-3PUFAs suppress GBC progression by inducing promoter...

Intrahepatic cholangiocarcinoma (ICC) is an aggressive liver malignancy with a rising global incidence and limited therapeutic options. Vascular invasion (VI) is a hallmark of advanced disease, correlating with early recurrence and dismal prognosis, yet its tumor microenvironment (TME) drivers remain elusive. We analyzed single-cell RNA sequencing (scRNA-seq) data from 25 ICC samples to systematically characterize the cellular composition and molecular features related to VI. By integrating bulk...

CONCLUSION: Our findings suggest that cholecystectomy provides better biliary pain control. However, conservative management may be considered in selected patients due to its lower surgical complication rate and comparable major clinical outcomes. Additional large RCTs are needed to confirm these findings.

CONCLUSIONS: This review will provide a methodologically explicit synthesis of comparative evidence on neoadjuvant therapy in cholangiocarcinoma while prespecifying separate analyses for initially resectable and initially unresectable disease. The findings are expected to inform future trial design, interpretation of emerging comparative evidence, and clinical decision-making in a setting where treatment intent varies substantially by resectability status.

The triglyceride-glucose (TyG) index and its obesity-related derivatives-TyG-body mass index, TyG-waist circumference, TyG-waist-to-height ratio (TyG-WHtR), and TyG-a body shape index (TyG-ABSI)-are emerging surrogates of insulin resistance. Their relationships with gallstone disease in the general population remain unclear. We investigated the associations between TyG-related indices and gallstone disease and compared their discriminatory performance. We performed a cross-sectional analysis of...

Gallbladder cancer (GBC) is the most common biliary tract malignancy with poor prognosis due to late diagnosis. Surgical resection, particularly oncologic extended resection, is the only curative option. Minimally invasive approaches, especially robotic-assisted surgery, have shown promise in improving perioperative outcomes while maintaining oncologic safety. Robotic surgery offers enhanced visualization, dexterity, and lymphadenectomy, though data remain limited. Incidental GBC requires...

PURPOSE OF REVIEW: This review evaluates the evolving management strategies for common bile duct stones (CBDSs), focusing on standard endoscopic techniques, advanced intraductal interventions for refractory stones, and contemporary minimally invasive surgical options.

CONCLUSION: The transcystic approach represents a valid, safe, and reproducible first-line technique for choledocholithiasis in patients with gallbladder in situ. Its standardization facilitates consistent outcomes and significantly shortens the learning curve, enabling its adoption as a routine practice in centers experienced in advanced laparoscopic biliary surgery.

CONCLUSION: Immediate LC (3-6 h) following ERCP is a safe and efficient strategy. This "extreme-early window" facilitates anatomical dissection before inflammatory changes become restrictive. The significantly reduced total hospital stay stems from clinical process optimization rather than accelerated physiological recovery. Therefore, immediate LC should be recommended as the preferred clinical pathway for eligible patients.

CONCLUSIONS: LM during KPE leads to increased intraoperative haemodynamic compromise requiring more intensive anaesthetic management and causes transient postoperative hepatic stress. LM does not appear to negatively affect LT and is associated with improved long-term native liver survival. These findings suggest potential benefits of LM during KPE, warranting further investigation in prospective studies.

CONCLUSION: In summary, based on multi-omics analysis, this study establishes a systemic mechanism that links tumor lipid metabolism, immune suppression, and therapeutic response in CCA. Targeting the USP1-mediated metabolic-immune axis not only significantly suppresses tumor progression but also enhances the efficacy of immunotherapy. These findings construct a conceptual framework that integrates metabolic reprogramming, immune evasion, and treatment sensitivity, thereby establishing USP1 as a...

CONCLUSION: Both LBEPS and ERCP + LC are safe, effective, and confer distinct benefits, achieving equivalent stone clearance and long-term outcomes. Individualized treatment selection should be guided by patient-specific clinical profiles.

INTRODUCTION: Common bile duct (CBD) stones are present in up to 20% of patients with gallstones and are associated with complications such as obstructive jaundice, cholangitis, and pancreatitis. Current guidelines support both endoscopic and surgical CBD stone extraction. While laparoscopic common bile duct exploration is an established technique, evidence on robotic CBD exploration remains limited.

CONCLUSION: In this retrospective propensity score weighting analysis, preoperative biliary drainage was associated with a higher incidence of posthepatectomy liver failure in resectable perihilar cholangiocarcinoma. These findings suggest that a subgroup of patients with perihilar cholangiocarcinoma can be operated safely without biliary drainage. The indication for preoperative biliary drainage should be considered on an individual basis.

There are few reliable predictors for reduced pain after biliary sphincterotomy or medical therapy in patients with sphincter of Oddi dysfunction (SOD). We explored whether prolonged intestinal bile excretion time, dilated common bile duct (CBD) diameter, or elevated alanine aminotransferase (ALT) were associated with reduced pain after treatment for SOD. This is a retrospective, single-centre study. Consecutive patients suspected of SOD were identified and screened. Medical treatment for SOD...

Cholangiocarcinoma (CCA) remains a difficult-to-treat biliary malignancy in which therapeutic stratification increasingly depends on predictive biomarkers. Although next-generation sequencing is essential for the detection of targetable genomic alterations, immunohistochemistry (IHC) retains a practical role because it is widely available, rapid, and tissue-sparing. This narrative review summarizes the current and emerging role of predictive IHC in CCA, with emphasis on its clinical utility,...

Autoimmune hepatitis (AIH) poses distinct diagnostic challenges due to its heterogeneous clinical presentation and lack of disease-specific features. This is further complicated by drug-induced liver injury (DILI), which can present with laboratory and histological findings indistinguishable from those of AIH. Here, we report the case of an elderly man who presented with elevated liver enzymes of unclear etiology. Initial laboratory tests showed negative antinuclear antibody (ANA) and normal...

CONCLUSIONS: Non-invasive serum markers and SWE all showed moderate value for fibrosis assessment in BA. SWE may be a promising and useful non-invasive tool, while selected serum biomarker combinations may provide complementary value for identifying severe fibrosis.

CONCLUSION: Postoperative morbidity and mortality were comparable between groups, with no significant differences observed in long-term survival outcomes.

CONCLUSION: Although SLD is frequently observed in PBC, it does not appear to adversely affect UDCA response or long-term hepatic outcomes.

CONCLUSIONS: A proactive approach to LDLT in children with BA is associated with improved long-term graft and patient survival. Low PELD LDLT should be considered to increase early transplant access for children with BA.

CONCLUSIONS AND RELEVANCE: In this Delphi consensus study, expert agreement was achieved on key aspects of the management and follow-up of PCDs. These recommendations may help standardize clinical practice and inform decision-making in the management of AC.

CONCLUSION: GLP-1 RAs use in patients with T2DM was associated with modestly higher rates of cholelithiasis/choledocholithiasis, cholecystitis, and cholecystectomy, whereas there were no significant differences in rates of pancreatitis or ERCP.

CONCLUSION: The regimen of camrelizumab combined with gemcitabine and cisplatin demonstrated potential conversion therapy value in this patient with advanced gallbladder cancer. However, its definitive efficacy and the specific role of camrelizumab still require validation through large-scale clinical trials.

CONCLUSION: The DNI levels were markedly elevated in ICP and varied with disease severity, suggesting its potential as a noninvasive marker for both diagnosis and risk stratification.

Cholangiocarcinoma (CCA) is an adenocarcinoma of the hepatobiliary system that has recently risen in incidence and mortality with unsatisfactory treatment options. Claudin-1 (CLDN1) is a transmembrane protein expressed in tight junctions and exposed on the cell surface in liver fibrosis and cancer. Using single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics of tissues of patients with CCA, we show that CLDN1 expression is up-regulated in cancer cells and is associated with stemness...

CONCLUSION: RES effectively ameliorated ICP through multi-faceted mechanisms involving the attenuation of inflammation, restoration of gut microbiota and intestinal barrier, and correction of bile acid homeostasis via activation of the FXR signaling pathway. Our findings highlight RES as a promising multi-mechanistic therapeutic candidate for ICP.

This study evaluated the safety and feasibility of gasless laparoscopic cholecystectomy in dogs, identifying factors associated with surgical time and survival. Twenty-five dogs with symptomatic gallbladder disease-predominantly gallbladder mucocele (72.0%) and cholelithiasis-underwent cholecystectomy using a mechanical abdominal wall lift system. Variables including gallbladder volume, age, body condition score, and intraoperative complications were recorded. Statistical analyses employed...

CONCLUSION: ERRFI1 mutations represent actionable biomarkers in BTC, with EGFR-targeted therapy demonstrating meaningful clinical benefit in this heavily pretreated population. These findings support integration of ERRFI1 testing into routine molecular profiling of BTC and other EGFR-driven malignancies.

This study aimed to evaluate and compare perioperative outcomes of robotic versus laparoscopic cholecystectomy in patients with acute cholecystitis within an Acute Care Surgery setting. A retrospective cohort study was conducted including patients who underwent cholecystectomy for acute cholecystitis between January 1, 2023, and March 1, 2026. Patients were stratified by operative approach (robotic vs. laparoscopic). Baseline demographics, comorbidities, and postoperative outcomes were analyzed....

Gallstones are small stones that form in the gallbladder. Around 80% of individuals with gallstones do not present any symptoms. Despite the high accuracy of image-based machine learning (ML) models in the detection of gallstones, less research has been carried out regarding tabular data. This paper has discussed a publicly available tabular dataset in order to study some predictive models to determine the presence of gallstones. We have employed the Catboost (CB) classifier model and the Sea...

CONCLUSIONS: Our results provide evidence of a potential association between null genotypes in PFIC diseases and the indication of LT as a treatment. Further trials are needed to confirm our results and guide decisions regarding personalized and early preventive LT.

BACKGROUND Stasis within the biliary limb of the Roux loop is rarely reported after successful Kasai portoenterostomy (KPE) for biliary atresia (BA). CASE REPORT This retrospective report describes 2 children (cases 1 and 2, aged 47 and 42 months) who underwent KPE for type 3 BA at 33 and 54 days of life, respectively, with postoperative jaundice clearance at 3 months (total bilirubin levels of 15 and 6 μmol/L, respectively). Both children experienced frequent episodes of cholangitis (5 episodes...

ObjectiveTo describe a rare case of concurrent emphysematous cholecystitis, emphysematous cholangitis, and ischemic bowel in an older patient.Case Presentation: An 88-year-old man with end-stage renal disease on hemodialysis presented with abdominal pain and altered mental status. Computed tomography revealed intramural gas in the gallbladder and distal common bile duct. Emergency laparotomy confirmed a gangrenous gallbladder and ischemic bowel. Bile cultures grew Clostridium perfringens and...

The incidence of primary biliary cholangitis (PBC) is on the rise, attributed to autoimmune-mediated bile duct damage in genetically susceptible individuals triggered by environmental factors. The close association between immune cell infiltration around the intrahepatic bile ducts and bile duct damage, and the causal and potential relationships of immune cells in the pathogenesis of PBC, remain unclear. Utilizing summary statistics from published genome-wide association studies, we evaluated...

CONCLUSION: Fenofibrate add-on therapy improved not only biochemical responses but also long-term transplant-free survival in PBC patients with suboptimal response to UDCA. However, liver injury needs to be closely monitored and properly managed.

Objective: To investigate the clinical characteristics and gene mutation status of progressive familial intrahepatic cholestasis caused by a ubiquitin-specific peptidase 53 (USP53) gene mutation (USP53-FIC) in a family. Methods: A female infant patient with USP53-FIC and her family who presented to the Department of Gastroenterology, Children's Hospital Affiliated with Zhengzhou University, in May 2025 with a one-month history of jaundice and yellow urine, which worsened over a one-week period...

In recent years, significant progress has been made in the imaging, molecular characterization, and systemic treatment of extrahepatic cholangiocarcinoma (CCA). However, early-stage detection, accurate classification, and effective management of CCA possess challenges. Therefore, the EASL commissioned an expert panel to draft evidence-based recommendations on account of recent research advances and significant differences in CCA subtypes for the management of extrahepatic CCA, including distal...

虽然对乙酰氨基酚（APAP）引起的肝损伤已有广泛报道，但关于APAP导致的严重高胆固醇血症的文献有限。现报道１例伴有严重高胆固醇血症的对乙酰氨基酚致胆汁淤积性肝损伤，在临床诊治中具有参考意义。.

Background and Objectives: Acute cholecystitis is a common indication for emergency surgery. While acute calculous cholecystitis (ACC) is most common, acute acalculous cholecystitis (AAC) occurs without gallstones and is often associated with severe systemic illness. We compared early postoperative outcomes after cholecystectomy for AAC versus ACC, with emphasis on complication severity and overall morbidity burden. Materials and Methods: We performed a single-center retrospective cohort study...

Background and Objectives: Early identification of patients at risk for severe forms of acute cholangitis (AC) is crucial for guiding prompt therapeutic interventions. In addition to traditional biomarkers such as C-reactive protein (CRP), newer indices like the neutrophil-to-lymphocyte ratio (NLR) are cost-effective and easy-to-use diagnostic tools. In the context of limited evidence from Eastern European populations, this study aimed to compare the performance of NLR and CRP in identifying...

Background and Objectives: Incidental gallbladder cancer (IGBC) is an uncommon but clinically important diagnosis after cholecystectomy for presumed benign biliary disease. This study aimed to determine the incidence of invasive IGBC in a large cholecystectomy cohort and to describe its clinicopathological profile, stage-specific management pathway, and exploratory univariable survival associations. Materials and Methods: We retrospectively reviewed all cholecystectomies performed between...

Pancreatic ductal adenocarcinoma (PDAC) and biliary tract cancers (BTCs) remain highly lethal gastrointestinal malignancies because of late presentation, marked molecular heterogeneity, and limited durable benefit from conventional systemic therapy. This narrative review summarizes recent advances in both diseases, focusing on practice-informing clinical trials, biomarker-driven treatment strategies, and translational insights into tumor biology and resistance. In PDAC, progress includes...

CONCLUSION: SpyDS achieved comparable technical success to PTCS and was associated with a markedly shorter hospitalization period. Although adjusted analyses did not show a significant cost difference, the shorter length of stay and favorable recovery trends suggest potential clinical and economic advantages. SpyDS may represent a practical alternative for DBDSs management. ClinicalTrials.gov trial number: NCT04743089.

CONCLUSION: Despite high morbidity, HPD can provide meaningful long-term survival in carefully selected patients. Preoperative CA 19-9 and angiolymphatic invasion may aid risk stratification. Associations between adjuvant treatment and survival outcomes should be interpreted cautiously and warrant confirmation in larger, prospective multicenter studies.

CONCLUSION: The addition of aprepitant significantly improves the delayed-phase TC rate by approximately 20%. These findings suggest the significance of aprepitant in the management of CINV during GC therapy.

CONCLUSIONS: IC after TACE is not rare and is frequently asymptomatic, often detected incidentally on routine CT follow-up. Systematic biochemical monitoring and selective MRCP could improve detection, particularly when TACE sessions are closely spaced.

Serum biomarkers play a key role in the early diagnosis and risk stratification of intrahepatic cholestasis of pregnancy (ICP). Our previous study showed that acyl-CoA oxidase 1 (ACOX1) was elevated in the serum and placenta of ICP patients. In this study, a pair of commercially available anti-ACOX1 antibodies was purchased and used to develop a double-antibody sandwich time-resolved fluorescent nanomicrosphere immunochromatographic (TRFNI) strip for the quantitative detection of ACOX1 in serum....