Billiary System/Pancreas Pubmed Results

Cholelithiasis and cholecystic polyps are common gastrointestinal conditions, and recent studies suggest that biliary microbiota dysbiosis may be closely associated with their pathogenesis. In this small cohort (n = 11), bile samples were aseptically collected during surgery from 6 patients with cholelithiasis and 5 patients with cholecystic polyps. Metagenomic sequencing was performed to investigate differences in the microbial composition and functional profiles between the 2 groups. The...

This study used a two-sample Mendelian randomization (MR) method to explore the potential causal relationship between air quality, cholelithiasis, and its related risk factor, blood lipids. This study used MR in European and East Asian groups, utilizing publicly available genome-wide association study data. The main method was inverse-variance weighting, with additional quality checks including weighted median, MR-Egger, simple, and weighted models. The Cochran Q test assessed heterogeneity....

CONCLUSIONS: UGIB is a rare but severe complication in BTC. Tumor-associated UGIB was associated with poor prognosis and markedly shortened survival, underscoring the necessity for careful clinical assessment and close follow-up in this high-risk cohort.

Biliary tract cancers (BTCs) are aggressive malignancies with limited treatment options. Despite advances with durvalumab plus chemotherapy, prognosis remains poor. The tumor immune microenvironment (TIME) is increasingly recognized as a determinant of immunotherapy response, yet its spatial organization in BTC is poorly understood. We applied multiplex immunofluorescence to pre-treatment tumor samples from 11 patients with advanced BTC, staining for CD4, CD8, CD20, and CD163 to identify T...

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.

CONCLUSION: Among native liver survivors with jaundice clearance, recurrent cholangitis (≥ 3 episodes) warrants long-term monitoring for PH. Continuous low-dose UDCA until 48 months is recommended for high-risk patients to improve outcomes.

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...

Primary sclerosing cholangitis (PSC) is a chronic inflammatory precursor associated with an increased risk of intrahepatic cholangiocarcinoma (ICC), yet identifying malignant features within the persistent inflammatory background remains challenging. In this study, a background-deviation framework was applied to explore malignant-associated determinants during PSC-associated cholangiocarcinogenesis. Single-cell RNA sequencing data from PSC, ICC tumor tissues, and adjacent non-tumor tissues were...

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...

Current data on neuroendocrine tumors (NETs) of the gallbladder and cystic duct (GB-NETs) are highly limited, and the available evidence, largely derived from cancer registry data, suggests that these tumors exhibit a substantially more aggressive clinical behavior than NETs arising at other anatomical sites. We analyzed 26 GB-NETs. Female-to-male ratio: 1.9:1; median age: 50 years. They were typically incidental small (median: 0.8 cm, range: 0.08-2.3 cm) tumors, with 81% classified as grade 1...

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: Implementation of the ERAS program in patients undergoing extended liver resection for PCH is feasible and safe. It was associated with a reduction in postoperative complications and a trend towards improved overall survival. These effects were most pronounced when the ERAS protocol was guided and supervised by dedicated ERAS staff.

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.

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...

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...

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.

Minimally invasive liver surgery (MILS), including laparoscopic liver surgery and robotic liver surgery, has come a long way in the management of primary liver tumors. This article summarizes current evidence and institutional experience regarding the role of MILS in primary liver tumors such as hepatocellular carcinoma and cholangiocarcinoma. Compared with open liver surgery, MILS provides equivalent oncologic outcomes with improved perioperative results. Robotic platforms further extend the...

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,...

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.

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.

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...

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...

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

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: 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.

BACKGROUND: Routine intraoperative cholangiogram (IOC) remains controversial. Current literature evaluating routine (rIOC) versus selective (sIOC) during laparoscopic cholecystectomy (LC) often overlooks the impact of bile duct injuries (BDIs) and choledocholithiasis.

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.

CONCLUSION: Laparoscopic cholecystectomy performed beyond seven days from symptom onset was safe, with outcomes comparable to patients with a shorter symptom duration. These findings challenge the necessity of the seven-day threshold in experienced centers. A randomized trial is warranted to determine whether early surgery offers advantages over conservative treatment in patients with prolonged symptoms.

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...

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: 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: These results provide a strong rationale for evaluating the iCas9.B7-H3 CAR T cell strategy in clinical trials for patients with advanced ICC.

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: 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.

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...

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.