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Lu JJ, Chen YZ, Huang YP. Critical assessment of the reported bidirectional associations between gallstone, non-alcoholic fatty liver, and kidney stone diseases. World J Gastroenterol 2025; 31:102047. [PMID: 39926217 PMCID: PMC11718616 DOI: 10.3748/wjg.v31.i5.102047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Revised: 11/26/2024] [Accepted: 12/06/2024] [Indexed: 12/30/2024] Open
Abstract
The recent article by Jiang et al published in World Journal of Gastroenterology reports substantial bidirectional associations between gallstone disease (GSD), non-alcoholic fatty liver disease (NAFLD), and kidney stone disease (KSD), based on multicenter cross-sectional studies and a systematic review with meta-analysis. While the findings have the potential to significantly impact clinical and preventive strategies, several methodological issues merit closer examination. This letter critiques key aspects of the study, including sample population heterogeneity, potential confounding variables, and the reliance on cross-sectional data that may limit causal inferences. We also discuss the generalizability of these results to broader populations given the study's focus on the Chinese demographic. By addressing these concerns, we suggest a more nuanced interpretation of the associations between GSD, NAFLD, and KSD, advocating for longitudinal studies to validate these findings and enhance their applicability in global health contexts.
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Affiliation(s)
- Jing-Jing Lu
- Department of Internal Medicine, Xiamen Hospital of Traditional Chinese Medicine, The Affiliated with Fujian University of Traditional Chinese Medicine, Xiamen 361015, Fujian Province, China
- The Eighth School of Clinical Medicine Xiamen Hospital, Beijing University of Chinese Medicine, Xiamen 361015, Fujian Province, China
| | - Yuan-Zhi Chen
- School of Public Health, Xiamen University, Xiamen 361102, Fujian Province, China
| | - Yuan-Peng Huang
- Department of Internal Medicine, Xiamen Hospital of Traditional Chinese Medicine, The Affiliated with Fujian University of Traditional Chinese Medicine, Xiamen 361015, Fujian Province, China
- The Eighth School of Clinical Medicine Xiamen Hospital, Beijing University of Chinese Medicine, Xiamen 361015, Fujian Province, China
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Geng J, Ruan X, Wu X, Chen X, Fu T, Gill D, Burgess S, Chen J, Ludvigsson JF, Larsson SC, Li X, Du Z, Yuan S. Network Mendelian randomisation analysis deciphers protein pathways linking type 2 diabetes and gastrointestinal disease. Diabetes Obes Metab 2025; 27:866-875. [PMID: 39592890 PMCID: PMC7617254 DOI: 10.1111/dom.16087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 11/09/2024] [Accepted: 11/09/2024] [Indexed: 11/28/2024]
Abstract
AIMS The molecular mechanisms underlying the association between type 2 diabetes (T2D) and gastrointestinal (GI) disease are unclear. To identify protein pathways, we conducted a two-stage network Mendelian randomisation (MR) study. MATERIALS AND METHODS Genetic instruments for T2D were obtained from a large-scale summary-level genome-wide meta-analysis. Genetic associations with blood protein levels were obtained from three genome-wide association studies on plasma proteins (i.e. the deCODE study as the discovery and the UKB-PPP and Fenland studies as the replication). Summary-level data on 10 GI diseases were derived from genome-wide meta-analysis of the UK Biobank and FinnGen. MR and colocalisation analyses were performed. Pathways were constructed according to the directionality of total and indirect effects, and corresponding proportional mediation was estimated. Druggability assessments were conducted across four databases to prioritise protein mediators. RESULTS Genetic liability to T2D was associated with 69 proteins in the discovery protein dataset after multiple testing corrections. All associations were replicated at the nominal significance level. Among T2D-associated proteins, genetically predicted levels of nine proteins were associated with at least one of the GI diseases. Genetically predicted levels of SULT2A1 (odds ratio = 1.98, 95% CI 1.80-2.18), and ADH1B (odds ratio = 2.05, 95% CI 1.43-2.94) were associated with cholelithiasis and cirrhosis respectively. SULT2A1 and cholelithiasis (PH4 = 0.996) and ADH1B and cirrhosis (PH4 = 0.931) have strong colocalisation support, accounting for the mediation proportion of 72.8% (95% CI 45.7-99.9) and 42.9% (95% CI 15.5-70.4) respectively. CONCLUSIONS The study identified some proteins mediating T2D-GI disease associations, which provided biological insights into the underlying pathways.
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Affiliation(s)
- Jiawei Geng
- Zhejiang Key Laboratory of Blood-Stasis-Toxin Syndrome, Zhejiang Chinese Medical University, Hangzhou, 310053, China
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xixian Ruan
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xing Wu
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xuejie Chen
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Tian Fu
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, LondonSW7 2BX, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jie Chen
- Zhejiang Key Laboratory of Blood-Stasis-Toxin Syndrome, Zhejiang Chinese Medical University, Hangzhou, 310053, China
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatrics, Orebro University Hospital, Orebro, Sweden
- Department of Medicine, Celiac Disease Center at Columbia University Medical Center, New York, New York, USA
| | - Susanna C. Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, 10Uppsala, Sweden
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhongyan Du
- Zhejiang Key Laboratory of Blood-Stasis-Toxin Syndrome, Zhejiang Chinese Medical University, Hangzhou, 310053, China
- Zhejiang Engineering Research Center for "Preventive Treatment" Smart Health of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Li X, Yin X, Xu J, Geng L, Liu Z. Relationship between Abnormal Lipid Metabolism and Gallstone Formation. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2025; 85:11-21. [PMID: 39849808 DOI: 10.4166/kjg.2024.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2024] [Revised: 11/22/2024] [Accepted: 11/27/2024] [Indexed: 01/25/2025]
Abstract
Cholelithiasis is a common biliary system disease with a high incidence worldwide. Abnormal lipid metabolism has been shown to play a key role in the mechanism of gallstones. Therefore, recent research literature on the genes, proteins, and molecular substances involved in lipid metabolism during the pathogenesis of gallstones has been conducted. This study aimed to determine the role of lipid metabolism in the pathogenesis of gallstones and provide insights for future studies using previous research in genomics, metabolomics, transcriptomics, and other fields.
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Affiliation(s)
- Xiang Li
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- NHC Key Laboratory of Combined Multi-organ Transplantation, Key Laboratory of the diagnosis and treatment of organ Transplantation, CAMS, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Organ Transplantation, Zhejiang Province, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaodan Yin
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- NHC Key Laboratory of Combined Multi-organ Transplantation, Key Laboratory of the diagnosis and treatment of organ Transplantation, CAMS, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Organ Transplantation, Zhejiang Province, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Xu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- NHC Key Laboratory of Combined Multi-organ Transplantation, Key Laboratory of the diagnosis and treatment of organ Transplantation, CAMS, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Organ Transplantation, Zhejiang Province, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lei Geng
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- NHC Key Laboratory of Combined Multi-organ Transplantation, Key Laboratory of the diagnosis and treatment of organ Transplantation, CAMS, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Organ Transplantation, Zhejiang Province, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhengtao Liu
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
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4
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Zhang X, Yang X, Wang Y, Xu Z, Yi S, Guo T, Liao Y, Tang X, Zhang J, Wang R. A supramolecular nanoprodrug for prevention of gallstone formation. CHINESE CHEM LETT 2025; 36:109854. [DOI: 10.1016/j.cclet.2024.109854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Singh S, Dwivedi M, Pawar A, Kori M, Yadav A, Porwal P. Therapeutic prospects and challenges in the human genetic disorder hyperbiliverdinemia. HUMAN GENE 2024; 42:201342. [DOI: 10.1016/j.humgen.2024.201342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Kovacheva-Slavova M, Dimitrov V, Gecov P, Golemanov B, Vladimirov B. Combined Cholecystoenteric Fistula and Choledocholithiasis: A Report of a Rare Case. Cureus 2024; 16:e76608. [PMID: 39881910 PMCID: PMC11776032 DOI: 10.7759/cureus.76608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2024] [Indexed: 01/31/2025] Open
Abstract
Cholecystoenteric fistulas are a rare complication of chronic gallstone disease. If not diagnosed on time, they can cause several complications such as gallstone ileus, gastric outlet obstruction (Bouveret syndrome), cholangitis, or liver abscess. We present a case of a patient with chronic calculous cholecystitis, who was admitted due to unspecific abdominal discomfort and impaired liver function with increased cholestatic liver enzymes. We found a stone in the distal part of the common bile duct with the papilla orifice located in a duodenal diverticulum and a cholecystoduodenal fistula as an additional finding, which at that point was uncomplicated. After successful endoscopic therapy of the choledocholithiasis, the patient was referred for laparoscopic cholecystectomy and treatment of the fistula. During follow-up, the patient was in an excellent overall condition.
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Affiliation(s)
- Mila Kovacheva-Slavova
- Gastroenterology, University Hospital Tsaritsa Ioanna, Medical University of Sofia, Sofia, BGR
| | - Victor Dimitrov
- Gastroenterology, University Hospital Tsaritsa Ioanna, Medical University of Sofia, Sofia, BGR
| | - Plamen Gecov
- Medical Imaging, University Hospital Tsaritsa Ioanna, Medical University of Sofia, Sofia, BGR
| | - Branimir Golemanov
- Gastroenterology, University Hospital Tsaritsa Ioanna, Medical University of Sofia, Sofia, BGR
| | - Borislav Vladimirov
- Gastroenterology, University Hospital Tsaritsa Ioanna, Medical University of Sofia, Sofia, BGR
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Ding GJ, Jiang W, Lyu JQ, Ma J, Chen GC, Li FR, Yang SJ, Miao MY, Hua YF. Menopausal characteristics and hormone replacement therapy in relation to long-term risk of cholecystectomy in women. Front Med (Lausanne) 2024; 11:1446271. [PMID: 39664317 PMCID: PMC11631607 DOI: 10.3389/fmed.2024.1446271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 11/11/2024] [Indexed: 12/13/2024] Open
Abstract
Background Women are known to be at higher risk for gallbladder disease than men, suggesting a role of female hormones in the pathogenesis of gallbladder disease. This study aimed to assess menopausal characteristics, hormone replacement therapy (HRT) and their joint effect on long-term risk of cholecystectomy in women. Methods A total of 184,677 women were included from the UK Biobank. Multivariable Cox regression models were used to estimate the associations of menopausal characteristics and HRT with risk of cholecystectomy. The joint influence of HRT use and the status and type of menopause on incident cholecystectomy were further evaluated. Results During a median of 12.7 years of follow-up, 4,991 incident cases of cholecystectomy were identified. Natural menopause, regardless of menopausal age, was not associated with risk of cholecystectomy, while surgical menopause at a young age was associated with a higher risk of cholecystectomy. Ever use of HRT was associated with a higher risk of cholecystectomy. In particular, women who were surgically-menopausal and started HRT before menopause had the highest risk for cholecystectomy (hazard ratio = 2.28; 95% confidence interval: 1.70-3.04), when compared with women who were naturally-menopausal and never used HRT. Conclusions Early surgical menopause and ever use of HRT was independently associated with the risk of cholecystectomy.
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Affiliation(s)
- Guan-Jun Ding
- The Second Department of General Surgery, Ningbo No. 9 Hospital, Ningbo, China
| | - Wei Jiang
- Department of Hepatopancreatobiliary Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Jie-Qiong Lyu
- Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jie Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Fu-Rong Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Si-Jia Yang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Meng-Yuan Miao
- Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yong-Fei Hua
- Department of Hepatopancreatobiliary Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
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Choi SY, Hong YR, Oh CE, Lee JH. Cornelia de Lange Syndrome Accompanied by Cholelithiasis and Nephrolithiasis: A Case Report. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1433. [PMID: 39767862 PMCID: PMC11674812 DOI: 10.3390/children11121433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Revised: 11/22/2024] [Accepted: 11/24/2024] [Indexed: 01/11/2025]
Abstract
Cornelia de Lange syndrome (CdLS) is a rare genetic disorder characterized by a distinctive facial appearance, growth/cognitive retardation, developmental delay, skeletal malformation, hypertrichosis, and other abnormalities. Patients with mild CdLS have less severe phenotypes, while retaining representative facial features. Mutations in the genes NIPBL, SMC1A, SMC3, HDAC8, and RAD21 have been associated with CdLS, with mutations in NIPBL accounting for approximately 60% of cases. Herein, we present a case of CdLS accompanied by cholelithiasis and nephrolithiasis. A 9-year-old Korean boy presented with vomiting and abdominal pain. Abdominal ultrasonography revealed several gallstones and renal stones. Extracorporeal shock wave lithotripsy failed; therefore, cholecystectomy and nephrolithotomy were performed. Postoperative stone composition analysis revealed calcium oxalate as the primary component. CdLS was suspected based on the characteristic appearance and physical examination, with genetic testing confirming an NIPBL gene mutation. Simultaneous CdLS, cholelithiasis, and nephrolithiasis requires careful management and treatment tailored to each patient's specific needs and challenges.
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Affiliation(s)
- So Yoon Choi
- Departments of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - Yoo-Rha Hong
- Departments of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - Chi-Eun Oh
- Departments of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
- Departments of Pathology, Kosin University Gospel Hospital, Busan 49267, Republic of Korea
| | - Jung Hyun Lee
- Departments of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
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Beigi F, Salehifard Jouneghani A, Heidari-Soureshjani S, Sherwin CMT, Rahimian G. Association Between Gallstone Disease and Kidney Stone Disease: A Systematic Review and Meta-analysis. EPIDEMIOLOGY AND HEALTH SYSTEM JOURNAL 2024; 11:158-165. [DOI: 10.34172/ehsj.26270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Accepted: 10/22/2024] [Indexed: 01/03/2025]
Abstract
Background and aims: Gallstone disease (GSD) and kidney stone disease (KSD) have increased due to lifestyle in recent decades. This systematic review and meta-analysis aimed to investigate the association between these two diseases. Methods: A comprehensive electronic database search was conducted before August 25, 2024. This systematic review and meta-analysis included observational studies. The meta-analysis employed a random-effects model to compute the overall summary estimates of the association between GSD and KSD using risk ratios with 95% confidence intervals (CIs) as the primary measure of the effect size. Heterogeneity was evaluated using chi-square tests, the I² statistic, and forest plots. Publication bias was assessed through Begg’s and Egger’s tests. A P value of less than 0.05 was considered statistically significant, and all analyses were performed using Stata 17 software. Results: The meta-analysis included 9 studies encompassing 982847 participants. The pooled analysis revealed a statistically significant association between GSD and KSD, with a risk of 1.78 (95% CI: 1.572.03, P≤0.001). Begg’s and Egger’s tests demonstrated no significant bias (Begg’s test P=0.835, Egger’s test P=0.812). Variables such as study year, sample size, mean age of participants, mean follow-up, and study quality as determined by the Newcastle-Ottawa Scale (NOS) were examined, but none could significantly impact heterogeneity (P>0.10). Conclusion: This systematic review and meta-analysis provide evidence of a significant association between GSD and KSD. Therefore, further investigation into the underlying mechanisms and potential risk factors is necessary.
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Affiliation(s)
- Faramarz Beigi
- Department of Urology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | | | - Catherine MT Sherwin
- Pediatric Clinical Pharmacology and Toxicology, Department of Pediatrics, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, USA
| | - Ghorbanali Rahimian
- Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Shulpekova YO, Popova IR, Nechaev VM. Functional Disorders of the Biliary Tract and Cholelithiasis: Analysis of a Possible Relationship. RUSSIAN JOURNAL OF GASTROENTEROLOGY, HEPATOLOGY, COLOPROCTOLOGY 2024; 34:94-103. [DOI: 10.22416/1382-4376-2024-34-4-94-103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
Abstract
Aim: Diagnostic criteria for functional disorders of the biliary tract are presented in the materials of the Rome IV consensus, as well as expert councils of Russian and foreign specialists. Episodes of functional biliary pain are caused by a violation of bile outflow through the cystic duct and sphincter of Oddi. It has been suggested that there is a “biliary continuum” in which in some patients’ biliary dysfunction is transformed into cholelithiasis. Key points. Lithogenic bile is considered as the pathophysiological basis for the development of biliary dyskinesia and cholelithiasis. Lithogenic bile provokes inflammation of low grades in the mucous membrane of the biliary tract, decreased contractility of the gallbladder and impaired relaxation of the biliary sphincters, impaired physiological response to cholecystokinin. Changes in motility of the biliary tract may be associated with the influence of hydrophobic bile salts and impaired eicosanoid metabolism. Hyperplasia of the epithelium and muscle layer, hypersecretion of mucin and cholesterol precipitation further impair the outflow of bile. Experimental data and some clinical observations indicate the possibility of transformation of biliary dysfunction into cholelithiasis. Dysfunction of the sphincter of Oddi is one of the possible consequences of cholecystectomy and, in fact, acts as a variant of postcholecystectomy syndrome. The basis for the treatment of biliary dysfunctions are antispasmodics of different classes, which can be combined with ursodeoxycholic acid. The biliary tract-selective antispasmodic hymecromone has shown high effectiveness in relieving biliary pain, which also has a moderate choleretic effect and the ability to prevent the crystallization of cholesterol in bile and can be used both for functional diseases and for cholelithiasis. The domestic drug hymecromone “Odecromone” entered the pharmaceutical market. Conclusion. There is no doubt that the relevance of further study of the patterns of development of biliary dysfunctions and GI is obvious. The study of this problem will contribute to the development of effective preventive approaches, including in the field of nutraceuticals.
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Affiliation(s)
- Yu. O. Shulpekova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - I. R. Popova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - V. M. Nechaev
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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11
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Parker MA, Kragh N, Sandoval J, Erabti S, Soliman B. Surgical Management of Gallstone Ileus: Approach, Outcome, Case Report, and Literature Review. Cureus 2024; 16:e69930. [PMID: 39439607 PMCID: PMC11495830 DOI: 10.7759/cureus.69930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2024] [Indexed: 10/25/2024] Open
Abstract
Gallstone ileus (GSI) is a condition caused by migrating gallstones lodged in the terminal ileum. Stone migration results from fistula formation, typically between the gallbladder and duodenum, termed a cholecystoduodenal fistula. This mechanical obstruction has high mortality and requires prompt intervention. This discussion focuses on two GSI cases caused by cholecystoduodenal fistula managed by the surgical removal of the mechanical obstruction and a conservative approach to the fistula. Patient 1 is a 51-year-old male with no significant past medical history. After radiological imaging and laboratory findings raised concern for cholecystoduodenal fistula, the patient underwent a diagnostic laparoscopy with small bowel resection. The second patient is a 74-year-old female with a past medical history of hypertension, myocardial infarction, and laparoscopic uterine lift. The patient underwent diagnostic laparoscopy, lysis of adhesions, mini-laparotomy, and segmental small bowel resection with primary anastomosis. Many factors lead to gallstone formation, including gender, genetics, ethnicity, etc. Fistulas are formed from chronic inflammation and tissue necrosis from gallstone pressure on surrounding tissue. Classic radiologic findings of GSI are pneumobilia, bowel obstruction, and gallstones outside the gallbladder. The most common approach to GSI management is solely relieving the mechanical obstruction by an enterotomy proximal to the obstruction, associated with reduced mortality. Both patients had good outcomes which we attributed to our surgical removal of the small bowel obstruction and a non-operative approach to the cholecystoduodenal fistula.
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Affiliation(s)
- Madison A Parker
- Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, USA
| | - Nathan Kragh
- Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, USA
| | - Jeannette Sandoval
- Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, USA
| | - Sana Erabti
- Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, USA
| | - Basem Soliman
- Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, USA
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Sun Y, Xu C, Luo J, Li S, Chen S, Cen Y, Xu P. Comprehensive analysis of differential long non-coding RNA and messenger RNA expression in cholelithiasis using high-throughput sequencing and bioinformatics. Front Genet 2024; 15:1375019. [PMID: 38808330 PMCID: PMC11130440 DOI: 10.3389/fgene.2024.1375019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/24/2024] [Indexed: 05/30/2024] Open
Abstract
Background The etiology of gallstone disease (GSD) has not been fully elucidated. Consequently, the primary objective of this study was to scrutinize and provisionally authenticate the distinctive expression profiles of long non-coding RNAs (lncRNAs) and messenger RNAs (mRNAs) in GSD. Methods RiboNucleic Acid (RNA) sequencing was used on four paired human gallbladder samples for the purpose of this study. Differentially expressed lncRNAs (DElncRNAs) and mRNAs (DEmRNAs) were identified and subjected to analysis of their biological functions. The Pearson's correlation coefficients between DElncRNAs and DEmRNAs were computed to construct a co-expression network delineating their associations. Furthermore, both cis- and trans-regulatory networks of selected lncRNAs were established and visualized. Additionally, a competing endogenous RNA (ceRNA) regulatory network was constructed. To validate the RNA-sequencing data, we performed a Quantitative Real-time Polymerase Chain Reaction (RT-qPCR) on 10 paired human gallbladder samples, assessing the expressions of the top 4 DEmRNAs and DElncRNAs in gallstone and control samples. Results A total of 934 DEmRNAs and 304DElncRNAs were successfully identified. Functional enrichment analysis indicated a predominant involvement in metabolic-related biological functions. Correlation analysis revealed a strong association between the expressions of 597 DEmRNAs and 194 DElncRNAs. Subsequently, both a cis-lncRNA-mRNA and a trans-lncRNA-Transcription Factor (TF)-mRNA regulatory network were meticulously constructed. Additionally, a ceRNA network, comprising of 24 DElncRNAs, 201 DEmRNAs, and 120 predicted miRNAs, was established. Furthermore, using RT-qPCR, we observed significant upregulation of AC004692.4, HECW1-IT1, SFRP4, and COMP, while LINC01564, SLC26A3, RP1-27K12.2, and GSTA2 exhibited marked downregulation in gallstone samples. Importantly, these findings were consistent with the sequencing. Conclusion We conducted a screening process to identify DElncRNAs and DEmRNAs in GSD. This approach contributes to a deeper understanding of the genetic factors involved in the etiology of gallstones.
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Affiliation(s)
- Yanbo Sun
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Conghui Xu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
- School of Medicine, Yunnan University, Kunming, China
| | - Jing Luo
- Department of Gastrointestinal Surgery, Qujing No. 1 People’s Hospital, Qujing, Yunnan, China
| | - Shumin Li
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shi Chen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yunyun Cen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Pengyuan Xu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Zhang B, Nie P, Lin Y, Ma Z, Ma G, Wang Y, Ma Y, Zhao J, Zhang J, Yue P, Jiang N, Zhang X, Tian L, Lu L, Yuan J, Meng W. High incidence of gallstones after Roux-en-Y reconstruction gastrectomy in gastric cancer: a multicenter, long-term cohort study. Int J Surg 2024; 110:2253-2262. [PMID: 38320088 PMCID: PMC11020035 DOI: 10.1097/js9.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Roux-en-Y reconstruction is a common anastomosis technique during gastrectomy in gastric cancer. There is a lack of studies on gallstones after Roux-en-Y reconstruction gastrectomy. This study investigated the incidence and potential risk factors associated with gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. METHODS The study analyzed data from gastric cancer who underwent radical gastrectomy and Roux-en-Y reconstruction at two hospitals between January 2014 and December 2020. The patients fall into distal and total gastrectomy groups based on the extent of gastrectomy. The cumulative event probability curve was plotted using the Kaplan-Meier, and differences in gallstone between groups were evaluated using the Log-Rank. Propensity score matching was applied to construct a balanced total versus distal gastrectomies cohort. A Cox regression was employed to analyze the risk factors for gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. Further subgroup analysis was performed. RESULTS Five hundred thirty-one patients were included in this study, 201 in the distal gastrectomy group and 330 in the total gastrectomy. During the follow-up, gallstones occurred in 170 cases after gastrectomy, of which 145 cases accounted for 85.29% of all stones in the first two years after surgery. Then, to reduce the impact of bias, a 1:1 propensity score matching analysis was performed on the two groups of patients. A total of 344 patients were evaluated, with each subgroup comprising 172 patients. In the matched population, the Cox regression analysis revealed that females, BMI ≥23 kg/m 2 , total gastrectomy, No.12 lymph node dissection, and adjuvant chemotherapy were risk factors for gallstones after Roux-en-Y reconstructive gastrectomy. Subgroup analysis showed that open surgery further increased the risk of gallstones after total gastrectomy. CONCLUSION The incidence of gallstones increased significantly within 2years after Roux-en-Y reconstructive gastrectomy for gastric cancer. Patients with these risk factors should be followed closely after gastrectomy to avoid symptomatic gallstones.
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Affiliation(s)
- Baoping Zhang
- The First Clinical Medical College, Lanzhou University
| | | | - Yanyan Lin
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou
| | - Zelong Ma
- The First Clinical Medical College, Lanzhou University
| | | | | | - Yuhu Ma
- Department of Anesthesiology
| | - Jinyu Zhao
- The First Clinical Medical College, Lanzhou University
| | - Jinduo Zhang
- The First Clinical Medical College, Lanzhou University
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou
| | - Ping Yue
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou
| | - Ningzu Jiang
- The First Clinical Medical College, Lanzhou University
| | | | - Liang Tian
- The First Clinical Medical College, Lanzhou University
| | - Linzhi Lu
- Department of Gastroenterology, Gansu Wuwei Tumor Hospital, Wuwei, Gansu
| | - Jinqiu Yuan
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, People’s Republic of China
| | - Wenbo Meng
- The First Clinical Medical College, Lanzhou University
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou
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Moglia T, Falkenstein C, Rieker F, Tun N, Rajaram-Gilkes M. Anatomical Ignorance Resulting in Iatrogenic Causes of Human Morbidity. Cureus 2024; 16:e56480. [PMID: 38638713 PMCID: PMC11025880 DOI: 10.7759/cureus.56480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
This article discusses how inadequate anatomy education contributes to iatrogenic causes of human morbidity and mortality. Through a review of the relevant literature, high-yield clinical cases were identified in which a lack of sufficient anatomical knowledge contributed to patient morbidity, such as abscess formation and neuropathy as a result of improper intramuscular injections, superior gluteal nerve injuries due to surgical procedures, and misdiagnoses due to physicians' inability to examine and correlate clinical and radiological findings. The importance of a multimodal learning approach in anatomy education for medical students, which includes the utilization of the cadaveric dissection approach to emphasize spatial understanding, is crucial for the development of competent physicians with a deep-rooted foundational knowledge of anatomy and related concepts, such as physiology, pathology, and radiology. It cannot be understated that anatomy education and a lack of knowledge of anatomy and related concepts may influence iatrogenic causes of human morbidity and mortality. Therefore, all efforts should be made to ensure that students develop a strong foundational anatomy knowledge during their preclinical years.
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Affiliation(s)
- Taylor Moglia
- Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA
| | | | - Finn Rieker
- Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA
| | - Nang Tun
- Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA
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15
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SAXENA AVANISHKUMAR, FATIMA ANAM, VENKATA SIVA KUNDRAPUVEERA, PARIYA ANUSHKA, CHINMAYI VAYALAPALLISYAMA. THYROID FUNCTION ABNORMALITIES IN PATIENTS WITH CHOLELITHIASIS: A HOSPITAL-BASED CROSS-SECTIONAL STUDY. ASIAN JOURNAL OF PHARMACEUTICAL AND CLINICAL RESEARCH 2024:138-141. [DOI: 10.22159/ajpcr.2024.v17i2.50442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
Abstract
Objective: The objective of the study is to analyze the association between thyroid function abnormalities and cholelithiasis, focusing on the prevalence and types of thyroid dysfunctions in patients with gallstone disease compared to a healthy control group.
Methods: A comparative, hospital-based cross-sectional study was conducted in the department of general surgery at a tertiary care medical college. The study included 60 patients diagnosed with cholelithiasis (Group A) and 60 age-matched healthy individuals (Group B). Detailed history, physical examinations, ultrasound imaging, and thyroid function tests (TFTs) were performed. TFTs included measurements of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone. Patients were categorized based on thyroid status into euthyroid, subclinical and clinical hypothyroidism, and hyperthyroidism. Statistical analysis was performed using SPSS version 21.0, with significance set at p<0.05.
Results: The study revealed a female preponderance in cholelithiasis cases (76.67% in Group A vs. 65.00% in Group B). The mean age and BMI were comparable between the groups. Thyroid function abnormalities were more prevalent in the cholelithiasis group (p=0.0251), with a higher incidence of hypothyroidism compared to the control group. Subclinical hypothyroidism was the most common thyroid dysfunction in cholelithiasis patients. Common complaints in the cholelithiasis group included anemia, menstrual irregularities, skin changes, and weakness.
Conclusion: The study demonstrates a significant association between cholelithiasis and thyroid function abnormalities, particularly hypothyroidism. The findings suggest the need for routine thyroid function evaluation in patients with cholelithiasis, which could influence management strategies and improve patient outcomes.
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Gardner D. Cholelithiasis management during hepatitis C treatment: a case report including pathophysiology and literature review. GASTROINTESTINAL NURSING 2024; 22:S12-S16. [DOI: 10.12968/gasn.2024.22.sup1.s12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
Abstract
This case reports a 56-year-old male attending a nurse-led hepatitis C (HCV) clinic complaining of abdominal pain. Right upper quadrant abdominal tenderness on palpation with a positive Murphy's sign (pain on inspiration during palpation to the right subcostal area) encouraged timely investigation and diagnosis of non-obstructive cholelithiasis (gallstones). This was managed with interval review and regular clinical assessment pending successful HCV treatment and surgical referral. The main lessons from this case study emphasise the importance of considering concurrent diagnoses for patients complaining of abdominal pain when presenting with a primary diagnosis of HCV. This case also supports a pragmatic approach in considering the treatment of HCV before the surgical intervention of uncomplicated gallstones. Furthermore, it also highlights the value of advanced nurse practice within the multi-disciplinary team.
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Affiliation(s)
- Dean Gardner
- Practice Development Nurse, Chelsea and Westminster NHS Foundation Trust
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17
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Bhattacharya T, Nandi A, Das A, El-Shazly M. Role of liver in gallstone formation. GALLSTONE FORMATION, DIAGNOSIS, TREATMENT AND PREVENTION 2024:51-70. [DOI: 10.1016/b978-0-443-16098-1.00014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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18
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Alzain AA, Mukhtar RM. Application of computational approaches for the drug discovery of cholesterol gallstone disease: identification of new farnesoid X receptor modulators as a case study. GALLSTONE FORMATION, DIAGNOSIS, TREATMENT AND PREVENTION 2024:223-243. [DOI: 10.1016/b978-0-443-16098-1.00003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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19
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Chatterjee A, Irani R. Molecular aspect of gallstone formation: a systematic review. GALLSTONE FORMATION, DIAGNOSIS, TREATMENT AND PREVENTION 2024:71-82. [DOI: 10.1016/b978-0-443-16098-1.00010-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Hlušička J, Žák A. Dyslipidaemia in Liver Diseases. Folia Biol (Praha) 2024; 70:239-247. [PMID: 39889216 DOI: 10.14712/fb2024070050239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2025]
Abstract
The liver is the central organ in lipid metabolism and plays a key role in a variety of biochemical processes. It is involved in lipoprotein synthesis, fatty acid beta oxidation, ketone body production, cholesterol synthesis, bile production, and storage and mobilization of lipids. Metabolic diseases such as obesity, type 2 diabetes mellitus and certain dyslipidaemias can lead to chronic liver conditions, especially non-alcoholic fatty liver disease. Conversely, chronic liver diseases such as liver cirrhosis and chronic cholestasis can induce dyslipidaemias. This review provides a comprehensive biochemical and clinical overview of the intricate relationship between the lipid-lipoprotein metabolism and chronic liver diseases, including non-alcoholic fatty liver disease, cholestasis, alcohol-related liver disease, viral hepatitis and cirrhosis, all of which have been selected due to their importance in current clinical practice. These conditions not only affect liver function but also have widespread metabolic implications critical for patient management and therapeutic strategies. In addition to discussing the clinical manifestations and pathophysiology of liver diseases, this review delves into the genetic and non-genetic factors that influence their development and progression. By bridging clinical observations with biochemical me-chanisms, this review aims to improve the understan-ding of how lipid metabolism disorders contribute to chronic liver diseases and to identify potential targets for therapeutic intervention.
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Affiliation(s)
- Jiří Hlušička
- 4th Department of Medicine - Department of Gastroenterology and Hepatology, First Faculty of Medicine, Charles University and General University Hospital Prague, Prague, Czech Republic.
| | - Aleš Žák
- 4th Department of Medicine - Department of Gastroenterology and Hepatology, First Faculty of Medicine, Charles University and General University Hospital Prague, Prague, Czech Republic
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21
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Tendulkar R, Tendulkar M. Chemical and herbal treatment for gallstone treatment. GALLSTONE FORMATION, DIAGNOSIS, TREATMENT AND PREVENTION 2024:189-206. [DOI: 10.1016/b978-0-443-16098-1.00002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Bali GPK, Singh B, Ashraf M, Kamalanathan T. Factors prevailing for gallstone formation. GALLSTONE FORMATION, DIAGNOSIS, TREATMENT AND PREVENTION 2024:39-50. [DOI: 10.1016/b978-0-443-16098-1.00005-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Mutiri B, Etonyeaku AC, Aloufi M, Alsaud JS. A Review of the Management of Cholelithiasis at Buraydah Central Hospital in the Qassim Region, Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e50846. [PMID: 38249213 PMCID: PMC10798649 DOI: 10.7759/cureus.50846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Cholelithiasis is the most common cause of gastroenterological hospitalization. Given this significant risk, perfectly managing cholelithiasis is crucial to reduce hospitalization. Unfortunately, we have not found a study on a review of the management of cholelithiasis in Saudi Arabia. Therefore, we aim to evaluate cholelithiasis concerning demographic features, presentation symptoms, predisposing risk factors, laboratory features, complications, and outcomes in the Qassim region. This cross-sectional study of all patients with a radiological diagnosis of gallstones, whether symptomatic or not, was diagnostic in 2022. The researchers fielded a preformed data collection sheet for each patient from the hospital system. Data obtained were entered into a spreadsheet and analyzed using SPSS Statistics version 23.0 (IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp.). A total of 526 patients were included in the study. Most patients (116, 22.1%), were aged 38-42. The finding also indicated that most patients were females (397, 75.5%), while males were only 129 (24.5%). The study also found that the difference between women and men presenting complaints of fat intolerance and right shoulder pain was statistically significant. Women were 100 (84%) and men were 19 (16%) for fat intolerance, while for right shoulder pain, women were 50 (89.3%) and men were six (10.7%). The p-values were 0.014 and 0.011, respectively. Further, there was a statistically significant difference in terms of the complaints presented by the patients between the complicated and non-complicated cases of abdominal pain (p=0.001), nausea (p=0.001), vomiting (p=0.001), change in urine and stool color (p=0.001), and right shoulder pain (p=0.001), among other complaints (p=0.001). The study concludes that most patients affected by cholelithiasis are individuals in the middle age group, with women being more affected by the disease than men. Further, among the individuals affected by the disease, the majority of them were overweight and obese. On the other hand, the study concludes that the majority of patients who suffer more from cholelithiasis are affected mainly by other associated diseases such as hypertension, hypothyroidism, and diabetes mellitus. In conclusion, many factors may contribute to gallstone formation and the outcome of the disease and surgery. Therefore, the study recommends that health workers offer tailored education, especially targeting the highlighted factors found in this study, to create awareness of disease control measures in the general population. Also, keep in mind these factors when dealing with patients who complain of abdominal pain.
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Affiliation(s)
- Bandar Mutiri
- General Surgery, Buraydah Central Hospital, Buraydah, SAU
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24
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Wu Y, Zhang Y, Jiang XM, Xu CJ, Wang YY, Gu JY, Li Y, Xu SF. Risk Factors for Single and Multiple Recurrences for Endoscopic Retrograde Cholangiopancreatography and Open Choledochotomy in Treating Choledocholithiasis. Gastroenterol Res Pract 2023; 2023:4738985. [PMID: 37941974 PMCID: PMC10630008 DOI: 10.1155/2023/4738985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 06/29/2023] [Accepted: 10/14/2023] [Indexed: 11/10/2023] Open
Abstract
Background There are few studies comparing recurrences between endoscopic retrograde cholangiopancreatography (ERCP) and open choledochotomy (OCT). Aims To compare the effect of different surgical methods on single and multiple recurrences of choledocholithiasis. Methods A total of 1255 patients with choledocholithiasis who underwent ERCP or OCT were retrospectively studied. The recurrence of choledocholithiasis was calculated by the Kaplan-Meier method with the log-rank test. Multivariate analyses of recurrent choledocholithiasis were performed by introducing variables with P < 0.20 in univariate analysis into the logistic regression model. Results A total of 204 (16.7%, 204/1225) patients relapsed. Among the 204 patients, 74.5% relapsed within three years after surgery, of whom 39.7% (81/204) had multiple relapses (≥ 2). The recurrence rate of ERCP (17.2%, 119/692) was higher than that of OCT (15.1%, 85/563), but the difference was not statistically significant. The independent risk factors for a single recurrence of choledocholithiasis were diabetes, stone number ≥ 2, maximum stone diameter ≥ 15 mm, sedentary occupation, the approach of ERCP (EST or EPBD), periampullary diverticulum, primary suture, high-fat diet (postoperative), frequency of weekly vegetable intake (< 4, postoperative), and drinking (postoperative). However, the ERCP approach (EST or EPBD), OCT approach (LCBDE), primary suture, high-fat diet (postoperative), and frequency of weekly vegetable intake (< 4, postoperative) were independent risk factors for multiple recurrences of choledocholithiasis. Conclusion Patients with choledocholithiasis should be followed up regularly for one to three years after treatment. Stone number ≥ 2, diabetes mellitus, periampullary diverticulum, surgical methods, and lifestyle are all risk factors for the recurrence of choledocholithiasis. ERCP is still the preferred surgical method based on the advantages of low risk of cholangitis recurrence, less hospital stay, minimally invasive surgery, fewer postoperative complications, and easier acceptance by elderly patients. In addition to optimizing the treatment plans, postoperative lifestyle management is also vital.
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Affiliation(s)
- Yao Wu
- Sir Run Run Hospital, Nanjing Medical University, Nanjing 211100, China
| | - Ying Zhang
- School of Public Health, Southeast University, Nanjing 211189, China
| | - Xiao Meng Jiang
- Sir Run Run Hospital, Nanjing Medical University, Nanjing 211100, China
| | - Chen Jing Xu
- Jiangsu Province Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Yan Yan Wang
- Sir Run Run Hospital, Nanjing Medical University, Nanjing 211100, China
| | - Jin Yuan Gu
- Sir Run Run Hospital, Nanjing Medical University, Nanjing 211100, China
| | - Yi Li
- Sir Run Run Hospital, Nanjing Medical University, Nanjing 211100, China
| | - Shun Fu Xu
- Sir Run Run Hospital, Nanjing Medical University, Nanjing 211100, China
- Jiangsu Province Hospital, Nanjing Medical University, Nanjing 210029, China
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Wang H, He YQ, Dong SY, Zhong W, Tao P, Yang SY, Liu ZJ. Recurrence of common bile duct stones after choledocholithotomy in elderly patients: risk factor analysis and clinical prediction model development. Front Med (Lausanne) 2023; 10:1239902. [PMID: 37937139 PMCID: PMC10626465 DOI: 10.3389/fmed.2023.1239902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/11/2023] [Indexed: 11/09/2023] Open
Abstract
Background The reasons for the recurrence of common bile duct stones (CBDS) in elderly patients after choledocholithotomy are still unclear. This study aims to establish a prediction model for CBDS recurrence by identifying risk factors. Methods We conducted a retrospective analysis of 1804 elderly patients aged 65 years and above who were diagnosed to have CBDS and were admitted to Nanjing First Hospital between January 1, 2010, and January 1, 2021. According to inclusion and exclusion criteria, 706 patients were selected for the final analysis. The patients were assigned to two groups according to the presence or absence of CBDS recurrence, and their clinical data were then statistically analyzed. Subsequently, a prediction model and nomogram were developed, evaluating effectiveness using the concordance index (C-index). Results Of the 706 elderly patients, 62 patients experienced CBDS recurrence after surgery, resulting in a recurrence rate of 8.8%. The multivariate Cox analysis showed that prior history of cholecystectomy (hazard ratio [HR] = 1.931, 95% confidence interval [CI]: 1.051-3.547, p = 0.034), white blood cell (WBC) count ≥11.0 × 109/L (HR = 2.923, 95% CI: 1.723-4.957, p < 0.001), preoperative total bilirubin (TBIL) level ≥ 36.5 mmol/L (HR = 2.172, 95% CI: 1.296-3.639, p = 0.003), number of stones ≥2 (HR = 2.093, 95% CI: 1.592-5.294, p = 0.001), maximum stone diameter ≥ 0.85 cm (HR = 1.940, 95% CI: 1.090-3.452, p = 0.024), and T-tube drainage (HR = 2.718, 95% CI: 1.230-6.010, p = 0.013) were independent risk factors of CBDS recurrence in elderly patients after choledocholithotomy. A postoperative CBDS recurrence prediction model was constructed with a C-index value of 0.758 (95% CI: 0.698-0.818) and internal validation value of 0.758 (95% CI: 0.641-0.875). Conclusion A history of cholecystectomy, WBC count ≥11.0 × 109/L, preoperative TBIL level ≥ 36.5 mmol/L, number of stones ≥2, maximum stone diameter ≥ 0.85 cm, and T-tube drainage are the independent risk factors of CBDS recurrence after choledocholithotomy in elderly patients. Our developed prediction model for CBDS recurrence has good predictive ability and can help predict the prognosis of patients with CBDS.
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Affiliation(s)
| | | | | | | | | | | | - Zi-jun Liu
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Wu T, Wang Q, Pu C, Zhang K. The Correlation between Islet β Cell Secretion Function and Gallbladder Stone Disease: A Retrospective Study Based on Chinese Patients with Newly Diagnosed Type 2 Diabetes Mellitus. Biomedicines 2023; 11:2840. [PMID: 37893213 PMCID: PMC10603909 DOI: 10.3390/biomedicines11102840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/07/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND This study aimed to analyze the correlation between islet β cell function and gallbladder stone (GBS) in newly diagnosed type 2 diabetes mellitus (T2DM) patients. METHODS A total of 438 newly diagnosed T2DM patients in Peking University International Hospital from January 2017 to August 2022 were retrospectively analyzed and divided into a non-GBS group and a GBS group. RESULTS (1) The homeostasis model assessment of the insulin resistance (HOMA-IR) of the GBS group was higher than that of the non-GBS group (p < 0.05), while the homeostasis model assessment of β cell (HOMA-β), disposition index (DI0), and Matsuda index of the GBS group were lower than those of the non-GBS group (all p < 0.05). (2) For male patients, HOMA-IR is an independent risk factor for GBS (OR = 2.00, 95% CI:1.03, 3.88, p < 0.05), and the Matsuda index value is a protective factor for GBS (OR = 0.76, 95% CI:0.60, 0.96, p < 0.05). For female patients, HOMA-IR is an independent risk factor for GBS (OR = 2.80, 95% CI:1.03, 7.58, p < 0.05) and the Matsuda index value is a protective factor for GBS (OR = 0.59, 95% CI:0.39, 0.90, p < 0.05). (3) For male patients, the area under curve (AUC) for predicting GBS was 0.77 (95% CI 0.67, 0.87), with a specificity of 75.26%, a sensitivity of 80.00%, and an accuracy of 75.64%. For female patients, the AUC for predicting GBS was 0.77 (95% CI 0.63, 0.88), with a specificity of 79.63%, a sensitivity of 71.43%, and an accuracy of 78.69%. CONCLUSIONS Insulin resistance may be an independent risk factor for the incidence of GBS in patients with newly diagnosed T2DM, both male or female, which provides a new clinical basis and research direction for the prevention and treatment of GBS in patients with T2DM. This study has established a predictive model of GBS in T2DM and found it to be accurate, thus representing an effective tool for the early prediction of GBS in patients with T2DM.
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Affiliation(s)
- Tiantian Wu
- Department of Hepatobiliary Surgery, Peking University International Hospital, Beijing 100001, China; (Q.W.); (C.P.); (K.Z.)
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Liu Q, Zheng L, Wang Y, Huang Z, Zhu J, Fang M, Xie L, Ding C, Gu Y, Xu D, Jin H, Yang J, Zhang X, Shen H. Primary choledocholithiasis occurrence and recurrence is synergetcally modulated by the bile microbiome and metabolome alternations. Life Sci 2023; 331:122073. [PMID: 37678747 DOI: 10.1016/j.lfs.2023.122073] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023]
Abstract
AIMS Primary choledocholithiasis is a common digestive disease with high morbidity and relapse. However, the compositions and functions of the bile microbial ecosystem and the pathogenesis of microfloral regulation of host metabolism resulting in stone formation are poorly understood. MAIN METHODS Biliary samples collected from patients with acute cholangitis induced by benign biliary stricture (nonlithiasis group, n = 17) and primary choledocholithiasis (lithiasis group, n = 33) were subjected to multiomics analyses. Furthermore, clinicopathological features collected over a 24-month follow-up period were examined to evaluate the predictive value of candidate microbes. KEY FINDINGS Five alpha diversity indices of the bile microbiome were significantly decreased in the lithiasis group. Furthermore, we identified 49 differential bile flora between the two groups, and the relative abundances of 6 bacteria, Actinobacteria, Actinobacteriota, Staphylococcales, Micrococcales, Altererythrobacter and Carnobacteriaceae, were associated with primary choledocholithiasis relapse conditions. Multiomics analyses showed that specific changes in disease-related bacterial taxa were closely related to metabolite variation (low-molecular weight carboxylic acids, sterol liquid and acylcarnitine), which might reflect disease prognosis. According to microbiomic and metabolomic pathway analyses, we revealed that bacterial infections, microbiota-derived amino acid metabolites and secondary bile acid-related pathways were significantly enriched in the stone-formation group, suggesting a novel host-microbial metabolic mechanism of primary choledocholithiasis. SIGNIFICANCE Our study first indicates bile host-microbial dysbiosis modulates the abnormal accumulation of metabolites might further disrupt calcium homeostasis and generate insoluble saponification. Additionally, we determined the predictive value of Actinomycetes phylum reduction for recurrence in primary common bile duct stone patients.
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Affiliation(s)
- Qiang Liu
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310006, China.
| | - Liyun Zheng
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310006, China.
| | - Yue Wang
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Zhicheng Huang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310003, China
| | - Jianpeng Zhu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310003, China
| | - Mengdie Fang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310003, China
| | - Lu Xie
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Cong Ding
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Ye Gu
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Dongchao Xu
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310006, China
| | - Hangbin Jin
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310006, China; Hangzhou Hospital & Institute of Digestive Diseases, Hangzhou, Hangzhou 310006, China
| | - Jianfeng Yang
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310006, China; Hangzhou Hospital & Institute of Digestive Diseases, Hangzhou, Hangzhou 310006, China
| | - Xiaofeng Zhang
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310006, China; Hangzhou Hospital & Institute of Digestive Diseases, Hangzhou, Hangzhou 310006, China; The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310003, China; Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Hongzhang Shen
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310006, China.
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Azimirad M, Sadeghi A, Hosseinkhan N, Mirbagheri SZ, Alebouyeh M. Microbiome analysis of bile samples in patients with choledocholithiasis and hepatobiliary disorders. Germs 2023; 13:238-253. [PMID: 38146380 PMCID: PMC10748839 DOI: 10.18683/germs.2023.1390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/18/2023] [Accepted: 08/15/2023] [Indexed: 12/27/2023]
Abstract
Introduction The involvement of bacteria in the pathogenesis of biliary tract disease is largely unknown. In this study, we investigated the microbiota of the biliary tissue among adult patients with choledocholithiasis during endoscopic retrograde cholangiography (ERCP). Methods 16S rDNA sequencing of bile samples, culture, and data of the medication history, underlying diseases, and liver function tests were used for the interpretation of differences in the composition of detected bacterial taxa. Results The four most common phyla in the bile samples included Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes. Infection with anaerobic and microaerophilic bacteria showed host specificity, where Fusobacterium, Prevotella, Veillonella, Propionibacterium, Gemella, and Helicobacter coexist in the same patients. Clostridium and Peptoclostridium spp. were detected in 80% and 86% of the patients, where the highest relative abundance rates were detected in patients with elevated alkaline phosphatase (ALP) levels and leukocytosis, respectively. Higher diversity in the bacterial population was detected in patients with common bile duct (CBD) stone, in which the richness of an unclassified member of Alphaproteobacteria plus Helicobacter, Enterobacter/Cronobacter spp., Sphingomonas, Prevotella, Fusobacterium and Aeromonas were detected. Conclusions Our findings suggested correlations between the presence and relative abundance of several bacterial taxa and CBD stone formation and the effect of medication and underlying diseases on the bile microbial communities. A study on a higher number of bile samples from patients compared with the control group could reveal the role of these bacteria in the pathogenesis of biliary tract disease.
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Affiliation(s)
- Masoumeh Azimirad
- MSc, Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, postal code: 1985717411, Iran
| | - Amir Sadeghi
- MD, Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, postal code: 1985717413, Iran
| | - Nazanin Hosseinkhan
- PhD, Endocrine Research Center, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, postal code: 1411713119, Iran
| | - Seyedeh Zohre Mirbagheri
- PhD, Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, postal code: 141761315, Iran
| | - Masoud Alebouyeh
- PhD, Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, postal code: 1985717411, Iran
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Hardy MA, Yang C. How to Diagnose and Manage Acute Abdomen and Intra-Abdominal Infections in Low- and Middle-Income Countries. GLOBAL SURGERY 2023:317-337. [DOI: 10.1007/978-3-031-28127-3_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Risk factors for gallstone disease onset in Japan: Findings from the Shizuoka Study, a population-based cohort study. PLoS One 2022; 17:e0274659. [PMID: 36584097 PMCID: PMC9803237 DOI: 10.1371/journal.pone.0274659] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022] Open
Abstract
In the research literature on factors associated with gallstones, large population-based cohort studies are rare. We carried out a study of this type to explore risk factors for the onset of gallstones. This study included Japanese participants aged 40-107 years who were followed prospectively from January 2012 to September 2020 using a dataset composed of two individually linked databases, one containing annual health checkup records and the other containing medical claims for beneficiaries of the National Health Insurance System and the Medical Care System for Elderly in the Latter Stage of Life in Shizuoka Prefecture, Japan. Among the 611,930 participants in the analysis set, 23,843 (3.9%) were diagnosed with gallstones during the observational period (median [max]: 5.68 [7.5] years). Multivariate analysis revealed that risk of gallstone disease was increased by male sex, cerebrovascular disease, any malignancy, dementia, rheumatic disease, chronic pulmonary disease, hypertension, and H. pylori-infected gastritis. These findings provide essential insights into the etiology of cholelithiasis and may contribute to efforts to reduce the incidence of the disease.
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Lodha M, Chauhan AS, Puranik A, Meena SP, Badkur M, Chaudhary R, Chaudhary IS, Sairam MV, Kumar V, Lodha R. Clinical Profile and Evaluation of Outcomes of Symptomatic Gallstone Disease in the Senior Citizen Population. Cureus 2022; 14:e28492. [PMID: 36185904 PMCID: PMC9513743 DOI: 10.7759/cureus.28492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background There is a heavy burden of gallstone disease on the world’s population. The incidence and severity of symptomatic cholelithiasis increase with age. There is often a delay in presentation, leading to complicated disease, diagnostic delay, and increased morbidity. There is a paucity of studies on the presentation and management of cholelithiasis in elderly persons from the western part of India. This study aimed to observe the spectrum of presentation and management of symptomatic cholelithiasis in senior citizens. Objectives The primary objective of this study was to describe the presentation, diagnosis and intraoperative findings of symptomatic gallstone disease (GSD) in patients aged over 60 years. The secondary objectives of this study were to find the association of GSD with age, sex, and comorbidities, including diabetes mellitus, hypertension, and thyroid disorders. Methods All patients above the age of 60 years presenting to the surgical outpatient and emergency departments from January 2020 to July 2021 with symptomatic GSD were included. Details of history, physical examination, blood investigations, and imaging of the abdomen (ultrasonography and Magnetic Resonance Cholangiopancreaticography, when indicated) were recorded. Patients were managed as per the advice of the treating consultant. Details of management and outcomes, including hospital stay, mortality, and morbidity, were noted. The descriptive data were organised into tables and percentages. The significance of various data and relationships between various variables was analysed using the Pearson chi-square test, Fischer exact test and scatter plots. Results A total of 76 patients were evaluated in this study, of which 73.7% were female. The mean age was 70.8 ± 1.7 years. The majority of patients (63.2%) were admitted through the outpatient department (OPD). The most common presenting complaint was abdominal pain (96.1%). Clinical jaundice was noted in 9.2%. Complicated Gall Stone Disease (GSD) was found more commonly in the female population (57.1%). Complicated GSD was more commonly found in patients with diabetes (p=0.075) and hypothyroidism (p=0.057). No association of age with intraoperative complications was noted (p = 0.446). Conclusion Senior citizens can present with both complicated and uncomplicated GSD. GSD, in the presence of hypothyroidism or diabetes mellitus, presents in a much more complicated form. Early surgical intervention in form of laparoscopic cholecystectomy can be beneficial to the patient if diagnosed with symptomatic gallstones. Patients of this age group need not be over investigated if a benign pathology is suspected.
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Balakrishnan G, Iqbal T, Uppinakudru G, Fernandes R, Bangera S, Dutt RA. The impact of lifestyle stressors, menstrual pattern, and cardiometabolic risk factors on young females with cholelithiasis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:255. [PMID: 36325235 PMCID: PMC9621381 DOI: 10.4103/jehp.jehp_1767_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/30/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Lifestyle and nutritional transitions in the society driven by globalization have led to the rising burden of cholelithiasis. The present study was done to assess the impact of lifestyle, stress, menstrual pattern, and cardiometabolic risk factors on young females with cholelithiasis. MATERIALS AND METHODS A hospital-based case-control study was conducted on young females of 18-45 years. Cases and age-matched controls were compared on their lifestyle parameters like demography, marital status, occupation, educational status, family income, stress along with menstrual pattern, cardiometabolic parameters like anthropometric measures, blood pressure (BP), fasting blood sugar (FBS), and lipid profile. Chi-square test and unpaired t-test were used for the analysis of data using SPSS software, and P < 0.05 was considered statistically significant. RESULTS The majority of the cases were from rural areas, married, homemakers leading a comparatively sedentary lifestyle consuming more red meat, less literate, and belonged to a lower economic group with significantly more stress compared to controls. The age of menarche, neither the regularity nor irregularity of the menstrual cycle (regular cycle 21-35 days), showed any difference, but cases had significantly more pregnancies and usage of oral contraceptives compared to controls. Waist-height ratio, systolic BP, FBS, triglyceride, low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) were significantly higher in cases. Cases had a 14.4 times more risk of developing metabolic syndrome when compared with controls. CONCLUSION Married, rural, less literate Indian women leading a sedentary lifestyle, consuming more of red meat, and soft drinks with increased psychosomatic stress are more prone to develop cholelithiasis. Women who use hormonal contraceptives have increased occurrence of cholelithiasis and they were more prone to develop metabolic syndrome. The need for the hour is health education, to implement simple lifestyle changes, thereby decreasing the incidence of cholelithiasis in young females.
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Affiliation(s)
- Grrishma Balakrishnan
- Department of Physiology, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Tubah Iqbal
- SNCU officer, Department of Pediatrics, Koosamma Shambhu Shetty Memorial Haji Abdulla Mother and Child Hospital, Udupi, Karnataka, India
| | - Gurunandan Uppinakudru
- Department of Cardiothoracic and Vascular Surgery, Yenepoya Medical College Hospital, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Ryan Fernandes
- Department of General Surgery, A. J Institute of Medical Sciences, Mangalore, Karnataka, India
| | - Shobith Bangera
- Department of Physiology, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - R. Aswini Dutt
- Department of Physiology, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
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Koishibayeva L, Turgunov Y, Sandblom G, Koishibayev Z, Teleuov M. Quality-of-life After Cholecystectomy in Kazakhstan and Sweden: Comparative Study Based on the Gastrointestinal Quality-of-life Index Questionnaire. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: As severe morbidity rarely is the focus in gallstone surgery, health-related quality of life has evolved as the main outcome measure of the management of patients with gallstone disease (GSD). The lack of universally accepted guidelines on treatment of GSD has also resulted in regional differences in the preoperative evaluation and management of patients with GSD.
AIM: The aim of this study was to compare quality-of-life (QoL) following gallstone surgery in cohorts from Kazakhstan and Sweden.
METHODS: A comparative study on QoL after cholecystectomy (CE) in two cohorts from Sweden and Kazakhstan using the gastrointestinal QoL index (GIQLI) questionnaire. QoL measures of 259 patients in Kazakhstan and 448 patients in Sweden were compared taking into account surgical approach, mode of admission, and indication for surgery. Patients in both cohorts were requested to fill in the GIQLI questionnaire after surgery. Similar routines were applied to ensure high coverage in both countries.
RESULTS: The mean overall GIQLI score was higher for patients undergoing CE in Sweden than those in Kazakhstan (p < 0.01). The same was seen when stratifying for open or laparoscopic surgery (both p < 0.05), absence of presence of acute cholecystitis (both p < 0.05), and emergency admission (p < 0.05), but not in case of planned admission (p = 0.54).
CONCLUSIONS: There were large differences in QoL, especially in the group having undergone surgery for pain attacks or chronic cholecystitis. These differences in may be explained by differences in attitudes to health status and treatment expectations. Standardized routines for evaluating the outcome after surgery are needed.
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Mhatre S, Lacey B, Sherliker P, Chatterjee N, Rajaraman P, Goel M, Patkar S, Ostwal V, Patil P, Shrikhande SV, Chitkara G, Badwe R, Lewington S, Dikshit R. Reproductive factors and gall-bladder cancer, and the effect of common genetic variants on these associations: a case-control study in India. Int J Epidemiol 2022; 51:789-798. [PMID: 34550362 PMCID: PMC9189936 DOI: 10.1093/ije/dyab197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In India, as elsewhere, the incidence of gall-bladder cancer (GBC) is substantially higher in women than in men. Yet, the relevance of reproductive factors to GBC remains poorly understood. METHODS We used logistic regression adjusted for age, education and area to examine associations between reproductive factors and GBC risk, using 790 cases of histologically confirmed GBC and group-matched 1726 visitor controls. We tested the interaction of these associations by genetic variants known to increase the risk of GBC. RESULTS Parity was strongly positively associated with GBC risk: each additional pregnancy was associated with an ∼25% higher risk {odds ratio [OR] 1.26 [95% confidence interval (95% CI) 1.17-1.37]}. After controlling for parity, GBC risk was weakly positively associated with later age of menarche [postmenopausal women, OR 1.11 (95% CI 1.00-1.22) per year], earlier menopause [OR 1.03 (95% CI 1.00-1.06) per year] and shorter reproductive lifespan [OR 1.04 (95% CI 1.01-1.07) per year], but there was little evidence of an association with breastfeeding duration or years since last pregnancy. Risk alleles of single-nucleotide polymorphisms in the ABCB4 and ABCB1 genetic regions had a multiplicative effect on the association with parity, but did not interact with other reproductive factors. CONCLUSIONS We observed higher GBC risk with higher parity and shorter reproductive lifespan, suggesting an important role for reproductive and hormonal factors.
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Affiliation(s)
- Sharayu Mhatre
- Section of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ben Lacey
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paul Sherliker
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nilanjan Chatterjee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Department of Biostatistics, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
- Department of Oncology, School of Medicine, John Hopkins University, Baltimore, MD, USA
| | - Preetha Rajaraman
- Office of Global Affairs, Department of Health and Human Services, Washington, DC, USA
| | - Mahesh Goel
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shraddha Patkar
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vikas Ostwal
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Prachi Patil
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Gastroenterology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shailesh V Shrikhande
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Garvit Chitkara
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rajendra Badwe
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rajesh Dikshit
- Section of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
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Feng R, Zhang T, Kayani MUR, Wang Z, Shen Y, Su KL, Bielike K, Chen L. Patients with Primary and Secondary Bile Duct Stones Harbor Distinct Biliary Microbial Composition and Metabolic Potential. Front Cell Infect Microbiol 2022; 12:881489. [PMID: 35548466 PMCID: PMC9082501 DOI: 10.3389/fcimb.2022.881489] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/25/2022] [Indexed: 12/29/2022] Open
Abstract
IntroductionCholelithiasis has a high incidence worldwide and limited treatment options due to its poorly understood pathogenesis. Furthermore, the role of biliary microbiota in cholelithiasis remains understudied. To address these questions, we performed microbial sequencing from biliary samples from primary bile duct stone (PBDS) and secondary bile duct stone (SBDS) patients.ResultsWe analyzed in total 45 biliary samples, including those from cholelithiasis patients with PBDS or SBDS and people with other digestive diseases. 16S rRNA sequencing showed the bacteria family Alcaligenaceae increased in relative abundance in the lithiasis group compared with the non-lithiasis group. In addition, the PBDS group showed significantly lower bacterial diversity than SBDS, with Propionibacteriaceae, Sphingomonadaceae, and Lactobacillaceae as the most significant bacteria families decreased in relative abundance. We further performed whole metagenomic shotgun sequencing (wMGS) and found increased ability of biofilm synthesis and the ability to sense external stimuli in PBDS based on functional annotation of mapped reads. From genome-resolved analysis of the samples, we identified 36 high-quality draft bacterial genome sequences with completion ≥70% and contamination ≤10%. Most of these genomes were classified into Proteobacteria, Firmicutes, or Actinobacteria.ConclusionsOur findings indicated that there is a subtle impact on biliary microbiome from cholelithiasis while the difference is more pronounced between the PBDS and SBDS. It was revealed that the diversity of biliary microbiota in PBDS is lower, while some metabolic pathways are up-regulated, including those linked to higher incidence of different types of cancer, providing new insights for the understanding of cholelithiasis with different origin.
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Affiliation(s)
- Ru Feng
- Center for Microbiota and Immunological Diseases, Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianyu Zhang
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Masood ur Rehman Kayani
- Center for Microbiota and Immunological Diseases, Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengting Wang
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Shen
- Center for Microbiota and Immunological Diseases, Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kenn Liu Su
- Center for Microbiota and Immunological Diseases, Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kouken Bielike
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Lei Chen, ; Kouken Bielike,
| | - Lei Chen
- Center for Microbiota and Immunological Diseases, Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Lei Chen, ; Kouken Bielike,
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Sharma R, Kumar K, Tanvi K. Dealkenylation of neoandrographolide, a phytochemical from Andrographis paniculata stimulates FXR (Farnesoid X Receptor) and enhances gallstone dissolution. J Biomol Struct Dyn 2022; 41:3339-3348. [PMID: 35253613 DOI: 10.1080/07391102.2022.2048078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
FXR (Farnesoid X Receptor) is one of the nuclear receptors expressed in the liver performing a significant role in the maintenance of bile acid concentration. An imbalance of cholesterol and bile acid ratio due to any undefined reason could cause gallstone formation. Hence, this paper aims to screen phytochemicals that could maintain a requisite balance of cholesterol and bile acid by targeting FXR and thereby contributing to the dissolution of gallstone. Nineteen phytochemicals were selected and queried for Pa and Pi in the way2drug online server for hepatoprotective property, cholesterol synthesis and absorption inhibition property, and β-glucuronidase inhibiting activity. Cianidanol, neoandrographolide, cynarine, saponins, and tanins with satisfying stated properties were docked with the screened FXR (PDB ID- 1OSH) using HADDOCK server, followed by pharmacokinetics study utilizing SwissADME tool. Neoandrographolide fits best among the other selected literature-based phytochemicals with minor violation of 'Brenk's rule'. The violation was corrected with the removal of an alkene group in the provided ChemDraw space of SwissADME. This Dealkenylated compound was further docked with FXR. The promising response under the static condition of the Dealkenylated compound was analyzed for molecular dynamic simulation at physiological conditions for 100 ns. Dealkenylated Neoandrographolide (DN) exhibited hepatoprotective, cholesterol synthesis and absorption inhibition property, and β-glucuronidase inhibition activity with a superior binding score of -42.6+/-1.5 with FXR. The interaction of the FXR receptor and the DN showed exceptional stability at physiological conditions during MD simulation and fit for the ADME properties, therefore it could be a potent candidate to dissolve gallstones.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Rajani Sharma
- Amity Institute of Biotechnology, Amity University Jharkhand, Ranchi, India
| | - Kunal Kumar
- Amity Institute of Biotechnology, Amity University Jharkhand, Ranchi, India
| | - Kumari Tanvi
- Amity Institute of Biotechnology, Amity University Jharkhand, Ranchi, India
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Miyakawa T, Michihata N, Morita K, Matsui H, Honda M, Yasunaga H. Ambient temperature and hospital admissions for acute cholecystitis: a nationwide inpatient database study in Japan. HPB (Oxford) 2022; 24:398-403. [PMID: 34284962 DOI: 10.1016/j.hpb.2021.06.431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The incidence of acute cholecystitis has a seasonal peak in summer. However, the reason for such seasonality remains unclear. This retrospective cohort study was performed to examine the association between ambient temperature and acute cholecystitis. METHODS We identified admissions for acute cholecystitis from January 2011 to December 2017 from a nationwide inpatient database in Japan. We performed a Poisson regression analysis to investigate the association between ambient temperature and admission for acute cholecystitis with adjustment for relative humidity, national holidays, day of the week, and year. We accounted for clustering of the outcome within prefectures using a generalized estimating equation. RESULTS We analyzed 601 665 admissions for acute cholecystitis. With an ambient temperature of 5.0 °C-9.9 °C as a reference, Poisson regression showed that the number of admissions increased significantly with increasing temperature (highest above 30 °C; relative risk, 1.35; 95% confidence interval, 1.34-1.37). An ambient temperature of <5.0 °C was also associated with higher admission for acute cholecystitis than an ambient temperature of 5.0 °C-9.9 °C (relative risk, 1.23; 95% confidence interval, 1.21-1.25). CONCLUSION The present nationwide Japanese inpatient database study showed that high temperature (≥10.0 °C) and low temperature (<5.0 °C) were associated with increased admission for acute cholecystitis.
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Affiliation(s)
- Teppei Miyakawa
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan; Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan.
| | - Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kojiro Morita
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan; Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Michitaka Honda
- Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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Environmental and Lifestyle Risk Factors in the Carcinogenesis of Gallbladder Cancer. J Pers Med 2022; 12:jpm12020234. [PMID: 35207722 PMCID: PMC8877116 DOI: 10.3390/jpm12020234] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/08/2021] [Accepted: 12/23/2021] [Indexed: 02/01/2023] Open
Abstract
Gallbladder cancer (GBC) is an aggressive neoplasm that in an early stage is generally asymptomatic and, in most cases, is diagnosed in advanced stages with a very low life expectancy because there is no curative treatment. Therefore, understanding the early carcinogenic mechanisms of this pathology is crucial to proposing preventive strategies for this cancer. The main risk factor is the presence of gallstones, which are associated with some environmental factors such as a sedentary lifestyle and a high-fat diet. Other risk factors such as autoimmune disorders and bacterial, parasitic and fungal infections have also been described. All these factors can generate a long-term inflammatory state characterized by the persistent activation of the immune system, the frequent release of pro-inflammatory cytokines, and the constant production of reactive oxygen species that result in a chronic damage/repair cycle, subsequently inducing the loss of the normal architecture of the gallbladder mucosa that leads to the development of GBC. This review addresses how the different risk factors could promote a chronic inflammatory state essential to the development of gallbladder carcinogenesis, which will make it possible to define some strategies such as anti-inflammatory drugs or public health proposals in the prevention of GBC.
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Belal S, Hamed HM, Kamal A, Al-Sayed MAW, Hamid HMAE. Risk Factors Associated with Cholelithiasis during Pregnancy and Postpartum. OPEN JOURNAL OF OBSTETRICS AND GYNECOLOGY 2022; 12:1166-1175. [DOI: 10.4236/ojog.2022.1211101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Liang KW, Huang HH, Wang L, Lu WY, Chou YH, Tantoh DM, Nfor ON, Chiu NY, Tyan YS, Liaw YP. Risk of gallstones based on ABCG8 rs11887534 single nucleotide polymorphism among Taiwanese men and women. BMC Gastroenterol 2021; 21:468. [PMID: 34906072 PMCID: PMC8672562 DOI: 10.1186/s12876-021-02060-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gallstones are abnormal masses caused by impaired metabolism of cholesterol, bilirubin, or bile salts in the gallbladder or biliary tract. ATP-binding cassette subfamily G member 8 (ABCG8) is a protein that regulates cholesterol efflux from the liver. Genome-wide association studies (GWAS) and meta-analyses of GWAS revealed the ABCG8 rs11887534 variant as the most common genetic determinant of gallstones in humans. These findings have not been extensively replicated in Taiwanese. Therefore, we appraised the relationship between gallstones and rs11887534 in a relatively large Taiwanese sample. METHODS We retrieved data collected through questionnaires, physical and biochemical tests from the Taiwan Biobank Bank (TWB). The study participants comprised 7388 men and 13,880 women who voluntarily enrolled in the Taiwan Biobank project between 2008 and 2019. Gallstones were self-reported. RESULTS The overall sample size was 21,268 comprising 938 gallstone patients and 20,330 non-gallstone individuals. Among the participants, 20,640 had the GG and 628 had the GC + CC genotype. At p-value < 0.05, the baseline genotypes and gallstone status between men and women were not significantly different. The risk of gallstones was higher in participants having the GC + CC compared to the GG genotype: odds ratio (OR); 95% confidence interval (CI) = 1.698; 1.240-2.325), but was lower in men compared to women (OR = 0.763; 95% CI = 0.638-0.913). Compared to men with the rs11887534 GG genotype, women with the GG and GC + CC genotypes had a higher risk of gallstone (OR; 95% CI = 1.304; 1.087-1.565 for GG and 2.291; 1.514-3.467 for GC + CC). The positive association between GC + CC and gallstones was retained after we restricted the analysis to the female participants (OR; 95% CI = 1.789 = 1.208-2.648). Hormone use was associated with an elevated risk of gallstones (OR; 95% CI = 1.359; 1.107-1.668). Relative to GG and no hormone use, we found a significantly high risk among hormone users with the GC + CC genotype (OR; 95% CI = 3.596; 1.495-8.650). CONCLUSIONS The rs11887534 GC + CC genotype was independently associated with a higher risk of gallstones. This risk was much higher among women, especially those who used hormones for various gynecological purposes.
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Grants
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
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Affiliation(s)
- Keng-Wei Liang
- Institute of Medicine, Chung Shan Medical University, Taichung City, 40201, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
| | - Hsin-Hui Huang
- School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
| | - Lee Wang
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Wen-Yu Lu
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Ying-Hsiang Chou
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Radiation Oncology, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Disline Manli Tantoh
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Oswald Ndi Nfor
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan.
| | - Neng-Yu Chiu
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
| | - Yeu-Sheng Tyan
- School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
| | - Yung-Po Liaw
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan.
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan.
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Choi H, Kwon SK, Han JH, Lee JS, Kang G, Kang M. Incidence of acute cholecystitis underwent cholecystectomy in incident dialysis patients: a nationwide population-based cohort study in Korea. Kidney Res Clin Pract 2021; 41:253-262. [PMID: 34974655 PMCID: PMC8995489 DOI: 10.23876/j.krcp.20.250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 06/28/2021] [Indexed: 12/07/2022] Open
Abstract
Background Patients on dialysis have numerous gastrointestinal problems related to uremia, which may represent concealed cholecystitis. We investigated the incidence and risk of acute cholecystitis in dialysis patients and used national health insurance data to identify acute cholecystitis in Korea. Methods The Korean National Health Insurance Database was used, with excerpted data from the insurance claim of the International Classification of Diseases code of dialysis and acute cholecystitis treated with cholecystectomy. We included all patients who commenced dialysis between 2004 and 2013 and selected the same number of controls via propensity score matching. Results A total of 59,999 dialysis and control patients were analyzed; of these, 3,940 dialysis patients (6.6%) and 647 controls (1.1%) developed acute cholecystitis. The overall incidence of acute cholecystitis was 8.04-fold higher in dialysis patients than in controls (95% confidence interval, 7.40–8.76). The acute cholecystitis incidence rate (incidence rate ratio, 23.13) was especially high in the oldest group of dialysis patients (aged ≥80 years) compared with that of controls. Dialysis was a significant risk factor for acute cholecystitis (adjusted hazard ratio, 8.94; 95% confidence interval, 8.19–9.76). Acute cholecystitis developed in 3,558 of 54,103 hemodialysis patients (6.6%) and in 382 of 5,896 patients (6.5%) undergoing peritoneal dialysis. Conclusions Patients undergoing dialysis had a higher incidence and risk of acute cholecystitis than the general population. The possibility of a gallbladder disorder developing in patients with gastrointestinal problems should be considered in the dialysis clinic.
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Affiliation(s)
- Hanlim Choi
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Soon Kil Kwon
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Joung-Ho Han
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Jun Su Lee
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Gilwon Kang
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Minseok Kang
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
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Kim Y, Oh C, Ha E, Park SK, Jung JY, Ryoo J. Association between metabolic syndrome and incidence of cholelithiasis in the Korean population. J Gastroenterol Hepatol 2021; 36:3524-3531. [PMID: 34097775 PMCID: PMC9291184 DOI: 10.1111/jgh.15568] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/26/2021] [Accepted: 06/05/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIM Cholelithiasis is one of the most common gastrointestinal diseases worldwide. The metabolic syndrome (MetS), a combination of various metabolic abnormalities, is also common with a continually increasing prevalence. These diseases are associated with several risk factors. However, data on the association between MetS components and cholelithiasis are insufficient. This study aimed to analyze the association of MetS and its components with the incidence of cholelithiasis using national data from the Korean population. METHODS Data were obtained from the National Health Insurance Corporation of Korea, and 207 850 individuals without cholelithiasis in 2009 were enrolled and followed up until 2013. A multivariate Cox proportional hazard model was used to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of cholelithiasis according to the presence of MetS and the number of MetS components. Furthermore, the risk of cholelithiasis was evaluated in individuals with a single metabolic component. RESULTS The multivariate adjusted HRs and 95% CIs for incident cholelithiasis according to 1, 2, 3, and 4-5 MetS components were 1.08 (0.93-1.24), 1.22 (1.06-1.41), 1.35 (1.17-1.57), and 1.35 (1.15-1.57), respectively (P < 0.001). This increasing trend was observed in both sexes. Compared with participants with no metabolic components, those with low high-density lipoprotein (HDL) cholesterol had a significantly increased risk for cholelithiasis (adjusted HR, 1.39 [95% CI, 1.05-1.85]). CONCLUSIONS Metabolic syndrome is a potential risk factor for cholelithiasis. Low HDL cholesterol level is the most relevant factor among MetS components for incident cholelithiasis.
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Affiliation(s)
- Yeji Kim
- Department of Occupational and Environmental MedicineKyung Hee University HospitalSeoulKorea
| | - Chang‐Mo Oh
- Department of Preventive Medicine, School of MedicineKyung Hee UniversitySeoulKorea
| | - Eunhee Ha
- Department of Occupational and Environment Medicine, College of MedicineEwha Womans UniversitySeoulKorea
| | - Sung Keun Park
- Total Healthcare Center, Kangbuk Samsung Hospital, School of MedicineSungkyunkwan UniversitySeoulKorea
| | - Ju Young Jung
- Total Healthcare Center, Kangbuk Samsung Hospital, School of MedicineSungkyunkwan UniversitySeoulKorea
| | - Jae‐Hong Ryoo
- Department of Occupational and Environmental Medicine, School of MedicineKyung Hee UniversitySeoulKorea
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Allan F, Watson PJ, McCallum KE. Clinical features and outcomes in 38 dogs with cholelithiasis receiving conservative or surgical management. J Vet Intern Med 2021; 35:2730-2742. [PMID: 34714561 PMCID: PMC8692201 DOI: 10.1111/jvim.16284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 09/17/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022] Open
Abstract
Background Ursodeoxycholic acid is used in human medicine for litholytic management of choleliths, but the efficacy of medical management in dogs with cholelithiasis is unknown. Objectives To describe the clinical features and outcomes of dogs with cholelithiasis, focusing on cases that received medical treatment, and to identify patient factors that influenced decision‐making for surgical or medical management. Animals Thirty‐eight dogs with cholelithiasis identified on abdominal ultrasonography (AUS). Methods Medical records of dogs with cholelithiasis on AUS between 2010 and 2019 were retrospectively reviewed. Cases were classified as symptomatic (n = 18) or incidental (n = 20) and divided into medically treated (n = 13), surgically treated (n = 10), and no treatment (n = 15) groups. Biochemical variables and cholelith location were compared between symptomatic and incidental groups using Mann‐Whitney U and chi‐squared tests, respectively. Survival times were compared using Kaplan‐Meier survival analysis. Results Symptomatic cases had higher alkaline phosphatase (P = .03), gamma‐glutamyl transferase (P = .03), and alanine transferase (P = .02) activities than did incidental cases. A higher proportion of symptomatic cases (44.4%) had choledocholithiasis than did incidental cases (0%; P = .003). Seventy percent of surgically managed dogs, 7.7% of medically managed dogs, and 0% of nontreated dogs had choledocholiths at presentation. Seventeen dogs had follow‐up AUS: cholelithiasis completely resolved in 4/8 medically treated, 5/7 of surgically treated, and 1/2 nontreated dogs. Median survival time was 457.4 days, with no significant difference between incidental and symptomatic dogs. Conclusions and Clinical Importance Medical treatment can be effective for management of cholelithiasis in dogs, with clinical presentation and cholelith location playing important roles in treatment decision‐making.
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Affiliation(s)
- Frederik Allan
- Queen's Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Penny J Watson
- Queen's Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Katie E McCallum
- Queen's Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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Liu S, Luorong Q, Hu K, Cao W, Tao W, Liu H, Zhang D. Aqueous Extract of Lysimachia christinae Hance Prevents Cholesterol Gallstone in Mice by Affecting the Intestinal Microflora. J Microbiol Biotechnol 2021; 31:1272-1280. [PMID: 34261853 PMCID: PMC9706107 DOI: 10.4014/jmb.2106.06043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 12/15/2022]
Abstract
With changes in human dietary patterns, the proportion of high-fat and high-cholesterol foods in the daily diet has increased. As a result, the incidence rate of cholelithiasis is increasing rapidly. Many studies have reported on the crucial role that the intestinal microflora plays in the progression of gallstones. Although the whole herb of Lysimachia christinae, a traditional Chinese medicine, has long been extensively used as a remedy for cholelithiasis in China, its effects on the intestinal microflora remain unknown. Hence, in this study, we investigated the ability of the aqueous extract of L. christinae (LAE) to prevent cholesterol gallstones (CGSs) in model animals by affecting the intestinal microflora. The effects of LAE on body weight, serum lipid profile, visceral organ indexes, and histomorphology were studied in male C57BL/6J mice, which were induced by a lithogenic diet. After the 8-week study, CGSs formation was greatly reduced after LAE treatment. LAE also reduced body weight gain and hyperlipidemia and restored the histomorphological changes. Moreover, the intestinal microflora exhibited significant variation. In the model group fed the lithogenic diet, the abundances of the genera unclassified Porphyromonadaceae, Lactobacillus and Alloprevotella decreased, but in contrast, Akkermansia dramatically increased compared with the control check group, which was fed a normal diet; the administration of LAE reversed these changes. These results imply that L. christinae can be considered an efficient therapy for eliminating CGSs induced by a high-fat and high-cholesterol diet, which may be achieved by influencing the intestinal microflora.
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Affiliation(s)
- Shijia Liu
- First Clinical College, Chongqing Medical University, Chongqing 400016, P.R.China
| | - Quji Luorong
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing 400016, P.R.China
| | - Kaizhi Hu
- Chongqing Institute of Pharmaceutical Plant, Chongqing 408435, P.R.China
| | - Weiguo Cao
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing 400016, P.R.China
| | - Wei Tao
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing 400016, P.R.China
| | - Handeng Liu
- Laboratory of Tissue and Cell Biology, Experimental Teaching Center, Chongqing Medical University, Chongqing 400016, P.R.China,Molecular Medicine and Cancer Research Center, Department of Cell Biology and Genetics, Chongqing Medical University, Chongqing 400016, P.R.China,Corresponding authors H. Liu Phone: +86-23-6571-2090 E-mail:
| | - Dan Zhang
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing 400016, P.R.China,
D. Zhang Phone: +86-23-6370-2109 E-mail: zhangdan01234567@ hotmail.com
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Sartelli M, Coccolini F, Kluger Y, Agastra E, Abu-Zidan FM, Abbas AES, Ansaloni L, Adesunkanmi AK, Atanasov B, Augustin G, Bala M, Baraket O, Baral S, Biffl WL, Boermeester MA, Ceresoli M, Cerutti E, Chiara O, Cicuttin E, Chiarugi M, Coimbra R, Colak E, Corsi D, Cortese F, Cui Y, Damaskos D, de’ Angelis N, Delibegovic S, Demetrashvili Z, De Simone B, de Jonge SW, Dhingra S, Di Bella S, Di Marzo F, Di Saverio S, Dogjani A, Duane TM, Enani MA, Fugazzola P, Galante JM, Gachabayov M, Ghnnam W, Gkiokas G, Gomes CA, Griffiths EA, Hardcastle TC, Hecker A, Herzog T, Kabir SMU, Karamarkovic A, Khokha V, Kim PK, Kim JI, Kirkpatrick AW, Kong V, Koshy RM, Kryvoruchko IA, Inaba K, Isik A, Iskandar K, Ivatury R, Labricciosa FM, Lee YY, Leppäniemi A, Litvin A, Luppi D, Machain GM, Maier RV, Marinis A, Marmorale C, Marwah S, Mesina C, Moore EE, Moore FA, Negoi I, Olaoye I, Ordoñez CA, Ouadii M, Peitzman AB, Perrone G, Pikoulis M, Pintar T, Pipitone G, Podda M, Raşa K, Ribeiro J, Rodrigues G, Rubio-Perez I, Sall I, Sato N, Sawyer RG, Segovia Lohse H, Sganga G, Shelat VG, Stephens I, Sugrue M, Tarasconi A, Tochie JN, Tolonen M, Tomadze G, et alSartelli M, Coccolini F, Kluger Y, Agastra E, Abu-Zidan FM, Abbas AES, Ansaloni L, Adesunkanmi AK, Atanasov B, Augustin G, Bala M, Baraket O, Baral S, Biffl WL, Boermeester MA, Ceresoli M, Cerutti E, Chiara O, Cicuttin E, Chiarugi M, Coimbra R, Colak E, Corsi D, Cortese F, Cui Y, Damaskos D, de’ Angelis N, Delibegovic S, Demetrashvili Z, De Simone B, de Jonge SW, Dhingra S, Di Bella S, Di Marzo F, Di Saverio S, Dogjani A, Duane TM, Enani MA, Fugazzola P, Galante JM, Gachabayov M, Ghnnam W, Gkiokas G, Gomes CA, Griffiths EA, Hardcastle TC, Hecker A, Herzog T, Kabir SMU, Karamarkovic A, Khokha V, Kim PK, Kim JI, Kirkpatrick AW, Kong V, Koshy RM, Kryvoruchko IA, Inaba K, Isik A, Iskandar K, Ivatury R, Labricciosa FM, Lee YY, Leppäniemi A, Litvin A, Luppi D, Machain GM, Maier RV, Marinis A, Marmorale C, Marwah S, Mesina C, Moore EE, Moore FA, Negoi I, Olaoye I, Ordoñez CA, Ouadii M, Peitzman AB, Perrone G, Pikoulis M, Pintar T, Pipitone G, Podda M, Raşa K, Ribeiro J, Rodrigues G, Rubio-Perez I, Sall I, Sato N, Sawyer RG, Segovia Lohse H, Sganga G, Shelat VG, Stephens I, Sugrue M, Tarasconi A, Tochie JN, Tolonen M, Tomadze G, Ulrych J, Vereczkei A, Viaggi B, Gurioli C, Casella C, Pagani L, Baiocchi GL, Catena F. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections. World J Emerg Surg 2021; 16:49. [PMID: 34563232 PMCID: PMC8467193 DOI: 10.1186/s13017-021-00387-8] [Show More Authors] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/05/2021] [Indexed: 02/08/2023] Open
Abstract
Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.
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Affiliation(s)
- Massimo Sartelli
- Department of Surgery Department of Surgery, Macerata Hospital, Macerata, Italy
| | - Federico Coccolini
- Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Yoram Kluger
- Department of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ervis Agastra
- General Surgery Department, Regional Hospital of Durres, Durres, Albania
| | - Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Ashraf El Sayed Abbas
- Department of General and Emergency Surgery Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt
| | - Luca Ansaloni
- Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Abdulrashid Kayode Adesunkanmi
- Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Osun State, Ile-Ife, Nigeria
| | - Boyko Atanasov
- Department of General Surgery, Medical University of Plovdiv, UMHAT Eurohospital, Plovdiv, Bulgaria
| | - Goran Augustin
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Miklosh Bala
- Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Oussama Baraket
- Department of general surgery Bizerte hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Suman Baral
- Department of Surgery, Lumbini Medical College and Teaching Hospital Ltd., Palpa, Tansen, Nepal
| | - Walter L. Biffl
- Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA USA
| | - Marja A. Boermeester
- Department of Surgery, Amsterdam University Medical Centers, location AMC, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, The Netherlands
| | - Marco Ceresoli
- Emergency and General Surgery Department, University of Milan-Bicocca, Milan, Italy
| | - Elisabetta Cerutti
- Anesthesia and Transplant Surgical Intensive Care Unit, Ospedali Riuniti, Ancona, Italy
| | - Osvaldo Chiara
- Emergency Department, Niguarda Ca’Granda Hospital, Milan, Italy
| | - Enrico Cicuttin
- Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Massimo Chiarugi
- Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Raul Coimbra
- Riverside University Health System, CECORC Research Center, Loma Linda University, Loma Linda, USA
| | - Elif Colak
- Department of General Surgery, Health Sciences University, Samsun Training and Research Hospital, Samsun, Turkey
| | - Daniela Corsi
- General Direction, Area Vasta 3, ASUR Marche, Macerata, Italy
| | | | - Yunfeng Cui
- Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | | | - Nicola de’ Angelis
- Minimally Invasive and Robotic Digestive Surgery Unit, Regional General Hospital F. Miulli, Bari, Italy
- Université Paris Est, UPEC, Creteil, France
| | - Samir Delibegovic
- Department of Surgery, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zaza Demetrashvili
- Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Belinda De Simone
- Department of general, Digestive and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal De Poissy/St Germain en Laye, Poissy, France
| | - Stijn W. de Jonge
- Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA USA
| | - Sameer Dhingra
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, Bihar India
| | - Stefano Di Bella
- Clinical Department of Medical, Surgical and Health sciences, Trieste University, Trieste, Italy
| | | | - Salomone Di Saverio
- Department of General Surgery, University of Insubria, University Hospital of Varese, ASST Sette Laghi, Regione Lombardia, Varese, Italy
| | - Agron Dogjani
- Department of Surgery, University Hospital of Trauma, Tirana, Albania
| | - Therese M. Duane
- Department of Surgery, Texas Health Resources, Fort Worth, TX USA
| | - Mushira Abdulaziz Enani
- Department of Medicine, Infectious Disease Division, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Paola Fugazzola
- Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Joseph M. Galante
- Division of Trauma and Acute Care Surgery, Department of Surgery, University of California Davis, Sacramento, CA USA
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia
| | - Wagih Ghnnam
- Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - George Gkiokas
- Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlos Augusto Gomes
- Department of Surgery, Hospital Universitário Terezinha de Jesus, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, Brazil
| | - Ewen A. Griffiths
- Department of Upper GI Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Timothy C. Hardcastle
- Trauma Service, Inkosi Albert Luthuli Central Hospital and Department of Surgery, Nelson R Mandela School of Clinical Medicine, Durban, South Africa
| | - Andreas Hecker
- Department of General and Thoracic Surgery, University Hospital Giessen, Giessen, Germany
| | - Torsten Herzog
- Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Syed Mohammad Umar Kabir
- Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland
| | - Aleksandar Karamarkovic
- Surgical Clinic “Nikola Spasic”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Peter K. Kim
- Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Jae Il Kim
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Andrew W. Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Victor Kong
- Department of Surgery, Edendale Hospital, Pietermaritzburg, South Africa
| | - Renol M. Koshy
- Department of General Surgery, University Hospital of Coventry & Warwickshire, Coventry, UK
| | | | - Kenji Inaba
- Division of Trauma and Surgical Critical Care, Department of Surgery, University of Southern California, Los Angeles, CA USA
| | - Arda Isik
- Department of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Katia Iskandar
- Department of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rao Ivatury
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA USA
| | | | - Yeong Yeh Lee
- School of Medical Sciences, Universitiy Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Ari Leppäniemi
- Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Andrey Litvin
- Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia
| | - Davide Luppi
- Department of General and Emergency Surgery, ASMN, Reggio Emilia, Italy
| | - Gustavo M. Machain
- Department of Surgery, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | - Ronald V. Maier
- Department of Surgery, University of Washington, Seattle, WA USA
| | | | - Cristina Marmorale
- Department of Surgery, Università Politecnica delle Marche, Ancona, Italy
| | - Sanjay Marwah
- Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - Cristian Mesina
- Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania
| | - Ernest E. Moore
- Ernest E Moore Shock Trauma Center at Denver Health, Denver, USA
| | - Frederick A. Moore
- Department of Surgery, Division of Acute Care Surgery, and Center for Sepsis and Critical Illness Research, University of Florida College of Medicine, Gainesville, FL USA
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Iyiade Olaoye
- Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Carlos A. Ordoñez
- Division of Trauma and Acute Care Surgery, Fundacion Valle del Lili, Cali, Colombia
- Department of Surgery, Universidad del Valle, Cali, Colombia
| | - Mouaqit Ouadii
- Department of Surgery, Hassan II University Hospital, Medical School of Fez, Sidi Mohamed Benabdellah University, Fez, Morocco
| | - Andrew B. Peitzman
- Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, USA
| | - Gennaro Perrone
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Manos Pikoulis
- 3rd Department of Surgery, Attiko Hospital, MSc “Global Health-Disaster Medicine”, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Tadeja Pintar
- Department of Surgery, UMC Ljubljana, Ljubljana, Slovenia
| | - Giuseppe Pipitone
- National Institute for Infectious Diseases - INMI - Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Mauro Podda
- Department of General and Emergency Surgery, Cagliari University Hospital, Cagliari, Italy
| | - Kemal Raşa
- Department of Surgery, Anadolu Medical Center, Kocaeli, Turkey
| | | | - Gabriel Rodrigues
- Department of General Surgery, Kasturba Medical College & Hospital, Manipal Academy of Higher Education, Manipal, India
| | - Ines Rubio-Perez
- General Surgery Department, Colorectal Surgery Unit, La Paz University Hospital, Madrid, Spain
| | - Ibrahima Sall
- General Surgery Department, Military Teaching Hospital, Dakar, Senegal
| | - Norio Sato
- Department of Aeromedical Services for Emergency and Trauma Care, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Robert G. Sawyer
- Department of Surgery, Western Michigan University School of Medicine, Kalamazoo, MI USA
| | | | - Gabriele Sganga
- Department of Medical and Surgical Sciences, Emergency Surgery & Trauma, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vishal G. Shelat
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Ian Stephens
- Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland
| | - Michael Sugrue
- Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland
| | - Antonio Tarasconi
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Joel Noutakdie Tochie
- Department of Emergency medicine, Anesthesiology and critical care, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Matti Tolonen
- Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Gia Tomadze
- Surgery Department, Tbilisi State Medical University, Tbilisi, Georgia
| | - Jan Ulrych
- First Department of Surgery, Department of Abdominal, Thoracic Surgery and Traumatology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Andras Vereczkei
- Department of Surgery, Clinical Center University of Pecs, Pecs, Hungary
| | - Bruno Viaggi
- Department of Anesthesiology, Neuro Intensive Care Unit, Florence Careggi University Hospital, Florence, Italy
| | - Chiara Gurioli
- Department of Surgery, Camerino Hospital, Macerata, Italy
| | - Claudio Casella
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Leonardo Pagani
- Department of Infectious Diseases, Bolzano Hospital, Bolzano, Italy
| | - Gian Luca Baiocchi
- Department of Surgery, AAST Cremona, Cremona, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
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Jorba R, Pavel MC, Llàcer-Millán E, Estalella L, Achalandabaso M, Julià-Verdaguer E, Nve E, Padilla-Zegarra ED, Badia JM, O'Connor DB, Memba R. Contemporary management of concomitant gallstones and common bile duct stones: a survey of Spanish surgeons. Surg Endosc 2021; 35:5024-5033. [PMID: 32968916 DOI: 10.1007/s00464-020-07984-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/14/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Concomitant gallstones and common bile duct stones (CBDS) is a relatively frequent presentation. The optimal treatment remains controversial and the debate persists between two strategies. The one-stage approach: laparoscopic cholecystectomy with laparoscopic common bile duct exploration (LCBDE) has been shown to be equally safe and more cost-effective than the more traditional two-stage approach: endoscopic retrograde cholangiography followed by laparoscopic cholecystectomy (ERCP + LC). However, many surgeons worldwide still prefer the two-stage procedure. This survey evaluated contemporary management of CBDS in Spain and assessed the impact of surgeon and hospital factors on provision of LCBDE. METHODS A 25-item, web-based anonymous survey was sent to general surgeons members of the Spanish Surgeons Association. Descriptive statistics were applied to summarize results. RESULTS Responses from 305 surgeons across 173 Spanish hospitals were analyzed. ERCP is the initial approach for preoperatively suspected CBDS for 86% of surgeons. LCBDE is the preferred method for only 11% of surgeons and only 11% treat more than 10 cases per year. For CBDS discovered intraoperatively, 59% of respondents attempt extraction while 32% defer to a postoperative ERCP. The main reasons cited for not performing LCBDE were lack of equipment, training and timely availability of an ERCP proceduralist. Despite these barriers, most surgeons (84%) responded that LCBDE should be implemented in their departments. CONCLUSIONS ERCP was the preferred approach for CBDS for the majority of respondents. There remains limited use of LCBDE despite many surgeons indicating it should be implemented. Focused planning and resourcing of both training and operational demands are required to facilitate adoption of LCBDE as option for patients.
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Affiliation(s)
- Rosa Jorba
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain.
| | - Mihai C Pavel
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Erik Llàcer-Millán
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Laia Estalella
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Mar Achalandabaso
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Elisabet Julià-Verdaguer
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Esther Nve
- Department of General Surgery, Hospital de Granollers, Granollers, Spain
| | - Erlinda D Padilla-Zegarra
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
| | - Josep M Badia
- Department of General Surgery, Hospital de Granollers, Granollers, Spain
| | - Donal B O'Connor
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Robert Memba
- Department of Abdominal and General Surgery, Hospital Universitari de Tarragona, Joan XXIII, Dr Mallafre Guasch, 4, 43005, Tarragona, Spain
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Majeed NF, Braschi Amirfarzan M, Wald C, Wortman JR. Spectral detector CT applications in advanced liver imaging. Br J Radiol 2021; 94:20201290. [PMID: 34048285 PMCID: PMC8248211 DOI: 10.1259/bjr.20201290] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/16/2021] [Accepted: 05/13/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Spectral detector CT (SDCT) has many applications in advanced liver imaging. If appropriately utilized, this technology has the potential to improve image quality, provide new diagnostic information, and allow for decreased radiation dose. The purpose of this review is to familiarize radiologists with the uses of SDCT in liver imaging. CONCLUSION SDCT has a variety of post-processing techniques, which can be used in advanced liver imaging and can significantly add value in clinical practice.
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Affiliation(s)
- Noor Fatima Majeed
- Department of Radiology, Lahey Hospital and Medical Center, 41 Burlington Mall Road, Burlington, United States
| | - Marta Braschi Amirfarzan
- Department of Radiology, Lahey Hospital and Medical Center, 41 Burlington Mall Road, Burlington, United States
| | - Christoph Wald
- Department of Radiology, Lahey Hospital and Medical Center, 41 Burlington Mall Road, Burlington, United States
| | - Jeremy R Wortman
- Department of Radiology, Lahey Hospital and Medical Center, 41 Burlington Mall Road, Burlington, United States
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48
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Fu BB, Zhao JN, Wu SD, Fan Y. Cholesterol gallstones: Focusing on the role of interstitial Cajal-like cells. World J Clin Cases 2021; 9:3498-3505. [PMID: 34046450 PMCID: PMC8130069 DOI: 10.12998/wjcc.v9.i15.3498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/08/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023] Open
Abstract
Cholesterol gallstone (CG) is a common, frequent biliary system disease in China, with a complex and multifactorial etiology. Declined gallbladder motility reportedly contributes to CG pathogenesis. Furthermore, interstitial Cajal-like cells (ICLCs) are reportedly present in human and guinea pig gallbladder tissue. ICLCs potentially contribute to the regulation of gallbladder motility, and aberrant conditions involving the loss of ICLCs and/or a reduction in its pacing potential and reactivity to cholecystokinin may promote CG pathogenesis. This review discusses the association between ICLCs and CG pathogenesis and provides a basis for further studies on the functions of ICLCs and the etiologies of CG.
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Affiliation(s)
- Bei-Bei Fu
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Jian-Nan Zhao
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Shuo-Dong Wu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Ying Fan
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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49
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Zhou Q, Hu H, Zhao G, Liu P, Wang Y, Zhang H. Effect and related mechanism of Yinchenhao decoction on mice with lithogenic diet-induced cholelithiasis. Exp Ther Med 2021; 21:316. [PMID: 33717259 PMCID: PMC7885065 DOI: 10.3892/etm.2021.9747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to investigate the effects and the underlying mechanisms of Yinchenhao Decoction (YCHD), a traditional Chinese medicine formulation, on C57BL/6 mice with lithogenic diet (LD)-induced cholelithiasis. The condition of cholelithiasis was evaluated using a six-level criteria. Levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) in the serum and liver tissue were measured using enzyme colorimetry. Concentrations of TC, phospholipids (PL) and total bile acids (TBA) in the bile were measured to calculate the cholesterol saturation index. Liver histopathology was microscopically observed and mRNA expression levels of ABCG5, ABCG8, SRBI, ABCB4, ABCB11 and NPC1L1 involved in cholesterol metabolism were measured using reverse transcription-quantitative PCR. The results showed that feeding mice the LD induced cholelithiasis, along with abnormal serum biochemical indices and imbalances in biliary cholesterol homeostasis. Increased ALT and ALP levels in the serum and ALT, ALP, TC and LDL-C levels in the serum and liver indicated the existence of hepatocyte injury, which were consistent with the pathological changes. YCHD treatment ameliorated the serum and hepatic biochemical abnormalities and adjusted the biliary imbalance. In addition, elevated expression of ATP-binding cassette subfamily G member 5/8, scavenger receptor class B type I and Niemann-Pick C1 Like 1 in the liver and small intestine were observed at the onset of cholelithiasis but were reversed by YCHD. Taken together, results from the present study suggest that YCHD ameliorated LD-induced cholelithiasis mice, which may be caused by improvements in biliary cholesterol supersaturation and regulation of cholesterol metabolism.
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Affiliation(s)
- Qun Zhou
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Key Laboratory of Clinical Chinese Medicine, Key Laboratory of Liver and Kidney Diseases of Ministry of Education, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai 201203, P.R. China
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P.R. China
| | - Hai Hu
- Department of Cholelithiasis, East Hospital Affiliated to Tongji University, Shanghai 200120, P.R. China
| | - Gang Zhao
- Department of Cholelithiasis, East Hospital Affiliated to Tongji University, Shanghai 200120, P.R. China
| | - Ping Liu
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Key Laboratory of Clinical Chinese Medicine, Key Laboratory of Liver and Kidney Diseases of Ministry of Education, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai 201203, P.R. China
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P.R. China
| | - Yixing Wang
- Department of Traditional Chinese Medicine, East Hospital Affiliated to Tongji University, Shanghai 200120, P.R. China
| | - Hua Zhang
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Key Laboratory of Clinical Chinese Medicine, Key Laboratory of Liver and Kidney Diseases of Ministry of Education, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai 201203, P.R. China
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50
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Wu Y, Xu CJ, Xu SF. Advances in Risk Factors for Recurrence of Common Bile Duct Stones. Int J Med Sci 2021; 18:1067-1074. [PMID: 33456365 PMCID: PMC7807200 DOI: 10.7150/ijms.52974] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022] Open
Abstract
Choledocholithiasis is a chronic common disease. The incidence of cholelithiasis is 5%-15%, of which 5%-30% are combined with Choledocholithiasis. Although endoscopic cholangiopancreatography (ERCP) + endoscopic sphincterotomy (EST) is the most common treatment procedure, which clearance rate is up to 95%, the incidence of recurrent choledocholithiasis was 4%-25%. The risk factors of recurrence after choledocholithiasis clearance are the focuses of current researches, which are caused by multiple factors. We first systematically summarize the risk factors of common bile duct stones (CBDS) recurrence into five aspects: first-episode stone related factors, congenital factors, biological factors, behavioral intervention factors, and the numbers of stone recurrence.
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Affiliation(s)
- Yao Wu
- Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211100, China
| | - Chen Jing Xu
- Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211100, China
| | - Shun Fu Xu
- Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211100, China.,Jiangsu Province Hospital, Nanjing Medical University, Nanjing, 210029, China
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