AIM:To investigate the pathogenesis of biliary casts after liver transplantation relative to their morphology and biochemical markers.METHODS:The microstructure of biliary casts was assessed using scanning electron mi...AIM:To investigate the pathogenesis of biliary casts after liver transplantation relative to their morphology and biochemical markers.METHODS:The microstructure of biliary casts was assessed using scanning electron microscopy and Hematoxylin and eosin staining assessed their histology.The expression levels of CD3,CD5,CD34,CD68 and CD79a in these biliary casts were evaluated immunohistochemically.RESULTS:Biliary casts differed widely in their microstructure,with some containing blood vessels positive for CD34 and collagen fibers with positive Masson staining.Large numbers of neutrophils and other inflammatory cells were present,but only on the edge of the biliary casts;although the boundaries were clear without crossover.None of the biliary casts contained T-lymphocytes,B-lymphocytes,macrophages and other inflammatory cells.CONCLUSION:The microcostructure of biliary casts differed.Bacteria and acute rejection are not clearly related to their formation.展开更多
Fibrin glue is widely used in clinical practice and plays an important role in reducing postoperative complications.We report a case of a 65-year-old man, whose common bile duct was injured by fibrin glue, with a hist...Fibrin glue is widely used in clinical practice and plays an important role in reducing postoperative complications.We report a case of a 65-year-old man, whose common bile duct was injured by fibrin glue, with a history of failed laparoscopic cholecystectomy and open operation for uncontrolled laparoscopic bleeding.In view of thepersistent liver dysfunction, xanthochromia and skin itching, the patient was admitted to us for further management.Ultrasound, computed tomography, and magnetic resonance cholangiopancreatography(MRCP) revealed multiple stones in the common bile duct, and liver function tests confirmed the presence of obstructive jaundice and liver damage.Endoscopic retrograde cholangiopancreatography was unsuccessfully performed to remove choledocholithiasis, but a small amount of tissue was removed and pathologically confirmed as calcified biliary mucosa.This was followed by open surgery for suspicious cholangiocarcinoma.There was no evidence of cholangiocarcinoma, but the common bile duct wall had a defect of 8 mm × 10 mm at Calot's triangle.A hard, grid-like foreign body was removed, which proved to be solid fibrin glue.Subsequently, the residual choledocholithiasis was removed by a choledochoscopic procedure, and the common bile duct deletion was repaired by liver round ligament with T-tube drainage.Six months later, endoscopy was performed through the T-tube fistula and showed a well-repaired bile duct wall.Eight months later, MRCP confirmed no bile duct stenosis.A review of reported cases showed that fibrin glue is widely used in surgery, but it can also cause organ damage.Its mechanism may be related to discharge reactions.展开更多
文摘AIM:To investigate the pathogenesis of biliary casts after liver transplantation relative to their morphology and biochemical markers.METHODS:The microstructure of biliary casts was assessed using scanning electron microscopy and Hematoxylin and eosin staining assessed their histology.The expression levels of CD3,CD5,CD34,CD68 and CD79a in these biliary casts were evaluated immunohistochemically.RESULTS:Biliary casts differed widely in their microstructure,with some containing blood vessels positive for CD34 and collagen fibers with positive Masson staining.Large numbers of neutrophils and other inflammatory cells were present,but only on the edge of the biliary casts;although the boundaries were clear without crossover.None of the biliary casts contained T-lymphocytes,B-lymphocytes,macrophages and other inflammatory cells.CONCLUSION:The microcostructure of biliary casts differed.Bacteria and acute rejection are not clearly related to their formation.
文摘Fibrin glue is widely used in clinical practice and plays an important role in reducing postoperative complications.We report a case of a 65-year-old man, whose common bile duct was injured by fibrin glue, with a history of failed laparoscopic cholecystectomy and open operation for uncontrolled laparoscopic bleeding.In view of thepersistent liver dysfunction, xanthochromia and skin itching, the patient was admitted to us for further management.Ultrasound, computed tomography, and magnetic resonance cholangiopancreatography(MRCP) revealed multiple stones in the common bile duct, and liver function tests confirmed the presence of obstructive jaundice and liver damage.Endoscopic retrograde cholangiopancreatography was unsuccessfully performed to remove choledocholithiasis, but a small amount of tissue was removed and pathologically confirmed as calcified biliary mucosa.This was followed by open surgery for suspicious cholangiocarcinoma.There was no evidence of cholangiocarcinoma, but the common bile duct wall had a defect of 8 mm × 10 mm at Calot's triangle.A hard, grid-like foreign body was removed, which proved to be solid fibrin glue.Subsequently, the residual choledocholithiasis was removed by a choledochoscopic procedure, and the common bile duct deletion was repaired by liver round ligament with T-tube drainage.Six months later, endoscopy was performed through the T-tube fistula and showed a well-repaired bile duct wall.Eight months later, MRCP confirmed no bile duct stenosis.A review of reported cases showed that fibrin glue is widely used in surgery, but it can also cause organ damage.Its mechanism may be related to discharge reactions.
