This study reports a case of unresectable intrahepatic mass-forming cholangiocarcinoma which showed a dramatic response to gemcitabine that led to curative resection and a long-term survival of more than five years.Si...This study reports a case of unresectable intrahepatic mass-forming cholangiocarcinoma which showed a dramatic response to gemcitabine that led to curative resection and a long-term survival of more than five years.Six and five cycles of gemcitabine monotherapy were administered separately over a three-year period and a radical excision was performed at 4.5 years after diagnosis.This case indicates the role of gemcitabine as a neoadjuvant chemotherapeutic agent for cholangiocarcinoma and guarantees a randomized controlled prospective study.展开更多
AIM: To compare the value of endoscopic retrograde cholangiography (ERC) and standard T2-weighted magnetic resonance cholangiography (MRC) in the evaluation process as adult-to-adult right lobe living donor liver tran...AIM: To compare the value of endoscopic retrograde cholangiography (ERC) and standard T2-weighted magnetic resonance cholangiography (MRC) in the evaluation process as adult-to-adult right lobe living donor liver transplantation (LDLTx) demands a successful outcome, and exact knowledge of the biliary tree is implicated to avoid biliary complications, postoperatively.METHODS: After starting the LDLTx program, 18 liver transplant candidates were selected for LDLTx by a stepwise evaluation process. ERC and standard T2-weighted MRC were performed to evaluate the biliary system of the donor liver. The anatomical findings of ERC and MRC mapping were compared using the Ohkubo classification. RESULTS: ERC allowed mapping of the whole biliary system in 15/15 (100%) cases, including 14/15 (93.3%) with biliary variants while routine MRC was only accurate in 2/13 (15.4%) cases. MRC was limited in depicting the biliary system proximal of the hepatic bifurcation. Postoperative biliary complications occurred in 2 donors and 8 recipients. Biliary complications were associated with Ohkubo type C, E or G in 6/8 recipients, and 2/3 recipients with biliary leak received a graft with multiple (≥2) bile ducts. CONCLUSION: Pretransplant ERC is safe and superior over standard MRC for detection of biliary variations that occur with a high frequency. However, precise knowledge of biliary variants did not reduce the incidence of postoperative biliary complications.展开更多
目的 观察肝脏祖细胞(hepatic progenitor cells,hpcs)在乙型肝炎肝硬化患者肝组织中的激活特征,探讨hbv感染是否影响hpcs的激活.方法 以细胞角蛋白(ck7)为标记,对16例乙型肝炎肝硬化患者的肝组织做免疫组织化学染色,定量分析hpcs数目...目的 观察肝脏祖细胞(hepatic progenitor cells,hpcs)在乙型肝炎肝硬化患者肝组织中的激活特征,探讨hbv感染是否影响hpcs的激活.方法 以细胞角蛋白(ck7)为标记,对16例乙型肝炎肝硬化患者的肝组织做免疫组织化学染色,定量分析hpcs数目及胆管反应面积.hbsag和hbcag染色,观察两种病毒蛋白的表达与hpcs激活的关系.结果 乙型肝炎肝硬化患者肝组织中hpcs激活程度高,胆管反应明显.肝组织中hbsag的表达与hpcs激活程度呈正相关.结论 在乙型肝炎肝硬化患者的肝组织中,hpcs被明显激活和扩增,hbv感染可能参与hpcs的激活.
abstract：
objective to observe the characteristics of hepatic progenitor cells(hpcs)activation in liver tissues of patients with hepatitis b cirrhosis,and to investigate the relationship between the number of hpcs and hbv infection.methods cytokeratin 7(ck7)-was stained immunohistochemically in liver tissues of 16 patients with hepatitis b cirrhosis.hpcs and duetular reactions were quantitively analyzed.the expression of hbsag and hbcag were also detected to evaluate its relationship with hpcs activation.results hpcs were extensively activated and marked duetular reactions can be observed in cirrhotic liver tissues.tlle expression of hbsag was positively correlated with hpcs activation.conclusions hpcs are extensively activated in cirrhotic liver tissues,and hbv infection may facilitate its activation.展开更多
文摘This study reports a case of unresectable intrahepatic mass-forming cholangiocarcinoma which showed a dramatic response to gemcitabine that led to curative resection and a long-term survival of more than five years.Six and five cycles of gemcitabine monotherapy were administered separately over a three-year period and a radical excision was performed at 4.5 years after diagnosis.This case indicates the role of gemcitabine as a neoadjuvant chemotherapeutic agent for cholangiocarcinoma and guarantees a randomized controlled prospective study.
文摘AIM: To compare the value of endoscopic retrograde cholangiography (ERC) and standard T2-weighted magnetic resonance cholangiography (MRC) in the evaluation process as adult-to-adult right lobe living donor liver transplantation (LDLTx) demands a successful outcome, and exact knowledge of the biliary tree is implicated to avoid biliary complications, postoperatively.METHODS: After starting the LDLTx program, 18 liver transplant candidates were selected for LDLTx by a stepwise evaluation process. ERC and standard T2-weighted MRC were performed to evaluate the biliary system of the donor liver. The anatomical findings of ERC and MRC mapping were compared using the Ohkubo classification. RESULTS: ERC allowed mapping of the whole biliary system in 15/15 (100%) cases, including 14/15 (93.3%) with biliary variants while routine MRC was only accurate in 2/13 (15.4%) cases. MRC was limited in depicting the biliary system proximal of the hepatic bifurcation. Postoperative biliary complications occurred in 2 donors and 8 recipients. Biliary complications were associated with Ohkubo type C, E or G in 6/8 recipients, and 2/3 recipients with biliary leak received a graft with multiple (≥2) bile ducts. CONCLUSION: Pretransplant ERC is safe and superior over standard MRC for detection of biliary variations that occur with a high frequency. However, precise knowledge of biliary variants did not reduce the incidence of postoperative biliary complications.
文摘目的 观察肝脏祖细胞(hepatic progenitor cells,hpcs)在乙型肝炎肝硬化患者肝组织中的激活特征,探讨hbv感染是否影响hpcs的激活.方法 以细胞角蛋白(ck7)为标记,对16例乙型肝炎肝硬化患者的肝组织做免疫组织化学染色,定量分析hpcs数目及胆管反应面积.hbsag和hbcag染色,观察两种病毒蛋白的表达与hpcs激活的关系.结果 乙型肝炎肝硬化患者肝组织中hpcs激活程度高,胆管反应明显.肝组织中hbsag的表达与hpcs激活程度呈正相关.结论 在乙型肝炎肝硬化患者的肝组织中,hpcs被明显激活和扩增,hbv感染可能参与hpcs的激活.
abstract：
objective to observe the characteristics of hepatic progenitor cells(hpcs)activation in liver tissues of patients with hepatitis b cirrhosis,and to investigate the relationship between the number of hpcs and hbv infection.methods cytokeratin 7(ck7)-was stained immunohistochemically in liver tissues of 16 patients with hepatitis b cirrhosis.hpcs and duetular reactions were quantitively analyzed.the expression of hbsag and hbcag were also detected to evaluate its relationship with hpcs activation.results hpcs were extensively activated and marked duetular reactions can be observed in cirrhotic liver tissues.tlle expression of hbsag was positively correlated with hpcs activation.conclusions hpcs are extensively activated in cirrhotic liver tissues,and hbv infection may facilitate its activation.
