AIM： To investigate prevalence of C/onorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea. METHODS： Consecutive patients w...AIM： To investigate prevalence of C/onorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea. METHODS： Consecutive patients who had been admitted to the Division of Gastroenterology with gastrointestinal symptoms were enrolled from March to April 2005. Of those who had been diagnosed with clonorchiasis, epidemiology and correlation between infection and hepatobiliary diseases were surveyed by questionnaire. RESULTS： Of 3080 patients with gastrointestinal diseases, 396 （12.9%） had clonorchiasis and 1140 patients （37.2%） had a history of eating raw freshwater fish. Of those with a history of raw freshwater fish ingestion, 238 （20.9%） patients had clonorchiasis. Cholangiocarcinoma was more prevalent in C. sinensis-infected patients than nonnfected patients [34/396 （8.6%） vs 145/2684 （5.4%）, P = 0.015]. Cholangiocarcinoma and clonorchiasis showed statistically significant positive cross-relation （P = 0.008）. Choledocholithiasis, cholecystolithiasis, cholangitis, hepatocellular carcinoma, and biliary pancreatitis did not correlate with clonorchiasis. CONCLUSION： Infection rate of clonorchiasis was still high in patients with gastrointestinal diseases in Korea, and has not decreased very much during the last two decades. Cholangiocarcinoma was related to clonorchiasis, which suggested an etiological role for the parasite.展开更多
AIM:To determine the utility of endoscopic ultrasoundguided biliary drainage(EUS-BD)with a fully covered self-expandable metal stent for managing malignant biliary stricture. METHODS:We collected data from 13 patients...AIM:To determine the utility of endoscopic ultrasoundguided biliary drainage(EUS-BD)with a fully covered self-expandable metal stent for managing malignant biliary stricture. METHODS:We collected data from 13 patients who presented with malignant biliary obstruction and underwent EUS-BD with a nitinol fully covered selfexpandable metal stent when endoscopic retrograde cholangiopancreatography(ERCP)fails.EUS-guided choledochoduodenostomy(EUS-CD)and EUS-guided hepaticogastrostomy(EUS-HG)was performed in 9 patients and 4 patients,respectively. RESULTS:The technical and functional success rate was 92.3%(12/13)and 91.7%(11/12),respectively. Using an intrahepatic approach(EUS-HG,n=4),there was mild peritonitis(n=1)and migration of the metal stent to the stomach(n=1).With an extrahepatic approach(EUS-CD,n=10),there was pneumoperitoneum(n=2),migration(n=2),and mild peritonitis (n=1).All patients were managed conservatively with antibiotics.During follow-up(range,1-12 mo),there was re-intervention(4/13 cases,30.7%)necessitated by stent migration(n=2)and stent occlusion(n=2). CONCLUSION:EUS-BD with a nitinol fully covered self-expandable metal stent may be a feasible and effective treatment option in patients with malignant biliary obstruction when ERCP fails.展开更多
AIMTo assess the effect of long-term oral nucleos(t)ide analogues (NUCs) therapy on liver volume change in patients with suppress hepatitis B virus (HBV)-related liver cirrhosis.METHODSWe reviewed the data of na&#...AIMTo assess the effect of long-term oral nucleos(t)ide analogues (NUCs) therapy on liver volume change in patients with suppress hepatitis B virus (HBV)-related liver cirrhosis.METHODSWe reviewed the data of naïve patients with HBV-related liver cirrhosis, who had taken oral NUCs therapy, between 2003 and 2007 at Chonbuk University Hospital. We analyzed two consecutive sets of abdominal computerized tomography scans-one at the time of treatment initiation and another at the second-year follow-up. Liver volume was calculated by 3-dimensional liver extraction volumetry program.RESULTSA total of 55 patients (34 males) were included. There was 114.3 mL ± 167.8 mL (12.9% ± 17.9%) of increase in liver volume during the two years of NUCs therapy (993.8 mL ± 242.8 mL at baseline vs 1108.1 mL ± 263.3 mL at two-year follow-up, P < 0.001). The ratio of the measured baseline liver volume to the estimated standard liver volume was improved from 70.8% to 78.0%. An increase in liver volume was shown not only in patients with compensated cirrhosis (P = 0.046) but also in those with decompensated cirrhosis (P < 0.001). Significant factors for volume increases were Child-Turcotte-Pugh grade and model for end-stage liver disease score improvement without virological breakthrough. In multiple linear regression analysis, delta albumin and delta alanine aminotransferase levels showed a significant association with the increase in liver volume (P = 0.002 and 0.005, respectively).CONCLUSIONLong-term oral NUCs therapy in patients with HBV-related liver cirrhosis lead to significant increase in liver volume assessed with 3-dimensional liver extraction volumetry program.展开更多
基金Supported by The Korean Society of Gastroenterology Research Fund, No. 2005-1
文摘AIM： To investigate prevalence of C/onorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea. METHODS： Consecutive patients who had been admitted to the Division of Gastroenterology with gastrointestinal symptoms were enrolled from March to April 2005. Of those who had been diagnosed with clonorchiasis, epidemiology and correlation between infection and hepatobiliary diseases were surveyed by questionnaire. RESULTS： Of 3080 patients with gastrointestinal diseases, 396 （12.9%） had clonorchiasis and 1140 patients （37.2%） had a history of eating raw freshwater fish. Of those with a history of raw freshwater fish ingestion, 238 （20.9%） patients had clonorchiasis. Cholangiocarcinoma was more prevalent in C. sinensis-infected patients than nonnfected patients [34/396 （8.6%） vs 145/2684 （5.4%）, P = 0.015]. Cholangiocarcinoma and clonorchiasis showed statistically significant positive cross-relation （P = 0.008）. Choledocholithiasis, cholecystolithiasis, cholangitis, hepatocellular carcinoma, and biliary pancreatitis did not correlate with clonorchiasis. CONCLUSION： Infection rate of clonorchiasis was still high in patients with gastrointestinal diseases in Korea, and has not decreased very much during the last two decades. Cholangiocarcinoma was related to clonorchiasis, which suggested an etiological role for the parasite.
基金Supported by Institute of Wonkwang Medical Science in 2011
文摘AIM:To determine the utility of endoscopic ultrasoundguided biliary drainage(EUS-BD)with a fully covered self-expandable metal stent for managing malignant biliary stricture. METHODS:We collected data from 13 patients who presented with malignant biliary obstruction and underwent EUS-BD with a nitinol fully covered selfexpandable metal stent when endoscopic retrograde cholangiopancreatography(ERCP)fails.EUS-guided choledochoduodenostomy(EUS-CD)and EUS-guided hepaticogastrostomy(EUS-HG)was performed in 9 patients and 4 patients,respectively. RESULTS:The technical and functional success rate was 92.3%(12/13)and 91.7%(11/12),respectively. Using an intrahepatic approach(EUS-HG,n=4),there was mild peritonitis(n=1)and migration of the metal stent to the stomach(n=1).With an extrahepatic approach(EUS-CD,n=10),there was pneumoperitoneum(n=2),migration(n=2),and mild peritonitis (n=1).All patients were managed conservatively with antibiotics.During follow-up(range,1-12 mo),there was re-intervention(4/13 cases,30.7%)necessitated by stent migration(n=2)and stent occlusion(n=2). CONCLUSION:EUS-BD with a nitinol fully covered self-expandable metal stent may be a feasible and effective treatment option in patients with malignant biliary obstruction when ERCP fails.
文摘AIMTo assess the effect of long-term oral nucleos(t)ide analogues (NUCs) therapy on liver volume change in patients with suppress hepatitis B virus (HBV)-related liver cirrhosis.METHODSWe reviewed the data of naïve patients with HBV-related liver cirrhosis, who had taken oral NUCs therapy, between 2003 and 2007 at Chonbuk University Hospital. We analyzed two consecutive sets of abdominal computerized tomography scans-one at the time of treatment initiation and another at the second-year follow-up. Liver volume was calculated by 3-dimensional liver extraction volumetry program.RESULTSA total of 55 patients (34 males) were included. There was 114.3 mL ± 167.8 mL (12.9% ± 17.9%) of increase in liver volume during the two years of NUCs therapy (993.8 mL ± 242.8 mL at baseline vs 1108.1 mL ± 263.3 mL at two-year follow-up, P < 0.001). The ratio of the measured baseline liver volume to the estimated standard liver volume was improved from 70.8% to 78.0%. An increase in liver volume was shown not only in patients with compensated cirrhosis (P = 0.046) but also in those with decompensated cirrhosis (P < 0.001). Significant factors for volume increases were Child-Turcotte-Pugh grade and model for end-stage liver disease score improvement without virological breakthrough. In multiple linear regression analysis, delta albumin and delta alanine aminotransferase levels showed a significant association with the increase in liver volume (P = 0.002 and 0.005, respectively).CONCLUSIONLong-term oral NUCs therapy in patients with HBV-related liver cirrhosis lead to significant increase in liver volume assessed with 3-dimensional liver extraction volumetry program.
