Publications by authors named "Henrike Lenzen"

Article Synopsis
  • Biliary strictures are common after liver transplantation, and when endoscopic techniques fail, percutaneous transhepatic biliary drainage (PTBD) can be an effective alternative.
  • A study involving 56 liver transplant recipients showed that PTBD has a high success rate (98%) and can improve various lab indicators, although the risk of subsequent biliary complications depends on the type of stricture present.
  • Patients who achieved internal drainage into the small intestine had better 12-month survival rates compared to those needing external drainage, highlighting the importance of the initial PTBD approach.
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Background: Since diet is generally recognized as an important factor directly modulating the gut microbiome, it is also considered a potential environmental triggering factor for the pathogenesis and onset of inflammatory bowel disease (IBD). While the habitual and sex-related dietary behavior of the general population has been the subject of extensive study and reporting, data on IBD patients' dietary behavior and especially its sex-related differences are underrepresented. However, as diet is an important factor in the course of IBD, we hypothesized that men and women with IBD have a different dietary profile than the general population.

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Article Synopsis
  • The study investigates the safety and significance of transjugular liver biopsy (TJLB) in diagnosing and managing acute liver failure (ALF) in patients at a transplant center over ten years.* -
  • Out of 43 patients studied, TJLB confirmed the suspected causes of ALF for most, but was particularly impactful in cases where treatable conditions like autoimmune hepatitis were suspected, altering treatment plans in these scenarios.* -
  • Although the degree of intrahepatic necrosis was shown to be significant in initial analyses, it did not significantly predict survival without a liver transplant when examined in more complex statistical models.*
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Article Synopsis
  • ERCP is a complex medical procedure that carries significant risks, including complications like pancreatitis and bleeding, making specialized training and a high volume of procedures essential for success.
  • The success rate of ERCPs is closely tied to the number of procedures performed annually, with studies suggesting that centers performing at least 200 ERCPs per year demonstrate better outcomes.
  • Emerging reforms in German hospitals emphasize the need for minimum procedure volumes in specialized centers, highlighting that high-quality ERCP requires not just frequency, but also the availability of comprehensive resources and support for managing complications.
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Aim: Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease characterized by inflammation of the intra- and extrahepatic bile ducts. Pathogenesis of PSC is still enigmatic but is likely to be multifactorial. Recently, we identified an interleukin-6 (IL-6)-dependent signal transducer and activator of transcription 3 (STAT3) activation in CD4 TH1 and TH17 cells in PSC.

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Background & Aims: Non-invasive tests (NITs) for clinically significant portal hypertension (CSPH) require validation in patients with hepatitis D virus (HDV)-related compensated advanced chronic liver disease (cACLD). Therefore, we aimed to validate existing NIT algorithms for CSPH in this context.

Methods: Patients with HDV-cACLD (LSM ≥10 kPa or histological METAVIR F3/F4 fibrosis) who underwent paired HVPG and NIT assessment at Medical University of Vienna or Hannover Medical School between 2013 and 2023 were retrospectively included.

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Perioperative hypothermia is associated with significant complications and can be prevented with forced-air heating systems (FAHS). Whether hypothermia occurs during prolonged endoscopic sedation is unclear and prevention measures are not addressed in endoscopic sedation guidelines. We hypothesized that hypothermia also occurs in a significant proportion of patients undergoing endoscopic interventions associated with longer sedation times such as endoscopic retrograde cholangiopancreaticography (ERCP), and that FAHS may prevent it.

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Article Synopsis
  • Bacterial cholangitis often occurs in liver transplant patients with biliary issues, requiring antibiotics and endoscopic procedures, but standard microbiological cultivation (SMC) has limitations in identifying all bacterial species.
  • A study involving 242 bile samples utilized next generation sequencing (NGS) to assess its effectiveness compared to SMC, revealing that NGS detected significantly more bacterial genera.
  • The findings suggest that NGS is a more sensitive diagnostic tool than SMC, indicating that using both methods together can enhance the identification of bacteria in bile and lead to better-targeted antibiotic therapies.
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Gastroenterology has made crucial advances in diagnostic and interventional endoscopic procedures, opening up improvements in the treatment of many patients. Thus, organ-preserving treatments are increasingly being made possible, replacing more invasive organ resecting surgical procedures. At the same time, the degree of complexity and risks varies widely between different endoscopic procedures.

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Importance: The potential association of low-volume paracentesis of less than 5 L with complications in patients with ascites remains unclear, and individuals with cirrhosis and refractory ascites (RA) treated with devices like Alfapump or tunneled-intraperitoneal catheters perform daily low-volume drainage without albumin substitution. Studies indicate marked differences regarding the daily drainage volume between patients; however, it is currently unknown if this alters the clinical course.

Objective: To determine whether the incidence of complications, such as hyponatremia or acute kidney injury (AKI), is associated with the daily drainage volume in patients with devices.

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Background: Management and follow-up strategies for primary sclerosing cholangitis (PSC) vary. The aim of the present study was to assess patient-reported quality of care to identify the most important areas for improvement.

Methods: Data were collected via an online survey hosted on the EU Survey platform in 11 languages between October 2021 and January 2022.

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Aims: Cholecystitis generally warrants immediate cholecystectomy; however, high-risk patients require non-surgical options for gallbladder decompression. The continuous evolution of endoscopic techniques makes it difficult for clinicians tochoose the best technique for high-risk patients. Here we aimed to show that percutaneous transhepatic gallbladder aspiration, a technique that has fallen into disuse, is a safe and rapid method for gallbladder decompression.

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Background: Onset of refractory ascites is the hallmark of end-stage liver disease. If liver transplantation (LTx) is not available and contraindications for a transjugular portosystemic shunt (TIPS) are present, repeated paracentesis remains the standard of care (SOC). Home-based, tunnelled peritoneal catheters (PeCa) have been suggested as an alternative treatment option.

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Background & Aims: Evidence for the benefit of scheduled imaging for early detection of hepatobiliary malignancies in primary sclerosing cholangitis (PSC) is limited. We aimed to compare different follow-up strategies in PSC with the hypothesis that regular imaging improves survival.

Methods: We collected retrospective data from 2975 PSC patients from 27 centres.

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Background And Study Aim: Secondary Aortoenteric Fistulas (sAEF) are difficult to diagnose and usually result in fatal gastrointestinal (GI) bleeding following aortic repair. Outcomes are largely dependent on a timely diagnosis, but AEFs remain challenging to identify endoscopically and are usually diagnosed on computed tomography (CT) scans. The aim of our study was optimize diagnosis of AEF by identifying patients developing GI bleeding after aortic repair, investigate their clinical course and identify factors specific to different bleeding sources.

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Article Synopsis
  • Primary liver cancer, including hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA), is a leading cause of cancer deaths globally, with limited treatment options available.
  • The study investigates the use of a live-attenuated Listeria monocytogenes strain as both a preventive and therapeutic vaccine, showing strong safety and efficacy in mouse models of liver diseases.
  • Combining Listeria vaccination with checkpoint inhibitor therapy significantly improved survival rates in mice with advanced HCC, highlighting the potential of this approach for treating liver fibrosis and hepatobiliary cancers.
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Article Synopsis
  • * Researchers found that the microbes in ITBL patients were very different from those in patients with another issue called anastomotic strictures (AS), especially when treatments like stenting were used.
  • * They learned that giving antibiotics (medicine that fights germs) might not help much for ITBL, so using them carefully is important to avoid making the germs stronger against these meds.
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Background And Aims: Immunoglobulin G4-associated cholangitis (IAC) is characterized by distinctly elevated immunoglobulin G4 in serum (sIgG4) and responds well to corticosteroid therapy. Primary Sclerosing Cholangitis (PSC) is a progressive liver disease without causal treatment options usually not responding to immunosuppression. Increased serum levels of sIgG4 in patients with PSC, that do not meet criteria of IAC, have been reported in 10%-25%.

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Objectives: To develop and evaluate a deep learning algorithm for fully automated detection of primary sclerosing cholangitis (PSC)-compatible cholangiographic changes on three-dimensional magnetic resonance cholangiopancreatography (3D-MRCP) images.

Methods: The datasets of 428 patients (n = 205 with confirmed diagnosis of PSC; n = 223 non-PSC patients) referred for MRI including MRCP were included in this retrospective IRB-approved study. Datasets were randomly assigned to a training (n = 386) and a validation group (n = 42).

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Background & Aims: The pathogenesis of primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) remains unclear. The aim of this study was to reveal certain single nucleotide polymorphisms (SNP) in genes for regulatory proteins in the immunologic pathway possibly going along with susceptibility of attaining PBC or PSC.

Methods: 126 patients with either PBC or PSC with clinical and laboratory data were enrolled in the study.

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Purpose: First, to evaluate and describe the clinical and MRI progression of patients with small duct primary sclerosing cholangitis (sdPSC), and second, to look for MRI features associated with disease progression to large duct PSC.

Method: 16 patients (7 female, 9 male; median age 27 years) with diagnosis of sdPSC and available MR imaging were included in this retrospective dual-center study. Liver function tests (LFTs) and imaging was reviewed in consensus by two radiologists at baseline and follow-up, and compared by means of non-parametric tests, with p < 0.

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At a time of growing governmental restrictions and 'physical distancing' in order to decelerate the spread of COVID-19, psychological challenges are increasing. Social media plays an important role in maintaining social contact as well as exerting political influence. World leaders use it not only to keep citizens informed but also to boost morale and manage people's fears.

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Background And Aims: Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease without a curative medical therapy. The human UDP-glucuronosyltransferases 1A play a major role in the detoxification and elimination of bilirubin, bile acids and xenobiotics. Whether genetic UGT1A variants determine course and outcome of PSC has not yet been described.

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