When analysing the results of examination of 773 patients with obstructive jaundice (OJ) of benign genesis, purulent cholangitis (PC) was revealed in 323. In PC diagnosis, the ultrasound study is a valuable adjunctive method. In presence of the clinical signs of PC in patients and absence of the effect from conservative therapy, and as well in preservation of the high indices of bilirubinemia, the early operative treatment performed, as a rule, no later than 48 h after hospitalization is indicated. PC in patients with OJ is most frequently caused by choledocholithiasis. The causative agents of PC are represented by aerobic and anaerobic microorganisms, requiring the use of broad spectrum antibiotics before the operation and 6-12 h after it. Adequate restoration of bile passage and pathogenetically substantiated local influencing upon the inflammatory process in the bile ducts are tasks of operative intervention. Direct administration into the bile ducts of antibiotics and antiinflammatory preparations, in particular of quercitrol, via the external drain of the common bile duct is expedient.
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Semin Pediatr Surg
January 2025
Swiss Pediatric Liver Center, Geneva University Hospitals, Geneva, Switzerland; Division of Child and Adolescent Surgery, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
Cholangitis, defined as the inflammation of the bile ducts, is the most frequent complication after Kasai hepatoportoenterostomy in patients with biliary atresia (BA). This review seeks to provide a comprehensive synthesis of current knowledge on diagnosing and managing BA-associated cholangitis while identifying gaps in the existing literature. A scoping literature review was conducted to gather global insights into the definition, evaluation, and management of post-Kasai cholangitis, illustrated through data from the Swiss Biliary Atresia Registry (SBAR).
View Article and Find Full Text PDFSemin Pediatr Surg
January 2025
Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Dr Li Dak-Sum Research Centre, The University of Hong Kong - Karolinska Institutet Collaboration in Regenerative Medicine, Hong Kong, China. Electronic address:
Biliary atresia (BA) is a severe neonatal cholestatic disorder marked by fibro-obliteration of the extrahepatic and intrahepatic bile ducts. It is the most common cause of pediatric end-stage liver disease and the leading indication for liver transplantation in children. There is significant heterogeneity in the etiology, involving various genetic and environmental factors such as viral infection, immune dysregulation and genetic predisposition to defective hepatobiliary development.
View Article and Find Full Text PDFFront Biosci (Landmark Ed)
January 2025
Department of Surgery, School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
Sulfatides or 3-O-sulfogalactosylceramide are negatively charged sulfated glycosphingolipids abundant in the brain and kidneys and play crucial roles in nerve impulse conduction and urinary pH regulation. Sulfatides are present in the liver, specifically in the biliary tract. Sulfatides are self-lipid antigens presented by cholangiocytes to activate cluster of differentiation 1d (CD1d)-restricted type II natural killer T (NKT) cells.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Surgery, Riga Stradinš University, 16 Dzirciema Street, LV-1007 Riga, Latvia.
Laparoscopic cholecystectomy for acute cholecystitis carries an increased risk of biliovascular injuries. Fluorescence cholangiography (FC) is a valuable diagnostic tool for identifying extrahepatic bile ducts (EHBD). The objective of this study was to evaluate the efficacy of FC in delineating EHBD anatomy, both before and after dissection, based on the critical view of safety (CVS) principles.
View Article and Find Full Text PDFChildren (Basel)
January 2025
Department of Paediatric Surgery, Kings College Hospital, Denmark Hill, London SE5 9RS, UK.
Biliary atresia (BA) is an obliterative disease of the bile ducts affecting between 1 in 10,000-20,000 infants with a predominance in Asian countries. It is clinically heterogeneous with a number of distinct variants (e.g.
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