Effect of transient obstructive cholestasis on liver histology: a cross-sectional study

Abstract

BACKGROUND: The role of transient obstructive cholestasis on liver histology remains undetermined. OBJECTIVE: To investigate whether transient cholestasis impairs liver histology. DESIGN AND SETTING: Cross-sectional study at a public university hospital (UNICAMP), Brazil. METHODS: 169 individuals undergoing cholecystectomy, with or without cholestasis. were enrolled. Histopathological findings were correlated with clinical and biochemical characteristics. RESULTS: Biliary hepatopathy was more frequent in individuals with resolved cholestasis than in those with active obstruction or no jaundice (P < 0.01), as also were fibrosis and ductular proliferation (P = 0.02). Cholestasis was commoner in individuals with resolved obstruction than in those with no history (P < 0.01) or active cholestasis (P < 0.05). Biliary hepatopathy was associated with longer duration of cholestasis (P < 0.001) and higher bilirubin levels (P = 0.02) in individuals with active obstruction; with lower body mass index (P = 0.02) and longer cholestasis (P < 0.001) in individuals with resolved obstruction; and with longer cholestasis (P < 0.001) and longer interval between endoscopic retrograde cholangiopancreatography and surgery (P = 0.03) overall. In individuals with active obstruction, duration of cholestasis (R = 0.7; P < 0.001) and bilirubin levels (R = 0.6; P = 0.004) were independently correlated with cholestasis severity. Duration of cholestasis (R = 0.7; P < 0.001) was independently correlated with ductular proliferation severity. CONCLUSIONS: Transient cholestasis was associated with significant histopathological changes, even after its resolution. Longer duration of obstruction correlated with greater severity of histopathological changes, especially cholestasis and ductular proliferation. This emphasizes the need for early treatment of obstructive cholestasis.

Comparing animal well-being between bile duct ligation models

“…For this purpose, it is important to compare the pathophysiological features between a human disease and specific animal models [ 57 ]. During obstructive cholestasis, primary biliary cholangitis, primary sclerosing cholangitis, and biliary atresia, pathological features such as focal necrosis, fibrosis, inflammation, and elevated activity of liver enzymes in the blood can be observed ( Table 1 ) [ 58 – 67 ]. During acute liver failure fibrosis, inflammation and elevated activity of liver enzymes in the blood can also be noticed.…”

Relationships of hepatic histopathological findings and bile microbiological aspects with bile duct injury repair surgical outcomes: A historical cohort

“…Our findings are comparable with those of Negi et al [19] who identified liver fibrosis or cirrhosis in 92% of patients. Although most histological changes are reversible after stricture repair in experimental studies, the presence of liver cirrhosis is an important risk factor for postoperative morbidity and mortality, in addition to being a predictor of surgical repair failure [20][21][22][23][24].…”

PIWI-interacting RNAs (PiRNAs) as emerging biomarkers and therapeutic targets in biliary tract cancers: A comprehensive review

“…Biliary tract obstruction is a common clinical problem that can be caused by various factors, including gallstones, cancerous tumors, inflammation of the pancreas, metastatic disease to the liver, and disease of the bile ducts [ 1 ]. Extensive research has been conducted on both humans and animals, which consistently demonstrates that blockages in the bile duct can potentially result in cholestasis and severe harm to the liver [ [2] , [3] , [4] , [5] ]. As an important cause of cholestasis, biliary tract cancers (BTCs) encompass a diverse range of malignant tumors that are typically categorized into distinct subgroups based on their anatomical location.…”