Hepatolithiasis in East Asia retrospective study

Abstract

Hepatolithiasis is a major disease in Asia but differences in operative incidence between countries have not been examined. A retrospective study was conducted in Taiwan, Hong Kong, and Singapore, and the results were compared with those in Japan with the aim of defining factors involved in the etiology of the condition. In order to ensure uniformity of the data collected, the same form was used throughout the study and was completed by the same personnel after reviewing the patient's record and radiographs in each case. The years 1976-1980 were chosen for the study, since the newer methods of diagnosis such as ultrasound, endoscopic retrograde cholangiography, and percutaneous transhepatic cholangiography became available during that period. The most significant finding was the difference in the relative prevalence of hepatolithiasis as a proportion of all gallstone cases in Taiwan, Hong Kong, and Singapore, where the majority of the population consisted of patients of Chinese descent. The highest prevalence, 53.5%, was found in Taiwan, while in Hong Kong it was 3.1% and in Singapore 1.7%. Environmental rather than ethnic factors are implicated in the cause of hepatolithiasis.

Suppression of proliferative cholangitis in a rat model with direct adenovirus-mediated retinoblastoma gene transfer to the biliary tract

“…3,4 It is the main cause of residual and recurrent stones, [1][2][3][5][6][7]15 which are the most difficult problems in hepatolithiasis treatments. [1][2][3] A number of hepatolithiasis treatment options, including surgical procedures like choledochotomy, hepaticojejunostomy, hepatectomy, and papilloplasty, have been performed. Recently, there has been increasing endoscopic lithotomy using intraoperative and postoperative choledochoscopy and percutaneous transhepatic choledochoscopy.…”

“…In the pathogenesis of hepatolithiasis, cholestasis and biliary infection have been widely accepted as indispensable factors. [1][2][3][4][5] The most characteristic pathological feature is proliferative cholangitis (PC), which shows the peribiliary gland hyperplasia and the proliferation of the biliary epithelium and fibrous tissue, resulting in considerable thickening of the bile duct wall. [3][4][5] PC frequently induces residual and/or recurrent stones, [1][2][3][5][6][7] which are the largest problem after repeated treatments for hepatolithiasis.…”

“…[1][2][3][4][5] The most characteristic pathological feature is proliferative cholangitis (PC), which shows the peribiliary gland hyperplasia and the proliferation of the biliary epithelium and fibrous tissue, resulting in considerable thickening of the bile duct wall. [3][4][5] PC frequently induces residual and/or recurrent stones, [1][2][3][5][6][7] which are the largest problem after repeated treatments for hepatolithiasis. [1][2][3] In the present study, gene therapy using the adenovirus vector encoding nonphosphorylatable, constitutively active form of retinoblastoma gene product (AdRb) was introduced to reduce proliferation caused by PC.…”

“…[3][4][5] PC frequently induces residual and/or recurrent stones, [1][2][3][5][6][7] which are the largest problem after repeated treatments for hepatolithiasis. [1][2][3] In the present study, gene therapy using the adenovirus vector encoding nonphosphorylatable, constitutively active form of retinoblastoma gene product (AdRb) was introduced to reduce proliferation caused by PC. Retinoblastoma (Rb) protein is known to inhibit cell-cycle progression in mammalian cells.…”

“…Cholestasis and biliary infection are considered to play important roles in the formation of intrahepatic stones and to remain even after treatments for hepatolithiasis. [1][2][3][5][6][7] We assumed that inhibition of the formation of proliferative changes in this model could lead to some new adjuvant treatment modality for reducing recurrence of PC and stones after treatments. Therefore, we investigated in the current study whether the adenovirus-mediated overexpression of human Rb into the biliary tract could control the formation of proliferative changes in this model.…”