Predictors of hepatic insufficiency in obstructive jaundice

Vinnik, Yu. S.; Пахомова, Р. А.; Кочетова, Л. В.; Воронова, Е А; Kozlov, Vasiliy; Кириченко, А. К.

doi:10.17116/hirurgia2018337-41

Cited by 7 publications

(1 citation statement)

References 5 publications

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“…Hepatocellular carcinoma with obstructive jaundice is defined as obstruction of bile excretion and cholestasis due to invasion or compression of the hepatobiliary duct or common bile duct by various direct or indirect causes, which is clinically characterized by hyperbilirubinemia, yellow staining of tissues or body fluids, and bile duct dilatation [ 1 ]. Obstructive jaundice can be divided into benign and malignant obstructive jaundice [ 2 ]. The hilar bile duct is often used as the demarcation line for the two, and the causes of obstruction can be direct compression of the bile duct by the primary tumor around the liver, gallbladder, bile duct, pancreas, and ampulla, or obstruction caused by tumor metastasis invading the bile duct at other sites [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Cholangiopancreatography to Evaluate Improvement Effect of FXR Regulating Bile Acid on Hepatocellular Carcinoma with Obstructive Jaundice

Wang

Liu

2022

Contrast Media & Molecular Imaging

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This research aimed at exploring the improvement effect of Farnesoid X receptor (FXR) regulating bile acid (BA) on hepatocellular carcinoma with obstructive jaundice under magnetic resonance cholangiopancreatography (MRCP). Forty-eight hepatocellular carcinoma patients with obstructive jaundice who were examined in hospital were selected as the study group, and another 10 healthy volunteers who were examined at the same period were selected as the control group. The patients were treated with FXR inhibitor, and the therapeutic effect was observed. The results showed that after treatment, the AST content and TBIL content in serum of the study group were 123.5 ± 4.9 U/L and 1.8 ± 0.3 μmol/L, respectively, which were significantly lower than those before treatment, P < 0.05; the ALT content and AST content in serum in patients with high obstruction were significantly lower than those before treatment, and the K+ content was significantly higher than that before treatment ( P < 0.05). The ALT, AST, and TBIL contents in serum in patients with low obstruction were significantly lower than those before treatment ( P < 0.05). Apparent diffusion coefficient (ADC) was 1.17 ± 0.49 × 10−3 mm2/s in patients with moderate jaundice and 1.20 ± 0.27 × 10−3 mm2/s in patients with severe jaundice, compared with that before treatment, and the difference was statistically significant ( P < 0.05). Based on FXR, it can regulate BA synthesis and metabolism, restore BA metabolic homeostasis, effectively play a hepatoprotective role, reduce bilirubin content in the body, and improve jaundice injury, which has application value.

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Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Cholangiopancreatography to Evaluate Improvement Effect of FXR Regulating Bile Acid on Hepatocellular Carcinoma with Obstructive Jaundice

Wang

Liu

2022

Contrast Media & Molecular Imaging

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Characteristics of cellular and humoral immunity parameters in patients with mechanical jaundice, caused by cholangiocarcinoma

Смирнова

Darenskaya

Каспаров

et al. 2022

Russian Journal of Infection and Immunity

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Abstract. In the modern world, obstructive jaundice caused by developing a malignant disease - cholangiocarcinoma, holds one of the places in the pattern of cancer morbidity and mortality in developing countries as well as poses a significant medical and social problem in economically developed countries. The aim of this study was to examine parameters of cellular and humoral immunity in patients with obstructive jaundice caused by cholangiocarcinoma before and after surgical intervention. There were enrolled 56 patients with obstructive jaundice caused by cholangiocarcinoma (stages T2-3N0-1M0) and 90 age-matched apparently healthy volunteers. Cellular immunity parameters were studied by using an FC500 flow cytometer (Beckman Coulter, USA). The parameters of humoral immunity were assessed by measuring level of serum immunoglobulins A, M, G, E by using enzyme-linked immunosorbent assay kits manufactured by ZAO Vector-Best. The results were statistically analyzed using the Statistica v.12.0 software (StftSoft Inc., USA). According to the study results, in patients with obstructive jaundice caused by cholangiocarcinoma, there was revealed activation of humoral immunity due to increased serum level of IgA, IgG, IgE with a profoundly depressed some arms of cellular immunity contributing to the imbalanced work of the entire immune system. The imbalance in the cellular arm of immune system was manifested by decreased count of T-helper and increased cytotoxic T-cell subsets as well as decline in the CD4+/ CD8+ T cell ratio. An increased count of cytotoxic T-lymphocytes points at lowered T-cell immunity and existence of a cytotoxic effect at the cellular level. A decrease in the count of pan-marker-positive T-lymphocytes indicates about generally reduced activity of the T-cell arm due to altered T-cell function and, as a result, affected antigen-presenting function in immune cells. The development of T-cell immunodeficiency due to T-cell apoptosis confirms upregulated expression of immunomarkers CD38+, CD95+. An increased serum level for some immunoglobulins suggests developing imbalance in the humoral immunity, whereas rise in the circulating immune complexes indicates about pronounced body intoxication caused by obstructive jaundice due to hyperbilirubinemia and disintegration of tumor cells. Application of surgical correction of obstructive jaundice contributed to normalizing parameters of cellular and humoral immunity, resulting in immunocorrective effect.

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Difficulties in assessing the severity of liver dysfunction for obstructive jaundice

et al. 2021

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A literature review is devoted to the current classifications of liver failure that occurs in obstructive jaundice. Modern methods of diagnosis and criteria for determining the time of development and assessing the severity of this disease, model assessment and prognosis of acute liver failure are also considered. Attention is paid to assessing the severity and determining the timing of the development of liver failure in extrahepatic cholestasis. In addition, there is no common understanding of the role of liver compensatory mechanisms involved in the development of this condition. There are no generally accepted views on the surgical tactics of treatment of patients with obstructive jaundice complicated by liver failure. The limits of application of step-by-step treatment of patients with neoplastic obstructive jaundice have not been reliably determined. All these issues require further research, search for universal tools for assessing liver failure, predicting postoperative complications for choosing the optimal surgical treatment tactics.

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Predictors of hepatic insufficiency in obstructive jaundice

Cited by 7 publications

References 5 publications

Magnetic Resonance Cholangiopancreatography to Evaluate Improvement Effect of FXR Regulating Bile Acid on Hepatocellular Carcinoma with Obstructive Jaundice

Magnetic Resonance Cholangiopancreatography to Evaluate Improvement Effect of FXR Regulating Bile Acid on Hepatocellular Carcinoma with Obstructive Jaundice

Characteristics of cellular and humoral immunity parameters in patients with mechanical jaundice, caused by cholangiocarcinoma

Difficulties in assessing the severity of liver dysfunction for obstructive jaundice

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