• 한국간담췌외과학회지
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• 제27권3호
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• pp.241-250
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• 2023

Helicobacter pylori is a gram-negative pathogen commonly associated with peptic ulcer disease and gastric cancer. H. pylori infection has also been reported in cholelithiasis, cholecystitis, gallbladder polyps, and biliary tract cancers. However, the association between H. pylori and gallbladder and biliary tract pathologies remains unclear due to the paucity of literature. In response to the current literature gap, we aim to review and provide an updated summary of the association between H. pylori with gallbladder and biliary tract diseases and its impact on their clinical management. Relevant peer-reviewed studies were retrieved from Medline, PubMed, Embase, and Cochrane databases. We found that H. pylori infection was associated with cholelithiasis, chronic cholecystitis, biliary tract cancer, primary sclerosing cholangitis, and primary biliary cholangitis but not with gallbladder polyps. While causal links have been reported, prospective longitudinal studies are required to conclude the association between H. pylori and gallbladder pathologies. Clinicians should be aware of the implications that H. pylori infection has on the management of these diseases.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9391-9394
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• 2014

Purpose: To evaluate the effect of internal-external percutaneous transhepatic biliary drainage (IEPTBD) for patients with malignant obstructive jaundice. Methods: During the period of January 2008 and July 2013, internal-external drainage was performed in 42 patients with malignant obstructive jaundice. During the procedure, if the guide wire could pass through the occlusion and into the duodenum, IEPTBD was performed. External drainage biliary catheter was placed if the occlusion was not crossed. Newly onset of infection, degree of bilirubin decrease and the survival time of patients were selected as parameters to evaluate the effect of IEPTBD. Results: Twenty newly onset of infection were recorded after procedure and new infectious rate was 47.6%. Sixteen patients with infection (3 before, 13 after drainage) were uncontrolled after procedure, 12 of them (3 before, 9 after drainage) died within 1 month. The mean TBIL levels declined from 299.53 umol/L before drainage to 257.62 umol/L after drainage, while uninfected group decline from 274.86 umol/L to 132.34 umol/Lp (P < 0.5). The median survival time for uninfected group was 107 days, and for infection group was 43 days (P < 0.05). Conclusions: The IEPTBD drainage may increase the chance of biliary infection, reduce bile drainage efficiency and decrease the long-term prognosis, and the external drainage is a better choice for patients with malignant obstructive jaundice need to biliary drainage.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2543-2546
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• 2015

Purpose: Percutaneous transhepatic biliary drainage (PTBD) is a form of palliative care for patients with malignant obstructive jaundice. We here compared the infection incidence between internal-external and external drainage for patients with malignant obstructive jaundice. Methods: Patients with malignant obstructive jaundice without infection before surgery receiving internal-external or external drainage from January 2008 to July 2014 were recruited. According to percutaneous transhepatic cholangiography (PTC), if the guide wire could pass through the occlusion and enter the duodenum, we recommended internal-external drainage, and external drainage biliary drainage was set up if the occlusion was not crossed. All patients with infection after procedure received a cultivation of blood and a bile bacteriological test. Results: Among 110 patients with malignant obstructive jaundice, 22 (52.4%) were diagnosed with infection after the procedure in the internal-external drainage group, whereas 19 (27.9%) patients were so affected in the external drainage group, the difference being significant (p<0.05). In 8 patients (36.3%) in the internal-external group infection was controlled, as compared to 12 (63.1%) in the external group (p< 0.05). The mortality rate for patients with infection not controlled in internal-external group in one month was 42.8%, while this rate in external group was 28.6% (p< 0.05). Conclusion: External drainage is a good choice, which could significantly reduce the chance of biliary infection caused by bacteria, and decrease the mortality rate at one month and improve the long-term prognosis.

• 대한영상의학회지
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• 제83권1호
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• pp.224-229
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• 2022

담관 원주 증후군은 간이식을 받은 환자들에게서 발생하는 흔치 않은 합병증이다. 간이식을 받은 환자의 약 5%-18%에서 발생한다. 간이식을 받지 않은 환자에게서 드물게 담관 원주 증후군이 발생하는 것으로 보고되었다. 이식 후 담관 손상, 허혈, 담도 감염, 수술 후 거치된 담도 배액관 등이 병리요인으로 제안되었으나 담도 원주의 병리현상은 아직 명확히 규명되지 않았다. 이에 저자들은 간이식을 받지 않은 49세 남성에게서 총담관 결석에 대해 내시경과 경피적 담관 조영 시술 후에 발생된 담관 원주 증후군의 사례를 소개한다.

• Parasites, Hosts and Diseases
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• 제25권2호
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• pp.110-122
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• 1987

간흡충(Clonorchis sinensis)에 감염된 토끼에 프라지관텔을 $50{\;}mg/kg{\times}2회{\times}2일의$ 용법으로 투여하여 12주 후까지 간의 조직병리학적인 소견을 관찰한 바 아래의 결론을 얻었다. 감염 2주까지 관찰된 간내 담관 상피층의 미약한 증식, 담도주위 염증과 부종 등은 치료 4주 후에 모두 소실되어 이 때 까지의 변화는 가역적인 것으로 판단된다. 그러나 감염 4주 이후에는 치료 후 1주에 이미 상당히 정도가 약해 졌으나 12주까지도 담관과 담관상피층의 증식이 많이 완화된 수준으로 계속 관찰되었고 담관주위 섬유화도 지속되었다. 이러한 잔존 병변은 감염 후 경과한 기간이 길수록 정도가 심하였다. 간흡충증이 감염 초기가 아니면 치료 후에도 간에 형성된 병변이 잔존하는 것으로 미루어, 감염자의 감염 후 2~4주 이내의 조기치료가 중요하다고 판단된다.

• 대한의생명과학회지
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• 제19권3호
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• pp.280-283
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• 2013

Leuconostoc spp. is intrinsically resistant against vancomycin and rarely causes the infection in immunocompromised patients. In this report, we describe a fatal case of Leuconostoc lactis bacteremia in a patient with biliary tract stent insertion to resolve the biliary tract obstruction by multiple pseudocysts in the pancreatic head region. Leuconostic lactis isolated from the blood of the patients was confirmed by 16S rRNA sequencing and this isolate was susceptible against most antibiotics, including levofloxacin, penicillin, erythromycin and cefotaxime except vancomycin. The septic shock and multi-organ failure was abruptly progressed due to delayed use of adequate antibiotic. Using vancomycin as the empirical antibiotics in a bacteremic patient by Gram positive cocci, the treatment failures by the isolates with intrinsic resistance against vancomycin have to be considered. In addition, the prompt and accurate identification of Leuconostoc spp. are very important to select the adequate antibiotics.

• Parasites, Hosts and Diseases
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• 제50권2호
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• pp.133-136
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• 2012

Visceral leishmaniasis (VL) is a life-threatening infection caused by Leishmania species. In addition to typical clinical findings as fever, hepatosplenomegaly, and cachexia, VL is associated with autoimmune phenomena. To date, VL mimicking or exacerbating various autoimmune diseases have been described, including systemic lupus erythematosus (SLE), rheumatoid arthritis, and autoimmune hepatitis (AIH). Herein, we presented a patient with VL who had overlapping clinical features with SLE, AIH, as well as antimitochondrial antibody (AMA-M2) positive primary biliary cirrhosis.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1963-1969
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• 2012

Objectives: Recent data show that the metabolic syndrome may play a role in several cancers, but the etiology for biliary tract cancer is incompletely defined. The present aim was to evaluate risk factors for biliary tract cancer in China. Methods: A case-control study in which cases were biliary tract cancer patients referred to Peking Union Medical College Hospital (PUMCH). Controls were randomly selected from an existing database of healthy individuals at the Health Screening Center of PUMCH. Data on the metabolic syndrome, liver diseases, family history, and history of diabetes and hypertension were collected by retrospective review of the patients' records and health examination reports or by interview. Results: A total of 281 patients (102 intrahepatic cholangiocarcinoma (ICC), 86 extrahepatic cholangiocarcinoma (ECC) and 93 gallbladder carcinoma (GC)) and 835 age- and sex-matched controls were enrolled. $HBsAg^+/anti-HBc^+$ (P=0.002), history of diabetes (P=0.000), cholelithiasis (P=0.000), TC (P=0.003), and HDL (P=0.000) were significantly related to ICC. Cholelithiasis (P=0.000), Tri (P=0.001), LDL (P=0.000), diabetes (P=0.000), Apo A (P=0.000) and Apo B (P=0.012) were significantly associated with ECC. Diabetes (P=0.017), cholelithiasis (P=0.000) and Apo A (P=0.000) were strongly inversely correlated with GC. Conclusion: Cholelithiasis, HBV infection and metabolic symptoms may be potential risk factors for the development of biliary tract cancer.

• Pediatric Infection and Vaccine
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• 제4권2호
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• pp.308-313
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• 1997

Ceftriaxone, an effective third generation cephalosporin with a wide range of antimicrobial activity, has become widely used by pediatricians for a variety of bacterial infections including meningitis. It has been associated with the development of sludge or stone in the gallbladder of some patients treated with this drug. Ceftriaxone associated biliary sludge has unusual acoustic characteristics and resembles gallstone. The sludge can cause symptoms such as cramping abdominal pain, and disappears after stopping ceftriaxone administration. Because of these seemingly confusing observations, it is important for the clinicians to recognize these findings that ceftriaxone treatment can cause. We report a case of ceftriaxone associated biliary sludge in Korean children. A 6-year-old girl who was treated for meningitis with ceftriaxone (100mg/kg/day) developed cramping upper abdominal pain from 5th hospital day. Physical examination, liver function tests and X-ray revealed no specific abnormal findings. But abdominal ultrasound revealed high amplitude echogenic sludge with prominent post-acoustic shadow in gallbladder and its diameter was 1.5cm. We stopped ceftriaxone administration and tried conservative care. Abdominal cramping pain subsided after 3 days of ceftriaxone removal. Second abdominal ultrasound confirmed the disappearance of sludge at 3 weeks later.

• 대한간호학회지
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• 제1권1호
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• pp.95-102
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• 1970

Ascariasis symptoms penetrated into biliary tract are reported to be found much more in Korea than in foreign countries. And the present writer believes there are also many cases of biliary tract symptoms that are actually experienced but that are not reported. As a result of experiencing and nursing twenty cases of ascariasis symptoms of biliary tract, the present writer has got several conclusions, and reports them together with reference to sundry records. (1) The penetrating rate of ascariasis in male versus female was 1 to 1.5. Consequently the rate of female was higher than that of male. The highest age of the case was 67, the lowest 19, and the average age was 45.2. (2) As to symptoms, right upper quadrant abdomen pain and fat diet intolerance were the largest in number. By laboratory findings there were depressive pain on right upper quadrant abdomen in all the cases. (3) As to the location of ascariasis, choledochus occupied the largest part, and the longer illness history was, the more cases coexisting with calculus were found. (4) As to operative method, cholecystectomy and choledochotomy weres the largest in number, and choledochotomy T-tube was inserted in all cases. As to complication after operation, there were operative wound infection, excoriation through bile juice issue, etc. There were three cases of re-penetration of ascariasis and only one case of reoperation.