scholarly journals Whipple’s Pancreatoduodenectomy in the Background of Chronic Liver Disease (CLD): An Institutional Experience

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Samrat Ray ◽  
Suvendu S. Jena ◽  
Amitabh Yadav ◽  
Sri Aurobindo Prasad Das ◽  
Naimish N. Mehta ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
High Volume ◽  
Chronic Liver ◽  
Preoperative Selection ◽  
Liver Decompensation ◽  
Institutional Experience ◽  
Complications And Mortality ◽  
Underlying Chronic Liver Disease

Introduction. Whipple’s pancreatoduodenectomy (PD) is a formidable operation, associated with a high risk of morbidity and mortality. In the setting of an underlying chronic liver disease, the incidence of complications and mortality increases manifold. Patients and Outcomes. Of the 112 Whipple’s PD performed between 2018 to 2020 at a high-volume HPB and liver transplant centre, 4 patients underwent the surgery in the background of an underlying chronic liver disease (CLD). All except one were performed in Child’s A cirrhotics. There was a single 30-day mortality in this series of 4 patients that occurred in the background of Child’s B cirrhosis. On follow-up at 1 year, there was one more mortality in the series, owing to liver decompensation following chemotherapy. Conclusion. Judicious preoperative selection criteria, adequate preoperative nutritional and physiological optimisation, and prudent weighing of risk vs. benefit of undergoing Whipple’s PD in periampullary malignancies in the setting of CLD are the major determinants of the surgical outcome.

scholarly journals Outcomes of excessive alcohol drinkers without baseline evidence of chronic liver disease after 15 years follow-up: Heavy burden of cancer and liver disease mortality

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252218
Author(s):  
Sónia Bernardo ◽  
Ricardo Crespo ◽  
Sofia Saraiva ◽  
Rui Barata ◽  
Sara Gonçalves ◽  
...  
Keyword(s):  
Liver Disease ◽  
Alcohol Consumption ◽  
Chronic Liver Disease ◽  
Alcohol Intake ◽  
Chronic Liver ◽  
Portuguese Population ◽  
Heavy Drinkers ◽  
Heavy Burden

Background Most long-term heavy drinkers do not have clinically evident chronic liver disease (CLD). However, at any time-point, their risk of developing CLD remains unknown. We aimed to evaluate the long-term outcomes of a group of heavy drinkers, without evidence of CLD at baseline. Methods A cohort of 123 long-term heavy drinkers without CLD were prospectively recruited in 2002 and retrospectively followed until 2018. Results At baseline (2002), median alcohol consumption was 271±203g/day during 21.5±20 years, 65% being abstinent during the previous 1.75±5 months. Patients were followed for 14±3 years. During follow-up, 53% reported any alcohol intake. Alcohol consumption during follow-up associated weakly with either 1- or 6-months previous abstinence at baseline. Until 2018, progression to CLD occurred in 6%, associating with years of alcohol intake during follow-up (OR 1.15 [1.01–1.31]) and baseline alkaline-phosphatase (OR 1.05 [1.01–1.10]). During follow-up, being abstinent for at least 1 year positively associated with CLD-free survival. 27% died (55% of cancer–mostly oropharyngeal cancer, 27% of cardiovascular disease, and 9% of liver disease), with a mean age of 71 years [69–74] (10 years less than the expected in the Portuguese population). Achieving abstinence for at least 1 year positively associated with overall survival, while smoking, and hepatic steatosis at baseline associated negatively. Conclusion Long-term heavy drinkers seemed to have a decreased life expectancy compared with the overall Portuguese population. Cancer was the main cause of death. Our results suggest that progression to CLD depends mostly on continued alcohol intake. Alcohol abstinence, even if temporary, seems to decrease the risks of CLD and mortality.

scholarly journals Chronic Hepatitis C Virus Infection After Treatment for Pediatric Malignancy

Blood ◽  
1997 ◽  
Vol 90 (3) ◽  
pp. 1315-1320 ◽  
Author(s):  
Simone Cesaro ◽  
Maria Grazia Petris ◽  
Flavio Rossetti ◽  
Riccardo Cusinato ◽  
Corrado Pipan ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Virus Infection ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Hcv Infection ◽  
Pediatric Malignancy ◽  
Infection Markers

Abstract Sera of 658 patients who had completed treatment for pediatric malignancy were analyzed by a second-generation enzyme-linked immunosorbent assay and recombinant immunoblot assay test to assess the prevalence of hepatitis C virus (HCV)-seropositivity. All HCV-seropositive patients underwent detailed clinical, laboratory, virologic, and histologic study to analyze the course of HCV infection. One hundred seventeen of the 658 patients (17.8%) were positive for HCV infection markers. Among the 117 anti-HCV+ patients, 41 (35%) were also positive for markers of hepatitis B virus infection with or without delta virus infection markers, 91 (77.8%) had previously received blood product transfusions, and 25 (21.4%) showed a normal alanine aminotransferase (ALT) level during the last 5-year follow-up (11 of them never had abnormal ALT levels). The remaining 92 patients showed ALT levels higher than the upper limit of normal range. Eighty-one of 117 (70%) anti-HCV+ patients were HCV-RNA+, with genotype 1b being present in most patients (54%). In univariate analysis, no risk factor for chronic liver disease was statistically significant. In this study, the prevalence of HCV infection was high in patients who were treated for a childhood malignancy. In about 20% of anti-HCV+ patients, routes other than blood transfusions are to be considered in the epidemiology of HCV infection. After a 14-year median follow-up, chronic liver disease of anti-HCV+ positive patients did not show progression to liver failure.

scholarly journals P-98 BIOCHEMICAL MAKERS AMONG CHRONIC LIVER DISEASE PATIENTS ACCORDING COVID-19 INFECTION: A FOLLOW-UP STUDY

2021 ◽  
Vol 24 ◽  
pp. 100459
Author(s):  
Lucas Lima da Silva ◽  
Alanna Calheiros Santos ◽  
Fabiola Justina Fumero Leon ◽  
Vanessa Duarte da Costa ◽  
Juliana Custódio Miguel ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Follow Up Study

scholarly journals Role of High-Density Lipoprotein Cholesterol (HDL-C) as a Clinical Predictor of Decompensation in Patients with Chronic Liver Disease (CLD)

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Harshavardhan Rao B ◽  
Priya Nair ◽  
Anoop K. Koshy ◽  
S. Krishnapriya ◽  
C. R. Greeshma ◽  
...  
Keyword(s):  
Liver Disease ◽  
High Density Lipoprotein ◽  
Chronic Liver Disease ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
High Density ◽  
Chronic Liver ◽  
Lipoprotein Cholesterol

Introduction. Systemic inflammation triggered by bacterial products like lipopolysaccharides (LPS) in the circulation is an important factor leading to decompensation in patients with chronic liver disease (CLD). High-density lipoprotein cholesterol (HDL-C) has a significant role in innate immune response to LPS in the circulation and could therefore increase the risk for decompensation in patients with CLD. In this study, we have explored the role of HDL-C as a prognostic marker for decompensation. Methods. This was a prospective, observational, cohort study where consecutive patients with CLD were included. Patients with cholestatic liver disease and hepatocellular carcinoma were excluded. Fasting lipids were measured in all patients at the time of recruitment. Each patient was carefully followed up for development of decompensation events such as new-onset/worsening ascites, hepatic encephalopathy, or variceal bleed during follow-up. Results. A total of 170 patients were included (mean age 60 ± 11.5 years, M : F = 6 : 1 ). At the end of follow-up, 97/170 patients (57%) had decompensation events. Mean HDL-C levels were significantly lower among patients with decompensation ( 27.5 ± 15  mg/dL vs. 43.5 ± 13.9  mg/dL; p value 0.004). Using ROC analysis, cut-off for HDL-C of 36.4 mg/dL was identified. On multivariate analysis, HDL-C ( OR = 6.072 ; 95% CI 2.39-15.39) was found to have an independent association with risk of decompensation. Conclusions. HDL-C level (<36.4 mg/dL) is a reliable marker for risk of decompensation and can be a useful addition to existing prognostic scoring systems in CLD. It can be a valuable tool to streamline treatment protocols and prioritise liver transplantation.

scholarly journals Risk of Major Liver Resection in Patients With Underlying Chronic Liver Disease

1999 ◽  
Vol 229 (2) ◽  
pp. 210-215 ◽  
Author(s):  
Olivier Farges ◽  
Benoit Malassagne ◽  
Jean François Flejou ◽  
Silvio Balzan ◽  
Alain Sauvanet ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Resection ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Major Liver Resection ◽  
Underlying Chronic Liver Disease

scholarly journals EPIDEMIOLOGICAL ASPECTS OF HEPATOCELLULAR CARCINOMA IN A REFERRAL CENTER OF MINAS GERAIS, BRAZIL

2013 ◽  
Vol 50 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Fernanda Maria Farage OSÓRIO ◽  
Gabriel Martin LAUAR ◽  
Agnaldo Soares LIMA ◽  
Paula Vieira Teixeira VIDIGAL ◽  
Teresa Cristina Abreu FERRARI ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Ethanol Injection ◽  
Referral Center ◽  
Ethanol Abuse ◽  
Underlying Chronic Liver Disease

Context Studies on epidemiology of hepatocellular carcinoma and modalities of therapy used to treat this condition are scarce in Brazil. Our aim was to characterize hepatocellular carcinoma according to etiology of the underlying chronic liver disease, and treatment modalities, in a referral center in Brazil. Methods All cases of hepatocellular carcinoma registered in the Department of Pathology during a 12-year period (1998-2010) were included. Demographic data, etiology of the underlying liver disease and treatment performed were collected. Results This case series included 215 patients, mean age 57.3 (± 14.1) years, 164 (76.2 %) male. Virus C and virus B infection were detected in 88 (43%) and 47 (23%) patients, respectively. Ethanol abuse alone or combined with other etiologies was identified in 64 (32%) individuals. Schistosomiasis was found in 18 (9%) patients. Liver transplantation was the treatment of choice in 112 (51%) patients. This procedure was more frequently performed in hepatitis C virus-related hepatocellular carcinoma (70%) than B virus-related hepatocellular carcinoma (17%). Tumor resection was performed in 40 (18%) individuals, ethanol injection or thermo ablation in 18 (14%), and chemoembolization in 14 (7%). In 40 (19.4%) patients no treatment was performed and this percentage remained constant over the years. Conclusions Chronic hepatitis C, followed by ethanol abuse and chronic hepatitis B were the leading causes of underlying chronic liver disease associated with hepatocellular carcinoma. The results show a trend of increasing incidence of hepatocellular carcinoma; however, the proportion of untreated patients remained constant over the analyzed period.

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