ObjectiveTo explore the safety and effectiveness of endoscopic treatment for biliary tract complications after liver transplantation.MethodsPatients who underwent endoscopic treatment for biliary tract complications after liver transplantation from January 2009 to December 2018 in West China Hospital were enrolled. Characteristics of patients, types of biliary tract complications, effectiveness of endoscopic treatment and endoscopic related complications were collected and analyzed.ResultsAmong the 57 patients with biliary tract complications, 37 patients had biliary stricture alone, 4 patients had bile leak alone, 15 patients had biliary stricture plus biliary stones or sludge, and 1 patient had biliary stricture combined with biliary leakage. A total of 112 treatments of endoscopic retrograde cholangiopancreatography (ERCP) were performed, among which 100 treatments were accomplished successfully (89.3%), including the improvement of bile duct stenosis, the cure of bile leak and the successful removal of common bile duct stones. The number of total ERCP related complications was 15 (13.4%), among which post ERCP pancreatitis was the most common (9.8%).ConclusionEndoscopic therapy can be considered as an initial treatment for biliary tract complications after liver transplantation as its safety and effectiveness.
Objective To explore the effects of celecoxib, a selective COX-2 inhibitor, on the expression of NHE1 and intracellular pH (pHi) of SGC-7901 human gastric carcinoma cells. Methods Human gastric carcinoma cell line SGC-7901 was used as research object. MTT method was used to detect the celecoxib's depressant effect on the proliferation of SGC-7901 cells after intervening with different concentrations of celecoxib (5, 12.5, 25, 50, 75, and 100 μmol/L) for different time. Western blot was applied to detect influence of different concentrations of celecoxib on NHE1 expression in SGC-7901 human gastric carcinoma cells. On this basis, pHi of SGC-7901 cells was tested by BCECF-AM immunofluorescence. Results Celecoxib could effectively inhibit the proliferation of SGC-7901 human gastric carcinoma cells. And within a certain concentration range, the inhibitory action on SGC-7901 cells increased with the increase of celecoxib concentration. It also increased with the extension of explosion time while at the same concentration (P<0.05). Different concentrations (except 5 μmol/L) of celecoxib could down-regulate the expression of NHE1 in SGC-7901 cells, which was concentration dependent (P<0.05). The pHi of SGC-7901 cells that were not intervened with celecoxib is alkaline. Compared the pHi of cells in control group, the pHi of SGC-7901 cells decreased significantly after intervening with different concentrations of celecoxib (except 5 μmol/L) for 24 h (P<0.05). And the decrease of pHi was also concentration dependent (P<0.05). Conclusion Celecoxib may inhibit the growth of SGC-7901 cells through down-regulating the expression of NHE1 and declining the pHi.
ObjectiveTo summarize the clinical characteristics and evaluate the long-term outcomes of endoscopic retrograde cholangiopancreatography (ERCP) therapy in patients with pancreatic divisum (PD)-associated pancreatitis (PDAP). MethodsClinical data of patients diagnosed with PDAP at West China Hospital of Sichuan University from June 2011 to June 2024 were retrospectively collected. The pancreatitis remission rate at the last follow-up, the incidence of post-ERCP pancreatitis and the cannulation failure rate were calculated. ResultsA total of 65 patients were enrolled, with an age of (44±17) years. Thirty-four (52.3%) patients were diagnosed with chronic pancreatitis, and 31 (47.7%) patients had recurrent acute pancreatitis (RAP). In terms of PD classification, incomplete-type PD was identified in 38 (58.5%) patients, complete-type PD in 24 (36.9%) patients, and classification data were unavailable for the remaining 3 (4.6%) patients. Patients with complete-type PD were diagnosed at a significantly younger age than those with incomplete-type PD [(37±18) years vs. (48±15) years, P=0.014], and no other baseline characteristics differed significantly between the two groups (P>0.05). ERCP was performed in 58 (89.2%) patients, the cannulation failure rate was 12.1% (7/58). Major papilla cannulation failed in all patients with complete-type PD. Post-ERCP pancreatitis occurred in 22.4% (13/58), with no severe adverse events (e.g., massive hemorrhage or perforation). After excluding 2 patients lost to follow-up, valid data were available for 56 patients (follow-up rate: 96.6%). The overall remission rate was 62.5% (35/56). Compared with the achieved clinical improvement, the proportion of the patients with RAP was lower [19.0% (4/21) vs. 54.3% (19/35), P=0.009], ERCP failure rate was higher [28.6% (6/21) vs. 2.9% (1/35), P=0.009], pancreatic stent placement ratio was lower [57.1% (12/21) vs. 85.7% (30/35), P=0.017] in the patients with non-achieved clinical improvement. No statistically significant differences were found in other baseline characteristics between the two groups (P>0.05). ConclusionsThese findings suggest that therapeutic ERCP is both feasible and efficacious for PDAP. Furthermore, patients with PD-related RAP might achieve better outcomes than those with chronic pancreatitis, indicating a potential phenotype-specific response to endoscopic therapy.