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2. PC.01.7 SAME-SESSION DOUBLE EUS-BYPASS VERSUS SURGICAL GASTROENTEROSTOMY AND HEPATICOJEJUNOSTOMY: AN INTERNATIONAL MULTICENTER COMPARISON

Author

Bronswijk, M., primary, Vanella, G., additional, Van Wanrooij, R.L.J., additional, Jajanta, S., additional, Lauwereys, J., additional, Perez-Cuadrado-Robles, E., additional, Dell'Anna, G., additional, Dhar, J., additional, Gupta, V., additional, Van, Malenstein H., additional, Laleman, W., additional, Jaekers, J., additional, Topal, H., additional, Topal, B., additional, Crippa, S., additional, Falconi, M., additional, Besselink, M., additional, Messaoudi, N., additional, Arcidiacono, P., additional, Kunda, R., additional, and Van, Der Merwe S., additional

Published
2023
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3. Clinical models are inaccurate in predicting bile duct stones in situ for patients with gallbladder

Author

Topal, B., Fieuws, S., Tomczyk, K., Aerts, R., Van Steenbergen, W., Verslype, C., and Penninckx, F.

Abstract

Abstract: Background: The probability that a patient has common bile duct stones (CBDS) is a key factor in determining diagnostic and treatment strategies. This prospective cohort study evaluated the accuracy of clinical models in predicting CBDS for patients who will undergo cholecystectomy for lithiasis. Methods: From October 2005 until September 2006, 335 consecutive patients with symptoms of gallstone disease underwent cholecystectomy. Statistical analysis was performed on prospective patient data obtained at the time of first presentation to the hospital. Demonstrable CBDS at the time of endoscopic retrograde cholangiopancreatography (ERCP) or intraoperative cholangiography (IOC) was considered the gold standard for the presence of CBDS. Results: Common bile duct stones were demonstrated in 53 patients. For 35 patients, ERCP was performed, with successful stone clearance in 24 of 30 patients who had proven CBDS. In 29 patients, IOC showed CBDS, which were managed successfully via laparoscopic common bile duct exploration, with stone extraction at the time of cholecystectomy. Prospective validation of the existing model for CBDS resulted in a predictive accuracy rate of 73%. The new model showed a predictive accuracy rate of 79%. Conclusion: Clinical models are inaccurate in predicting CBDS in patients with cholelithiasis. Management strategies should be based on the local availability of therapeutic expertise.

Published
2024
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5. Expert opinion on management of pancreatic exocrine insufficiency in pancreatic cancer.

Author

UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Unité d'oncologie médicale, UCL - (SLuc) Service de gastro-entérologie, Roeyen, G, Berrevoet, F, Borbath, I, Geboes, K, Peeters, M, Topal, B, Van Cutsem, E, Van Laethem, J-L, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Unité d'oncologie médicale, UCL - (SLuc) Service de gastro-entérologie, Roeyen, G, Berrevoet, F, Borbath, I, Geboes, K, Peeters, M, Topal, B, Van Cutsem, E, and Van Laethem, J-L

Abstract

Pancreatic exocrine insufficiency (PEI) is a common condition in patients with pancreatic cancer (PC). PEI can be due to the tumor, which, if located in the head, causes obstruction of the pancreatic duct with subsequent atrophy of the pancreatic parenchyma, or it can be the consequence of pancreatic surgical resection. The standard treatment of PEI is pancreatic enzyme replacement therapy (PERT). Clinical data to support the use of PERT in PC are however limited. There are very few randomized clinical trials that evaluated PERT in PC. Most data come from observational studies. Despite this limited clinical evidence, PERT treatment for PEI is an essential part of supportive therapy to ensure optimal nutritional status in PC patients who will receive surgery, neoadjuvant/adjuvant or palliative treatment. The objective of this review is to increase the awareness about PEI in PC patients and to provide expert recommendations on the use of PERT in resected, borderline resectable and unresectable patients, based on clinical experience and literature review.

Published
2022

6. Multi-institutional expert update on the use of laparoscopic bile duct exploration in the management of choledocholithiasis: Lesson learned from 3950 procedures

Author

Universitat Rovira i Virgili, Lopez-Lopez V; Gil-Vazquez PJ; Ferreras D; Nassar AHM; Bansal VK; Topal B; Zhu JG; Chuang SH; Jorba R; Bekheit M; Martinez-Cecilia D; Parra-Membrives P; Sgourakis G; Mattila A; Bove A; Quaresima S; Barreras González JE; Sharma A; Ruiz JJ; Sánchez-Bueno F; Robles-Campos R; Martinez-Isla A, Universitat Rovira i Virgili, and Lopez-Lopez V; Gil-Vazquez PJ; Ferreras D; Nassar AHM; Bansal VK; Topal B; Zhu JG; Chuang SH; Jorba R; Bekheit M; Martinez-Cecilia D; Parra-Membrives P; Sgourakis G; Mattila A; Bove A; Quaresima S; Barreras González JE; Sharma A; Ruiz JJ; Sánchez-Bueno F; Robles-Campos R; Martinez-Isla A

Abstract

Background: Recently there has been a growing interest in the laparoscopic management of common bile duct stones with gallbladder in situ (LBDE), which is favoring the expansion of this technique. Our study identified the standardization factors of LBDE and its implementation in the single-stage management of choledocholithiasis. Methods: A retrospective multi-institutional study among 17 centers with proven experience in LBDE was performed. A cross-sectional survey consisting of a semi-structured pretested questionnaire was distributed covering the main aspects on the use of LBDE in the management of choledocholithiasis. Results: A total of 3950 LBDEs were analyzed. The most frequent indication was jaundice (58.8%). LBDEs were performed after failed ERCP in 15.2%. The most common approach used was the transcystic (63.11%). The overall series failure rate of LBDE was 4% and the median rate for each center was 6% (IQR, 4.5-12.5). Median operative time ranged between 60-120 min (70.6%). Overall morbidity rate was 14.6%, with a postoperative bile leak and complications ≥3a rate of 4.5% and 2.5%, respectively. The operative time decreased with experience (P =.03) and length of hospital stay was longer in the presence of a biliary leak (P =.04). Current training of LBDE was defined as poor or very poor by 82.4%. Conclusion: Based on this multicenter survey, LBDE is a safe and effective approach when performed by experienced teams. The generalization of LBDE will be based on developing training programs.

Published
2022

9. Macrophage scavenger receptor 1 mediates lipid-induced inflammation in non-alcoholic fatty liver disease

Author

Govaere, O. Petersen, S.K. Martinez-Lopez, N. Wouters, J. Van Haele, M. Mancina, R.M. Jamialahmadi, O. Bilkei-Gorzo, O. Lassen, P.B. Darlay, R. Peltier, J. Palmer, J.M. Younes, R. Tiniakos, D. Aithal, G.P. Allison, M. Vacca, M. Göransson, M. Berlinguer-Palmini, R. Clark, J.E. Drinnan, M.J. Yki-Järvinen, H. Dufour, J.-F. Ekstedt, M. Francque, S. Petta, S. Bugianesi, E. Schattenberg, J.M. Day, C.P. Cordell, H.J. Topal, B. Clément, K. Romeo, S. Ratziu, V. Roskams, T. Daly, A.K. Anstee, Q.M. Trost, M. Härtlova, A.

Abstract

Background & Aims: Obesity-associated inflammation is a key player in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). However, the role of macrophage scavenger receptor 1 (MSR1, CD204) remains incompletely understood. Methods: A total of 170 NAFLD liver biopsies were processed for transcriptomic analysis and correlated with clinicopathological features. Msr1-/- and wild-type mice were subjected to a 16-week high-fat and high-cholesterol diet. Mice and ex vivo human liver slices were treated with a monoclonal antibody against MSR1. Genetic susceptibility was assessed using genome-wide association study data from 1,483 patients with NAFLD and 430,101 participants of the UK Biobank. Results: MSR1 expression was associated with the occurrence of hepatic lipid-laden foamy macrophages and correlated with the degree of steatosis and steatohepatitis in patients with NAFLD. Mice lacking Msr1 were protected against diet-induced metabolic disorder, showing fewer hepatic foamy macrophages, less hepatic inflammation, improved dyslipidaemia and glucose tolerance, and altered hepatic lipid metabolism. Upon induction by saturated fatty acids, MSR1 induced a pro-inflammatory response via the JNK signalling pathway. In vitro blockade of the receptor prevented the accumulation of lipids in primary macrophages which inhibited the switch towards a pro-inflammatory phenotype and the release of cytokines such as TNF-ɑ. Targeting MSR1 using monoclonal antibody therapy in an obesity-associated NAFLD mouse model and human liver slices resulted in the prevention of foamy macrophage formation and inflammation. Moreover, we identified that rs41505344, a polymorphism in the upstream transcriptional region of MSR1, was associated with altered serum triglycerides and aspartate aminotransferase levels in a cohort of over 400,000 patients. Conclusions: Taken together, our data suggest that MSR1 plays a critical role in lipid-induced inflammation and could thus be a potential therapeutic target for the treatment of NAFLD. Lay summary: Non-alcoholic fatty liver disease (NAFLD) is a chronic disease primarily caused by excessive consumption of fat and sugar combined with a lack of exercise or a sedentary lifestyle. Herein, we show that the macrophage scavenger receptor MSR1, an innate immune receptor, mediates lipid uptake and accumulation in Kupffer cells, resulting in liver inflammation and thereby promoting the progression of NAFLD in humans and mice. © 2021 The Authors

Published
2022

11. Multi-institutional Expert Update on the Use of Laparoscopic Bile Duct Exploration in the Management of Choledocholithiasis: Lesson Learned from 3950 Procedure

Author

Lopez-Lopez, V., primary, Gil Vazquez, P.J., additional, Ferreras, D., additional, Nassar, A.H., additional, Bansal, V.K., additional, Topal, B., additional, Zhu, J., additional, Chuang, S.-H., additional, Jorba, R., additional, Bekheit, M., additional, Martinez-Cecilia, D., additional, Parra-Membrives, P., additional, Sgourakis, G., additional, Mattila, A., additional, Bove, A., additional, Quaresima, S., additional, Barreras González, J.E., additional, Sharma, A., additional, Ruiz Manzanera, J.J., additional, Sánchez-Bueno, F., additional, Robles-Campos, R., additional, and Martinez-Isla, A., additional

Published
2022
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14. PC.01.1 LAPAROSCOPIC VERSUS EUS-GUIDED GASTROENTEROSTOMY FOR GASTRIC OUTLET OBSTRUCTION: AN INTERNATIONAL MULTICENTER PROPENSITY SCORE-MATCHED COMPARISON

Author

Vanella, G., primary, Bronswijk, M., additional, Van Malenstein, H., additional, Laleman, W., additional, Jaekers, J., additional, Topal, B., additional, Daams, F., additional, Besselink, M.G., additional, Arcidiacono, P.G., additional, Voermans, R.P., additional, Fockens, P., additional, Larghi, A., additional, Van Wanrooij, R.L., additional, and Van Der Merwe, S., additional

Published
2021
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16. Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: An international multicenter propensity score-matched comparison

Author

BronswijK, M., primary, Vanella, G., additional, van Malenstein, H., additional, Laleman, W., additional, Jaekers, J., additional, Topal, B., additional, Daams, F., additional, Besselink, M.G., additional, Arcidiacono, P.G., additional, Voermans, R.P., additional, Fockens, P., additional, Larghi, A., additional, van Wanrooij, R.L., additional, and van der Merwe, S., additional

Published
2021
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24. Laparoscopic Versus Eus-Guided Gastroenterostomy For Gastric Outlet Obstruction: An International Multicenter Propensity Score-Matched Comparison

Author

Bronswijk, M, additional, Vanella, G, additional, van Malenstein, H, additional, Laleman, W, additional, Jaekers, J, additional, Topal, B, additional, Daams, F, additional, Besselink, MG, additional, Arcidiacono, PG, additional, Voermans, RP, additional, Fockens, P, additional, Larghi, A, additional, van Wanrooij, RL, additional, and van der Merwe, S, additional

Published
2021
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35. Laparoscopic liver resection of benign liver tumors

Author

Descottes, B., Glineur, D., Lachachi, F., Valleix, D., Paineau, J., Hamy, A., Morino, M., Bismuth, H., Castaing, D., Savier, E., Honore, P., Detry, O., Legrand, M., Azagra, J.S., Goergen, M., Ceuterick, M., Marescaux, J., Mutter, D., Hemptinne, B., Troisi, R., Weerts, J., Dallemagne, B., Jehaes, C., Gelin, M., Donckier, V., Aerts, R., Topal, B., Bertrand, C., Mansvelt, B., Krunckelsven, L., Herman, D., Kint, M., Totte, E., Schockmel, R., and Gigot, J.F.

Published
2003
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