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Objective To evaluate retrospectively the clinical efficacy of percutaneous transhepatic gallbladder drainage (PTGBD) in the patients with acute biliary pancreatitis (ABP). Methods A total of 244 patients with ABP recei-ving treatment in our department from January 2014 to November 2021 were included in this study. There were 76 cases in study group using PTGBD treatment, among them, 41 cases with performed endoscopic retrograde cholangiopancreatography (ERCP) after symptoms remission, and 168 cases without PTGBD in control group with 49 cases using ERCP and 119 cases with conservative treatment. The rate of post-ERCP pancreatitis (PEP) and postoperative adverse events were compared between two groups. Results The rate of PEP was significantly lower in study group (11/41) than in control group (23/49), 26.8% vs.46.9%, P=0.008. The patients in both groups were performed cholecystectomy or cholecystectomy with bile duct drainage in late stage (73 cases in study group and 152 cases in control group). The shorter operative time [(76.3±28.3) min vs.(121.6±34.9) min, P=0.011], less intraoperative blood loss [(65.7±27.6) mL vs. (99.2±60.3) mL, P=0.028], shorter abdominal drainage duration [(3.6±2.5) d vs. (8.9±4.9) d, P=0.016] in study group than in control group. The rate of postoperative sepsis [2.7% (2 cases) vs. 5.3% (8 cases), P=0.003], rate of reoperation [1.4%(1 case) vs. 3.9%(6 cases), P

Background: Currently, researches about single-incision laparoscopic cholecystectomy (SILC) are various, but long-term reviews assessing relevant complications after SILC with considerable amount of case series are rare.Study Design: We retrospectively reviewed a large series of 529 patients undergoing SILC to assess the long-term postoperative recovery, including postoperative complications, retained symptoms, and quality of life. Finally, we assessed its associated risk factors related to SILC patients' recovery in the long term.Results: During a mean follow-up period of 36.8 ± 8.8 months after SILC, 402 (76.0 %) patients underwent complete resolution. Frequent diarrhea (12.1 %) and recurrent omphalitis (5.9 %) were most commonly seen among other complications and retained symptoms within overall the patients. We identified 1 (0.3 %) incision hernia and 1 (0.3 %) intra-abdominal abscess among overall the patients, while 3 (0.8 %) common bile duct stones and 1 (0.3 %) biliary pancreatitis among the patients with symptomatic cholelithiasis during long-term review period. No significant differences were identified between patients with symptomatic cholelithiasis and gallbladder polyps when considering other incidences (all p > 0.05). Patients undergoing SILC with older age (p = 0.023) or female gender (p = 0.020) contributed to complete resolution.Conclusions: SILC via traditional devices is feasible and safe with acceptable postoperative incidence rate in the long run. Patients with older age or female gender, who have no severe systemic diseases, tend to benefit more from the surgical intervention. [ABSTRACT FROM AUTHOR]

Hepatolithiasis is a common disease that represents a serious health threat to the Chinese population. The pathological mechanism underlying hepatolithiasis is closely related to bacterial infections of the intrahepatic bile duct, followed by chronic inflammation and the overexpression of mucin 5AC (MUC5AC). However, the exact mechanism responsible for the lipopolysaccharide (LPS)-induced upregulation of MUC5AC has yet to be elucidated. Specificity protein 1 (Sp1) is a ubiquitous transcription factor that plays a vital role in the regulation of a number of genes that are responsible for normal cellular function. microRNA (miR/miRNA)-130b is a member of the miRNA family. miRNAs can bind to the 3′-untralsated region (3′-UTR) of a target gene and influence its expression levels. The present study found that LPS increases the expression of MUC5AC by influencing Sp1 secretion. Chromatin immunoprecipitation-quantitative PCR experiments further verified three Sp1 binding sites in the MUC5AC promoter sequence that can regulate the expression of MUC5AC. Further analysis demonstrated that Sp1 expression was regulated by miR-130b. Luciferase experiments identified one miR-130b binding site in the Sp1 3′-UTR region. In vivo experiments also confirmed the role of the miR-130b-Sp1-MUC5AC signaling pathway in the formation of biliary stones and indicated that this pathway may provide targeted therapeutic strategies for the treatment of intrahepatic bile duct stones. [ABSTRACT FROM AUTHOR]