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1. Tsukada K, Takada T, Miyazaki M, Miyakawa S, Nagino M, Kondo S, Furuse J, Saito H, Tsuyuguchi T, Kimura F, Yoshitomi H, Nozawa S, Yoshida M, Wada K, Amano H, Miura F, Japanese Association of Biliary Surgery, Japanese Society of Hepato-Biliary-Pancreatic Surgery, Japan Society of Clinical Oncology: Diagnosis of biliary tract and ampullary carcinomas. J Hepatobiliary Pancreat Surg; 2008;15(1):31-40

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnosis of biliary tract and ampullary carcinomas.
  • Diagnostic methods for biliary tract carcinoma and the efficacy of these methods are discussed.
  • When this disease is suspected on the basis of clinical symptoms and risk factors, hemato-biochemical examination and abdominal ultrasonography are performed and, where appropriate, enhanced computed tomography (CT) and/or magnetic resonance cholangiopancreatography (MRCP) is carried out.
  • Although rare, abdominal pain and pyrexia, as well as abnormal findings of the hepatobiliary system detected by hemato-biochemical examination, serve as a clue to making a diagnosis of these diseases.
  • On the other hand, the early diagnosis of gallbladder cancer is scarcely possible on the basis of clinical symptoms, so when this cancer is found with the onset of abdominal pain and jaundice, it is already advanced at the time of detection, thus making a cure difficult.
  • When gallbladder cancer is suspected, enhanced CT is carried out.
  • Multidetector computed tomography (MDCT), in particular--one of the methods of enhanced CT--is useful for decision of surgical criteria, because MDCT shows findings such as localization and extension of the tumor, and the presence or absence of remote metastasis.
  • However, direct biliary tract imaging is necessary for making a precise diagnosis of the horizontal extension of bile duct cancer.
  • [MeSH-major] Ampulla of Vater. Biliary Tract Neoplasms / diagnosis. Carcinoma / diagnosis
  • [MeSH-minor] Endoscopy, Digestive System. Evidence-Based Medicine / methods. Humans. Magnetic Resonance Imaging / methods. Tomography, X-Ray Computed / methods. Ultrasonography / methods

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  • (PMID = 18274842.001).
  • [ISSN] 0944-1166
  • [Journal-full-title] Journal of hepato-biliary-pancreatic surgery
  • [ISO-abbreviation] J Hepatobiliary Pancreat Surg
  • [Language] eng
  • [Publication-type] Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Other-IDs] NLM/ PMC2794353
  • [Investigator] Kai M; Kimura Y; Sawada S; Shimizu H; Nakagawara H; Nakachi K; Yoshitome H; Saisyo H; Ryu M; Shikata S; Nimura Y
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2. Donelli G, Guaglianone E, Di Rosa R, Fiocca F, Basoli A: Plastic biliary stent occlusion: factors involved and possible preventive approaches. Clin Med Res; 2007 Mar;5(1):53-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Plastic biliary stent occlusion: factors involved and possible preventive approaches.
  • Endoscopic biliary stenting is today the most common palliative treatment for patients suffering from obstructive jaundice associated with malignant hepatobiliary tumors or benign strictures.
  • However, recurrent jaundice, with or without cholangitis, is a major complication of a biliary endoprosthesis insertion.
  • Thus, stent removal and replacement with a new one frequently occurs as a consequence of device blockage caused by microbial biofilm growth and biliary sludge accumulation in the lumen.
  • Factors and mechanisms involved in plastic stent clogging arising from epidemiological, clinical and experimental data, as well as the possible strategies to prevent biliary stent failure, will be reviewed and discussed.
  • [MeSH-major] Biliary Tract / pathology. Jaundice, Obstructive / etiology. Plastics. Stents
  • [MeSH-minor] Bile Duct Diseases. Bile Ducts / pathology. Biliary Tract Neoplasms / complications. Biliary Tract Neoplasms / therapy. Biofilms. Endoscopy / adverse effects. Equipment Contamination. Equipment Design. Equipment Failure. Humans. Prosthesis Implantation / adverse effects

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  • (PMID = 17456835.001).
  • [ISSN] 1539-4182
  • [Journal-full-title] Clinical medicine & research
  • [ISO-abbreviation] Clin Med Res
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Plastics
  • [Number-of-references] 83
  • [Other-IDs] NLM/ PMC1855334
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3. Saisho T, Okusaka T, Ueno H, Morizane C, Okada S: Prognostic factors in patients with advanced biliary tract cancer receiving chemotherapy. Hepatogastroenterology; 2005 Nov-Dec;52(66):1654-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic factors in patients with advanced biliary tract cancer receiving chemotherapy.
  • BACKGROUND/AIMS: Prognostic factors in patients with advanced biliary tract cancer receiving chemotherapy have not been fully examined.
  • This study investigated prognostic factors in patients with advanced biliary tract cancer receiving chemotherapy.
  • METHODOLOGY: Sixty-five consecutive chemo-naive patients with advanced biliary tract cancer, who received chemotherapy, were analyzed retrospectively to investigate prognostic factors.
  • RESULTS: Median survival time and overall survival rates at 1 and 2 years were 180 days, 21%, and 5%, respectively.
  • The median survival times for these three groups were 246, 152, and 33 days, respectively.
  • CONCLUSIONS: The results may be helpful for predicting life expectancy, determining treatment strategies, and designing future clinical trials in patients with advanced biliary tract cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biliary Tract Neoplasms / drug therapy. Biliary Tract Neoplasms / mortality. Biomarkers, Tumor / analysis. Cause of Death. Palliative Care
  • [MeSH-minor] Adult. Age Factors. Aged. Analysis of Variance. Biopsy, Needle. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Immunohistochemistry. Liver Function Tests. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Probability. Prognosis. Proportional Hazards Models. Retrospective Studies. Risk Assessment. Sex Factors. Survival Analysis

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  • (PMID = 16334750.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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4. Morine Y, Shimada M, Ikegami T, Imura S, Kanemura H, Arakawa Y, Hanaoka J, Kanamoto M, Nii A: Usefulness of gemcitabine combined with 5-fluorouracil and cisplatin (GFP) in patients for unresectable biliary carcinoma. Hepatogastroenterology; 2009 Mar-Apr;56(90):307-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Usefulness of gemcitabine combined with 5-fluorouracil and cisplatin (GFP) in patients for unresectable biliary carcinoma.
  • BACKGROUND/AIMS: Advanced biliary carcinoma have poor prognosis and chemotherapy has been shown to have little impact.
  • The aim of the present study is to clarify the effectiveness of GEM combined with CDDP and 5FU (GFP) therapy for unresectable biliary carcinoma.
  • METHODOLOGY: Fourteen patients with biliary carcinoma (4 patients; gallbladder cancer, 10 patients; biliary tract) who had no prior chemotherapy were enrolled.
  • A triple combination of agents was administered with a 4-week cycle GFP chemotherapy consisting of GEM at 1000 mg/m2 on days 1 and of 5-FU at 250 mg/m2 and CDDP at 3mg/m2 on days 1 to 5.
  • According to the tumor site, overall response rate was 20.0% in biliary tract carcinoma, on the other hand, 25.0% in gallbladder carcinoma.
  • CONCLUSIONS: The significant antitumor activity of GFP chemotherapy has been seen in patients with advanced biliary carcinoma.
  • However, further evaluation in large numbers of patients is needed to determine the difference in chemosensitivity according to the tumor site.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bile Duct Neoplasms / drug therapy. Gallbladder Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chi-Square Distribution. Cisplatin / administration & dosage. Cisplatin / adverse effects. Deoxycytidine / administration & dosage. Deoxycytidine / adverse effects. Deoxycytidine / analogs & derivatives. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Male. Middle Aged. Statistics, Nonparametric. Survival Rate. Treatment Outcome

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  • (PMID = 19579588.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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5. Ferrari VD, Amoroso V, Valcamonico F, Fusi A, Simoncini E, Vasalli L, Rangoni G, Mambrini A, Marpicati P, Montini E, Marini G: Epirubicin, cisplatin, and raltitrexed in patients with advanced gastric and hepatobiliary carcinoma: a phase II study. Am J Clin Oncol; 2004 Oct;27(5):445-8
Hazardous Substances Data Bank. EPIRUBICIN .

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  • [Title] Epirubicin, cisplatin, and raltitrexed in patients with advanced gastric and hepatobiliary carcinoma: a phase II study.
  • The combination of epirubicin, cisplatin, and protracted venous-infusion 5-fluorouracil is the standard treatment of advanced gastric carcinoma in many European countries, and it is also an active regimen in hepatobiliary tumors.
  • The aim of the study was to evaluate the clinical activity and toxicity of the combination of epirubicin, cisplatin, and raltitrexed in patients with advanced gastric and hepatobiliary tumors.
  • Twenty consecutive patients with gastric carcinoma, 7 with biliary-tract carcinoma, and 5 patients with hepatocarcinoma were treated with epirubicin (60 mg/m2), cisplatin (60 mg/m2) on day 1, and raltitrexed (1 mg/m2) on days 1 and 8, every 3 weeks.
  • Eight patients had locally advanced disease and 24 had metastatic tumors.
  • Seven of the 18 evaluable patients (39%) with gastric carcinoma and 2 of the 5 patients with hepatocarcinoma have a partial response; 1 minimal response and 4 stabilization of disease were documented in the 7 patients with biliary-tract carcinoma.
  • The median time to progression of the entire group was 6.8 months, and the median survival was 9.0 months.
  • The combination of epirubicin, cisplatin, and raltitrexed, using this schedule, is tolerable and has clinical activity in gastric and hepatobiliary tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biliary Tract Neoplasms / drug therapy. Liver Neoplasms / drug therapy. Stomach Neoplasms / drug therapy

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  • (PMID = 15596907.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Quinazolines; 0 / Thiophenes; 3Z8479ZZ5X / Epirubicin; FCB9EGG971 / raltitrexed; Q20Q21Q62J / Cisplatin
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6. Lee DK: Drug-eluting stent in malignant biliary obstruction. J Hepatobiliary Pancreat Surg; 2009;16(5):628-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Drug-eluting stent in malignant biliary obstruction.
  • INTRODUCTION: In unresectable malignant bile duct obstruction, endoscopic stent insertion is the treatment of choice.
  • However, the current stent allows only mechanical palliation of the obstruction, and has no anti-tumor effect.
  • Currently, in the vascular field, the drug-eluting stent (DES) is very highly favored.
  • MATERIAL AND METHODS: The requirements for a DES in a non-vascular tract, such as the bile duct, are far different from those of a DES to be used in the vascular tract.
  • The non-vascular DES must suppress tumor proliferation as well as mucosal hyperplasia.
  • For example, the non-vascular stent might be covered with a membrane that gradually releases a chemo-agent.
  • We do not have much experience with DES in the bile duct.
  • Nonetheless, we are continuously testing many anti-tumor agents in animal and human studies.
  • CONCLUSION: We expect and hope DES will work effectively for tumor cells in diverse ways and, more importantly, will prolong stent patency and the patients' survival periods.
  • But considerable investigation and a clinical study of DES will be required to achieve these goals.
  • [MeSH-major] Bile Duct Neoplasms / therapy. Cholestasis / pathology. Cholestasis / therapy. Drug-Eluting Stents
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Catheterization / instrumentation. Endoscopy, Digestive System / methods. Female. Humans. Male. Prognosis. Risk Assessment. Treatment Outcome

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  • (PMID = 19554255.001).
  • [ISSN] 1436-0691
  • [Journal-full-title] Journal of hepato-biliary-pancreatic surgery
  • [ISO-abbreviation] J Hepatobiliary Pancreat Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 24
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7. Kasuya K, Shimazu M, Suzuki M, Kuroiwa Y, Usuda J, Itoi T, Tsuchida A, Aoki T: Novel photodynamic therapy against biliary tract carcinoma using mono-L: -aspartyl chlorine e6: basic evaluation for its feasibility and efficacy. J Hepatobiliary Pancreat Sci; 2010 May;17(3):313-21

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Novel photodynamic therapy against biliary tract carcinoma using mono-L: -aspartyl chlorine e6: basic evaluation for its feasibility and efficacy.
  • BACKGROUND: Recently, a second-generation photosensory agent for photodynamic therapy (PDT), mono-L: -aspartyl chlorine e6 (NPe6), which degrades rapidly in vivo, has been developed.
  • We evaluated its feasibility and efficacy for treatment in biliary tract carcinoma.
  • METHODS: A transmittance of semiconductor laser light (664 nm), sensitivity of a human biliary tract carcinoma cell line, and disorder to normal tissue including Glissonian constructs and adjacent hepatocytes were investigated.
  • The NOZ cell-tumor volume was reduced significantly 14 days after irradiation in the PDT group (PDT 69.9 +/- 44.6 mm(3) vs control 296.3 +/- 239.9 mm(3) P < 0.05).
  • No severe hepatic disorder including Glisson components was observed by the histological findings.
  • CONCLUSION: NPe6 PDT was effective in carcinomas even in the presence of bile, and causes no serious complication for the liver and Glisson structure.
  • Therefore, NPe6 PDT will be a useful candidate as a new therapy for biliary tract carcinomas.
  • [MeSH-major] Biliary Tract Neoplasms / drug therapy. Photochemotherapy / methods. Photosensitizing Agents / therapeutic use. Porphyrins / therapeutic use
  • [MeSH-minor] Cell Line, Tumor. Dose-Response Relationship, Drug. Feasibility Studies. Gallbladder Neoplasms / drug therapy. Hepatocytes / drug effects. Humans. Lethal Dose 50

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  • (PMID = 20464561.001).
  • [ISSN] 1868-6982
  • [Journal-full-title] Journal of hepato-biliary-pancreatic sciences
  • [ISO-abbreviation] J Hepatobiliary Pancreat Sci
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 0 / Porphyrins; P4ROX5ELT2 / Talaporfin
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8. Balkman C: Hepatobiliary neoplasia in dogs and cats. Vet Clin North Am Small Anim Pract; 2009 May;39(3):617-25
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  • [Title] Hepatobiliary neoplasia in dogs and cats.
  • Hepatobiliary tumors are uncommon in dogs and cats.
  • They generally occur in older animals with nonspecific clinical signs, usually relating to the gastrointestinal tract.
  • Liver enzyme concentrations are commonly elevated.
  • Early detection for massive-type lesions may allow for surgical resection and prolonged survival especially for hepatocellular carcinomas.
  • Chemotherapy, in general, is not effective for primary liver tumors.
  • [MeSH-major] Bile Duct Neoplasms / veterinary. Cat Diseases. Dog Diseases. Liver Neoplasms / veterinary

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  • (PMID = 19524795.001).
  • [ISSN] 1878-1306
  • [Journal-full-title] The Veterinary clinics of North America. Small animal practice
  • [ISO-abbreviation] Vet. Clin. North Am. Small Anim. Pract.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 63
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9. Kaiho T, Tanaka T, Tsuchiya S, Yanagisawa S, Takeuchi O, Miura M, Saigusa N, Hayasaka A, Matsuzaki O, Miyazaki M: A case of small cell carcinoma of the common bile duct. Hepatogastroenterology; 2005 Mar-Apr;52(62):363-7
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  • Small cell carcinoma occasionally occurs in the gastrointestinal tract, but rarely in the biliary tract.
  • Computed tomography and ultrasonography showed a mass near the pancreas head and dilatation of the intrahepatic bile ducts.
  • Upon laparotomy, a tumor was found to be located in the middle common bile duct.
  • The main trunk of the portal vein and the right hepatic artery were resected concomitantly because of tumor involvement.
  • The patient then underwent two postoperative courses of systemic chemotherapy.
  • Nevertheless, she died of cancer recurrence eight months after the operation, which showed that the tumor had a highly lethal nature, with rapid and widespread dissemination.
  • Further therapeutic trials are needed to improve survival in such cases.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Carcinoma, Small Cell / diagnosis. Common Bile Duct
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Cholangiopancreatography, Magnetic Resonance. Fatal Outcome. Female. Humans. Neoplasm Recurrence, Local. Pancreaticoduodenectomy / methods. Tomography, X-Ray Computed. Ultrasonography

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  • (PMID = 15816436.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
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10. Mastoraki A, Papanikolaou IS, Konstandiadou I, Sakorafas G, Safioleas M: Facing the challenge of treating gallbladder carcinoma. Review of the literature. Hepatogastroenterology; 2010 Mar-Apr;57(98):215-9
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  • [Title] Facing the challenge of treating gallbladder carcinoma. Review of the literature.
  • Gallbladder carcinoma (GBC) remains the most common biliary tract malignancy and is characterized as an aggressive and highly lethal disease.
  • There is also a wide discrepancy among sources regarding the epidemiology of the tumor.
  • Despite recent research on the therapeutic strategies against gallbladder neoplastic disorders, surgical resection appears the only potentially curative approach.
  • In addition, surgical removal of gallbladder tumor does not necessarily guarantee patient's long-term recovery.
  • Alternative therapies, such as radio and chemotherapy proved insufficient.
  • The aim of this review was to evaluate the results of surgical treatment for GBC with special reference to the extent of its histological spread and to present the recent literature in order to provide an update on the current concepts of surgical management of the disease.
  • [MeSH-major] Gallbladder Neoplasms / surgery
  • [MeSH-minor] Humans. Neoplasm Staging. Prognosis

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  • (PMID = 20583415.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Greece
  • [Number-of-references] 34
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11. Isayama H: Current topics in pancreato-biliary endotherapy: what can we do? J Hepatobiliary Pancreat Surg; 2009;16(5):589-91
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  • [Title] Current topics in pancreato-biliary endotherapy: what can we do?
  • INTRODUCTION: Endotherapy is progressing steadily, especially for various pancreato-biliary diseases.
  • This article introduced new procedures and devices, and revealed improvement of treatment outcomes.
  • MATERIALS AND METHODS: Biliary covered metallic stent (CMS) has developed, and the indication of CMS placement is changing because of its removability.
  • CMS is effective not only for unresectable biliary malignancies but also for resectable tumors, benign biliary strictures, and benign pancreatic strictures.
  • Drug-eluting CMS can be used as anti-tumor agents.
  • Interventional endoscopic ultrasonography (EUS) has shifted the treatment paradigm because it is possible to approach lesions through the digestive tract wall.
  • The diagnosis and treatment of pancreatic cancer using interventional EUS technique are effective, feasible, and promising.
  • Recently, trans-gastric necrosectomy for an infected pseudocyst was reported as an alternative treatment to surgery.
  • Double- and single-balloon enteroscopy will be performed more frequently to treat the pancreato-biliary disorders in the patients with altered anatomy.
  • Endoscopic papillary large balloon dilation (EPLBD), new procedure to the papilla, can treat large bile duct stones effectively without lithotripsy.
  • These procedures are of very great interest because they alter the treatment algorithms for many pancreato-biliary diseases.
  • [MeSH-major] Biliary Tract Diseases / therapy. Biliary Tract Diseases / ultrasonography. Endoscopy, Digestive System / methods. Pancreatic Diseases / therapy. Pancreatic Diseases / ultrasonography
  • [MeSH-minor] Catheterization / methods. Cholangiopancreatography, Endoscopic Retrograde / methods. Cholangiopancreatography, Endoscopic Retrograde / trends. Endosonography / methods. Endosonography / trends. Female. Forecasting. Humans. Male. Risk Assessment. Stents. Treatment Outcome. Ultrasonography, Interventional

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  • (PMID = 19543686.001).
  • [ISSN] 1436-0691
  • [Journal-full-title] Journal of hepato-biliary-pancreatic surgery
  • [ISO-abbreviation] J Hepatobiliary Pancreat Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 27
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12. Huang SF, Ko CW, Chang CS, Chen GH: Liver abscess formation after transarterial chemoembolization for malignant hepatic tumor. Hepatogastroenterology; 2003 Jul-Aug;50(52):1115-8
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  • [Title] Liver abscess formation after transarterial chemoembolization for malignant hepatic tumor.
  • BACKGROUND/AIMS: To study and review the clinical manifestations, microbiology, comorbidity, and diagnosis of liver abscess after transarterial chemoembolization for malignant hepatic tumor.
  • METHODOLOGY: We retrospectively reviewed 1374 patients who underwent 2581 transarterial chemoembolization procedures due to malignant hepatic tumors over an 8-year period.
  • RESULTS: 7 patients had liver abscess after transarterial chemoembolization.
  • Hepatocellular carcinoma was diagnosed in all 7 patients, whose liver function was classified as stage A by the Child-Pugh criteria.
  • All the patients had hyperechoic spots with reverberative shadows on sonograms or low attenuation areas with different Hounsfield units on computed tomography scan, which expressed the 100% incidence (7 of 7) of gas-forming abscesses.
  • No patients died of liver abscess after aspiration, drainage, or debridement of abscess combined with parenteral antibiotic treatment.
  • Biliary tract diseases, found in 4 patients, were the most common comorbidity.
  • CONCLUSIONS: Liver abscess after transarterial chemoembolization is a very rare complication, which usually develops in patients with biliary tract disease.
  • However, the prognosis is good after adequate clearance of pus and antibiotic treatment.
  • [MeSH-major] Carcinoma, Hepatocellular / drug therapy. Chemoembolization, Therapeutic / adverse effects. Liver Abscess / etiology. Liver Neoplasms / drug therapy
  • [MeSH-minor] Biliary Tract Diseases / epidemiology. Common Bile Duct / pathology. Comorbidity. Drainage. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Prognosis. Retrospective Studies

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  • (PMID = 12845993.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
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13. Menias CO, Surabhi VR, Prasad SR, Wang HL, Narra VR, Chintapalli KN: Mimics of cholangiocarcinoma: spectrum of disease. Radiographics; 2008 Jul-Aug;28(4):1115-29
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  • Cholangiocarcinoma is the second most common primary malignant hepatobiliary neoplasm, accounting for approximately 15% of liver cancers.
  • A wide spectrum of neoplastic and nonneoplastic conditions of the biliary tract may masquerade as cholangiocarcinoma, adding to the complexity of management in patients suspected to have cholangiocarcinoma.
  • Mimics of cholangiocarcinoma constitute a heterogeneous group of entities that includes primary sclerosing cholangitis, recurrent pyogenic cholangitis, acquired immunodeficiency syndrome cholangiopathy, autoimmune pancreatitis, inflammatory pseudotumor, Mirizzi syndrome, xanthogranulomatous cholangitis, sarcoidosis, chemotherapy-induced sclerosis, hepatocellular carcinoma, metastases, melanoma, lymphoma, leukemia, and carcinoid tumors.
  • In most cases, a definitive diagnosis can be established only with histopathologic examination of a biopsy specimen.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Ducts, Intrahepatic / pathology. Bile Ducts, Intrahepatic / radiography. Carcinoma / diagnosis. Cholangiocarcinoma / diagnosis. Liver Neoplasms / diagnosis

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  • (PMID = 18635632.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 69
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14. Aldrighetti L, Arru M, Ronzoni M, Salvioni M, Villa E, Ferla G: Extrahepatic biliary stenoses after hepatic arterial infusion (HAI) of floxuridine (FUdR) for liver metastases from colorectal cancer. Hepatogastroenterology; 2001 Sep-Oct;48(41):1302-7
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  • [Title] Extrahepatic biliary stenoses after hepatic arterial infusion (HAI) of floxuridine (FUdR) for liver metastases from colorectal cancer.
  • Hepatic arterial infusion of floxuridine is an effective treatment for unresectable hepatic metastases from colorectal cancer.
  • Despite its pharmacological advantage of higher tumor drug concentration with minimal systemic toxicity, hepatic arterial infusion of floxuridine is characterized by regional toxicity, including hepatobiliary damage resembling idiopathic sclerosing cholangitis (5-29% of treated cases).
  • Unlike previous reports describing biliary damage of both intrahepatic and extrahepatic ducts, a case series of extrahepatic biliary stenosis after hepatic arterial infusion with floxuridine is herein described.
  • Between September 1993 and February 1999, 54 patients received intraarterial hepatic chemotherapy based on continuous infusion of floxuridine (dose escalation 0.15-0.30 mg/kg/day for 14 days every 28 days) plus dexamethasone 28 mg.
  • Twenty-seven patients underwent laparotomy to implant the catheter into the hepatic artery, the other 27 patients receiving a percutaneous catheter into the hepatic artery through a transaxillary access.
  • Five patients (9.2%) developed biliary toxicity with jaundice and cholangitis (3 cases), alterations of liver function tests and radiological features of biliary tract abnormalities.
  • They received from 9 to 19 cycles (mean 14.5 +/- 6.3 cycles) of floxuridine infusion with a total drug delivered dose ranging from 20.3 to 41.02 mg/kg (mean: 31.4 +/- 13.5 mg/kg).
  • Extrahepatic biliary sclerosis was discovered by computed tomography scan and ultrasound, followed by endoscopic retrograde cholangiopancreatography and/or percutaneous cholangiography in 3 cases.
  • Radiological findings included common hepatic duct complete obstruction in 1 case, common hepatic duct stenosis in 2 cases, common bile duct obstruction in 1 case, and intrahepatic bile ducts dilation without a well-recognized obstruction in 1 case.
  • Two patients were treated by sequentially percutaneous biliary drainage and balloon dilation while 1 patient had an endoscopic transpapillary biliary prosthesis placed.
  • Percutaneous or endoscopic procedures obtained the improvement of hepatic function and cholestatic indexes without subsequent jaundice or cholangitis.
  • In two patients suppression of floxuridine infusion allowed the improvement of hepatic function.
  • The present series suggests that in some patients receiving hepatic arterial infusion of floxuridine extrahepatic biliary stenosis may represent the primary event leading to a secondary intrahepatic biliary damage that does not correlate with specific floxuridine toxicity but results from bile stasis and infection, recurrent cholangitis and eventually biliary sclerosis.
  • Aggressive research for extrahepatic biliary sclerosis is advised, since an early nonsurgical treatment of extrahepatic biliary stenosis may prevent an irreversible intrahepatic biliary sclerosis worsening the prognosis of metastatic liver disease.
  • [MeSH-major] Adenocarcinoma / secondary. Cholestasis, Extrahepatic / chemically induced. Colorectal Neoplasms / drug therapy. Floxuridine / adverse effects. Infusions, Intra-Arterial. Liver Neoplasms / secondary
  • [MeSH-minor] Aged. Cholangiography. Cholangitis, Sclerosing / chemically induced. Cholangitis, Sclerosing / diagnosis. Cholangitis, Sclerosing / therapy. Dose-Response Relationship, Drug. Female. Follow-Up Studies. Humans. Liver Function Tests. Male. Middle Aged. Stents


15. Kimura Y, Arai K, Iwasaki Y, Takahashi K, Yamaguchi T, Takahashi T: [A case of intrahepatic bile duct necrosis following hepatic arterial infusion chemotherapy]. Gan To Kagaku Ryoho; 2002 Nov;29(12):2071-3
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  • [Title] [A case of intrahepatic bile duct necrosis following hepatic arterial infusion chemotherapy].
  • A 51-year-old man underwent partial hepatectomy in July 2000 for metastatic liver tumor after gastrectomy for gastric cancer.
  • He received seven cycles of hepatic arterial infusion with mitomycin C 20 mg during induced hypertension with angiotensin II from October 2000 to April 2001.
  • Based on an enhanced CT scan of the liver showing a low-density area along intrahepatic biliary tracts and hepatic arteriography showing stenosis of the proper hepatic artery, we diagnosed bile duct necrosis and hepatic necrosis.
  • Bile duct necrosis is a serious complication in arterial infusion chemotherapy, and the infusion chemotherapy should be suspended or the dose should be reduced for patients with abnormalities shown by hepato-biliary function tests.
  • [MeSH-minor] Alkaline Phosphatase / blood. Humans. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary. Male. Middle Aged. Mitomycin / administration & dosage. Mitomycin / adverse effects. Necrosis. gamma-Glutamyltransferase / blood

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  • (PMID = 12484005.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 50SG953SK6 / Mitomycin; EC 2.3.2.2 / gamma-Glutamyltransferase; EC 3.1.3.1 / Alkaline Phosphatase
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16. Tan MC, Linehan DC, Hawkins WG, Siegel BA, Strasberg SM: Chemotherapy-induced normalization of FDG uptake by colorectal liver metastases does not usually indicate complete pathologic response. J Gastrointest Surg; 2007 Sep;11(9):1112-9
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  • [Title] Chemotherapy-induced normalization of FDG uptake by colorectal liver metastases does not usually indicate complete pathologic response.
  • Dramatic responses are being observed in colorectal cancer liver metastases treated with newer chemotherapeutic regimens.
  • These have been associated with normalization of [(18)F]fluoro-2-deoxy-D-glucose (FDG) uptake (complete metabolic response) on follow-up Positron Emission Tomography with [(18)F]fluoro-2-deoxy-D-glucose (FDG-PET) scans in some patients.
  • It is unclear how often complete metabolic response is indicative of complete tumor destruction.
  • We analyzed a subset of patients who had neoadjuvant chemotherapy for hepatic metastases from colorectal adenocarcinoma.
  • (1) FDG-avid hepatic lesions before initiation of chemotherapy;.
  • (2) complete metabolic response of the same lesions after chemotherapy; and (3) histopathologic examination of hepatic lesions.
  • Complete pathologic response was defined as no histologically identifiable viable tumor.
  • All had synchronous, hepatic-only colorectal metastases.
  • Seven lesions had complete metabolic response and disappeared on computed tomography (CT); of these, six still contained viable tumor.
  • We conclude that complete metabolic response on FDG-PET after neoadjuvant chemotherapy is an unreliable indicator of complete pathologic response.
  • Therefore, currently, curative resection of liver metastases in these patients should not be deferred on the basis of FDG-PET findings.
  • [MeSH-major] Liver Neoplasms / diagnostic imaging. Liver Neoplasms / drug therapy. Positron-Emission Tomography
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Angiogenesis Inhibitors / therapeutic use. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Humanized. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bevacizumab. Chemotherapy, Adjuvant. Colorectal Neoplasms / pathology. Drug Therapy, Combination. Female. Fluorouracil / therapeutic use. Glucose-6-Phosphate / analogs & derivatives. Humans. Leucovorin / therapeutic use. Male. Middle Aged. Neoadjuvant Therapy. Organoplatinum Compounds / therapeutic use. Treatment Outcome

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  • (PMID = 17623263.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Organoplatinum Compounds; 2S9ZZM9Q9V / Bevacizumab; 40871-47-4 / 2-fluoro-2-deoxyglucose-6-phosphate; 56-73-5 / Glucose-6-Phosphate; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; Folfox protocol
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17. Chung KY, Kemeny N: Regional and systemic chemotherapy for primary hepatobiliary cancers and for colorectal cancer metastatic to the liver. Semin Radiat Oncol; 2005 Oct;15(4):284-98
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Regional and systemic chemotherapy for primary hepatobiliary cancers and for colorectal cancer metastatic to the liver.
  • Hepatic arterial infusional (HAI) chemotherapy is based on the premise that primary and metastatic tumors derive their blood supply from the hepatic artery, whereas normal liver derives its blood supply from the portal vein.
  • This approach has been extensively studied in liver-only colorectal metastasis patients, with 10 published prospective randomized clinical trials comparing fluoropyrimidine-based HAI therapy with systemic chemotherapy.
  • Most of these studies showed a statistically significant superior response rate and improved disease-free survival with HAI chemotherapy compared with systemic fluoropyrimidine-based chemotherapy alone.
  • In contrast, hepatobiliary tumors remain difficult to treat with overall poor response and survival with systemic chemotherapy.
  • Few clinical trials have attempted to address the role of HAI-based therapy for these regional tumors, although encouraging response rates up to 60% have been reported.
  • Therefore, the regional approach for hepatobiliary tumors deserves further investigation as well as randomized trials for adequate comparison to new systemic chemotherapies.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biliary Tract Neoplasms / drug therapy. Carcinoma, Hepatocellular / drug therapy. Colorectal Neoplasms / drug therapy. Liver Neoplasms / drug therapy
  • [MeSH-minor] Digestive System Surgical Procedures / adverse effects. Hepatic Artery / chemistry. Humans. Infusions, Intra-Arterial. Randomized Controlled Trials as Topic


18. Nuzzo G, Giuliante F, Ardito F, Vellone M, Pozzo C, Cassano A, Giovannini I, Barone C: Liver resection for primarily unresectable colorectal metastases downsized by chemotherapy. J Gastrointest Surg; 2007 Mar;11(3):318-24
Hazardous Substances Data Bank. LEUCOVORIN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Liver resection for primarily unresectable colorectal metastases downsized by chemotherapy.
  • This study was performed prospectively to assess the effect of systemic chemotherapy (FOLFIRI protocol) in patients with initially unresectable colorectal liver metastases (CRLM) and, after performing liver resection in patients with downsized metastases, to compare the postoperative and long-term results with those of patients with primarily resectable CRLM.
  • The analysis addressed all patients who underwent hepatectomy for primarily resectable CRLM (Group A), or underwent chemotherapy for primarily unresectable CRLM and among these, particularly the patients who were finally resected after downsizing of CRLM (Group B).
  • Forty-two other patients underwent chemotherapy; after an average of nine courses, 18 of them (42.8%) with significantly downsized lesions were explored and 15 (35.7%, Group B) were resected, whereas three had peritoneal metastases.
  • Group B differed from Group A for a significantly higher rate of synchronous CRLM upon diagnosis of colorectal cancer, a larger size of CRLM upon evaluation in our center, and a lower rate of major hepatectomies (20.0% vs. 51.6 %) at surgery.
  • ), disease-free survival rate was 31% vs. 58% (p = 0.04) and, at a median follow-up of 34 months, tumor recurrence rate was 53.3% vs. 28.3% (n.s.).
  • These results show that in about one-third of the patients with primarily unresectable CRLM, downsizing of the lesions by chemotherapy (FOLFIRI protocol) permitted a subsequent curative resection.
  • In these patients, operative risk and survival did not differ from the figures observed in primarily resectable patients and, in spite of a lower disease-free survival with more frequent recurrence, re-resection still represented a valid option to continue treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colorectal Neoplasms / pathology. Hepatectomy. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Camptothecin / analogs & derivatives. Camptothecin / therapeutic use. Combined Modality Therapy. Female. Fluorouracil / therapeutic use. Humans. Leucovorin / therapeutic use. Male. Middle Aged. Postoperative Complications

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  • (PMID = 17458605.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; XT3Z54Z28A / Camptothecin; IFL protocol
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19. Fiorentini G, Giovanis P, Leoni M, De Giorgi U, Cariello A, Dazzi C, Caldeo A: Amifostine (Ethyol) as modulator of hepatic and biliary toxicity from intraarterial hepatic chemoembolization: results of a phase I study. Hepatogastroenterology; 2001 Mar-Apr;48(38):313-6
Hazardous Substances Data Bank. AMIFOSTINE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Amifostine (Ethyol) as modulator of hepatic and biliary toxicity from intraarterial hepatic chemoembolization: results of a phase I study.
  • BACKGROUND/AIMS: Hepatic and biliary toxicity are still significant problems after intraarterial hepatic chemoembolization for liver metastases from large bowel cancers.
  • In about 30-60% of the patients hepatic and biliary toxicity are the limiting aspects of intraarterial hepatic chemoembolization and exclude a lot of patients from a repeated beneficial treatment.
  • Amifostine (Ethyol) is a prodrug that must be dephosphorylated to the free thiol in which form it can detoxify free oxygen radicals generated by radiation, hypoxia and by drugs such anthracyclines, platinum analogues and alkylating agents.
  • Amifostine as inactive prodrug is primarily metabolized at the tissue site by membrane alkaline phosphatase, which is highly active in the cell membranes of normal endothelial cells and biliary tree cells but not in the cell membranes and neovascular capillaries of tumor.
  • When dephosphorylated to WR-1065, amifostine is rapidly taken up into normal liver cells by a carrier-mediated facilitated diffusion transport process.
  • The resulting high thiol content in normal liver tissue (biliary cells and hepatocytes) compared with the negligible concentration in liver metastases from large bowel cancers probably provides for selective drug resistance to intraarterial hepatic chemoembolization protecting normal tissue and allowing full therapeutic effect on tumor.
  • METHODOLOGY: From May 1997 we planned a phase I study in patients receiving intraarterial hepatic chemoembolization for liver metastases from large bowel cancers.
  • We started at 200 mg/m2 dissolved in 250 cc of normal saline given in 15 min in the intrahepatic artery 20 min before an intraarterial hepatic chemoembolization consisting of mitomycin 10 mg/m2, epirubicin-50, cisplatin-60 diluted in 10 mL of contrast media, mixed in 15 mL of lipiodol UF followed by a gelfoam powder solution until stagnation of the flow.
  • Also the duration of necrotic damage, always observed after intraarterial hepatic chemoembolization, seems shorter compared with historical controls.
  • CONCLUSIONS: Amifostine can be certainly administered at 300 mg/m2 as intraarterial infusion and could be a significant step to ameliorate the therapeutic ratio of intraarterial hepatic chemoembolization.
  • [MeSH-major] Amifostine / administration & dosage. Biliary Tract / drug effects. Chemoembolization, Therapeutic / adverse effects. Liver / drug effects. Liver Neoplasms / therapy. Prodrugs / administration & dosage. Radiation-Protective Agents / administration & dosage
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Female. Humans. Infusions, Intra-Arterial. Intestinal Neoplasms / pathology. Male. Middle Aged

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  • (PMID = 11379297.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Prodrugs; 0 / Radiation-Protective Agents; M487QF2F4V / Amifostine
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