Guest guest Posted November 19, 2003 Report Share Posted November 19, 2003 Hi every 1 Its terri(14) here just want to ask a few things. Well I dont know if any one else has had joint problems with psc, as I suffer fom bad joint pain. I would also love to know one some itch and others dont, what makes one itch? My last question is to ask if any one else here is on permanent antibiotics. I would really love to hear from you,thanks. Terri(14) South Africa BILIARY COMPLICATIONS AFTER TX Transplant Proc. 2003 Nov. Do biliary endoprostheses decrease biliary complications after liver transplantation?Barkun JS, Tzimas GN, Cantarovich M, Metrakos PP, Deschenes M, Alpert E, Paraskevas S, Tchervenkov JI.Department of General Surgery, Section of Transplantation and Hepatobiliary Surgery Montreal, Quebec, CanadaMost technical complications after orthotopic liver transplantation (OLT) are related to the biliary tree. This report reviews the role of routine intraoperative placement of stents to reduce biliary complications.We retrospectively analyzed 396 consecutive OLTs. We reviewed rates of biliary complications after hepaticojejunostomy (HJA) as well as following choledochocholedochostomy (CCA) groups: "experimental" group (routine intraoperative biliary stenting, last 10 months), "recent" control group (nonstented, previous 10 months), "historical" control group (prior to that period of time).All groups were matched for donor/recipient characteristics and for graft cold/warm ischemia time. The overall prevalence of biliary complications was 30.7% after CCA versus 35% after HJA. In the experimental group 21 patients had a 4.8% biliary complication rate compared to the recent control and historical groups, where biliary complication rates were 30% and 32.6%, respectively (P <.05).The intraoperative use of biliary stents is feasible and appears to decrease the rate of biliary complications. These results support the need for a prospective randomized trial. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2003 Report Share Posted November 19, 2003 Hey Terri, No one really knows why some of us itch and some don't. Itching was one of my worst symptoms pre dx and even since. The theory is that bile salts come out through the pores and crystallize. The more we scratch, the worse the itching is. I know that sometimes the palms of my hands and soles of my feet itch so bad that I actually rub the skin off of them. I've almost lost my big toe nail from scratching too vigorously. The nail was attached on the sides but not in the middle. It is almost grown out now. I also got sores before scratching and some from scratching. I'm one of the few that have not benefited from any of the medications that normally help people with their itching. Some triggers I have found are stress and taking pain meds. My first GI/liver doctor didn't believe that the itching was caused by bile salts. When my bilirubin count went down to normal, he just acted like the horrible itching was in my head. I switched doctors about 6 months later, my new GI/liver doctor believes in the bile salts theory. Joint pain can happen. It is not common. I have joint pain really bad; my feet get really sore so they feel bruised. But then the doctor has diagnosed me with fibromyalgia. I guess I have muscle ache too. There are some other people who suffer from joint and muscle pain here as well. I can't remember if anyone else is on permanent antibiotics, but some doctors have considered it. Usually if you are on a maintenance dose of antibiotics it is not as high a dose. I think some of the treatments for UC are an antibiotic? not sure about that. Do you feel confident in your doctor? I would ask my doctor how long he thinks you need to be on the antibiotic. I want to give you and everyone some advice to save you from some of the problems I'm having now. Don't let your body weight get too low. Force yourself to eat even if it makes you sick. Excercise regularly. Make sure you do weight bearing excercises. two and a half years ago, I had normal bone density for a forty something woman. Now I have osteoporosis. This does not run in my family. My weight has been down for years now, I was on prednisone for just over a year, I haven't been excercising, and maybe some of the drugs I take cause problems too (6-mp?). I have been taking about 1500 mg of Calcium citrate w/ vitamin D since dx. I hate to see any of you with this problem on top of the others. Terri, are you a Harry Potter fan? I am. My fifteen year old daughter is a fanatic. Cheryl Berg, Idaho 45Married 25 years, 4 children, 2 grchildrenPSC 01, UC 00, Fibromyalgia, hypothyroid,hiatal hernia, ulcer, gall baldder removed '93disability (retired English teacher) BILIARY COMPLICATIONS AFTER TX Transplant Proc. 2003 Nov. Do biliary endoprostheses decrease biliary complications after liver transplantation?Barkun JS, Tzimas GN, Cantarovich M, Metrakos PP, Deschenes M, Alpert E, Paraskevas S, Tchervenkov JI.Department of General Surgery, Section of Transplantation and Hepatobiliary Surgery Montreal, Quebec, CanadaMost technical complications after orthotopic liver transplantation (OLT) are related to the biliary tree. This report reviews the role of routine intraoperative placement of stents to reduce biliary complications.We retrospectively analyzed 396 consecutive OLTs. We reviewed rates of biliary complications after hepaticojejunostomy (HJA) as well as following choledochocholedochostomy (CCA) groups: "experimental" group (routine intraoperative biliary stenting, last 10 months), "recent" control group (nonstented, previous 10 months), "historical" control group (prior to that period of time).All groups were matched for donor/recipient characteristics and for graft cold/warm ischemia time. The overall prevalence of biliary complications was 30.7% after CCA versus 35% after HJA. In the experimental group 21 patients had a 4.8% biliary complication rate compared to the recent control and historical groups, where biliary complication rates were 30% and 32.6%, respectively (P <.05).The intraoperative use of biliary stents is feasible and appears to decrease the rate of biliary complications. These results support the need for a prospective randomized trial. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2003 Report Share Posted November 19, 2003 > Well I dont know if any one else has had joint problems with psc, as I suffer fom bad joint pain. Rheumatoid Arthritis is one of the autoimmune diseases that are more frequent among PSCers than the general population, so you are not alone in having joint pain. > I would also love to know one some itch and others dont, what makes one itch? Good question, but no definite answers. There is the bile salt theory, but although I itched when my biilrubin was in the 0.5 to 2.0 (6-22) range the itching stopped when my bilirubin went above 3.0 (33). So high bilirubin depositing bile salts can't be the only cause. But since light (either sun or tanning booths) help for some people it is the problem or part of the pproblem for some people. Rifampin (an antibiotic developed for TB) increases the activity of certain liver enzymes and stops or reduces itching for some (I am one that it helps). By supercharging the liver it processes some chemicals faster. Some of those must be involved in causing itching. Naltraxone, an anti-opiate, helps relieve itching for some people. This implies that liver damage has caused an increase in release of natural opiates or increased the nervous systems sensitivity to them. Reducing the effect of the natural opiates calms the nervous system activity and reduces the itching. Most of the bile produced by the liver is reabsorbed as bilirubin in the lower small intestine within a few hours of entering the upper small intestine. It is then processed in the liver into bile again. Breaking this cycle - either by use of Questran, other absorbing materials or direct removal via an external drain - can relieve itching. This implies that the amount of bile salts circulating and the liver's capacity to process them has an effect on itching. I haven't heard anyone tie all these various causes and methods of providing relief to itching into a cohesive theory, maybe there isn't one. > My last question is to ask if any one else here is on permanent antibiotics. When I started having cholangitis attacks my doctor discussed constant antibiotic therapy (switching antibiotics every 6 weeks), but decided that it would be best for me to take antibiotics one when fevers recurred. Right now I take Rifampin (mentioned above) for the side effect it gives of relief from itching. There are others in this group that are on constant antibiotic to suppress assending cholangitis (rotating between 2 or 3 different antibiotics on a regular basis). Tim R > I would really love to hear from you,thanks. > Terri(14) > South Africa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2003 Report Share Posted November 19, 2003 Hey cheryl Well I am not the biggest fan of harry potter but more I like the books like lance armstorngs book and reading at the moment a book called My lifes an apple tree. Have ya read it. Well I happen to get this joint pains in my knees,elbows,hands and feet but it mostly happens in the night.So how long have you had psc and has it gotten any better or any worse? Hope all is well Terri(14) South Africa BILIARY COMPLICATIONS AFTER TX Transplant Proc. 2003 Nov. Do biliary endoprostheses decrease biliary complications after liver transplantation?Barkun JS, Tzimas GN, Cantarovich M, Metrakos PP, Deschenes M, Alpert E, Paraskevas S, Tchervenkov JI.Department of General Surgery, Section of Transplantation and Hepatobiliary Surgery Montreal, Quebec, CanadaMost technical complications after orthotopic liver transplantation (OLT) are related to the biliary tree. This report reviews the role of routine intraoperative placement of stents to reduce biliary complications.We retrospectively analyzed 396 consecutive OLTs. We reviewed rates of biliary complications after hepaticojejunostomy (HJA) as well as following choledochocholedochostomy (CCA) groups: "experimental" group (routine intraoperative biliary stenting, last 10 months), "recent" control group (nonstented, previous 10 months), "historical" control group (prior to that period of time).All groups were matched for donor/recipient characteristics and for graft cold/warm ischemia time. The overall prevalence of biliary complications was 30.7% after CCA versus 35% after HJA. In the experimental group 21 patients had a 4.8% biliary complication rate compared to the recent control and historical groups, where biliary complication rates were 30% and 32.6%, respectively (P <.05).The intraoperative use of biliary stents is feasible and appears to decrease the rate of biliary complications. These results support the need for a prospective randomized trial. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2004 Report Share Posted January 19, 2004 Mark, I've had a roux-en-Y for 15 years and didn't noticed any constipation when I had it or in later years. Slow gut immediately after surgeries, but that is due more to the drugs that the roux-en-Y. However, that is just my experience. I can easily imagine that adhesions due to the surgery could effect the colon and its operation. The roux-en-Y is near the start of the small intestine and should have very little effect on the condition and operation of the colon. As for how PSC affects regenerated tissue, I don't have any information. I do know from personal experience that some parts of the liver may exhibit advanced PSC features while other parts appear normal. 10 years before transplant one side of my biliary tree appeared normal while the other showed a great deal of strictures and beading on a cholangiogram. So even a " normal " liver can have different rates of attack by PSC within it. Tim R roux-en-y 1989, ltx 4/4/98, recurrent PSC 2002 > Dear group: > I have a question to anybody whom has had a roux-en-Y: > > 1) Do you find that your digestive system tends to get constipated since your Rouex-en-Y surgeries? > I tend to get so constipated that I get nausea and vomiting even though I take colace daily and it seems to cycle into a bad time about every other week. > > 2) Does anyone know about any research concerning effect of PSC on regenerated liver tissue post surgical resections? > Does PSC effect regenerated tissue faster, slower. or at the same rate? Does it effect the remaining tissue at the same rate? > there are less ducts so does PSC attack them with greater vigor? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2004 Report Share Posted January 20, 2004 Thanks Tim ! I appreciate your insight and answers to my questions Mark (and ) from Las Vegas PSC 2003, lt lobe resection 2003, roux-en-y 2003 Quote Link to comment Share on other sites More sharing options...
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